Differences in Clinical and Dietary Characteristics, Serum Adipokine Levels, and Metabolomic Profiles between Early- and Late-Onset Gout

This study aimed to identify differences in clinical and dietary characteristics, serum adipokine levels, and metabolomic profiles between early- and late-onset gout. Eighty-three men with gout were divided into an early-onset group (n = 38, aged < 40 years) and a late-onset group (n = 45, aged ≥ 40 years). Dietary and clinical information was obtained at baseline. Serum adipokines, including adiponectin, resistin, leptin, and plasminogen activator inhibitor-1 (PAI-1), were quantified by a Luminex multiplex immunoassay. Metabolite expression levels in plasma were measured in 22 representative samples using metabolomics analysis based on ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry. Average body mass index, rate of consumption of sugar-sweetened beverages, and serum uric acid levels were significantly higher in the early-onset group (p < 0.05), as was the PAI-I concentration (105.01 ± 42.45 ng/mL vs. 83.76 ± 31.16 ng/mL, p = 0.013). Changes in levels of metabolites mostly involved those related to lipid metabolism. In the early-onset group, acylcarnitine analog and propylparaben levels were downregulated and negatively correlated with the PAI-1 concentration whereas LPC (22:6) and LPC (18:0) levels were upregulated and positively correlated with the PAI-1 concentration. Dietary and clinical features, serum adipokine concentrations, and metabolites differed according to whether the gout is early-onset or late-onset. The mechanisms of gout may differ between these groups and require different treatment approaches.

A COMPARATIVE STUDY OF PHENOMENOLOGY BETWEEN EARLY ONSET AND LATE ONSET PSYCHOSIS

Introduction: Phenomenology is the study of subjective experience. Psychiatric diagnoses are based on cross-sectional psychopathological features, for example, the presence of rst-rank symptoms in the case of schizophrenia. Phenomenological investigation focuses on the form of experience, i.e. the way in which the content is experienced, while the content itself is of secondary importance. This study was conducted to investigate the subtle differences between early-onset group (onset before 18 years of age) and late onset (onset after age of 40 years). Aim And Objectives: To study the socio-demographic prole and phenomenology of early onset psychosis and late onset psychosis compare them based on the variables studied. It is a cross sectional observational Materials And Methods: study carried out in the Department of Psychiatry, Gauhati Medical College and Hospital during the period of June 2018- May 2019. A semi structured, self designed proforma has been used to collect the socio-demographic data and personal details of the patients and their treatment history. The ICD-10 Classication of Mental and Behavioural Disorders, WHO, 1992, Brief Psychiatric Rating Scale (BPRS) Version 4.0, Modied Kuppuswamy Socio-economic status scale were used along with. All the data that was derived from the study were analyzed by using the software IBM SPSS 21.0. Observations And Results: Mean age of presentation in early onset psychosis is 19.22 years with Standard Deviation ±5.69. Mean age of presentation in early onset psychosis is 54.5 years with Standard Deviation ±11.9. Signicantly higher ratio of male was noted in early onset group and higher ratio of female was noted in that of the late onset group. Somatic concern, anxiety, depression and suspiciousness was signicantly more in late onset psychosis. In comparison to the group of late onset psychosis, self-neglect, blunted affect, emotional withdrawn, motor retardation, motor hyperactivity, mannerisms and posturing were signicantly more in early-onset psychosis. Major distinction was noted in the Conclusion: distribution of delusional disorders and acute and transient psychotic disorders. Age of onset was skewed to late adolescence with more number of male patients. Late onset psychosis group had more uneducated patients with considerable proportion of adults left unmarried in the late onset group. Late onset psychosis group shows predominance of somatic concern, anxiety, depression and suspiciousness in contrast to early onset psychosis group which shows predominance of motor hyperactivity, self-neglect, blunted affect, motor retardation, mannerisms and posturing

Assessing standards for prevention of early onset group B streptococcal (GBS) disease in Ireland

Background: Early onset group B streptococcal (GBS) disease can cause significant neonatal morbidity and mortality. There is currently no Irish national guideline for GBS screening, and protocols vary across maternity units. Polymerase chain reaction (PCR) testing at induction or labour onset informs triage for antibiotic prophylaxis; however, there are human and infrastructural resource requirements to enable widespread implementation. Aim: Our aim was to identify current standard practices for GBS prevention in Irish obstetric and neonatal services and to utilise this data to inform the need for, and potential impact of implementation of, a national guideline. Methods: A questionnaire on GBS screening, management and existing resources was completed by an informed staff member from each of the 19 Irish maternity units, including questions regarding timing and method of screening, antibiotic usage, and neonatal management. Results: One unit (5.2%) performs routine GBS screening at 35–37 weeks of gestation. Twelve units (63%) screen for GBS following spontaneous rupture of membranes (SROM) after 37 weeks, of which two (17%) perform PCR and ten (83%) culture testing. Seventeen units (89.3%) have access to a GeneXpert PCR machine, and of these, two (11.7%) use the machine for rapid GBS testing. Two units screen patients for GBS at either the start of labour or induction of labour. Four units (21%) use the neonatal early onset sepsis (EOS) calculator. Sixteen units (84%) do not treat asymptomatic infants born to GBS-positive mothers. Conclusion: There is a lack of consistency in the methods for GBS screening and disease prevention across the country, highlighting the need for a national guideline accompanied by an implementation plan and budget to standardise care.

