Gertsenengland0165

Sepsis remains a leading cause of morbidity and mortality in the neonatal population, and at present, there is no unified definition of neonatal sepsis. Existing consensus sepsis definitions within paediatrics are not suited for use in the NICU and do not address sepsis in the premature population. Many neonatal research and surveillance networks have criteria for the definition of sepsis within their publications though these vary greatly and there is typically a heavy emphasis on microbiological culture. selleck The concept of organ dysfunction as a diagnostic criterion for sepsis is rarely considered in neonatal literature, and it remains unclear how to most accurately screen neonates for organ dysfunction. Accurately defining and screening for sepsis is important for clinical management, health service design and future research. The progress made by the Sepsis-3 group provides a roadmap of how definitions and screening criteria may be developed. Similar initiatives in neonatology are likely to be more challenging and would need to account for the unique presentation of sepsis in term and premature neonates. The outputs of similar consensus work within neonatology should be twofold a validated definition of neonatal sepsis and screening criteria to identify at-risk patients earlier in their clinical course. IMPACT There is currently no consensus definition of neonatal sepsis and the definitions that are currently in use are varied. A consensus definition of neonatal sepsis would benefit clinicians, patients and researchers. Recent progress in adults with publication of Sepsis-3 provides guidance on how a consensus definition and screening criteria for sepsis could be produced in neonatology. We discuss common themes and potential shortcomings in sepsis definitions within neonatology. We highlight the need for a consensus definition of neonatal sepsis and the challenges that this task poses.BACKGROUND To investigate the relationship between unexplained indirect hyperbilirubinemia of Vietnamese newborns and the polymorphism of the promoter TATA box and exon 1 of bilirubin uridine diphosphate glucuronosyltransferase (UGT1A1) gene. METHODS A total of 149 neonates were divided into the hyperbilirubinemia group (n = 99) and control group (n = 50). The gene polymorphisms of UGT1A1 gene in the two groups were detected by PCR and direct sequencing, which revealed the relationship between UGT1A1 polymorphism with neonatal hyperbilirubinemia of neonates. The types of UGT1A1 polymorphism in the hyperbilirubinemia group and the peak total serum bilirubin (PSB) levels with different genotypes were observed. RESULTS (1) (TA)7 insertion mutation, 211G>A, 189C>T, 190G>A, 378C>T and 686C>A were detected. (2) The allele frequency of 211G>A allele mutation was significantly different between the two groups (p A polymorphism was related to the degree of hyperbilirubinemia. IMPACT Our article provided data on UGT1A1 polymorphism distribution in the Vietnamese population, which have not been reported yet.Our findings revealed that mutations in UGT1A1 gene are risk factors for unexplained hyperbilirubinemia in Vietnamese neonates.Our article will strengthen the cognition of neonatal jaundice at the genetic level in the pediatric field in Vietnam.Memory for prior drinking experiences may powerfully drive later alcohol use in familiar drinking contexts, yet we know little about what patients with alcohol use disorder (AUD) remember of alcohol-related episodes. Although animal and theoretical models of addiction emphasize the importance of different memory systems for understanding maladaptive use, clinical research parsing what AUD patients remember from alcohol-related episodes is lacking. The current study applied a novel memory task in which moderate drinkers (N = 30) and treatment-seeking individuals with alcohol use disorder (AUD N = 29) encoded associations between photographs of objects (alcoholic beverages and neutral items) and photographs of neutral scenes. At least 24 h later, two types of memory were assessed item memory (object recognition) and associative memory (cued recognition of scenes associated with objects). To assess which memories predicted drinking, real-world behavior was assessed in patients with AUD at baseline and for 4 weeks following memory tests. link2 Despite demographic differences, the results showed broadly impaired item memory in AUD compared with moderate drinkers (p  less then  0.001), but enhanced associative memory for scenes paired with alcohol (p = 0.015). These associative memory biases were especially pronounced for stimuli rated as more affectively salient. Furthermore, stronger but less detailed memory for alcohol-related associations (i.e., choosing the correct scene but the incorrect photograph) significantly predicted heavier baseline (p = 0.002) and higher subsequent (p = 0.01) drinking in patients with AUD. These findings reveal a novel alcohol-related memory bias in AUD, and uncover the importance of associative memory for understanding real-world heavy alcohol use.OBJECTIVES To observed the relationship between serum 25-hydroxyvitamin D (25-(OH) D) and different cognitive domains and evaluated the predictive value of 25-(OH) D level for cognitive impairment in patients with white matter lesions (WML). METHODS The Mini-mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) were used to evaluate cognitive function in patients with WML. The differences in clinical data including 25-(OH) D were analysed between cognitive normality (n=87) and impairment (n=139) groups and variant cognitive domains