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Tremblay A, Xu X, Colee J, Tompkins TA. Efficacy of a Multi-Strain Probiotic Formulation in Pediatric Populations: A Comprehensive Review of Clinical Studies. Nutrients 2021; 13:nu13061908. [PMID: 34206098 PMCID: PMC8226750 DOI: 10.3390/nu13061908] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 12/22/2022] Open
Abstract
A probiotic formulation combining Lactobacillus helveticus Rosell®-52, Bifidobacterium infantis Rosell®-33, and Bifidobacterium bifidum Rosell®-71 with fructooligosaccharides, first commercialized in China, has been sold in over 28 countries since 2002. Clinical studies with this blend of strains were conducted mainly in pediatric populations, and most were published in non-English journals. This comprehensive review summarizes the clinical studies in infants and children to evaluate the efficacy of this probiotic for pediatric indications. Literature searches for pediatric studies on Biostime® or Probiokid® (non-commercial name) in 6 international and Chinese databases identified 28 studies, which were classified by indications. Twelve studies show that the probiotic significantly increases the efficacy of standard diarrhea treatment regardless of etiology, reducing the risk of unresolved diarrhea (RR 0.31 [0.23; 0.42]; p < 0.0001) by 69%. In eight studies, the probiotic enhanced immune defenses, assessed by levels of various immune competence and mucosal immunity markers (six studies), and reduced the incidence of common infections (two studies). The probiotic improved iron deficiency anemia treatment efficacy (three studies), reducing the risk of unresolved anemia by 49% (RR 0.51 [0.28; 0.92]; p = 0.0263) and significantly reducing treatment side effects by 47% (RR 0.53 [0.37; 0.77]; p = 0.0009). Other studies support further investigation into this probiotic for oral candidiasis, eczema, feeding intolerance in premature babies, or hyperbilirubinemia in newborns.
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Affiliation(s)
- Annie Tremblay
- Rosell Institute for Microbiome and Probiotics, Lallemand Health Solutions Inc., 6100 Royalmount Avenue, Montreal, QC H4P2R2, Canada; (A.T.); (X.X.)
| | - Xiaoyu Xu
- Rosell Institute for Microbiome and Probiotics, Lallemand Health Solutions Inc., 6100 Royalmount Avenue, Montreal, QC H4P2R2, Canada; (A.T.); (X.X.)
| | - James Colee
- IFAS Statistical Consulting Unit, University of Florida, P.O. Box 110500, Gainesville, FL 32611-0500, USA;
| | - Thomas A. Tompkins
- Rosell Institute for Microbiome and Probiotics, Lallemand Health Solutions Inc., 6100 Royalmount Avenue, Montreal, QC H4P2R2, Canada; (A.T.); (X.X.)
- Correspondence:
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202
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Dubois J, Alison M, Counsell SJ, Hertz‐Pannier L, Hüppi PS, Benders MJ. MRI of the Neonatal Brain: A Review of Methodological Challenges and Neuroscientific Advances. J Magn Reson Imaging 2021; 53:1318-1343. [PMID: 32420684 PMCID: PMC8247362 DOI: 10.1002/jmri.27192] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/24/2020] [Accepted: 04/24/2020] [Indexed: 01/04/2023] Open
Abstract
In recent years, exploration of the developing brain has become a major focus for researchers and clinicians in an attempt to understand what allows children to acquire amazing and unique abilities, as well as the impact of early disruptions (eg, prematurity, neonatal insults) that can lead to a wide range of neurodevelopmental disorders. Noninvasive neuroimaging methods such as MRI are essential to establish links between the brain and behavioral changes in newborns and infants. In this review article, we aim to highlight recent and representative studies using the various techniques available: anatomical MRI, quantitative MRI (relaxometry, diffusion MRI), multiparametric approaches, and functional MRI. Today, protocols use 1.5 or 3T MRI scanners, and specialized methodologies have been put in place for data acquisition and processing to address the methodological challenges specific to this population, such as sensitivity to motion. MR sequences must be adapted to the brains of newborns and infants to obtain relevant good soft-tissue contrast, given the small size of the cerebral structures and the incomplete maturation of tissues. The use of age-specific image postprocessing tools is also essential, as signal and contrast differ from the adult brain. Appropriate methodologies then make it possible to explore multiple neurodevelopmental mechanisms in a precise way, and assess changes with age or differences between groups of subjects, particularly through large-scale projects. Although MRI measurements only indirectly reflect the complex series of dynamic processes observed throughout development at the molecular and cellular levels, this technique can provide information on brain morphology, structural connectivity, microstructural properties of gray and white matter, and on the functional architecture. Finally, MRI measures related to clinical, behavioral, and electrophysiological markers have a key role to play from a diagnostic and prognostic perspective in the implementation of early interventions to avoid long-term disabilities in children. EVIDENCE LEVEL: 2 TECHNICAL EFFICACY STAGE: 1.
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Affiliation(s)
- Jessica Dubois
- University of ParisNeuroDiderot, INSERM,ParisFrance
- UNIACT, NeuroSpin, CEA; Paris‐Saclay UniversityGif‐sur‐YvetteFrance
| | - Marianne Alison
- University of ParisNeuroDiderot, INSERM,ParisFrance
- Department of Pediatric RadiologyAPHP, Robert‐Debré HospitalParisFrance
| | - Serena J. Counsell
- Centre for the Developing BrainSchool of Biomedical Engineering & Imaging Sciences, King's College LondonLondonUK
| | - Lucie Hertz‐Pannier
- University of ParisNeuroDiderot, INSERM,ParisFrance
- UNIACT, NeuroSpin, CEA; Paris‐Saclay UniversityGif‐sur‐YvetteFrance
| | - Petra S. Hüppi
- Division of Development and Growth, Department of Woman, Child and AdolescentUniversity Hospitals of GenevaGenevaSwitzerland
| | - Manon J.N.L. Benders
- Department of NeonatologyUniversity Medical Center Utrecht, Utrecht UniversityUtrechtthe Netherlands
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203
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El-Attar LM, Bahashwan AA, Bakhsh AD, Moshrif YM. The prevalence and patterns of chromosome abnormalities in newborns with major congenital anomalies: A retrospective study from Saudi Arabia. Intractable Rare Dis Res 2021; 10:81-87. [PMID: 33996352 PMCID: PMC8122309 DOI: 10.5582/irdr.2021.01016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Congenital anomalies are a worldwide health problem that places a burden on the family and society. Chromosome abnormalities are one of the leading causes for congenital anomalies in newborns. Despite the remarkable development in cytogenetic services in the past years, still there are limited data from Middle East countries. The current study aimed to evaluate the prevalence and patterns of chromosomal aberrations in newborns admitted to the neonatal intensive care unit (NICU) with major congenital anomalies at Medina province in the western region of Saudi Arabia. Out of 2,541 live births, 150 newborns were selected based on the presence of major birth defects. Demographic and clinical data were collected from hospital medical records and statistically analyzed. The prevalence of major congenital anomalies was 10.7/1,000 live births (95% CI: 9.076- 12.583). The most common congenital anomalies in descending order were congenital heart disease, musculoskeletal and chromosome abnormalities. The birth prevalence of chromosome abnormalities was 4.22/1,000 live births (95% CI: 3.211-5.441). The most common chromosome abnormality was Down syndrome-nondisjunction type (66%). Advanced parental age was strongly associated with chromosome aberrations (p < 0.001) while consanguinity was evident in cases with normal karyotype (p < 0.001). High birth prevalence of chromosome abnormalities in newborns with congenital anomalies in Al Madinah was evident and advanced parental age is a potential risk factor. A local registry system for congenital anomalies is highly recommended to provide proper health services to high risk families.
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Affiliation(s)
- Lama Mohammed El-Attar
- Department of Human Genetics, Medical Research Institute, Alexandria University, Alexandria, Egypt
- Address correspondence to:Lama Mohammed El-Attar, Department of Human Genetics, Medical Research Institute, Alexandria University, 165 ElHoreya Rd, Al Ibrahimeyah Qebli; Alexandria, Egypt. E-mail:
| | - Ahmed Abdelrahman Bahashwan
- Main Laboratory and Blood Bank, Madinah Maternity and Children Hospital (MMCH), Al-Madinah Al-Munawarah, Saudi Arabia
| | - Ameen Deen Bakhsh
- Main Laboratory and Blood Bank, Madinah Maternity and Children Hospital (MMCH), Al-Madinah Al-Munawarah, Saudi Arabia
| | - Yasser Mohammed Moshrif
- Main Laboratory and Blood Bank, Madinah Maternity and Children Hospital (MMCH), Al-Madinah Al-Munawarah, Saudi Arabia
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204
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Martínez JI, Figueroa MI, Alfaro Gómez EL, Dipierri JE. Newborn anthropometry, maternal capital, and altitude in the highland population from the province of Jujuy, Argentina. Am J Phys Anthropol 2021; 175:25-35. [PMID: 33368163 DOI: 10.1002/ajpa.24215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 12/05/2020] [Accepted: 12/13/2020] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To analyze variability in newborn (NB) anthropometry among Jujenean NBs as a function of geographic altitude (500 m to ≈4000 masl), maternal anthropometry and other maternal characteristics within the maternal capital framework. MATERIALS AND METHODS Data obtained from 41,371 mother/child pairs recorded in the Jujuy Perinatal Information System (SIP) between 2009 and 2014, including: NB and maternal weight, length/height and BMI; gestational age (corrected); maternal age, educational level, nutritional status, and marital status; birth interval; and planned pregnancy. Based on the declared place of residence, the prevalence of unsatisfied basic needs (% UBN) was determined and the data was split into two altitudinal groups: highlands (HL, >2500 masl) and lowlands (LL, <2500 masl). ANOVA, Chi-squared and Pearson tests were applied as needed. Statistical associations between the response variables-NB weight, length and BMI-and maternal and environmental variables were tested using a Generalized Additive Mixed Model (GAMM). RESULTS All NB and maternal anthropometric variables were lower in HL compared to LL; they also presented negative correlations with altitude, except NB length. Apart from gestational age and birth interval, HL and LL presented statistically significant differences in all study variables. GAMM results showed that maternal anthropometry was the main influence on NB weight and length. DISCUSSION Of all the maternal capital features examined, only maternal anthropometric variables were found to protect offspring against the negative impact of HL environments.
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Affiliation(s)
- Jorge I Martínez
- National University of Jujuy, Institute of Altitude Biology, Jujuy, Argentina
- CONICET, Institute of Andean Ecoregions (INECOA), Jujuy, Argentina
| | - Marcelo I Figueroa
- CONICET, Institute of Andean Ecoregions (INECOA), Jujuy, Argentina
- National University of Jujuy, Institute of Cellular, Genetic and Molecular Studies, Jujuy, Argentina
| | - Emma L Alfaro Gómez
- National University of Jujuy, Institute of Altitude Biology, Jujuy, Argentina
- CONICET, Institute of Andean Ecoregions (INECOA), Jujuy, Argentina
| | - José E Dipierri
- National University of Jujuy, Institute of Altitude Biology, Jujuy, Argentina
- CONICET, Institute of Andean Ecoregions (INECOA), Jujuy, Argentina
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205
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Moreda-Piñeiro J, Cocho JA, Couce ML, Moreda-Piñeiro A, Bermejo-Barrera P. Trace elements in dried blood spots as potential discriminating features for metabolic disorder diagnosis in newborns. Metallomics 2021; 13:6261194. [PMID: 33930140 PMCID: PMC8755940 DOI: 10.1093/mtomcs/mfab018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 03/26/2021] [Accepted: 04/08/2021] [Indexed: 11/13/2022]
Abstract
Trace elements in dried blood spots (DBSs) from newborns were determined by laser ablation coupled with inductively coupled plasma mass spectrometry, and data were subjected to chemometric evaluation in an attempt to classify healthy newborns and newborns suffering from metabolic disorders. Unsupervised [principal component analysis (PCA) and cluster analysis (CA)] and supervised [linear discriminant analysis (LDA) and soft independent modeling by class analogy (SIMCA)] pattern recognition techniques were used as classification techniques. PCA and CA have shown a clear tendency to form two groups (healthy newborns and newborns suffering from metabolic disorders). LDA and SIMCA have predicted that 90.5% and 83.9% of originally grouped healthy newborn cases were correctly classified by LDA and SIMCA, respectively. In addition, these percentages were 97.6% (LDA) and 80.6% (SIMCA) for DBSs from newborns suffering from metabolic disorders. However, SIMCA has only detected one misclassified DBS from the healthy group, and the lower percentage is attributed to four DBSs from the healthy newborn group and five DBSs from newborns with disorders that were found as belonging to both categories (healthy newborns and newborns with disorders) in the training set. LDA also gave a percentage of grouped maple syrup urine disease (MSUD) cases correctly classified of 100%, although the percentage fells to 66.7% when classifying phenylketonuria (PKU) cases. Finally, essential elements such as Fe, K, Rb, and Zn were found to be matched (correlated) with the concentration of amino acids such as phenylalanine, valine, and leucine, biomarkers linked with MSUD and PKU diseases.
