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Journal of Minimally Invasive Gynecology Dec 2023To study the impact of Müllerian anomalies on reproductive outcomes in a recurrent pregnancy loss (RPL) population and to evaluate the effect of surgical correction of...
STUDY OBJECTIVE
To study the impact of Müllerian anomalies on reproductive outcomes in a recurrent pregnancy loss (RPL) population and to evaluate the effect of surgical correction of uterine septum on the odds of achieving live birth in RPL patients with a septate uterus.
DESIGN
A retrospective cohort study.
SETTING
A specialized RPL clinic at a tertiary center.
PATIENTS
RPL patients with ≥ 2 pregnancy losses before 20 weeks' gestation who attended a specialized RPL clinic.
INTERVENTION
We aimed to assess the association between a possible risk factor (Müllerian anomalies) and reproductive outcomes and that between having surgery for septate uterus and achieving a live birth.
MEASUREMENTS AND MAIN RESULTS
The primary outcome is live birth rate in RPL patients with Müllerian anomalies compared with those without; secondary outcome measures include rates of full-term live birth, preterm live birth, first and second trimester pregnancy loss, and stillbirth. After adjusting for patient age at the initial RPL visit, the number of pregnancy losses, and the presence of any other abnormal RPL investigation, the odds of achieving live birth were on average 49.4% lower for patients with a septate uterus than those without Müllerian anomalies (odds ratio, 0.51; 95% confidence interval, 0.30-0.86) in the studied cohort (n = 377). A subanalysis of 72 patients with septate uterus demonstrated a higher likelihood of live birth in those who underwent septum resection (46/72; 63.9%) than those who elected to go for expectant management (26/72; 36.1%), yet this study was underpowered to establish a significant difference (52.2% vs 34.6%; p = .22).
CONCLUSION
In RPL patients, having a septate uterus significantly decreased the chances of achieving live birth. Patients with septate uterus who received hysteroscopic septum division had a higher tendency to achieve more live births than those who elected expectant management. However, our study was underpowered to detect a statistically significant difference.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Septate Uterus; Hysteroscopy; Retrospective Studies; Uterus; Abortion, Habitual; Premature Birth
PubMed: 37506876
DOI: 10.1016/j.jmig.2023.07.012 -
Clinical Microbiology and Infection :... Aug 2023Invasive fungal infections are an important cause of morbidity and mortality in a broad range of patients. Adequate and early diagnosis is a challenge and of importance... (Review)
Review
BACKGROUND
Invasive fungal infections are an important cause of morbidity and mortality in a broad range of patients. Adequate and early diagnosis is a challenge and of importance for improved survival. New molecular-based diagnostic methods are trendsetting, yet with the drawback that conventional tests receive less attention, in the laboratory as well as in the clinical setting.
OBJECTIVES
We aimed to provide a useful recommendation for direct microscopy for effectively managing numerous specimens related to fungal infections, mainly covering opportunistic pathogens.
SOURCES
A PubMed literature search covering direct fungal microscopy was performed with no restrictions on publication dates.
CONTENT
Best practise recommendations targeting the role of direct microscopy in diagnosing fungal infections are given. This review highlights when to perform direct microscopy, displays the main fungal morphologies, discusses the pitfalls related to microscopy, and recommends how to best report the results to clinicians.
IMPLICATION
In many samples, the performance of direct microscopy provides an important diagnostic benefit that is greater than culture alone. Fluorescent dyes improve sensitivity and allow a fast and rapid read. Reporting includes the presence or absence of yeast forms, septate or non-septate hyphae, pigmentation, cellular location, or any other specific structures being present. The visualization of fungal elements from a sterile body site is proof of an infection, independent of other test reports.
Topics: Humans; Microscopy; Mycoses; Yeasts
PubMed: 37187349
DOI: 10.1016/j.cmi.2023.05.012 -
Neurosurgical Review Apr 2024To analyse the imaging findings of papillary glioneuronal tumors (PGNTs), in order to improve the accuracy of preoperative diagnosis of this tumor. The clinical and...
