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1.
Am J Perinatol ; 2019 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-31756756

RESUMO

OBJECTIVE: There is insufficient study of the association of blood groups with neonatal diseases. The aim of this study was to evaluate the blood groups associated with sepsis and blood groups in preterm infants. STUDY DESIGN: This retrospective study was conducted between January 1, 2010 and November 31, 2018 in the neonatal intensive care unit (NICU). This study was done in single-center tertiary NICU. Infants born at gestational age (GA) <32 weeks with birth weight (BW) <1,500 g were included in the study. RESULTS: A total of 2,548 infants were included. The culture-proven sepsis ratio (30.2%) was the lowest in the O blood group and the highest in the AB blood group (37.5%) (p = 0.045). Meningitis ratio (6.5%) was significantly higher, and hospital stay (64.1 ± 33.9 days) was significantly longer in B blood group (respectively, p = 0.005, p < 0.001). In the AB blood group, GA (27.68 ± 1.12 weeks) was the lowest and early onset sepsis (EOS) (40.1%) and mortality (28.9%) ratio were found to be statistically higher (p < 0.001 for all groups). The AB group was significantly related to higher frequency of EOS (odds ratio [OR] = 2.93, 95% confidence interval [CI] = 1.68-5.12, p = 0.000), in addition to mortality (OR = 1.1, 95% CI = 0.55-2.19, p = 0.001). The O group was found to be associated with lower risk of late onset sepsis (LOS) (OR = 1.67, 95% CI = 1.06-3.058, p = 0.003) according to the model with corrected risk factor including GA, BW, and time of hospitalization. CONCLUSION: Our study was the first study showing a relationship between certain blood groups and EOS/LOS in premature infants as well as meningitis.

2.
J Food Biochem ; 43(12): e13068, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31583737

RESUMO

Leukotrienes, free oxygen radicals, tumor necrosis factor-alpha, and inflammatory mediators play major roles in the development of necrotizing enterocolitis (NEC). Rhus coriaria (RC: sumac) extracts may enhance cell viability by reinforcing defenses against free radical species in several progressive diseases as well as inflammatory diseases. The aim of the present study was to evaluate the effects of RC in a rat NEC model in terms of intestinal damage. Newborn pups were separated into three groups: control, NEC, and NEC treated with RC. Mortality and clinical sickness scores were evaluated. At the end of the study, ileum and proximal colon were obtained from all rats and histopathological and immunohistochemical studies were performed. In this study, the anti-inflammatory, antioxidant, immunomodulatory, and anti-apoptotic activities of RC were demonstrated in a rat NEC model, which suggests RC as a promising treatment option for preventing intestinal tissue damage. PRACTICAL APPLICATIONS: Free oxygen radicals, tumor necrosis factor-alpha, and inflammatory mediators play major roles in the development of NEC. Intestinal tissue damage is caused by necrosis and apoptosis as a result of intestinal inflammation and release of pro-inflammatory cytokines. Anti-inflammatory, antioxidant, immunomodulatory, and anti-apoptotic activities of RC are especially due to its phenolic compounds. In this study, the anti-inflammatory, antioxidant, immunomodulatory, and anti-apoptotic activities of RC were demonstrated in a rat NEC model. RC can suggest as a new treatment option for preventing intestinal injury.

3.
Pediatr Allergy Immunol Pulmonol ; 32(1): 12-17, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-31508250

RESUMO

Background: Bronchopulmonary dysplasia (BPD) is an important clinical problem for premature infants. Previously, some biomarkers associated with severity of BPD have been studied. In our study, we aimed to investigate the value of interleukin-33 (IL-33) levels as a new biomarker in the follow-up of BPD severity and response to treatment. Materials and Methods: Premature infants of <32 weeks of gestational age and birth weight <1,500 g were included in the study. Infants with BPD were divided into moderate and severe BPD groups. Infants without BPD were assigned as the control group. Cord blood samples were taken from both groups immediately after birth. In addition, blood samples were obtained at the time of diagnosis of BPD and after the end of hydrocortisone (HC) treatment to measure IL-33 values in the serum. Results: During the study period, a total of 192 infants were eligible: 96 infants in the BPD group and 96 in the control group. Cord IL-33 values were similar between control (1.29 ± 0.68 pg/mL) and BPD (moderate/severe) (1.31 ± 0.84 pg/mL) groups (P = 0.813). The levels of IL-33 were higher in BPD group (3.43 ± 0.98 pg/mL) than in the control group (0.98 ± 0.51 pg/mL) (P < 0.001). IL-33 values decreased significantly after HC treatment (pretreatment: 3.43 ± 0.98 pg/mL versus post-treatment: 2.97 ± 0.28 pg/mL) (P < 0.001). In addition, IL-33 levels were significantly higher in severe BPD (3.91 ± 1.22 pg/mL) than in moderate BPD (2.82 ± 0.74) group (P < 0.001). Conclusions: Although the IL-33 level was not predictive of the development of BPD immediately after birth, it may be used as a new biomarker to diagnose, monitor, and follow the response to treatment of BPD.

