Biomedical subjects

Eric Wong

Publications and source records attributed to Eric Wong.

At least 19 recordsLinked to original sources

PubMed2007

IP-10 is an early diagnostic marker for identification of late-onset bacterial infection in preterm infants.

Very low birth weight (VLBW) infants with suspected late-onset infection requiring sepsis screening were enrolled in a prospective study to evaluate the diagnostic utilities of a comprehensive panel of key chemokines and cytokines, both individually and in combination, to identify diagnostic markers for early recognition of bacterial sepsis and necrotizing enterocolitis (NEC). Plasma chemokines interleukin (IL)-8, interferon-gamma-inducible protein 10 (IP-10), monokine induced by interferon-gamma (MIG), monocyte chemoattractant protein 1 (MCP-1), growth-related oncogene-alpha (GRO-alpha), and regulated upon activation of normal T cell expressed and secreted (RANTES) and cytokines IL-1beta, IL-6, IL-10, IL-12p70, and tumor necrosis factor alpha (TNF-alpha) were measured at the onset of sepsis (0 h) and 24 h later. Of 155 suspected infection episodes, 44 were classified as infected. Concentrations of all studied inflammatory mediators (except IL-1beta and RANTES) were significantly higher in the infected than in the noninfected group at 0 h, but the levels decreased precipitously by 24 h. IP-10 with a plasma cutoff concentration > or = 1250 pg/mL could identify all septicemic and NEC cases and had the highest overall sensitivity (93%) and specificity (89%) at 0 h. We conclude that preterm infants have the ability to induce a robust chemokine and cytokine response during sepsis, and IP-10 is a sensitive early marker of infection.

Age of Onset↗

PubMed2007

Effects of nocturnal noninvasive mechanical ventilation on heart rate variability of patients with advanced COPD.

BACKGROUND: Cardiovascular comorbidities have a negative impact on the health status and prognosis of patients with COPD. We determined whether nocturnal noninvasive (positive) mechanical ventilation (NIMV) can improve heart rate variability (HRV), decrease circulating natriuretic peptide levels, and improve functional performance of patients with very advanced COPD. METHODS: A randomized, double-blind, parallel controlled trial was conducted in 23 participants with stable but advanced COPD. Participants received standard medical therapy plus nocturnal NIMV or standard medical therapy plus sham NIMV for 3 months. RESULTS: After 3 months of NIMV therapy, the 24-h triangular interpolation of N-N intervals increased from 322 to 473 ms (p = 0.034), the 24-h HRV index (HRVI) increased from 21.8 to 29.9 ms (p = 0.035), nocturnal HRVI increased from 6.1 to 8.0 ms (p = 0.026), and the SD of the average N-N interval increased from 37 to 41 ms (p = 0.020). None of these indexes changed significantly in the control group. Additionally, compared with the control group, the pro-atrial natriuretic peptide levels declined significantly in the NIMV group (p = 0.013). CONCLUSIONS: NIMV applied nocturnally over 3 months may improve HRV, reduce circulating natriuretic peptide levels, and enhance the functional performance of patients with advanced but stable COPD. While not definitive due to small sample size, these data suggest that nocturnal NIMV may reduce the impact of cardiac comorbidities in COPD patients.

Aged↗

PubMed2007

Decision to breastfeed and early cessation of breastfeeding in infants below 6 months old--a population-based study of 3,204 infants in Hong Kong.

Breastfeeding rate has been low in Hong Kong over the last three decades. This has happened with concomitant rapid economic development and improved living standards. A population-based survey was conducted to evaluate factors influencing decision, duration and early cessation of breastfeeding in 3,204 full-term healthy infants under 6 months throughout Hong Kong in 1993. A self-administered questionnaire was used. The overall percentage of breastfed infants was particularly low (9.6%), 36.1%had already given up breastfeeding and were being formula-fed (FFBF), 54.3% have been exclusively formula-fed since birth. The proportion of breastfed infants in the 5th month was even lower than in the 1st month (4.2% vs. 14.7%). Mothers who sustained breastfeeding tended to have parity >or =2, were less educated, housewives and residing in Hong Kong <5 years when compared to FFBF mothers (p<0.009). Husbands had a decisive role on wives initiating breastfeeding while health-professionals had an influence on early switching to FFBF (p<0.003). More breastfeeding mothers perceived breastfeeding benefits than FFBF mothers (p<0.03). The Cox proportional hazard model showed that mother's residency status >or =5-year (HR=2.4), working mothers (HR=1.5) and health-professionals' opinions (HR=1.5) were associated with an early cessation of breastfeeding (p<0.001). However, strengthening immunity (HR=0.67) and parity >or =2 (HR=0.72) helped sustain breastfeeding (p<0.001). To conclude, the proportion of breastfed infants was low in Hong Kong in the early 1990s. Major factors associated with the decision to breastfeed and early cessation of breastfeeding were identified which would help formulate an inter-disciplinary approach for promotion of breastfeeding up-to 6 months and beyond.

