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Russell AB, Slater J, Woods N. Regulation of the illicit drugs industry will save lives and reduce misery. BMJ 2024; 384:q304. [PMID: 38325887 DOI: 10.1136/bmj.q304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
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Khalil BA, Zarroug AE, Elawad A, Moussa S, Donnelly C, Mammoo S, Brisseau G, Bedford Russell A, Hummler H. Outcomes following the establishment of Qatar’s quaternary neonatal general surgical service in a hospital with a “Tabula Rasa” for service development. J Neonatal Surg 2021. [DOI: 10.47338/jns.v10.975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background: Sidra Medicine is the first dedicated Children and Maternity hospital in the State of Qatar. This paper describes the preparations for and results of activating quaternary neonatal surgical services in a brand new, "greenfield" hospital. We believe that these are the first published national results of neonatal general surgical services from the Gulf region.
Methods: A review of surgical babies below four weeks corrected age from 1st of April 2018 – 31st of March 2020 was undertaken. Patient demographics, primary diagnosis, surgical procedures, 30-day postoperative mortality, overall mortality, and cause of death were recorded.
Results: One hundred and sixty-nine babies (169) were identified (44.4% term and 55.6% preterm). Major surgery included laparotomy (76), congenital diaphragmatic hernia repair (20), surgery for anorectal malformations (25), and esophageal atresia (13). One set of conjoined twins were also separated successfully. Fourteen babies died, resulting in overall mortality of 8.3 %. Excluding babies who died of life-limiting conditions, two babies died within 30 days of surgery, resulting in 30 days postoperative mortality rate of 1.2 %.
Conclusions: The neonatal surgical mortality rate is comparable with those from top international centers. This low rate could be attributed to the high level of expertise preceded by months of preparations.
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Steer PJ, Russell AB, Kochhar S, Cox P, Plumb J, Gopal Rao G. Group B streptococcal disease in the mother and newborn-A review. Eur J Obstet Gynecol Reprod Biol 2020; 252:526-533. [PMID: 32586597 PMCID: PMC7295463 DOI: 10.1016/j.ejogrb.2020.06.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/12/2020] [Accepted: 06/13/2020] [Indexed: 02/06/2023]
Abstract
Group B Streptococcus, a common commensal in the gut of humans and in the lower genital tract in women, remains an important cause of neonatal mortality and morbidity. The incidence of early onset disease has fallen markedly in countries that test women for carriage at 35-37 weeks of pregnancy and then offer intrapartum prophylaxis with penicillin during labour. Countries that do not test, but instead employ a risk factor approach, have not seen a similar fall. There are concerns about the effect on the neonatal microbiome of widespread use of antibiotic prophylaxis during labour, but so far the effects seem minor and temporary. Vaccination against GBS would be acceptable to most women and GBS vaccines are in the early stages of development. Tweetable abstract: Group B Strep is a key cause of infection, death and disability in young babies. Antibiotics given in labour remain the mainstay of prevention, until a vaccine is available.
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Affiliation(s)
- Philip J Steer
- Imperial College London, Academic Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital, London SW10 9NH, United Kingdom.
