Description of a new oncogenic mechanism for atypical teratoid rhabdoid tumors in patients with ring chromosome 22

Atypical teratoid rhabdoid tumors of the central nervous system are rare, highly malignant, embryonal tumors most often occurring in children under age 3 years. Most are due to a somatic change in tumor suppressor gene SMARCB1 followed by a second-hit, typically loss of heterozygosity, best detected on immunohistochemical staining. Despite the noteworthy genetic homogeneity of atypical teratoid rhabdoid tumors, relatively little is known about the oncogenic mechanisms that lead to biallelic inactivation of SMARCB1. Herein, we describe a patient with constitutional ring chromosome 22, Phelan–McDermid syndrome and atypical teratoid rhabdoid tumor of the brain. During mitosis, sister chromatids of a ring chromosome may form interlocking and dicentric rings, resulting in chromosomal loss, complex karyotypes, and ongoing somatic variation. We hypothesized that the inherent instability of the patient's ring chromosome could lead to mosaic monosomy chromosome 22, resulting in allelic inactivation of the tumor-suppressor gene SMARCB1 and AT/RT if a second-hit occurred. Utilizing high-density microarray technology to analyze peripheral blood and tumor tissue, we confirmed this oncogenic mechanism, previously undescribed in patients with atypical teratoid rhabdoid tumors. Our data demonstrate chromosomal loss as a consequence of ring chromosome instability serving as the first hit in oncogenesis. This rare but possibly under-recognized mechanism is important to note in children with ATRT and syndromic features. Further investigation is warranted to assess if this oncogenic mechanism has management and/or prognostic implications. © 2016 Wiley Periodicals, Inc.

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First report of congenital adrenal cysts and pheochromocytoma in a patient with mosaic genome-wide paternal uniparental disomy

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Genome-Wide Association Study of Meiotic Recombination Phenotypes

Meiotic recombination is an essential step in gametogenesis and is one that also generates genetic diversity. Genome-wide association and molecular studies have identified genes that influence of human meiotic recombination. RNF212 is associated with total or average number of recombination events, and PRDM9 is associated with the locations of hotspots, or sequences where crossing over appears to cluster. In addition, a common inversion on chromosome 17 is strongly associated with recombination. Other genes have been identified by GWAS, but those results have not been replicated. In this study, using new datasets, we characterized additional recombination phenotypes to uncover novel candidates and further dissect the role of already known loci. We used three data sets totaling 1,562 two-generation families including 3,108 parents with 4,304 children. We estimated five different recombination phenotypes including two novel phenotypes (average recombination counts within recombination hotspots and outside of hotspots) using dense SNP array genotype data. We then performed gender-specific and combined-sex GWAS meta-analyses. We replicated associations for several previously reported recombination genes, including RNF212 and PRDM9. By looking specifically at recombination events outside of hotspots, we showed for the first time that PRDM9 has different effects in males and females. We identified several new candidate loci, particularly for recombination events outside of hotspots. These include regions near the genes SPINK6, EVC2, ARHGAP25, and DLGAP2. This study expands our understanding of human meiotic recombination by characterizing additional features that vary across individuals, and identifying regulatory variants influencing the numbers and locations of recombination events.

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A Linkage Map and QTL Analysis for Pyrethroid Resistance in the Bed Bug Cimex lectularius

The rapid evolution of insecticide resistance remains one of the biggest challenges in the control of medically and economically important pests. Insects have evolved a diverse range of mechanisms to reduce the efficacy of the commonly used classes of insecticides and finding the genetic basis of resistance is a major aid to management. In a previously unstudied population, we performed an F₂ resistance mapping cross for the common bed bug, Cimex lectularius, for which insecticide resistance is increasingly widespread. Using 334 SNP markers obtained through RAD-sequencing, we constructed the first linkage map for the species, consisting of 14 putative linkage groups (LG), with a length of 407 cM and an average marker spacing of 1.3 cM. The linkage map was used to reassemble the recently published reference genome, facilitating refinement and validation of the current genome assembly. We detected a major QTL on LG12 associated with insecticide resistance, occurring in close proximity (1.2 Mb) to a carboxylesterase encoding candidate gene for pyrethroid resistance. This provides another example of this candidate gene playing a major role in determining survival in a bed bug population following pesticide resistance evolution. The recent availability of the bed bug genome, complete with a full list of potential candidate genes related to insecticide resistance, in addition to the linkage map generated here, provides an excellent resource for future research on the development and spread of insecticide resistance in this resurging pest species.