Adult↗

PubMed2006

Prevalence and factors associated with social avoidance of recovered SARS patients in the Hong Kong general population.

The study investigated the general population's perceived infectivity of asymptomatic and recovered severe acute respiratory syndrome (SARS) patients and factors associated with avoidance and discriminatory attitudes, including demographic background, SARS-related perceptions and emotional response to the SARS epidemic. A population-based survey was conducted in Hong Kong during 3 December 2003 through 4 January 2004; 475 Hong Kong Chinese adults participated in the survey. Perceptions of the infectivity and health conditions of recovered SARS patients and avoidance and discrimination towards them were measured. Of the respondents, 75.7% and 16.2%, respectively, believed that SARS could be transmitted via asymptomatic SARS patients and those patients who have recovered from SARS for 18 months; 72.7% of the respondents believed that the health of SARS patients would severely and permanently be damaged; 16.6% showed some tendency of avoiding recovered SARS patients and 35.7% expressed some sort of job-related discriminatory attitudes. Perceived infectivity of asymptomatic and recovered SARS patients, health sequelae and emotional distress from SARS were independently associated with avoidance and discriminatory attitudes. The study showed that misconceptions about the infectivity of asymptomatic and recovered SARS patients were common. Recovered SARS patients may also be facing avoidance and discrimination.

Adolescent↗

PubMed2006

Early prediction of sepsis-induced disseminated intravascular coagulation with interleukin-10, interleukin-6, and RANTES in preterm infants.

BACKGROUND: The progression to disseminated intravascular coagulation (DIC) in infected very low birth weight (VLBW; <1500 g) infants is difficult to predict with precision at the onset of sepsis. We investigated the immunologic profiles of preterm infants with sepsis, using chemokine and cytokine measurements to predict the development of sepsis-induced DIC at the onset of infection. METHODS: We measured a panel of chemokines and cytokines at 0 and 24 h after clinical presentation in VLBW infants with suspected infection requiring full sepsis screening. The chemokines measured were interleukin (IL)-8, interferon-gamma-inducible protein-10 (IP-10), monokine induced by interferon-gamma, monocyte chemoattractant protein-1, and regulated upon activation normal T-cell expressed and secreted (RANTES), and the cytokines were IL-6, IL-10, and tumor necrosis factor-alpha. RESULTS: Of 195 episodes of suspected clinical sepsis investigated, 62 were culture-confirmed septicemia or necrotizing enterocolitis (28 of these infants developed DIC), 22 were culture-negative clinical infections, and 111 involved noninfected episodes. All studied inflammatory mediators except RANTES showed significantly greater up-regulation in culture-positive infected infants than in noninfected infants at 0 and 24 h, whereas RANTES showed significant down-regulation. The model that used plasma IL-10 (>208 ng/L), IL-6 (>168 ng/L), and RANTES (<3110 ng/L) at 0 h had sensitivity, specificity, and positive and negative predictive values of 100%, 97%, 85%, and 100%, respectively, for identifying infected patients who subsequently developed DIC. CONCLUSIONS: IL-10, IL-6, and RANTES measured at clinical presentation sensitively and accurately predicted the development of DIC in severely infected infants. This information could be vital for early and effective treatment of neonatal sepsis.

Chemokine CCL5↗

PubMed2006

Can inhaled fluticasone alone or in combination with salmeterol reduce systemic inflammation in chronic obstructive pulmonary disease? Study protocol for a randomized controlled trial [NCT00120978].

