RESUMEN
Bronchopulmonary dysplasia (BPD) is a chronic lung disease in premature infants characterized by alveolar dysplasia, vascular simplification and dysmorphic vascular development. Supplemental oxygen and mechanical ventilation commonly used as life-saving measures in premature infants may cause BPD. microRNAs (miRNAs), a class of small, non-coding RNAs, regulate target gene expression mainly through post-transcriptional repression. miRNAs play important roles in modulating oxidative stress, proliferation, apoptosis, senescence, inflammatory responses, and angiogenesis. These cellular processes play pivotal roles in the pathogenesis of BPD. Accumulating evidence demonstrates that miRNAs are dysregulated in the lung of premature infants with BPD, and in animal models of this disease, suggesting contributing roles of dysregulated miRNAs in the development of BPD. Therefore, miRNAs are considered promising biomarker candidates and therapeutic agents for this disease. In this review, we discuss how dysregulated miRNAs and their modulation alter cellular processes involved in BPD. We then focus on therapeutic approaches targeting miRNAs for BPD. This review provides an overview of miRNAs as biomarkers, and highlights potential pathogenic roles, and therapeutic strategies for BPD using miRNAs.
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Biomarcadores , Displasia Broncopulmonar , MicroARNs , Displasia Broncopulmonar/genética , Displasia Broncopulmonar/metabolismo , Displasia Broncopulmonar/terapia , Humanos , MicroARNs/genética , MicroARNs/metabolismo , Biomarcadores/metabolismo , Recién Nacido , Animales , Recien Nacido PrematuroRESUMEN
Enteral zinc supplementation in preterm infants has been reported to improve short-term weight and height gain. This study aims to evaluate whether early enteral zinc supplementation in preterm infants admitted to the neonatal intensive care unit (NICU) affects their physical measurements at discharge, and to periodically test serum copper levels. Of the 221 patients admitted to the NICU, 102 were in the zinc group and 119 were in the no-zinc group. The zinc group was administered 3 mg/kg/day of zinc. Body weight, height, and head circumference at discharge (or on the expected delivery date) were evaluated, and the factors affecting these parameters were examined. Serum zinc and copper levels were also evaluated on admission and monthly thereafter. Multivariate analysis was performed and showed that the weeks of gestational age and small for gestational age (SGA) status affected the height and weight at discharge. SGA also affected the head circumference. Serum copper levels were within the reference range for all patients at 3 months of age. Enteral zinc supplementation of 3 mg/kg/day in preterm infants did not affect the weight, height, or head circumference at discharge, but was shown to be relatively safe.
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Cobre , Suplementos Dietéticos , Nutrición Enteral , Recien Nacido Prematuro , Unidades de Cuidado Intensivo Neonatal , Alta del Paciente , Zinc , Humanos , Zinc/sangre , Zinc/administración & dosificación , Zinc/deficiencia , Cobre/sangre , Recién Nacido , Recien Nacido Prematuro/sangre , Masculino , Femenino , Nutrición Enteral/métodos , Edad Gestacional , Antropometría , Estatura/efectos de los fármacos , Recién Nacido Pequeño para la Edad Gestacional , Peso CorporalRESUMEN
The appropriate arrangement of near-infrared (NIR) chromophores allows for the modification of the peak wavelength in the NIR region and efficient use of NIR light. However, the preparation of novel NIR chromophores using simple procedures remains a formidable challenge. Herein, we report the synthesis of ball-shaped ruthenium complex oligomers. The metal complexes can be synthesized in a single step and interact strongly with NIR light. Alkyne-substituted low-symmetry ball-shaped ruthenium complexes were synthesized and subjected to Eglinton coupling to obtain dehydro[12] and [18]annulene-fused dimers and trimers. Fine-tuning of the reaction conditions led to the selective synthesis of the target oligomers. NMR spectroscopy confirmed that the 18π-aromatic and 12π-antiaromatic properties of the annulene influenced the ruthenium complex chromophore, and magnetic circular dichroism spectroscopy showed changes in the electronic structure of their excited state owing to molecular-symmetry differences. The absorption coefficient in the NIR region of the absorption spectra of the oligomers increased significantly, supporting the efficient use of light by oligomerization. The formation of oligomers using ball-shaped metal complexes is a simple and effective strategy for controlling NIR optical properties.