| | | | - Sonali Kochhar
- Global Healthcare Consulting, India; Department of Global Health, University of Washington, Seattle, United States
| | - Philippa Cox
- Homerton University Hospital NHS Foundation Trust, London, United Kingdom
| | - Jane Plumb
- Group B Strep Support, Haywards Heath, RH16 1UA, United Kingdom
| | - Gopal Gopal Rao
- London North West University Healthcare NHS Trust, Harrow, United Kingdom
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Oeser C, Pond M, Butcher P, Bedford Russell A, Henneke P, Laing K, Planche T, Heath PT, Harris K. PCR for the detection of pathogens in neonatal early onset sepsis. PLoS One 2020; 15:e0226817. [PMID: 31978082 PMCID: PMC6980546 DOI: 10.1371/journal.pone.0226817] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 12/05/2019] [Indexed: 11/21/2022] Open
Abstract
Background A large proportion of neonates are treated for presumed bacterial sepsis with broad spectrum antibiotics even though their blood cultures subsequently show no growth. This study aimed to investigate PCR-based methods to identify pathogens not detected by conventional culture. Methods Whole blood samples of 208 neonates with suspected early onset sepsis were tested using a panel of multiplexed bacterial PCRs targeting Streptococcus pneumoniae, Streptococcus agalactiae (GBS), Staphylococcus aureus, Streptococcus pyogenes (GAS), Enterobacteriaceae, Enterococcus faecalis, Enterococcus faecium, Ureaplasma parvum, Ureaplasma urealyticum, Mycoplasma hominis and Mycoplasma genitalium, a 16S rRNA gene broad-range PCR and a multiplexed PCR for Candida spp. Results Two-hundred and eight samples were processed. In five of those samples, organisms were detected by conventional culture; all of those were also identified by PCR. PCR detected bacteria in 91 (45%) of the 203 samples that did not show bacterial growth in culture. S. aureus, Enterobacteriaceae and S. pneumoniae were the most frequently detected pathogens. A higher bacterial load detected by PCR was correlated positively with the number of clinical signs at presentation. Conclusion Real-time PCR has the potential to be a valuable additional tool for the diagnosis of neonatal sepsis.
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Affiliation(s)
- Clarissa Oeser
- Paediatric Infectious Diseases, Institute of Infection and Immunity, St George’s, University of London, London, United Kingdom
- * E-mail:
| | - Marcus Pond
- Molecular Microbiology, Institute of Infection and Immunity, St George’s, University of London, London, United Kingdom
| | - Philip Butcher
- Molecular Microbiology, Institute of Infection and Immunity, St George’s, University of London, London, United Kingdom
| | | | - Philipp Henneke
- Pediatric Infectious Disease and Rheumatology, University Medical Center Freiburg, Freiburg, Germany
| | - Ken Laing
- Molecular Microbiology, Institute of Infection and Immunity, St George’s, University of London, London, United Kingdom
| | - Timothy Planche
- Molecular Microbiology, Institute of Infection and Immunity, St George’s, University of London, London, United Kingdom
| | - Paul T. Heath
- Paediatric Infectious Diseases, Institute of Infection and Immunity, St George’s, University of London, London, United Kingdom
| | - Kathryn Harris
- Microbiology, Virology and Infection Control, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
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Cailes B, Kortsalioudaki C, Buttery J, Pattnayak S, Greenough A, Matthes J, Bedford Russell A, Kennea N, Heath PT. Epidemiology of UK neonatal infections: the neonIN infection surveillance network. Arch Dis Child Fetal Neonatal Ed 2018; 103:F547-F553. [PMID: 29208666 DOI: 10.1136/archdischild-2017-313203] [Citation(s) in RCA: 116] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 11/09/2017] [Accepted: 11/18/2017] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To describe the epidemiology of neonatal infection over the past decade in UK neonatal units. DESIGN Retrospective analysis of prospectively collected infection surveillance network data from 2005 to 2014. SETTING 30 neonatal units in the UK. PATIENTS Newborns on participating neonatal units who had a positive blood, cerebrospinal fluid or urine culture and were treated with at least 5 days of appropriate antibiotics. RESULTS 2171 episodes of neonatal infection in 1922 infants were recorded. The incidence of infection was 6.1/1000 live births and 48.8/1000 neonatal admissions (2.9 and 23.5 respectively if coagulase-negative staphylococci (CoNS) cultures excluded). The incidence of infection showed a statistically significant reduction over time with reductions in the rates of both early-onset sepsis (EOS) and late-onset sepsis (LOS).The majority of episodes (76%) represented LOS (diagnosed > 48 hours after birth), and infection was more common in premature (<37 weeks gestation) and low birth weight (<2500 g) neonates (84% and 81%, respectively). Commonly identified pathogens included group B streptococci (43%) and Escherichia coli (18%) for EOS, while E. coli (15%), Staphylococcus aureus (14%) and CoNS were prominent causes of LOS. CONCLUSIONS This paper describes the epidemiology of neonatal infection in the UK over the past decade. These data enable benchmarking of practice and inform areas of future research and guideline development. The results support the hypothesis that the introduction of infection prevention care bundles and antibiotic stewardship programmes in the UK has reduced the burden of LOS.
