Biomarkers of hepatic injury and function in neonatal hypoxic ischemic encephalopathy and with therapeutic hypothermia

Therapeutic hypothermia (TH) is now provided as standard care to infants with moderate-severe hypoxic ischemic encephalopathy (HIE). The role of TH in limiting neuronal injury is well recognized, but its effect on hepatic injury which occurs frequently in neonatal HIE is not known. Our objective was to characterize biomarkers of liver injury and function in the setting of neonatal HIE and to describe whether HIE severity and provision of TH influence these hepatic biomarkers. We performed a multicenter retrospective study and compared hepatic biomarkers obtained during the first postnatal week, according to the severity of HIE and whether treated with TH. Of a total of 361 infants with HIE, 223 (62%) received TH and 138 (38%) were managed at normal temperature. Most hepatic biomarkers and C-reactive protein (CRP) were significantly associated with the severity of HIE (p<0.001). Infants treated with TH had lower peak Alanine aminotransferase (ALT) concentrations (p=0.025) and delay in reaching peak CRP concentration (p<0.001).  Conclusion: We observed a significant association between the clinical grade of HIE and biomarkers of liver metabolism and function. Therapeutic hypothermia was associated with delayed CRP responses and with lower ALT concentrations and so may have the potential to modulate hepatic injury

Irrigation Water Source Matters: Saline Groundwater Irrigation Lowers Date Palm Root-Associated Fungal Richness and Alters Their Community Structural Patterns

Saline groundwater irrigation is commonly used in arid regions of the Middle East and North Africa for date palm (Phoenix dactylifera) cultivation, yet little is known about its impact on communities of root-associated fungi (RAF). We investigated the impact of irrigation water sources (freshwater versus saline groundwater) on date palm RAF diversity, communities, and their assembly processes. RAF richness was lower in roots under saline groundwater irrigation and was significantly related to soil and water electrical conductivity (EC), and only 25.3% of the total operational taxonomic units (OTUs) were strictly found in roots under saline groundwater irrigation. Overall, the RAF communities were distinct among irrigation water sources, wherein water pH and EC were the major structuring factors. The relative importance of drift assembly was higher for RAF distribution under saline groundwater irrigation. Saprotrophic and pathotrophic communities were also distinct between irrigation water sources and shaped by irrigation water pH. In addition, we found higher abundance of saprotrophic OTUs Acrocalymma vagum, Coprinopsis sp., and Myrothecium sp. in roots under saline groundwater irrigation. In summary, we show that saline groundwater irrigation lowers RAF richness and alters overall and guild level RAF communities (saprotroph and pathotroph), which assemble mainly through drift process, wherein overall communities are shaped by irrigation water pH and EC, while saprotrophic and pathotrophic communities are structured by water pH. The high abundance of specific saprotrophs under saline groundwater irrigation indicates their potential role in nutrient cycling and plant growth promotion in arid agroecosystems

Auditory hallucinations in a 15-year-old boy: an unusual presentation of hypothyroidism

It is well recognised that thyroid disorders may present with a wide range of symptoms and signs in adults and children. We describe an unusual presentation of thyroid disease in an adolescent with psychiatric symptoms, in whom normalisation of his thyroid function resulted in significant improvement in his mental state. Although agitation and depression are commonly listed as symptoms of hyper- and hypothyroidism, respectively, presentation to psychiatric services is not well documented in the adolescent age group and thyroid function tests are not a routine inclusion as part of a paediatric psychiatric assessment