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BACKGROUND: In the recent years, a high risk of developmental delay not only in very low birth weight infants and late preterm infants but also in early term infants (37-38 weeks) have increasingly been reported. However, in Japan, there are virtually no studies regarding the development delays in early term infants. METHODS: This study used the data from the Japan Environment and Children's Study (JECS), a birth cohort study conducted in Japan. Data were selected for analysis from the records of 104,065 fetal records. The risk of neurodevelopmental delays at 6 months and 12 months after birth was evaluated using multivariate analysis for infants of various gestational ages, using the 40th week of pregnancy as a reference value. Neurodevelopment was evaluated at 6 months and 12 months after birth using the Ages and Stages Questionnaires, Japanese translation (J-ASQ-3). RESULTS: The proportion of infants born at a gestational age of 37 to 38 weeks who did not reach the J-ASQ-3 score cutoff value was significantly higher in all areas at both 6 months and 12 months after birth, when compared to that of infants born at 40 weeks. The odds ratio decreased at 12 months after birth compared to that at 6 months after birth. CONCLUSION: Early term infants in Japan are at an increased risk of neurodevelopmental delay at 12 months after birth.
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Discapacidades del Desarrollo , Edad Gestacional , Nacimiento a Término , Humanos , Japón/epidemiología , Femenino , Lactante , Masculino , Recién Nacido , Embarazo , Discapacidades del Desarrollo/epidemiología , Trastornos del Neurodesarrollo/epidemiología , Desarrollo Infantil/fisiología , Cohorte de Nacimiento , Estudios de Cohortes , Encuestas y Cuestionarios , Factores de Riesgo , AdultoRESUMEN
BACKGROUND: There has been a recent decrease in the prevalence of infectious diseases in children worldwide due to the usage of vaccines. However, the association between cesarean delivery and infectious diseases remains unclear. Here, we aimed to clarify the association between cesarean delivery and the development of infectious diseases. METHODS: This study is a cross-sectional study. We used data from the Japan Environment and Children's Study, which is a prospective, nationwide, government-funded birth cohort study. The data of 104,065 records were included. Information about the mode of delivery, central nervous system infection (CNSI), otitis media (OM), upper respiratory tract infection (URTI), lower respiratory tract infection (LRTI), gastrointestinal infection (GI), and urinary tract infection (UTI) was obtained from questionnaires and medical records transcripts. Multiple logistic regression analysis was used to assess the association between cesarean delivery and CNSI, OM, URTI, LRTI, GI, and UTI risk. RESULTS: We included a total of 74,477 subjects in this study, of which 18.4% underwent cesarean deliveries. After adjusting for the perinatal, socioeconomic, and postnatal confounding factors, children born by cesarean delivery did not have an increased risk of developing CNSI (95% confidence interval [CI] 0.46-1.35), OM (95% CI 0.99-1.12), URTI (95% CI 0.97-1.06), LRTI (95% CI 0.98-1.15), GI (95% CI 0.98-1.11), or UTI (95% CI 0.95-1.45). CONCLUSIONS: This nationwide cohort study did not find an association between cesarean delivery and CNSI, OM, URTI, LRTI, GI, and UTI. However, further studies are needed to evaluate the role of cesarean delivery in the development of infectious diseases.
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Enfermedades Transmisibles , Infecciones del Sistema Respiratorio , Infecciones Urinarias , Lactante , Niño , Humanos , Embarazo , Femenino , Cesárea/efectos adversos , Estudios de Cohortes , Estudios Prospectivos , Japón/epidemiología , Estudios Transversales , Modelos Logísticos , Enfermedades Transmisibles/complicaciones , Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/etiología , Infecciones Urinarias/complicacionesRESUMEN
This study aimed to investigate the associations between cord serum total cholesterol (TC) and triglyceride (TG)levels and perinatal factors and determine the reference levels of cord blood TC and TG in Japanese neonates. This was a prospective birth cohort study using data from the Japan Environment and Children's Study, which included data on births from 2011 to 2014 in Japan. TC and TG levels were determined in cord blood samples. A total of 70,535 pairs of neonates (male: 36,001, female: 34,524) and mothers were included. The mean cord blood TC and TG levels were 72.2 mg/dL and 24.4 mg/dL, respectively. Multiple regression analyses revealed that gestational age and birth weight were significantly associated with cord blood TC (coefficient -2.35, 95% confidence interval [CI] -2.40 - -2.22 and coefficient 0.002, 95% CI 0.002-0.003, respectively) and TG (coefficient 3.09, 95% CI 3.01-3.17 and coefficient - 0.009, 95% CI - 0.009-0.008, respectively) levels. Mean cord blood TG and TC levels decreased over the preterm period; however, these parameters increased during the term. Furthermore, the mean cord blood TC and TG levels decreased over the entire range of birth weight categories. Conclusion: Mean cord blood TG and TC levels decreased over the preterm period; however, these parameters increased during the term. Furthermore, the mean cord blood TC and TG levels decreased over the entire range of birth weight categories in Japanese newborns. Maternal complications such as maternal parity, HDP, PROM, maternal obesity and income level were associated with cord TC and TG levels. What is Known: ⢠No studies have ascertained the reference levels of cord blood lipid levels in Japan. What is New: ⢠Mean cord blood TG and TC levels decreased over the preterm period; however, these parameters increased during the term.