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Seeing a straight line on a curved surface: Decoupling of patterns from surfaces by single IT neurons

We have no difficulty seeing a straight line drawn on a paper even when the paper is bent, but this inference is in fact nontrivial. Doing so requires either matching of local features or representing the pattern after factoring out the surface shape. Here we show that single neurons in the monkey inferior temporal cortex show invariant responses to patterns across rigid and non-rigid changes of surfaces. We recorded neuronal responses to stimuli in which the pattern and the surrounding surface were varied independently. In a subset of neurons, we found pattern-surface interactions that produced similar responses to stimuli across congruent pattern & surface transformations. These interactions produced systematic shifts in curvature tuning of patterns when overlaid on convex and flat surfaces. Our results show that surfaces are factored out of patterns by single neurons, thereby enabling complex perceptual inferences.

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Changes in activity of fast-spiking interneurons of the monkey striatum during reaching at a visual target

Recent works highlight the importance of local inhibitory interneurons in regulating the function of the striatum. In particular, fast-spiking interneurons (FSIs), which likely correspond to a subgroup of GABAergic interneurons, have been involved in the control of movement by exerting strong inhibition on striatal output pathways. However, little is known about the exact contribution of these presumed interneurons in movement preparation, initiation, and execution. We recorded the activity of FSIs in the striatum of monkeys as they performed reaching movements to a visual target under two task conditions: one in which the movement target was presented at unsignaled left or right locations, and another in which advance information about target location was available, thus allowing monkeys to react faster. Modulations of FSI activity around the initiation of movement (62% of 55 neurons) consisted mostly of increases reaching maximal firing immediately before or, less frequently, after movement onset. Another subset of FSIs showed decreases in activity during movement execution. Rarely did movement-related changes in FSI firing depend on response direction and movement speed. Modulations of FSI activity occurring relatively early in relation to movement initiation were more influenced by the preparation for movement, compared with those occurring later. Conversely, FSI activity remained unaffected as monkeys were preparing a movement toward a specific location and instead moved to the opposite direction when the trigger occurred. These results provide evidence that changes in activity of presumed GABAergic interneurons of the primate striatum could make distinct contributions to processes involved in movement generation.

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Sensorimotor integration of vision and proprioception for obstacle crossing in ambulatory individuals with spinal cord injury

Background: Skilled walking, such as obstacle crossing, is an essential component of functional mobility. Sensorimotor integration of visual and proprioceptive inputs is important for successful obstacle crossing. The objective of this study was to understand how proprioceptive deficits affect obstacle-crossing strategies when controlling for variations in motor deficits in ambulatory individuals with spinal cord injury (SCI). Methods: 15 ambulatory individuals with SCI and 15 able-bodied controls were asked to step over an obstacle scaled to their motor abilities under full and obstructed vision conditions. An eye tracker was used to determine gaze behaviour and motion capture analysis was used to determine toe kinematics relative to the obstacle. Hip and knee proprioceptive sense (joint position sense and movement detection sense) was assessed using the Lokomat and customized software controls. Results: Hip and knee proprioceptive sense in subjects with SCI varied and was significantly different from able-bodied subjects. Subjects with greater proprioceptive deficits stepped higher over the obstacle with their lead and trail limbs in the obstructed vision condition compared to full vision. Subjects with SCI also glanced at the obstacle more frequently and with longer fixation times compared to controls, but this was not related to proprioceptive sense. Conclusion: This study indicates that ambulatory individuals with SCI rely more heavily on vision to cross obstacles and show impairments in key gait parameters required for successful obstacle crossing. Our data suggest that proprioceptive deficits need to be considered in rehabilitation programs aimed at improving functional mobility in ambulatory individuals with SCI.

