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Objective: To assess the incidence, risk, and associated factors that contribute to an acquired surgical site infection (SSI) after emergency cesarean section (CS)., Methods: This retrospective case-control study was conducted in an acute district general hospital in England with 206 patients (101 SSI patients and 105 non-SSI patients) who had an emergency CS in 2017. Grade of surgeon, smoking status, preoperative vaginal swab status (positive or negative), diabetes status, age, body mass index, membrane rupture to delivery interval, and length of surgery were recorded. Risk factors were identified using simple and multiple logistic regression., Results: Body mass index was significantly associated with SSI (odds ratio, 1.17; 95% confidence interval, 1.11 to 1.24; P < .001). Further, substantive nonsignificant associations were recorded between SSI and patient age and vaginal swab status., Conclusions: Body mass index was the only significant risk factor for the development of an SSI after emergency CS, possibly because of the impact of excessive adipose tissue on the immune system and reduced effectiveness of antibiotics. Diabetes status, patient age, and preoperative vaginal swab status were not significantly associated with SSI. Improved guidelines and strategies for managing at-risk patients would enable clinicians to reduce the risk of SSI development. The importance of wound management including frequent wound cleaning, appropriate dressings, dressing changes, and education is highlighted. Future research on larger samples should be conducted to validate these findings., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Background: One area of space suits that is ripe for innovation is the glove. Existing models allow for some fine motor control, but the power grip--the act of grasping a bar--is cumbersome due to high torque requirements at the knuckle or metacarpal phalangeal joint (MCP). This area in particular is also a major source of complaints of pain and injury as reported by astronauts., Method: This paper explores a novel fabrication and patterning technique that allows for more freedom of movement and less pain at this crucial joint in the manned space suit glove. The improvements are evaluated through unmanned testing, manned testing while depressurized in a vacuum glove box, and pressurized testing with a robotic hand., Results: MCP joint flex score improved from 6 to 6.75 (out of 10) in the final glove relative to the baseline glove, and torque required for flexion decreased an average of 17% across all fingers. Qualitative assessments during unpressurized and depressurized manned testing also indicated the final glove was more comfortable than the baseline glove., Discussion: The quantitative results from both human subject questionnaires and robotic torque evaluation suggest that the final iteration of the glove design enables flexion at the MCP joint with less torque and more comfort than the baseline glove.

Chlamydia trachomatis is an obligate intracellular mucosotropic pathogen that causes human infections of global importance. C. trachomatis causes trachoma, the leading cause of preventable blindness worldwide, and is the most common cause of bacterial sexually transmitted disease. Although oculogenital infections are treatable with antibiotics, a vaccine is needed to control C. trachomatis infection. Ideally, a vaccine would provide coverage against most, if not all, naturally occurring antigenically distinct serovariants. The development of a subunit vaccine to prevent oculogenital disease could be advanced by identifying chlamydial antigens that elicit pan-neutralizing antibodies, particularly among infected human populations of known risk factors. There is currently no objective high-throughput in vitro assay to screen human sera for neutralization to aid in identification of these antigens. This report describes an objective, high-throughput in vitro assay that measures C. trachomatis-neutralizing antibodies. Antibody-mediated neutralization of chlamydial infection was performed in a 96-well microtiter format, and neutralization was quantified by immunostaining fixed cells followed by automated fluorometric analysis. This report shows that fluorometric analysis of C. trachomatis infection directly correlates to labor-intensive manual inclusion counts. Furthermore, this report shows that fluorometry can be used to identify C. trachomatis serovar- and serocomplex-specific neutralization. This objective, high-throughput analysis of serum neutralization is amenable to epidemiological studies of human chlamydial infection, human clinical vaccine trials, and preclinical animal model experiments of Chlamydia infection.

Cervical choristoma is a rare tumor of the head and neck. Definition of the embryology of this unusual lesion and review of the literature concerning it suggests that its usual location can cause life threatening airway obstruction. A successfully managed case of a giant congenital choristoma is presented.

The case history is given of a 6-month-old girl who survived an attack of malignant hyperthermia that occurred during the repair of a cleft lip. We believe that this is the youngest such patient reported to date. The current concepts of the mechanisms of excessive heat production and muscular rigidity are presented. The need for constant awareness, early recognition, and prompt and proper treatment on the part of both the operating surgeon and the anesthesiologist are stressed to avoid a fatal outcome. Unfortunately, as yet there is no conclusive, consistent screening test available to identify those who will experience such an episode. Because a patient has once undergone general anesthesia uneventfully does not mean that malignant hyperthermia will not occur during a subsequent procedure or even during use of some amide local anesthetics.