So Yoon Ahn, Dong Kyung Sung, Young Eun Kim, Sein Sung, Yun Sil Chang, Won Soon Park
Brain-derived neurotropic factor (BDNF), which is secreted by mesenchymal stem cells (MSCs), protects against severe intraventricular hemorrhage (IVH)-induced brain injuries. Although the paracrine protective effects of MSCs are mediated primarily by extracellular vesicles (EVs), the therapeutic efficacy of MSC-derived EVs and the role of the BDNF in the EVs have not been studied. This study aimed to determine whether MSC-derived EVs attenuate severe IVH-induced brain injuries, and if so, whether this protection is mediated by BDNF transfer...
December 15, 2020: Stem Cells Translational Medicine
Parvathi Nataraj, Marcela Svojsik, Livia Sura, Kelly Curry, Nikolay Bliznyuk, Dhanashree Rajderkar, Michael D Weiss
OBJECTIVE: Intraventricular hemorrhage (IVH) is a complication of prematurity. Grades III and IV IVH lead to significant morbidity, but mounting evidence shows low-grade IVH (grades I-II) may be associated with adverse sequelae. Head ultrasounds (HUS) are used to screen infants for IVH but may miss low-grade IVH. Our study compared the results of HUS around 7 days of age to susceptibility-weighted imaging (SWI) obtained at term-corrected age in infants born at <30 wGA. STUDY DESIGN: Infants <30 weeks gestational age (GA) with an HUS and MRI at admission to UF Health were identified by a retrospective chart review...
December 14, 2020: Journal of Perinatology: Official Journal of the California Perinatal Association
Sean P Polster, Julián Carrión-Penagos, Seán B Lyne, Fernando D Goldenberg, Ali Mansour, Wendy Ziai, Andrew P Carlson, Paul J Camarata, Jean-Louis Caron, Mark R Harrigan, Barbara Gregson, A David Mendelow, Mario Zuccarello, Daniel F Hanley, Robert Dodd, Issam A Awad
BACKGROUND: Minimally Invasive Surgery Plus Recombinant Tissue Plasminogen Activator for Intracerebral Hemorrhage Evacuation (MISTIE) procedure was recently tested in a large phase III randomized trial showing a significant probability of functional benefit in those cases that reached the goal hematoma evacuation of ≤15 mL residual (or ≥70% removal). Benefit of thrombolysis was also identified in cases with large intraventricular hemorrhage, and achieving at least 85% volume reduction in the Evaluating Accelerated Resolution of Intraventricular Hemorrhage (CLEAR) III trial...
December 11, 2020: Operative Neurosurgery (Hagerstown, Md.)
Souvik Mitra, Alexandra Scrivens, Adelaide M von Kursell, Tim Disher
BACKGROUND: Patent ductus arteriosus (PDA) is associated with significant morbidity and mortality in preterm infants. Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to prevent or treat a PDA. There are concerns regarding adverse effects of NSAIDs in preterm infants. Controversy exists on whether early targeted treatment of a hemodynamically significant (hs) PDA improves clinical outcomes. OBJECTIVES: To assess the effectiveness and safety of early treatment strategies versus expectant management for an hs-PDA in reducing mortality and morbidity in preterm infants...
December 10, 2020: Cochrane Database of Systematic Reviews
Marcos Devanir Silva da Costa, Renan R de Souza Lopes, Juan Leonardo Serrato-Avila, Sergio Cavalheiro, Feres Chaddad-Neto
Background: Intracranial aneurysms are common vascular malformation occurring in 1-2% of the population and accounting for 80-85% of nontraumatic subarachnoid hemorrhages. About 10% of the ruptured aneurysm causing subarachnoid hemorrhage (SHA) develop intraventricular hemorrhage (IVH). In this scenario, the external ventricular drain (EVD) is a usual treatment for IVH. To reduce the time for the clot absorption, the neuroendoscopy with clot removal and ventricular irrigation is a feasible option, although not routinely used...
