The Influence of Maternal-Foetal Parameters on Concentrations of Zonulin and Calprotectin in the Blood and Stool of Healthy Newborns during the First Seven Days of Life. An Observational Prospective Cohort Study.

BACKGROUND: It can be hypothetically assumed that maternal and perinatal factors influence the intestinal barrier. METHODS: The study was conducted with 100 healthy, full-term newborns breastfed in the first week of life, with similar analyses for their mothers. Zonulin and calprotectin levels were used as intestinal permeability markers. RESULTS: The median (range) zonulin concentrations (ng/mL) were in mothers: serum, 21.39 (6.39⁻57.54); stool, 82.23 (42.52⁻225.74); and newborns: serum cord blood, 11.14 (5.82⁻52.34); meconium, 54.15 (1.36⁻700.65); and stool at age seven days, 114.41 (29.38⁻593.72). Calprotectin median (range) concentrations (µg/mL) in mothers were: stool, 74.79 (3.89⁻211.77); and newborns: meconium, 154.76 (6.93⁻8884.11); and stool at age seven days 139.12 (11.89⁻627.35). The use of antibiotics during pregnancy resulted in higher zonulin concentrations in umbilical-cord serum and calprotectin concentrations in newborn stool at seven days, while antibiotic therapy during labour resulted in higher zonulin concentrations in the stool of newborns at seven days. Zonulin concentrations in the stool of newborns (at seven days) who were born via caesarean section were higher compared to with vaginal birth. With further analyses, caesarean section was found to have a greater effect on zonulin concentrations than prophylactic administration of antibiotics in the perinatal period. Pregnancy mass gain >18 kg was associated with higher calprotectin concentrations in maternal stool. Body Mass Index (BMI) increase >5.7 during pregnancy was associated with decreased zonulin concentrations in maternal stool and increased calprotectin concentrations in stool of mothers and newborns at seven days. There was also a negative correlation between higher BMI increase in pregnancy and maternal zonulin stool concentrations and a positive correlation between BMI increase in pregnancy and maternal calprotectin stool concentrations. CONCLUSION: Maternal-foetal factors such as caesarean section, antibiotic therapy during pregnancy, as well as change in mother's BMI during pregnancy may increase intestinal permeability in newborns. Changes in body mass during pregnancy can also affect intestinal permeability in mothers. However, health consequences associated with increased intestinal permeability during the first days of life are unknown. Additionally, before the zonulin and calprotectin tests can be adopted as universal diagnostic applications to assess increased intestinal permeability, validation of these tests is necessary.

The Use of Noninvasive Ventilation with High Frequency in Newborns-A Single-Center Experience.

OBJECTIVE: The aim of the study is to evaluate the efficacy of noninvasive high-frequency ventilation (nHFV) in respiratory-deficient infants. STUDY DESIGN: Retrospective analysis of 32 cases of nHFV in 30 term (n = 4) and preterm (n = 26) newborns using a noninvasive ventilation (NIV) device. nHFV avoided intubation of children performed with NIV and reintubation after long-term mechanical ventilation (MV). Patients were divided into three groups: Group 1: NIV from birth (n = 18, mean birth weight [BW]: 1,987 g, gestational age [GA]: 33.1 weeks); Group 2: MV, also used temporarily, and NIV (n = 10, BW: 1,074 g, GA: 28.2 weeks); and Group 3: two cases with nHFV avoided reintubation after long-term MV (BW: 725 g, GA: 24.5 weeks). RESULTS: From 32 episodes of nHFV application, positive effect was achieved 26 times (81%) (24 of 30 children). All newborns had a significant increase in pH (7.23-7.27) and reduction in partial pressure of CO2 (66.7-58.9 mm Hg, over 1-2 hours). Failures in application of nHFV reported only in Group 1 (6/18, 33%) (failures primarily due to increasing demand for oxygen). There were two reports of pneumothorax in preterm infants with congenital pneumonia. No other nHFV-related complications were noted. CONCLUSION: nHFV is a promising NIV mode which can be also used with NIV devices.

[An abdominal inflammatory pseudotumor in a 9-year-old girl with newly diagnosed diabetes mellitus type 1--a case report]. / Guz zapalny jamy brzusznej u 9-letniej pacjentki ze swiezo ujawniona cukrzyca typu 1--opis przypadku.

An inflammatory tumor is a rare, benign pathology with a variable natural course. The hypotheses of the etiology of the inflammatory tumor are associated with trauma, infections or the immune mechanisms. To our knowledge, in the literature are described some single cases of solid omental and peritoneal masses as an uncommon cause of abdominal lump in children. We describe a case of a 9-year-old girl with clinical symptoms at onset of type 1 diabetes and accidentally diagnosed omental and peritoneal tumor.