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In addition, in cases with isolated PMS2 defects, there were more tumours in the right colon and, more mucinous carcinoma cases than in cases with MMR-proficient CRCs, but had a similar cancer onset age. This study identified the rate, clinicopathological and age characteristics of PMS2 defects in CRCs in China and highlighted the importance of universal screening and germline detection of PMS2 in CRC.

The use of ultrabrief pulse (UBP) stimuli and individual seizure threshold determination have been proposed as ways of minimizing the cognitive side effects of electroconvulsive therapy (ECT), but large samples of patients receiving UBP ECT are lacking. This study reports a retrospective cohort of patients receiving an index course of right unilateral UBP ECT and characterizes the amount of charge required to induce a seizure.

A single-center retrospective chart review was conducted of adult patients receiving a first lifetime course of ECT using an UBP titration from 2005 to 2017.

There were 2328 patients that received a dose titration during the study period, with a mean dose of 21.82 ± 21.61 mC applied to induce a seizure. During the early part of the study period, a mean dose of 18.73 ± 8.99 mC was used, with 28% of patients seizing at a dose of less than 19.2 mC. In the later period, the initial step of dose titration was standardized at 19.2 mC, yielding a mean initial dose to induce a seizure of 22.72 ± 24.00 mC.

Mean seizure thresholds may be lower than reported in previous studies, and a significant proportion of patients may have a seizure threshold lower than the first step of many existing dose titration protocols.

Mean seizure thresholds may be lower than reported in previous studies, and a significant proportion of patients may have a seizure threshold lower than the first step of many existing dose titration protocols.Recent reviews of the literature suggest that one singular theory of the mechanism of action of electroconvulsive therapy (ECT) is unlikely to now emerge and suggest integrating competing hypotheses, for example the anticonvulsant and neuroplasticity hypotheses. The gamma-aminobutyric acid (GABA) hypothesis of ECT was developed in the 1980s, derived from evidence that the brain is flooded with the inhibitory neurochemical GABA after each ECT treatment, to terminate the seizure. This hypothesis evolved into the anticonvulsant hypothesis of ECT, which focused on neurophysiological measures. This commentary traces the origins and evidence for and against the original GABA hypothesis, and then updates it in the context of advances in knowledge on GABA neurochemistry in epilepsy; hyperconnectivity in frontal circuits in major depression; and neuroplasticity in ECT. There is a growing body of evidence that GABA, a ubiquitous neurochemical in the frontal cortex, itself stimulates neuroplasticity. The commentary concludes that focusing research on neurochemical aspects of the anticonvulsant hypothesis and resultant connections with neuroplasticity, should reawaken interest in this historical hypothesis.The objective of this study was to explore neonatal skin injury period prevalence, classification, and risk factors. Skin injury period prevalence over 9 months and χ, Mann-Whitney U, and independent-samples t tests compared injured and noninjured neonates, with P values less than .05 considered statistically significant. Injury prediction models were developed using Classification and Regression Tree (CART) analysis for the entire cohort and separately for those classified as high or low acuity. The study took place in 3 Australian and New Zealand units. Neonates enrolled (N = 501) had a mean birth gestational age of 33.48 ± 4.61 weeks and weight of 2138.81 ± 998.92 g. Of the 501 enrolled neonates, 206 sustained skin injuries (41.1%), resulting in 391 injuries to the feet (16.4%; n = 64), cheek (12.5%; n = 49), and nose (11.3%; n = 44). Medical devices were directly associated with 61.4% (n = 240) of injuries; of these medical devices, 50.0% (n = 120) were unable to be repositioned and remained in a fixed position for treatment duration. The strongest predictor of skin injury was birth gestation of 30 weeks or less, followed by length of stay of more than 12 days, and birth weight of less than 1255 g. Prediction for injury based on illness acuity identified neonates less than 30 weeks’ gestation and length of stay more than 39 days were at a greater risk (high acuity), as well as neonates less than 33 weeks’ gestation and length of stay of more than 9 days (low acuity). More than 40% of hospitalized neonates acquired skin injury, of which the majority skin injuries were associated with medical devices required to sustain life. Increased neonatal clinician education and improved skin injury frameworks, informed by neonatal epidemiological data, are vital for the development of effective prevention strategies.

To investigate the outcomes of cataract surgery in eyes with pseudoexfoliation syndrome in a real-world National Health Service setting.

Prince Charles Eye Unit, Windsor, United Kingdom.

Single-center retrospective cohort study.

All eyes that underwent phacoemulsification cataract surgery from January 2010 to December 2019 were included. Eyes with combined intraocular surgery or with a history of ocular trauma were excluded. Eyes were classified as pseudoexfoliation (n=280, 1.2%) or no pseudoexfoliation (n=23,049). The primary outcome was mean change in logarithm of the minimum angle of resolution (logMAR) visual acuity (VA). Secondary outcomes included intraoperative and postoperative complications.

The study comprised 23329 eyes of 15257 patients. Eyes in the pseudoexfoliation group were older and more likely to have multiple co-pathologies. Intraoperatively, they were more likely to experience zonular dialysis and dropped nucleus. Postoperatively, they had significantly higher rates of corneal edema, elevated intraocular pressure, postoperative uveitis, and intraocular lens subluxation, and were more likely to require a second operation within 90 days. Although the pseudoexfoliation group had worse preoperative and postoperative logMAR VA, logistic regression analysis confirmed that mean VA improvement was comparable to the reference group (mean±SD -0.49±0.52 vs -0.55±0.66, adjusted MD 0.02 (95%CI -0.01-0.06)).

Although patients with pseudoexfoliation had a significantly higher risk of some complications, they achieved similar VA improvements with cataract surgery compared to the non-pseudoexfoliation group. HRO761 These findings will help inform the consent process and management of patient expectations.

Although patients with pseudoexfoliation had a significantly higher risk of some complications, they achieved similar VA improvements with cataract surgery compared to the non-pseudoexfoliation group. These findings will help inform the consent process and management of patient expectations.