BACKGROUND: Systemic inflammation is associated with various complications in chronic obstructive pulmonary disease including weight loss, cachexia, osteoporosis, cancer and cardiovascular diseases. Inhaled corticosteroids attenuate airway inflammation, reduce exacerbations, and improve mortality in chronic obstructive pulmonary disease. Whether inhaled corticosteroids by themselves or in combination with a long-acting beta2-adrenoceptor agonist repress systemic inflammation in chronic obstructive pulmonary disease is unknown. The Advair Biomarkers in COPD (ABC) study will determine whether the effects of inhaled corticosteroids alone or in combination with a long-acting beta2-adrenoceptor agonist reduce systemic inflammation and improve health status in patients with chronic obstructive pulmonary disease. METHODS/DESIGN: After a 4-week run-in phase during which patients with stable chronic obstructive pulmonary disease will receive inhaled fluticasone (500 micrograms twice daily), followed by a 4-week withdrawal phase during which all inhaled corticosteroids and long acting beta2-adrenoceptor agonists will be discontinued, patients will be randomized to receive fluticasone (500 micrograms twice daily), fluticasone/salmeterol combination (500/50 micrograms twice daily), or placebo for four weeks. The study will recruit 250 patients across 11 centers in western Canada. Patients must be 40 years of age or older with at least 10 pack-year smoking history and have chronic obstructive pulmonary disease defined as forced expiratory volume in one second to vital capacity ratio of 0.70 or less and forced expiratory volume in one second that is 80% of predicted or less. Patients will be excluded if they have any known chronic systemic infections, inflammatory conditions, history of previous solid organ transplantation, myocardial infarction, or cerebrovascular accident within the past 3 months prior to study enrollment. The primary end-point is serum C-reactive protein level. Secondary end-points include circulating inflammatory cytokines such as interleukin-6 and interleukin-8 as well as health-related quality of life and lung function. DISCUSSION: If inhaled corticosteroids by themselves or in combination with a long-acting beta2-adrenoceptor agonist could repress systemic inflammation, they might greatly improve clinical prognosis by reducing various complications in chronic obstructive pulmonary disease.

Administration, Inhalation↗

PubMed2006

Bronchodilator effect of salbutamol from two different spacer devices.

Our aim was to compare the bronchodilator effect of salbutamol delivered via a new holding chamber (Volumatic Soft, VS) with that of an established device (Volumatic, V) in asthmatic children. Children with stable asthma were recruited. They inhaled 100 microg, and 10 min later, 300 microg of salbutamol aerosol delivered via VS or V on day 1, and vice versa on day 2. Spirometry was measured at baseline, 10 min after 100 microg, and 15 min after 300 microg of salbutamol were given. The preference for either device was assessed by visual analogue score. Forty-four children with a median age of 9.2 years (interquartile range, 8.0-10.7) completed the study. There were significant improvements in forced expired volume in 1 sec (FEV1) with time throughout the study period for both V and VS (linear and quadratic trend P < 0.001). There was a statistically significant difference in postbronchodilator FEV1 between V and VS (P = 0.013). VS gave an overall greater change in FEV1 than V, by 1.8%. The preference scores for V and VS were 7.0 (IQR 5.0-8.0) and 9.0 (IQR 8.0-10.0) (p < 0.0005), respectively. In conclusion, comparable clinical efficacy was found for V and VS with respect to changes in FEV1 after salbutamol. Patients also showed a strong preference for the new device.

Adrenergic beta-Agonists↗

PubMed2006

Validation of a questionnaire instrument for prediction of obstructive sleep apnea in Hong Kong Chinese children.