2020: Surgical Neurology International
Indrani Bhattacharjee, Anirudha Das, Marc Collin, Hany Aly
BACKGROUND: Extremely low birth weight (ELBW) infants have significant morbidities and higher mortality. The major morbidities are bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH) and retinopathy of prematurity (ROP). Release of proinflammatory cytokines has been implicated in the development of systemic inflammation that contributes to BPD aND ROP. Also, cumulative oxygen exposure in the first 3 days of life and use of mechanical ventilation was associated with 3-fold increase in severe IVH...
December 6, 2020: Journal of Maternal-fetal & Neonatal Medicine
Jeffrey B Gould, Mihoko V Bennett, Ciaran S Phibbs, Henry C Lee
OBJECTIVE: To examine the hypothesis that increasing rates and differential uptake of antenatal steroids (would bias estimation of impact of ANS on neonatal death and severe (grade III-IV) intraventricular hemorrhage (IVH). STUDY DESIGN: The study population included infants born between 24 to 28 weeks gestational age in the California Perinatal Quality Care Collaborative. Outcomes were in-hospital mortality and severe IVH. Mixed multivariable logistic regression models estimated the effect of ANS exposure, one model accounting for individual risk factors as fixed effects, and a second model incorporating a predicted probability factor estimating overall risk status for each time period...
December 1, 2020: Journal of Pediatrics
Katarzyna Kosik, Dawid Szpecht, Salwan R Al-Saad, Lukasz M Karbowski, Grażyna Kurzawińska, Marta Szymankiewicz, Krzysztof Drews, Hubert Wolski, Agnieszka Seremak-Mrozikiewicz
The vitamin D receptor (VDR), coded by the VDR gene, plays a pivotal role in executing cellular functions when bound by the active form of vitamin D. Gene polymorphisms in this receptor have been increasingly associated with a heightened state of vulnerability to certain diseases. However, limited data is available concerning the role of VDR gene polymorphisms in preterm infant complications. In 114 premature infants (< 32 weeks gestation) we analyze four single nucleotide VDR polymorphisms (rs2228570 (FokI), rs1544410 (BsmI), rs797532 (ApaI), rs731236 (TaqI)) for their association with respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC) and retinopathy of prematurity (ROP)...
December 3, 2020: Scientific Reports
Jingqin Ma, Ximing Gong, Jianjun Luo, Junying Gu, Zhiping Yan, Wen Zhang, Changyu Li, Zihan Zhang, Minjie Yang
PURPOSE: To quantitatively analyze the impact of intrahepatic venovenous shunt (IHVS) on hepatic venous pressure gradient (HVPG) measurement. MATERIALS AND METHODS: From 2015 to 2019, 222 HVPG measurements performed during transjugular intrahepatic portosystemic shunt creation were eligible for this study. Digital subtraction angiography (DSA) software color-coded each pixel of a two-dimensional DSA series by time-intensity curve to classify IHVS. Different degrees of IHVS were found in 36...
December 2020: Journal of Vascular and Interventional Radiology: JVIR
Ling Ling Liau, Maimonah Eissa Al-Masawa, Benson Koh, Qi Hao Looi, Jhi Biau Foo, Sau Har Lee, Fook Choe Cheah, Jia Xian Law
Mesenchymal stromal cells (MSCs) can be derived from various tissue sources, such as the bone marrow (BMSCs), adipose tissue (ADSCs), umbilical cord (UC-MSCs) and umbilical cord blood (UCB-MSCs). Clinical trials have been conducted to investigate the potential of MSCs in ameliorating neonatal diseases, including bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH) and necrotizing enterocolitis (NEC). In preclinical studies, MSC therapy has been tested for the treatment of various neonatal diseases affecting the heart, eye, gut, and brain as well as sepsis...