4.
BMC Infect Dis ; 19(1): 695, 2019 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-31387523

RESUMO

BACKGROUND: Diagnosis is the most strenuous step in the evaluation of neonatal sepsis. No gold standard diagnostic method is available except for blood culture. We aimed to investigate the role of positive and negative acute phase reactants, namely presepsin and fetuin-A, in the diagnosis of culture-proven late-onset sepsis. METHODS: A prospective, case-control study with the infants ≤32 weeks of age with a diagnosis of culture-proven late-onset sepsis was designed. Twenty-nine preterm infants with similar gestational and postnatal ages without sepsis constituted the control group. Serum values of presepsin, fetuin-A, C-reactive protein and interleukin-6 were evaluated at the enrollment, third and seventh days of the diagnosis in the infants with positive blood culture results. RESULTS: First-day presepsin values were significantly higher in the culture-positive infants than the control group [1583 ng/L (1023-1731) vs. 426 ng/L (287-589), p = < 0.0001]. Presepsin was found to have an 88.9% sensitivity and 88.9% specificity with a cut-off value of 823 ng/ml for culture-proven LOS in our study, and area under the receiver-operating curve was 0.939. Fetuin-A levels were similar between the study and control groups (p > 0.05). CONCLUSION: Presepsin may be an accurate marker for both diagnosis and monitoring of treatment response for culture-proven late-onset sepsis in preterm infants. However, fetuin-A does not seem to be a useful tool for the diagnosis of sepsis.


Assuntos
Recém-Nascido Prematuro , Receptores de Lipopolissacarídeos/sangue , Sepse Neonatal/diagnóstico , Fragmentos de Peptídeos/sangue , alfa-2-Glicoproteína-HS/análise , Bacteriemia/sangue , Bacteriemia/diagnóstico , Biomarcadores/sangue , Estudos de Casos e Controles , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Recém-Nascido Prematuro/sangue , Interleucina-6/sangue , Masculino , Sepse Neonatal/sangue , Sepse Neonatal/microbiologia , Estudos Prospectivos , Sensibilidade e Especificidade
5.
Early Hum Dev ; 135: 32-36, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31229792

RESUMO

BACKGROUND: Surfactant administration traditionally involved endotracheal intubation and mechanical ventilation, which is associated with a risk of barotrauma and volutrauma. OBJECTIVE: To compare the morbidity and mortality rates between LISA-treated and INSURE-treated premature babies with respiratory distress syndrome (RDS). METHODS: We assessed retrospectively the medical records of preterm infants who were born at 250/7 to 296/7 weeks of gestation and were administered surfactant initially either with LISA or INSURE method over a five-year period. RESULTS: Analysis of the data of 205 LISA-treated and 178 INSURE-treated infants revealed the mean gestational age as 28.1 ±â€¯1.3 and 28 ±â€¯1.3 weeks and mean birth weight as 1041 ±â€¯205 and 1029 ±â€¯222 g in LISA and INSURE groups, respectively. The mechanical ventilation requirement in the first 72 h of life (%26.8-%42.1, p = 0.002) and the incidence of moderate-severe BPD (%12.2-%21.9, p = 0.01) were lower in LISA-treated infants. LISA method was found as an independent factor in reducing mechanical ventilation requirement in the first 72 h of life and incidence of moderate-severe BPD [RR: -0.49 (%95 CI -0.28 to -0.85), p = 0.01]. CONCLUSION: Data obtained from our five-year clinical experience are comparable with the recent literature. LISA is currently the most suitable method of surfactant administration and it should be the first choice in spontaneously breathing infants considering its favorable effects on respiratory morbidities in preterm infants with RDS.