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Affiliation(s)
- Benjamin Cailes
- Paediatric Infectious Diseases Research Group and Vaccine Institute, St George's Hospital University of London, London, UK
| | - Christina Kortsalioudaki
- Paediatric Infectious Diseases Research Group and Vaccine Institute, St George's Hospital University of London, London, UK
| | - Jim Buttery
- Department of Infection and Immunity, Monash Children's, Monash Medical Centre, Clayton, Victoria, Australia
| | - Santosh Pattnayak
- Oliver Fisher Neonatal Unit, Medway NHS Foundation Trust, Gillingham, UK
| | - Anne Greenough
- Department of Women and Children's Health, Kings College Hospital, London, UK
| | - Jean Matthes
- Singleton Hospital NICU, Singleton Hospital, Swansea, UK
| | - Alison Bedford Russell
- Birmingham Women's Hospital NICU, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Nigel Kennea
- Department of Neonatology, St. George's University NHS Foundation Trust, London, UK
| | - Paul T Heath
- Paediatric Infectious Diseases Research Group and Vaccine Institute, St George's Hospital University of London, London, UK
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Cailes B, Kortsalioudaki C, Buttery J, Pattnayak S, Greenough A, Matthes J, Bedford Russell A, Kennea N, Heath PT. Antimicrobial resistance in UK neonatal units: neonIN infection surveillance network. Arch Dis Child Fetal Neonatal Ed 2018; 103:F474-F478. [PMID: 29074716 DOI: 10.1136/archdischild-2017-313238] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 09/25/2017] [Accepted: 09/26/2017] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To define the susceptibilities of the common causative pathogens of neonatal sepsis in the UK. DESIGN Retrospective analysis of the prospectively collected neonIN infection surveillance network data between 2005 and 2014. SETTING 30 neonatal units in the UK. PATIENTS Newborns admitted to participating neonatal units who return a positive blood, cerebrospinal fluid or urine culture and are treated with at least 5 days of appropriate antibiotics. RESULTS 1568 isolates with recorded antimicrobial data were collected including 328 early-onset sepsis (EOS) isolates and 1240 late-onset sepsis (LOS) isolates. The majority of EOS pathogens (>92%) were susceptible to the four empirical commonly used antimicrobial combinations (eg, 93% for benzylpenicillin/gentamicin), while LOS pathogens demonstrated higher levels of resistance (eg, 89% for flucloxacillin/gentamicin). Among infants<1500 g and <32 weeks gestation, an amoxicillin/gentamicin combination demonstrated a trend towards improved coverage of EOS isolates than benzylpenicillin/gentamicin (93% vs 86%, p=0.211). CONCLUSIONS This analysis provides insights into the patterns of antimicrobial resistance among UK neonatal pathogens. These data will inform areas of future research and can be used to update national evidence-based guidelines on antimicrobial usage.