2020: Frontiers in Pediatrics
Roberto F Delgadillo, Katie A Carnes, Nestor Valles-Villarreal, Omar Olmos, Kathia Zaleta-Rivera, Lawrence J Parkhurst
The Stopped-Flow apparatus (SF) tracks molecular events by mixing the reactants in sub-millisecond regimes. The reaction of intrinsically or extrinsically labeled biomolecules can be monitored by recording the fluorescence, F ( t ), anisotropy, r ( t ), polarization, p ( t ), or FRET, F ( t ) FRET , traces at nanomolar concentrations. These kinetic measurements are critical to elucidate reaction mechanisms, structural information, and even thermodynamics. In a single detector SF, or L-configuration, the r ( t ), p ( t ), and F ( t ) traces are acquired by switching the orientation of the emission polarizer to collect the IVV and IVH signals however it requires two-shot experiments...
November 19, 2020: Biosensors
Danielle R Rios, Fernando de Freitas Martins, Afif El-Khuffash, Dany E Weisz, Regan E Giesinger, Patrick J McNamara
BACKGROUND: High-volume systemic-to-pulmonary ductus arteriosus shunts in premature infants are associated with adverse neonatal outcomes. The role of an atrial communication (AC) in modulating effects of a presumed hemodynamically significant patent ductus arteriosus (hsPDA) is poorly studied. The objective of this study was to characterize the relationship between early AC and echocardiography indices of PDA shunt volume and clinical neonatal outcomes. METHODS: We performed a retrospective review of preterm infants (born <32 weeks' gestation) with echocardiography in the first postnatal week...
November 20, 2020: Journal of the American Society of Echocardiography
Huiling Cao, Huanhuan Li, Xingwang Zhu, Li Wang, Ming Yi, Chuanfeng Li, Long Chen, Yuan Shi
Introduction: The present study was designed and conducted to compare the efficacy between nasal continuous positive airway pressure (NCPAP), nasal intermittent positive-pressure ventilation (NIPPV), and noninvasive high-frequency oscillatory ventilation (NHFOV) as the primary noninvasive ventilation in preterm infants with respiratory distress syndrome (RDS). Material and methods: This multicenter retrospective cohort study was performed using data from four tertiary neonatal intensive care units (NICUs) in China between 2016 and 2018...
2020: Archives of Medical Science: AMS
François Lechanoine, Julien Francisco Zaldivar-Jolissaint, Florian Le Lann, Emmanuel De Schlichting
Premature infants with severe germinal matrix intraventricular hemorrhage (IVH) are at high risk of posthemorrhagic ventricular dilation and hydrocephalus (Video 1). We report the case of a 3-month-old premature infant referred for posthemorrhagic multilocated hydrocephalus. He presented with somnolence, hypotonia, and a bulging fontanelle. His past medical history included an IVH grade III with hydrocephalus initially treated by temporary ventriculosubgaleal shunting. Magnetic resonance imaging (MRI) showed persistent hydrocephalus associated to a cyst extending anteriorly from the mesencephalon to the posterior wall of the sixth cervical vertebra, causing severe brainstem and spinal cord compression...
October 22, 2020: World Neurosurgery
Martin McDonnell, Richard J Harris, Florina Borca, Tilly Mills, Louise Downey, Suranga Dharmasiri, Mayank Patel, Benjamin Zare, Matt Stammers, Trevor R Smith, Richard Felwick, J R Fraser Cummings, Hang T T Phan, Markus Gwiggner
BACKGROUND: Glucocorticosteroids (GC) are long-established, widely used agents for induction of remission in inflammatory bowel disease (IBD). Hyperglycaemia is a known complication of GC treatment with implications for morbidity and mortality. Published data on prevalence and risk factors for GC-induced hyperglycaemia in the IBD population are limited. We prospectively characterise this complication in our cohort, employing machine-learning methods to identify key predictors of risk...