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Affiliation(s)
- Jorge Moreda-Piñeiro
- Department of Chemistry, Faculty of Sciences, Universidade da Coruña, Grupo Química Analítica Aplicada (QANAP), University Institute of Research in Environmental Studies (IUMA), Centro de Investigaciones Científicas Avanzadas (CICA), Campus de A Coruña, s/n, 15071 A Coruña, Spain
| | - José A Cocho
- Unit of Diagnosis and Treatment of Congenital Metabolic Diseases, Department of Pediatrics, University Hospital of Santiago de Compostela, IDIS, CIBERER, A Choupana, s/n, 15706 Santiago de Compostela, Spain
| | - María Luz Couce
- Unit of Diagnosis and Treatment of Congenital Metabolic Diseases, Department of Pediatrics, University Hospital of Santiago de Compostela, IDIS, CIBERER, A Choupana, s/n, 15706 Santiago de Compostela, Spain
| | - Antonio Moreda-Piñeiro
- Group of Trace Elements, Speciation and Spectroscopy (GETEE), Strategic Grouping in Materials (AEMAT), Department of Analytical Chemistry, Nutrition and Bromatology, Faculty of Chemistry, Universidade de Santiago de Compostela, Avenida das Ciencias, s/n, 15782 Santiago de Compostela, Spain
| | - Pilar Bermejo-Barrera
- Group of Trace Elements, Speciation and Spectroscopy (GETEE), Strategic Grouping in Materials (AEMAT), Department of Analytical Chemistry, Nutrition and Bromatology, Faculty of Chemistry, Universidade de Santiago de Compostela, Avenida das Ciencias, s/n, 15782 Santiago de Compostela, Spain
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206
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Marcotte EL, Spector LG, Mendes-de-Almeida DP, Nelson HH. The Prenatal Origin of Childhood Leukemia: Potential Applications for Epidemiology and Newborn Screening. Front Pediatr 2021; 9:639479. [PMID: 33968846 PMCID: PMC8102903 DOI: 10.3389/fped.2021.639479] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 02/22/2021] [Indexed: 12/22/2022] Open
Abstract
Childhood leukemias are heterogeneous diseases with widely differing incident rates worldwide. As circulating tumors, childhood acute leukemias are uniquely accessible, and their natural history has been described in greater detail than for solid tumors. For several decades, it has been apparent that most cases of childhood acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) initiate in utero. Circumstantial evidence in support of this contention includes the young age of onset and high rate of concordance among identical twins. "Backtracking" of leukemic somatic mutations, particularly gene translocations, to cord blood and dried blood spots collected during the perinatal period has provided molecular proof of prenatal leukemogenesis. Detection of a patient's leukemia translocation in easily accessible birth samples, such as dried blood spots, is straightforward with the knowledge of their idiosyncratic breakpoints. However, to translate these findings into population-based screening and leukemia prevention requires novel methods able to detect translocations at all possible breakpoints when present in a low frequency of cells. Several studies have attempted to screen for leukemic translocations, mainly the common ETV6-RUNX1 translocation, in cord blood samples from healthy children. Most studies have reported finding translocations in healthy children, but estimates of prevalence have varied widely and greatly exceed the incidence of leukemia, leading to concerns that technical artifact or contamination produced an artificially inflated estimate of translocation prevalence at birth. New generation techniques that capture the presence of these translocations at birth have the potential to vastly increase our understanding of the epidemiology of acute leukemias. For instance, if leukemic translocations are present at birth in a far higher proportion of children than eventually develop acute leukemia, what are the exposures and somatic molecular events that lead to disease? And could children with translocations present at birth be targeted for prevention of disease? These questions must be answered before large-scale newborn screening for leukemia can occur as a public health initiative. Here, we review the literature regarding backtracking of acute leukemias and the prevalence of leukemic translocations at birth. We further suggest an agenda for epidemiologic research using new tools for population screening of leukemic translocations.
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Affiliation(s)
- Erin L. Marcotte
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States
| | - Logan G. Spector
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States
| | - Daniela P. Mendes-de-Almeida
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States
- Department of Hematology, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
- Division of Molecular Carcinogenesis, Research Center, Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil
| | - Heather H. Nelson
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
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207
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Jans J, Unger WW, Raeven EAM, Simonetti ER, Eleveld MJ, de Groot R, de Jonge MI, Ferwerda G. Lack of Cell Cycle Inhibitor p21 and Low CD4 + T Cell Suppression in Newborns After Exposure to IFN-β. Front Immunol 2021; 12:652965. [PMID: 33912177 PMCID: PMC8071872 DOI: 10.3389/fimmu.2021.652965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/18/2021] [Indexed: 11/16/2022] Open
Abstract
Type I IFNs, such as interferon alpha and interferon beta, are key regulators of the adaptive immune response during infectious diseases. Type I IFNs are induced upon infection, bind interferon α/β receptors on T-cells and activate intracellular pathways. The activating and inhibitory consequences of type I IFN-signaling are determined by cell type and cellular environment. The neonatal immune system is associated with increased vulnerability to infectious diseases which could partly be explained by an immature CD4+ T-cell compartment. Here, we show low IFN-β-mediated inhibition of CD4+ T-cell proliferation, phosphorylation of retinoblastoma protein and cytokine production in human newborns compared to adults. In addition, both naïve and total newborn CD4+ T-cells are unable to induce the cell-cycle inhibitor p21 upon exposure to IFN-β in contrast to adults. The distinct IFN-β-signaling in newborns provides novel insights into T cell functionality and regulation of T cell-dependent inflammation during early life immune responses.
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Affiliation(s)
- Jop Jans
- Laboratory of Pediatrics, Division of Pediatric Infectious Diseases and Immunology, Erasmus MC University Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands.,Laboratory of Medical Immunology, Section Pediatric Infectious Diseases, Department of Laboratory Medicine, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, Netherlands.,Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Netherlands
| | - Wendy W Unger
- Laboratory of Pediatrics, Division of Pediatric Infectious Diseases and Immunology, Erasmus MC University Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands
| | - Elisabeth A M Raeven
- Laboratory of Medical Immunology, Section Pediatric Infectious Diseases, Department of Laboratory Medicine, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, Netherlands.,Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Netherlands
| | - Elles R Simonetti
- Laboratory of Medical Immunology, Section Pediatric Infectious Diseases, Department of Laboratory Medicine, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, Netherlands.,Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Netherlands
| | - Marc J Eleveld
- Laboratory of Medical Immunology, Section Pediatric Infectious Diseases, Department of Laboratory Medicine, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, Netherlands.,Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Netherlands
| | - Ronald de Groot
- Laboratory of Medical Immunology, Section Pediatric Infectious Diseases, Department of Laboratory Medicine, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, Netherlands.,Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Netherlands
| | - Marien I de Jonge
- Laboratory of Medical Immunology, Section Pediatric Infectious Diseases, Department of Laboratory Medicine, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, Netherlands.,Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Netherlands
| | - Gerben Ferwerda
- Laboratory of Medical Immunology, Section Pediatric Infectious Diseases, Department of Laboratory Medicine, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, Netherlands.,Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Netherlands
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208
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Bieleninik Ł, Lutkiewicz K, Jurek P, Bidzan M. Paternal Postpartum Bonding and Its Predictors in the Early Postpartum Period: Cross-Sectional Study in a Polish Cohort. Front Psychol 2021; 12:628650. [PMID: 33897536 PMCID: PMC8062924 DOI: 10.3389/fpsyg.2021.628650] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 03/15/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Parental postpartum bonding has been studied by many researchers focusing on maternal bonding. The objective of this study was to examine the psychological and socio-demographic predictors of paternal postpartum bonding in the early postpartum period. Methods: In this cross-sectional study, 131 couples (fathers median age of 32.37 years, SD = 4.59; mothers median age of 30.23 years, SD = 3.90) of newborns from full-term pregnancies were recruited from November 2019 until March 2020. The primary outcome was paternal postpartum bonding as measured by the Postpartum Bonding Questionnaire (PBQ). Secondary outcomes included: maternal and paternal anxiety [with the Generalized Anxiety Disorder (GAD) Assessment]; maternal and paternal stress [with the Parental Stress Scale (PSS)]; maternal depressive symptoms [with the Edinburgh Postpartum Depression Scale (EPDS)]; and maternal and paternal socio-demographic variables as fathers' presence at childbirth, education level, age, and parental experience. Results: Paternal postpartum bonding was significantly correlated with paternal anxiety (moderate strength), maternal stress (strong correlation), and maternal postpartum bonding. No significant correlations between paternal postpartum bonding, maternal depression symptoms, and maternal anxiety were found. The mediating role of paternal stress in paternal postpartum bonding was proven. Paternal anxiety strengthens paternal stress (b = 0.98). Further, a high level of paternal stress disrupts paternal postpartum bonding (b = 0.41). Results of regression analyses have revelated that maternal infant bonding (p < 0.01) and paternal stress (p < 0.01) are the only predictors of parental postpartum bonding across all included variables. None of investigated socio-demographic variables were associated with paternal postpartum bonding. Conclusion: Notwithstanding limitations, the current findings add to a growing body of literature on paternal postpartum bonding. The results have shown that paternal mental health is related to parental postpartum bonding directly after delivery. Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT04118751.
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Affiliation(s)
- Łucja Bieleninik
- Department of Clinical and Health Psychology, Faculty of Social Sciences, Institute of Psychology, University of Gdańsk, Gdańsk, Poland
- GAMUT-The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre, Bergen, Norway
| | - Karolina Lutkiewicz
- Department of Clinical and Health Psychology, Faculty of Social Sciences, Institute of Psychology, University of Gdańsk, Gdańsk, Poland
| | - Paweł Jurek
- Department of Social Psychology, Faculty of Social Sciences, Institute of Psychology, University of Gdańsk, Gdańsk, Poland
| | - Mariola Bidzan
- Department of Clinical and Health Psychology, Faculty of Social Sciences, Institute of Psychology, University of Gdańsk, Gdańsk, Poland
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209
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Demers-Mathieu V, Hines DJ, Hines RM, Lavangnananda S, Fels S, Medo E. Influence of Previous COVID-19 and Mastitis Infections on the Secretion of Brain-Derived Neurotrophic Factor and Nerve Growth Factor in Human Milk. Int J Mol Sci 2021; 22:3846. [PMID: 33917718 PMCID: PMC8068104 DOI: 10.3390/ijms22083846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/23/2021] [Accepted: 04/06/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) play a critical role in neurodevelopment, where breast milk is a significant dietary source. The impact of previous COVID-19 infection and mastitis on the concentration of BDNF and NGF in human milk was investigated. METHODS Concentrations of BDNF and NGF were measured via ELISA in human milk samples collected from 12 mothers with a confirmed COVID-19 PCR, 13 mothers with viral symptoms suggestive of COVID-19, and 22 unexposed mothers (pre-pandemic Ctl-2018). These neurotrophins were also determined in 12 mothers with previous mastitis and 18 mothers without mastitis. RESULTS The NGF concentration in human milk was lower in the COVID-19 PCR and viral symptoms groups than in the unexposed group, but BDNF did not differ significantly. Within the COVID-19 group, BDNF was higher in mothers who reported headaches or loss of smell/taste when compared with mothers without the respective symptom. BDNF was lower in mothers with mastitis than in mothers without mastitis. CONCLUSIONS Previous COVID-19 and mastitis infections changed differently the secretion of NGF and BDNF in human milk. Whether the changes in NGF and BDNF levels in milk from mothers with infection influence their infant's development remains to be investigated.
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Affiliation(s)
- Veronique Demers-Mathieu
- Department of Neonatal Immunology and Microbiology, Medolac Laboratories A Public Benefit Corporation, Boulder City, NV 89005, USA; (S.L.); (S.F.); (E.M.)
| | - Dustin J. Hines
- Department of Psychology, University of Nevada Las Vegas, Las Vegas, NV 89154, USA; (D.J.H.); (R.M.H.)
| | - Rochelle M. Hines
- Department of Psychology, University of Nevada Las Vegas, Las Vegas, NV 89154, USA; (D.J.H.); (R.M.H.)
| | - Sirima Lavangnananda
- Department of Neonatal Immunology and Microbiology, Medolac Laboratories A Public Benefit Corporation, Boulder City, NV 89005, USA; (S.L.); (S.F.); (E.M.)
| | - Shawn Fels
- Department of Neonatal Immunology and Microbiology, Medolac Laboratories A Public Benefit Corporation, Boulder City, NV 89005, USA; (S.L.); (S.F.); (E.M.)
| | - Elena Medo
- Department of Neonatal Immunology and Microbiology, Medolac Laboratories A Public Benefit Corporation, Boulder City, NV 89005, USA; (S.L.); (S.F.); (E.M.)
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210
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Ronga I, Galigani M, Bruno V, Noel JP, Gazzin A, Perathoner C, Serino A, Garbarini F. Spatial tuning of electrophysiological responses to multisensory stimuli reveals a primitive coding of the body boundaries in newborns. Proc Natl Acad Sci U S A 2021; 118:e2024548118. [PMID: 33798099 DOI: 10.1073/pnas.2024548118] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The ability to identify our own body and its boundaries is crucial for survival. Ideally, the sooner we learn to discriminate external stimuli occurring close to our body from those occurring far from it, the better (and safer) we may interact with the sensory environment. However, when this mechanism emerges within ontogeny is unknown. Is it something acquired throughout infancy, or is it already present soon after birth? The presence of a spatial modulation of multisensory integration (MSI) is considered a hallmark of a functioning representation of the body position in space. Here, we investigated whether MSI is present and spatially organized in 18- to 92-h-old newborns. We compared electrophysiological responses to tactile stimulation when concurrent auditory events were delivered close to, as opposed to far from, the body in healthy newborns and in a control group of adult participants. In accordance with previous studies, adult controls showed a clear spatial modulation of MSI, with greater superadditive responses for multisensory stimuli close to the body. In newborns, we demonstrated the presence of a genuine electrophysiological pattern of MSI, with older newborns showing a larger MSI effect. Importantly, as for adults, multisensory superadditive responses were modulated by the proximity to the body. This finding may represent the electrophysiological mechanism responsible for a primitive coding of bodily self boundaries, thus suggesting that even just a few hours after birth, human newborns identify their own body as a distinct entity from the environment.
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211
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De Rose DU, Santisi A, Ronchetti MP, Martini L, Serafini L, Betta P, Maino M, Cavigioli F, Cocchi I, Pugni L, Bonanno E, Tzialla C, Giuffrè M, Bua J, Della Torre B, Nardella G, Mazzeo D, Manzoni P, Dotta A, Bagolan P, Auriti C, On Behalf Of Study Group Of Neonatal Infectious Diseases. Invasive Candida Infections in Neonates after Major Surgery: Current Evidence and New Directions. Pathogens 2021; 10:319. [PMID: 33803104 DOI: 10.3390/pathogens10030319] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 02/07/2023] Open
Abstract
Infections represent a serious health problem in neonates. Invasive Candida infections (ICIs) are still a leading cause of mortality and morbidity in neonatal intensive care units (NICUs). Infants hospitalized in NICUs are at high risk of ICIs, because of several risk factors: broad spectrum antibiotic treatments, central catheters and other invasive devices, fungal colonization, and impaired immune responses. In this review we summarize 19 published studies which provide the prevalence of previous surgery in neonates with invasive Candida infections. We also provide an overview of risk factors for ICIs after major surgery, fungal colonization, and innate defense mechanisms against fungi, as well as the roles of different Candida spp., the epidemiology and costs of ICIs, diagnosis of ICIs, and antifungal prophylaxis and treatment.
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212
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Rynjah MM, Venkatachalam J, Adhisivam B, Olickal JJ, Sundaram SP, Chinnakali P. Non-exclusive breastfeeding amongst high-risk children: Factors and barriers associated with non-exclusive breastfeeding at a tertiary care hospital in Southern India. Niger Postgrad Med J 2021; 28:62-67. [PMID: 33642327 DOI: 10.4103/npmj.npmj_294_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background In the first 6 months of life, non-exclusive breastfeeding (NEBF) is estimated to be the cause of 1.4 million deaths worldwide and contributes to 10% of the disease burden in under-five children. Aims and Objectives The objective of the study was to determine the prevalence of NEBF amongst the high-risk children and the factors associated with NEBF. Methods This cross-sectional study was conducted amongst high-risk babies admitted between August 2016 and February 2018 who also attended the high-risk follow-up clinic at the neonatology department. Data were collected using a pre-tested structured questionnaire. Chi-square test was used to determine the factors associated with NEBF and prevalence ratios (PR) with 95% confidence interval (CI) were calculated. Results Amongst 304 children, 56.3% were male and 87% had birth weight <2500 g. Nearly three-fourth of the mothers were <30 years of age. The prevalence of NEBF was 49.3% (95% CI: 43.7-55.0). There was a significant association of NEBF with employment status of the mother (PR = 1.45; 95% CI: 1.1-1.9), NEBF in previous child (PR = 2.3; 95% CI: 1.4-3.9) and EBF at the point of discharge (PR = 2.3; 95% CI: 2-2.6). The barriers reported by the mothers leading to NEBF were insufficient or less milk secretion, poor breastfeeding attachment, perceived thirst and poor maternal health. Conclusion One out of every two children admitted in neonatal intensive care unit were non-exclusively breastfed before 6 months of age. The employment status of mother, practice of exclusively breastfeeding the previous child and EBF at the time of discharge were significantly associated with NEBF.