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Affiliation(s)
- Benjamin Cailes
- Paediatric Infectious Diseases Research Group, St George's University of London, London, UK
| | | | - Jim Buttery
- Department of Infection and Immunity, Monash Children's, Monash Medical Centre, Clayton, Australia
| | - Santosh Pattnayak
- Oliver Fisher Neonatal Unit, Medway NHS Foundation Trust, Gillingham, UK
| | - Anne Greenough
- Department of Women and Children's Health, Kings College London, Kings College Hospital, London, UK
| | - Jean Matthes
- Singleton Hospital NICU, Singleton Hospital, Swansea, UK
| | - Alison Bedford Russell
- Birmingham Women's Hospital NICU, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Nigel Kennea
- St George's University NHS Foundation Trust, London, UK
| | - Paul T Heath
- Paediatric Infectious Diseases Research Group, St George's University of London, London, UK
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Saimbi S, Batchelor H, Whitticase L, Holder G, Russell AB. ASSESSMENT OF VANCOMYCIN CONCENTRATIONS IN SYRINGES PREPARED WITHIN A WARD SETTING. Arch Dis Child 2016; 101:e2. [PMID: 27540196 DOI: 10.1136/archdischild-2016-311535.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM Vancomycin is used as a second line antibiotic in the treatment of late onset neonatal infection for its activity against coagulase negative staphylococci. Vancomycin infusions are prepared within a ward setting for administration to neonates. Differences in preparation techniques on the ward have previously been recognised as a potential source of variation in vancomycin concentrations, as compared to concentrations in pre-made preparations. This study analyses a consecutive series of vancomycin syringes prepared in a ward for administration to neonates, to determine how accurate the concentration of each preparation was compared to the expected concentration. METHOD Vancomycin concentrations were determined by UV analysis (λ=280 nm) with a UV spectrophotometer (Jenway Genova Plus). A calibration curve for vancomycin was created (R2=0.9996) by manufacturing a series of solutions of vancomycin hydrochloride in glucose 5% w/v.Samples of vancomycin from syringes from which doses were administered to neonates were then analysed to assess their concentration. For each syringe, mean vancomycin concentration±standard deviation was calculated (n=3).Reasonable errors in preparations were calculated based on errors in each step of the preparation process. Theoretical error was calculated based on apparatus used, and experimental error was recorded based on a simulated process. Two preparation methods were compared; the method complying with that described in the local formulary, 1 and an alternative method reported by the nurses preparing the dose. RESULTS Analysis of results showed that concentration of the vancomycin syringes prepared ranged from 0.85 to 8.24 mg/mL. The expected concentration was 4.17 mg/ml.Theoretical error in preparation of vancomycin doses was lower with the formulary-compliant method1 versus an alternative method, as were variations in in vancomycin concentration.Depending on the type of error (theoretical or experimental) and method by which vancomycin syringes were prepared (formulary1 or alternative method), the percentage of syringes with vancomycin concentration outside of the specified ranges varied from 20%-43%. This is higher compared to the findings of the Department of Health2, where it was found that 19.2% of morphine infusions prepared by nurses in the neonatal intensive care unit were outside British Pharmacopoeia concentration limits. CONCLUSION Preparation of vancomycin doses should follow the formulary method1 to minimise variation in concentration of the final product. Alternatively, pre-made syringes may be preferred as an alternative to ward-made syringes as this removes individualised preparation as a source of error.
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Affiliation(s)
- Sarina Saimbi
- Pharmacy and Therapeutics, College of Medical and Dental Sciences, University of Birmingham
| | - Hannah Batchelor
- Pharmacy and Therapeutics, College of Medical and Dental Sciences, University of Birmingham
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Steer P, Bedford Russell A, McCartney AC, Cox P, Plumb J. Group B Strep Support replies to Margaret McCartney. BMJ 2012; 344:e3381. [PMID: 22589513 DOI: 10.1136/bmj.e3381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Martin A, Vergnano S, Heath PT, Anthony M, Russell AB, Kennea N, Watts T, Embleton N, Collinson A. Early onset group B streptococcus sepsis: guidelines review. J Infect Prev 2012. [DOI: 10.1177/1757177412437985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Group B streptococcus (GBS) is the commonest cause of early onset sepsis in UK newborns. Several risk factors for early onset GBS sepsis (EOGBS) have been described. The presence of these risk factors provides an opportunity for intrapartum antibiotic prophylaxis (IAP) and forms the basis of current UK EOGBS prevention guidance. Having observed poor compliance with national guidelines in a review of EOGBS cases within the UK Neonatal Infection Surveillance Network (NeonIN), we reviewed 14 NeonIN unit guidelines. We found substantial variation in recommendations within and between units on indications for IAP and treatment of asymptomatic neonates, and discrepancies between obstetric and neonatal guidelines, potentially increasing infants’ risk of infection. The lack of high quality evidence in this area and related ambiguity in national guidance may have contributed to diverse local approaches. A common approach would permit prospective evaluation of an EOGBS prevention strategy, generating an evidence base to benefit future guidelines.
