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Aneurysmal subarachnoid hemorrhage (SAH) during pregnancy is quite rare, however it has a high maternal mortality rate. A pregnant woman in the 16th gestational week was admitted to our hospital with a drowsy level of consciousness. A brain magnetic resonance (MR) image showed hemorrhage on the prepontine cistern, and both sylvian fissures, and MR angiography and cerebral digital subtraction angiography demonstrated an aneurysm at the left posterior inferior cerebellar artery (PICA). We performed endovascular coil embolization attempting to minimize radiation exposure. She was discharged with no neurologic deficit and delivered a healthy baby by cesarean section at the 38th week of gestation. This case study reported the shortest gestational period and this is the first report on an aneurysmal rupture arising from PICA which was treated using an endovascular method. Using an appropriate technique for reduced radiation exposure to the fetus and limited alterations in maternal-fetal physiology, endovascular coil embolization could guarantee good results in treatment of aneurysmal SAH in pregnant women.
Embolization, Posterior inferior cerebellar artery, Pregnancy, Radiation, Subarachnoid hemorrhage
Endovascular Treatment of a Ruptured Posterior Inferior Cerebellar Artery Aneurysm during Pregnancy
Ki Dae Kim, M.D., Chul Hoon Chang, M.D., Byung Yon Choi, M.D., and Young Jin Jung, M.D.corresponding author
Chikungunya has had a substantial impact on public health because of the magnitude of its epidemics and its highly debilitating symptoms. We estimated the seroprevalence, proportion of symptomatic cases, and proportion of chronic form of disease after introduction of chikungunya virus (CHIKV) in 2 cities in Brazil. We conducted the population-based study through household interviews and serologic surveys during October-December 2015. In Feira de Santana, we conducted a serologic survey of 385 persons; 57.1% were CHIKV-positive. Among them, 32.7% reported symptoms, and 68.1% contracted chronic chikungunya disease. A similar survey in Riachão do Jacuipe included 446 persons; 45.7% were CHIKV-positive, 41.2% reported symptoms, and 75.0% contracted the chronic form. Our data confirm intense CHIKV transmission during the continuing epidemic. Chronic pain developed in a high proportion of patients. We recommend training health professionals in management of chronic pain, which will improve the quality of life of chikungunya-affected persons.
chikungunya virus, CHIKV, survey, seroprevalence, incidence, attack rate, mosquito, viruses, vector-borne infections, Brazil
Seroprevalence of Chikungunya Virus after Its Emergence in Brazil
Juarez P. Dias, Maria da Conceicão N. Costa, Gubio Soares Campos, Enny S. Paixão, Marcio S. Natividade, Florisneide R. Barreto, Martha Suely C. Itaparica, Cristina Goes, Francisca L.S. Oliveira, Eloisa B. Santana, Neusa S.J. Silva, Carlos A.A. Brito, Laura C. Rodrigues, Silvia Inez Sardi, Ramon C. Saavedra, and Maria Gloria Teixeiracorresponding author
Estimates of genetic effective population size (Ne) using molecular markers are a potentially useful tool for the management of endangered through to commercial species. However, pitfalls are predicted when the effective size is large because estimates require large numbers of samples from wild populations for statistical validity. Our simulations showed that linkage disequilibrium estimates of Ne up to 10,000 with finite confidence limits can be achieved with sample sizes of approximately 5000. This number was deduced from empirical allele frequencies of seven polymorphic microsatellite loci in a commercially harvested fisheries species, the narrow-barred Spanish mackerel (Scomberomorus commerson). As expected, the smallest SD of Ne estimates occurred when low-frequency alleles were excluded. Additional simulations indicated that the linkage disequilibrium method was sensitive to small numbers of genotypes from cryptic species or conspecific immigrants. A correspondence analysis algorithm was developed to detect and remove outlier genotypes that could possibly be inadvertently sampled from cryptic species or nonbreeding immigrants from genetically separate populations. Simulations demonstrated the value of this approach in Spanish mackerel data. When putative immigrants were removed from the empirical data, 95% of the Ne estimates from jacknife resampling were greater than 24,000.
effective population size, bias, nontarget populations, correspondence analysis, outliers
Linkage Disequilibrium Estimation of Effective Population Size with Immigrants from Divergent Populations: A Case Study on Spanish Mackerel (Scomberomorus commerson)
Gilbert Michael Macbeth,*,1 Damien Broderick,* Rik C. Buckworth,† and Jennifer R. Ovenden*