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Affiliation(s)
- Mary Magdalene Rynjah
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Jayaseelan Venkatachalam
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - B Adhisivam
- Department of Neonatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Jeby Jose Olickal
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Shanthosh Priyan Sundaram
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Palanivel Chinnakali
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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213
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Guzmán-Navarro G, de León MB, Martín-Estal I, Durán RCD, Villarreal-Alvarado L, Vaquera-Vázquez A, Cuevas-Cerda T, Garza-García K, Cuervo-Pérez LE, Barbosa-Quintana Á, Pérez-Saucedo JE, Lara-Díaz VJ, Castorena-Torres F. Prenatal indole-3-carbinol administration activates aryl hydrocarbon receptor-responsive genes and attenuates lung injury in a bronchopulmonary dysplasia model. Exp Biol Med (Maywood) 2021; 246:695-706. [PMID: 33148012 PMCID: PMC7988727 DOI: 10.1177/1535370220963789] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 09/14/2020] [Indexed: 12/12/2022] Open
Abstract
Hyperoxia-hypoxia exposure is a proposed cause of alveolar developmental arrest in bronchopulmonary dysplasia in preterm infants, where mitochondrial reactive oxygen species and oxidative stress vulnerability are increased. The aryl hydrocarbon receptor (AhR) is one of the main activators of the antioxidant enzyme system that protects tissues and systems from damage. The present study aimed to determine if the activation of the AhR signaling pathway by prenatal administration of indole-3-carbinol (I3C) protects rat pups from hyperoxia-hypoxia-induced lung injury. To assess the activation of protein-encoding genes related to the AhR signaling pathway (Cyp1a1, Cyp1b1, Ugt1a6, Nqo1, and Gsta1), pup lungs were excised at 0, 24, and 72 h after birth, and mRNA expression levels were quantified by reverse transcription-quantitative polymerase chain reaction assays (RT-qPCR). An adapted Ratner's method was used in rats to evaluate radial alveolar counts (RACs) and the degree of fibrosis. The results reveal that the relative expression of AhR-related genes in rat pups of prenatally I3C-treated dams was significantly different from that of untreated dams. The RAC was significantly lower in the hyperoxia-hypoxia group (4.0 ± 1.0) than that in the unexposed control group (8.0 ± 2.0; P < 0.01). When rat pups of prenatally I3C-treated dams were exposed to hyperoxia-hypoxia, an RAC recovery was observed, and the fibrosis index was similar to that of the unexposed control group. A cytokine antibody array revealed an increase in the NF-κB signaling cascade in I3C-treated pups, suggesting that the pathway could regulate the inflammatory process under the stimulus of this compound. In conclusion, the present study demonstrates that I3C prenatal treatment activates AhR-responsive genes in pup's lungs and hence attenuates lung damage caused by hyperoxia-hypoxia exposure in newborns.
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Affiliation(s)
- Gabriela Guzmán-Navarro
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey 64710, Mexico
| | - Mario Bermúdez de León
- Departamento de Biología Molecular, Centro de Investigación Biomédica del Noreste, Instituto Mexicano del Seguro Social, Monterrey 64720, Mexico
| | - Irene Martín-Estal
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey 64710, Mexico
| | | | | | | | - Tania Cuevas-Cerda
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey 64710, Mexico
| | - Karina Garza-García
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey 64710, Mexico
| | | | | | | | - Víctor J Lara-Díaz
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey 64710, Mexico
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214
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Della Longa L, Dragovic D, Farroni T. In Touch with the Heartbeat: Newborns' Cardiac Sensitivity to Affective and Non-Affective Touch. Int J Environ Res Public Health 2021; 18. [PMID: 33668108 DOI: 10.3390/ijerph18052212] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/05/2021] [Accepted: 02/21/2021] [Indexed: 12/14/2022]
Abstract
The sense of touch is the first manner of contact with the external world, providing a foundation for the development of sensorimotor skills and socio-affective behaviors. In particular, affective touch is at the core of early interpersonal interactions and the developing bodily self, promoting the balance between internal physiological state and responsiveness to external environment. The aim of the present study is to investigate whether newborns are able to discriminate between affective touch and non-affective somatosensory stimulations and whether affective touch promotes a positive physiological state. We recorded full-term newborns' (N = 30) heart rate variability (HRV)-which reflects oscillations of heart rate associated with autonomic cardio-respiratory regulation-while newborns were presented with two minutes of affective (stroking) and non-affective (tapping) touch alternated with two minutes of resting in a within-subject design. The results revealed that non-affective touch elicits a decrease in HRV, whereas affective touch does not result in a change of HRV possibly indicating maintenance of calm physiological state. Thus, newborns showed cardiac sensitivity to different types of touch, suggesting that early somatosensory stimulation represents scaffolding for development of autonomic self-regulation with important implications on infant's ability to adaptively respond to the surrounding social and physical environment.
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215
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Vieira BDSPP, Anchieta LM, Cardoso DR, Ribeiro SNS, Ribeiro-Samora GA, Parreira VF. Effects of two modalities of noninvasive ventilation on breathing pattern of very low birth weight preterm infants immediately after extubation: a quasi-experimental study. J Matern Fetal Neonatal Med 2021; 35:5717-5723. [PMID: 33645398 DOI: 10.1080/14767058.2021.1892063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIM The primary objective of this study was to investigate the effects of two modalities of noninvasive ventilation, continuous positive airway pressure-CPAP and non-synchronized nasal intermittent positive pressure ventilation-nsNIPPV, on breathing pattern of very low birth weight preterm infants immediately after extubation. METHODS It was conducted a quasi-experimental study at a public university hospital. Infants with gestacional age ≤32 weeks and birth weight ≤1,500 g were randomized into the sequences, prior extubation: CPAP - nsNIPPV (1) or nsNIPPV - CPAP (2). Each preterm infant was studied for a period of 60 min in each ventilatory mode. Respiratory inductive plethysmography was used to assess breathing pattern. Inferential analysis was performed by repeated measures ANOVA or Friedman test. RESULTS Eleven preterm infants were studied and a total of 7,564 respiratory cycles were analyzed. No significant differences were observed in any of the comparisons made for any of the breathing pattern variables (p > .05). CONCLUSIONS There was no significant difference on breathing pattern between CPAP and nsNIPPV of preterm infants after extubation.
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Affiliation(s)
- Bruna da Silva Pinto Pinheiro Vieira
- Rehabilitation Sciences Graduation Program, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Hospital of Clinics, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Leni Márcia Anchieta
- Hospital of Clinics, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Department of Pediatrics, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Daniella Rocha Cardoso
- Physiotherapy Undergraduation Course, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Giane Amorim Ribeiro-Samora
- Rehabilitation Sciences Graduation Program, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Verônica Franco Parreira
- Department of Physiotherapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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216
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Abstract
Prematurely born infants face unique risks, and the treatment of imminent preterm birth is thus an important part of perinatal care. Ritodrine hydrochloride (Rito) is widely used as a therapeutic agent to treat imminent preterm birth in Japan. Following assessment of the risks and benefits of short-acting β-agonists, including Rito, in Europe, however, the use of Rito has begun to be questioned. Thus, in this study we investigated the safety of Rito in the treatment of imminent preterm birth, with a particular focus on the adverse effects (AEs) on fetuses and newborn infants. Using the Pharmaceuticals and Medical Devices Agency of Japan's Japanese Adverse Drug Event Report (JADER) database, the AEs on fetuses and newborns caused by oral and injected Rito were extracted and analyzed. The reported odds ratios for oral Rito were significantly higher for fetal tachycardia, fetal bradycardia, neonatal hypoglycemia, and neonatal heart failure than for other drugs. The reported odds ratios for Rito injection were significantly higher for fetal tachycardia and neonatal hypoglycemia than for other drugs. Oral drugs had more adverse effect reports than injectable drugs.
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Affiliation(s)
- Yuriko Yonaga
- Department of Pharmaceutical Sciences, Teikyo Heisei University, Nakano, Tokyo, Japan
| | - Akihiko Ito
- Department of Pharmaceutical Sciences, Teikyo Heisei University, Nakano, Tokyo, Japan
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217
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Vidavalur R, Bhutani VK. Economic evaluation of point of care universal newborn screening for glucose-6-Phosphate dehydrogenase deficiency in United States. J Matern Fetal Neonatal Med 2021; 35:5745-5753. [PMID: 33627013 DOI: 10.1080/14767058.2021.1892067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVES Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency is frequent inherited enzymopathy that poses potentially preventable risk for extreme hyperbilirubinemia (EHB) which can, rarely, lead to acute bilirubin encephalopathy, childhood kernicterus and death. We aimed to estimate quality adjusted life years (QALY) lost due to G6PD deficiency associated with EHB and economic costs to best estimate value of universal pre-discharge screening. METHODS We did a cost utility analysis for US birth cohort utilizing pre-discharge screening decision tree model to estimate population burden and EHB outcomes, based on literature search and expert opinions. Employing human capital approach, we measured health benefits in terms of QALYs and economic losses. QALYs and costs were discounted at 3%; one-way sensitivity analysis was used for decision variables. RESULTS We determined for USA live births of 3.86 million in 2017, 1464 cases of EHB were estimated to be due to G6PD deficiency (CI 95%; range: 1270-1656) and contributed 2 deaths (CI 95%; range 1.3-3.2) and 14 (CI 95%; range: 9.1-21.5) cases of kernicterus. Over lifetime horizon, the model predicted undiscounted and discounted gains of 165 (102-252) life years; 241 (183-433) QALYs and 16 (9.9-24.5) life years; 89 (67.9-160.5) QALYs, respectively. Assuming 50% effectiveness, benefit cost ratios ranged from 0.19 to 3.42 for diverse operational settings. The cost to prevent a single case of kernicterus was $2.7 to 6.8 million per annum with cost per QALY gained at $35,946 to $89,159. CONCLUSION At incremental cost-effective threshold of $100,000/life year, pre-discharge screening would be expected to prove cost effective in preventing EHB related morbidities and mortality attributed to G6PD deficiency.
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Affiliation(s)
- Ramesh Vidavalur
- Department of Neonatology, Cayuga Medical Center, Ithaca, NY, USA
| | - Vinod K Bhutani
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford Children's Health, Stanford University School of Medicine, Stanford, CA, USA
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218
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Herath MP, Beckett JM, Hills AP, Byrne NM, Ahuja KDK. Gestational Diabetes Mellitus and Infant Adiposity at Birth: A Systematic Review and Meta-Analysis of Therapeutic Interventions. J Clin Med 2021; 10:jcm10040835. [PMID: 33670645 PMCID: PMC7922793 DOI: 10.3390/jcm10040835] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/03/2021] [Accepted: 02/16/2021] [Indexed: 12/16/2022] Open
Abstract
Exposure to untreated gestational diabetes mellitus (GDM) in utero increases the risk of obesity and type 2 diabetes in adulthood, and increased adiposity in GDM-exposed infants is suggested as a plausible mediator of this increased risk of later-life metabolic disorders. Evidence is equivocal regarding the impact of good glycaemic control in GDM mothers on infant adiposity at birth. We systematically reviewed studies reporting fat mass (FM), percent fat mass (%FM) and skinfold thicknesses (SFT) at birth in infants of mothers with GDM controlled with therapeutic interventions (IGDMtr). While treating GDM lowered FM in newborns compared to no treatment, there was no difference in FM and SFT according to the type of treatment (insulin, metformin, glyburide). IGDMtr had higher overall adiposity (mean difference, 95% confidence interval) measured with FM (68.46 g, 29.91 to 107.01) and %FM (1.98%, 0.54 to 3.42) but similar subcutaneous adiposity measured with SFT, compared to infants exposed to normal glucose tolerance (INGT). This suggests that IGDMtr may be characterised by excess fat accrual in internal adipose tissue. Given that intra-abdominal adiposity is a major risk factor for metabolic disorders, future studies should distinguish adipose tissue distribution of IGDMtr and INGT.
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219
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Vinhaes CL, Arriaga MB, de Almeida BL, Oliveira JV, Santos CS, Calcagno JI, Carvalho TX, Giovanetti M, Alcantara LCJ, de Siqueira IC, Andrade BB. Newborns With Zika Virus-Associated Microcephaly Exhibit Marked Systemic Inflammatory Imbalance. J Infect Dis 2021; 222:670-680. [PMID: 32311029 DOI: 10.1093/infdis/jiaa197] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 04/17/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Zika virus (ZIKV) is an emergent flavivirus initially considered a benign and self-limited exanthematic illness. In 2015, a new epidemic emerged in northeastern of Brazil with increased incidence of a previously rare clinical outcome, microcephaly, in newborns from mothers who were infected during pregnancy. Little is known about the immunopathogenesis of ZIKV-associated microcephaly. Understanding the inflammatory profile and degree of inflammation of persons affected with such condition is an important step towards development of innovative therapeutic strategies. METHODS A case-control study compared plasma levels of several inflammatory biomarkers from newborns with ZIKV microcephaly, asymptomatic ZKV infection, or uninfected controls. Plasma biomarkers were assessed using Luminex. A series of multidimensional analysis was performed to characterize the systemic immune activation profile of the clinical groups. RESULTS We identified an inflammatory signature associated with ZIKV microcephaly that suggested an increased inflammation. Network analysis suggested that ZIKV microcephaly is associated with imbalanced immune activation and inflammation. The cephalic perimeter was inversely proportional with the degree of inflammatory perturbation. Furthermore, a combination of plasma inflammatory biomarkers could discriminate ZIKV with microcephaly from those with ZIKV without microcephaly or uninfected neonates. CONCLUSIONS An intense inflammatory imbalance that is proportional to the disease severity hallmarks ZIKV microcephaly.
