An experience of renal replacement therapy in a combined neonatal and paediatric intensive care unit of Hong Kong

Intensive care services are expensive. The experience of developing a combined paediatric and neonatal intensive care unit (ICU) in a regional hospital is reported with reference to the provision of renal support for the critically ill patients. The combined unit is staffed by a team of paediatric intensivists, each of whom has special interest in a subspecialty, including cardiology, respiratory medicine, nephrology and neonatology. In the past 7 years, renal replacement therapy (peritoneal dialysis and haemofiltration) was provided to 40 patients, with comparable mortality and complication rates to other reports. This arrangement has been feasible and might be more efficient than running separate paediatric and neonatal ICUs or combining the paediatric ICU with the adult ICU

Investigation of Complement Component <i>C4</i> Copy Number Variation in Human Longevity

<div><p>Genetic factors have been estimated to account for about 25% of the variation in an adult's life span. The complement component C4 with the isotypes C4A and C4B is an effector protein of the immune system, and differences in the overall <i>C4</i> copy number or gene size (long <i>C4L</i>; short <i>C4S</i>) may influence the strength of the immune response and disease susceptibilities. Previously, an association between <i>C4B</i> copy number and life span was reported for Hungarians and Icelanders, where the <i>C4B*Q0</i> genotype, which is defined by <i>C4B</i> gene deficiency, showed a decrease in frequency with age. Additionally, one of the studies indicated that a low <i>C4B</i> copy number might be a genetic trait that is manifested only in the presence of the environmental risk factor “smoking”. These observations prompted us to investigate the role of the <i>C4</i> alleles in our large German longevity sample (∼700 cases; 94–110 years and ∼900 younger controls). No significant differences in the number of <i>C4A</i>, <i>C4B</i> and <i>C4S</i> were detected. Besides, the <i>C4B*Q0</i> carrier state did not decrease with age, irrespective of smoking as an interacting variable. However, for <i>C4L*Q0</i> a significantly different carrier frequency was observed in the cases compared with controls (cases: 5.08%; controls: 9.12%; p = 0.003). In a replication sample of 714 German cases (91–108 years) and 890 controls this result was not replicated (p = 0.14) although a similar trend of decreased <i>C4L*Q0</i> carrier frequency in cases was visible (cases: 7.84%; controls: 10.00%).</p></div