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1.
Sci Rep ; 11(1): 19593, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34599264

RESUMO

IFIX, a newly discovered member of the interferon-inducible HIN-200 family, has been identified as a tumor suppressor in breast cancer; however, the involvement of IFIX in oral cancer are poorly understood. Here, we demonstrate a relationship between the level of IFIX expression and the invasive or migratory abilities of oral squamous cell carcinoma. Higher IFIX expression significantly correlated with clinicopathological parameters such as the histopathological grade of clinical samples. In vitro, IFIX overexpression suppressed the invasiveness of human tongue squamous cell carcinoma CAL-27 cells, and this inhibitory effect was mediated by stabilization of the cytoskeleton through various cytokeratins along with downregulation of paxillin, an intracellular adaptor protein that promotes tumor invasion. This inhibitory effect does not appear to affect the transformation of cancer stem-like cells in this cell culture model. Altogether, these data provide novel insights into the tumor-suppressive function of IFIX, namely, stabilization of the cancer cell cytoskeleton.

2.
Artigo em Inglês | MEDLINE | ID: mdl-34610154

RESUMO

OBJECTIVE: While evidence-based guidelines exist for placenta accreta spectrum (PAS) diagnosis and management, there is a paucity of data on PAS practice patterns worldwide. The objective of this study was to describe global geographic variations in the diagnosis and management of PAS. METHODS: An international cross-sectional study was conducted among PAS experts practicing at medical institutions in member states of the United Nations. Survey questions focused on diagnostic evaluation and management strategies for PAS. RESULTS: A total of 136 centers participated. Participating centers represented each of the United Nations' designated regions. Of those, 88% reported practicing in a medium or high volume center. First trimester PAS screen was reported in 26.1% of centers. Respondents consistently implement guideline-supported care practices, including utilization of ultrasound as the primary diagnostic modality (100%) and implementation of multidisciplinary care teams (85.8%). Less than 10% of respondents reported routinely managing PAS without hysterectomy; these centers were predominantly located in Europe and Africa. Antepartum management and availability of mental health support for PAS patients varied widely. CONCLUSION: Worldwide, there is a strong adherence to PAS care guidelines; however, regional variations do exist. Comparing variations in care to outcomes will provide insight into the clinically significant practice variability.

3.
Dalton Trans ; 2021 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-34610629

RESUMO

Hydrogen production by electrocatalytic water splitting is a pollution-free, energy-saving, and efficient method. The low efficiency of hydrogen production, high overpotentials and expensive noble-metal catalysts have limited the development of hydrogen production from electrocatalytic water splitting. Therefore, the exploration of bifunctional electrocatalysts for water overall splitting to produce hydrogen is of profound significance. Herein, Ni3S2@Ni2P/MoS2 heterostructure electrocatalysts were synthesized on Ni foam through an environmentally friendly hydrothermal method and low-temperature phosphating method. The synergistic effects between different components and the mutual substitution principle between sulfur atoms and phosphorus atoms greatly improve the OER performance of the electrocatalyst. It is also an effective strategy to optimize the adsorption energies of intermediates by the design of heterostructured catalysts composed of multiple substances. Ni3S2@Ni2P/MoS2 only requires a low overpotential (η10) of 175 mV at a current density of 10 mA cm-2 in 1.0 M KOH solution and the stable duration exceeds 40 h. In addition, this heterogeneous structure is assembled into an electrolytic cell for overall water splitting, which exhibits a low cell voltage of 1.61 volts and retains the robust stability over 30 h at 10 mA cm-2. The Ni3S2@Ni2P/MoS2 heterostructure prepared in this research provides a strategy for exploring other heterostructured electrocatalysts with different components.