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Affiliation(s)
- Caian L Vinhaes
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil.,Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Brazil.,Curso de Medicina, Faculdade de Tecnologia e Ciências (UniFTC), Salvador, Brazil
| | - María B Arriaga
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil.,Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Brazil.,Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
| | | | - João V Oliveira
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Cleiton S Santos
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Juan I Calcagno
- Maternidade de Referência Prof. José Maria de Magalhães Netto-Secretaria de Saúde do Estado da Bahia (SESAB), Salvador, Brazil
| | - Tereza X Carvalho
- Maternidade de Referência Prof. José Maria de Magalhães Netto-Secretaria de Saúde do Estado da Bahia (SESAB), Salvador, Brazil
| | - Marta Giovanetti
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.,Laboratório de Genética Celular e Molecular, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Luiz Carlos J Alcantara
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.,Laboratório de Genética Celular e Molecular, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Bruno B Andrade
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil.,Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Brazil.,Curso de Medicina, Faculdade de Tecnologia e Ciências (UniFTC), Salvador, Brazil.,Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil.,Universidade Salvador (UNIFACS), Laureate Universities, Salvador, Brazil.,Wellcome Centre for Infectious Disease Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.,Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
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220
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Medina NY, Edwards RC, Zhang Y, Hans SL. A longitudinal investigation of young mothers' prenatal attachment, depressive symptoms, and early parenting behaviour. J Reprod Infant Psychol 2021; 40:196-211. [PMID: 33586534 DOI: 10.1080/02646838.2021.1886257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objectives: This study explores whether young, low-income mothers' prenatal attachment to their infants is related to attachment and parenting behaviour postnatally.Background: A small literature has documented continuity in maternal attachment from pregnancy to postpartum and shown that early maternal attachment is associated with positive parenting behaviour. Less is known about whether prenatal attachment has a unique impact on parenting behaviour, or if it is primarily a step in the development of postnatal attachment, which in turn influences parenting. Additionally, it is unclear whether associations between attachment and early parenting might be attributable to other factors such as depressive symptoms.Method: This longitudinal study followed young primiparous mothers from pregnancy through 3-weeks postnatal. 240 ethnically/racially diverse low-income American women reported their attachment-related thoughts and feelings and their depressive symptoms during pregnancy and postnatally. At 3 weeks postpartum, mothers were observed interacting with their infant.Results: There was stability in attachment and depressive symptoms from pregnancy to postpartum. In multivariate path models, prenatal attachment was directly associated with two types of parenting behaviour: positive engagement and encouragement of learning, even when accounting for depressive symptoms and postnatal attachment. There was an indirect effect of prenatal attachment on sensitivity through postnatal attachment.Conclusion: The foundation of a mother's emotional connection to her infant begins before birth. Parenting support programmes for young mothers should begin during pregnancy. Supporting the establishment of positive prenatal attachment may also have a positive influence on later parenting behaviour among mothers, including mothers experiencing depressive symptoms.
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Affiliation(s)
- Nora Y Medina
- School of Social Service Administration, The University of Chicago, Chicago, IL, USA
| | - Renee C Edwards
- School of Social Service Administration, The University of Chicago, Chicago, IL, USA
| | - Yudong Zhang
- School of Social Service Administration, The University of Chicago, Chicago, IL, USA
| | - Sydney L Hans
- School of Social Service Administration, The University of Chicago, Chicago, IL, USA
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221
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Gałązka P, Redloch K, Kroczek K, Styczyński J. Minimally Invasive Surgery for Congenital Abdominal Cystic Lesions in Newborns and Infants. In Vivo 2021; 34:1215-1221. [PMID: 32354912 DOI: 10.21873/invivo.11895] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 03/10/2020] [Accepted: 03/12/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND/AIM In the variety of congenital abdominal cystic lesions (CACL) of different origin, ovarian cyst is the most common intra-abdominal pathology in female neonates. The prognosis and timing of treatment varies depending on the nature of CACL. This study aimed to assess the results of diagnostics and treatment of CACL. PATIENTS AND METHODS A retrospective analysis was performed of 39 cases of CACL, with the spectrum including ovarian, enteric, mesenteric and pancreatic origin. Outcome of minimally invasive surgery, open surgery or conservative approach was analyzed. RESULTS Twenty-eight neonates underwent surgery, while 11 were treated conservatively. Twenty patients were treated with a laparoscopic technique and eight with laparotomy combined with laparoscopy. Final diagnosis included: Fifteen cases of ovarian pathology (ovarian torsion in 11 cases), 12 treated laparoscopically and three with laparotomy, six enteric duplications (four laparoscopic and two laparotomic), three mesenteric cysts (one laparoscopic and two laparotomic), two pancreatic cysts (both laparoscopic only), two duodenal stenoses, including duodenal septum (both laparotomies with Heineke-Mikulicz plasty). No blood transfusion apart from two cases requiring re-laparotomy and no early complications were observed in any case; no death occurred. CONCLUSION With the strategy of management based on ultrasound and laboratory data, a laparoscopically assisted minimal access approach resulted in minimal risk of complications and complete recovery in all patients, leading to exclusion of oncological risk.
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Affiliation(s)
- Przemysław Gałązka
- Department of General and Oncological Surgery for Children and Adolescents with Unit of Neonatal Surgery and Intensive Care, Nicolaus Copernicus University in Torun, Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland .,Department of Pediatric Hematology and Oncology, Nicolaus Copernicus University in Torun, Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland
| | - Krzysztof Redloch
- Department of Radiology, Nicolaus Copernicus University in Torun, Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland
| | - Kacper Kroczek
- Department of General and Oncological Surgery for Children and Adolescents with Unit of Neonatal Surgery and Intensive Care, Nicolaus Copernicus University in Torun, Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland.,Department of Pediatric Hematology and Oncology, Nicolaus Copernicus University in Torun, Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland
| | - Jan Styczyński
- Department of Pediatric Hematology and Oncology, Nicolaus Copernicus University in Torun, Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland
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222
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Hirfanoglu T, Ozturk Z, Gokdogan GS, Hirfanoglu IM, Onal EE, Turkyilmaz C, Ergenekon E, Koc E. Neonatal Seizures and Future Epilepsy: Predictive Value of Perinatal Risk Factors, Electroencephalography, and Imaging. J Pediatr Neurosci 2021; 15:190-198. [PMID: 33531931 PMCID: PMC7847114 DOI: 10.4103/jpn.jpn_159_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 11/18/2019] [Accepted: 05/25/2020] [Indexed: 11/04/2022] Open
Abstract
Context There are limited data in the literature about the relationship between neonatal seizures and subsequent epilepsy. Aims This study aimed to identify the predictive value of perinatal factors, etiologies, electroencephalography (EEG), and cranial ultrasonography (USG) for future epilepsy after neonatal seizures. Materials and Methods A total of 92 children with epilepsy who had seizures during their neonatal period were retrospectively evaluated whether the contribution of perinatal, natal, and postnatal risk factors confining clinical, laboratory, EEG, and imaging to subsequent epilepsy. Chi-square, uni, and multivariate logistic regression were applied to find out predictive factors for subsequent epilepsy. Results The rate of epilepsy was 57.6 % during 1-6 years follow-up. Birth weight, Apgar scores at first and fifth minutes, resuscitation history, abnormal neurological examination, etiology, response to the treatment, abnormal EEG, or USG findings were the most important risk factors for future epilepsy in univariate analysis (P < 0.05). Furthermore, asphyxia, fifth minute Apgar scores, response to the treatment, USG, and EEG were independent predictors (P < 0.05) for subsequent epilepsy in multivariate logistic regression. No relationship was found between subsequent epilepsy and mode of delivery, seizure onset time, and seizure types (P > 0.05). Conclusion Although there are recent promising and advanced techniques in neonatal intensive care units, asphyxia is still one of the most important risk factors for not only poor neurological conditions but also for future epilepsy after neonatal seizures. Apgar scores, treatment with multiple antiepileptic drugs, poor background EEG activity, and abnormal neuroimaging seem to have strong predictive values for developing subsequent epilepsy. Therefore, patients with a history of neonatal seizures should be closely followed up to decrease the risk of long-term outcomes and early detection of epilepsy.
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Affiliation(s)
- Tugba Hirfanoglu
- Department of Pediatric Neurology, Gazi University School of Medicine, Ankara, Turkey
| | - Zeynep Ozturk
- Department of Pediatric Neurology, Gazi University School of Medicine, Ankara, Turkey
| | | | | | - Eray Esra Onal
- Department of Pediatrics & Neonatology, Gazi University School of Medicine, Ankara, Turkey
| | - Canan Turkyilmaz
- Department of Pediatrics & Neonatology, Gazi University School of Medicine, Ankara, Turkey
| | - Ebru Ergenekon
- Department of Pediatrics & Neonatology, Gazi University School of Medicine, Ankara, Turkey
| | - Esin Koc
- Department of Pediatrics & Neonatology, Gazi University School of Medicine, Ankara, Turkey
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223
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Leung C. The younger the milder clinical course of COVID-19: Even in newborns? Pediatr Allergy Immunol 2021; 32:358-362. [PMID: 32931058 DOI: 10.1111/pai.13371] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 07/13/2020] [Accepted: 09/03/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Milder symptoms were observed in children with COVID-19. However, whether this also holds true for neonates is not known. METHODS The clinical data of a total of 3213 patients aged 2 years or below, including 749 neonates, in Brazil nationwide were studied. Comparisons were made between neonate and infant patients by conducting statistical tests. RESULTS Neonates appeared to bear more severe clinical courses. In addition to higher case fatality rates, newborns with COVID-19 had much shorter time from symptom onset to death and longer time from symptom onset to discharge. Dyspnoea, sore throat and cough were more prominent in neonate patients, suggestive of both upper and lower respiratory tract infection, as opposed to upper respiratory tract symptoms mostly observed in children. CONCLUSION Findings suggested that trained immunity provides a possible explanation because the innate immune system in newborns is not "well-trained" while that in adult tends to hyperactive.
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Affiliation(s)
- Char Leung
- Deakin University, Burwood, Vic, Australia
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224
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Rico A, Dollard SC, Valencia D, Corchuelo S, Tong VT, Laiton-Donato K, Amin MM, Benavides M, Wong P, Newton S, Daza M, Cates J, Gonzalez M, Zambrano LD, Mercado MM, Ailes EC, Rodriguez HM, Gilboa SM, Acosta J, Ricaldi J, Pelaez D, Honein MA, Ospina ML, Lanzieri TM. Epidemiology of cytomegalovirus Infection among mothers and infants in Colombia. J Med Virol 2021; 93:6393-6397. [PMID: 33475162 DOI: 10.1002/jmv.26815] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/07/2021] [Accepted: 01/19/2021] [Indexed: 11/12/2022]
Abstract
We assessed maternal and infant cytomegalovirus (CMV) infection in Colombia. Maternal serum was tested for CMV immunoglobulin G antibodies at a median of 10 (interquartile range: 8-12) weeks gestation (n = 1501). CMV DNA polymerase chain reaction was performed on infant urine to diagnose congenital (≤21 days of life) and postnatal (>21 days) infection. Maternal CMV seroprevalence was 98.1% (95% confidence interval [CI]: 97.5%-98.8%). Congenital CMV prevalence was 8.4 (95% CI: 3.9%-18.3%; 6/711) per 1000 live births. Among 472 infants without confirmed congenital CMV infection subsequently tested at age 6 months, 258 (54.7%, 95% CI: 50.2%-59.1%) had postnatal infection.
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Affiliation(s)
| | - Sheila C Dollard
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Diana Valencia
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Van T Tong
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Minal M Amin
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Phili Wong
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | | | - Jordan Cates
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Laura D Zambrano
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Elizabeth C Ailes
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Suzanne M Gilboa
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Jessica Ricaldi
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Margaret A Honein
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Tatiana M Lanzieri
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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225
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Abstract
Intrauterine infections - infectious diseases in which infection of the fetus occurred in the ante- or intrapartum period, accompanied by clinical manifestations. The purpose of this study was to study the information content and diagnostic significance of the microbiological research method for the etiological diagnosis of intrauterine infections of a bacterial nature. A retrospective (2011-2014) and prospective (2015-2019) analysis of the results of microbiological studies of biomaterials from puerperas and their newborns was carried out in 63 cases of early neonatal mortality with established diagnoses of intrauterine infections. In the study of the separated cervical canal, placenta samples, and amniotic fluid, seeding of coagulase-negative staphylococci was most frequently observed, among which the species Staphylococcus epidermidis dominated, Staphylococcus hominis, Staphylococcus haemolyticus, Staphylococcus warneri also met. Frequent isolation of group B streptococci from the placenta and amniotic fluid was revealed in comparison with the material from the cervical canal.The information content of the microbiological study of materials from the puerpera and the newborn in terms of confirmation of the pathogen and the fact of its transmission from mother to fetus/newborn does not exceed 30%. Even with high contamination of the genital tract of the puerpera, placenta or amniotic fluid, examination of the materials from the newborn immediately after birth often does not allow to identify the causative agent, probably due to the low degree of contamination at the initial stage of development of the infectious process. An increase in the diagnostic value of microbiological research can be facilitated by an increase in the frequency of examinations, the number of samples taken; the use of techniques to increase the sensitivity of cultural research at the stage of analysis; the use of molecular genetic methods, especially in the study of materials from newborns.
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Affiliation(s)
- Elena Vitalevna Naumkina
- Federal State Budgetary Educational Institution of Higher Education «Omsk State Medical University».,Budgetary Healthcare Institution of the Omsk Region «City Clinical Perinatal Center»
| | - L V Kuklina
- Federal State Budgetary Educational Institution of Higher Education «Omsk State Medical University»
| | - E N Kravchenko
- Federal State Budgetary Educational Institution of Higher Education «Omsk State Medical University»
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226
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Olchawa-Czech A, Ptak K, Szymońska I, Kwinta P. Severe enterovirus infections in infants <3 months of age and the importance of medical history. J Mother Child 2021; 24:37-44. [PMID: 33548163 PMCID: PMC8258841 DOI: 10.34763/jmotherandchild.20202403.2022.d-20-00007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background Enteroviral infections in infants <3 months of age are frequent and under-diagnosed even though they can be life-threatening. Properly conducted subjective examination, which is repeatedly neglected, plays a key role in the diagnosis and treatment of these infections. Materials and methods Analyses included children <3 months of age with confirmed enterovirus infection, hospitalised in the Department of Paediatrics from January 2019 to February 2020. Infections were confirmed by reverse transcription polymerase chain reaction in the cerebrospinal fluid using Neuro9 FTD set and in the stool using PB-03/Neuro; antibodies were determined in one patient. Results This study presents a detailed description of three cases with confirmed enterovirus infection and a positive epidemiological history. The cases involve viral sepsis, myocarditis with arrhythmia and circulatory failure, and meningitis with seizures. In addition, the details of 10 patients hospitalised in the Children’s Clinic with a confirmed enterovirus infection are presented. Based on these cases, a significant influence of family history-taking on the diagnosis and implementation of appropriate treatment was found. Conclusion In most of the analysed cases, family history of viral infection was positive. In patients with the most severe course of the enterovirus infection, accurate epidemiological history is extremely important, and the suspicion of viral infection and securing appropriate materials for testing may significantly speed up the diagnosis in the newborn and help to implement an appropriate treatment.