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Affiliation(s)
- Alice Martin
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | | | - Paul T Heath
- Division of Child Health, St George’s, University of London, UK
| | | | | | | | - Timothy Watts
- Guys’ and St Thomas’ NHS Foundation Trust, London, UK
| | | | - Andrew Collinson
- Neonatal Unit, Princess Alexandra Maternity Wing, Royal Cornwall Hospitals NHS Trust, UK
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Abstract
Antibiotics are increasingly prescribed in the peripartum period, for both maternal and fetal indications. Their effective use can be life-saving, however, injudicious use drives antibiotic resistance and contributes to the development of abnormal faecal flora and subsequent immune dysregulation. Neonatal units are a high risk area for the selection and transmission of multi-resistant organisms. Very few new antibiotics with activity against Gram-negative bacteria are under development, and no significantly new Gram-negative antibiotics will be available in the next decade. This review seeks to summarise current practice, and suggests restrictive antibiotic strategies based on epidemiological data from recently published UK neonatal infection surveillance studies.
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Vergnano S, Menson E, Kennea N, Embleton N, Russell AB, Watts T, Robinson MJ, Collinson A, Heath PT. Neonatal infections in England: the NeonIN surveillance network. Arch Dis Child Fetal Neonatal Ed 2011; 96:F9-F14. [PMID: 20876594 DOI: 10.1136/adc.2009.178798] [Citation(s) in RCA: 305] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Neonatal infection is an important cause of morbidity and mortality. Neonatal infection surveillance networks are necessary for defining the epidemiology of infections and monitoring changes over time. DESIGN Prospective multicentre surveillance using a web-based database. SETTING 12 English neonatal units. PARTICIPANTS Newborns admitted in 2006-2008, with positive blood, cerebrospinal fluid or urine culture and treated with antibiotics for at least 5 days. OUTCOME MEASURE Incidence, age at infection, pathogens and antibiotic resistance profiles. RESULTS With the inclusion of coagulase negative Staphylococci (CoNS), the incidence of all neonatal infection was 8/1000 live births and 71/1000 neonatal admissions (2007-2008). The majority of infections occurred in premature (<37 weeks) and low birthweight (<2500 g) infants (82% and 81%, respectively). The incidence of early onset sepsis (EOS; ≤48 h of age) was 0.9/1000 live births and 9/1000 neonatal admissions, and group B Streptococcus (58%) and Escherichia coli (18%) were the most common organisms. The incidence of late onset sepsis (LOS; >48 h of age) was 3/1000 live births and 29/1000 neonatal admissions (7/1000 live births and 61/1000 admissions including CoNS) and the most common organisms were CoNS (54%), Enterobacteriaceae (21%) and Staphylococcus aureus (18%, 11% of which were methicillin resistant S aureus). Fungi accounted for 9% of LOS (72% Candida albicans). The majority of pathogens causing EOS (95%) and LOS (84%) were susceptible to commonly used empiric first line antibiotic combinations of penicillin/gentamicin and flucloxacillin/gentamicin, respectively (excluding CoNS). CONCLUSIONS The authors have established NeonIN in England and defined the current epidemiology of neonatal infections. These data can be used for benchmarking among units, international comparisons and as a platform for interventional studies.
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Affiliation(s)
- Stefania Vergnano
- Division of Child Health, St George's, University of London, Cranmer Terrace, London, UK.