To analyse the imaging findings of papillary glioneuronal tumors (PGNTs), in order to improve the accuracy of preoperative diagnosis of this tumor. The clinical and imaging manifestations of 36 cases of PGNT confirmed by pathology were analyzed retrospectively. A total of 17 males and 19 females, averaging 22.47 (± 11.23) years. Initial symptoms included epilepsy in ten, headache in seven, and others in 19 cases. 97.2% (35/36) of the lesions were located in the supratentorial area, and 80.5% (29/36) in the intraventricular or deep white matter adjacent to the lateral ventricles. Twenty-four of the lesions (66.7%) were mixed cystic and solid, four (11.1%) were cystic with mural nodules, four (11.1%) were cystic, and four (11.1%) were solid. Four cases of PGNT of cystic imaging showed a "T2-FLAIR mismatch" sign. 69.4% (25/36) had septations. Nine lesions (25%) were accompanied by edema, and 9 (25%) of the mixed cystic and solid lesions were accompanied by hemorrhage. Among the 18 patients who underwent computed tomography (CT) or susceptibility-weighted imaging (SWI), nine had lesions with calcification. PGNTs mostly manifest as cystic mass with mural nodules or mixed cystic and solid mass in the white matter around the supratentorial ventricle, and the cystic part of the lesion is mostly accompanied by septations. Pure cystic lesions may exhibit the sign of "T2-FLAIR mismatch". PGNT is rarely accompanied by edema but sometimes by calcification and hemorrhage. Patients often present with seizures, headaches, and mass effect symptoms.
Topics: Humans; Male; Female; Adult; Adolescent; Young Adult; Child; Magnetic Resonance Imaging; Retrospective Studies; Brain Neoplasms; Tomography, X-Ray Computed; Middle Aged; Ganglioglioma; Child, Preschool
PubMed: 38649515
DOI: 10.1007/s10143-024-02393-1 -
European Journal of Radiology Nov 2023Ovarian-Adnexal Reporting and Data System (O-RADS) MRI uses a 5-point scale to establish malignancy risk in sonographically-indeterminate adnexal masses. The management...
PURPOSE
Ovarian-Adnexal Reporting and Data System (O-RADS) MRI uses a 5-point scale to establish malignancy risk in sonographically-indeterminate adnexal masses. The management of O-RADS MRI score 4 lesions is challenging, as the prevalence of malignancy is widely variable (5-90%). We assessed imaging features that may sub-stratify O-RADS MRI 4 lesions into malignant and benign subgroups.
METHOD
Retrospective single-institution study of women with O-RADS MRI score of 4 adnexal masses between April 2021-August 2022. Imaging findings were assessed independently by 2 radiologists according to the O-RADS lexicon white paper. MRI and clinical findingswere compared between malignant and benign adnexal masses, and inter-reader agreement was calculated.
RESULTS
Seventy-four women (median age 52 years, IQR 36-61) were included. On pathology, 41 (55.4%) adnexal masses were malignant. Patients with malignant masses were younger (p = 0.02) with higher CA-125 levels (p = 0.03). Size of solid tissue was greater in malignant masses (p = 0.01-0.04). Papillary projections and larger solid portion were more common in malignant lesions; irregular septations and predominantly solid composition were more frequent in benign lesions (p < 0.01). Solid tissue of malignant lesions was more often hyperintense on T2-weighted and diffusion-weighted imaging (p ≤ 0.03). Other imaging findings were not significantly different (p = 0.09-0.77). Inter-reader agreement was excellent-good for most features (ICC = 0. 662-0.950; k = 0. 650-0.860).
CONCLUSION
Various MRI and clinical features differed between malignant and benign O-RADS MRI score 4 adnexal masses. O-RADS MRI 4 lesions may be sub-stratified (high vs low risk) based on solid tissue characteristics and CA-125 levels.
Topics: Humans; Female; Middle Aged; Ovarian Neoplasms; Retrospective Studies; Adnexal Diseases; Magnetic Resonance Imaging; CA-125 Antigen; Risk Assessment; Ultrasonography; Sensitivity and Specificity
PubMed: 37806193
DOI: 10.1016/j.ejrad.2023.111122 -
Plant Disease Sep 2023Auricularia cornea is a widely cultivated mushroom in China, which has high medicinal values such as hemostaticity, analgesia, antioxidation and anti-tumor (Wu et al.,...