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Affiliation(s)
- Anna Olchawa-Czech
- Faculty of Medicine, Institute of Paediatrics, Jagiellonian University Medical College, Cracow, Poland
| | - Katarzyna Ptak
- Faculty of Medicine, Institute of Paediatrics, Jagiellonian University Medical College, Cracow, Poland
| | - Izabela Szymońska
- Faculty of Medicine, Institute of Paediatrics, Jagiellonian University Medical College, Cracow, Poland
| | - Przemko Kwinta
- Faculty of Medicine, Institute of Paediatrics, Jagiellonian University Medical College, Cracow, Poland
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227
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De Rose DU, Perri A, Auriti C, Gallini F, Maggio L, Fiori B, D’Inzeo T, Spanu T, Vento G. Time to Positivity of Blood Cultures Could Inform Decisions on Antibiotics Administration in Neonatal Early-Onset Sepsis. Antibiotics (Basel) 2021; 10:antibiotics10020123. [PMID: 33525647 PMCID: PMC7910918 DOI: 10.3390/antibiotics10020123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 11/30/2022] Open
Abstract
(1) Background: Empirical antibiotics for suspected neonatal early-onset sepsis are often prolonged administered, even in the absence of clinical signs of infection, while awaiting the blood cultures results. The C-reactive protein is widely used to guide antibiotic therapy, although its increase in the first hours of life is not always evidence of infection. The aim of this study was to evaluate the time to positivity (TTP) of blood cultures (BC) that develop pathogens in our population of neonates and determine whether TTP could safely inform the decisions on empirical antibiotic discontinuation in neonatal early-onset sepsis and reduce the use of unnecessary antibiotics. (2) Methods: We retrospectively collected data of all newborns ≥ 34 weeks admitted to the Neonatal Intermediate-Care Unit at Policlinico “A. Gemelli” University Hospital (Rome, Italy) from 2014 to 2018, with suspected early-onset sepsis (EOS). The TTP was the time in hours from the first BC inoculation to the bacterial growth. We defined as positive BC only those with a pathogenic organism. (3) Results: In total, 103 out of 20,528 infants born in the five-year study period were admitted to our Neonatal Intermediate-Care Unit because of a suspected EOS and enrolled into the study. The mean TTP of pathogenic organisms was 17.7 ± 12.5 h versus 80.5 ± 55.8 h of contaminants (p = 0.003). We found ten positive BCs. The TTP of BC was lower than 12, 36, and 48 h in 80%, 90%, and 100% of cases, respectively. CRP levels on admission were similar in infants with a positive and negative BC (p = 0.067). The discontinuation of therapy in asymptomatic infants 48 h after initiation would have resulted in a saving of 217 days of antibiotics (31.1% of total days administered). (4) Conclusion: From our data, the TTP of blood cultures that develop pathogens is less than 48 h in 100% of cases. Therefore, in late preterm and full-term infants with suspected EOS, stopping empiric antibiotics 48 h after initiation may be a safe practice to reduce unnecessary antibiotic use, when blood cultures are negative and infants asymptomatic.
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Affiliation(s)
- Domenico Umberto De Rose
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant—“Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy;
- Correspondence: ; Tel.: +39-06-68592427; Fax: +39-06-68593916
| | - Alessandro Perri
- Neonatology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (A.P.); (F.G.); (L.M.); (G.V.)
| | - Cinzia Auriti
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant—“Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy;
| | - Francesca Gallini
- Neonatology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (A.P.); (F.G.); (L.M.); (G.V.)
- Dipartimento di Scienze della Vita e Sanità Pubblica, Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Luca Maggio
- Neonatology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (A.P.); (F.G.); (L.M.); (G.V.)
- Dipartimento di Scienze della Vita e Sanità Pubblica, Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Barbara Fiori
- Department of Laboratory and Infectious Sciences, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (B.F.); (T.D.); (T.S.)
| | - Tiziana D’Inzeo
- Department of Laboratory and Infectious Sciences, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (B.F.); (T.D.); (T.S.)
| | - Teresa Spanu
- Department of Laboratory and Infectious Sciences, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (B.F.); (T.D.); (T.S.)
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giovanni Vento
- Neonatology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (A.P.); (F.G.); (L.M.); (G.V.)
- Dipartimento di Scienze della Vita e Sanità Pubblica, Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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228
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Mohsenpour H, Pesce M, Patruno A, Bahrami A, Pour PM, Farzaei MH. A Review of Plant Extracts and Plant-Derived Natural Compounds in the Prevention/Treatment of Neonatal Hypoxic-Ischemic Brain Injury. Int J Mol Sci 2021; 22:E833. [PMID: 33467663 PMCID: PMC7830094 DOI: 10.3390/ijms22020833] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/05/2021] [Accepted: 01/11/2021] [Indexed: 12/13/2022] Open
Abstract
Neonatal hypoxic-ischemic (HI) brain injury is one of the major drawbacks of mortality and causes significant short/long-term neurological dysfunction in newborn infants worldwide. To date, due to multifunctional complex mechanisms of brain injury, there is no well-established effective strategy to completely provide neuroprotection. Although therapeutic hypothermia is the proven treatment for hypoxic-ischemic encephalopathy (HIE), it does not completely chang outcomes in severe forms of HIE. Therefore, there is a critical need for reviewing the effective therapeutic strategies to explore the protective agents and methods. In recent years, it is widely believed that there are neuroprotective possibilities of natural compounds extracted from plants against HIE. These natural agents with the anti-inflammatory, anti-oxidative, anti-apoptotic, and neurofunctional regulatory properties exhibit preventive or therapeutic effects against experimental neonatal HI brain damage. In this study, it was aimed to review the literature in scientific databases that investigate the neuroprotective effects of plant extracts/plant-derived compounds in experimental animal models of neonatal HI brain damage and their possible underlying molecular mechanisms of action.
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Affiliation(s)
- Hadi Mohsenpour
- Department of Pediatrics, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah 75333–67427, Iran;
| | - Mirko Pesce
- Department of Medicine and Aging Sciences, University G. d’Annunzio, 66100 Chieti, Italy
| | - Antonia Patruno
- Department of Medicine and Aging Sciences, University G. d’Annunzio, 66100 Chieti, Italy
| | - Azam Bahrami
- Medical Technology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah 67158-47141, Iran;
| | - Pardis Mohammadi Pour
- Department of Pharmacognosy, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran;
| | - Mohammad Hosein Farzaei
- Medical Technology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah 67158-47141, Iran;
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229
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Patil UP, Krishnan P, Abudinen-Vasquez S, Maru S, Noble L. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Positive Newborns of COVID-19 Mothers After Dyad-Care: A Case Series. Cureus 2021; 13:e12528. [PMID: 33569259 PMCID: PMC7864286 DOI: 10.7759/cureus.12528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in newborns is extremely rare, and there is a scarcity of research pertaining to epidemiology, clinical presentation, transmission, and prognosis in this population. We present five newborns who tested positive while colocating with their SARS-CoV-2 positive mothers from March 19 to May 15, 2020, at a large public hospital in Queens, New York that was severely affected by the coronavirus disease 2019 (COVID-19) pandemic. All the newborns subsequently tested negative and remained asymptomatic, including through median outpatient follow-up of three weeks.
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Affiliation(s)
- Uday P Patil
- Pediatrics / Neonatal-Perinatal Medicine, Icahn School of Medicine at Mt. Sinai and New York City Health + Hospitals/Elmhurst, Elmhurst, USA
| | - Parvathy Krishnan
- Pediatrics, Icahn School of Medicine at Mt. Sinai and New York City Health + Hospitals/Elmhurst, Elmhurst, USA
| | - Samira Abudinen-Vasquez
- Pediatrics, Icahn School of Medicine at Mt. Sinai and New York City Health + Hospitals/Elmhurst, Elmhurst, USA
| | - Sheela Maru
- Obstetrics, Gynecology and Reproductive Science, New York City Health + Hospitals/Elmhurst, New York City, USA.,Health System Design and Global Health and Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, USA
| | - Lawrence Noble
- Pediatrics / Neonatal-Perinatal Medicine, Icahn School of Medicine at Mt. Sinai and New York City Health + Hospitals/Elmhurst, Elmhurst, USA
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230
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Bilal R, Rustemov D, Sakuov Z, Ibraimov B, Kozhakhmetov A. Case Report: A Rare Case of a Combination of Omphalocele With Umbilical Teratoma. Front Pediatr 2021; 9:726593. [PMID: 34589457 PMCID: PMC8473732 DOI: 10.3389/fped.2021.726593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/18/2021] [Indexed: 11/13/2022] Open
Abstract
Omphalocele is a congenital malformation of the abdominal wall, which occurs with a frequency of 1-5,000 newborns. The prognosis of treatment often depends on the presence of concomitant malformations. The most common contents of the hernia with omphalocele are the intestinal loops, liver, spleen. However, all organs of the abdominal cavity can be part of the hernial sac with large sizes of omphalocele. Teratoma is a germ cell tumor made up of several different types of tissue, such as hair, muscle, teeth, or bone. They are a type of germ cell tumor and divided into two types: mature and immature. In this article, we describe a rare case of a combination of an omphalocele with a mature teratoma and report the successful single step surgical treatment. On the first day after birth, a simultaneous operation-Removal of teratoma with abdominoplasty was performed. The postoperative period was uneventful, and the child was discharged for recovery.
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Affiliation(s)
- Ruslan Bilal
- Department of Medicine, School of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan
| | - Dastan Rustemov
- Department of Pediatric Surgery, National Research Mother and Child Center, Nur-Sultan, Kazakhstan
| | - Zhenis Sakuov
- Department of Pediatric Surgery, National Research Mother and Child Center, Nur-Sultan, Kazakhstan
| | - Bahytkaly Ibraimov
- Department of Pediatric Surgery, National Research Mother and Child Center, Nur-Sultan, Kazakhstan
| | - Arman Kozhakhmetov
- Department of Medicine, School of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan
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231
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Rabbani S, Afaq S, Fazid S, Khattak MI, Yousafzai YM, Habib SH, Lowe N, Ul‐Haq Z. Correlation between maternal and neonatal blood Vitamin D level: Study from Pakistan. Matern Child Nutr 2021; 17:e13028. [PMID: 32815629 PMCID: PMC7729540 DOI: 10.1111/mcn.13028] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 04/25/2020] [Accepted: 04/27/2020] [Indexed: 12/11/2022]
Abstract
In Pakistan, there is limited evidence for the levels and relationship of 25 (OH) Vitamin D (25(OH)D) status in pregnant women and their newborns, while the association between maternal 25(OH)D and newborn anthropometric measurements remains unexplored. Sociodemographic data were collected from 213 pregnant mothers during their visit to a tertiary care hospital at the time of childbirth. Anthropometric measurements were performed on all mothers and their newborns and blood samples collected from both for 25(OH)D levels. Participants were classified into two groups according to their 25(OH)D status: sufficient (25(OH)D ≥50 nmol L-1 ) and deficient (25(OH)D <50 nmol L-1 ). Simple and multiple regression models were used for analysis. Among 213 pregnant women, prevalence of 25(OH)D deficiency was 61.5%, and their newborn was 99.5% (mean 25(OH)D levels: 46.3 [11.3] and 24.9 [5.4] nmol L-1 , respectively). Maternal sociodemographic characteristics were similar between 25(OH)D deficient and sufficient mothers, whereas newborn 25(OH)D levels were significantly lower in the former (22.60 [4.53] vs. 27.67 [3.82] nmol L-1 , respectively, P < 0.001). There was a strong positive association between maternal and newborn 25(OH)D levels (r, 0.66; r2 , 43%, B [SE], 0.3 [0.02]; P < 0.001). Association of maternal 25(OH)D levels with newborn weight, length and head circumference was not significant (all P > 0.05). Our study shows a high prevalence of 25(OH)D deficiency in pregnant women and their newborns and a strong positive association between maternal and newborn 25(OH)D levels. Findings of this study indicate the importance of maintaining sufficient 25(OH)D levels during pregnancy.
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Affiliation(s)
- Shahida Rabbani
- Institute of Public Health and Social SciencesKhyber Medical UniversityPeshawarPaksitan
| | - Saima Afaq
- Institute of Public Health and Social SciencesKhyber Medical UniversityPeshawarPaksitan
- School of Public Health, Faculty of MedicineImperial College LondonLondonUK
| | - Sheraz Fazid
- Institute of Public Health and Social SciencesKhyber Medical UniversityPeshawarPaksitan
| | - Maria Ishaq Khattak
- Institute of Public Health and Social SciencesKhyber Medical UniversityPeshawarPaksitan
| | | | - Syed Hamid Habib
- Institute of Public Health and Social SciencesKhyber Medical UniversityPeshawarPaksitan
| | - Nicky Lowe
- School of Sport and Nutritional SciencesUniversity of Central LancashirePrestonUK
| | - Zia Ul‐Haq
- Institute of Public Health and Social SciencesKhyber Medical UniversityPeshawarPaksitan
- Institute of Health and Well‐beingUniversity of GlasgowGlasgowUK
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Vitali R, Terrin G, Palone F, Laudadio I, Cucchiara S, Boscarino G, Di Chiara M, Stronati L. Fecal High-Mobility Group Box 1 as a Marker of Early Stage of Necrotizing Enterocolitis in Preterm Neonates. Front Pediatr 2021; 9:672131. [PMID: 34178888 PMCID: PMC8222523 DOI: 10.3389/fped.2021.672131] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/22/2021] [Indexed: 12/28/2022] Open
Abstract
Introduction: An early diagnosis of necrotizing enterocolitis (NEC), a major gastrointestinal emergency in preterm newborns, is crucial to improve diagnostic approach and prognosis. We evaluated whether fecal high-mobility group box protein 1 (HMGB1) may early identify preterms at risk of developing NEC. Materials and Methods: A case-control study including neonates admitted at the Neonatal Intensive Care Unit (NICU) of the Sapienza University Hospital "Umberto I" in Rome, from July 2015 to December 2016. Stool samples obtained from cases (preterm newborns with NEC) and controls (newborns without NEC) were collected at the enrolment (T0) and within 7-14 days after the first sample collection (T1). HMGB1, extracted and measured with western blot, was reported as densitometry units (DUS). Results: HMGB1 levels in 30 cases (n = 28-Bell stage 1, n = 2 Bell stage 2) were higher [T0: 21,462 DUS (95% CI, 16,370-26,553 DUS)-T1: 17,533 DUS (95% CI, 13,052-22,014 DUS)] than in 30 preterm controls [T0: 9,446 DUS (95% CI, 6,147-12,746 DUS)-T1: 9,261 DUS (95% CI, 5,126-13,396 DUS), p < 0.001). Preterm newborns showed significant higher levels of HMGB1 (15,690 DUS (95% CI, 11,929-19,451 DUS)] in comparison with 30 full-term neonates with birth weight >2,500 g [6,599 DUS (95% CI, 3,141-10,058 DUS), p = 0.003]. Multivariate analysis showed that the risk of NEC was significantly (p = 0.012) related to the HMGB1 fecal levels at T0. Conclusions: We suggest fecal HMGB1 as a reliable marker of early NEC in preterm neonates. This study supports further investigation on the role of fecal HMGB1 assessment in managing preterm newborns at risk of NEC. Further studies are advocated to evaluate diagnostic accuracy of this marker in more severe forms of the disease.