To develop and validate a questionnaire scale that can be used as a screening tool to investigate for the presence of childhood obstructive sleep apnea syndrome (OSAS) in Hong Kong Chinese children. Subjects suspected to have OSAS and controls were recruited. Parents completed a Hong Kong children sleep questionnaire (HK-CSQ) and all recruited subjects underwent at least one overnight polysomnographic study (PSG). An obstructive apnea index (OAI) >or= 1/h was diagnostic of OSAS. Receiver-operating characteristics (ROC) curve was constructed to determine optimal sensitivity and specificity. Reliability and validity of the questionnaire scale were also assessed. Two hundred twenty-nine children (149 boys and 80 girls) with a mean age of 10.0 years (SD = 2.1) were recruited. Their mean body mass index (BMI) and OAI were 19.8 (SD = 5.1) and 2.6 (SD = 7.6), respectively. Fifty-four boys and 12 girls were found to have OSAS. Three questions were found to be highly significant in predicting for the presence of OSAS-snoring, nocturnal mouth breathing, and sweating. A composite score of 7 from the three questions (range 0-12) was found to discriminate the OSAS cases best [ROC curve, AUC = 0.8 (95% CI = 0.8-0.9)]. The sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs) were 75.4, 80.5, 61.3, and 88.9%, respectively. Test-retest reliability was undertaken in 51 subjects and the measurement of agreement (Kappa value) was 0.6. This HK-CSQ is a useful, valid, and reliable screening instrument for the presence of OSAS in children.

Adolescent↗

PubMed2006

Quality of life of stroke survivors: a 1-year follow-up study.

OBJECTIVES: To examine the changes in and to identify determinants of health-related quality of life (HRQOL) during the first year after stroke. DESIGN: Prospective cohort study. SETTING: Regional university teaching hospital in China. PARTICIPANTS: Chinese survivors of stroke (N=303). Patients who were previously physically handicapped were excluded. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Barthel Index, Lawton Instrumental Activities of Daily Living (IADL), Chinese Mini-Mental State Examination, Geriatric Depression Scale (GDS), and the abbreviated Hong Kong Chinese version of the World Health Organization Quality of Life measure domain scores at 3, 6, and 12 months after the stroke. RESULTS: A total of 268 (88%) subjects completed the study. HRQOL data were available in 247 (82%) subjects at 3 months. Between 3 and 12 months, there was no significant change in Barthel Index and IADL scores, but there was significant increase in GDS scores. On multivariate analysis and multilevel modeling, there was a small but significant decrease in social interaction and environment HRQOL domain scores with time. GDS score was negatively associated with all 4 domains of HRQOL, whereas the Barthel Index score was associated with physical and psychological HRQOL domains only. Female sex, nursing home residence, welfare assistance, pain in affected limbs, soft diet or tube feeding, and lack of physical exercise were associated with poorer HRQOL. CONCLUSIONS: Environment and social interaction HRQOL may decrease after 1 year of stroke among Chinese stroke patients. Depression has a more generalized adverse effect on HRQOL than basic functional disabilities. Health care professionals should focus on treating depression; group exercises and self-help group activities may help in promoting socialization and reintegration into community life.

Activities of Daily Living↗

PubMed2006

Routine duplex ultrasound screening after TKA is not necessary.

We determined if negative ultrasound screening at the time of acute care hospital discharge or 2 weeks post operatively would reliably identify patients without deep venous thrombosis, thus allowing discontinuation of warfarin chemoprophylaxis. Patients undergoing primary TKA (1344) were treated with adjusted-dose warfarin (target prothrombin time, 15-18 seconds; internationalized normalization ratio, 1.4-1.7) until screening and then aspirin (325 mg po bid) until 6 weeks postoperatively. Deep venous thrombosis as determined by ultrasound was the measured outcome. From 1994 to 1997, 525 patients underwent screening ultrasound before discharge (usually postoperative Day 3): 12 (2.3%) patients with proximal deep venous thrombosis and three (0.6%) patients with distal deep venous thrombosis were identified. From 1997 to 2001, 819 patients underwent ultrasound screening at Day 14 postoperatively: 10 (1.2%) patients with proximal deep venous thrombosis and 29 (3.6%) patients with distal deep venous thromboses were identified. There was no difference in proximal deep venous thrombosis detection, but there was a difference in distal deep venous thrombosis detection. We no longer screen asymptomatic patients with ultrasound for deep venous thrombosis after TKA.

Anticoagulants↗

PubMed2006

A double-blind, randomized, controlled study of a "stress dose" of hydrocortisone for rescue treatment of refractory hypotension in preterm infants.