Auricularia cornea is a widely cultivated mushroom in China, which has high medicinal values such as hemostaticity, analgesia, antioxidation and anti-tumor (Wu et al., 2019). In 2022, an investigation on edible mushroom diseases in Guizhou Province observed a suspected cobweb disease in an A. cornea growing factory, with up to 30% incidence. The pathogen first produced flocculent hyphae on the surface of the fruiting body of A. cornea, and then developed spider web-like aerial hyphae, covering the entire fruiting bodies. It hinders the normal growth of A. cornea, resulting in deformity and rot of the fruiting bodies. These symptoms seriously affect the quantity and quality of mushroom yields and cause huge economic losses. Three fungal isolates (GUCCX001, GUCCX002 and GUCCX003) were recovered from the diseased mushroom fruiting bodies and purified through single spore isolation. The colonies of three isolates spread rapidly on PDA, reaching 79-82 mm in seven days. The flocculent mycelium was whitish, and its reverse turned from yellowish to amber after 14 days. The branched conidiophores arising from aerial mycelia were septate and each cell contained several denticulate conidiogenous loci. Each denticle contained a single conidium. Conidia were observed at the tip of conidiophore branches and were 0-1-septate, oval or spherical, transparent, 5.2-11.3 × 11.7-18.7 μm (n = 35). Chlamydospores were visible as 3-4 thick-walled cells at the tip of lateral hyphal branches. Three isolates were tentatively identified as H. mycophilus based on their morphological characteristics similar to those described by Rogerson and Samuels (1993). The sequence of internal transcribed spacer (ITS) region (primers ITS5/ITS4) (Rehner and Samuels, 1994) and nuclear ribosomal large subunit (LSU) region (primers LR0R/LR5) (Vilgalys and Heste, 1990) of GUCCX001 (ITS: OP777905; LSU: OQ152071), GUCCX002 (ITS: OP862872; LSU: OQ152072) and GUCCX003 (ITS: OP862873; LSU: OP862873) were 99%-100% similar to H. mycophilus CBS 175.56 (ITS: MH857567; LSU: MH869110). Fifteen healthy fruiting bodies of A. cornea were inoculated by spraying spore suspension (106 conidia/mL) of the three isolates and five healthy fruiting bodies were sprayed with sterile water as control. All inoculated fruiting bodies were kept at 25 ℃. After three days, fruiting bodies of A. cornea treated with the spore suspension exhibited the same symptoms of cobweb as in the factory, while no symptom appeared in the control. Pathogens re-isolated from diseased fruiting bodies were confirmed to be H. mycophilus based on morphological characteristics, which fulfills the Koch's postulate. Zeng et al. (2017) reported H. mycophilus on the fruiting bodies of Auricularia sp. as a new record in Guangdong, China. H. mycophilus caused cobweb disease on A. auricula (Liu et al., 2020), A. cornea var. Li. (Cao et al., 2023) and A. heimuer (Zhang et al., 2023). To our knowledge, this is the first report of cobweb disease in A. cornea caused by H. mycophilus in Guizhou, China. Our findings will provide a basis for correct diagnosis and management of cobweb diseases on A. cornea.
PubMed: 37700472
DOI: 10.1094/PDIS-02-23-0322-PDN -
Mycopathologia Dec 2023The diagnosis of chronic pulmonary aspergillosis (CPA) is established by combined clinic-radio-microbiological criteria. Out of the different microbiological criteria, a...
The diagnosis of chronic pulmonary aspergillosis (CPA) is established by combined clinic-radio-microbiological criteria. Out of the different microbiological criteria, a positive serology for Aspergillus-specific IgG levels is the cornerstone of diagnosis. Alternatively, other microbiological evidence are sometimes sought viz., positive Aspergillus antigen (broncho-alveolar lavage fluid, i.e., BALF galactomannan ≥ 1.0), histopathological demonstration of the fungi following lung biopsy or resection, demonstration of hyaline septate hyphae in direct microscopy resembling Aspergillus spp. or its growth on a respiratory specimen. However, the exact roles of BALF- GM and the newer BALF-PCR have not been confirmed by studies till date. This study enrolled 210 patients with suspected CPA. Of the participants, 88 patients met the criteria for CPA, whereas 122 patients had an alternative diagnosis. The sensitivity-specificity of AsperGenius® PCR and "in-house" PCR were 52.27(36.69-67.54) %-33.78 (23.19-45.72) % and 36.36 (22.41-52.23) %-39.19 (28.04-51.23) % respectively. The sensitivity/specificity of BALF (> 1.0) and serum galactomannan (> 1.0) were 46.55% (33.34-60.13)/64.08% (54.03-73.3) and 29.82% (22.05-37.6)/86.84% (81.1-92.59) respectively. The optimal cut-off values for BALF-Galactomannan and serum galactomannan in diagnosing CPA were found to be 0.69 (sensitivity: 64%; specificity: 53%) and 0.458 (sensitivity: 67%; specificity: 64%) respectively. This results of this study suggests that Aspergillus PCR from BAL may not be a good "rule-in" test for diagnosing CPA. While the performances of GM in BAL and serum may be better than PCR, it should be best used in conjunction with other clinical, radiological, and other microbiological characteristics.