analysed between groups of different levels of serum 25-(OH) D. And risk factors for cognitive impairments were evaluated with multivariate logistic regression analysis and receiver operating characteristic (ROC) curve of 25-(OH) D level were performed to examine the association between 25-(OH) D and WML with cognitive dysfunction. Results： As the severity of WML increased, the proportion of patients with low level of serum 25-(OH) D increased (P less then 0.05) . The total MoCA scores and its all domain scores except for naming were significantly lower in patients with low levels of serum 25-(OH) D than that in patients with high levels of serum 25-(OH) D (P less then 0.05). Multivariate logistic regression analyses showed that the serum 25-(OH) D levels, age, lower education level, hypertension, Systolic pressure, stroke, TC and uric acid levels were independently correlated with cognitive impairment. Conclusion：In patients with WML, low levels of serum 25-(OH) D is correlated with impairments of multiple cognitive domains and is an independent risk factor for cognitive impairment. © 2020 The Author(s). Published by S. link3 Karger AG, Basel.PURPOSE To review visual outcomes in untreated premacular membrane (PMM) with macular pucker (MP) and evaluate novel predictors of progression. METHODS In this retrospective observation study, we included 342 eyes with untreated PMM with MP between 2012 and 2015. PMMs were characterized by spectral-domain optical coherence tomography (SD-OCT) imaging based on foveal morphologies, number of retinal contraction centers, central subfield thickness (CST), inner segment ellipsoid band integrity, and photoreceptor deformation index. Additionally, the thickened retina portion was identified by en face OCT and processed digitally to calculate its area. Parameters were retrospectively analyzed using multiple regression analyses to identify associations with change in visual acuity (VA) between initial to final follow-up visit. RESULTS In 468 eyes with untreated PMM, VA and CST did not change significantly during a mean observation period of 448 days (p = 0.52 and 0.35, respectively). Specifically, VA improved or stayed the same in 80% and worsened by 2 lines or more in 20% of eyes. The only consistent predictor of PMM progression was area of retinal thickening for every 1 mm2 of retinal thickening at baseline, the odds of having worsened vision at follow-up increased by 6% (OR 1.0606, 95% CI 1.0031-1.1214, p = 0.0387). CONCLUSIONS The majority of eyes with PMM and good visual function at baseline remain stable or spontaneously improve in VA and macular thickness. Area of retinal thickening as evaluated by en face OCT may be a novel predictor of vision loss in untreated PMM with MP. © 2019 S. Karger AG, Basel.INTRODUCTION Noise-induced hearing loss (NIHL) is a common occupational disease that represents an irreversible hearing damage to the auditory system. It has been identified as a complicated disease involving both environmental and genetic factors. More efforts need to be made to explore the genes associated with susceptibility to NIHL. The main aim of this research is to detect the associations between SIK3 polymorphisms and NIHL susceptibility in Han people in China. METHODS A case-control study was performed in 586 cases and 639 controls in a textile factory matched for sex, age, smoking, drinking, work time with noise, and intensity of noise exposure. Three single nucleotide polymorphisms (SNPs) (rs493134, rs6589574, and rs7121898) of SIK3 were genotyped in the participants. Then, the main influences of the SNPs on and their interactions with NIHL were assessed. RESULTS Under the allelic model, distributions of rs493134 T, rs6589574 G, and rs7121898 A in the NIHL group are statistically different from those of the normal group (p = 0.001, p less then 0.001, and p = 0.019, respectively). The following haplotype analysis shows that TAA (rs493134-rs6589574-rs7121898) may have a protective effect, while TGA (rs493134-rs6589574-rs7121898) (OR = 1.49, 95% CI = 1.25-1.79) may be a risk factor for NIHL. Multifactor dimensionality reduction analysis shows that the interaction of the 3 selected SNPs is associated with NIHL susceptibility (OR = 1.88, 95% CI = 1.50-2.36). CONCLUSION The results suggest that 3 SNPs (rs493134, rs6589574, and rs7121898) of SIK3 may be an important part of NIHL susceptibility and can be applied in the prevention, early diagnosis, and treatment of NIHL in noise-exposed Chinese workers. © 2020 S. Karger AG, Basel.BACKGROUND/AIMS This study aimed to investigate the level of soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) and its correlation with micro-inflammation and atherosclerosis in continuous ambulatory peritoneal dialysis (PD) patients. METHODS This retrospective study involved 23 healthy subjects (control group), 23 hemodialysis (HD) patients (HD group) and 26 PD patients (PD group). Serum biochemical measurements and sTWEAK assessments were tested. The association between intima-media thickness (IMT) and sTWEAK concentrations was evaluated. RESULTS The TWEAK level was lower in PD (155.16 ± 3.69 pg/mL, p 161.9 pg/mL) had a lower IMT (0.97 ± 0.04 vs. 0.84 ± 0.03 cm, p = 0.029). After adjusted for sex, age, hypertension, diabetes, duration of dialysis, triglyceride, total cholesterol, low-density lipoprotein, and serum glucose, sTWEAK (B = -0.002, r = 0.015) and CRP (B = 0.022, r = 0.015) were independent risk factors for the IMT of ESRD patients. CONCLUSION Plasma TWEAK is inversely associated with carotid IMT among patients undergoing HD and PD. © 2020 S. Karger AG, Basel.