November 2020: BMJ Open Gastroenterology
Lara M Leijser, James N Scott, Smita Roychoudhury, Hussein Zein, Prashanth Murthy, Sumesh P Thomas, Khorshid Mohammad
BACKGROUND: Post-hemorrhagic ventricular dilatation (PHVD) in preterm infants can be assessed with ventricular size indices from cranial ultrasound. We explored inter-observer reliability of these indices for prediction of severe PHVD. METHODS: For all 139 infants with IVH, serial neonatal ultrasound at 3 time points (days 4-7, day 14, 36 weeks PMA) were assessed independently by 3 observers with differing levels of training/experience. Ventricular index (VI), anterior horn width (AHW), and fronto-temporal horn ratio (FTHR) were measured and used to diagnose PHVD...
November 12, 2020: Pediatric Research
Harald Krenzlin, Christina Frenz, Jan Schmitt, Julia Masomi-Bornwasser, Dominik Wesp, Darius Kalasauskas, Thomas Kerz, Johannes Lotz, Beat Alessandri, Florian Ringel, Naureen Keric
BACKGROUND: The cerebral thrombin system is activated in the early stage after intracerebral hemorrhage (ICH). Expression of thrombin leads to concentration dependent secondary neuronal damage and detrimental neurological outcome. In this study we aimed to investigate the impact of thrombin concentration and activity in the cerebrospinal fluid (CSF) of patients with ICH on clinical outcome. METHODS: Patients presenting with space-occupying lobar supratentorial hemorrhage requiring extra-ventricular drainage (EVD) were included in our study...
2020: PloS One
Wen-Song Yang, Yi-Qing Shen, Xiao-Dong Zhang, Li-Bo Zhao, Xiao Wei, Xin Xiong, Xiong-Fei Xie, Rui Li, Lan Deng, Xin-Hui Li, Xin-Ni Lv, Fa-Jin Lv, Qi Li, Peng Xie
BACKGROUND/OBJECTIVES: To propose a novel definition for hydrocephalus growth and to further describe the association between hydrocephalus growth and poor outcome among patients with intracerebral hemorrhage (ICH). METHODS: We analyzed consecutive patients who presented within 6 h after ICH ictus between July 2011 and June 2017. Follow-up CT scans were performed within 36 h after initial CT scans. The degree of hydrocephalus were evaluated by the hydrocephalus score of Diringer et al...
November 10, 2020: Neurocritical Care
Isabel Atienza-Navarro, Pilar Alves-Martinez, Simon Lubian-Lopez, Monica Garcia-Alloza
The germinal matrix-intraventricular hemorrhage (GM-IVH) is one of the most important complications of the preterm newborn. Since these children are born at a critical time in brain development, they can develop short and long term neurological, sensory, cognitive and motor disabilities depending on the severity of the GM-IVH. In addition, hemorrhage triggers a microglia-mediated inflammatory response that damages the tissue adjacent to the injury. Nevertheless, a neuroprotective and neuroreparative role of the microglia has also been described, suggesting that neonatal microglia may have unique functions...
November 6, 2020: International Journal of Molecular Sciences
Sandra Horsch, Alessandro Parodi, Boubou Hallberg, Mariya Malova, Isabella M Björkman-Burtscher, Ingrid Hansen-Pupp, Neil Marlow, Kathryn Beardsall, David Dunger, Mirjam van Weissenbruch, Lois E H Smith, Mohamed Hamdani, Alexandra Mangili, Norman Barton, Luca A Ramenghi, Ann Hellström, David Ley
Background: Postnatal insulin-like growth factor-1 (IGF-1) replacement with recombinant human (rh)IGF-1 and IGF binding protein-3 (rhIGF-1/rhIGFBP-3) is being studied as a potential treatment to reduce comorbidities of prematurity. We have recently reported on a phase II, multicenter, randomized, controlled trial comparing postnatal rhIGF-1/rhIGFBP-3 replacement with standard of care (SOC) in extremely preterm infants (NCT01096784). Maximum severity of retinopathy of prematurity was the primary endpoint of the trial and presence of GMH-IVH/PHI one of the pre-specified secondary endpoints...
2020: Frontiers in Pediatrics
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