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A novel computational model to probe visual search deficits during motor performance

Successful execution of many motor skills relies on well-organized visual search (voluntary eye movements that actively scan the environment for task-relevant information). Although impairments of visual search that result from brain injuries are linked to diminished motor performance, the neural processes that guide visual search within this context remain largely unknown. The first objective of this study was to examine how visual search in healthy adults and stroke survivors is used to guide hand movements during the Trail Making Test (TMT), a neuropsychological task that is a strong predictor of visuomotor and cognitive deficits. Our second objective was to develop a novel computational model to investigate combinatorial interactions between three underlying processes of visual search (spatial planning, working memory and peripheral visual processing). We predicted that stroke survivors would exhibit deficits in integrating the three underlying processes, resulting in deteriorated overall task performance. We found that normal TMT performance is associated with patterns of visual search that primarily rely on spatial planning and/or working memory (but not peripheral visual processing). Our computational model suggested that abnormal TMT performance following stroke is associated with impairments of visual search that are characterized by deficits integrating spatial planning and working memory. This innovative methodology provides a novel framework for studying how the neural processes underlying visual search interact combinatorially to guide motor performance.

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Passive stimulation and behavioral training differentially transform temporal processing in the inferior colliculus and primary auditory cortex

In profoundly deaf cats, behavioral training with intracochlear electric stimulation (ICES) can improve temporal processing in the primary auditory cortex (AI). To investigate whether similar effects are manifest in the auditory midbrain, ICES was initiated in neonatally deafened cats either during development after short durations of deafness (8 wk of age) or in adulthood after long durations of deafness (≥3.5 yr). All of these animals received behaviorally-meaningless, 'passive' ICES. Some animals also received behavioral training with ICES. Two long-deaf cats received no ICES prior to acute electrophysiological recording. After several months of passive ICES and behavioral training, animals were anesthetized, and neuronal responses to pulse trains of increasing rates were recorded in the central (ICC) and external (ICX) nuclei of the inferior colliculus. Neuronal temporal response patterns (repetition rate coding, minimum latencies, response precision) were compared with results from recordings made in the AI of the same animals (Beitel et al. 2011; Vollmer and Beitel 2011). Passive ICES in long-deaf cats remediated severely degraded temporal processing in the ICC and had no effects in the ICX. In contrast to observations in the AI, behaviorally-relevant ICES had no effects on temporal processing in the ICC or ICX, with the single exception of shorter latencies in the ICC in short-deaf cats. The results suggest that independent of deafness duration passive stimulation and behavioral training differentially transform temporal processing in auditory midbrain and cortex, and primary auditory cortex emerges as a pivotal site for behaviorally driven neuronal temporal plasticity in the deaf cat.

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Clarithromycin increases neuronal excitability in CA3 pyramidal neurons through a reduction in GABA-ergic signaling.

Antibiotics are used in the treatment and prevention of bacterial infections, but effects on neuron excitability have been documented. A recent study demonstrated that clarithromycin alleviates daytime sleepiness in hypersomnia patients (Trotti et al. 2014). To explore the potential application of clarithromycin as a stimulant, we performed whole cell patch clamp recordings in rat pyramidal cells from the CA3 region of hippocampus. In the presence of the antibiotic, rheobase current was reduced by 50%, F-I relationship (number of action potentials as a function of injected current) was shifted to the left, and the resting membrane potential was more depolarized. Clarithromycin-induced hyperexcitability was dose-dependent; doses of 30 and 300 µM clarithromycin significantly increased the firing frequency and membrane potential as compared to controls (p=0.003, p<0.0001). We hypothesized that clarithromycin enhanced excitability by reducing GABAA receptor activation. 30 µM clarithromycin significantly reduced (p=0.001) the amplitude of spontaneous miniature inhibitory GABA-ergic currents (GABA-mPSCs) and at 300 µM had a minor effect on action potential width. Additionally, we tested the effect of clarithromycin in an ex vivo seizure model by evaluating its effect on spontaneous local field potentials. Bath application of 300 µM clarithromycin enhanced burst frequency 2 fold compared to controls (p=0.0006). Taken together, these results suggest that blocking GABA-ergic signaling by clarithromycin increases cellular excitability and potentially serve as a stimulant, facilitating emergence from anesthesia or normalizing vigilance in hypersomnia and narcolepsy. However, the administration of clarithromycin should be carefully considered in patients with seizure disorders.

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Overlap of movement planning and movement execution reduces reaction time.

