Phramongkutklao Hospital

Prematurity can lead to various ocular conditions, including strabismus, refractive errors, amblyopia, and cataracts. However, comprehensive data on these outcomes in preterm Thai infants is limited. This study aimed to investigate the incidence of retinopathy of prematurity (ROP) and assess long-term ocular sequelae, such as cataracts, refractive errors, strabismus, and amblyopia, among preterm infants at Phramongkutklao Hospital. A retrospective review of medical records was conducted for premature infants screened for ROP between January 2011 and April 2022. Data were collected at birth, and follow-up visits were analyzed at 6 months, 1 year, and 2 years of age. The primary outcomes included the incidence of ROP and the prevalence of long-term ocular sequelae. A total of 308 preterm infants were included in the study. The incidence of ROP was found to be 31.5%. At the 2-year follow-up, the prevalence of cataracts was 0.65%, strabismus 14.4%, and amblyopia 6%. Refractive errors were observed in 51.8% of the infants, with 18.1% showing myopia and 33.7% hyperopia. Logistic regression analysis indicated that delayed growth and development (adjusted odds ratio = 13.28, 95% confidence interval: 1.83–96.68) and amblyopia (adjusted odds ratio = 19.65, 95% confidence interval: 2.85–135.54) were significantly associated with an increased risk of developing strabismus, after adjusting for confounding factors. The study identified an ROP incidence of 31.5% in the preterm cohort. At 2 years, long-term ocular sequelae included a prevalence of cataracts (0.65%), strabismus (14.4%), amblyopia (6%), and refractive errors (51.8%). Delayed growth and development, along with amblyopia, were found to elevate the risk of strabismus development significantly.

Cognitive training (CT) has been one of the important non-pharmaceutical interventions that could delay cognitive decline. Currently, no definite CT methods are available. Furthermore, little attention has been paid to the effect of CT on mood and instrumental activities of daily living (IADL).

To assess the effectiveness of a multicomponent CT using a training program of executive functions, attention, memory and visuospatial functions (TEAM-V Program) on cognition, mood and instrumental ADL.

A randomized, single-blinded, treatment-as-usual controlled trial.

Geriatric clinic in Bangkok, Thailand.

80 nondemented community-dwelling older adults (mean age 65.7 ± 4.3 years).

The CT (TEAM-V) Program or the treatment-as-usual controlled group. The TEAM-V intervention was conducted over 5 sessions, with a 2-week interval between each session. A total of 80 participants were randomized (n = 40 the TEAM-V Program; n = 40 the control group).

The Thai version of Montreal Cognitive Assessment (MoCA), The Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-cog), Thai version of Hospital Anxiety and Depression Scale (HADS) and The Chula ADL were used to assess at baseline, 6 months, 1 year and 2 years.

Compared with the control arm (n = 36), the TEAM-V Program (n = 39) was associated with significantly improved general cognition (MoCA, P = 0.02) at 2 years. Compared with baseline, participants receiving the TEAM-V Program were associated with significantly improved immediate recall (word recall task, P < 0.001), retrieval and retention of memory processes (word recognition task, P = 0.01) and attention (number cancellation part A, P = 0.01) at 2 years. No training effects on anxiety (P = 0.94), depression (P = 0.093) and IADL (P = 0.48) were detected.

The TEAM-V Program was effective in improving global cognitive function. Even though, the program did not significantly improve anxiety, depression and IADL compared with the control group, memory and attention improved in the intervention group compared with baseline. Further studies incorporating a larger sample size, longitudinal follow-up and higher-intensity CT should be conducted.

Background Cervical spinal cord injury (SCI) is a severe condition that can lead to neurogenic shock, a life-threatening complication. Neurogenic shock is characterized by a sudden impairment of sympathetic tone, resulting in vasodilation, hypotension, and bradycardia. This disruption can significantly affect blood flow dynamics, particularly in the microcirculation. Near-infrared spectroscopy (NIRS) is a device that enables the monitoring of tissue oxygenation and the assessment of microcirculatory status. This study aimed to apply NIRS in conjunction with the vascular occlusion test (VOT) to evaluate microcirculatory function in SCI patients with neurogenic shock and analyze its association with in-hospital mortality. Methods This prospective study included cervical SCI patients with neurogenic shock on whom NIRS was performed along with VOT within 24 hours after admission in the ICU (T0). Follow-up measurements were taken at the time of the acute phase (D0), and on days 3, 5, and 7. The de-oxygenation (DeO2) slope, re-oxygenation (ReO2) slope, and the reperfusion area were recorded. The prevalence of microcirculatory dysfunction, and mortality rate were primary outcomes of this study. Results The prevalence of microcirculatory alterations was 239 (92%), with 122 (47%) of patients still exhibiting alterations at day 7 (D7). Survivors had higher NIRS parameters at D0 compared to non-survivors. The ReO2 slope at D0 was significantly decreased in patients who developed new-onset kidney injury and nosocomial infections. Conclusion The prevalence of microcirculatory disturbance was high in patients with an SCI and neurogenic shock, and it was linked to in-hospital mortality and complications.