4.
Food Chem ; 372: 131334, 2021 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-34638063

RESUMO

Due to the poor lipophilicity of chlorogenic acid (CA), five CA derivatives (C2-CA, C4-CA, C6-CA, C8-CA, and C12-CA) with different lipophilicities were synthesized using acylation catalyzed by lipase in present study. The inhibitory activities and mechanisms of CA and its derivatives on α-amylase and α-glucosidase were then determined. Results showed that the inhibitory activities of CA derivatives on α-amylase and α-glucosidase were enhanced as lipophilicity increased, and the inhibitory activities of C12-CA were stronger than those of CA. IC50 values of C12-CA were 13.30 ± 0.26 µmol/mL for α-amylase and 3.42 ± 0.10 µmol/mL for α-glucosidase. C12-CA possessed the smallest Kic and Kiu values, and its inhibitory actions on α-amylase and α-glucosidase were stronger than those of CA and the other derivatives. Effects of C12-CA on microenvironments of amino acid residues and secondary structures of α-amylase and α-glucosidase were greater than those of CA and the other derivatives.

5.
Zhongguo Zhen Jiu ; 41(10): 1171-4, 2021 Oct 12.
Artigo em Chinês | MEDLINE | ID: mdl-34628753

RESUMO

Through analyzing the indication distribution of the different acupoints located at the upper limbs recorded in Science of Acupoints and Science of Meridians and Acupoints, the industry planning teaching materials of traditional Chinese medicine, it is discovered that the acupoints located at the upper arms are commonly selected for the treatment of scrofula and goiter, while the acupoints below the elbow at the hand meridians and those at the lower limbs of the foot meridians which running through the neck, do not have the similar indications. Based on a further analysis on the literature at ancient and modern times, it is believed that the acupoints located on the lateral side of the upper arms, especially those at the large intestine meridian of hand-yangming perhaps have the specific effect in treatment of scrofula and goiter.


Assuntos
Bócio , Meridianos , Tuberculose dos Linfonodos , Pontos de Acupuntura , Braço , Humanos
7.
Zhongguo Zhong Yao Za Zhi ; 46(15): 3873-3876, 2021 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-34472262

RESUMO

Compounds(1-6) were isolated and identified from 90% ethanol extract of the stems and leaves of Cassia occidentalis through column chromatography with silica gel, ODS, and Sephadex LH-20. These compounds were identified as 7-hydroxy-5-(3-hydroxy-2-oxopropyl)-2-methyl-4H-chromen-4-one(1), saccharonol A(2), S-6-hydroxymullein(3), 2-methyl-5-acetonyl-7-hydroxy-chromone(4), 2-(2'-hydroxypropyl)-5-methyl-7-hydroxychromone(5) and 7,4'-dihydroxyflavone(6) based on their physicochemical and spectroscopic data. Among them, compound 1 was a new compound, and all the compounds were isolated from this plant for the first time. DPPH method was employed to determine the antioxidant activities of these compounds in vitro. Six compounds exhibited weak antioxidant activities.


Assuntos
Senna (Planta) , Cromonas , Folhas de Planta , Análise Espectral
10.
Blood Adv ; 2021 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-34521107

RESUMO

Single antigen-targeted chimeric antigen receptor (CAR) T-cell therapy may be insufficient to induce a durable response in pediatric aggressive B-cell lymphomas. The clinical trial (ChiCTR1800014457) examined the feasibility of sequential different B cell antigen-targeted CAR T-cell therapy for pediatric refractory/relapsed Burkitt lymphoma. Twenty-three patients received the first CD19 CAR T-cell infusion. The patients who did not achieve an ongoing complete response sequentially underwent one or more additional infusions of CAR T-cell targeting CD22 followed by CD20 according to their disease status and CAR T-cell persistence after each infusion. The median time from the last infusion to cutoff date was 17 months (range, 15 to 23). The estimated 18-month complete response rate was 78% (95% confidence interval [CI], 54 to 91). The estimated 18-month progression-free survival rate was 78% (95% CI, 55 to 90), with 78% (95% CI, 37 to 94) in patients with bulky diseases and 60% (95% CI, 25 to 83) in patients with central nervous system (CNS) involvement. During the first CD19 CAR T-cell infusion, grade 3 or higher cytokine release syndrome (CRS) and neurotoxicity occurred in 34.8% and 21.7% of all patients, respectively. During subsequent infusions, few incidences of higher than grade 2 CRS and neurotoxicity were observed. All adverse events were reversible. The severity of neurotoxicity was not significantly different between patients with CNS and non-CNS involvement. Sequential CAR T-cell therapy may result in a durable response and is safe in pediatric refractory/relapsed Burkitt lymphoma. Patients with CNS involvement may benefit from sequential CAR T-cell therapy. This trial was registered at www.chictr.org.cn/index.aspx as ChiCTR1800014457.

