Weekend admissions to paediatric/neonatal intensive care units are associated with longer hospitalisation time but not with greater mortality.

BACKGROUND: To evaluate the impact on mortality and duration of stay of weekend admission of paediatric patients to the Paediatric/Neonatal Intensive Care Unit (PNICU). METHODS: Retrospective, nine-year cohort study. The study was performed in a tertiary level PNICU between 1 January 1999 and 31 December 2007. Data about the day of admission, diagnosis, outcome, and duration of stay was collected using a computerised database. RESULTS: 2,223 out of 2,240 patients treated in the PNICU during the analysed period were enrolled to the analysis. 61.9% of the group were newborns. Overall mortality equalled 10.9% and did not differ depending on weekend or weekday admission (10.95% vs. 10.86% respectively, P = 0.96). A negative trend of mortality in both groups was observed (P < 0.001). The frequency of deaths occurring during the initial 48 hours of treatment also did not differ between weekend and weekday admissions (4.1% vs. 3.3%, P = 0.52). Overall duration of PNICU stay was significantly longer for weekend admissions (median 10 vs. 8 days, P = 0.01). The difference was absent in the neonatal group (12 vs. 11 days; P = 0.9) but was evident in children (median 6 vs. 5 days P = 0.002) regardless of primary diagnosis. The difference was the greatest in children with sepsis and/or haematological malignancy (five days in both subgroups, P = 0.01 and 0.002 respectively). CONCLUSIONS: No day-of-admission-dependent differences of mortality were detected in the analysed group. Weekend admissions were associated with longer duration of PNICU stay in children.

GlyCulator: a glycemic variability calculation tool for continuous glucose monitoring data.

Glycemic variability has become a major concern over the years as growing evidence is gathered on its detrimental impact on the risk of diabetes complications. Glycated hemoglobin, although ubiquitous in clinical practice, does not adequately summarize short-term glycemic variability. This gap may be addressed through the use of continuous glucose monitoring, which continuously estimates glycemia based on interstitial fluid glucose concentration. As the amount of collected data is substantial, variability of the glycemic pattern can be analyzed in context of its direction, periodicity, and amplitude. As freely available variability calculation tools are limited in number and complexity, the authors have devised a simple-to-use Web-based application, "GlyCulator," allowing for rapid computation of glucose variability parameters from continuous glucose monitoring data.

[Proinsulin C-peptide -- the bioactive peptide with a huge promise]. / Proinsulinowy peptyd C - bioaktywny peptyd z wielkim potencjalem.

Proinsulin connecting peptide (C-peptide) has been initially regarded as deprived of biological functions other than correct scaffolding of insulin. This was caused by the lack of evident effect of C-peptide administration to healthy subjects or animals. At present, in view of numerous studies concerning its structure, membrane binding and biological functions, C-peptide seems to constitute a crucial role in the pathogenesis of complications in diabetes mellitus type 1 (DM1). Patients who maintain high remnant insulin secretion (and therefore also of C-peptide) develop complications such as nephropathy, neuropathy and later microangiopathy with a milder clinical course. In this article we have covered molecular and cellular aspects of C-peptide functioning, such as: activation of protein kinase C, Na+,K+- ATP-ase, nitric oxide synthase, MAP and ERK 1/2 kinases, improvement of nerve conduction velocity and interactions with exogenous and endogenous insulin. We also outline the clinical consequences of deficiency of this underestimated peptide along with its potential therapeutical possibilities in the primary and secondary prevention of DM1 complications.