Non-standard therapeutic methods for severe bronchopulmonary dysplasia in a premature newborn – case report

Bronchopulmonary dysplasia is a lung disease that is the most common complication of prematurity and the most common chronic lung disease in neonates treated with mechanical ventilation and/or oxygen therapy. Children with bronchopulmonary dysplasia are at risk of cardiovascular complications, such as pulmonary arterial hypertension and left ventricular hypertrophy. The presented case concerns a premature infant born at 24 weeks gestation with severe bronchopulmonary dysplasia complicated by pulmonary arterial hypertension, interstitial emphysema and emphysema. The patient was subject to non-standard therapeutic procedures including L-citrulline, which may have a beneficial effect on the treatment of complications of severe bronchopulmonary dysplasia. Despite proper treatment, it is not always possible to avoid severe complications of bronchopulmonary dysplasia. Currently, available therapies are not always fully effective and it is necessary to continue searching and implementing new treatments to lower the risk of infant death and minimise long-term complications.

Pregnancy and childbirth during the coronavirus pandemic - current stage of knowledge

SARS-CoV-2 (Severe Respiratory Syndrome Coronavirus-2), is a new strain of β-coronavirus. At the time of the current pandemic, pregnant women fear of infection by this pathogen and related consequences both for themselves and for their children. Adaptive changes occurring in the body of a pregnant woman can increase her susceptibility to infections, especially when it concerns the cardiopulmonary system. Clinical data relating to infection by this pathogen, referred to as Coronavirus Disease 2019 (COVID-19) in pregnant women are still limited. Most of the cases in which these data are available apply to the third trimester of pregnancy. This article provides an overview of a current knowledge and recommendations regarding the management of SARS-CoV-2 infection during pregnancy and its impact on the pregnancy outcome.

COVID-19 and pregnancy - where are we now? A review

The new acute respiratory disease severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is highly contagious. It has caused many deaths, despite a relatively low general case fatality rate (CFR). The most common early manifestations of infection are fever, cough, fatigue and myalgia. The diagnosis is based on the exposure history, clinical manifestation, laboratory test results, chest computed tomography (CT) findings and a positive reverse transcription-polymerase chain reaction (RT-PCR) result for coronavirus disease 2019 (COVID-19). The effect of SARS-CoV-2 on pregnancy is not already clear. There is no evidence that pregnant women are more susceptible than the general population. In the third trimester, COVID-19 can cause premature rupture of membranes, premature labour and fetal distress. There are no data on complications of SARS-CoV-2 infection before the third trimester. COVID-19 infection is an indication for delivery if necessary to improve maternal oxygenation. Decision on delivery mode should be individualised. Vertical transmission of coronavirus from the pregnant woman to the fetus has not been proven. As the virus is absent in breast milk, the experts encourage breastfeeding for neonatal acquisition of protective antibodies.

Maternal plasma lipopolysaccharide binding protein (LBP) concentrations in pregnancy complicated by preterm premature rupture of membranes

OBJECTIVES

To compare maternal plasma LBP concentrations in pregnancies complicated by preterm premature rupture of membranes (pPROM), and PROM at term, with their levels in uncomplicated pregnancy, and to determine whether LBP concentrations are of value in the diagnosis of subclinical intra-amniotic infection (IAI) in the prediction of the length of the pPROM-to-delivery interval, and in the prediction of neonatal congenital infection.

STUDY DESIGN

Thirty-one patients with pPROM, 35 with PROM at term, 33 healthy women at preterm gestation and 35 healthy women at term were included. In the pPROM group, analysis of maternal plasma LBP concentrations with reference to leukocytosis, C-reactive protein, vaginal fluid culture, neonatal infection and pPROM-to-delivery interval was carried out.

RESULTS

LBP concentrations in the four studied groups were comparable. Although in 58.1% of pPROM cases at least one laboratory parameter of infection was observed, the only difference concerned the subgroup with CRP above 10mg/L, in which LBP concentrations were higher. Comparison of LBP concentrations in patients delivered within 24 and 72h of pPROM and after these times showed no differences, or between patients who gave birth to newborns with and without congenital infection. The predictive values of these measurements were poor.

CONCLUSION

The predictive value of maternal LBP determinations in the diagnostics of pPROM cases suspected of IAI is unsatisfactory. LBP measurements performed shortly after pPROM, are not of value either in the prediction of newborn's infection, or in the prognosis of latency period duration.

[Vaginal and cervical bacterial colonization in patients with threatening preterm labor]

OBJECTIVES

The aim of the following work was to evaluate vaginal and cervical colonization in patients with threatening preterm labor and comparing the frequency of colonization of the term and preterm labor groups.

MATERIAL AND METHODS

532 pregnant women with threatening preterm labor were included into the clinical trial. The frequency of colonization was established and the frequency of colonization depending on the duration of pregnancy was checked.