11.
Artigo em Inglês | MEDLINE | ID: mdl-34570458

RESUMO

Understanding how the catalyst morphology influences surface sites is crucial for designing active and stable catalysts and electrocatalysts. We here report a new approach to this understanding by decorating gold (Au) nanoparticles on the surface of cuprous oxides (Cu2O) with three different shape morphologies (spheres, cubes, and petals). The Au-Cu2O particles are dispersed onto carbon nanotube (CNT) matrix with high surface area, stability, and conductivity for oxygen reduction reaction. A clear morphology-dependent enhancement of the electrocatalytic activity is revealed. Oxygenated gold species (AuO-) are found to coexist with Au0 on the cube and petal catalysts, whereas only Au0 species are present on the sphere catalyst. The AuO- species function effectively as active sites, resulting in the improved catalytic performance by changing the reaction mechanism. The enhanced catalytic performance of the petal-shaped catalyst in terms of onset potential, half-wave potential, diffusion-limited current density, and stability is closely associated with the presence of the most abundant AuO- species on its surface. Highly active AuO- species are identified on the surface of the catalysts as a result of the unique structural characteristics, which is attributed to the structural origin of high activity and stability. This insight constitutes the basis for assessing the detailed correlation between the morphology and the electrocatalytic properties of the nanocomposite catalysts, which has implications for the design of surface-active sites on metal/metal oxide electrocatalysts.

12.
Mediators Inflamm ; 2021: 5573594, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34531703

RESUMO

Background: Abnormal endometrial repair after injury results in the formation of intrauterine adhesions (IUA) and a thin endometrium, which are key causes for implantation failure and infertility. Stem cell transplantation offers a potential alternative for some cases of severe Asherman's syndrome that cannot be treated with surgery or hormonal therapy. Umbilical cord-derived mesenchymal stem cells (UCMSCs) have been reported to repair the damaged endometrium. However, there is no report on the effects of UCMSCs previously seeded on human acellular amniotic matrix (AAM) on endometrial injury. Methods: Absolute ethanol was injected into rat uteri to damage the endometrium. UCMSCs previously seeded on AAM were surgically transplanted. Using a variety of methods, the treatment response was assessed by endometrial thickness, endometrial biomarker expression, endometrial receptivity, cell proliferation, and inflammatory factors. Results: Endometrial thickness was markedly improved after UCMSC-AAM transplantation. The expression of endometrial biomarkers, namely, vimentin, cytokeratin, and integrin ß3, in treated rats increased compared with untreated rats. In the UCMSC-AAM group, the VEGF expression decreased, whereas that of MMP9 increased compared with the injury group. Moreover, in the AAM group, the MMP9 expression increased. The expression of proinflammatory factors (IL-2, TNFα, and IFN-γ) in the UCMSC-AAM group decreased compared with the untreated group, whereas the expression of anti-inflammatory factors (IL-4, IL-10) increased significantly. Conclusions: UCMSC transplantation using AAM as the carrier can be applied to treat endometrial injury in rats. The successful preparation of lyophilized AAM provides the possibility of secondary infectious disease screening and amniotic matrix quality detection, followed by retrospective analysis. The UCMSC-AAM complex may promote the better application of UCMSCs on the treatment of injured endometrium.

13.
Nat Commun ; 12(1): 5667, 2021 09 27.
Artigo em Inglês | MEDLINE | ID: mdl-34580311

RESUMO

Spirocycles play an important role in drug discovery and development. The direct, catalytic, and enantioselective synthesis of spirocycles from readily available starting materials and in an atom economic manner remains a highly sought-after task in organic synthesis. Herein, an enantioselective Pd-hydride-catalyzed cycloaddition method for the synthesis of spirocyclic compounds directly from two classes of commonly available starting materials, 1,3-enynes and cyclic carbon-hydrogen (C-H) bonds, is reported. The reactions employ a chiral Pd/WingPhos catalyst to both suppress the formation of bis-allenyl by-products and control the stereoselectivity. 1,3-Enynes are used as dielectrophilic four-carbon units in the cycloaddition reactions, which also enables an enyne substrate-directed enantioselectivity switch with good levels of stereocontrol. The present spirocycle synthesis tolerates a broad range of functional groups of 1,3-enyne substrates, including alcohols, esters, nitriles, halides, and olefins. A variety of diverse cyclic nucleophiles, including pharmaceutically important heterocycles and carbocycles, can be flexibly incorporated with spiro scaffolds.