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Affiliation(s)
- Roberta Vitali
- Division of Health Protection Technologies, Territorial and Production Systems Sustainability Department, Agenzia nazionale per le nuove tecnologie, l'energia e lo sviluppo economico sostenibile (ENEA), Rome, Italy
| | - Gianluca Terrin
- Department of Maternal and Child Health, University of Roma La Sapienza, Rome, Italy
| | - Francesca Palone
- Division of Health Protection Technologies, Territorial and Production Systems Sustainability Department, Agenzia nazionale per le nuove tecnologie, l'energia e lo sviluppo economico sostenibile (ENEA), Rome, Italy
| | - Ilaria Laudadio
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Salvatore Cucchiara
- Department of Maternal and Child Health, University of Roma La Sapienza, Rome, Italy
| | - Giovanni Boscarino
- Department of Maternal and Child Health, University of Roma La Sapienza, Rome, Italy
| | - Maria Di Chiara
- Department of Maternal and Child Health, University of Roma La Sapienza, Rome, Italy
| | - Laura Stronati
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
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233
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Lin Z, Chen Y, Zhou L, Chen S, Xia H. Serum N-Terminal Pro-B-Type Natriuretic Peptide as a Biomarker of Critical Pulmonary Stenosis in Neonates. Front Pediatr 2021; 9:788715. [PMID: 35071134 PMCID: PMC8767013 DOI: 10.3389/fped.2021.788715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 12/14/2021] [Indexed: 11/23/2022] Open
Abstract
Objectives: To determine the efficacy of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in predicting critical pulmonary stenosis (CPS) in neonates. Methods: All neonates with pulmonary stenosis (PS) admitted to the neonatal intensive care unit of Xinhua Hospital from October 2014 to December 2020 were retrospectively reviewed. Infants with serum NT-proBNP levels measured within 48 h after birth were enrolled and divided into CPS and non-CPS groups. Serum NT-proBNP levels and cardiac Doppler indices were compared between the two groups. Correlations were determined using the Spearman's rank correlation coefficient. Receiver operator characteristic curve analysis was used to explore the predictive value of NT-proBNP for identifying neonatal CPS. Results: Among 96 infants diagnosed with PS by echocardiography, 46 were enrolled (21 and 25 in the non-CPS and CPS groups, respectively). Serum NT-proBNP levels were significantly higher in the CPS group than in the non-CPS group [3,600 (2,040-8,251) vs. 1,280 (953-2,386) pg/ml, P = 0.003]. Spearman's analysis suggested a positive correlation between Ln(NT-proBNP) levels and the transvalvular pulmonary gradient (r = 0.311, P = 0.038), as well as between Ln(NT-proBNP) levels and pulmonary artery velocity (r = 0.308, P = 0.040). Receiver operating characteristic curve analysis showed that a cutoff serum NT-proBNP level of 2,395 pg/ml yielded a 66.7 and 78.9% sensitivity and specificity for identifying CPS, respectively. The area under the curve was 0.784 (95% CI, 0.637-0.931). A positive correlation was found between Ln(NT-proBNP) and length of hospital stay (r = 0.312, P < 0.05). Conclusion: Serum NT-proBNP level was positively correlated with PS severity and could be used as a biomarker to identify CPS in neonates.
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Affiliation(s)
- Zhiwei Lin
- Department of Neonatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanru Chen
- Department of Neonatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lin Zhou
- Department of Neonatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sun Chen
- Pediatric Cardiac Center, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongping Xia
- Department of Neonatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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234
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Manzotti A, Cerritelli F, Lombardi E, La Rocca S, Biasi P, Chiera M, Galli M, Lista G. The Neonatal Assessment Manual scorE: A Reliability Study on Hospitalized Neonates. Front Pediatr 2021; 9:715091. [PMID: 34631618 PMCID: PMC8492991 DOI: 10.3389/fped.2021.715091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 08/18/2021] [Indexed: 01/20/2023] Open
Abstract
Despite clinical improvements in neonatal intensive care units (NICUs), prematurity keeps causing several comorbidities. To enhance the management of such conditions, in previous studies we devised the Neonatal Assessment Manual scorE (NAME) model, a structured touch-based assessment that aims to evaluate how newborns respond to gentle touch-based stimuli. The present study aimed to begin assessing the NAME interrater reliability and specific agreements. At the "Vittore Buzzi" Pediatric Hospital NICU ward in Milan, Italy, we enrolled 144 newborns, 85 male and 59 female, with a mean age of 35.9 weeks (±4.1) and a weight of 2,055.3 g (±750.6). Two experienced manual professionals performed the NAME procedure on all the infants. Regarding the total sample and the analysis by sex, we found moderate and statistically significant results for the interrater reliability (p < 0.001) and the specific agreements (p < 0.05), in particular for the "Marginal" score. Furthermore, interrater reliability significantly (p < 0.05) increased as age and weight increased, whereas there was an almost constant moderate and significant (p < 0.05) agreement especially for the "Marginal" score. Therefore, we found preliminary results showing that the NAME could be a reliable diagnostic tool for assessing the newborns' general condition.
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Affiliation(s)
- Andrea Manzotti
- RAISE lab, Foundation COME Collaboration, Pescara, Italy.,Division of Neonatology, Department of Pediatrics, "V. Buzzi" Children's Hospital, ASST-FBF-Sacco, Milan, Italy.,Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
| | | | - Erica Lombardi
- RAISE lab, Foundation COME Collaboration, Pescara, Italy.,Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
| | - Simona La Rocca
- RAISE lab, Foundation COME Collaboration, Pescara, Italy.,Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
| | - Pamela Biasi
- RAISE lab, Foundation COME Collaboration, Pescara, Italy.,Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
| | - Marco Chiera
- RAISE lab, Foundation COME Collaboration, Pescara, Italy
| | - Matteo Galli
- RAISE lab, Foundation COME Collaboration, Pescara, Italy.,Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
| | - Gianluca Lista
- Division of Neonatology, Department of Pediatrics, "V. Buzzi" Children's Hospital, ASST-FBF-Sacco, Milan, Italy
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235
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Costerus SA, Kortenbout AJ, Vos HJ, Govaert P, Tibboel D, Wijnen RMH, de Jong N, Bosch JG, de Graaff JC. Feasibility of Doppler Ultrasound for Cortical Cerebral Blood Flow Velocity Monitoring During Major Non-cardiac Surgery of Newborns. Front Pediatr 2021; 9:656806. [PMID: 33829005 PMCID: PMC8019737 DOI: 10.3389/fped.2021.656806] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 02/25/2021] [Indexed: 11/13/2022] Open
Abstract
Background and Aim: Newborns needing major surgical intervention are at risk of brain injury and impaired neurodevelopment later in life. Disturbance of cerebral perfusion might be an underlying factor. This study investigates the feasibility of serial transfontanellar ultrasound measurements of the pial arteries during neonatal surgery, and whether perioperative changes in cerebral perfusion can be observed and related to changes in the perioperative management. Methods: In this prospective, observational feasibility study, neonates with congenital diaphragmatic hernia and esophageal atresia scheduled for surgical treatment within the first 28 days of life were eligible for inclusion. We performed transfontanellar directional power Doppler and pulsed wave Doppler ultrasound during major high-risk non-cardiac neonatal surgery. Pial arteries were of interest for the measurements. Extracted Doppler ultrasound parameters were: peak systolic velocity, end diastolic velocity, the resistivity index and pulsatility index. Results: In 10 out of 14 patients it was possible to perform perioperative measurements; the others failed for logistic and technical reasons. In 6 out of 10 patients, it was feasible to perform serial intraoperative transfontanellar ultrasound measurements with directional power Doppler and pulsed wave Doppler of the same pial artery during neonatal surgery. Median peak systolic velocity was ranging between 5.7 and 7.0 cm s-1 and end diastolic velocity between 1.9 and 3.2 cm s-1. In patients with a vasoactive-inotropic score below 12 the trend of peak systolic velocity and end diastolic velocity corresponded with the mean arterial blood pressure trend. Conclusion: Perioperative transfontanellar ultrasound Doppler measurements of the pial arteries are feasible and provide new longitudinal data about perioperative cortical cerebral blood flow velocity. Trial Registration: https://www.trialregister.nl/trial/6972, identifier: NL6972.
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Affiliation(s)
- Sophie A Costerus
- Department of Paediatric Surgery, Erasmus MC University Medical Centre-Sophia Children's Hospital, Rotterdam, Netherlands
| | - Anna J Kortenbout
- Department of Biomedical Engineering, Thorax Centre, Erasmus MC University Medical Centre, Rotterdam, Netherlands
| | - Hendrik J Vos
- Department of Biomedical Engineering, Thorax Centre, Erasmus MC University Medical Centre, Rotterdam, Netherlands
| | - Paul Govaert
- Department of Neonatology, Ziekenhuis Netwerk Antwerp, Middelheim Antwerp, Belgium
| | - Dick Tibboel
- Department of Paediatric Surgery, Erasmus MC University Medical Centre-Sophia Children's Hospital, Rotterdam, Netherlands
| | - René M H Wijnen
- Department of Paediatric Surgery, Erasmus MC University Medical Centre-Sophia Children's Hospital, Rotterdam, Netherlands
| | - Nico de Jong
- Department of Biomedical Engineering, Thorax Centre, Erasmus MC University Medical Centre, Rotterdam, Netherlands
| | - Johan G Bosch
- Department of Biomedical Engineering, Thorax Centre, Erasmus MC University Medical Centre, Rotterdam, Netherlands
| | - Jurgen C de Graaff
- Department of Anaesthesiology, Erasmus MC University Medical Centre, Rotterdam, Netherlands
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236
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Al-Hammadi S, Yahya AM, Al-Amri A, Shibli A, Balhaj GB, Tawil MI, Vijayan R, Souid AK. Case Report: BCG-Triggered Hemophagocytic Lymphohistiocytosis in an Infant With X-Linked Recessive Mendelian Susceptibility to Mycobacterial Disease Due to a Variant of Chronic Granulomatous Disease. Front Pediatr 2021; 9:687538. [PMID: 34268280 PMCID: PMC8275851 DOI: 10.3389/fped.2021.687538] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/24/2021] [Indexed: 01/25/2023] Open
Abstract
In the United Arab Emirates, BCG (Bacillus Calmette-Guérin) is administered to all newborns. We present here a young infant with an inborn error of immunity (IEI) who developed fatal adverse events to this live-attenuated vaccine. This male infant received BCG (Serum Institute of India Pvt., Ltd., India) on Day 11 of life. On Day 25, he developed fever, followed by cervical lymphadenitis and bilateral otitis media with fluid drainage. On Day 118, he was admitted with severe hemophagocytic lymphohistiocytosis (HLH), and passed away on Day 145. The diagnostic exome sequencing test identified a hemizygous nonsense variant, NM_000397.3(CYBB):c.676C>T, p.Arg226* (rs137854592). Pathogenic variants of CYBB [cytochrome b(-245), beta subunit; Mendelian Inheritance in Man [MIM] accession code, 300481] are known to cause "immunodeficiency 34, mycobacteriosis, X-linked" (IMD34, MIM#300645) and "chronic granulomatous disease, X-linked" (CGDX, MIM#306400). The natural history of his illness is consistent with "X-linked recessive Mendelian susceptibility to mycobacterial disease (MSMD)." This entity is responsible for his BCG disease and is a likely trigger of his HLH. This disastrous event underlines the importance of developing worldwide policies that target BCG disease prevention, especially in communities with high prevalence of IEI. Moreover, screening for genetic causes of MSMD in the community could pave the way, at least partially, for scale-up of tuberculosis (TB) prevention.
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Affiliation(s)
- Suleiman Al-Hammadi
- College of Medicine, Mohamed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.,Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
| | - Amal M Yahya
- Department of Pediatrics, Tawam Hospital, Al Ain, Abu Dhabi, United Arab Emirates
| | - Abdulla Al-Amri
- Department of Pediatrics, Tawam Hospital, Al Ain, Abu Dhabi, United Arab Emirates
| | - Amar Shibli
- Department of Pediatrics, Tawam Hospital, Al Ain, Abu Dhabi, United Arab Emirates
| | - Ghazala B Balhaj
- Department of Pediatrics, Al Ain Hospital, Al Ain, Abu Dhabi, United Arab Emirates
| | - Mohamed I Tawil
- Department of Radiology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Ranjit Vijayan
- Department of Biology, College of Science, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
| | - Abdul-Kader Souid
- Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
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237
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Popova IG, Sitnikova OG, Nazarov SB, Sadov RI, Panova IA, Kuzmenko GN, Klycheva MM, Veselkova YN. Evaluation of oxidative stress and antioxidant activity in women with moderate and severe preeclampsia in the third trimester of pregnancy and their newborns. Klin Lab Diagn 2020; 65:733-737. [PMID: 33373503 DOI: 10.18821/0869-2084-2020-65-12-733-737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We examined 66 women who were 22-40 weeks pregnant and their newborns. Of these, 15 women with moderate PE were in group 1, 22 women with severe PE were in group 2, and 55 women with uncomplicated pregnancy without hypertensive disorders were in the control group. Blood was taken from women when they were admitted to the clinic, and newborns ' blood was taken for 3-5 days of life. Free radical oxidation and antioxidant activity were evaluated by induced chemiluminescence. It was found that in patients with severe and moderate preeclampsia, the development of oxidative stress is accompanied by a weakening of antioxidant activity. In newborns born to mothers with preeclampsia, oxidative stress is accompanied by a compensatory increase in antioxidant activity.