Topics: Humans; Pulmonary Aspergillosis; Aspergillus; Mannans; Bronchoalveolar Lavage Fluid; Sensitivity and Specificity; Polymerase Chain Reaction; Invasive Pulmonary Aspergillosis
PubMed: 37857979
DOI: 10.1007/s11046-023-00797-z -
Nature Communications Mar 2024The growth and division of mycobacteria, which include clinically relevant pathogens, deviate from that of canonical bacterial models. Despite their Gram-positive...
The growth and division of mycobacteria, which include clinically relevant pathogens, deviate from that of canonical bacterial models. Despite their Gram-positive ancestry, mycobacteria synthesize and elongate a diderm envelope asymmetrically from the poles, with the old pole elongating more robustly than the new pole. The phosphatidylinositol-anchored lipoglycans lipomannan (LM) and lipoarabinomannan (LAM) are cell envelope components critical for host-pathogen interactions, but their physiological functions in mycobacteria remained elusive. In this work, using biosynthetic mutants of these lipoglycans, we examine their roles in maintaining cell envelope integrity in Mycobacterium smegmatis and Mycobacterium tuberculosis. We find that mutants defective in producing mature LAM fail to maintain rod cell shape specifically at the new pole and para-septal regions whereas a mutant that produces a larger LAM becomes multi-septated. Therefore, LAM plays critical and distinct roles at subcellular locations associated with division in mycobacteria, including maintenance of local cell wall integrity and septal placement.
Topics: Lipopolysaccharides; Mycobacterium smegmatis; Cell Wall; Mycobacterium tuberculosis
PubMed: 38467648
DOI: 10.1038/s41467-024-46565-5 -
FEMS Yeast Research Jan 2024The ∼1 200 known species in subphylum Saccharomycotina are a highly diverse clade of unicellular fungi. During its lifecycle, a typical yeast exhibits multiple cell...
The ∼1 200 known species in subphylum Saccharomycotina are a highly diverse clade of unicellular fungi. During its lifecycle, a typical yeast exhibits multiple cell types with various morphologies; these morphologies vary across Saccharomycotina species. Here, we synthesize the evolutionary dimensions of variation in cellular morphology of yeasts across the subphylum, focusing on variation in cell shape, cell size, type of budding, and filament production. Examination of 332 representative species across the subphylum revealed that the most common budding cell shapes are ovoid, spherical, and ellipsoidal, and that their average length and width is 5.6 µm and 3.6 µm, respectively. 58.4% of yeast species examined can produce filamentous cells, and 87.3% of species reproduce asexually by multilateral budding, which does not require utilization of cell polarity for mitosis. Interestingly, ∼1.8% of species examined have not been observed to produce budding cells, but rather only produce filaments of septate hyphae and/or pseudohyphae. 76.9% of yeast species examined have sexual cycle descriptions, with most producing one to four ascospores that are most commonly hat-shaped (37.4%). Systematic description of yeast cellular morphological diversity and reconstruction of its evolution promises to enrich our understanding of the evolutionary cell biology of this major fungal lineage.
Topics: Phylogeny; Ascomycota; Yeasts
PubMed: 38142225
DOI: 10.1093/femsyr/foad055 -
PloS One 2023The Pilbara craton of northwestern Australia is known for what were, when reported, the oldest known microfossils and paleosols on Earth. Both interpretations are mired...
The Pilbara craton of northwestern Australia is known for what were, when reported, the oldest known microfossils and paleosols on Earth. Both interpretations are mired in controversy, and neither remain the oldest known. Both the microfossils and the paleosols have been considered hydrothermal artefacts: carbon films of vents and a large hydrothermal cupola, respectively. This study resampled and analyzed putative paleosols within and below the Strelley Pool Formation (3.3 Ga), at four classic locations: Strelley Pool, Steer Ridge, Trendall Ridge, and Streckfuss, and also at newly discovered outcrops near Marble Bar. The same sequence of sedimentary facies and paleosols was newly recognized unconformably above the locality for microfossils in chert of the Apex Basalt (3.5 Ga) near Marble Bar. The fossiliferous Apex chert was not a hydrothermal vein but a thick (15 m) sedimentary interbed within a sequence of pillow basalts, which form an angular unconformity capped by the same pre-Strelley paleosol and Strelley Pool Formation facies found elsewhere in the Pilbara region. Baritic alluvial paleosols within the Strelley Pool Formation include common microfossil spindles (cf. Eopoikilofusa) distinct from marine microfossil communities with septate filaments (Primaevifilum) of cherts in the Apex and Mt Ada Basalts. Phosphorus and iron depletion in paleosols within and below the Strelley Pool Formation are evidence of soil communities of stable landscapes living under an atmosphere of high CO2 (2473 ± 134 ppmv or 8.8 ± 0.5 times preindustrial atmospheric level of 280 ppm) and low O2 (2181 ± 3018 ppmv or 0.01 ± 0.014 times modern).
