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Shock In Preterm

Aggeliki Makri, Charalampos Siristatidis, Charalampos Chrelias, Chrysi Christodoulaki, Nikolaos Evangelinakis, Dimitrios Kassanos, Evangelos J Giamarellos-Bourboulis, Aikaterini Pistiki
PROBLEM: To study the balance of circulating heat shock protein (HSP)60 and HSP70 in preterm delivery METHOD OF STUDY: A two-stage approach was used. At first stage we run retrospective analysis of prospective collected clinical data and at a second stage we studied an animal model of preterm delivery (PTD). Blood samples were collected for prenatal screening in 3,629 women. Samples from 23 women with miscarriage before gestational week 21 and 53 well-matched comparators for age, body mass index, parity and previous miscarriage with full-term pregnancy were depicted...
January 4, 2019: American Journal of Reproductive Immunology: AJRI
M N Tarana, S M Shamsuzzaman
Pathogenic microorganisms are important cause of maternal and neonatal infections which are transmitted from colonized vagina of mother. The purpose of the present study was to detect the potential pathogens other than Group B Streptococcus in vaginal swab of pregnant women. This prospective cross sectional study was conducted from July 2013 to June 2014 at Dhaka Medical College Hospital, Dhaka, Bangladesh. A total of 224 vaginal swab samples were studied. Gram stain Nugent score was applied for all vaginal smear to detect bacterial vaginosis...
October 2018: Mymensingh Medical Journal: MMJ
Marie-Eve Brien, Bernadette Baker, Cyntia Duval, Virginie Gaudreault, Rebecca Lee Jones, Sylvie Girard
Inflammation is known to be associated with placental dysfunction and pregnancy complications. Infections are well known to be a cause of inflammation but they are frequently undetectable in pregnancy complications. More recently, the focus has been extended to inflammation of non-infectious origin, namely caused by endogenous mediators known as "damage-associated molecular patterns - DAMPs" or alarmins. In this manuscript we review the mechanism by which inflammation; sterile or infectious can alter the placenta and its function...
November 28, 2018: Canadian Journal of Physiology and Pharmacology
L Chen, H Wen, D Xu, L Q Chen, J He
Objective: To investigate the clinical features, diagnosis and treatments of heterotopic pregnancy (HP) and demonstrate the outcomes of HP after the surgical treatment of ectopic pregnancies. Methods: A retrospective analysis was performed on 144 cases of HP in Women ' s Hospital, School of Medicine, Zhejiang University from January 2003 to December 2016. Results: (1) Clinical features of HP:the average age of patients was (30.8±3.8) years old, body mass index (BMI) was (21.9±2.9) kg/m(2), and was diagnosed at (6...
November 25, 2018: Zhonghua Fu Chan Ke za Zhi
H Chan, A Cougnard-Grégoire, J F Korobelnik, M N Delyfer, D Touboul, V Coste, J Sarlangue, C Dutheil, C Paya
PURPOSE: To analyze the prevalence and risk factors for retinopathy of prematurity (ROP) and severe (treatment-requiring) ROP. METHODS: A retrospective study was conducted in a level III neonatal unit in Bordeaux, France, from 2009 to 2015. Four hundred and nineteen preterm infants who were screened for ROP exclusively by RetCam were included. RESULTS: ROP of any degree was diagnosed in 27.68% of infants. Stages 1, 2, 3 and 4 ROP was found in 44%, 46%, 9% and 1% of subjects, respectively...
November 12, 2018: Journal Français D'ophtalmologie
Mei-Hsin Hsu, Jen-Fu Hsu, Hsuan-Chang Kuo, Mei-Yin Lai, Ming-Chou Chiang, Ying-Jui Lin, Hsuan-Rong Huang, Shih-Ming Chu, Ming-Horng Tsai
We aimed to evaluate the occurrence, treatment, and outcomes of neurological complications after bacterial meningitis in young infants. A case series study from a retrospective cohort from two tertiary-level medical centers in Taiwan between 2007 and 2016 was conducted. Eighty-five young infants aged < 90 days with bacterial meningitis were identified. 25 (29.4%) were born at preterm. Group B Streptococcus (GBS) and Escherichia coli caused 74.1% of identified cases. Despite the majority (90.6%) initially received microbiologically appropriate antibiotics, 65 (76...
2018: Frontiers in Neurology
Mikko Hallman, Antti Haapalainen, Johanna M Huusko, Minna K Karjalainen, Ge Zhang, Louis J Muglia, Mika Rämet
Spontaneous preterm birth is a serious and common pregnancy complication associated with hormonal dysregulation, infection, inflammation, immunity, rupture of fetal membranes, stress, bleeding, and uterine distention. Heredity is 25-40% and mostly involves the maternal genome, with contribution of the fetal genome. Significant discoveries of candidate genes by genome-wide studies and confirmation in independent replicate populations serve as signposts for further research. The main task is to define the candidate genes, their roles, localization, regulation, and the associated pathways that influence the onset of human labor...
September 18, 2018: Pediatric Research
Selma Alves Valente do Amaral Lopes, Isabel Cristina Britto Guimarães, Sofia Fontes de Oliva Costa, Angelina Xavier Acosta, Kyoko Abe Sandes, Carlos Maurício Cardeal Mendes
BACKGROUND: Congenital heart diseases are the most common type of congenital defects, and account for more deaths in the first year of life than any other condition, when infectious etiologies are ruled out. OBJECTIVES: To evaluate survival, and to identify risk factors in deaths in newborns with critical and/or complex congenital heart disease in the neonatal period. METHODS: A cohort study, nested to a randomized case-control, was performed, considering the Confidence Interval of 95% (95% CI) and significance level of 5%, paired by gender of the newborn and maternal age...
