Elevated maternal serum-free β-human chorionic gonadotropin (β-hCG) and reduced risk of spontaneous preterm delivery*

Objective: To evaluate the relationship between first and second trimester maternal serum-free β-hCG and the risk of spontaneous preterm delivery (PTD).

Study design: This was a case-control study of women evaluated and delivered at our institution from 2011 to 2015. Spontaneous PTD was defined as delivery before 37 weeks due to spontaneous preterm labor or premature rupture of membranes. Patient with multifetal gestation and those with medically indicated term or PTD were excluded.

Results: Of 877 women meeting the inclusion criteria, 173 delivered preterm and 704 delivered at term, and 8.1% had high free β-hCG in one or both trimesters. High maternal first and/or second trimester free β-hCG (≥95th percentile) was associated with lower rates of PTD. Thirty-two women with high free β-hCG in both first and second trimesters delivered at term. Gestational age at delivery and birth weights were lower in women who did not have high free β-hCG in any trimester. Low free β-hCG (≤5th percentile) in either trimester was not associated with an increased or decreased likelihood of PTD. Logistic regression demonstrated an independent association of high free β-hCG (≥95th percentile) with a reduced likelihood of PTD. Stratified analysis revealed a stronger impact of this association in women with no prior history of PTD.

Conclusions: High free β-hCG, in the absence of risk factors for medically indicated PTD, is associated with a reduced likelihood of spontaneous PTD and may represent a marker indicating lower risk.     

Longitudinal associations between circulating interleukin-6 and C-reactive protein in childhood,and eating disorders and disordered eating in adolescence

ObjectiveFew studies have explored the association between inflammation and eating disorders and none used a longitudinal design. We investigated the association between serum-levels of interleukin 6 (IL-6) and C-reactive protein (CRP) measured in childhood and eating disorders and related behaviours and cognitions in adolescence in a large general population sample.MethodsWe used data from the Avon Longitudinal Study of Parents and Children (ALSPAC). Our exposures were thirds of IL6 and CRP derived from serum measurements taken at age nine years, and outcomes were eating disorder diagnoses and self-reported disordered eating behaviours at ages 14, 16, and 18 years. We used univariable and multivariable multilevel logistic regression models adjusting for a number of potential confounders, including sex, fat mass, and pre-existing mental health difficulties.ResultsOur sample included 3480 children. Those in the top third of CRP had lower odds of binge eating (odds ratio(OR):0.62, 95% confidence interval (CI):0.39,1.00,p “equals” 0.05) and fasting (OR:0.63, 95% CI:0.38,1.07,p “equals” 0.09) after adjustment for confounders. We also observed weak associations of comparable magnitude for purging, anorexia nervosa, and bulimia nervosa. We did not find any associations between levels of IL6 and any of the outcomes under study.ConclusionsThere was little evidence of an association between CRP and IL-6 and adolescent eating disorder outcomes. The inverse association observed between CRP and binge eating was unexpected, so caution is needed when interpreting it. One possible explanation is that higher CRP levels could have a protective role for disordered eating by affecting appetitive traits.     

Influence of early-life factors on the development of endometriosis

Objective: Our aim was to study the association between early-life factors and the development of endometriosis.

Methods: This case–control study included 440 women with surgically confirmed endometriosis (cases) and 880 women without endometriosis (controls). Information on early-life factors was ascertained retrospectively by in-person interviews with participants and their mothers. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between endometriosis and maternal and paternal characteristics and foetal and infant exposures were estimated using unconditional logistic regression, adjusting for frequency matching and confounding variables.

Results: We observed that women who were not breastfed as infants had twice the risk of endometriosis compared with women who were breastfed (adjusted OR 2.0; 95% CI 1.6, 4.5). Our data suggested an increased endometriosis risk with neonatal vaginal bleeding (adjusted OR 1.9; 95% CI 1.2, 4.3) and paternal smoking (adjusted OR 1.8; 95% CI 1.1, 4.9). Although the CIs included the null hypothesis value, caesarean section (adjusted OR 1.7; 95% CI 1.0, 3.5) and prematurity (adjusted OR 1.4; 95% CI 0.8, 3.7) were probably associated with the incidence of endometriosis.

Conclusions: Some early-life factors including breastfeeding, neonatal vaginal bleeding and paternal smoking were associated with subsequent, surgically confirmed endometriosis in this cohort of Chinese women.     