6.
Am J Perinatol ; 2019 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-31167236

RESUMO

OBJECTIVE: We investigated the relationship of serum potassium (K+) and ionized calcium (iCa2+) levels with the persistence of ductus arteriosus. STUDY DESIGN: This retrospective cohort study included infants with birth weight < 1,500 g and gestational age < 32 weeks. Serum K+ and iCa2+ levels at the 1st and 48th hour of life were measured from samples. The difference between the two levels was calculated for both serum K+ (ΔK+) and iCa2+ (ΔCa2+). These values were compared between hemodynamically significant patent ductus arteriosus (hsPDA) and non-hsPDA. RESULTS: Of 1,322 hospitalized preterm nonates, 1,196 were included in the study. Mean serum K+ levels at the 1st and 48th hour were higher and iCa2+ levels at the 1st and 48th hour were lower in hsPDA and non-hsPDA, respectively (p < 0.001). Ionized ΔCa2+ (-0.06 ± 0.13 vs. -0.02 ± 0.12 mmol/L) was higher in hsPDA (p < 0.001). CONCLUSION: We demonstrated that serum K+ and iCa2+ level might play a role in ductal constriction.

7.
Am J Perinatol ; 36(14): 1521-1527, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31087312

RESUMO

OBJECTIVE: The aim of this study was to assess the utility of early postnatal platelet indices in the prediction of hemodynamically significant patent ductus arteriosus (hsPDA) and its response to pharmacological treatment in preterm infants. STUDY DESIGN: The medical records of 971 infants with gestational age < 30 weeks and birth weight < 1,500 g were analyzed retrospectively. Infants with hsPDA comprised the study group and those without hsPDA comprised the control group. Complete blood count results were recorded, and red cell distribution width-to-platelet ratio (RPR) and platelet mass were calculated. RESULTS: A total of 481 infants, 169 in the hsPDA group and 312 in the control group, were included. In terms of platelet indices, the hsPDA group showed significantly lower mean platelet volume (MPV) and platelet mass, whereas RPR was significantly higher (p < 0.05, respectively). Multiple logistic regression analysis showed that RDS (relative ratio [RR]: 2.39; 95% confidence interval [CI]: 1.45-3.93; p < 0.001), MPV < 7.85 (RR: 3.71; 95% CI: 2.29-6.01; p < 0.001), and RPR > 0.070 (RR: 5.33; 95% CI: 3.28-8.65; p < 0.001) were independent risk factors for hsPDA. CONCLUSION: Low MPV and platelet mass and high RPR in the first hours of life are risk factors for hsPDA and hsPDA refractive to pharmacological treatment with ibuprofen in preterm infants.

8.
Artigo em Inglês | MEDLINE | ID: mdl-30914019

RESUMO

BACKGROUND: Retinopathy of Prematurity (ROP) is a pathophysiologic condition of the retina due to abnormal proliferation of retinal vessels. OBJECTIVE: The study aimed too ascertain the importance of vascular endothelial growth factor (VEGF), insulin-like growth factor-1 (IGF-1), interleukin-33 (IL-33) and endocan in the diagnosis and follow-up of ROP. METHODS: This prospective cohort study was conducted in the neonatal intensive care unit (NICU) of Health Science University, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey, between February 2017 and August 2018. Preterm infants (gestational age (GA) of ≤32 weeks and birth weight of ≤1500 gr), diagnosed ROP were included in the study. VEGF, IGF-1, IL-33 and endocan levels were evaluated in the cord blood and in the serum before and after treatment of infants in the ROP and control groups. RESULTS: A final number of 146 infants were included in the study. During the study period, 73 infants were identified as the ROP group, and 73 infants were allocated as the control group. In the ROP group, the cord blood VEGF value was higher than the control group (p <0.05). However, IGF-1 levels in the cord blood were lower in the ROP group than control (P<0.05). IL-33 and endocan values in the cord blood were similar in both control and ROP groups (p>0.05). Although serum levels of IL-33, VEGF and endocan were higher before laser treatment, these biomarkers decreased significantly after laser treatment (p <0.05). CONCLUSION: We determined that serum IL-33 and endocan levels might be suggested as sensitive novel markers for the prediction of severe ROP.