14.
Dalton Trans ; 50(38): 13387-13398, 2021 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-34473154

RESUMO

Novel [CuL2Cl]Cl·H2O (1) and [FeL2Cl2]Cl·MeOH·CHCl3·H2O (2) complexes of (Z)-N'-((E)-3-methyl-4-oxothiazolidin-2-ylidene)picolinohydrazonamide (L) as antitumor agents were designed and synthesized in order to explore DNA and serum albumin interaction. X-ray diffraction revealed that both 1 and 2 were a triclinic crystal system with P1̄ space group, which consisted of a positive electric main unit, a negative chloride ion and some solvent molecules. The complexes with DNA and bovine serum albumin (BSA) were studied by fluorescence and electronic absorption spectrometry. The results indicated that there was moderate intercalative binding mode between the complexes and DNA with Kapp values of 2.40 × 105 M-1 (1) and 6.49 × 105 M-1 (2). Agarose gel electrophoresis experiment showed that both 1 and 2 exhibited obvious DNA cleavage activity via an oxidative DNA damage pathway, and the cleavage activities of 1 were stronger than those of 2. Cytotoxicity assay showed that 1 had a more effective antitumor activity than 2. The two complexes were bound to BSA by a high affinity and quenched the fluorescence of BSA through a static mechanism. The thermodynamic parameters suggested that hydrophobic interactions played a key role in the binding process. The binding energy xpscore of 1 and 2 were -10.529 kcal mol-1 and -10.826 kcal mol-1 by docking studies, and this suggested that the binding process was spontaneous. Complex 1 displayed a lysosome-specific targeting behavior with a Pearson coefficient value of 0.82 by confocal laser scanning microscopy (CLSM), and accumulated in the lysosomes, followed by the disruption of lysosomal integrity.

15.
Food Res Int ; 148: 110578, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34507726

RESUMO

Food allergies are one of the major health concerns worldwide and have been increasing at an alarming rate in recent times. The elimination of food allergenicity has been an important issue in current research on food. Irradiation is a typical nonthermal treatment technology that can effectively reduce the allergenicity of food, showing great application prospects in improving the quality and safety of foods. In this review, the mechanism and remarkable features of irradiation in the elimination of food allergens are mainly introduced, and the research progress on reducing the allergenicity of animal foods (milk, egg, fish and shrimp) and plant foods (soybean, peanut, wheat and nuts) using irradiation is summarized. Furthermore, the influencing factors for irradiation in the elimination of food allergens are analyzed and further research directions of irradiation desensitization technology are also discussed. This article aims to provide a reference for promoting the application of irradiation technology in improving the safety of foods.


Assuntos
Hipersensibilidade Alimentar , Alérgenos , Animais , Arachis , Hipersensibilidade Alimentar/prevenção & controle , Nozes , Alimentos Marinhos
16.
Med Sci Monit ; 27: e931427, 2021 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-34366426

RESUMO

BACKGROUND Acute chemical liver injury needs to be further explored. The present study aimed to compare the effects of intraperitoneal injection with carbon tetrachloride on acute liver toxicity after 24 h in male and female Kunming mice. MATERIAL AND METHODS In this study, female and male mice were simultaneously divided into 3 different groups. Each group was treated differently, and after 24 h, blood samples were collected to check for changes in the activity of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), which were used to assess liver toxicity. Liver samples were used for hematoxylin-eosin staining, and periodic acid Schiff reagent staining was performed to detect the pathological changes of each group. The expression level of biomarker molecules in liver cells was also systematically analyzed. RESULTS Our results showed that, compared with male mice, female mice showed more serious damage: reduced glycogen and higher degree of necrosis, and the levels of heatshock protein 27 (HSP27), heat-shock protein 70 (HSP70), proliferating cell nuclear antigen (PCNA) and B cell lymphoma/lewkmia-2 (Bcl-2) were significantly lower than in the male group (P<0.05 or P<0.01), while the results of Bcl-2-associated X protein (Bax), cysteinyl aspartate specific proteinase 3 (Caspase3), and cytochrome P450 2E1 (CYP2E1) were the opposite (P<0.05 or P<0.01). CONCLUSIONS The findings from this study showed that, compared with male mice, at 24 h after CCl4 toxicity, female mice showed more severe changes of hepatocyte necrosis and PAS-positivity, with significantly reduced expression of HSP27, HSP70, PCNA, and Bcl-2, and significantly increased expression of Bax, caspase-3, and CYP2E1.