Motor planning is the process of preparing the appropriate motor commands in order to achieve a goal. This process has largely been thought to occur before movement onset and traditionally has been associated with reaction time. However, in a virtual line bisection task, we observed an overlap between movement planning and execution. In this task performed with a robotic manipulandum, we observed that participants (N=30) made straight movements when the line was in front of them (near target), but often made curved movements when the same target was moved sideways (far target, which had the same orientation) in such a way that they crossed the line perpendicular to its orientation. Unexpectedly, movements to the far targets had shorter reaction times than movements to the near targets (mean difference: 32ms, SE: 5ms, max: 104ms). In addition, the curvature of the movement modulated reaction time. A larger increase in movement curvature from the near to the far target was associated with a larger reduction in reaction time. These highly curved movements started with a transport phase during which accuracy demands were not taken into account. We conclude that an accuracy demand imposes a reaction time penalty if processed before movement onset. This penalty is reduced if the start of the movement consists of a transport phase and if the movement plan can be refined with respect to accuracy demands later in the movement, hence demonstrating an overlap between movement planning and execution.

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Temporal coordination of olfactory cortex sharp-wave activity with up- and down-states in the orbitofrontal cortex during slow-wave sleep

During slow-wave sleep, inter-areal communications via coordinated slow oscillatory activities occur in the large-scale networks of the mammalian neocortex. Because olfactory cortex (OC) areas, which belong to paleocortex, show characteristic sharp-wave activity during slow-wave sleep, we examined whether OC sharp-waves in freely behaving rats occur in temporal coordination with up- and down-states of the orbitofrontal cortex (OFC) slow oscillation. Simultaneous recordings of local field potentials and spike activities in the OC and OFC showed that during the down-state in the OFC, the OC also exhibited down-state with greatly reduced neuronal activity and suppression of sharp-wave generation. OC sharp-waves occurred during two distinct phases of the up-state of the OFC: early phase sharp-waves occurred at the start of up-state shortly after the down-to-up transition in the OFC, while late phase sharp-waves were generated at the end of up-state shortly before the up-to-down transition. Such temporal coordination between neocortical up- and down-states and olfactory system sharp-waves was observed between the prefrontal cortex areas (orbitofrontal cortex and medial prefrontal cortex) and the OC areas (anterior piriform cortex and posterior piriform cortex). These results suggest that during slow-wave sleep, OC and OFC areas communicate preferentially in specific time windows shortly after the down-to-up transition and shortly before the up-to-down transition.

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Usefulness of the conicity index together with the conjoint use of adipocytokines and nutritional-inflammatory markers in hemodialysis patients

Abstract

Abdominal fat has been recognized as the most hormonally active tissue secreting a variety of adipocytokines and, therefore, potentially contributing to inflammation. The conicity index (C_index) has been considered a valuable indicator of central obesity. This study aims to relate plasma concentrations of leptin, adiponectin, interleukin-6 (IL-6), and serum C-reactive protein (CRP) with C_index values in hemodialysis (HD) patients. Cross-sectional study in 45 HD patients (55.6 % men; DM 20 %; mean age, 68.1 year). C_index and nutritional-inflammatory markers were used for the abdominal fat depot assessment. Patients were classified as having a low or high median C_index (MC_index): low group (men, <1.39; women, <1.33) and high group (men, ≥1.39; women, ≥1.33). A combination of plasma leptin, IL-6, adiponectin, and CRP was used to design an inflammatory index (I_index) while a protein-energy wasting index (PEW_index) was calculated from the I_index plus the malnutrition-inflammation score (MIS). Waist circumference (WC) and C_index but not BMI were significantly higher in men than in women (p < 0.01). The MC_index was significantly associated with the adipocytokine profile (CRP, leptin, and adiponectin). Patients with a high MC_index had a higher I_index and PEW_index (p < 0.01). ROC curve analyses measured by area under the curve (AUC) were 0.69 and 0.68 (p < 0.05), for the C_index and MC_index, respectively, demonstrating the usefulness of the C_index as an abdominal fat mass biomarker able for wasting-inflamed HD patients. These findings in HD patients underscore the importance of incorporating the evaluation of one abdominal fat indicator, such as the C_index and an inflammatory biomarker such as the IL-6 and CRP, in substitution of the BMI, in current clinical practice.

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Sergei V. Jargin. 2016. Hypothesis: overestimation of Chernobyl consequences. Journal of Environmental and Occupational Science 5(3):59-63.