Assuntos
Interleucina-33/sangue , Proteínas de Neoplasias/sangue , Proteoglicanas/sangue , Retinopatia da Prematuridade/sangue , Biomarcadores/sangue , Proliferação de Células , Estudos de Coortes , Feminino , Humanos , Lactente , Lasers , Masculino , Estudos Prospectivos , Retinopatia da Prematuridade/diagnóstico , Retinopatia da Prematuridade/radioterapia
9.
Arch Bronconeumol ; 55(9): 465-471, 2019 Sep.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30833192

RESUMO

INTRODUCTION: Endocan levels were found to be associated with severity and mortality of the respiratory system diseases. OBJECTIVE: We aimed to figure out whether endocan was an important marker for the diagnosis, severity and follow-up of bronchopulmonary dysplasia (BPD). MATERIALS AND METHODS: Infants with moderate/severe BPD, and who required hydrocortisone treatment were included in the study group. Infants without BPD were allocated in the control group. Endocan levels were compared between the control group and the study group, and before and after the treatment in the study group. RESULTS: A total of 148 infants, 74 infants in the control group and 74 infants in the BPD group, were included. The endocan level was higher in the BPD group than in the control group (P = .001). Endocan levels before treatment in the BPD group was found to be higher than endocan level after treatment (P = .021). CONCLUSION: Our study found that endocan levels increased in moderate/severe BPD. Serum endocan levels may be a safe and novel indicator for the follow-up of response to treatment and the prognosis of the severity of the disease.

10.
J Pediatr Endocrinol Metab ; 32(1): 65-70, 2019 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-30511932

RESUMO

Background It is known that thyroid hormones have effects on bone development. In particular, the effect of thyroid hormones on osteopenia of prematurity (OOP) has not been examined in preterm infants. Our study aimed to examine the relationship between OOP and congenital hypothyroidism (CH) in preterm infants. Methods Very low birth weight infants (VLBW, <1500 g) were included in the study. Thyroid-stimulating hormone (TSH) and free thyroxine (fT4) levels were measured on postnatal day 5. Serum calcium, phosphorus and alkaline phosphatase (ALP) levels were studied as standard screening parameters for OOP at postnatal week 4. Patients with serum ALP level >700 IU/L were included in the OOP group. We intended to figure out the relationship between OOP and CH in infants. Results In our study, OOP frequency was 14.9% among 543 VLBW infants. There was no statistically significant difference between groups with and without CH (21.7% and 14.8%, respectively) in terms of OOP (p=0.632). Gestational age (GA) was significantly lower in infants with diagnosed OOP (p<0.001, p<0.001, respectively). In addition, the prevalence rates of mothers with preeclampsia, small for gestational age (SGA), respiratory support requirement, late-onset neonatal sepsis (LOS), bronchopulmonary dysplasia (BPD) and full enteral feeding time were found to be higher in the OOP group (p<0.05). Conclusions We found that thyroid hormones had no effect on OOP in preterm infants. Therefore, future randomized controlled studies as well as long-term outcome studies are warranted on this topic.


Assuntos
Doenças Ósseas Metabólicas/etiologia , Hipotireoidismo Congênito/complicações , Doenças do Prematuro/etiologia , Recém-Nascido Prematuro , Recém-Nascido de muito Baixo Peso , Glândula Tireoide/fisiopatologia , Doenças Ósseas Metabólicas/patologia , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Doenças do Prematuro/patologia , Masculino , Gravidez , Prognóstico , Estudos Retrospectivos , Testes de Função Tireóidea
11.
Am J Perinatol ; 36(6): 641-646, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30292174

RESUMO

OBJECTIVE: Patent ductus arteriosus (PDA) is an important clinical problem associated with mortality and serious morbidities. It is thought that serum osmolality may affect ductal patency. We aimed to investigate the importance of serum osmolality related to ductal patency in preterm infants. STUDY DESIGN: Our study was conducted between January 2013 and December 2017. Premature infants with birth weight <1,500 g and gestational age <32 weeks were included in the study. Serum osmolality was compared between infants with hemodynamically significant PDA (hsPDA) and non-hsPDA. RESULTS: During the study period, 799 patients were evaluated. Mean serum osmolality levels were higher in the "hsPDA" group (297 ± 10.9 vs. 292 ± 8.3 mOsm/L) (p = 0.001). The area under the curve for osmolality was 0.582 (p = 0.0006, 95% confidence interval: 0.541-0.622) at the time of diagnosis for predicting hsPDA, with a cutoff value for osmolality of 300 mOsm/L. CONCLUSION: Serum osmolality may be recognized as an important contributing factor for ductal patency especially among extremely preterm infants who are most likely to have hsPDA in the early days of life.