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Abstract
Infant mortality is highest during the neonatal period. The provision of medical care for low birth weight and premature babies is challenging. Neonatal networks aim to improve outcome, optimize efficiency and increase the quality of care for these infants.
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Abstract
We present the longest known surviving case of a male infant with a mosaic complete trisomy 1q. Born at 39 weeks of gestation with respiratory distress, his weight was 3,330 g (25th centile); he had micrognathia, a posterior cleft of palate, abnormal ears and left thumb, syndactyly, and an absent corpus callosum. Initial blood karyotype was normal (46,XY). He died at age 5 months. Autopsy suggested aspiration as the primary cause of death and confirmed the antemortem findings of an absent corpus callosum and atrial septal defect. It also identified some central nervous system, cardiac, gastrointestinal, and lung anomalies not previously recognized. Cytogenetic analysis of skin fibroblasts obtained at autopsy showed a de novo unbalanced translocation between chromosomes 1 and 22: 46,XY,+1,der(1;22)(q10;q10)[25]/46,XY[65] in the cells examined. The previously reported cases had a similar phenotype with birth weight above the 50th centile for gestational age, small mouth, micrognathia, abnormal ears, abnormal fingers, microphthalmia, and hydrocephalus. The present case and a review of the literature delineates the phenotype in trisomy 1q, and reinforces the critical importance of effective communication between specialists, and obtaining permission for autopsy and skin biopsy, in the pursuit of a diagnosis.
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Affiliation(s)
- Chirag Patel
- Department of Clinical Genetics, Birmingham Women's Hospital NHS Foundation Trust, UK.
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Abstract
Estimates of incidence of early-onset group B streptococcal (EOGBS) infection are based on blood or cerebrospinal fluid culture-proven cases, which can be falsely negative and hence underestimate the true burden of disease. Probable EOGBS infection can be defined as colonisation by group B streptococci accompanied by features of clinical sepsis. Data collected prospectively in the UK over 1 year for neonates who required a septic screen in the first 72 h of life indicated a combined rate of definite and probable EOGBS infection of 3.6 per 1000 livebirths. This estimate indicates a much greater disease burden in the UK than that suggested by figures of culture-proven sepsis, and lends support to the need for prevention strategies.
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Abstract
Respiratory syncytial virus (RSV) affects almost all children in their first 2 years of life and can cause severe or even life-threatening disease in some at-risk infants. Treatment is limited and there is currently no safe or effective vaccine. However, a new monoclonal antibody, palivizumab, reduces RSV hospitalization by 55% in at-risk groups if given prophylactically throughout the RSV season.
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Russell AB, Carlson SS. Neurexin is expressed on nerves, but not at nerve terminals, in the electric organ. J Neurosci 1997; 17:4734-43. [PMID: 9169533 PMCID: PMC6573345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Neurexins are highly variable transmembrane proteins hypothesized to be nerve terminal-specific cell adhesion molecules. As a test of the hypothesis that neurexin is restricted to the nerve terminal, we examined neurexins in the electric organ of the elasmobranch electric fish. Specific antibodies generated against the intracellular domain of electric fish neurexin were used in immunocytochemical and Western blot analyses of the electromotor neurons that innervate the electric organ. Our results indicate that neurexin is not expressed at electric organ nerve terminals, as expected by the neurexin hypothesis. Instead, neurexin is expressed by electromotor neurons and on myelinated axons. This neurexin has a molecular weight of 140 kDa, consistent with an alpha-neurexin. In addition, we find that perineurial cells of the electromotor nerve also express a neurexin. These cells surround bundles of axons to form a diffusion barrier and are thought to be a special form of fibroblast. The results of the study argue against a universal role for neurexins as nerve terminal-specific proteins but suggest that neurexins are involved in axon-Schwann cell and perineurial cell interactions.
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Affiliation(s)
- A B Russell
- Department of Physiology and Biophysics, University of Washington, Seattle, Washington 98195, USA
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