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Colesterol , Sangre Fetal , Recién Nacido , Humanos , Masculino , Femenino , Embarazo , Niño , Triglicéridos , Peso al Nacer , Estudios de Cohortes , Estudios Prospectivos , Japón , Valores de ReferenciaRESUMEN
BACKGROUND: Breast milk, nature's optimum source of nutrition for infants, can contain undesirable microorganisms that cause severe morbidity. After an outbreak of multidrug-resistant Escherichia coli among neonates receiving breast milk donated by another mother in our neonatal intensive care unit (NICU), we were motivated to develop a high-grade breast milk pasteurizer (BMP) designed to thaw and pasteurize breast milk at 63°C for 30 min in a sealed bag without having to open the bag or immerse it in water. METHODS: Pre-existing bacteria and spiked cytomegalovirus (CMV) were measured pre- and post-pasteurization in frozen breast milk donated by mothers of children admitted to the NICU. RESULTS: Among 48 breast milk samples (mean ± standard deviation [SD]), pre-existing bacterial counts of 5.1±1.1 × 104 colony forming units (cfu)/mL decreased to less than 10 cfu/mL (below detection level) in 45 samples after pasteurization for 30 min. In three samples, 10-110 cfu/mL persisted. As no CMV was detected in any of the 48 samples, CMV at ≥5 × 104 pfu/mL was spiked into 11 breast milk samples. After just 10 min of pasteurization, infectious CMV was not detected (threshold <50 pfu/mL) in any sample. CONCLUSION: A new BMP was shown to pasteurize milk effectively with more than a 3-log reduction of microorganisms. Compared to conventional pasteurizers, this device reduces the effort involved in pasteurizing breast milk, avoids various contamination risks, and may reduce the risk of infectious disease transmission via breast milk.
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Infecciones por Citomegalovirus , Leche Humana , Recién Nacido , Lactante , Femenino , Niño , Humanos , Madres , Citomegalovirus , Infecciones por Citomegalovirus/epidemiología , Infecciones por Citomegalovirus/prevención & control , Esterilización , Escherichia coliRESUMEN
BACKGROUND: Although maternal triglyceride (TG) is important for fetal growth, there are few large cohort studies investigating the relationships between maternal TG during pregnancy and neonatal outcomes. OBJECTIVES: The objective of this study was to investigate the associations between maternal TG during the second and third trimesters and neonatal outcomes including preterm birth (PTB), low birth weight (LBW), small for gestational age (SGA) and large for gestational age (LGA). METHODS: This was a prospective birth cohort study using data of the Japan Environment and Children's Study included data of births from 2011-2014 in Japan including 79,519 pairs. Participants were divided into tertiles according to maternal TG in the second or third trimesters. Multiple logistic regression modeling was used to examine the risks of LBW, SGA, LGA and PTB in association with maternal TG levels in the second or third trimesters RESULTS: In the second trimester, compared with reference TG group (T2), women in higher TG group (T3) and lower TG group (T1) were also at increased risk of LGA (aOR 1.20, 95% CI 1.11-1.29) and SGA (aOR 1.25, 95% CI 1.10-1.41), respectively. In the third trimester, women in T3 and T1 were at increased risk of LGA (aOR 1.27, 95% CI 1.17-1.38) and SGA (aOR 1.17, 95% CI 1.02-1.34), respectively. CONCLUSION: In this study, higher maternal TG levels in the second or third trimesters were associated with risks of LGA, however, lower maternal TG levels in the second or third trimesters were conversely associated with risks of SGA.
