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but also showing its great potential to discover new diagnostic markers. Therefore, it not only can improve the efficiency of clinical diagnosis but also shorten the research period of researching a diagnosis basis to an extent. It has a positive significance to the development of the medical diagnosis level. © 2020 Liu et al.Objective We aimed to examine the effects of adding a longer-acting insulin glargine to existing glucose control on reducing blood-glucose fluctuations in an intensive care unit (ICU). Methods A total of 110 patients randomly received adjuvant insulin glargine 15 IU/day (glargine) or placebo (control), in addition to daily infusion of insulin to maintain glucose levels at a target of 140-180 mg/dL. End points were mean and variance of blood glucose and frequency of hypoglycemia, hyperglycemia, ICU stay, and mortality. Data were analyzed with repeated-measures ANOVA and Mann-Whitney U test. Results Average daily glucose level was significantly less in the glargine group than controls (P180 mg/dL) much longer among controls (P less then 0.001). Similar mortality rates were observed in both groups, while ICU length of stay was 2 days shorter in the glargine group. Conclusion Addition of insulin glargine to routine protocols more effectively reduces glucose levels and decreases incidence of hyperglycemic episodes and regular insulin usage. This adjustment may be associated with decreases in duration of ICU stay or increases in hypoglycemic events. © 2020 Nader et al.Background There has been a remarkable decline in the burden of malaria in the past few decades in Ethiopia. However, malaria remains a major impediment to both health and economic development in Ethiopia, with 60% of the population at risk of contracting malaria. Hence, this study aimed to estimate the economic burden of malaria among rural households in Chewaka district, Buno Bedele zone, Oromia regional state, Western Ethiopia. see more Methods Community-based cross-sectional study design was employed to estimate the economic burden of malaria at the household level from August 13 to September 2, 2018. A retrospective costing approach was employed, and cost was estimated from the perspective of households. The study included malaria expenditure of households during a one-year period (July 9, 2017 to July 9, 2018). Data were collected from 765 randomly selected households and analyzed using SPSS version 20. Multivariate logistic regression analysis was performed to identify predictors of the economic burden of malar number of malaria "ill days" and type of malaria diagnosis. Conclusion Malaria continues to significantly impose an economic burden on the rural households of Ethiopia. Hence, the national malaria program needs to recognize and address the catastrophic costs associated with malaria illness. Efforts should be made to ensure universal access to and utilization of malaria prevention, diagnosis, and treatment services. © 2020 Tefera et al.Background Mycoplasma pneumoniae pneumonia (MPP) is a common community-acquired pneumonia (CAP) in children, which may become refractory MPP (RMPP) to treatment. Objective The purpose of this study was to evaluate the clinical utility of measuring serum interleukin (IL)-17A to predict RMPP. Patients and Methods A retrospective clinical study at a single pediatric center included a review of the medical records of all children hospitalized for CAP between November 2015 and October 2019. The diagnosis of MPP was based on clinical presentation, chest radiography, and measurement of serum anti-Mycoplasma immunoglobulin IgM antibody titer using the microparticle agglutination method or sputum samples for Mycoplasma pneumoniae by PCR. Serum levels of IL-18 and IL-17A were determined by ELISA. Results Of the 625 children diagnosed with CAP, there were 154 children with MPP and without underlying diseases who were divided into a non-refractory MPP (NRMPP) group (n = 109) and a RMPP group (n = 45). The RMPP group had a higher incidence of tachypnea, cyanosis, hypoxia, segmental or lobar pneumonia, pleural effusion, and a longer period of hospitalization compared with NRMPP group (all P-values less then 0.05). A serum IL-17A level above 10.8 pg/mL was a predictor for RMPP area under the curve (AUC) 0.822; standard error (SE) 0.039; 95% confidence interval (CI) 0.746-0.897; diagnostic sensitivity and specificity of 77.8% and 77.1%, respectively. An LDH level above 436.5 IU/L and an IL-18 level above 464.5 pg/mL were the second most useful markers for RMPP AUC 0.775, 0.775; SE 0.038, 0.039; 95% CI 0.700-0.850, 0.698-0.852; sensitivity 77.8%, 82.2%; specificity 62.4%, 59.6%; respectively. Conclusion This preliminary study of MPP in a pediatric population has shown that measurement of serum IL-17A may be a useful marker for the predictor of RMPP. © 2020 Zhao et al.Objective This study assessed the possible effect of syphilis co-infection in the brain function in young HIV patients by using voxel-wise degree centrality (DC) analysis. Methods Forty-four syphilis-co-infected HIV patients (HIV+/syphilis+), 45 HIV patients without syphilis history (HIV+/syphilis-) and 43 matched healthy controls (HC) underwent resting-state fMRI examinations. Laboratory tests and a battery of neuropsychological tests were performed before each MRI examination. One-way ANOVA was used to compare the differences of DC among the three groups. The correlations between MRI metrics and laboratory/neuropsychological tests in each patient's group were performed by Pearson correlation analysis. Results Compared with HIV+/syphilis-, worse performance in complex motor skills was found in HIV+/syphilis+. Compared with HC, HIV+/syphilis+ and HIV+/syphilis- groups showed attenuated DC in the right orbital frontal cortex and increased DC in the left parietal/temporal cortex. Besides, we also found increased DC in the left inferior frontal cortex and bilateral posterior cingulated cortex/precuneus in HIV+/syphilis+ compared with HC. Moreover, compared with HIV+/syphilis-, HIV+/syphilis+ displayed decreased DC in the left middle occipital cortex. Additionally, in HIV+/syphilis+ group, the mean z value of DC was correlated to the CD4+ cell counts and the learning and delayed recall score. Conclusion Syphilis co-infection might be related to more brain functional reorganization in young HIV patients which could be reflected by DC value. © 2020 Zhang et al.

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