Arthritis is a common condition, which frequently involves the hands. Patients with inflammatory arthritis have been shown to experience significant delays in diagnosis. We sought to develop and test a screening tool combining an image of a patient's hands, a short series of questions, and a single examination technique, to determine the most likely diagnosis in a patient presenting with hand arthritis. Machine learning techniques were used to develop separate algorithms for each component, which were combined to produce a diagnosis. 280 consecutive new patients presenting to a Rheumatology practice with hand arthritis were enrolled. Each patient completed a 9-part questionnaire, had photographs taken of each hand, and had a single examination result recorded. The Rheumatologist diagnosis was recorded following a 45-minute consultation. The photograph algorithm was developed from 1000 previous hand images, and machine learning techniques were applied to the questionnaire results, training several models ay results are encouraging for the application of such techniques in clinical practice. This article is protected by copyright. All rights reserved. Acute kidney injury (AKI) during hospitalization is frequent and associated with adverse outcomes. We have now evaluated the association between renal function recovery after AKI and short-term post-discharge mortality. This is a retrospective study of all AKI episodes codified in the electronic records of a single center in 2013 and 2014. Epidemiological data and comorbidities at baseline and laboratory values at admission and discharge were collected. Persistent kidney dysfunction after AKI was defined as a last serum creatinine equal or above 1.2-fold over baseline level. Patients were followed for 30 days after discharge. Out of 1720 evaluated patients, 1541 (89%) were analyzed. https://www.selleckchem.com/products/sulfosuccinimidyl-oleate-sodium.html Of them, 869 (56%) recovered renal function. Independent predictors of renal function recovery after AKI were lower baseline estimated glomerular filtration rate (eGFR) (p < 0.001), higher admission eGFR (p < 0.001) and hemoglobin (p=0.016), milder AKI (p=0.037), absence of history of heart failure (p < 0.001), and lower admission blood pressure (p < 0.001). After discharge, 46 (3%) patients died in the first 30 days. Persistent kidney dysfunction was associated (p=0.01) to and independently predicted (OR 2.6, 95%CI (1.2-5.4), p=0.01) short term post-discharge mortality. Persistent kidney dysfunction after an AKI episode is an independent predictor of 30-day post-discharge mortality. This information may help select AKI patients who required closer follow-up and monitoring after discharge. This article is protected by copyright. All rights reserved.Persistent kidney dysfunction after an AKI episode is an independent predictor of 30-day post-discharge mortality. This information may help select AKI patients who required closer follow-up and monitoring after discharge. This article is protected by copyright. All rights reserved. Phaeochromocytoma and paraganglioma (PPGL) in pregnancy, if not diagnosed antepartum, pose a high risk for mother and child. To examine the clinical clues of antepartum and postpartum/postmortem diagnosis of PPGL. Case reports on PPGL in pregnancy published between 1 January 1988 and 30 June 2019 in English, German, Dutch or French. Case reports containing a predefined minimum of clinical data on PPGL and pregnancy. Two authors independently performed data extraction and assessed data quality. We calculated odds ratios (OR) (with 95% confidence intervals) and used uni- and multivariable logistic regression analysis. Maternal and fetal/neonatal mortalities were 9.0% (18/200) and 14.2% (29/204), respectively. Maternal mortality was 42-fold higher with PPGL diagnosed postpartum/postmortem (17/58; 29.3%) than antepartum (1/142; 0.7%) (adjusted OR 45.9, 95% CI 5.67-370, P=0.0003). Offspring mortality was 2.6-fold higher with PPGL diagnosed postpartum/postmortem than antepartum (OR 3.1, 95% CI 1.38-6.91, P=0.0044). Hypertension at admission (OR 2.29, 95% CI 1.12-4.68, P=0.022), sweating (OR 3.14, 95% CI 1.29-7.63, P=0.014) and a history of PPGL, a known PPGL-associated gene mutation or adrenal mass (OR 8.87, 95% CI 1.89-41.64, P=0.0056) were independent factors of antepartum diagnosis. Acute onset of symptoms (OR 8.49, 95% CI 3.52-20.5, P<0.0001), initial diagnosis of pre-eclampsia (OR 6.34, 95% CI 2.60-15.5, P<0.0001), admission for obstetric care (OR 10.71, 95% CI 2.70-42.45, P=0.0007) and maternal tachycardia (OR 2.72, 95% CI 1.26-5.85, P=0.011) were independent factors of postpartum diagnosis. Several clinical clues can assist clinicians in considering an antenatal diagnosis of PPGL in pregnancy, thus potentially improving outcome. Systematic review of 204 pregnant patients with phaeochromocytoma identified clinical clues for a timely antepartum diagnosis.Systematic review of 204 pregnant patients with phaeochromocytoma identified clinical clues for a timely antepartum diagnosis.Early life stress is an important vulnerability factor for the development of anxiety disorders, depression and late-onset cognitive decline. Recently, we demonstrated that juvenile stress (JS) lastingly enhanced long-term potentiation via reduction of steady-state glutamine synthetase mRNA expression and the associated dysregulation of the astrocytic glutamate-glutamine cycle in the rat ventral CA1. We now investigated the regulation of steady-state mRNA expression of neuronal gene products that determine GABAergic and glutamatergic neurotransmission in layers of the ventral and dorsal CA1 after JS. We further studied their interaction with stress in young adult age (AS) to address their putative role in psychopathology development. Strikingly, mRNA levels of the glutamic acid decarboxylase (GAD) isoforms GAD65 and of the GABA-A receptor α2 (Gabra2) were increased after single JS or AS, but not after combined JS/AS stress experience. In fact, JS/AS resulted in layer-specific reduction of Gabra2 and also of Gabra1 mRNA levels in the ventral CA1. Furthermore, GAD65 and Gabra2 mRNAs were correlated with glutamatergic AMPA and NMDA receptor subunit mRNAs after single JS and AS, but not after combined JS/AS. Together, these data indicate a loss of allostatic regulation of steady-state mRNA levels of key GABAergic components that may result in a dysregulation of excitation/ inhibition balance in the ventral CA1 upon dual stress exposure. Finally, individual differences in local glucocorticoid receptor mRNA expression may contribute to this regulation.