Early and late-onset nonconvulsive status epilepticus after stroke

ABSTRACT Background: Nonconvulsive status epilepticus (NCSE) is a condition that needs timely diagnosis and treatment. It has insignificant clinical features and presents high risk of misdiagnosis. Objective: To investigate NCSE among patients with stroke, given that stroke plays an important role in the etiology of NCSE. Methods: In this retrospective study, acute stroke patients who were admitted and followed up at a stroke outpatient clinic between January 2013 and March 2016 were included. Patients with previous histories of epilepsy, brain tumor, head trauma, hypertensive encephalopathy, arteriovenous malformation, subarachnoid hemorrhage or cerebral venous thrombosis were excluded. Demographic properties, stroke etiology, imaging method, EEG findings, stroke severity according to the NIHSS score, functional disability and modified Rankin Scale were recorded for all patients. Results: Thirty-nine out of 792 stoke patients experienced NCSE. The mean age of the study population was 70±1.2 years (min-max: 46‒90). The study population was composed of 28 females (71.8%) and 11 males (28.2%). NCSE had early onset in 23 patients (59%) and late onset in 16 (41%). The early-onset NCSE patients were older and this was statistically significant between the groups (early onset: 73.5±11.5; late onset: 65.9±12.1; p=0.04). A history of previous stroke was more frequent in the late-onset NCSE group (14; 87,5%) than in the early-onset group (11; 47.8%) (p=0.01). The prognosis was worse in the early-onset group, but without statistical significance. Conclusion: Changes in mental status in the early stages of stroke are mostly attributed to stroke itself, but NCSE should be suspected in the right clinical setting, such as in older patients with suspicious anatomical and clinical associations.

Developmental Trajectories of Delinquent Peer Association Among Korean Adolescents: A Latent Class Growth Analysis Approach to Assessing Peer Selection and Socialization Effects on Online and Offline Crimes

The relationship between peers and delinquency has been taken as evidence for selection and socialization effects in the etiology of adolescents. Accumulating evidence suggests that both effects are involved. This study examines whether adolescents’ aggressive propensities and behaviors predict their peers (selection) and whether peers’ propensities and behaviors predict adolescents’ behaviors (socialization). The latent class growth analysis approach revealed three distinct subgroups: an early-onset group (0.9%); a late-peak group (3.37%); and a normative group (95.73%). Both selection and socialization effects were supported using a longitudinal Korean adolescent self-report. The results showed that adolescents with less self-control who are online more frequently and exhibit higher levels of traditional bullying and delinquency were more likely to be members of both the early-onset and late-peak groups compared with the normative group. Also, the aggressive behaviors fully mediated the link between aggressive propensities and delinquent peer associations. Furthermore, adolescents in the late-peak group (but not those in the early-onset group) were associated with a greater likelihood of online and offline delinquency, but cyberbullying and traditional bullying in late adolescence levels were high in both groups’ members.

Timing of chemotherapy-induced neutropenia is a prognostic factor in patients with diffuse large B-cell lymphoma: a retrospective study

Background Chemotherapy-induced neutropenia (CIN) has been shown to be associated with improved clinical outcomes in patients with various solid tumors. The aim of this study was to investigate the relationship between the timing and degree of chemo-induced neutropenia (CIN) and short-term efficacy and survival in newly diagnosed patients with diffuse large B-cell lymphoma (DLBCL).Methods A retrospective study was conducted on 236 newly diagnosed DLBCL patients who received at least 6 cycles of R-CHOP (like) or CHOP (like) between January 2012 and December 2018. According to the occurrence time of CIN, subjects were divided into CIN-absent group, early-onset CIN group and late-onset CIN group. According to the degree of CIN, they were divided into CIN-absent group, mild (grade 1-2) CIN group, and severe (grade 3-4) CIN group. Short-term efficacy was evaluated after 4 cycles of treatment. The Kaplan-Meier method was used to draw the survival curve, and the Cox proportional hazards model was applied to determine the correlation between the timing and extent of CIN and clinical features, short-term efficacy, progression-free survival (PFS) and overall survival (OS).Results After 4 treatment cycles, the objective response rate (ORR) of the early-onset group was higher than that of in the late-onset group and CIN absent group (95.7% VS 88.4% VS 81.0%). Multivariate analysis, Ann Arbor staging, choice of treatment plan and CIN timing were the independent prognostic factors for OS and PFS. OS and PFS in the early-onset group were longer than those of in the absent group [OS (HR:0.241; 95%CI: 0.110-0.530; P < 0.001), PFS (HR: 0.313; 95%CI: 0.169-0.579; P < 0.001)] and late-onset group [OS (HR: 0.332; 95%CI: 0.161- 0.685; P = 0.003), PFS (HR: 0.376; 95%CI: 0.204-0.693; P = 0.002)].Conclusions The timing of CIN is an independent predictor of prognosis in DLBCL patients treated with R-CHOP (like) or CHOP (like) regimens, and patients with early-onset CIN have longer survival times. The degree of CIN is not an independent predictor of prognosis in patients with DLBCL.

Clinical Phenotype in an Early-Onset French Pediatric Population: Charcot–Marie–Tooth's Disease Type 2A

Charcot–Marie–Tooth's disease type 2A (MCT2A), induced by mutation of the mitofusin 2 (MFN2) gene represents the main cause of MCT2. The aim of this study is to provide details of the clinical and electromyographic phenotype of MCT2A in a pediatric population. We conducted a French multicenter retrospective study, including all children with a genetic diagnosis of MCT2A. Thirteen MCT2A children were included with a beginning of symptoms before the age of 10 years (“early-onset group”). We report two new mutations: c.1070 A → T (p.Lys357.Met) and c.280 C → G (p.Arg94Gly). The evolution of the disease is marked by a fast worsening for three patients with loss of motor autonomy, while the evolution is relatively stable for eight patients. The group of early-onset MCT2A seems more heterogeneous than previously described, with a nonconstant severe phenotype.