Variations of Redox Balance in Different Stages of Childhood Immune Thrombocytopenic Purpura.

BACKGROUND: Few previous studies indicated the role of oxidative stress in the pathogenesis of childhood idiopathic thrombocytopenic purpura (ITP), but there are little data regarding changes in redox balance in different forms of the disease, and changes after therapeutic procedures. We aimed to investigate the values of pro-oxidants and antioxidative capacity in various forms of ITP before and after the applying therapy. MATERIALS AND METHODS: The research included 102 children, classified into the following groups: (1) newly diagnosed ITP (ndITP), (2) persistent ITP, (3) chronic ITP (chITP), and (4) control groups: (A) healthy control and (B) previously experienced ITP-healthy children who had been suffering from ITP earlier. During the clinical assessment, a blood sample was taken from the patients, from which the value of pro-oxidants (index of lipid peroxidation measured as TBARS, nitrites [NO2 -], as measurement of nitric oxide [NO] production, superoxide anion radical [O2 -], and hydrogen peroxide [H2O2]) and the capacity of antioxidant protection (activity of superoxide dismutase and catalase, and quantity of reduced glutathione) were determined spectrophotometrically. RESULTS: Our results demonstrated that values of pro-oxidants, especially reflected through the TBARS and O2 -, were the highest in the ndITP and exacerbated chITP groups. Also, the activity of the endogenous antioxidative defense system was the lowest in these groups. Intravenous immunoglobulin therapy in the ndITP group exerted the most prominent effect on the redox balance. CONCLUSION: It can be concluded that severity and exacerbation of the ITP are closely related to the redox status.

Predictive value of biochemical, echocardiographic and electrocardiographic markers in non-surviving and surviving asphyxiated full-term newborns.

Severe perinatal asphyxia can cause multiple organ dysfunction and early neonatal mortality. This prospective study was conducted at the Regional University Hospital Neonatology Center in Serbia. The aim of this study was to compare fullterm asphyxiated newborn infants (n=55) with (n=13) and without (n=42) mortality outcome and healthy full-term newborns (n=36) regarding biochemical (cardiac troponin I, creatine kinase (total and MB fraction) and C-reactive protein), echocardiographic (ejection fraction, fractional shortening, mitral regurgitation, significant tricuspid regurgitation, and patent ductus arteriosus) and electrocardiographic (ST segment elevation/depression, T wave inversion and corrected QT interval) markers of myocardial damage in order to assess their predictive value in the clinical outcome. Statistically significant differences in the majority of the tested markers of ischemic myocardial lesion were found between perinatal asphyxia survivors and the control group. However, among the biochemical indicators, only the level of cardiac troponin I was significantly higher in the group of neonates who died compared to the group of asphyxiated neonates who survived (p: 0.000), with an area under the receiver operating characteristic curve of 0.821 and cutoff value for lethal outcome of 0.135 µg/L (sensitivity 0.85; specificity 0.69). In addition, differences in ejection fraction, fractional shortening and significant tricuspid regurgitation (≥2+) were also found between the two subgroups of asphyxiated newborns. Cardiac troponin I is the most sensitive ischemic myocardial lesion biochemical marker in the prediction of early mortality in perinatal asphyxia patients.