Customized compared to population-based centiles for detecting term small for gestational age infants in Greece.

BACKGROUND: Applying customized centiles may improve the accuracy of detecting small for gestational age (SGA) infants; however, the evidence is inconclusive whether adjusted centiles are more sensitive in identifying infants at increased risk of morbidity. We aimed to examine the validity of customized centiles in a Greek cohort and evaluate their performance compared to population-based centiles in predicting infants at risk of increased morbidity. METHODS: We prospectively recorded the neonatal and maternal characteristics of singleton, low-risk, term infants over a year. Infants were defined as SGA if their birth weight was under the tenth centile, classified both by population-based centiles and customized centiles, adjusted for maternal and innate factors. We performed a comparative analysis utilizing linear regression analysis and calculating the receiver operating characteristics (ROC) curves. RESULTS: Overall 657 infants were identified. Population-based centiles detected 42 (6 %) SGA infants, while customized centiles 80 (12 %). Perinatal morbidity was associated with an odds ratio of 1.02 with customized centiles [95 % confidence interval (CI): 1.01-1.04] and with an odds ratio of 1.02 with population-based centiles (95 % CI: 1.02-1.02). In predicting perinatal morbidity, no significant difference was detected between customized centiles [area under the ROC curve 0.773 (95 % CI: 0.699-0.847)] and population-based centiles [area under the ROC curve 0.737 (95 % CI: 0.662-0.813)] (p =0.272). CONCLUSIONS: Customized centiles provided increased accuracy in comparison to the population-based centiles in detecting SGA term infants. However, customized centiles had no better impact on predicting a poor perinatal outcome. HIPPOKRATIA 2020, 24(3): 133-137.

Glutathion-S-Transferase P1 polymorphisms association with broncopulmonary dysplasia in preterm infants.

BACKGROUND: Oxidative stress, characterized by the excretion of pre-oxidative and anti-oxidative proteases, has a key role in the pathogenesis of bronchopulmonary dysplasia (BPD). One of the many host anti-oxidant enzymes is glutathione-S-transferase P1 (GSTP1), with three polymorphic alleles having been identified: homozygous ile, heterozygous ile/val and homozygous val isomorph. The aim of this study was to examine the genetic predisposition to BPD in the GSTP1 polymorphisms. METHODS: A prospective case-control study was carried out in the 2nd Neonatal Intensive Care Unit of Aristotle University in Thessaloniki, Greece during 2008. The genetic polymorphisms of GSTP1 in 28 preterms <32 weeks gestational age (GA) with BPD compared to 74 controls (33 preterms without BPD and 41 healthy terms) were examined. RESULTS: The homozygous ile isomorph was predominant in all groups (preterms with BPD: 82%, preterms without BPD: 70%, healthy terms: 78%), followed by the heterozygous ile/val (14%, 18% and 20% respectively) and the homozygous val isomorph (4%, 12% and 2% respectively). The homozygous ile isomorph was also identified in the majority of preterms with mild (80%), moderate (100%) and severe (73%) BPD. The GSTP1 genetic distribution did not differ between the groups and GSTP1 polymorphisms were not associated with the severity of BPD. CONCLUSIONS: This study could not confirm an association between GSTP1 polymorphisms and the development of BPD or the severity of the disease.

Cellular toxicity of mineral trioxide aggregate mixed with an alternative delivery vehicle.

OBJECTIVE: Mineral trioxide aggregate (MTA) mixed with water has a short working time, delayed setting, and poor consistency. A preliminary study suggested that substituting KY Jelly as a mixing vehicle improves the working properties of MTA. The present study compared the biocompatibility of white MTA mixed with water or with KY Jelly to that of Fuji II cement and of silver amalgam. STUDY DESIGN: Periodontal ligament (PDL) cells were cultured using standard laboratory procedures. Cells were plated in wells at a density of 10,000 cells/well. The test materials were mixed and eluate placed in contact with the PDL cells. Cell viability was determined by measuring mitochondrial enzyme activity using the 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenytl)-2H-tetrazolium inner salt assay. Cytotoxicity was also measured in terms of cell lysis using the lactate dehydrogenase assay. The assays were completed in triplicate after time intervals of 24, 48, and 72 h. Mean cell counts were calculated and converted to a percentage of control results. A 2-way analysis of variance and Tukey honestly significant difference post-hoc test were performed to determine statistical significance. RESULTS: Eluate extractions from all materials caused significantly less cell viability and more cell death than control eluate (medium only) at all eluate time points tested. However, at 72 h the MTA/water, MTA/KY, and amalgam eluate extractions led to significantly better cell viability than the Fuji II eluates. However, there was significantly greater cell lysis for all eluates from the tested materials at 72 h than at 24 h. CONCLUSIONS: Within the limitations of this in vitro study, we conclude that MTA/KY, MTA/water, and amalgam have similar biocompatibility regarding effects of their eluates on human PDL cells, and eluates from all 3 materials demonstrate better biocompatibility than eluates derived from a resin-modified glass ionomer cement.

Radiologists' productivity in the interpretation of CT scans: a comparison of PACS with conventional film.

OBJECTIVE: We compared radiologists' times in the interpretation of CT using hardcopy films with the interpretation using a soft-copy picture archiving and communication system (PACS) computer workstation. MATERIALS AND METHODS: One hundred CT examinations were selected at random and reviewed by four board-certified radiologists experienced in soft-copy interpretation. We performed time-motion analysis to determine the total time required to display, interpret, and dictate the individual findings of CT using conventional hard-copy interpretation on a viewbox and soft-copy interpretation, using a four-monitor high-resolution (2048 x 1536 pixel) workstation. RESULTS: Time-motion analysis showed a reduction of 16.2% in the overall time required for soft-copy interpretation of CT compared with that of film. Time savings with soft-copy interpretation were observed for all four participating radiologists. The benefit of soft-copy interpretation was increased for examinations in which there were comparison studies. CONCLUSION: We found that soft-copy interpretation of CT using a PACS workstation requires less time than interpretation using conventional film hung on a viewbox. The transition to filmless imaging has the potential to improve radiologists' productivity and report-turnaround time.

Generic nursing outcome objectives for use in long-term care facilities.

Twenty-two registered nurses employed in four long-term care facilities generated data for a study about nursing diagnoses in long-term care (N = 360). Generic outcome objectives were developed as an integral part of the project. The research team also specified exceptions to the outcomes: instances where meeting outcome objectives might not be possible. The outcome objectives and exceptions for the sample's 20 most frequently occurring nursing diagnoses are presented as working statements. The authors expect that these outcome objectives and exceptions will be revised by nurses who use them in practice, basic and continuing education, and research.

Effect of combined administration of furosemide and aspirin on urinary urate excretion in man.

Furosemide (20 mg) was administered intravenously to 7 healthy volunteers, before and after 4 days of oral administration of aspirin in uricosuric dosage (1 g daily). Aspirin prevented the decrease in urinary urate excretion induced by furosemide, without interfering with its natriuretic action. This finding is suggested to be the result of the opposite and independent effects of the two drugs on tubular reabsorption of urate.