Aneuploidy ; Attitude to Health ; Female ; Fetal Diseases ; diagnosis ; Humans ; Informed Consent ; psychology ; Pregnancy ; Prenatal Diagnosis ; psychology

Aneuploidy ; Attitude to Health ; Female ; Fetal Diseases ; diagnosis ; Humans ; Informed Consent ; psychology ; Pregnancy ; Prenatal Diagnosis ; psychology

INTRODUCTIONAneuploidy screening is widely practised in the field of obstetrics in current times. This study thus aims to gain an insight on pregnant women's knowledge and risk perception of Down syndrome and first trimester screening (FTS), as well as their views on various potential pregnancy outcomes and how these may affect their decision-making processes.

MATERIALS AND METHODSA cross-sectional questionnaire-based qualitative study of consecutive 50 women choosing to undergo FTS at KK Women's and Children's Hospital (KKH), Singapore was conducted. The women completed a questionnaire after their FTS pretest counselling session. Basic knowledge of Down syndrome and FTS as well as participants' risk perception with regards to various cut-off values used in FTS were examined. Patients' views of various potential pregnancy outcomes were also studied.

RESULTSMost patients had good retention and comprehension of what FTS entailed after a FTS counselling session at the KKH Antenatal Monitoring Clinic. However, knowledge of the risks of invasive diagnostic testing was poor. Patients also did not possess an adequate understanding of FTS risk values. With regards to risk perception, patients had very different views on acceptable pregnancy outcomes and what constituted a high-risk FTS value to them personally. A significant number of women were concerned even at medically low-risk values of 1:500 and 1:1000 in FTS. The majority of patients viewed highest detection rate followed by a lowest false positive rate as the more important factors impacting their choice of a Down syndrome screening test.

CONCLUSIONThis study demonstrates the diversity of pregnant women's risk perception, risk aversion and participation in decision processes when there are 2 different values in competition. The study also highlights our patients' gaps in knowledge and lack of understanding of risk values used in FTS.

Adult ; Aneuploidy ; Cross-Sectional Studies ; Decision Making ; Down Syndrome ; diagnosis ; Female ; Humans ; Personal Autonomy ; Pregnancy ; Prenatal Diagnosis ; Risk Assessment ; Singapore ; Surveys and Questionnaires

Background: Acinetobacter baumannii infections cause high morbidity and mortality in intensive care unit (ICU) patients. However, there are limited data on the changes of longterm epidemiology of imipenem resistance in A. baumannii bacteremia among pediatric ICU (PICU) patients. Methods: A retrospective review was performed on patients with A. baumannii bacteremia in PICU of a tertiary teaching hospital from 2000 to 2016. Antimicrobial susceptibility tests, multilocus sequence typing (MLST), and polymerase chain reaction for antimicrobial resistance genes were performed for available isolates. Results: A. baumannii bacteremia occurred in 27 patients; imipenem-sensitive A. baumannii (ISAB, n = 10, 37%) and imipenem-resistant A. baumannii (IRAB, n = 17, 63%). There was a clear shift in the antibiogram of A. baumannii during the study period. From 2000 to 2003, all isolates were ISAB (n = 6). From 2005 to 2008, both IRAB (n = 5) and ISAB (n = 4) were isolated. However, from 2009, all isolates were IRAB (n = 12). Ten isolates were available for additional test and confirmed as IRAB. MLST analysis showed that among 10 isolates, sequence type 138 was predominant (n = 7). All 10 isolates were positive for OXA-23-like and OXA-51-like carbapenemase. Of 27 bacteremia patients, 11 were male (41%), the median age at bacteremia onset was 5.2 years (range, 0–18.6 years). In 33% (9/27) of patients, A. baumannii was isolated from tracheal aspirate prior to development of bacteremia (median, 8 days; range, 5–124 days). The overall case-fatality rate was 63% (17/27) within 28 days. There was no statistical difference in the case fatality rate between ISAB and IRAB groups (50% vs. 71%; P = 0.422). Conclusion IRAB bacteremia causes serious threat in patients in PICU. Proactive infection control measures and antimicrobial stewardship are crucial for managing IRAB infection in PICU.

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The aim of this study was to investigate antimicrobial effect of oleanolic acid (OA), ursolic acid (UA), and sophoraflavanone G against Enterococcus faecalis and Propionibacterium acnes, which are the major causative bacteria of endodontic infections. The antimicrobial activity was evaluated by the minimal inhibitory concentration (MIC). The data showed that the OA, UA, and sophoraflavanone G had antimicrobial effect on all the strains use in the study with 16-64 microg/ml, 8-64 microg/ml, and 1-8 microg/ml of MIC values, respectively. These results indicate that OA, UA, and sophoraflavanone G could be useful in the development of antiseptic solution for washing the root canal in endodontic treatments.
Bacteria ; Dental Pulp Cavity ; Enterococcus faecalis* ; Oleanolic Acid* ; Propionibacterium acnes*