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Nacimiento Prematuro , Embarazo , Recién Nacido , Femenino , Niño , Humanos , Estudios de Cohortes , Nacimiento Prematuro/epidemiología , Nacimiento Prematuro/etiología , Estudios Prospectivos , Japón/epidemiología , Retardo del Crecimiento Fetal , TriglicéridosRESUMEN
AIM: To investigate whether any reduction in all-cause mortality and cardiovascular disease morbidity was found over the decade in type 2 diabetes on real-world practice. METHODS: A prospective observational study was performed by following two independent cohorts recruited in 2004 (n = 3286, Cohort 1) and 2014 (n = 3919, Cohort 2). The primary outcome was a composite of onset of cardiovascular disease and death. Cox proportional hazards analysis was used to explore any difference between Cohort 2 and Cohort 1 for the composite endpoints and cardiovascular disease after adjustment for covariates and accumulation of five risks (smoking, HbA1c, blood pressure, lipids, and albuminuria) outside target ranges. RESULTS: During the 8-year follow-up, 391 (11.9%) and 270 (6.9%) primary outcomes, and 270 (8.2%) and 161 (4.1%) cardiovascular diseases occurred in Cohort 1 and Cohort 2, respectively. Cohort 2 (vs. Cohort 1) exhibited a significant risk reduction for composite endpoints (HR 0.73, 95% CI 0.62 to 0.86) and cardiovascular disease (HR 0.64, 95% CI 0.52 to 0.79), and similarly exhibited a significant reduction independent of the accumulation of the five risks. CONCLUSIONS: The significant reduction of Cohort 2 for cardiovascular disease independent of the baseline covariates suggests an integrated effect delivered by the recent treatment advances.
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Enfermedades Cardiovasculares , Diabetes Mellitus Tipo 2 , Humanos , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/prevención & control , Incidencia , Estudios Prospectivos , Fumar , Progresión de la Enfermedad , Factores de RiesgoRESUMEN
Senescence causes age-related diseases and stress-related injury. Paradoxically, it is also essential for organismal development. Whether senescence contributes to lung development or injury in early life remains unclear. Here, we show that lung senescence occurred at birth and decreased throughout the saccular stage in mice. Reducing senescent cells at this stage disrupted lung development. In mice (<12 h old) exposed to hyperoxia during the saccular stage followed by air recovery until adulthood, lung senescence increased particularly in type II cells and secondary crest myofibroblasts. This peaked during the alveolar stage and was mediated by the p53/p21 pathway. Decreasing senescent cells during the alveolar stage attenuated hyperoxia-induced alveolar and vascular simplification. Conclusively, early programmed senescence orchestrates postnatal lung development whereas later hyperoxia-induced senescence causes lung injury through different mechanisms. This defines the ontogeny of lung senescence and provides an optimal therapeutic window for mitigating neonatal hyperoxic lung injury by inhibiting senescence.
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Hiperoxia , Lesión Pulmonar , Animales , Ratones , Hiperoxia/metabolismo , Alveolos Pulmonares/metabolismo , Animales Recién Nacidos , Lesión Pulmonar/metabolismo , Pulmón/metabolismoRESUMEN
OBJECTIVES: Zinc and copper are trace elements, but their reference values during the neonatal and infant periods are not clear. We aimed to determine the trend of serum zinc levels in infants admitted to the neonatal intensive care unit and compare serum zinc and serum copper levels at admission between small-for-gestational-age (SGA) and non-SGA infants. METHODS: From 406 patients admitted to the neonatal intensive care unit from January 2009 to September 2012, 339 patients were included in this retrospective study. Blood samples were collected on admission, and serum zinc and serum copper levels were measured. Serum zinc was tested every month until discharge. RESULTS: Serum zinc levels of infants born at <30 wk of gestation decreased by 46% in the first month of life. All infants born at ≤34 wk of age became zinc deficient at 2 mo of age. The relationship between gestational age and serum zinc level at admission had a negative correlation (Spearman's rank correlation cofficients) = -0.66; P < 0.001). There was a negative correlation between serum zinc and serum copper at admission (rs = -0.49; P < 0.001). Serum copper levels of SGA infants at admission were significantly higher than those of non-SGA infants (P < 0.001). CONCLUSIONS: All of the infants admitted to the neonatal intensive care unit at ≤34 wk of gestation were zinc deficient by 2 mo of age, suggesting the need for enteral zinc administration. Serum copper was higher in SGA infants than in non-SGA infants on admission, but further studies are needed to determine whether excess copper affects development.