青光眼患者构成特点的统计学研究

目的：探讨门诊青光眼的疾病构成与年龄、性别分布及其变化特点，并与住院青光眼患者调查资料对比，分析其差异原因，为青光眼的防治研究提供新的流行病学资料。方法调查535例门诊青光眼患者的年龄、性别分布及不同类型青光眼的构成比等特点，并与本院近5年住院患者的调查结果进行比较。结果原发性闭角型青光眼274例、开角型青光眼108例、继发性青光眼93例、先天性青光眼60例，分别占门诊青光眼患者总数的51.21%、20.19%、17.39%和11.21%；其男女比例分别为1∶1.88、3.5∶1、2.44∶1和1∶1.07；原发性青光眼的构成比例中，PACG与POAG之比为2.54∶1。结论原发性闭角型青光眼和继发性青光眼仍为主要类型，且随着年龄增长，发病率有逐渐增高的趋势，是今后防盲致盲工作的两个重点。     

Data integration,analysis, and interpretation of eight academic CLARITY-BPA studies

“Consortium Linking Academic and Regulatory Insights on BPA Toxicity” (CLARITY-BPA) was a comprehensive “industry-standard” Good Laboratory Practice (GLP)-compliant 2-year chronic exposure study of bisphenol A (BPA) toxicity that was supplemented by hypothesis-driven independent investigator-initiated studies. The investigator-initiated studies were focused on integrating disease-associated, molecular, and physiological endpoints previously found by academic scientists into an industry standard guideline-compliant toxicity study. Thus, the goal of this collaboration was to provide a more comprehensive dataset upon which to base safety standards and to determine whether industry-standard tests are as sensitive and predictive as molecular and disease-associated endpoints. The goal of this report is to integrate the findings from the investigator-initiated studies into a comprehensive overview of the observed impacts of BPA across the multiple organs and systems analyzed. For each organ system, we provide the rationale for the study, an overview of methodology, and summarize major findings. We then compare the results of the CLARITY-BPA studies across organ systems with the results of previous peer-reviewed studies from independent labs. Finally, we discuss potential influences that contributed to differences between studies. Developmental exposure to BPA can lead to adverse effects in multiple organs systems, including the brain, prostate gland, urinary tract, ovary, mammary gland, and heart. As published previously, many effects were at the lowest dose tested, 2.5μg/kg /day, and many of the responses were non-monotonic. Because the low dose of BPA affected endpoints in the same animals across organs evaluated in different labs, we conclude that these are biologically – and toxicologically – relevant.     

An assessment of weight change associated with the initiation of a protease or integrase strand transfer inhibitor in patients with human immunodeficiency virus

Abstract

Objective

Evidence suggests that integrase strand transfer inhibitors (INSTIs) are associated with greater weight gain than other antiretrovirals. This real-world study compares weight/body mass index (BMI) change between insured US patients with human immunodeficiency virus (HIV-1) initiating a protease inhibitor (PI) or INSTI.     

布洛芬混悬滴剂和对乙酰氨基酚治疗小儿热性惊厥的疗效观察

目的 观察布洛芬混悬滴剂和对乙酰氨基酚治疗小儿热性惊厥(FS)的疗效。方法 选取2017年4月—2019年4月于本院就诊的FS患儿80例,随机分为对照组与观察组,每组40例,均进行抗惊厥、物理降温等常规治疗,在此基础上,对照组采用对乙酰氨基酚治疗,观察组采用布洛芬混悬滴剂治疗,观察2组临床疗效、退热效果、实验室检查结果(血红蛋白、血钠、血钙)及不良反应情况。结果 对照组治疗总有效率为77.5%,观察组为95%,差异有统计学意义(P<0.05);治疗后1 h,2组患儿体温差异无统计学意义(P>0.05),治疗后3 h、6 h,2组体温均低于服药前,观察组患儿体温低于对照组,差异有统计学意义(P<0.05);治疗后,2组血红蛋白、血钠、血钙浓度较服药前均显著升高(P<0.05),且观察组高于对照组(P<0.05);对照组不良反应率为7.5%,观察组为5%,差异无统计学意义(P>0.05)。结论 布洛芬混悬滴剂对小儿热性惊厥临床症状改善作用显著,值得推介。