2016-10-12T17-20-50Z
Source: Journal of Environmental and Occupational Science
Sergei V. Jargin.



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On the use of acetylcysteine as a mucolytic drug

2016-10-12T15-34-26Z
Source: Journal of Investigational Biochemistry
Sergei V. Jargin.



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FXR Agonists: From Bench to Bedside, a Guide for Clinicians

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Microproteinuria Predicts Organ Failure in Patients Presenting with Acute Pancreatitis

Abstract

Background and Aims

The disease course of acute pancreatitis (AP) ranges from mild and self-limiting to severe inflammation, associated with significant morbidity and mortality. At present, there are no universally accepted and reliable predictors for severity. Microproteinuria has been associated with the presence of systemic inflammatory response syndrome as well as trauma, although its association with AP is not well understood. The aim of this study was to investigate the value of microproteinuria to predict development of organ failure in AP.

Methods

Consecutive AP patients were prospectively enrolled. Urine samples were collected upon admission, 12–24 h after admission, and 3 months post-discharge for calculation of urine α1-microglobulin-, albumin-, IgG-, and IgM/creatinine ratios. Data regarding AP etiology, severity, and development of organ failure were registered.

Results

Overall, 92 AP patients were included (14 % with organ failure; 6 % with severe AP). The α1-microglobulin-, albumin-, and IgG/creatinine ratios correlated with high-sensitivity C-reactive protein 48 h after admission (r = 0.47–0.61, p < 0.001 for all). They were also significantly higher in patients with versus without organ failure (p < 0.05 for all). The α1-microglobulin/creatinine ratio upon admission predicted organ failure [adjusted odds ratio 1.286, 95 % confidence interval (CI) 1.024–1.614] with similar accuracy (AUROC 0.81, 95 % CI 0.69–0.94) as the more complex APACHE II score (AUROC 0.86, 95 % CI 0.70–1.00).

Conclusion

The α1-microglobulin/creatinine ratio upon presentation with AP is related to inflammation and predicts development of organ failure. Further studies are warranted to evaluate its potential usefulness in predicting outcome for AP patients.

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Do children and adolescent ice hockey players with and without a history of concussion differ in robotic testing of sensory, motor and cognitive function?

KINARM end point robotic testing on a range of tasks evaluating sensory, motor and cognitive function in children/adolescents with no neurologic impairment has been shown to be reliable. The objective of this ...

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OnStar donates $400K to first responders

By EMS1 Staff

DETROIT — OnStar celebrated its 20th anniversary last week by giving $20,000 to 20 different public safety personnel who experienced serious physical injury or hardship that impacted their ability to perform their jobs.

OnStar identified the 20 recipients by working with the International Association of Chiefs of Police Foundation, Association of Public Safety Communications Officials, the International Association of Fire Chiefs and the National Association of Emergency Medical Technicians.

"Each day, OnStar receives more than 245,000 calls from drivers in need of some support, so we understand the importance of a human connection, especially in an emergency situation," said Christine Sitek, OnStar chief operating officer for General Motors' Global Connected Customer Experience team. "The first responder community plays a vital role in working with OnStar advisors to quickly deliver emergency services to our drivers and passengers in need. We couldn't have become a leader in safety and security without their support."

One of the selected first responders, Andy Allison, was a firefighter at the Lewisville (Texas) Fire Department when he sustained career-altering injuries while responding to a structure fire. Since his injury, Allison has dedicated his life to helping others manage occupational medicine and advocating for others suffering debilitating injuries in the line of duty. He has spoken around the country on how to prepare for worst-case scenarios and manage life after a debilitating injury.

"My goal is to help other firefighters prepare for if, or when, they get hurt," Allison said. "In this career, you need to know what can be done proactively to protect yourself and your family, both physically and financially, and I want to help others be equipped to manage whatever comes their way."

One of the recipients, Arizona-based flight paramedic Derek Boehm, was the sole survivor of a helicopter crash that occurred while transporting a patient. Although he sustained serious injuries, Boehm is determined to return to work.

The read the full list of recipients, click here. 