RESULTS

Positive vaginal cultures were found in 29.5% of patients. The most frequent were: Escherichia coli and Streptoccocus agalactiae. There was no relationship between the duration of pregnancy the frequency of colonization or the type of bacterial culture.

CONCLUSIONS

30% of positive vaginal and cervical cultures may indicate about the deficiency of the used method. The most frequent microorganisms remain to be Candida, Escherichia coli and GBS. However, the frequency of colonization with rare bacteria increases. Not only bacterial colonization but a group of different factors may be the reason of preterm labor.

Synthesis and properties of tetra(hexa)hydropyrazolo [1,2-a]pyrido[3,4-d]pyridazine derivatives

The synthesis of tetra(hexa)hydropyrazolo[1,2-a]pyrido[3,4-d]pyridazine derivatives (14-21) and the results of pharmacological screening are described in this paper. All compounds tested were non-toxic and showed a significant analgesic action. The analgesic effects were associated with the suppression of the spontaneous locomotor activity. Furthermore most of the synthesized compounds displayed a weak antimycobacterial action in the preliminary screening.

[Why does nitroglycerin tolerance appear?]

Nitroglycerin (NTG) and other organic nitrates are beneficial drugs for the treatment of acute forms of coronary artery disease. The major limitation of organic nitrates use in clinical practice is the rapid development of hemodynamic tolerance. In general mechanisms of tolerance can be categorized into two different groups. One group of mechanisms is related to changes in the vascular smooth muscle bioactivation of organic nitrates. The other mechanisms are related to physiological response to increase nitric oxide (NO) production.

Gravimetric and spectrophotometric determination of some phenothiazine and imidazole derivatives in coated tablets and tablets

Two drugs in the form of coated tablets: Promazin (promazine hydrochloride) (1) and Thioridazin (thioridazine hydrochloride) (2), and tablets Clotrimazolum (clotrimazole) (3) were assayed gravimetrically and spectrophotometrically in the same process using complexes with ammonium molybdate. Stoichiometry of these complexes was established by elemental analysis and analysis of the incineration residue (MoO3). The complexes were subsequently characterized using their IR and UV spectra and melting points. The active substances of the complexes were also determined spectrophotometrically. Using this method Beers Law was found to hold for the concentration ranges of 5-40 microg/ml (complex of 1), 5-60 (microg/ml (complex of 2) and 2-10 microg/ml (complex of 3). The method was validated in terms of precision, linearity, detection limit and quantification limit. The two methods of drug determination, used in a single analytical process verify each other.

The effect of nitrogen oxide level modulation on the content of thiol compounds and anaerobic sulfur metabolism in mice brains

Aminoguanidine (AG) an inhibitor of NO-synthase reduces cysteine (Cys), cystine (CC), sulfane sulfur (SS) and glutathione (GSH) in brain stems but practically has no effects on the levels of reactive oxygen species (ROS). In cortex AG decreases to a lower degree the concentration of Cys, CC, GSH but in this brain part significantly decreases ROS levels and increases SS. Under the AG action cystathionase (CST) activity very seriously decreases in stems and in cortex and simultaneously activity of 3-mercaptopyruvate sulfurtransferase (MPST) increases. The morpholinosydnonimine (SIN-1) the specific donor of NO and O2 only slightly reduces Cys and GSH in brain stems and ROS and SS remain at the control levels. Simultaneously, there is an increase in cortex of the amounts of GSH with the reduction of ROS and SS. Furthermore, SIN-1 seriously decreases in stems and cortex the activity of CST and increases the activity of MPST. These results confirmed the relationship between intracellular levels of NO, sulfhydryl groups, ROS, and anaerobic sulfur metabolism.

Gravimetric and spectrophotometric determination of some drugs--tertiary amine hydrochlorides in coated tablets

Four drugs in the form of coated tablets: Amitryptylinum (Amitryptyline) (1), Imipramin (Imipramine) (2), Chloropyribenzaminum (Chloropyramine) (3), and Phenazolinum (Antazoline) (4) were determined gravimetrically and spectrophotometrically in the same process by using complexes with ammonium molybdate. Stoichiometry of the complexes was established by elemental analysis and analysis of the incineration residue (MoO3). The complexes were characterized by IR and UV spectra and melting points. Contents of the drugs in the complexes were also determined spectrophotometrically. In this method Beer's law was found to obey over the concentration ranges 10-80 micrograms/ml (complex of 1), 10-100 micrograms/ml (complexes of 2 and 3), and 10-60 micrograms/ml (complex of 4). This method was validated in terms of precision, linearity, limit of detection and limit of quantitation. The two methods of the drug determination used in a single process of analysis, verify each other.