12.
J Clin Lab Anal ; 33(2): e22664, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30175415

RESUMO

OBJECTIVE: Serum lactate levels provide information on metabolic capacity at the cellular level. In addition, lactate reflects tissue perfusion and oxygenation status. The aim of this study was to determine the usefulness of high lactate levels as a marker in hemodynamically significant patent ductus arteriosus (hsPDA), which may lead to tissue perfusion defects. METHODS: Preterm infants with gestational age ≤32 weeks and birthweight ≤1500 g were included. Lactate levels were determined at postnatal 48-72 hours before echocardiographic evaluation. Eligible infants were divided into two groups as infants with and without hsPDA. Cut-off values for lactate were taken as lactate >4 mmol/L, identified as a high lactate level. Infants were also divided into two groups according to lactate levels as group I: lactate levels >4 mmol/L and group II: lactate levels ≤4 mmol/L. Haemodynamic PDA and lactate levels were compared. RESULTS: A total of 119 patients with gestational age ≤32 weeks and birthweight ≤1500 g were included in the study. Fifty patients had echocardiographic hsPDA and 69 patients had no PDA. Twelve (24%) of the patients with hsPDA and 22 (31.9%) of the non-hsPDA patients had a lactate level of 4 mmol/L (P = 0.392). There was no correlation between hsPDA presence and lactate levels (P = 0.35). CONCLUSION: High lactate levels are multifactorial and usually indicate impairment of tissue perfusion. There are a number of factors that can lead to impaired tissue perfusion in preterm infants. For the first time in this study, it was shown that lactate levels did not significantly increase in the presence of hemodynamically significant PDA. This may be due to the fact that peripheral tissue perfusion in the presence of hemodynamic PDA does not deteriorate enough to cause an increase in anaerobic metabolism.


Assuntos
Permeabilidade do Canal Arterial , Recém-Nascido Prematuro , Lactatos/sangue , Biomarcadores/sangue , Permeabilidade do Canal Arterial/sangue , Permeabilidade do Canal Arterial/diagnóstico , Permeabilidade do Canal Arterial/epidemiologia , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Masculino , Estudos Prospectivos
13.
Biomed Pharmacother ; 110: 105-110, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30465999

RESUMO

Necrotizing enterocolitis (NEC) is a major neonatal health problem that especially affects preterm infants and causes severe morbidity and mortality. Although its pathogenesis is not fully understood, important risk factors include prematurity, oxidative stress, inflammation, and apoptosis. Ankaferd Blood Stopper® (ABS) has antioxidant, antiinflammatory, antimicrobial, antiapoptotic, and wound healing accelerant properties. In this study, we aimed to investigate whether treatment with ABS reduced the severity of NEC in rat pups in an experimental NEC model. Thirty-six newborn Wistar albino rat pups were randomly assigned to the control, NEC + saline, or NEC + ABS groups. NEC was induced by intraperitoneal injection of lipopolysaccharide, feeding with hyperosmolar enteral formula, and exposure to hypoxia/hyperoxia and cold stress. ABS was administered intraperitoneally to the pups in the NEC + ABS group daily starting on day 1 of the study at a dose of 2 ml/kg by diluting 2 ml with saline at a ratio of 1:3. All pups were sacrificed on day 4. The terminal ileum including the proximal colon was removed for histopathological and immunohistochemical examination and biochemical analysis. Macroscopic assessment and intestinal injury scores were lower in NEC + ABS group compared to the NEC + saline group (p < 0.05). Immunohistochemical evaluations of caspase-3, -8, and -9 revealed significantly reduced apoptosis in the NEC + ABS group compared to the NEC + saline group (p = 0.001). Total oxidant status, oxidative stress index, tumor necrosis factor α and interleukin-1ß levels, and lipid, protein, and deoxyribonucleic acid oxidation products were significantly lower in the NEC + ABS group compared to NEC + saline group (p < 0.001 for all), while total antioxidant status, glutathione, and superoxide dismutase levels were higher in the NEC + ABS group (p < 0.001, p < 0.001, p = 0.01, respectively). ABS treatment has the potential to effectively reduce the severity of intestinal damage in NEC due to its antioxidant, antiinflammatory, and antiapoptotic properties. Therefore, NEC may be an alternative option for treatment.