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Affiliation(s)
| | - O G Sitnikova
- Ivanovo Research Institute of Maternity and Childhood named after V.N. Gorodkov
| | - S B Nazarov
- Ivanovo Research Institute of Maternity and Childhood named after V.N. Gorodkov
| | - R I Sadov
- Ivanovo Research Institute of Maternity and Childhood named after V.N. Gorodkov
| | - I A Panova
- Ivanovo Research Institute of Maternity and Childhood named after V.N. Gorodkov
| | - G N Kuzmenko
- Ivanovo Research Institute of Maternity and Childhood named after V.N. Gorodkov
| | - M M Klycheva
- Ivanovo Research Institute of Maternity and Childhood named after V.N. Gorodkov
| | - Yu N Veselkova
- Ivanovo Research Institute of Maternity and Childhood named after V.N. Gorodkov
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238
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Gazzin S, Dal Ben M, Montrone M, Jayanti S, Lorenzon A, Bramante A, Bottin C, Moretti R, Tiribelli C. Curcumin Prevents Cerebellar Hypoplasia and Restores the Behavior in Hyperbilirubinemic Gunn Rat by a Pleiotropic Effect on the Molecular Effectors of Brain Damage. Int J Mol Sci 2020; 22:ijms22010299. [PMID: 33396688 PMCID: PMC7795686 DOI: 10.3390/ijms22010299] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/23/2020] [Accepted: 12/25/2020] [Indexed: 01/08/2023] Open
Abstract
Bilirubin toxicity to the central nervous system (CNS) is responsible for severe and permanent neurologic damage, resulting in hearing loss, cognitive, and movement impairment. Timely and effective management of severe neonatal hyperbilirubinemia by phototherapy or exchange transfusion is crucial for avoiding permanent neurological consequences, but these therapies are not always possible, particularly in low-income countries. To explore alternative options, we investigated a pharmaceutical approach focused on protecting the CNS from pigment toxicity, independently from serum bilirubin level. To this goal, we tested the ability of curcumin, a nutraceutical already used with relevant results in animal models as well as in clinics in other diseases, in the Gunn rat, the spontaneous model of neonatal hyperbilirubinemia. Curcumin treatment fully abolished the landmark cerebellar hypoplasia of Gunn rat, restoring the histological features, and reverting the behavioral abnormalities present in the hyperbilirubinemic rat. The protection was mediated by a multi-target action on the main bilirubin-induced pathological mechanism ongoing CNS damage (inflammation, redox imbalance, and glutamate neurotoxicity). If confirmed by independent studies, the result suggests the potential of curcumin as an alternative/complementary approach to bilirubin-induced brain damage in the clinical scenario.
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Affiliation(s)
- Silvia Gazzin
- Fondazione Italiana Fegato-Onlus, Bldg. Q, AREA Science Park, ss14, Km 163.5, Basovizza, 34149 Trieste, Italy; (M.D.B.); (M.M.); (S.J.); (C.T.)
- Correspondence:
| | - Matteo Dal Ben
- Fondazione Italiana Fegato-Onlus, Bldg. Q, AREA Science Park, ss14, Km 163.5, Basovizza, 34149 Trieste, Italy; (M.D.B.); (M.M.); (S.J.); (C.T.)
| | - Michele Montrone
- Fondazione Italiana Fegato-Onlus, Bldg. Q, AREA Science Park, ss14, Km 163.5, Basovizza, 34149 Trieste, Italy; (M.D.B.); (M.M.); (S.J.); (C.T.)
| | - Sri Jayanti
- Fondazione Italiana Fegato-Onlus, Bldg. Q, AREA Science Park, ss14, Km 163.5, Basovizza, 34149 Trieste, Italy; (M.D.B.); (M.M.); (S.J.); (C.T.)
| | - Andrea Lorenzon
- SPF Animal Facility, CBM Scarl, Bldg. Q2, AREA Science Park, ss14, Km 163.5, Basovizza, 34149 Trieste, Italy; (A.L.); (A.B.)
| | - Alessandra Bramante
- SPF Animal Facility, CBM Scarl, Bldg. Q2, AREA Science Park, ss14, Km 163.5, Basovizza, 34149 Trieste, Italy; (A.L.); (A.B.)
| | - Cristina Bottin
- Department of Medical Sciences, Ospedale di Cattinara, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy;
| | - Rita Moretti
- Neurology Clinic, Department of Medical, Surgical, and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy;
| | - Claudio Tiribelli
- Fondazione Italiana Fegato-Onlus, Bldg. Q, AREA Science Park, ss14, Km 163.5, Basovizza, 34149 Trieste, Italy; (M.D.B.); (M.M.); (S.J.); (C.T.)
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239
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Bharadwaj A, Wahi N, Saxena A. Occurrence of Inborn Errors of Metabolism in Newborns, Diagnosis and Prophylaxis. Endocr Metab Immune Disord Drug Targets 2020; 21:592-616. [PMID: 33357204 DOI: 10.2174/1871530321666201223110918] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 11/22/2022]
Abstract
Inborn errors of metabolism (IEM) are a heterogeneous group of rare genetic disorders that are generally transmitted as autosomal or X-linked recessive disorders. These defects arise due to mutations associated with specific gene(s), especially the ones associated with key metabolic enzymes. These enzymes or their product(s) are involved in various metabolic pathways, leading to the accumulation of intermediary metabolite(s), reflecting their toxic effects upon mutations. The diagnosis of these metabolic disorders is based on the biochemical analysis of the clinical manifestations produced and their molecular mechanism. Therefore, it is imperative to devise diagnostic tests with high sensitivity and specificity for early detection of IEM. Recent advances in biochemical and polymerase chain reaction-based genetic analysis along with pedigree and prenatal diagnosis can be life-saving in nature. The latest development in exome sequencing for rapid diagnosis and enzyme replacement therapy would facilitate the successful treatment of these metabolic disorders in the future. However, the longterm clinical implications of these genetic manipulations is still a matter of debate among intellectuals and requires further research.
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Affiliation(s)
- Alok Bharadwaj
- Department of Biotechnology, GLA University, Mathura, Uttar Pradesh, India
| | - Nitin Wahi
- Department of Bioinformatics, Pathfinder Research and Training Foundation, Greater Noida - 201308, Uttar Pradesh, India
| | - Aditya Saxena
- Department of Biotechnology, GLA University, Mathura, Uttar Pradesh, India
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240
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Adugna DG, Enyew EF, Jemberie MT. Prevalence and Associated Factors of Macrosomia Among Newborns Delivered in University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia: An Institution-Based Cross-Sectional Study. Pediatric Health Med Ther 2020; 11:495-503. [PMID: 33364874 PMCID: PMC7751438 DOI: 10.2147/phmt.s289218] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 12/10/2020] [Indexed: 11/23/2022]
Abstract
Background Macrosomia is defined as a birth weight of newborns ≥4000 grams irrespective of gestational age. It is becoming a burning public health issue in most developing countries and contributes to maternal and newborn complications. Though macrosomia has been increasing in Ethiopia, evidence about its magnitude and associated factors is limited yet. Therefore, this study aimed to assess the prevalence and associated factors of macrosomia among newborns delivered at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. Methods An institution-based cross-sectional study was carried out from February 23rd to April 23rd, 2020. A total of 491 mothers and their newborns were included in the study. The data were collected by interviewing the mothers and reviewing their charts using a structured questionnaire. The outcome variable was newborn birth weight. Data were entered using Epi-data version 4.6 and analyzed using STATA version 14 software. Bivariable and multivariable binary logistic regression were used to identify the factors associated with macrosomia. Results The prevalence of macrosomia was 7.54%. Gestational age ≥40 weeks (adjusted odds ratio (AOR) = 4.1 (95% CI = 1.7-9.7)), diabetes mellitus (AOR=5.5 (95% CI = 1.2-25)), previous history of macrosomia (AOR = 3.7 (95% CI = 1.4-10)), and male sex (AOR = 3.4 (95% CI = 1.3-8.7)) were significantly associated with macrosomia. Conclusion In the current study, the prevalence of macrosomia was relatively high. The study revealed that maternal diabetes mellitus, higher gestational age, history of macrosomia, and male newborns were the predictors of macrosomia. Thus, obstetric caregivers should give attention to early detection and management of mothers with diabetes mellitus, history of macrosomia, and gestational age of ≥40 weeks during pregnancy to prevent macrosomia and its complications.
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Affiliation(s)
- Dagnew Getnet Adugna
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Engidaw Fentahun Enyew
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Molla Taye Jemberie
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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241
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Ghorani-Azam A, Balali-Mood M, Riahi-Zanjani B, Darchini-Maragheh E, Sadeghi M. Acute Phenobarbital Poisoning for the Management of Seizures in Newborns and Children; A Systematic Literature Review. CNS Neurol Disord Drug Targets 2020; 20:174-180. [PMID: 33290203 DOI: 10.2174/1871527319666201207205916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/23/2020] [Accepted: 10/05/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVES While phenobarbital (PB) is commonly used for the management of seizures in newborns and pediatrics, its administration may accompany acute poisoning. We aimed to review the literature to find out the frequency of PB poisonings in newborns and children with seizures. METHOD A literature search was performed by two independent reviewers to find relevant articles about PB toxicity in neonates and pediatrics that were treated for the seizure. RESULTS 18 articles met the inclusion criteria and were included in this systematic review. The main reasons for PB poisoning in studied patients were therapeutic intoxication. Reported signs of PB poisoning were lethargy, sedation, lack of sucking, fever, skin rash, hepatic inflammation and alopecia. Moreover, respiratory depression, encephalopathy, myocardial failure, syndrome of inappropriate antidiuretic hormone, and coma were among the complications of acute PB toxicity in children and infants. CONCLUSION PB therapy for the management of seizures in newborns and children might be associated with poisoning. Although supportive and symptomatic treatments are available for PB overdose, it should be administered with caution, using drug monitoring to avoid toxicity.
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Affiliation(s)
- Adel Ghorani-Azam
- Department of Forensic Medicine and Toxicology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Mahdi Balali-Mood
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran
| | - Bamdad Riahi-Zanjani
- Medical Toxicology Research Center (MTRC), Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mahmood Sadeghi
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran
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242
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Mubungu G, Makay P, Lumaka A, Mvuama N, Tshika D, Tady BP, Biselele T, Roelants M, Tshilobo PL, Devriendt K. Dysmorphism and major anomalies are a main predictor of survival in newborns admitted to the neonatal intensive care unit in the Democratic Republic of Congo. Am J Med Genet A 2020; 185:453-460. [PMID: 33247552 DOI: 10.1002/ajmg.a.61987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/24/2020] [Accepted: 11/07/2020] [Indexed: 11/10/2022]
Abstract
In Central-Africa, neonatal infections, asphyxia and prematurity are main reasons for admission to the neonatal intensive care unit and major determinants of newborn survival. Also, the outcome of newborns with congenital anomalies is expected to be poor, due to a lack of state-of-the art care. We conducted a study of 102 newborns recruited in the Neonatal Intensive Care Unit (NICU) at the University Hospitals of Kinshasa, DR Congo, to assess the impact of congenital anomalies. The presence of a major anomaly was associated with a hazard ratio of death of 13.2 (95%CI: 3.7-46.7, p < .001). In addition, the presence of three or more minor anomalies was associated with a 4.5-fold increased risk of death (95%CI: 1.1-18.6, p = .04). We conclude that like major anomalies, the presence of three or more minor anomalies should also be given particular attention and that the evaluation of dysmorphism should be promoted in NICU.
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Affiliation(s)
- Gerrye Mubungu
- Faculty of Medicine, Center for Human Genetics, University of Kinshasa, Kinshasa, Congo.,Faculty of Medicine, Department of Pediatrics, University of Kinshasa, Kinshasa, Congo.,Center for Human Genetics, University Hospital, University of Leuven, Leuven, Belgium
| | - Prince Makay
- Faculty of Medicine, Center for Human Genetics, University of Kinshasa, Kinshasa, Congo.,Faculty of Medicine, Department of Pediatrics, University of Kinshasa, Kinshasa, Congo
| | - Aimé Lumaka
- Faculty of Medicine, Center for Human Genetics, University of Kinshasa, Kinshasa, Congo.,Faculty of Medicine, Department of Pediatrics, University of Kinshasa, Kinshasa, Congo.,Département des Sciences Biomédicales et Précliniques, GIGA-R, Laboratoire de Génétique Humaine, University of Liège, Liège, Belgium.,Institut National de Recherche Biomédicale, Kinshasa, Kinshasa, Congo
| | - Nono Mvuama
- Faculty of Medicine, Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Congo
| | - Dahlie Tshika
- Faculty of Medicine, Center for Human Genetics, University of Kinshasa, Kinshasa, Congo.,Faculty of Medicine, Department of Pediatrics, University of Kinshasa, Kinshasa, Congo
| | - Bruno-Paul Tady
- Faculty of Medicine, Department of Pediatrics, University of Kinshasa, Kinshasa, Congo
| | - Thérèse Biselele
- Faculty of Medicine, Department of Pediatrics, University of Kinshasa, Kinshasa, Congo
| | - Mathieu Roelants
- Department of Public Health and Primary Care, Environment and Health, KU Leuven-University of Leuven, Leuven, Belgium
| | - Prosper Lukusa Tshilobo
- Faculty of Medicine, Center for Human Genetics, University of Kinshasa, Kinshasa, Congo.,Faculty of Medicine, Department of Pediatrics, University of Kinshasa, Kinshasa, Congo.,Center for Human Genetics, University Hospital, University of Leuven, Leuven, Belgium.,Institut National de Recherche Biomédicale, Kinshasa, Kinshasa, Congo
| | - Koenraad Devriendt
- Center for Human Genetics, University Hospital, University of Leuven, Leuven, Belgium
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243
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Elahi S, Vega-López MA, Herman-Miguel V, Ramírez-Estudillo C, Mancilla-Ramírez J, Motyka B, West L, Oyegbami O. CD71 + Erythroid Cells in Human Neonates Exhibit Immunosuppressive Properties and Compromise Immune Response Against Systemic Infection in Neonatal Mice. Front Immunol 2020; 11:597433. [PMID: 33329589 PMCID: PMC7732591 DOI: 10.3389/fimmu.2020.597433] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 10/29/2020] [Indexed: 01/08/2023] Open
Abstract
Newborns are highly susceptible to infectious diseases. The underlying mechanism of neonatal infection susceptibility has generally been related to their under-developed immune system. Nevertheless, this notion has recently been challenged by the discovery of the physiological abundance of immunosuppressive erythroid precursors CD71+ erythroid cells (CECs) in newborn mice and human cord blood. Here, as proof of concept, we show that these cells are also abundant in the peripheral blood of human newborns. Although their frequency appears to be more variable compared to their counterparts in mice, they rapidly decline by 4 weeks of age. However, their proportion remains significantly higher in infants up to six months of age compared to older infants. We found CD45 expressing CECs, as erythroid progenitors, were the prominent source of reactive oxygen species (ROS) production in both humans and mice. Interestingly, a higher proportion of CD45+CECs was observed in the spleen versus bone marrow of neonatal mice, which was associated with a higher ROS production by splenic CECs compared to their siblings in the bone marrow. CECs from human newborns suppressed cytokine production by CD14 monocytes and T cells, which was partially abrogated by apocynin in vitro. Moreover, the depletion of CECs in neonatal mice increased the number of activated effector immune cells in their spleen and liver, which rendered them more resistant to Listeria monocytogenes infection. This was evident by a significant reduction in the bacteria load in the spleen, liver and brain of treated-mice compared to the control group, which enhanced their survival rate. Our finding highlights the immunoregulatory processes mediated by CECs in newborns. Thus, such tightly regulated immune system in newborns/infants may explain one potential mechanism for the asymptomatic or mild COVID-19 infection in this population.
