Prematurity and Sepsis - Features and Approach Difficulties During Neonatal Emergency Transfer.

Purpose - We aimed to identify conditions, means and methods of suspecting, certification and stratification of neonatal sepsis, to prioritize and define levels of management during evacuation, and to follow the neonatal sepsis succeeding the transfer. Material and method - An observational study was conducted between 1January 2011 - the 1 January 2015, that included 610 preterm newborns with suspected sepsis transferred by UTIM NN or HEMS Craiova. We statistically studied confirmation rate of suspected sepsis, the sepsis onset condition, severity stratification, and correlate with medical centers performance assisting newborns and planning transfers. A follow up performed two weeks after evacuation. Results - We detected low rate of detection and affirmed sepsis: n=38 (6.25%) - C.I. (95%): 4.454309335 and very high level of founded unsuspected sepsis: n=85 (13.98026316%) C.I. (95%): 4.982552268, 9of them being very low body weight newborns (1.480263158%). High rate of founded, unaffirmed respiratory distress 23.35526316% (n=142), C.I. (95%): 5.383960957, as sign of sepsis. High rate of accidental hypoglycemia/hypothermia founded by emergency evacuation team: n=131 (21.54605263%), especially to VLBW newborns, associate with sepsis, respiratory failure or confounding with. Conclusions - Newborns transfer its self generates multiple additional risks, including sepsis, but not neglected any stress generated by transport conditions, so that ,,in utero'' transfer has to be extended in current practice for high risk fetus, mother or special medical conditions to limit newborns transfers. Wider use of telemedicine would facilitate refining the transfer criteria.

Plurietiologyc Possibilities and Difficulties of Seizures Management in Pregnancy.

Background - Pre-existing pathology, the development of acute new one strictly dependent of the pregnancy or an independent acute or chronic medical problems generate a highly complex disease that requires a nuanced interpretation of the pregnant women in an attempt to identify the most favorable solutions for evaluation and treatment. Case report - 26-28 weeks pregnant women, 23 years old, known epilepsy, HIV encephalitis and pulmonary TB in inconsistent treatment with prolonged seizure status. Emergency air evacuation from a third degree medical center to regional center ( first level) under general anesthesia. After 24 hours, conscious, without focal signs. Favorable ongoing pregnancy. Conclusions - Considering the medical history, we analyzed several possibly triggering and maintenance of the crisis elements so that clarification of them constituted the main challenges. Finding an imaging examination solution with minimal harming effect on the fetus was a key decision points. Tocography and excluding eclampsia as the etiology were the main reasons to refrain from practicing cesarean section and magnesium sulphate administration. Paralytic agents use, in particular succinylcholine was a decisional key point, considering the variation in serum cholynesterase activity in peripartum period. The phenytoin administration was also a difficult choice because of the risk of bradycardia to the fetus. No any adverse event as effects of the crisis and medical intervention on the mother reported to the newborn during the first 8 months of life, but cerebral palsy continues to concern before 24 months.

Peroxidase-mediated cross-linking of a tyrosine-containing peptide with ferulic acid.

The tyrosine-containing peptide Gly-Tyr-Gly (GYG) was oxidatively cross-linked by horseradish peroxidase in the presence of hydrogen peroxide. As products, covalently coupled di- to pentamers of the peptide were identified by LC-MS. Oxidative cross-linking of ferulic acid with horseradish peroxidase and hydrogen peroxide resulted in the formation of dehydrodimers. Kinetic studies of conversion rates of either the peptide or ferulic acid revealed conditions that allow formation of heteroadducts of GYG and ferulic acid. To a GYG-containing incubation mixture was added ferulic acid in small aliquots, therewith keeping the molar ratio of the substrates favorable for hetero-cross-linking. This resulted in a predominant product consisting of two ferulic acid molecules dehydrogenatively linked to a single peptide and, furthermore, two ferulic acids linked to peptide oligomers, ranging from dimers to pentamers. Also, mono- and dimers of the peptide were linked to one molecule of ferulic acid. A mechanism explaining the formation of all these products is proposed.

Caseins and casein hydrolysates. 1. Lipoxygenase inhibitory properties.

Whole casein from bovine origin, the different casein subtypes alpha, beta, and kappa, and the related dephosphorylated proteins were assayed as modulators of soybean lipoxygenase 1 activity and were found to inhibit it. To define the lipoxygenase inhibitory domain, whole casein and beta-casein were digested by proteases (trypsin, clostripain, and subtilisin). The beta-casein tryptic digest and the tryptic and subtilisin digests of whole casein retained their inhibitory properties. The tryptic beta-casein digest was the most potent inhibitor of lipoxygenase activity and was further fractionated by FPLC or HPLC. The collected peptides inhibited the lipoxygenase-catalyzed reaction to different extents. The active fractions were analyzed by ESI-MS, and the sequences of several lipoxygenase inhibitory peptides, corresponding mainly to the C-terminal moiety of beta-casein, were identified.

Caseins and casein hydrolysates. 2. Antioxidative properties and relevance to lipoxygenase inhibition.

The antioxidant activity of caseins and casein-derived peptides was evaluated by using three free radical producing reactions-the lipoxygenase- and AAPH-catalyzed oxidation of linoleic acid and the hemoglobin-catalyzed oxidation of linoleic acid hydroperoxide. Caseins and casein-derived peptides were able to inhibit enzymatic and nonenzymatic lipid peroxidation, suggesting they were preferred targets for the free radical intermediates. The antioxidative feature was not lost with the dephosphorylation or the proteolysis of the proteins. The fractionation of the tryptic beta-casein digest yielded peptides with antioxidant activity. A structure-function relationship between the amino acid sequence and the antioxidant capacity and effectiveness is proposed. In addition, indirect evidence suggested that the trapping of free radicals by the proteins/peptides was accompanied by the oxidation of proteins/peptides, according to a sequence-specific mechanism.

Product and redox potential analysis of sauerkraut fermentation.

The relationships between the redox potential of the brine, during fermentation of white cabbage into sauerkraut of two early and two late fermentation processes, and the changes in the amount of sugars, organic acids, the redox potential of the brine and of the ascorbic acid redox couple, and pH are described. The trend in the change of the redox potential of the brine is the same for all four fermentation processes studied. In the first phase a sharp decrease in redox potential is followed by an increase in redox potential. In the second phase the redox potential is rather constant. This second phase is followed by another decrease in redox potential, which stabilizes at a minimum value, the third phase. It was observed that sugar fermentation and acid production mainly took place during the first and third phases, probably representing, respectively, the heterogeneous and homogeneous fermentation processes.