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Cobre , Unidades de Cuidado Intensivo Neonatal , Recién Nacido , Femenino , Humanos , Lactante , Estudios Retrospectivos , Recién Nacido Pequeño para la Edad Gestacional , Edad Gestacional , ZincRESUMEN
BACKGROUND: Tobacco exposure during pregnancy is associated with several adverse outcomes in infants. We investigated the association between tobacco exposure during pregnancy (both active and second-hand) and various infections in infants up to 1 year. METHODS: This prospective cohort study used a fixed dataset (jecs-an-20180131) from the Japan Environment and Children's Study of registered births in Japan during 2011-2014 that included 104,065 fetal records from enrolled pregnant women. Based on the participants' responses to the questionnaire on smoking status, mothers were first divided into "never smoked," "quit smoking," and "current smoker" groups and then into "no second-hand smoking (SHS)" and "SHS" groups. Infectious diseases included central nervous system infection, otitis media (OM), upper respiratory tract infection (URTI), lower respiratory tract infection (LRTI), gastroenteritis (GI), and urinary tract infection. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated using logistic regression analysis and adjusted for maternal, socioeconomic, and postnatal confounding factors. RESULTS: Among the 73,205 newborns enrolled, multivariable analysis revealed that the aOR of LRTI and GI was 1.20 (95% CI, 1.07-1.33) and 1.18 (95% CI, 1.04-1.35), respectively, for the "current smoker with/without SHS" group compared with the "never smoked without SHS" group. "Quit smoking without SHS" was not associated with the risk of LRTI. SHS was associated with an increased risk of OM, URTI, LRTI, and GI, especially with LRTI and GI. CONCLUSION: Exposure to tobacco smoke during pregnancy was associated with an increased risk of OM, URTI, LRTI, and GI in infants during their first year of life.
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Exposición Materna , Infecciones del Sistema Respiratorio , Contaminación por Humo de Tabaco , Niño , Femenino , Humanos , Lactante , Recién Nacido , Embarazo , Japón/epidemiología , Madres , Estudios Prospectivos , Infecciones del Sistema Respiratorio/epidemiología , Fumar/efectos adversos , Fumar/epidemiología , Nicotiana , Contaminación por Humo de Tabaco/efectos adversosRESUMEN
BACKGROUND: Although disseminated intravascular coagulation (DIC) is a critical disease, its mortality in neonates is hard to predict. The aim of this study was to investigate underlying conditions associated with neonatal DIC to see if a scoring system could predict mortality. METHODS: We retrospectively evaluated the DIC scores of neonates diagnosed on or after the second day of life, in conjunction with underlying conditions associated with DIC. The diagnosis of DIC was made according to Japan Society of Obstetrical, Gynecological & Neonatal Hematology (JSOGNH) 2016 neonatal DIC criteria. RESULTS: Among 23 neonates with DIC, 8 had gastrointestinal perforation with necrotizing enterocolitis and 6 had congenital heart disease. Although factors such as birth weight, gestational age, D-dimer, and fibrinogen were not predictive of mortality, median PT-INR differed significantly between the two groups (survived 1.69 vs died 2.37, P = 0.004). Furthermore, median DIC scores differed significantly by survival outcome (P = 0.013). CONCLUSION: DIC scores based on JSOGNH 2016 neonatal DIC criteria are predictive of mortality in infants diagnosed with DIC on or after the second day of life.
