Association Between Temperature During Intensive Care Unit and Mortality in Patients With Acute Respiratory Distress Syndrome.

The relationship between body temperature changes and prognosis in patients with acute respiratory distress syndrome (ARDS) remains inconclusive. Our study aimed to investigate the clinical value of body temperature in the management of ARDS. Data from the Medical Information Mart for Intensive Care III database were collected. Adult patients with ARDS were enrolled and further grouped based on their temperature values in the intensive care unit. Both the maximum (temperaturemax) and minimum (temperaturemin) temperatures were used. The primary outcome was 28-day mortality rate. Polynomial regression, subgroup analysis, and logistic regression analysis were performed in the final analysis. A total of 3922 patients with ARDS were enrolled. There was a U-shaped relationship between 28-day mortality and body temperature. For patients with infection, the elevated temperaturemax (≥37.0°C) was associated with decreased mortality, with an odds ratio ranging from 0.39 to 0.49, using temperaturemax from 36.5°C to 36.9°C as reference. For patients without infection, a similar tendency was observed, but the protective effect was lost at extremely high temperatures (≥38.0°C, p < 0.05). Elevated temperaturemin (≥37.0°C) and decreased temperaturemin (<35.0°C) were associated with increased mortality, using the temperaturemin from 36.0°C to 36.9°C as a reference. Hypothermia was associated with increased mortality in patients with ARDS, while the effect of hyperthermia (≥37.0°C) on the mortality of patients with ARDS was not fully consistent in the infection and noninfection subgroups. Short-term and transient temperatures above 37.0°C would be beneficial to patients with ARDS, but extreme hyperthermia and persistent temperatures above 37.0°C should be avoided.

Association of variants in KCNK17 gene with ischemic stroke and cerebral hemorrhage in a Chinese population.

BACKGROUND: KCNK17 (potassium channel, subfamily K, member17) has a role in the pathogenesis of stroke. We reported previously that rs10947803 single-nucleotide polymorphism (SNP) in KCNK17 is associated with cerebral hemorrhage in a Chinese population. The aim of the present study was to examine other SNPs in the KCNK17 gene that are associated with cerebral hemorrhage and other subtypes of stroke in the Chinese population. METHODS: A total of 1356 subjects with stroke and 1225 control patients were examined by a case-control methodology. The SNPs (rs12214600, rs12195376, rs2758912, and rs10807204) in KCNK17 gene were genotyped with the TaqMan real-time polymerase chain reaction assay. RESULTS: rs12214600 SNP in KCNK17 was significantly associated with cerebral hemorrhage (unadjusted odds ratio = .55, 95% confidence interval = .35-.86, P = .008, q = .0328) under the allele model. After adjusting for age, sex, and hypertension, we found that the association remained significant (odds ratio = .56, 95% confidence interval = .35-.90, P = .0158). There was no association detected for other SNPs in KCNK17 with cerebral hemorrhage, and none of the SNPs in KCNK17 had an association with ischemic stroke. CONCLUSIONS: The T carrier of an SNP (rs12214600) is associated with reduced risk of cerebral hemorrhage in the Chinese population, together with previous findings that SNPs rs10947803 and rs12214600 in the KCNK17 gene are associated with hemorrhagic stroke, but none of the SNPs tested had an association with ischemic stroke. KCNK17 may be important in the pathogenesis of cerebral hemorrhage.

Association of CVD candidate gene polymorphisms with ischemic stroke and cerebral hemorrhage in Chinese individuals.

BACKGROUND: Contribution of cardiovascular disease related genetic risk factors for stroke are not clearly defined. We performed a genetic association study to assess the association of 56 previously characterized gene variants in 34 candidate genes from cardiovascular disease related biological pathways with ischemic stroke and cerebral hemorrhage in a Chinese population. METHODS: There were 1280 stroke patients (1101 with ischemic stroke and 179 with cerebral hemorrhage) and 1380 controls in the study. The genotypes for 56 polymorphisms of 34 candidate genes were determined by the immobilized probe approach and the associations of gene polymorphisms with ischemic stroke and cerebral hemorrhage were performed by logistic regression under an allelic model. RESULTS: After adjusting for age, sex, BMI and hypertension status by logistic regression analysis, we found that NPPA rs5063 was significantly associated with both ischemic stroke (odds ratio [OR] 0.69; 95% confidence interval [CI], 0.52 to 0.90; P = 0.006) and cerebral hemorrhage(OR = 0.39; 95%CI, 0.19 to 0.78; P = 0.007). In addition, MTHFR rs1801133 also was associated with cerebral hemorrhage (OR = 1.48; 95%CI, 1.16 to 1.89; P = 0.001) but not with ischemic stroke (OR = 1.08; 95%CI, 0.96 to 1.22; P = 0.210). After false discovery rate (FDR) correction, the association of NPPA rs5063 and MTHFR rs1801133 with cerebral hemorrhage remained significant. CONCLUSIONS: The NPPA rs5063 is associated with reduced risk for cerebral hemorrhage and MTHFR rs1801133 is associated with increased risk of cerebral hemorrhage in a Chinese population.