Assuntos
Anti-Inflamatórios/uso terapêutico , Modelos Animais de Doenças , Enterocolite Necrosante/metabolismo , Enterocolite Necrosante/prevenção & controle , Extratos Vegetais/uso terapêutico , Animais , Animais Recém-Nascidos , Anti-Inflamatórios/farmacologia , Enterocolite Necrosante/patologia , Mediadores da Inflamação/antagonistas & inibidores , Mediadores da Inflamação/metabolismo , Extratos Vegetais/farmacologia , Distribuição Aleatória , Ratos , Ratos Wistar
14.
J Matern Fetal Neonatal Med ; : 1-9, 2018 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-30431380

RESUMO

OBJECTIVES: To ascertain the diagnostic value of endocan and interleukin (IL)-33 in infants with necrotizing enterocolitis (NEC) and to compare their effectiveness with C-reactive protein (CRP) and interleukin-6 (IL-6). METHODS: Eighty-four preterm infants including control (n = 42) and NEC (n = 42) were eligible. Blood samples were obtained from infants in the NEC for the assessment of CRP, IL-6, endocan, and IL-33 serum levels at the time of diagnosis (first day), at the third and seventh days of NEC. Endocan, IL-33, CRP, and IL-6 serum levels were measured at the 14th day of life in the control group. RESULTS: Serum levels of endocan, IL-33, CRP, and IL-6 were significantly higher in the NEC group compared to the control group at the first, third, and seventh days (p < .05). IL-33 and endocan levels continued to rise in the consequent days in patients with stage III NEC (p < .05). Serum endocan and IL-33 levels gradually increased in patients who underwent surgery (p < .05). Serum endocan levels were higher in patients with stage III NEC than those in the stage II NEC at the diagnosis. CONCLUSIONS: Serum levels of IL-33 and endocan can be used as markers in the diagnosis and follow-up of NEC.

15.
Comb Chem High Throughput Screen ; 21(7): 510-515, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30207217

RESUMO

BACKGROUND: Neonatal sepsis is considered as the most frequent cause of death in newborns. Early diagnosis is important to reduce mortality and morbidity. The rapid progression of the disease requires proper use of biomarkers specific for prompt diagnosis and intervention. OBJECTIVE: We aimed to evaluate the benefit of interleukin-33 serum levels in the diagnosis and treatment of neonatal sepsis. METHOD: We included 51 infants with neonatal sepsis as the main study group and 50 neonates without sepsis as the control group. Serum levels of interleukin-6, interleukin-33 and C-reactive protein were measured on the 1st, 3rd and 7th days of sepsis in the study group and on the 3rd postpartum day in the control group, respectively. RESULTS: Serum levels of interleukin-6, interleukin-33 and C-reactive protein were significantly higher in the first day of sepsis. Serum levels of interleukin-6, interleukin-33 and C-reactive protein decreased significantly on the 3rd and the 7th days of antibiotic treatment. We found a significant relationship between interleukin-33 and C-reactive protein and between interleukin-6 and C-reactive protein on the first day of sepsis. CONCLUSION: Serum interleukin-33 level is up-regulated in neonatal sepsis, which might be used as a novel diagnostic marker and also a useful tool to predict prognosis in early neonatal sepsis.


Assuntos
Recém-Nascido Prematuro/sangue , Interleucina-33/sangue , Sepse Neonatal/sangue , Biomarcadores/sangue , Biomarcadores/metabolismo , Ensaios de Triagem em Larga Escala , Humanos , Recém-Nascido , Interleucina-33/metabolismo , Curva ROC
16.
Turk J Med Sci ; 48(4): 892-900, 2018 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-30121057

RESUMO

Background/aim: Hyperoxia- and inflammation-induced lung injury is an important cause of the development of bronchopulmonary dysplasia (BPD) in premature infants. We aimed to ascertain the beneficial effects of ginger ( Zingiber officinale ) on rat pups exposed to hyperoxia and inflammation. Materials and methods: Thirty-six newborn Wistar rats were randomly divided into 3 groups as the hyperoxia (95% O 2 ) + lipopolysaccharide (LPS) group, the hyperoxia + LPS + ginger-treated group, and the control/no treatment group (21% O 2 ). Pups in the hyperoxia + LPS + ginger group were administered oral ginger at a dose of 1000 mg/kg daily during the study period. Histopathologic, immunochemical (SMA and lamellar body), and biochemical evaluations including total antioxidant status (TAS), total oxidant status (TOS), malondialdehyde (MDA), myeloperoxidase (MPO), tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1ß), interleukin-6 (IL-6), and caspase-3 activities were performed. Results: Better weight gain and survival rates were shown in the hyperoxia + LPS + ginger group (P < 0.05). In the histopathologic and immunochemical evaluation, severity of lung damage was significantly reduced in the hyperoxia + LPS + ginger group, as well as decreased apoptosis (ELISA for caspase-3) (P < 0.05). Tissue TAS levels were significantly protected, and TOS, MDA, and MPO levels were significantly lower in the hyperoxia + LPS + ginger group (P < 0.05). Tissue TNF-α, IL-1ß, and IL-6 concentrations were significantly decreased in the ginger-treated group (P < 0.05). Conclusion: Ginger efficiently reduced the lung damage and protected the lungs from severe damage due to hyperoxia and inflammation. Therefore, ginger may be an alternative option for the treatment of BPD.


