Retinopathy of prematurity in India: incidence, risk factors, outcome and the applicability of current screening criteria

Background: To study the incidence, risk factors and outcome of retinopathy of prematurity (ROP) in at-risk newborns at tertiary care hospital in Vadodara.Methods: Preterm infants with birth weight ?2000 gm and gestation ?34 weeks were screened for ROP at 4 weeks of birth for first screening or if <28 week or <1200 grams then at 3 weeks after delivery. Infants with birth weight >2000 gm and gestation >34 weeks were screened only if they had additional risk factors. Those found to have high risk ROP were treated.Results: The incidence of ROP in 286 infants who were screened was 24.1%, 12 ROP positive cases were having birth weight >2000 gm. On multivariate analysis risk factors predisposing to ROP (P<0.05) were birth asphyxia, Sepsis, multiple blood transfusion, respiratory distress syndrome, multiple birth, antenatal steroid use and Phototherapy. Out of 69 infants who developed ROP, 6(8.7%) needed invasive management.Conclusions: Risk factors predisposing to ROP were gestational age and birth weight alone and along with the various risk factors like birth asphyxia, sepsis, multiple blood transfusion, respiratory distress syndrome, multiple birth, antenatal steroid use and phototherapy. The occurrence of ROP is trending towards a rise including newborns with higher birth weight and gestational age in developing countries; hence necessitating to use different guideline for Screening of Newborns in these developing countries.

Comprehensive application of various screening strategies of Lynch syndrome / 中华胃肠外科杂志

Lynch syndrome (LS), which is the most common hereditary colorectal cancer, accounts for about 3% of all colorectal cancers. However, due to its various clinical manifestations, it is difficult to be diagnosed. The diagnosis of LS requires comprehensive application of various screening criteria (such as the Amsterdam criteria, Bethesda criteria), predictive models, risk factors, immunohistochemistry test of mismatch repair (MMR) protein, microsatellite instability (MSI) detection, MLH1 methylation detection, BRAF gene mutation detection, germline gene mutation detection, and so on. LS can be diagnosed only after the identification of pathogenic germline mutation of MMR gene. The first-degree and second-degree relatives of LS patients are recommended to be tested for the identified mutant gene. For LS patients and gene mutation carriers, LS associated cancer can be detected early or even prevented by monitoring and preventive surgery. Reproductive techniques can be used to prevent this disease from being passed down to the next generation.

The screening and assessment of the neoadjuvant chemotherapy for the ovarian cancer / 实用肿瘤学杂志

Ovarian cancer is the highest death rate of gynecologic malignant tumor .Currently,people rec-ognize standard treatment for ovarian cancer was that reduction -Tumor cells of platinum based chemotherapy af-ter surgery.But for those patients who have developed into advanced cancer that cannot be operated the surgeries directly,the application of preoperative Neoadjuvant chemotherapy ( NACT) does have the superiority .which is recognized by the majority of clinical doctors ,and has been widely used in the treatment of advanced malignant tumor.It is worthy to discussing which part of patients should choose the initial treatment of Neoadjuvant chemo -therapy,rather than a direct treatment of destroying tumor cells .This article is summarizing the empirical cases based on related research ,in order to help clinicians to make a decision on the treatment of ovarian cancer .

Retinopathy of Prematurity in Infants with Birth Weights Greater than 1,000 Grams

PURPOSE: To understand the incidence of retinopathy of prematurity (ROP) in preterm infants with birth weights more than 1,500 g or gestational age 30 weeks, and/or unstable clinical course, we investigated the highest gestational age and birth weight of preterm infants who require ROP treatment and those who do not. METHODS: The subjects were preterm infants admitted in Samsung medical center between January 1, 2000 and December 31, 2013. We retrospectively reviewed the medical records of 847 premature infants whose birth weights were more than 1,000 g. RESULTS: Of the 847 infants, 105 (12.4%) had stage 1 ROP, 54 (6.4%) had stage 2, 31 (3.7%) had stage 3, 0 had stage 4, and 2 (0.2%) had stage 5 ROP. Thirty-three (3.9%) of the 847 infants developed stage 3-5 ROP. Twenty (2.4%) of these 33 (3.9%) stage 3-5 ROP infants required treatment. Among the stage 1-3 ROP infants who did not require treatment, the highest gestational age was 37(+1) weeks (stage 1) and birth weight was 2,362 g (stage 1). Among the stage 3-5 ROP infants who needed treatment, the highest gestational age was 32 weeks and birth weight was 1,495 g. CONCLUSIONS: Newborn infants with gestational age more than 38 weeks or birth weight more than 2,400 g did not develop ROP even if they had an unstable clinical course. In our study, no preterm infants with gestational age more than 33 weeks or birth weight more than 1,500 g required ROP treatment.

Comparison of references for assessment of overweight and obesity in children of Shanghai / 上海交通大学学报（医学版）

Objective To compare and analyse four references for assessment of obesity in Chinese children. Methods The height and weight of 2347 children(1175 boys and 1172 girls) aged 7 to 8 years in Shanghai were measured,and their body mass indexes (BMI) were calculated.The prevalences of overweight and obesity were evaluated and compared among reference of Weight for Height 1985(WFH 1985 reference),BMI reference of Working Group on Obesity in China (WGOC reference),BMI reference of Europe International Obesity Task Force(IOTF reference) and BMI reference of Centers for Disease Control and Prevention of American 2000 (CDC reference). Results The prevalence of overweiight in boys evaluated by IOTF reference was significantly higher than those by the other three references(P<0.05),and the prevalence of overweight in girls evaluated by IOTF reference was significantly higher than those by WGOC and CDC references (P<0.05).The prevalence of obesity in boys evaluated by IOTF reference was significantly lower than those by the other three references (P<0.01),and the prevalence of obesity in girls evaluated by IOTF reference was significantly lower than those by WGOC and WFH 1985 references(P<0.01).There was no significant difference in the evaluation findings of obesity and overweight between WFH 1985 and WGOC references(P>0.05). Conclusion WFH 1985 and WGOC references are more suitable than IOTF and CDC references for assessment of overweight and obesity in Chinese children.