Accuracy and feasibility of point-of-care and continuous blood glucose analysis in critically ill ICU patients

Introduction  

To obtain strict glucose regulation, an accurate and feasible bedside glucometry method is essential. We evaluated three different types of point-of-care glucometry in seriously ill intensive care unit (ICU) patients. The study was performed as a single-centre, prospective, observational study in a 12-bed medical ICU of a university hospital.     

Fulminant infection with emphysematous changes in the biliary tract and air-filled liver abscesses

Gas-producing infections are related to anaerobic bacteria and usually associated with immunosuppressive pathologies such as diabetes and have a fulminating course. We present the clinical course of a patient with diabetes whose infection progressed rapidly and ended in her dramatic death in a short period; surgical therapy was impossible, and the disease behaved similarly to type I emphysematous pyelonephritis.     

Five siblings expand the spectrum of GPC6-related skeletal dysplasia

Skeletal dysplasias broadly include disorders of cartilage or bone. Omodysplasia-1 is a type of skeletal dysplasia caused by biallelic loss of function variants in the GPC6 gene. GPC6 codes for the protein glypican 6 (GPC6) (OMIM *604404), which stimulates bone growth. We report a family in which five out of nine children were presented with a skeletal dysplasia characterized phenotypically by mild short stature and rhizomelia. All affected individuals were found to have homozygous missense variants in GPC6: c.511 C>T (p.Arg171Trp). Radiograph findings included rhizomelic foreshortening of all four extremities, coxa breva, and ulna minus deformity. Using a Hedgehog (Hh) reporter assay, we demonstrate that the variant found in this family results in significantly reduced stimulation of Hh activity when compared to the wild-type GPC6 protein, however protein function is still present. Thus, the milder phenotype seen in the family presented is hypothesized due to decreased GPC6 protein activity versus complete loss of function as seen in omodysplasia-1. Given the unique phenotype and molecular mechanism, we propose that this family's findings widen the phenotypic spectrum of GPC6-related skeletal dysplasias.     

Digit ratios (2D:4D), postnatal testosterone and eye contact in toddlers

Previous research has shown an association between eye contact and prenatal testosterone measured in amniocenteses samples. The purpose of this study was to test the association between eye contact and prenatal androgen action measured via second to fourth digit ratios (2D:4D ratios), and to explore the relationship between eye contact and postnatal testosterone levels. Participants included 72 children, between the ages of 18 and 24 months, and their parents. Salivary testosterone levels were obtained when children were 3-months old. At 18-months, 2D:4D ratios were measured and parent–child dyads participated in an 8-min play session that was recorded and later coded for duration and frequency of eye contact. Results indicated that larger 2D:4D ratios (indicative of lower androgen levels) significantly predicted longer duration and more frequency of eye contact, while postnatal testosterone levels were unrelated to eye contact. These novel findings suggest prenatal androgens may influence the emergence of social development.     

Postnatal testosterone levels and disorder relevant behavior in the second year of life

The objective of the current study was to investigate the relationship between testosterone collected at 3–4 months of age and sex-linked disorder-relevant behaviors in the second year of life. Eighty-four children participated at 3–4 (when salivary testosterone levels were obtained and second to fourth digit ratios were measured) and 18–24 months of age (when behavioral ratings of aggression and verbal ability were coded from two 8-min play sessions). Parents also completed the Brief Infant–Toddler Social and Emotional Assessment, and the four subscales (Internalizing, Externalizing, Dysregulation, and Autism Spectrum Disorder) were used to indicate child specific problems. Greater postnatal testosterone levels in early infancy were predictive of more male-typical behaviors in the second year of life (i.e., more autism spectrum behaviors, less time vocalizing, and more Internalizing Problems). These results support the hypothesis that early infancy may be another critical period for the development of gender-linked behavior.