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Drug resistance mechanisms and novel drug targets for tuberculosis therapy

Publication date: Available online 11 October 2016
Source:Journal of Genetics and Genomics
Author(s): Md Mahmudul Islam, H.M. Adnan Hameed, Julius Mugweru, Chiranjibi Chhotaray, Changwei Wang, Yaoju Tan, Jianxiong Liu, Xinjie Li, Shouyong Tan, Iwao Ojima, Wing Wai Yew, Eric Nuermberger, Gyanu Lamichhane, Tianyu Zhang
Drug-resistant tuberculosis (TB) poses a significant challenge to the successful treatment and control of TB worldwide. Resistance to anti-TB drugs has existed since the beginning of the chemotherapy era. New insights into the resistant mechanisms to anti-TB drugs have been provided. Better understanding of drug resistance mechanisms helps in the development of new tools for the rapid diagnosis of drug-resistant TB. There is also a pressing need in development of new drugs with novel targets to improve the current treatment of TB and to prevent the emergence of drug resistance in Mycobacterium tuberculosis. This article reviews the anti-TB drug resistance mechanisms, furnishes some possible novel drug targets in the development of new agents for TB therapy and discusses the usefulness using known targets to develop new anti-TB drugs. Whole genome sequencing is currently an advanced technology to uncover drug resistance mechanisms in M. tuberculosis. However, further research is required to unravel the significance of some newly discovered gene mutations in their contribution to drug resistance.



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Most Dreadful and Fatal Equine Infections of Worldwide Occurrence: A Brief Review

2016-10-12T09-42-30Z
Source: International Journal of Livestock Research
SUBHA GANGULY, RAJESH WAKCHAURE, TANVI MAHAJAN, KAUSAR QADRI, PRAVEEN KUMAR PRAVEEN.
The healthy horse gets infected from another infected one. Mosquito or tick act as the vectors for transmitting most of the deadly disease in equines. The review focuses on the prominent equine infections very important in the field of equine practice and causing huge economic losses worldwide.


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FDNY launches first mobile stroke ambulance

The unit is equipped with stroke-specific medications and a portable CT scanner. (New York-Presbyterian Photo)

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How joining a first responder credit union can increase your savings

By Andre Wong and Megan Wells, EMS1 Contributors

Want to save more money" As an EMS provider, you're eligible for membership at many credit unions that serve first responders. These institutions may offer you special rates to help you grow your savings.

Credit unions and banks share many of the same functions. Both can make loans, issue checks and credit cards, and offer investment services. The main difference is that since credit unions are nonprofit organizations, they don't pay income taxes and can pass the savings to their members. For example, you may pay fewer fees and lower interest rates on large purchases and homes.

First responder credit unions are able to offer their members higher APY rates for savings deposits and IRA accounts. Depending on your banking needs, a credit union might be the best choice for setting up a retirement fund and long-term savings.

First responder credit unions and APY

APY stands for annual percentage yield, or the amount of money your deposit will earn over a single year just for letting the bank use it. If you made a deposit of $1,000 and had an APY of 1 percent, you'd end up with $1,010 after one year.

Wells Fargo savings account APY 0.01 - 0.07 percent

The vast majority of first responder credit unions on our list offer a starting APY of 0.05 percent for a savings deposit. That number may increase to 0.25, 0.50, and even 2.00 percent APY depending on the organization and how much money you deposit.

First responder credit unions and IRA accounts

IRA accounts are meant for long-term savings. You can expect greater returns from an IRA, but they require more money to start and can't be withdrawn without penalties until certain conditions (such as retirement) are met.

The rates offered by Wells Fargo are about what you can expect from a large bank, yielding a little over 1.00 percent annual growth when APY is maxed out.

Wells Fargo IRA account APY 0.10 - 1.05 percent

Not all EMS and fire credit unions offer the option of starting an IRA account, but many that do can offer even better rates for long-term savings. Of the 22 credit unions on this list, 19 offer a higher maximum APY on their members' IRA and CD accounts than what a large bank can provide.