Assuntos
Displasia Broncopulmonar/tratamento farmacológico , Gengibre , Recém-Nascido Prematuro , Inflamação/complicações , Pulmão/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Oxigênio/efeitos adversos , Animais , Animais Recém-Nascidos , Antioxidantes/metabolismo , Apoptose , Displasia Broncopulmonar/sangue , Displasia Broncopulmonar/etiologia , Corioamnionite , Modelos Animais de Doenças , Feminino , Humanos , Hiperóxia , Recém-Nascido , Inflamação/sangue , Inflamação/induzido quimicamente , Mediadores da Inflamação/sangue , Pulmão/patologia , Pneumopatias/tratamento farmacológico , Pneumopatias/etiologia , Malondialdeído/sangue , Oxigênio/administração & dosagem , Fitoterapia , Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêutico , Gravidez , Ratos Wistar
17.
Pediatr Pulmonol ; 53(10): 1407-1413, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29999603

RESUMO

BACKGROUND AND OBJECTIVES: It is believed, that sustained lung inflation (SLI) at birth in preterm infants reduces the need for mechanical ventilation (MV) and improves respiratory outcomes. The aim of this study was to compare need for MV in preterm infants at high risk for respiratory distress syndrome (RDS) after prophylactic SLI via short binasal prongs at birth combined with early nasal continuous positive airway pressure (nCPAP) versus nCPAP alone. METHODS: Medical records of infants born at 260/7 to 296/7 weeks gestation through 2015 and 2017 were retrospectively assessed. Infants who get sustained inflations at 25 cmH2 O pressure for 15 s following delivery via binasal short prongs comprised the study group. Gestational age matched infants who was supported solely with nCPAP (6 cmH2 O PEEP) comprised the control group. Early rescue surfactant (200 mg/kg poractant alfa) was delivered using the less invasive surfactant administration technique in infants with established RDS. RESULTS: A total of 215 infants were analyzed. Fewer infants in the SLI group required MV within the first 72 h of life compared to the control group (25.7% vs 56.9%, P < 0.001). In multiple logistic regression analysis, SLI emerged as an independent factor for reduced MV need. Bronchopulmonary dysplasia (BPD) incidence including mild BPD was significantly lower in the SLI group (31.9% vs 48%, P = 0.01); however, moderate and severe BPD rates did not reach to a statistical significance (11.5% vs 20.6%, P = 0.06). CONCLUSION: Prophylactic SLI maneuver at birth for preterm infants with impending RDS reduces the need for MV with no adverse effects.


Assuntos
Pressão Positiva Contínua nas Vias Aéreas/métodos , Síndrome do Desconforto Respiratório do Recém-Nascido/prevenção & controle , Produtos Biológicos/administração & dosagem , Displasia Broncopulmonar/etiologia , Displasia Broncopulmonar/prevenção & controle , Displasia Broncopulmonar/terapia , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Recém-Nascido de muito Baixo Peso , Insuflação , Masculino , Fosfolipídeos/administração & dosagem , Surfactantes Pulmonares/administração & dosagem , Respiração Artificial/efeitos adversos , Respiração Artificial/métodos , Síndrome do Desconforto Respiratório do Recém-Nascido/terapia , Estudos Retrospectivos , Fatores de Risco
18.
J Clin Lab Anal ; 32(9): e22616, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29978492

RESUMO

BACKGROUND: The role of red cell distribution width-to-platelet ratio (RPR) has not previously been mentioned in reports on patent ductus arteriosus (PDA). Our objective was to evaluate whether RPR would have a role in the diagnosis and/or prediction of pharmacological closure of PDA. METHODS: Preterm infants' gestational age ≤30 weeks and ≤1500 g who were given first ibuprofen treatment in the first week of life for hemodynamically significant PDA (hsPDA) were included in the study. The patients were matched for gestational age, birthweight, and sex. Patients were subdivided into two groups based on the response to medical treatment (open and closed PDA). Hemogram parameters were recorded before and after medical therapy. Groups were compared with regard to demographic and clinical characteristics and for three sequential hematological parameters. RPR was calculated. Patients with sepsis, anemia, perinatal asphyxia, and congenital/chromosomal anomaly were not included in the study. RESULTS: A total of 112 infants had medically treated hsPDA. Of those, ductus closed in 70 neonates (closed PDA). A total of 96 infants constituted the control group. Mean gestational age and birthweight of the patients were 28.9 ± 2.4 weeks and 1207 ± 372 g. While RPR was significantly increased, PCT was lower in both hsPDA and open PDA groups (P < 0.05 and P < 0.05, respectively). In multivariate analysis, high RPR (OR 3.3, 95% CI 1.438-5.872, P < 0.05) and RDS (OR 2.9, 95% CI 1.903-4.811, P < 0.01) were detected as independent risk factors for hsPDA. CONCLUSION: Red cell distribution width-to-platelet ratio and PCT may be promising supportive tools for the diagnosis and prediction of pharmacotherapy success.