OBJECTIVE: To assess the effectiveness of a "stress dose" of hydrocortisone for rescue treatment of refractory hypotension and adrenocortical insufficiency of prematurity in very low birth weight (VLBW) infants. We hypothesized that significantly more VLBW infants who were receiving dopamine > or =10 microg/kg per min could wean off vasopressor support 72 hours after treatment with hydrocortisone. METHODS: A double-blind, randomized, controlled study was conducted in a university neonatal center. Forty-eight VLBW infants who had refractory hypotension and required dopamine > or =10 microg/kg per min were randomly assigned to receive a stress dose of hydrocortisone (1 mg/kg every 8 hours for 5 days; n = 24) or an equivalent volume of the placebo solution (isotonic saline; n = 24). RESULTS: The baseline clinical characteristics were similar between the groups. Serum cortisol concentrations were very low immediately before randomization in both groups of infants. Significantly more VLBW infants who were treated with hydrocortisone weaned off vasopressor support 72 hours after starting treatment. The use of volume expander, cumulative dose of dopamine, and dobutamine were significantly less in hydrocortisone-treated infants compared with control infants. In addition, the median duration of vasopressor treatment was halved in hydrocortisone-treated patients. Two versus 11 infants in the hydrocortisone and control groups required a second vasopressor for treatment of refractory hypotension. The trend (linear and quadratic) of the mean arterial blood pressure was also significantly and consistently higher in hydrocortisone-treated infants. CONCLUSIONS: A stress dose of hydrocortisone was effective in treating refractory hypotension in VLBW infants. Although routine and prophylactic use of systemic corticosteroids could not be recommended because of their potential adverse effects, this relatively low dose of hydrocortisone would probably be preferable to high-dose dexamethasone for treatment of refractory hypotension in emergency and life-threatening situations.

Blood Pressure↗

PubMed2006

A population-based survey on infant feeding practice (0-2 years) in Hong Kong: breastfeeding rate and patterns among 3,161 infants below 6 months old.

The prevalence of breastfeeding for the first 6 months in infants has been low in Hong Kong since the 1970s. In order to develop effective breastfeeding policies and promotion programs, an appraisal of feeding practices and factors related to initiation and early cessation of breastfeeding is necessary. A survey with a population-based representative sample was conducted to determine social-demographic, personal and cultural factors that influenced decision, duration and practice of infant feeding among infants 0-24 months old. This paper focuses on infants below 6 months old to study factors related to decision, duration and practice of breastfeeding. In 1993, 7,298 healthy infants were recruited from 46 Maternal-and-Child-Health-Clinics (MCHC) throughout Hong Kong, of whom 3161 were below 6 months old. The mother reported her feeding decision, duration and practice in a questionnaire. Breastfeeding rate was found to be very low (8.4%) for infants below 6 months old. Only 50.9% infants were breastfed. Infant formulae were widely given among partially breastfed infants. 45% mothers were full-time employed. Most mothers were aware of the benefits of breastfeeding to the infants and themselves. Husbands (43.3%) were regarded the most influential on initiation and duration on breastfeeding. Restricted food varieties (54%), sore nipple and breast engorgement (67%), perceived home confinement (41.5%) and perceived inadequate milk supply (31.7%) were major concerns upon breastfeeding. Furthermore, 76.9% mothers turned to MCHC staff for advice when they encountered difficulties during breastfeeding. In conclusion, the survey collected population-based representative data on factors determining initiation and early cessation of breastfeeding in Hong Kong in 1993. The findings will serve as a cornerstone in understanding the evolution of breastfeeding practice in Hong Kong. It merits further study to investigate how the confounders interplay to modulate initiation, duration and patterns of breastfeeding.

Adult↗

PubMed2005

Hong Kong case-control study of sudden unexpected infant death.