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Coagulación Intravascular Diseminada , Humanos , Recién Nacido , Coagulación Intravascular Diseminada/diagnóstico , Coagulación Intravascular Diseminada/etiología , Estudios Retrospectivos , Mortalidad Infantil , Fibrinógeno , Japón/epidemiologíaRESUMEN
BACKGROUND: Premature infants, subjected to supplemental oxygen and mechanical ventilation, may develop bronchopulmonary dysplasia, a chronic lung disease characterized by alveolar dysplasia and impaired vascularization. We and others have shown that hyperoxia causes senescence in cultured lung epithelial cells and fibroblasts. Although miR-34a modulates senescence, it is unclear whether it contributes to hyperoxia-induced senescence. We hypothesized that hyperoxia increases miR-34a levels, leading to cellular senescence. METHODS: We exposed mouse lung epithelial (MLE-12) cells and primary human small airway epithelial cells to hyperoxia (95% O2/5% CO2) or air (21% O2/5% CO2) for 24 h. Newborn mice (< 12 h old) were exposed to hyperoxia (> 95% O2) for 3 days and allowed to recover in room air until postnatal day 7. Lung samples from premature human infants requiring mechanical ventilation and control subjects who were not mechanically ventilated were employed. RESULTS: Hyperoxia caused senescence as indicated by loss of nuclear lamin B1, increased p21 gene expression, and senescence-associated secretory phenotype factors. Expression of miR-34a-5p was increased in epithelial cells and newborn mice exposed to hyperoxia, and in premature infants requiring mechanical ventilation. Transfection with a miR-34a-5p inhibitor reduced hyperoxia-induced senescence in MLE-12 cells. Additionally, hyperoxia increased protein levels of the oncogene and tumor-suppressor Krüppel-like factor 4 (KLF4), which were inhibited by a miR-34a-5p inhibitor. Furthermore, KLF4 knockdown by siRNA transfection reduced hyperoxia-induced senescence. CONCLUSION: Hyperoxia increases miR-34a-5p, leading to senescence in lung epithelial cells. This is dictated in part by upregulation of KLF4 signaling. Therefore, inhibiting hyperoxia-induced senescence via miR-34a-5p or KLF4 suppression may provide a novel therapeutic strategy to mitigate the detrimental consequences of hyperoxia in the neonatal lung.
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Displasia Broncopulmonar , Hiperoxia , Factor 4 Similar a Kruppel , MicroARNs , Animales , Humanos , Ratones , Animales Recién Nacidos , Displasia Broncopulmonar/genética , Displasia Broncopulmonar/tratamiento farmacológico , Dióxido de Carbono , Senescencia Celular , Células Epiteliales/metabolismo , Hiperoxia/genética , Hiperoxia/metabolismo , Factor 4 Similar a Kruppel/genética , Factor 4 Similar a Kruppel/metabolismo , Pulmón/metabolismo , MicroARNs/metabolismoRESUMEN
BACKGROUND: Low birth weight (LBW), small for gestational age (SGA), and preterm birth (PTB) are important neonatal outcomes that may affect infant morbidity and mortality. The aim of this study is to investigate associations between maternal hemoglobin (Hb) concentrations and pregnancy outcomes of LBW, SGA, and PTB. METHODS: This was a prospective birth cohort study using data of the Japan Environment and Children's Study. Participants were divided into five groups according to maternal Hb (g/dL) in the first and second trimesters: group 1, Hb < 9; group 2, 9 ≤ Hb < 11.0; group 3, 11.0 ≤ Hb < 13.0; group 4, 13.0 < Hb < 14.0; and group 5, 14.0 ≤ Hb. We examined the relationships between LBW, PTB, SGA, and maternal Hb in the first and second trimesters. RESULTS: Excluding 29,673, a total of 74,392 newborns (first trimester: n = 39,084, second trimester: n = 35,308) were included. We obtained adjusted odds ratios (aORs) (95% confidence intervals (CIs)) using multivariate analysis; compared with group 3 in the first trimesters, women in group 1 were at increased risk of PTB (aOR, 3.20; 95% CI, 1.69-6.09), LBW (aOR, 2.21; 95% CI, 1.19-4.09). In the second trimester, multivariate analysis revealed that, compared with group 3 in the second trimester, women in group 1 were at increased risk of PTB (aOR, 2.30; 95% CI, 1.19-4.42) and women in group 5 were at increased risk of LBW (aOR, 1.87; 95% CI, 1.24-2.81) and PTB (aOR, 1.73; 95% CI, 1.06-2.83). CONCLUSIONS: Elevated maternal Hb in the second trimester was associated with risks of PTB and LBW.