Assuntos
Plaquetas/patologia , Permeabilidade do Canal Arterial/sangue , Permeabilidade do Canal Arterial/diagnóstico , Doenças do Prematuro/sangue , Recém-Nascido Prematuro , Estudos de Coortes , Permeabilidade do Canal Arterial/diagnóstico por imagem , Permeabilidade do Canal Arterial/epidemiologia , Ecocardiografia Doppler , Índices de Eritrócitos , Feminino , Idade Gestacional , Testes Hematológicos , Humanos , Lactente , Doenças do Prematuro/diagnóstico por imagem , Doenças do Prematuro/epidemiologia , Masculino , Curva ROC
19.
J Ethnopharmacol ; 225: 297-308, 2018 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-30005955

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Necrotizing enterocolitis (NEC) is the most important gastrointestinal emergency affecting especially preterm infants and causes severe morbidities and mortality. However, there is no cure. Oxidant stress, inflammation, apoptosis, as well as prematurity are believed to responsible in the pathogenesis of the disease. Ginger and its compounds have anti-inflammatory, antimicrobial, anti-oxidant properties and immunomodulatory, cytoprotective/regenerative actions. AIM OF THE STUDY: This study aimed to evaluate the beneficial effects of ginger on the intestinal damage in an experimental rat model of NEC. MATERIALS AND METHODS: Thirty newborn Wistar rats were divided into three groups: NEC, NEC + ginger and control in this experimental study. NEC was induced by injection of intraperitoneal lipopolysaccharide, feeding with enteral formula, hypoxia-hyperoxia and cold stress exposure. The pups in the NEC + ginger group were orally administered ginger at a dose of 1000 mg/kg/day. Proximal colon and ileum were excised. Histopathological, immunohistochemical (TUNEL for apoptosis, caspase 3 and 8) and biochemical assays including xanthine oxidase (XO), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), malonaldehyde (MDA) and myeloperoxidase (MPO), tumor necrosis factor-α (TNF-α), interleukin1ß (IL-1ß), and interleukin 6 (IL-6) activity were evaluated. RESULTS: Compared with the NEC group, the rat pups in the NEC + ginger group had better clinical disease scores and weight gain (p < 0.05). Macroscopic evaluation, Histopathologic and apoptosis assessment (TUNEL, caspase 3 and 8) releaved that severity of intestinal damage were significantly lower in the NEC + ginger group (p < 0.05). The levels of TNF-α, IL-1ß and IL-6 in the ginger treated group were significantly decreased (P < 0.05). The GSH-Px and SOD levels of the ginger treated group were significantly preserved in the NEC + ginger group (p < 0.05). The tissue XO, MDA and MPO levels of the NEC + ginger group were significantly lower than those in the NEC group (P < 0.05). CONCLUSION: Ginger therapy efficiently ameliorated the severity of intestinal damage in NEC and may be a promising treatment option.


Assuntos
Anti-Inflamatórios/uso terapêutico , Enterocolite Necrosante/tratamento farmacológico , Gengibre , Extratos Vegetais/uso terapêutico , Animais , Anti-Inflamatórios/farmacologia , Apoptose/efeitos dos fármacos , Caspase 3/metabolismo , Caspase 8/metabolismo , Citocinas/metabolismo , Enterocolite Necrosante/metabolismo , Enterocolite Necrosante/prevenção & controle , Glutationa Peroxidase/metabolismo , Mucosa Intestinal/metabolismo , Intestinos/efeitos dos fármacos , Intestinos/patologia , Malondialdeído/metabolismo , Peroxidase/metabolismo , Fitoterapia , Extratos Vegetais/farmacologia , Ratos Wistar , Superóxido Dismutase/metabolismo , Xantina Oxidase/metabolismo
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