AIM: To document causes of all unexpected child deaths under 2 years of age during a 4-year period (1999-2003), and to identify factors associated with sudden infant death syndrome (SIDS) in Hong Kong. METHODS: The case-control component of the study compared information from SIDS deaths (n=16) with healthy controls (n=223) identified randomly from all births in Hong Kong. Coroner records of all deaths under 2 years of age were later reviewed. RESULTS: SIDS risk factors included prone sleep position, smoking by mother, bedsharing with someone other than the parents, and baby found with head covered. Eighteen deaths were officially classified as SIDS but, on review of the coroner records, there were 33 potential SIDS deaths (many labelled as unascertained/unknown). CONCLUSION: Hong Kong SIDS incidence has fallen from 0.3/1000 (95% CI: 0.18-0.46 in 1987) to 0.16/1000 (95% CI: 0.11-0.22 in 1999-2002). Despite the small number of cases, key SIDS risk factors are shown to be important in this population. Hong Kong needs to take steps to standardise the investigation and management of these deaths and to establish a child mortality review mechanism to provide feedback to the public, to the health authorities, and to health professionals.

Age Distribution↗

PubMed2005

Improvement of feeding independence in end-stage cancer patients under palliative care--a prospective, uncontrolled study.

PURPOSE: Feeding independence is important to improve the quality of life (QOL) of patients receiving palliative care. Studies on feeding independence among cancer patients under palliative care are unavailable. This study aimed to evaluate the effectiveness of occupational therapy in promoting feeding independence in end-stage cancer patients in palliative care. PATIENTS AND METHODS: Thirty-six end-stage cancer inpatients with feeding difficulties attributable to improper positioning (58.3%), one-handedness (22.2%), and upper limb impairment (11.1%) were enrolled from two hospitals in Hong Kong. The feeding independence level (level 1> or =25% assistance; level 2<25% assistance) of patients was assessed weekly for 3 weeks. Major treatment modalities included positioning (58%), feeding aid support (25%), and upper limb support (11%). Multilevel models were used for comparing feeding independence levels at baseline and weekly intervals. RESULTS: There was a significant improvement in feeding independence from baseline to week 1 (P<0.0001). Multilevel models showed that there were no significant differences in the level of feeding independence between weeks 1 and 2 (P=0.246) and between weeks 1 and 3 (P=0.165) among the subjects after controlling for age and sex, indicating that the improved feeding independence in week 1 was sustainable through weeks 2 and 3. CONCLUSION: The prospective study showed for the first time that the provision of appropriate feeding supports could markedly enhance feeding independence in end-stage cancer patients receiving palliative care, which might improve activities of daily living and QOL, and minimize excessive disability. Furthermore, it merits cooperation among occupational therapists, caregivers, and ward staff to promote feeding independence in this group of patients.

Adult↗

PubMed2005

Anti-SARS-CoV IgG response in relation to disease severity of severe acute respiratory syndrome.

BACKGROUND: The association between a robust or depressed antibody response and clinical severity of SARS remains unknown. OBJECTIVES: To study seroconversion and the magnitude of IgG responses in a SARS cohort with different disease severities. STUDY DESIGN AND METHOD: A retrospective analysis of all acute and convalescent-phase sera collected from a cohort of laboratory-confirmed SARS cases. Anti-SARS-CoV IgG antibody was detected using indirect immunofluorescence technique and quantified by two-fold serial dilutions. Characteristics of patients who seroconverted "early" (<median interval) were compared to those documented to remain sero-negative during the same time interval. Median IgG levels in convalescent-phase sera (collected within 30 days) were compared among patients with different disease severities. Correlations between IgG levels and important laboratory parameters were assessed. RESULTS: A total of 325 laboratory-confirmed SARS cases were analyzed; of which 301 (92.6%) had anti-SARS-CoV IgG detected in their sera at the time of sampling. IgG was first detected on day 4 of illness; seroconversion occurred at a median of 16 days (range 4-35 days), and IgG peak levels were reached in the fourth week. Early seroconversion (<day 16) occurred more frequently among patients who required ICU-admission (chi2; p=0.011). Higher IgG levels were detected in patients who required supplemental oxygen (Mann-Whitney; p=0.002), ICU-admission (p=0.001), had negative pre-discharge fecal RT-PCR results (p=0.004), and lymphopenia at presentation (p=0.028). Peak IgG titres also correlated positively with peak LDH levels (Spearman's r=+0.360; p<0.001) among survivors. CONCLUSIONS: Severe SARS is associated with a more robust IgG response.

Adult↗

PubMed2005

The Geriatric Depression Scale should be shortened: results of Rasch analysis.