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Affiliation(s)
- Shokrollah Elahi
- School of Dentistry, University of Alberta, Edmonton, AB, Canada.,Department of Medical Microbiology and Immunology, University of Alberta, Edmonton AB, Canada.,Department of Oncology, University of Alberta, Edmonton, AB, Canada.,Faculty of Medicine and Dentistry, Li Ka Shing Institute of Virology, University of Alberta, Edmonton, AB, Canada
| | - Marco Antonio Vega-López
- Dept. Infectómica y Patogénesis Molecular, Centro de Investigación y de Estudios Avanzados del IPN, Mexico City, Mexico
| | - Vladimir Herman-Miguel
- Dept. Infectómica y Patogénesis Molecular, Centro de Investigación y de Estudios Avanzados del IPN, Mexico City, Mexico
| | - Carmen Ramírez-Estudillo
- Dept. Infectómica y Patogénesis Molecular, Centro de Investigación y de Estudios Avanzados del IPN, Mexico City, Mexico
| | - Javier Mancilla-Ramírez
- Escuela Superior deMedicina, Instituto Politecnico Nacional, Hospital de la Mujer, Secretaria de Salud, Mexico City, Mexico
| | - Bruce Motyka
- Alberta Transplant Institute and the Canadian Donation and Transplantation Research Program, Edmonton, AB, Canada.,Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Lori West
- Department of Medical Microbiology and Immunology, University of Alberta, Edmonton AB, Canada.,Alberta Transplant Institute and the Canadian Donation and Transplantation Research Program, Edmonton, AB, Canada.,Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.,Department of Surgery, University of Alberta, Edmonton, AB, Canada.,Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, AB, Canada
| | - Olaide Oyegbami
- School of Dentistry, University of Alberta, Edmonton, AB, Canada
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244
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Bommer C, Horn S, Vollmer S. The effect of routine probiotics supplementation on preterm newborn health: a regression discontinuity analysis. Am J Clin Nutr 2020; 112:1219-1227. [PMID: 32710779 DOI: 10.1093/ajcn/nqaa196] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 06/24/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Despite ongoing debate about the health impact of probiotics, rigorous evidence assessing the use of probiotics in routine preterm newborn care is lacking. OBJECTIVES We aimed to estimate the causal effect of routine probiotics supplementation on moderately preterm newborns' anthropometric development (weight-for-age and height-for-age z scores) and risk of late-onset sepsis. METHODS This study used a regression discontinuity analysis based on hospital guidelines that recommended routine probiotics supplementation for neonates born before 34 completed weeks of gestation. Data for this study came from electronic medical records of a level III neonatal care center in Germany and were collected between 2013 and 2019. Newborns born between 30 to 38 completed weeks of gestation without severe congenital defects were eligible for inclusion. Outcomes were weight-for-age and height-for-age z scores at discharge as well as late-onset sepsis. RESULTS Study participants included 1734 preterm neonates. The results showed no significant intention-to-treat effect on weight-for-age (effect: -0.033 SD; 95% CI: -0.220, 0.155), length-for-age (-0.133 SD; 95% CI: -0.380, 0.114), or late-onset sepsis probability (-1.175 percentage points; 95% CI: -6.556, 4.205). There was no evidence for significant effects of probiotics for any of the study's endpoints on those complying with the hospital guidelines (local average treatment effect). CONCLUSIONS Routine treatment of moderately preterm newborns with probiotics is unlikely to improve anthropometric outcomes. Complier-level analysis suggested that this finding was not simply driven by a lack of physician compliance with hospital guidelines but by an overall absence of large health effects from the treatment itself. Moreover, overall sepsis risk was low and did not change significantly as a result of probiotics supplementation. The findings of this study therefore do not support the routine use of probiotics for improving growth or preventing late-onset sepsis in moderately preterm neonates.
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Affiliation(s)
- Christian Bommer
- Centre for Modern Indian Studies, University of Goettingen, Goettingen, Germany.,Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Sebastian Horn
- Department of Paediatric Cardiology, Neonatology, Intensive Care and Pulmonology, University Hospital Medical Centre, University of Goettingen, Goettingen, Germany
| | - Sebastian Vollmer
- Centre for Modern Indian Studies, University of Goettingen, Goettingen, Germany
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245
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Zhao Z, Liu X, Huang C, Xu H, Fu C. Variants of the phenylalanine hydroxylase gene in neonates with phenylketonuria in Hainan, China. Scand J Clin Lab Invest 2020; 80:619-622. [PMID: 33161754 DOI: 10.1080/00365513.2020.1827287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To investigate the incidence of phenylalanine hydroxylase (PAH) deficiency and PAH genotypes in neonates in Hainan, China. Methods: We performed heal stick to collect blood and obtain dry blood spot specimens from newborns in Hainan from January 2007 to December 2016. Phenylalanine (Phe) concentration in these dry blood spots was measured by the fluorescence method to screen phenylketonuria (PKU). For suspicious samples, the genotypes of the PAH gene were amplified by biotin labeled oligonucleotide primers. Polymerase chain reaction (PCR) products were then analyzed by flow-through hybridization to detect genotypes. At the same time, peripheral blood samples of children suspicious of PKU and their parents were used to perform gene sequencing. Results: Of the 914,520 newborns screened, 29 of them had PAH deficiency. The incidence of PAH deficiency in Hainan was 3.17/100,000. A total of 58 mutant alleles belonging to 15 different types were identified in the 29 patients. In terms of genotypes frequency, the top 4 were: c.611A > G 20.7% (12/58) , c.728G > A 17.2%, c.158G > A 15.2% (9/58) and c.721C > T 13.8% (8/58). The frequencies of other genotypes were all below 10%. Conclusion: The incidence of PAH deficiency in Hainan is relatively high among all provinces in southern China. With a total frequency of 67.2%, c.611A > G, c.728G > A, c.158G > A and c.721C > T, and are the most common PAH gene genotypes.
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Affiliation(s)
- Zhendong Zhao
- Hainan Women and Children's Medical Center, Hainan Newborn Screening Center, Haikou, China
| | - Xiulian Liu
- Hainan Women and Children's Medical Center, Hainan Newborn Screening Center, Haikou, China
| | - Cidan Huang
- Hainan Women and Children's Medical Center, Hainan Newborn Screening Center, Haikou, China
| | - Haizhu Xu
- Hainan Women and Children's Medical Center, Hainan Newborn Screening Center, Haikou, China
| | - Chaohui Fu
- Hainan Women and Children's Medical Center, Hainan Newborn Screening Center, Haikou, China
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246
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Seither K, Tabbah S, Tadesse DG, Suhrie KR. Neonatal complications of Down syndrome and factors necessitating intensive care. Am J Med Genet A 2020; 185:336-343. [PMID: 33128508 DOI: 10.1002/ajmg.a.61948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 09/04/2020] [Accepted: 10/19/2020] [Indexed: 11/06/2022]
Abstract
Limited knowledge exists about how frequently newborns with Down syndrome receive a prenatal diagnosis, require intensive care, and what surgical and medical factors are contributory. A retrospective cohort study was performed for patients with a diagnosis of Down syndrome born in 2013 and 2014 who sought care at Cincinnati Children's Hospital Medical Center during the first year of life. Data were extracted from the electronic medical record through the first year of life including need for intensive care as a newborn, prenatal diagnosis, and medical and surgical complications. Of the 129 patients in the study, 65% required intensive care as newborns. The presence of a structural abnormality that required surgical correction in the neonatal period and certain types of congenital heart disease not requiring surgical intervention in the neonatal period were positively associated with the need for intensive care. A minority of infants, 8%, had a confirmed prenatal diagnosis. A majority of newborns with Down syndrome required intensive care following birth while a minority had any concern for the diagnosis prenatally. Improving prenatal diagnostic rates would allow for better prenatal counseling and delivery planning, while targeting therapeutic interventions for this population is needed to improve outcomes.
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Affiliation(s)
- Katelyn Seither
- Perinatal Institute, Division of Neonatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Sammy Tabbah
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Dawit G Tadesse
- Division of Epidemiology and Biostatistics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Kristen R Suhrie
- Perinatal Institute, Division of Neonatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA
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247
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Dietrich S, Bürger F, Kugler C. Implementierung eines neonatalen Schmerzassessmentinstruments auf einer neonatologischen Intensivstation - Ein Qualitätsentwicklungsprojekt. Pflege 2020; 33:385-395. [PMID: 33086942 DOI: 10.1024/1012-5302/a000769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Implementation of a Neonatal Pain Assessment Instrument at a Neonatal Intensive Care Unit - A Quality Improvement Project Abstract. Background: Optimal pain management is necessary in order to not jeopardize the development of preterm neonates. Aim: Implementation and evaluation of systematic and best possible pain assessment with the Bernese Pain Scale for Neonates for all preterm and sick neonates of a neonatal intensive care unit by nursing staff. Methods: The educational concept is based on three key strategies: knowledge translation (group- and one-on-one training), reflection (case conferences) and clinical training. The frequency of the use of the Pain Score was recorded before (T0) and after implementation (T1) and six months after completion of the project (T2). Results: Before the implementation (T0) the use of the Bernese Pain Scale was regulated by an internal guideline but its application could not be verified during the baseline period (fulfillment rate of 0 %). After implementation (T1) at least one assessment per shift per neonate could be achieved in 99.1 % of the cases. Nurses conducted 210 assessments on 38 neonates in T1. In follow-up (T2) six months after implementation fulfillment rate of 100 % in 34 neonates was achieved with 188 pain assessments. Conclusions: This implementation strategy was successful in establishing the assessment instrument in clinical practice.
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Affiliation(s)
| | - Florian Bürger
- Charité Universitätsmedizin Berlin, Core Teams des Geschäftsbereichs Pflegedirektion
| | - Christiane Kugler
- Albert-Ludwigs-Universität Freiburg, Medizinische Fakultät, Institut für Pflegewissenschaft
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248
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Velkavrh M, Paro-Panjan D, Benedik E, Mis NF, Godnov U, Salamon AS. The Influence of Maternal Levels of Vitamin D and Adiponectin on Anthropometrical Measures and Bone Health in Offspring. ACTA ACUST UNITED AC 2019; 40:91-8. [PMID: 32109213 DOI: 10.2478/prilozi-2020-0008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND From the conception onward, certain parameters associated with maternal health may affect foetal body composition, growth and bone mineral content. The objective of the study was to determine the association between maternal vitamin D and adiponectin status with the anthropometrical measures of newborns, and bone health status measured by Quantitative Ultrasound (QUS) at birth. METHODS Circulating 25OHD and adiponectin concentration were measured in 73 pregnant women. Correlations with the anthropometrical measures and bone health status in their infants were studied. Bone health was evaluated using QUS with the measurements of speed of sound (SOS, in m/s) and Z score on the right tibia. RESULTS There was no significant association between maternal 25OHD and newborn's anthropometrical measures at birth (weight p=0.35, length p=0.59 and head circumference p=0.47). There was a significant negative correlation between a maternal serum adiponectin and a) weight of infants at birth (R= -0.37, p=0.002); b) birth length (R= -0.31, p=0.008) and c) head circumference (R= -0.29, p=0.014). There was no significant correlation between maternal 25OHD blood levels during pregnancy and SOS in newborns (p=0.48). Additionally, a correlation between maternal adiponectin concentration during pregnancy and SOS in newborns was not significant (p=0.82). CONCLUSION Although a high prevalence of low 25OHD level among pregnant women was found, maternal vitamin D status did not influence growth and bone health of their offspring at birth. Maternal adiponectin levels in plasma showed an inverse relationship with anthropometrical measures of infants at birth, while no correlation with the newborn's bone health was found.
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249
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Warad D, Ismail M, Rusk D, Rodriguez V, Pruthi RK. Risk of perinatal intracranial hemorrhage and role of prenatal genetic testing in individuals with type 3 von Willebrand disease. J Thromb Haemost 2020; 18:2779-2780. [PMID: 33460294 DOI: 10.1111/jth.15000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 06/15/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Deepti Warad
- Special Coagulation Laboratory, Division of Hematopathology, Mayo Clinic, Rochester, Minnesota, USA
- Division of Pediatric Hematology Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Maryama Ismail
- Mayo Medical School, Mayo Clinic, Rochester, Minnesota, USA
| | - Dawn Rusk
- Division of Pediatric Hematology Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Vilmarie Rodriguez
- Division of Pediatric Hematology Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Rajiv K Pruthi
- Special Coagulation Laboratory, Division of Hematopathology, Mayo Clinic, Rochester, Minnesota, USA
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
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250
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Chaireti R, Trönnhagen I, Bremme K, Ranta S. Management and outcomes of newborns at risk for inherited antithrombin deficiency. J Thromb Haemost 2020; 18:2582-2589. [PMID: 32614493 DOI: 10.1111/jth.14982] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/19/2020] [Accepted: 06/23/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND As levels of antithrombin (AT) are low at birth, diagnosing inherited AT deficiency in newborns is challenging. In Stockholm, Sweden, pregnant women with known AT deficiency are referred to the Karolinska University Hospital, where local guidelines for management of newborns at risk of inherited AT deficiency have been established. Data on pregnancy, obstetric, and neonatal outcomes are recorded in a registry. OBJECTIVES We aimed to evaluate the current practice at the Karolinska University Hospital for managing delivery of newborns at risk for AT deficiency, the predictive value of AT levels at birth, and the neonatal outcomes of newborns with AT deficiency. PATIENTS/METHODS This was an observational, retrospective study. All children born to mothers with AT deficiency at the Karolinska University Hospital 2003-2018 were identified from the registry and included in the study. Data were collected from the medical records and the registry. AT activity was measured postnatally and after 6 months of age. RESULTS The total study cohort included 41 newborns. There was a significant association between low AT values postnatally and after 6 months of age (P = .001). Half (21/41) of the children were diagnosed with AT deficiency; two suffered from sinus thrombosis, which presented at 10 days of age. Both children with sinus thrombosis were delivered using vacuum extraction. CONCLUSIONS The current practice of testing newborns can in most cases predict inherited AT deficiency. The risk for thrombosis during the neonatal period is enhanced by the use of instrumental delivery.
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Affiliation(s)
- Roza Chaireti
- Department of Hematology, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Ida Trönnhagen
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Katarina Bremme
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Division of Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden
| | - Susanna Ranta
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
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