17.
J Hazard Mater ; 421: 126806, 2021 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-34388930

RESUMO

Under anoxic conditions, aqueous Fe(II) (Fe(II)aq)-induced recrystallization of iron (oxyhydr)oxides changes the speciation and geochemical cycle of trace elements in environments. Oxidation of trace element, i.e., As(III), driven by Fe(II)aq-iron (oxyhydr)oxides interactions under anoxic condition was observed previously, but the oxidative species and involved mechanisms are remained unknown. In the present study, we explored the formed oxidative intermediates during Fe(II)aq-induced recrystallization of goethite under anoxic conditions. The methyl phenyl sulfoxide-based probe experiment suggested the featured oxidation by Fe(IV) species in Fe(II)aq-goethite system. Both the Mössbauer spectra and X-ray absorption near edge structure spectroscopic evidenced the generation and quenching of Fe(IV) intermediate. It was proved that the interfacial electron exchange between Fe(II)aq and Fe(III) of goethite initiated the generation of Fe(IV). After transferring electrons to goethite, Fe(II)aq was transformed to labile Fe(III), which was then transformed to Fe(IV) via a proton-coupled electron transfer process. This highly reactive transient Fe(IV) could quickly react with reductive species, i.e. Fe(II) or As(III). Considering the ubiquitous occurrence of Fe(II)-iron (oxyhydr)oxides reactions under anoxic conditions, our findings are expected to provide new insight into the anoxic oxidative transformation processes of matters in non-surface environments on earth.

18.
J Nanobiotechnology ; 19(1): 249, 2021 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-34412639

RESUMO

BACKGROUND: Discovery of early-stage biomarkers is a long-sought goal of Alzheimer's disease (AD) diagnosis. Age is the greatest risk factor for most AD and accumulating evidence suggests that age-dependent elevation of asparaginyl endopeptidase (AEP) in the brain may represent a new biological marker for predicting AD. However, this speculation remains to be explored with an appropriate assay method because mammalian AEP exists in many organs and the level of AEP in body fluid isn't proportional to its concentration in brain parenchyma. To this end, we here modified gold nanoparticle (AuNPs) into an AEP-responsive imaging probe and choose transgenic APPswe/PS1dE9 (APP/PS1) mice as an animal model of AD. Our aim is to determine whether imaging of brain AEP can be used to predict AD pathology. RESULTS: This AEP-responsive imaging probe AuNPs-Cy5.5-A&C consisted of two particles, AuNPs-Cy5.5-AK and AuNPs-Cy5.5-CABT, which were respectively modified with Ala-Ala-Asn-Cys-Lys (AK) and 2-cyano-6-aminobenzothiazole (CABT). We showed that AuNPs-Cy5.5-A&C could be selectively activated by AEP to aggregate and emit strong fluorescence. Moreover, AuNPs-Cy5.5-A&C displayed a general applicability in various cell lines and its florescence intensity correlated well with AEP activity in these cells. In the brain of APP/PS1 transgenic mice , AEP activity was increased at an early disease stage of AD that precedes formation of senile plaques and cognitive impairment. Pharmacological inhibition of AEP with δ-secretase inhibitor 11 (10 mg kg-1, p.o.) reduced production of ß-amyloid (Aß) and ameliorated memory loss. Therefore, elevation of AEP is an early sign of AD onset. Finally, we showed that live animal imaging with this AEP-responsive probe could monitor the up-regulated AEP in the brain of APP/PS1 mice. CONCLUSIONS: The current work provided a proof of concept that assessment of brain AEP activity by in vivo imaging assay is a potential biomarker for early diagnosis of AD.