BACKGROUND: The purpose of this study was to examine the unidimensionality, item fit, redundancy and differential item functioning (DIF) of the 15-item version of the Geriatric Depression Scale (GDS) in a community sample of 300 Hong Kong Chinese patients with pneumoconiosis. METHODS: Participants were randomly selected from the case register of the Pneumoconiosis Compensation Fund Board of Hong Kong. A trained research assistant administered the GDS to all participants. A psychiatrist, who was blind to the GDS scores, conducted a structured clinical interview to diagnose depressive disorders according to the Diagnostic and Statistical Manual for Mental Disorders, Version IV (DSM-IV) criteria. RESULTS: Of the 300 participants, 37 (12.3%) had a DSM-IV diagnosis of depressive disorders. Eleven out of 15 items (73.3%) had INFIT/OUTFIT statistics between 0.7-1.3. Abbreviated versions were created by removal of misfit and redundant items resulting in similar overall performance as the original 15-item GDS. None of the items had significant DIF for age, level of education and cognitive impairment. CONCLUSIONS: Although the GDS was overall unidimensional, there was evidence of item redundancy indicating that a shortened version would be as adequate as the original version.

Adult↗

PubMed2005

Ghrelin in preterm and term newborns: relation to anthropometry, leptin and insulin.

AIMS: This study aimed to investigate (i) the plasma ghrelin concentration at birth, (ii) the relationship of ghrelin with metabolic hormones, including leptin and insulin, and (iii) its association with anthropometric parameters, in appropriately grown preterm (23-36 weeks gestation) and term (37-42 weeks gestation) newborns. PATIENTS AND METHODS: Blood samples for hormonal assay were obtained from preterm (n = 81) and term newborns (n = 40) within the first 2 h of life and before milk feeding or energy intake. The relationship between plasma ghrelin and other metabolic hormones or anthropometric parameters was evaluated. RESULTS: Plasma ghrelin was detectable in all studied infants and the concentrations did not differ significantly between term and preterm infants [median (interquartile range): 1.21 (0.86-1.48) nmol/l vs. 1.04 (0.71-1.51) nmol/l, P = 0.52, respectively]. There was no overall significant correlation between plasma ghrelin and gestational age, anthropometric parameters and leptin or insulin. However, when term and preterm infants were analysed independently, plasma ghrelin was inversely correlated with birth weight (r = -0.31, P = 0.05) and body length (r = -0.33, P = 0.04) in the term infant group. CONCLUSIONS: Our findings suggested that plasma ghrelin concentrations were relatively constant at birth, between 23 and 42 weeks gestation, and ghrelin secretion did not appear to undergo gestational age-related variations. An inverse relationship between plasma ghrelin and anthropometric indices in term infants raised the possibility that ghrelin might adopt its physiological role in regulating growth and metabolism at a late stage of gestation (> or = 37 weeks gestation). This phenomenon could be beneficial to term newborns by stimulating their appetite and maintaining an adequate blood sugar level at the most critical period when nutrients from mothers are abruptly terminated after birth.

Birth Weight↗

PubMed2005

Resistin in preterm and term newborns: relation to anthropometry, leptin, and insulin.

This study aimed to investigate 1) the plasma resistin concentration at birth, 2) the relationship of resistin with leptin and insulin, and 3) the association of resistin with anthropometric indexes in newborn infants. Blood samples for hormonal assay were obtained from preterm and term newborns within the first 2 h of life and before milk feeding or energy intake. Although these infants required blood sampling for clinical reasons, all were proved to be noninfected. Plasma resistin was significantly higher in term than in preterm infants. It was also significantly correlated with serum leptin, and both hormones were significantly associated with gestational age and anthropometric indexes. Infants who were born vaginally were found to have significantly higher plasma resistin levels compared with those who were born by cesarean section. In the multivariate forward stepwise regression models, resistin was found to be significantly associated with the mode of delivery and gestational age or birth weight. The association among resistin, leptin, and anthropometric indexes suggested that both hormones might be gestation related. A high circulating resistin level at term gestation could be advantageous to the infant by promoting hepatic glucose production and preventing hypoglycemia after birth. Infants who were born vaginally had significantly higher plasma resistin levels, suggesting that this hormone might also be associated with stress or inflammation induced by the birth process.

Anthropometry↗