Some of the APY rates for savings and IRA accounts offered by firefighter credit unions can be found in this table:

State Credit Union Savings APY IRA and CD All PenFed 0.05 - 0.15 0.05 - 1.26 Arkansas Little Rock Fire Department Federal Credit Union 1.10 - 1.60 N/A California San Diego Firefighters Federal Credit Union 0.10 - 0.50 0.15 - 2.00 California Firefighters First Credit Union 0.05 - 0.30 0.25 - .070 Colorado Denver Fire Department Federal Credit Union 0.10 - 0.20 0.15 - 0.30 Colorado Aventa Credit Union 0.05 - 0.30 0.35 - 2.02 Connecticut FD Community Federal Credit Union Varies 0.80 - 2.02 Delaware Wilmington Police & Fire Federal Credit Union 0.05 0.05 Florida Jacksonville Firemen's credit union 0.05 - 0.25 0.05 - 1.06 Hawaii Honolulu Fire Department Federal Credit Union 0.10 - 0.15 0.20 - 1.25 Illinois Chicago Firefighters Credit Union 0.10 - 0.25 N/A Indiana Firefighters Credit Union 0.10 - 0.25 0.30 - 1.30 Massachusetts Haverhill Fire Department credit union 0.05 0.25 - 2.00 Massachusetts Boston Firefighters Credit Union 0.25 - 0.60 0.75 - 2.02 Missouri Greater KC Public Safety Credit Union Max of 0.30 Max of 1.87 North Carolina Charlotte Fire Dept. Credit Union 0.15 - 0.25 0.35 - 1.00 North Carolina Emergency Responders Credit Union 0.25 - 0.65 0.25 - 1.25 Nebraska Omaha Firefighters Credit Union 0.10 - 0.20 0.85 - 1.40 New Jersey Bloomfield Fire & Police Federal Credit Union 0.50 - 0.70 0.85 New York Syracuse Fire Department Federal Credit Union 0.45 - 0.50 1.15 - 1.46 Ohio Dayton Firefighters Federal Credit Union 0.15 - 0.30 0.35 - 1.53 Ohio Firefighters Community Credit union 0.05 - 2.00 0.20 - 1.45 Ohio Akron Firefighters Credit Union 0.10 - 0.25 0.15 - 0.90 Oklahoma Fire Fighters Credit Union 0.05 - 0.40 VARIES Pennsylvania Police and Fire Federal Credit Union 0.10 - 0.50 0.50 - 2.00 Tennessee Nashville Firemen's Credit Union 0.10 - 0.29 0.75 - 1.15 Texas Houston Texas Fire Fighters Federal Credit Union 0.15 - 0.45 0.15 - 0.60 Utah Firefighters Credit Union 0.15 - 0.35 0.35 - 2.31 Virginia Richmond Virginia Fire Police Credit Union 0.20 - 0.60 0.40 - 1.51 Washington Spokane Firefighters Credit Union 0.10 - 0.35 0.75 - 1.00

Are we missing a credit union" If you're a member of a credit union for EMS and fire professionals that you don't see named here, please let us know in the comments below so we can include your organization on our list.

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Independent risk factors for surgical site infection after cesarean delivery in a rural tertiary care medical center

Abstract

Background

We aimed to determine the incidence of surgical site infection (SSI) after cesarean delivery (CD) and identify the risk factors in a rural population.

Methods

We identified 218 SSI patients by International Classification of Disease codes and matched them with 3131 parturients (control) from the electronic record database in a time-matched retrospective quality assurance analysis.

Results and discussion

The incidence of SSI after CD was 7.0 %. Risk factors included higher body mass index (BMI) [40.30 ± 10.60 kg/m² SSI (95 % CI 38.73–41.87) vs 34.05 ± 8.24 kg/m² control (95 % CI 33.75–34.35, P < 0.001)], years of education [13.28 ± 2.44 years SSI (95 % CI 12.9–13.66) vs 14.07 ± 2.81 years control (95 % CI 13.96–14.18, P < 0.001)], number of prior births [2 (1–9) SSI vs 1 (1–11) control (P < 0.001)], tobacco use (OR 1.49; 95 % CI 1.06–2.09, P = 0.03), prior diagnosis of hypertension (OR 1.80; 95 % CI 1.34–2.42, P < 0.001), gestational diabetes (OR 1.59; 95 % CI 1.18–2.13, P = 0.003), and an emergency/STAT CD (OR 1.6; 95 % CI 1.1–2.3, P = 0.01).

Conclusions

Risk factors for SSI after CD included higher BMI, less years of education, higher prior births, tobacco use, prior diagnosis of hypertension, gestational diabetes, and emergency/STAT CD. The presence of ruptured membranes was protective against SSI.

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