19.
BMC Geriatr ; 21(1): 462, 2021 08 11.
Artigo em Inglês | MEDLINE | ID: mdl-34380417

RESUMO

BACKGROUND: This study investigated the different blood pressure patterns that were evaluated by ambulatory blood pressure monitoring (ABPM) among elderly patients and explored the effect of pressure patterns on cognitive impairment and mortality. METHODS: A total of 305 elderly participants aged ≥65 years were divided into the cognitive impairment group (CI, n = 130) and the non-cognitive impairment group (NCI, n = 175) according to the MMSE score. All participants underwent ABPM to evaluate possible hypertensive disorder and cerebral MRI for the evaluation of cerebral small vessel disease. Follow-up was performed by telephone or medical records. The primary outcome was all-cause mortality. Secondary endpoints were major adverse cardiac and cerebrovascular events (MACCE). RESULTS: Among 305 participants, 130 (42.6%) were identified with cognitive impairment (CI), with average systolic blood pressure (BP) of 127 mmHg and diastolic BP of 66 mmHg. According to ABPM, only 13.1% had a dipper pattern, 45.6% had a nocturnal BP rise, while 41.3% had a non-dipper pattern. Compared with NCI patients, the CI group had significantly higher night-time systolic BP (130.0 ± 18.2 vs. 123.9 ± 15.1, p = 0.011), and more participants had nocturnal BP rise (52.3% vs. 40.6%, p = 0.042). Nocturnal BP rise was associated with greater white matter hyperintensities (WMH) (p = 0.013). After 2.03 years of follow-up, there were 35 all-cause deaths and 33 cases of major adverse cardiac and cerebrovascular events (MACCE). CI was independently associated with all-cause mortality during long-term observation (p < 0.01). Nocturnal BP rise had no significant predictive ability for all-cause mortality in elderly patients (p = 0.178). CONCLUSIONS: Nocturnal BP rise contributed to greater cognitive impairment in elderly patients. Not nocturnal BP rise, but CI could significantly increase all-cause mortality. Controlling BP based on ABPM is critical for preventing the progression of cognitive dysfunction.


Assuntos
Disfunção Cognitiva , Hipertensão , Idoso , Pressão Sanguínea , Monitorização Ambulatorial da Pressão Arterial , Ritmo Circadiano , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/epidemiologia , Humanos , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Estudos Retrospectivos
20.
Clin J Am Soc Nephrol ; 16(8): 1169-1177, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34348930

RESUMO

BACKGROUND AND OBJECTIVES: Neonatal AKI in the preterm population is an under-recognized morbidity. Detecting AKI in preterm infants is important for their long-term kidney health. We aimed to examine the yearly trends of incidence and the related morbidities and care practices affecting the occurrence of neonatal AKI in extremely preterm (gestational age <29 weeks) and very preterm (gestational age 29-32 weeks) infants. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The trends and the related risk factors and care practices of AKI were examined in the extremely preterm (n=434) and very preterm (n=257) infants who were admitted within 14 days after birth from 2005 to 2018 to the University Hospital and had at least two serum creatinine measurements during hospitalization. We defined AKI as a serum creatinine rise of 0.3 mg/dl or more within 48 hours or a 1.5-fold increase within 7 days. RESULTS: The extremely preterm group had a three-fold higher incidence of AKI (30% versus 10%) than the very preterm group. Among preterm infants with AKI, 92% had one episode of AKI, and 45% experienced stage 2 or 3 AKI; the mean duration of AKI was 12±9 days. Across the 14-year period, the crude incidence of AKI declined markedly from 56% to 17% in the extremely preterm group and from 23% to 6% in the very preterm group. After adjustment, a significant decline of AKI incidence was still observed in the extremely preterm group. The declining AKI in the extremely preterm infants was related to the trends of decreasing incidences of neonatal transfer, prolonged aminoglycoside exposure, prophylactic use of nonsteroidal anti-inflammatory drugs, and sepsis. CONCLUSIONS: We observed a declining trend in the incidence of neonatal AKI among extremely preterm infants from 2005 to 2018, which may be related to improvement of care practices.

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