The Comparative Study of The Large for Gestational Age Prevalence in Neonate of Diabetic Pregnant Women Between The Optimal and Suboptimal Glycemic Control Groups

Objective:To compare the prevalences of LGA (large for gestational age) newborns in diabetic pregnant women between the optimal glycemic control and suboptimal glycemic control. Materials and Methods: Total of 228 women, delivered at Ramathibodi Hospital between March 2010-December 2012, 114 women in each group, were enrolled. The medical records were reviewed for necessary data. The primary outcome were the prevalences of LGA in both groups and the secondary outcome were the prevalences of neonatal hypoglycemia.Results:The prevalence of LGA newborns in suboptimal controlled group was higher than in optimal controlled group (n = 33, 28.95% and n = 7, 6.14%, respectively) with the relative risk of 4.71 (95% CI; 2.18, 10.21). The factors that found the association with LGA newborns were prepregnant BMI and types of DM. Adjusted relative risk for both factors of the LGA in suboptiamal controlled group was 3.59 (95% CI; 1.60, 8.06 ). The prevalence of neonatal hypoglycemia were not different. (7.02% in suboptimal controlled group and 3.51% in optimal controlled group)Conclusion:Suboptimal glycemic controlled pregnant women were found increase risk of LGA newborns. The prevalence of neonatal hypoglycemia was not different

C-reactive protein for diagnosing late-onset infection in newborn infants

BACKGROUND: Late-onset infection is the most common serious complication associated with hospital care for newborn infants. Because confirming the diagnosis by microbiological culture typically takes 24 to 48 hours, the serum level of the inflammatory marker C-reactive protein (CRP) measured as part of the initial investigation is used as an adjunctive rapid test to guide management in infants with suspected late-onset infection. OBJECTIVES: To determine the diagnostic accuracy of serum CRP measurement in detecting late-onset infection in newborn infants. SEARCH METHODS: We searched electronic databases (MEDLINE, Embase, and Science Citation Index to September 2017), conference proceedings, previous reviews, and the reference lists of retrieved articles. SELECTION CRITERIA: We included cohort and cross-sectional studies evaluating the diagnostic accuracy of serum CRP levels for the detection of late-onset infection (occurring more than 72 hours after birth) in newborn infants. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed eligibility for inclusion, evaluated the methodological quality of included studies, and extracted data to estimate diagnostic accuracy using hierarchical summary receiver operating characteristic (SROC) models. We assessed heterogeneity by examining variability of study estimates and overlap of the 95% confidence interval (CI) in forest plots of sensitivity and specificity. MAIN RESULTS: The search identified 20 studies (1615 infants). Most were small, single-centre, prospective cohort studies conducted in neonatal units in high- or middle-income countries since the late 1990s. Risk of bias in the included studies was generally low with independent assessment of index and reference tests. Most studies used a prespecified serum CRP threshold level as the definition of a 'positive' index test (typical cut-off level between 5 mg/L and 10 mg/L) and the culture of a pathogenic micro-organism from blood as the reference standard.At median specificity (0.74), sensitivity was 0.62 (95% CI 0.50 to 0.73). Heterogeneity was evident in the forest plots but it was not possible to conduct subgroup or meta-regression analyses by gestational ages, types of infection, or types of infecting micro-organism. Covariates for whether studies used a predefined threshold or not, and whether studies used a standard threshold of between 5 mg/L and 10 mg/L, were not statistically significant. AUTHORS' CONCLUSIONS: The serum CRP level at initial evaluation of an infant with suspected late-onset infection is unlikely to be considered sufficiently accurate to aid early diagnosis or select infants to undergo further investigation or treatment with antimicrobial therapy or other interventions

Antimicrobial Strategies and Economic Considerations for Polymeric Medical Implants.

Healthcare acquired infections (HAI's) are a worldwide problem that can be exacerbated by surgery and the implantation of polymeric medical devices. The use of polymer based medical devices which incorporate antimicrobial strategies are now becoming an increasingly routine way of trying to prevent the potential for reduce chronic infection and device failure. There are a wide range of potential antimicrobial agents currently being incorporated into such polymers. However, it is difficult to determine which antimicrobial agent provides the greatest infection control. The economics of replacing current methods with impregnated polymer materials further complicates matters. It has been suggested that the use of a holistic system wide approach should to be developed around the implantation of medical devices which minimises the potential risk of infection. However, the use of such different approaches is still being developed. The control of such infections is important for individual patient health and the economic implications for healthcare services

Chain reactions in several 9-substituted fluorenes and bifluorenyls induced by electrogenerated bases

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