Protective effect of alpha-keto acids on the oxidative hemolysis

We studied antioxidative properties of various concentrations (0.3-2 mM) of biochemically important alpha-keto acids: pyruvate, alpha-ketoglutarate, oxaloacetate, glyoxylic acid as aldehyde acid and also 2-methyl-thiazolidyne-2,4-dicarboxylic acid and their effect on the oxidative hemolysis of human erythrocytes induced by hydrogen peroxide (H2O2). Normal erythrocytes proved to be very resistant to oxidative damages, so the high concentration of H2O2 (10 mM) as well as the presence of natrium azide, a catalase inhibitor, was necessary. The levels of malonyldialdehyde (MDA), reactive oxygen species (ROS) and hemoglobin (Hb) released were evaluated as the measure of red cell peroxidative hemolysis. Pyruvate, at the lowest used concentration (0.3 mM), caused the inhibition of lipid peroxidation (MDA) and a drop in the level of ROS, as well as a diminution of the degree of hemolysis and the effects were stronger than those of other alpha-keto acids. At the highest (2 mM) concentration, the protective effect against oxidative damage of all the investigated alpha-keto acids was similar and amounted to nearly 50% in relation to the control sample. On the contrary, in the case of aldehyde acid, e.g. glyoxylic acid, no protective effect in the same range of concentrations was found. This confirms the participation of non-enzymatic oxidative decarboxylation of alpha-keto acids in the hydrogen peroxide decomposition process.

Investigations on the synthesis and properties of N-phenyl derivatives of 1,4-dioxo(1,4,5-trioxo)-1,2,3,4-tetra(1,2,3,4,5,6-hexa) hydropyrido-[3,4-d]pyridazines and allied compounds

2-(1-Piperidino)- and 2-(4-methyl-1-piperazinyl)-6-methyl-3,4-pyridinedicarboximides (1, 2) react with N-phenylhydrazine yielding N-phenylamino-3,4-pyridinedicarboximides (7, 8). The same reaction with 1,6-dimethyl-2-oxo-1,2-dihydro- and 2-chloro-6-methyl-3,4-pyridinedicarboximides (3, 17) gives the salts of the corresponding N-phenylpyridopyridazines with phenylhydrazine (13, 18), which transform into N-phenylaminoimides (14, 19) during boiling in 80% acetic acid. Compounds 7, 8 and 14 isomerize to the corresponding 2-phenyl-1,4-dioxo(1,4,5-trioxo)-1,2,3,4-tetra(1,2,3,4,5,6-hexa) hydropyrido[3,4-d]pyridazines (9, 10, 15) under the influence of heating in alcoholic solution of C2H5ONa or CH3ONa. Only in the case of imide 19 are 2- and 3-phenyl isomers (20 and 21) formed under these conditions. Some of the obtained compounds were pharmacologically active.

Health inequalities in Poland

This text is a second paper on relations between social inequalities and health in Poland. Our first paper was included in a collective report from a conference on social inequalities in health and health services utilization in 24 European countries (The Health Burden of Social Inequalities: Poland, pp. 157-170. WHO EURO, Copenhagen, 1986). It contains a description of social inequalities in health occurring in Poland, based on existing statistical data and information from scientific research. This text is an expansion of the previous one; here we present more updated information; we also try to identify some reasons for existing inequalities in health.

The effects of reserpine and LHRH or salmon GnRH analogues on gonadotropin release, ovulation and spermiation in common carp (Cyprinus carpio L.)

The effects of reserpine (catecholamine depletor) and LHRH analogues on gonadotropin secretion, spermiation and ovulation of common carp were investigated. Injections of reserpine alone at a dose of 1 or 7 mg/kg of body weight stimulated spermiation, and reserpine at a dose of 1 mg/kg of body weight in combination with (D-Arg6, Trp7, Leu8, Pro9, NEt)-LHRH (s-GnRH-A) or with (D-Ala6, Pro9)-LHRH (LHRH-A) at a dose of 50 micrograms/kg of body weight caused an increase of plasma gonadotropin levels, spermiation and ovulation in 80-90% of the females. Simultaneous injection of reserpine and LHRH analogues was as effective as injection of reserpine followed by injection of LHRH analogues 6 h later.

Effects of pimozide and LHRH-Aa on carp (Cyprinus carpio L.) oocyte maturation and ovulationin vivo

Effects of pimozide (Pim) and [(D-Ala(6), Pro(9)-NEt) LHRH] (LRH-Aa) on common carp oocytes maturation and ovulationin vivo under laboratory and commercial fisheries farm conditions were investigated.Although injections of Pim and LRH-Aa at the doses of 10 mg and 50 µg/kg body weight respectively, did not increase mGtH levels (66.7-155.8 mg/ml) as much as injections of carp pituitary extract (chh) (382.1 ng/ml), induced GtH levels were high enough to induce ovulation. Changes in the ovary caused by Pim and LRH-Aa were similar to those induced by chh, and Pim injected together with LRH-Aa in a single injection gave the same results concerning ovulation induction as when they were applied separately at 6h interval.