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Recién Nacido Pequeño para la Edad Gestacional , Nacimiento Prematuro , Embarazo , Recién Nacido , Femenino , Niño , Humanos , Nacimiento Prematuro/epidemiología , Nacimiento Prematuro/etiología , Estudios de Cohortes , Japón/epidemiología , Estudios Prospectivos , Hemoglobinas/análisis , Factores de RiesgoRESUMEN
OBJECTIVES: We investigated the relationship between the daily dietary inflammatory index (DII) score 1 y before pregnancy and offspring neurodevelopment. METHODS: Data of singleton pregnancies from the Japan Environment and Children's Study involving live-term births from 2011 to 2014 were extracted. Individual meal patterns during 1 y before pregnancy obtained from food frequency questionnaires were used to calculate DII scores. Participants were stratified by DII quintiles (quantile [Q] 1 and Q5 represented the most anti- and proinflammatory dietary groups, respectively) and by sex of the newborn. Q3 (middle inflammatory diet group) was the reference for the multiple logistic regression model used to estimate the effect of anti- or proinflammatory diet on impaired neurodevelopment at age 3 y. RESULTS: During this study, 68 479 maternal and neonatal pair records were obtained (34 817 male and 33 662 female offspring). Male offspring in the Q1 group exhibited decreased delayed development in communication (adjusted odds ratio [aOR]: 0.79; 95% confidence interval [CI], 0.67-0.93), fine motor (aOR: 0.86; 95% CI, 0.76-0.98), problem-solving (aOR: 0.83; 95% CI, 0.73-0.94), and social (aOR: 0.75; 95% CI, 0.63-0.90) skills. Offspring in the Q5 group exhibited increased delay in fine motor skill development (aOR: 1.23; 95% CI, 1.10-1.39). Female offspring in the Q1 group exhibited decreased delayed development in problem-solving skills (aOR: 0.81; 95% CI, 0.67-0.98), and those in the Q5 group exhibited an increased delay in gross motor skill development (aOR: 1.24; 95% CI, 1.01-1.53). CONCLUSIONS: An antiinflammatory diet 1 y before pregnancy may decrease the risk of impaired neonatal neurodevelopment, and a proinflammatory diet may increase this risk.
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Dieta , Conducta Alimentaria , Niño , Preescolar , Dieta/efectos adversos , Femenino , Humanos , Recién Nacido , Japón/epidemiología , Masculino , Oportunidad Relativa , EmbarazoRESUMEN
High measles-specific antibody titers in the cerebrospinal fluid (CSF) have important diagnostic significance for subacute sclerosing panencephalitis (SSPE), a progressive neurological disorder caused by measles virus variants. However, the diagnostic reference value of antibody levels and the usefulness of the CSF/serum ratio measured using enzyme immunoassays (EIAs) for SSPE diagnosis remain unclear. To facilitate SSPE diagnosis using EIAs, measles immunoglobulin G (IgG) titers in the CSF and serum of patients with and without SSPE were measured and their CSF/serum antibody ratios evaluated. Serum and CSF antibody levels were compared among three patients with SSPE (59 paired samples), 37 non-SSPE patients, and 2618 patients of unknown backgrounds. Of the 59 paired samples from three patients with SSPE, 56 paired samples (94.9%) showed CSF measles IgG levels ≥0.5 IU/mL and a CSF/serum ratio ≥0.05, whereas non-SSPE cases showed CSF measles IgG levels <0.1 IU/mL and a CSF/serum ratio <0.03. Of the 2618 CSF samples with unknown backgrounds, 951 showed measurable IgG levels with EIA, with a CSF/serum ratio peak of 0.005-0.02, with a 90th percentile of 0.05. Assuming the SSPE criteria as CSF measles IgG ≥0.5 IU/mL and a CSF/serum ratio ≥0.05, only 20 samples (0.8%) with unknown backgrounds were categorized as having SSPE. Conversely, assuming the non-SSPE criteria as CSF measles IgG <0.1 IU/mL and a CSF/serum ratio <0.03, 2403 samples (92%) with unknown backgrounds were categorized as not having SSPE. In conclusion, high CSF/serum ratios (≥0.05) and high measles CSF IgG levels (≥0.5 IU/mL) may be useful for diagnosing SSPE.
