Effect of counseling quality on anxiety,grief, and coping after second-trimester abortion for pregnancy complications

Objective

We sought to explore the relationship between counseling quality, measured by shared decision making and decision satisfaction, and psychological outcomes (anxiety, grief, and posttraumatic stress) after second-trimester abortion for pregnancy complications.

Brief Report: Empirical audit and review and an assessment of evidentiary value in research on the psychological consequences of scarcity

Empirical audit and review is an approach to assessing the evidentiary value of a research area. It involves identifying a topic and selecting a cross-section of studies for replication. We apply the method to research on the psychological consequences of scarcity. Starting with the papers citing a seminal publication in the field, we conducted replications of 20 studies that evaluate the role of scarcity priming in pain sensitivity, resource allocation, materialism, and many other domains. There was considerable variability in the replicability, with some strong successes and other undeniable failures. Empirical audit and review does not attempt to assign an overall replication rate for a heterogeneous field, but rather facilitates researchers seeking to incorporate strength of evidence as they refine theories and plan new investigations in the research area. This method allows for an integration of qualitative and quantitative approaches to review and enables the growth of a cumulative science.     

Comparison of optical low coherence reflectometry and ultrasound pachymetry in the measurement of central corneal thickness before and after photorefractive keratectomy

PURPOSE: To compare an ultrasound pachymeter with an optical low coherence reflectometry (OLCR) pachymeter for measuring pre- and postoperative central corneal thickness of patients undergoing photorefractive keratectomy (PRK). METHODS: In a prospective, noncomparative, interventional study, 48 myopic eyes (mean manifest refractive spherical equivalent: -4.93 +/- 2.93 diopters [D]) of 30 healthy patients underwent PRK. Pre- and postoperative central corneal thickness was measured by two examiners (E1, E2) with an ultrasound pachymeter and an OLCR pachymeter. Agreement and inter-rater repeatability were determined using the comparison method described by Bland and Altman. RESULTS: The limits of agreement between the two devices ranged from 17.8 microm (E1) to 20.5 microm (E2) preoperatively and from 22.4 microm (E1) to 16.9 microm (E2) postoperatively. The coefficient of inter-rater repeatability ranged from 9.1 microm (ultrasound pachymeter) to 5.4 microm (OLCR pachymeter) preoperatively and from 7.1 microm (ultrasound pachymeter) to 4.7 microm (OLCR pachymeter) postoperatively. CONCLUSIONS: The OLCR pachymeter seems to show better pre- and postoperative repeatability compared to the ultrasound pachymeter. The agreement between the two devices should be considered acceptable for clinical practice. Photorefractive keratectomy did not affect the postoperative agreement and repeatability of the pachymeters.     

Human Leukocyte Antigen (HLA) Typing Study Identifies Maternal DQ2 Susceptibility Alleles among Infertile Women: Potential Associations with Autoimmunity and Micronutrients

Background. The interplay between female fertility and autoimmune diseases (AIDs) can involve HLA haplotypes and micronutrients. We analyzed the distribution of HLA-DQ2/-DQ8 in women with infertility or recurrent spontaneous abortion (RSA) and possible associations with AIDs and micronutrient status. Methods. Consecutive women (n = 187) with infertility and RSA, and controls (n = 350) were included. All women were genotyped for HLA-DQ2 (DQA1*0201, A1*05, and B1*02) and -DQ8 (DQA1*03 and DQB1*0302) alleles. Serum 25(OH)D, VB12, folate, and ferritin were evaluated. Results. DQA1*05/B1*02 and the occurrence of at least one DQ2 allele were more prevalent among RSA and infertile women than controls. Infertile women showed lower 25(OH)D and higher prevalence of AIDs than RSA women. In the multivariate analysis, DQA1*05/B1*02 was associated with a significantly higher risk of AIDs in infertile women, and DQA1*05 was independently associated with both 25(OH)D deficiency and AIDs. In RSA women, the presence of AIDs was associated with a significantly higher risk of 25(OH)D deficiency. Conclusion. Our findings showed, for the first time, a higher proportion of DQ2 alleles in infertile and RSA women as compared to controls. Predisposing DQ2 alleles are independent risk factors for AIDs and 25(OH)D deficiency in infertile women and could represent biomarkers for performing early detection of women requiring individually tailored management.     

