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“Background: Up to 15% of infants
with asymptomatic congenital cytomegalovirus (CMV) infection will experience some degree of sensorineural hearing loss. Many infants who fail newborn hearing screening (NHS) are likely to have congenital CMV infection, but may escape definitive virologic identification because diagnostic evaluation may not commence until several weeks or months of age, making differentiation between congenital and postnatal see more CMV infection difficult. Early diagnosis linking virologic identification of congenital CMV infection to infants failing NHS may improve diagnostic precision and enhance opportunities for therapeutic intervention.
Methods: The goal of this study was to compare newborn dried blood spots from Minnesota infants who had failed NHS, and were designated for referral, with control infants who passed NHS, for the presence of CMV DNA by real-time PCR, using hybridization probes for the CMV gene UL54.
Results: Of 479 infants with a failed NHS (bilateral failure), 13 had CMV DNA present in the blood spot (2.7%). This compared with only 2/479 positive results from a control group of infants who passed the NHS (0.4%; P = 0.007, Fisher exact test). Comparisons of the glycoprotein B (gB) genotype as well as direct
DNA sequencing of selected positives revealed that PCR positive samples represented unique clinical isolates. The mean viral load among the 15 positive MDV3100 molecular weight samples BYL719 was 1.6 x 10(3) genomes/microgram of total DNA.
Conclusions: Newborn bloodspot CMV screening by real-time PCR may be a useful and rapid adjunct to functional NHS and may enable more rapid etiologic diagnosis of sensorineural hearing loss in newborns.”
“Study Design. Systematic literature review.
Objective. A systematic review was designed to answer 3 primary research questions: (1) What is the most useful classification
system for surgical and nonsurgical decision-making with regard to thoracolumbar (TL) spine injuries? (2) For a TL burst fracture with incomplete neurologic deficit, what is the optimal surgical approach and stabilization technique? (3) Is complete disruption of the posterior ligamentous complex an indication for surgical intervention for TL burst fractures?
Summary of Background Data. Despite a long history of descriptive and clinical series, there remains considerable controversy and wide variation in the treatment of traumatic TL spine injuries.
Methods. A comprehensive search of the English literature was conducted using Medline and the Cochrane Database of Systematic Reviews. Standardized grading systems were used to assess the level of evidence and quality of articles impacting the research questions.
Results.