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Panencefalitis Esclerosante Subaguda , Anticuerpos Antivirales , Humanos , Técnicas para Inmunoenzimas , Inmunoglobulina G , Virus del Sarampión , Valores de Referencia , Panencefalitis Esclerosante Subaguda/líquido cefalorraquídeo , Panencefalitis Esclerosante Subaguda/diagnósticoRESUMEN
Objective: To clarify the safety and efficacy of pre-operative embolization using Onyx liquid embolic agent (Onyx; ev3) compared with N-butyl cyanoacrylate (NBCA; Cordis Neurovascular, Inc.) or coils in cerebral arteriovenous malformation (AVM) surgery. Methods: This was a retrospective review of a prospectively collected clinical database of brain AVMs treated at our institute from January 2005 to March 2021. A total of 38 consecutive patients who underwent AVM resection after pre-operative embolization were included. Based on pre-operative embolization materials, the patients were divided into the pre-Onyx group (n = 16), in which NBCA or coils were used for embolization, and the Onyx group (n = 22). Patient characteristics and treatment results were compared between the two groups. Results: Patient characteristics were comparable between the two groups in terms of age, sex, and rupture status. While the Spetzler-Martin grade was also similar between the two groups, the location of the AVM nidus in the eloquent area was slightly higher in patients in the Onyx group (72.7%) than in patients in the pre-Onyx group (43.8%) (P = 0.09). The embolization rate was higher in the pre-Onyx group (mean: 63.0%; range: 12.7-100%) than in the Onyx group (mean: 50.0%; range: 15.8-100%), but the difference was not statistically significant (P = 0.06). The time needed for surgical removal was shorter in the Onyx group (mean: 354.8 min; range: 144-884 min) than in the pre-Onyx group (mean: 457.9 min; range: 240-1,294 min); however, this difference was not statistically significant (P = 0.13). The amount of intraoperative bleeding was significantly lower in the Onyx group (mean: 129.8 ml; range: 20-540 mL) than in the pre-Onyx group (mean: 448.8 mL; range: 120-1,550 ml) (P = 0.0008). The surgical complication rates were comparable between the two groups (pre-Onyx group, 18.8%; Onyx group, 4.5%; P = 0.29). Conclusions: Pre-operative embolization with Onyx can significantly reduce the amount of intraoperative bleeding in AVM resection and may contribute to safe AVM surgery.
RESUMEN
Herein, we report the synthesis of sulfur-substituted boron(III) subphthalocyanines (SubPcs) with cationic axial ligands. Subphthalocyanines were synthesized by a condensation reaction using the corresponding phthalonitriles and boron trichloride as a template. An aminoalkyl group was introduced on the central boron atom; this process was followed by N-methylation to introduce a cationic axial ligand. The peripheral sulfur groups shifted the Q band of SubPcs to a longer wavelength. The cationic axial ligands increased the polarity and enhanced the hydrophilicity of SubPcs. The effect of axial ligands on absorption and fluorescence properties is generally small. However, a further red shift was observed by introducing cationic axial ligands into the sulfur-substituted SubPcs. This change is similar to that in sulfur-substituted silicon(IV) phthalocyanines. The unique effect of the cationic axial ligand was extensively investigated by theoretical calculations and electrochemistry. In particular, the precise oxidation potential was determined using ionization potential measurements. Thus, the results of the present study provide a novel strategy for developing functional dyes and pigments based on SubPcs.
Asunto(s)
Boro , Indoles , Boro/química , Cationes , Indoles/química , Ligandos , AzufreRESUMEN
BACKGROUND: Bronchopulmonary dysplasia (BPD) is the most common morbidity complicating preterm birth and affects long-term respiratory outcomes. The objectives of this study were to establish whether serum periostin at birth, day of life (DOL) 28, and corrected 36 weeks' gestational age could be potential biomarkers for BPD. METHODS: A total of 98 preterm Japanese infants born at <32 weeks and comparing 41 healthy controls born at term, were divided into BPD (n = 44) and non-BPD (n = 54) cohorts. Serum periostin levels were measured using an enzyme-linked immunosorbent assay. RESULTS: Among 98 preterm infants, the median serum periostin levels at birth were higher with BPD (338.0 ng/mL) than without (275.0 ng/mL, P < 0.001). Multivariate analysis revealed that serum periostin levels at birth were significantly associated with BPD (P = 0.013). Serum periostin levels at birth with moderate/severe BPD (345.0 ng/mL) were significantly higher than those with non-BPD/mild BPD (283.0 ng/mL, P = 0.006). CONCLUSIONS: Serum periostin levels were significantly correlated with birth weight and gestational age, and serum periostin levels at birth in BPD infants were significantly higher than that in non-BPD infants. IMPACT: This study found higher serum periostin levels at birth in preterm infants subsequently diagnosed with bronchopulmonary dysplasia. It also emerged that serum periostin levels at birth significantly correlated with gestational age and birth weight. The mechanism by which serum periostin is upregulated in BPD infants needs further investigation.