Rapid Extraction and Detection of African Swine Fever Virus DNA Based on Isothermal Recombinase Polymerase Amplification Assay

African swine fever virus (ASFV) is the causative agent of a deadly disease in pigs and is spread rapidly across borders. Samples collected from suspected cases must be sent to the reference laboratory for diagnosis using polymerase chain reaction (PCR). In this study, we aimed to develop a simple DNA isolation step and real-time recombinase polymerase amplification (RPA) assay for rapid detection of ASFV. RPA assay based on the p72 encoding B646L gene of ASFV was established. The assays limit of detection and cross-reactivity were investigated. Diagnostic performance was examined using 73 blood and serum samples. Two extraction approaches were tested: silica-column-based extraction method and simple non-purification DNA isolation (lysis buffer and heating, 70 °C for 20 min). All results were compared with well-established real-time PCR. In a field deployment during a disease outbreak event in Uganda, 20 whole blood samples were tested. The assay’s analytical sensitivity was 3.5 DNA copies of molecular standard per µL as determined by probit analysis on eight independent assay runs. The ASFV RPA assay only detected ASFV genotypes. Compared to real-time PCR, RPA diagnostic sensitivity and specificity were 100%. Using the heating/lysis buffer extraction procedure, ASFV-RPA revealed better tolerance to inhibitors than real-time PCR (97% and 38% positivity rate, respectively). In Uganda, infected animals were identified before the appearance of fever. The ASFV-RPA assay is shown to be as sensitive and specific as real-time PCR. Moreover, the combination of the simple extraction protocol allows its use at the point of need to improve control measures.     

Diagnosis of infected total knee arthroplasty with anti-granulocyte scintigraphy: the importance of a dual-time acquisition protocol

OBJECTIVE: To evaluate clinical efficacy of a dual-time acquisition protocol consisting of early 4 h and delayed 20-24 h imaging with anti-granulocyte scintigraphy (LeukoScan) in the diagnosis of infection in painful total knee arthroplasty (TKA). MATERIALS AND METHODS: Seventy-eight consecutive patients with TKA (12 bilateral) were prospectively enrolled in the study from August 2004 to July 2005. All the patients had clinical and biochemical suspicious of infection, except for the 12 patients with bilateral painless prosthesis who had no signs and symptoms of loosening and/or infection and were considered as controls. TKA prostheses had been implanted 4 months to 9.5 years before our studies. Forty-three patients were on antibiotic therapy at the moment of scintigraphic examination, and treatment was not discontinued. All patients underwent LeukoScan examination by performing both early 4 h and delayed 20-24 h imaging. In addition to planar imaging SPECT was performed in 18 cases. A decrease in radiotracer uptake from early to delayed LeukoScan imaging was interpreted as an unspecific finding (negative for infection), while an increasing uptake was interpreted as a positive finding for the presence of infection. Three-phase Tc-MDP bone scan was also routinely performed by standard technique. Sensitivity and specificity of early and delayed LeukoScan imaging were calculated. RESULTS: Sensitivity for early and delayed imaging were 92.7%, while specificity was 78.4% for early imaging and 100% for delayed imaging approach. SPECT imaging did not add any significant information as regard to specificity in our experience. Eight false positive early scans were correctly diagnosed as negative at delayed imaging. Three false negative results were recorded. Sensitivity and specificity were similar when patients were on or off antibiotic therapy. Imaging was negative in all 12 controls. CONCLUSIONS: Our results, based on a large group of patients, suggest that delayed LeukoScan imaging is important in identifying false positive results detect at early imaging. Thus, a dual-time, 4 h early and 20-24 h delayed LeukoScan imaging approach should be recommended to increase the diagnostic accuracy of the scintigraphy, with the exception of patients with a negative early LeukoScan examination, in whom the acquisition of delayed imaging appears unnecessary. In our experience, concomitant antibiotic therapy did not influence the diagnostic value of LeukoScan.