Topics: Humans; Western Australia; Facies; Australia; Artifacts; Calcium Carbonate
PubMed: 37756287
DOI: 10.1371/journal.pone.0291074 -
Plant Disease Oct 2023Melon (Cucumis melo L.) is the second most exported fruit in Brazil with an annual production of 27.5 million tons (FAO 2023). From September 2019 through February 2020,...
Melon (Cucumis melo L.) is the second most exported fruit in Brazil with an annual production of 27.5 million tons (FAO 2023). From September 2019 through February 2020, 50-day-old melon plants started showing root rot symptoms (dark-brow necrotic zones in their roots that extended to the collar zone) in northeastern Brazil, 30% of the plants in the fields were affected by the disease. The fields are in clay soil where melon, in monoculture, is produced all year long with three cycles of the culture per year. A total of 132 samples from "Yellow" and "Cantaloupe" cultivars were collected from four melon fields (4°59'45.3"S, 37°33'39.7"W; 4°57'10.2"S, 37°31'37.1"W; 5°38'17.9"S, 37°56'27.7"W; and 5°00'25.5"S, 37°23'55.3"W). Small pieces of diseased tissues were surface disinfested in 70% ethanol for 30 sec, in 2% sodium hypochlorite for 1 min, washed in sterilized distilled water, plated on a PDA Petri dishes with tetracycline (0.05g/L), and incubated for seven days at 28 ± 2 ºC. Nine representative isolates were selected for downstream analysis. Colonies were white and later became dark gray, pycnidia and conidia were produced after 30 days ofncubation at 25°C under near-UV light in water-agar medium. Conidia were hyaline when immature and dark brown when mature, ranging from cylindrical subovoid to ellipsoidal and septate to non-septate, and with an average size of 12.54 to 21.97 µm. The colonies were morphologically identified as Lasiodiplodia sp. (Phillips et al. 2013). Total DNA from the isolates was extracted and the ITS, TUB, and TEF-1α genes (Jayawardena et al. 2019) were partially amplified by PCR, Sanger sequenced, and deposited in Genbank: ITS (OM102511 to OM102520), TUB (OR062087 to OR062094 and OR062095), and TEF-1α (OP536826 to OP536835). Blastn analysis of the partial sequences ITS (519bp), TUB (388bp), and TEF-1α (315bp) showed 100% nucleotide similarity of the isolates with sequences of L. brasiliensis and L. theobromae from the GenBank. A phylogenetic tree was constructed using the Maximum Parsimony Analysis method. All nine isolates were grouped into the L. brasiliensis clade with 71% bootstrap support, confirming the isolates's identity. Pathogenicity assays were conducted in a greenhouse using the wooden toothpick inoculation method (Nogueira et al. 2019). "Goldex" Yellow melon seedlings were used in a completely randomized experimental design, with 10 treatments (9 isolates + Mock) and six replicates, with one plant per pot. Plants were inoculated 15 days after sowing, and disease severity was evaluated 50 days after inoculation. All nine isolates caused symptoms in the assessed melon plants. The fungus was reisolated from the lesions and looked morphologically identical to the inoculated fungus, fulfilling Koch's postulates. The pathogenicity test was repeated and yielded similar results. All samples in this study were provided by melon growers who were concerned about the high incidence of root rot disease in their plantations. More research needs to be conducted to determine the epidemiology and the extension of the economic impact caused by this pathogen to melons to develop strategies for disease control to properly assist the growers's concerns. This pathogen has been reported to cause disease in other crops in Brazil, e.g., watermelon (Alves et al. 2023) and apples (Martins et al. 2018). However, to the best of our knowledge, this is the first report of L. brasiliensis causing root rot in melons in Brazil.
PubMed: 37807088
DOI: 10.1094/PDIS-07-23-1443-PDN