September 21, 2018: Arquivos Brasileiros de Cardiologia
Sailaja Devi Kallur, Tarakeswari Surapaneni, Hari Kishan Boorugu, Nuzhat Aziz, Anisha Ramniklal Gala, Swathi Donnuri
The incidence of dengue has risen in India in recent years. Evidence suggests that dengue in pregnancy may be associated with adverse maternal and fetal outcomes. The aim of our study was to analyse outcomes in pregnant women with confirmed dengue infection who had the benefit of close monitoring and intensive management at a tertiary maternity facility. We reviewed hospital data of 44 (0.11%) such women at Fernandez Hospital, a tertiary maternity unit, during the five-year period from 2011 to 2016. Maternal and fetal variables were collected from case sheets...
September 30, 2018: Tropical Doctor
Norberto Perico, David Askenazi, Monica Cortinovis, Giuseppe Remuzzi
Acute kidney injury (AKI) is a common and life-threatening complication in critically ill neonates. Gestational risk factors for AKI include premature birth, intrauterine growth restriction and low birthweight, which are associated with poor nephron development and are often the consequence of pre-gestational and gestational factors, such as poor nutritional status. Our understanding of how to best optimize renal development and prevent AKI is in its infancy; however, the identification of pre-gestational and gestational factors that increase the risk of adverse neonatal outcomes and the implementation of interventions, such as improving nutritional status early in pregnancy, have the potential to optimize fetal growth and reduce the risk of preterm birth, thereby improving kidney health...
November 2018: Nature Reviews. Nephrology
Eric Giannoni, Philipp K A Agyeman, Martin Stocker, Klara M Posfay-Barbe, Ulrich Heininger, Ben D Spycher, Sara Bernhard-Stirnemann, Anita Niederer-Loher, Christian R Kahlert, Alex Donas, Antonio Leone, Paul Hasters, Christa Relly, Thomas Riedel, Claudia Kuehni, Christoph Aebi, Christoph Berger, Luregn J Schlapbach
OBJECTIVE: To assess the epidemiology of blood culture-proven early- (EOS) and late-onset neonatal sepsis (LOS). STUDY DESIGN: All newborn infants admitted to tertiary care neonatal intensive care units in Switzerland and presenting with blood culture-proven sepsis between September 2011 and December 2015 were included in the study. We defined EOS as infection occurring <3 days after birth, and LOS as infection ≥3 days after birth. Infants with LOS were classified as having community-acquired LOS if onset of infection was ≤48 hours after admission, and hospital-acquired LOS, if onset was >48 hours after admission...
October 2018: Journal of Pediatrics
Livia Lopes Barreiros, Filipe Moreira de Andrade, Ronaldo Afonso Torres, Lucas Vilas Boas Magalhães, Bruno Dos Santos Farnetano, Rossano Kepler Alvim Fiorelli
OBJECTIVE: to determine the incidence of pericardial effusion with cardiac tamponade in preterm infants in a pediatric intensive care unit, with emphasis on the relationship between pericardial effusion and peripherally inserted central catheter, and to evaluate the role of bedside ultrasound in approaching these cases. METHODS: we conducted a retrospective analysis of patients admitted to a pediatric intensive care unit between July 2014 and December 2016, who presented pericardial effusion with hemodynamic repercussion, evaluated by ultrasonography...
July 16, 2018: Revista do Colégio Brasileiro de Cirurgiões
Jane Hitti, Laura Sienas, Suzan Walker, Thomas J Benedetti, Thomas Easterling
BACKGROUND: Maternal mortality and severe maternal morbidity are growing public health concerns in the United States. The Centers for Disease Control and Prevention Severe Maternal Morbidity measure provides insight into processes underlying maternal mortality and may highlight modifiable risk factors for adverse maternal health outcomes. OBJECTIVE: The primary objective of this study was to evaluate the association between hypertensive disorders and severe maternal morbidity at a regional perinatal referral center...
July 27, 2018: American Journal of Obstetrics and Gynecology
Johanna M Huusko, Minna K Karjalainen, Britney E Graham, Ge Zhang, Emily G Farrow, Neil A Miller, Bo Jacobsson, Haley R Eidem, Jeffrey C Murray, Bruce Bedell, Patrick Breheny, Noah W Brown, Frans L Bødker, Nadia K Litterman, Pan-Pan Jiang, Laura Russell, David A Hinds, Youna Hu, Antonis Rokas, Kari Teramo, Kaare Christensen, Scott M Williams, Mika Rämet, Stephen F Kingsmore, Kelli K Ryckman, Mikko Hallman, Louis J Muglia
Preterm birth is a leading cause of morbidity and mortality in infants. Genetic and environmental factors play a role in the susceptibility to preterm birth, but despite many investigations, the genetic basis for preterm birth remain largely unknown. Our objective was to identify rare, possibly damaging, nucleotide variants in mothers from families with recurrent spontaneous preterm births (SPTB). DNA samples from 17 Finnish mothers who delivered at least one infant preterm were subjected to whole exome sequencing...
July 2018: PLoS Genetics
Naomi Maeda, Hideharu Hagiya, Tsuyoshi Takiuchi, Shinsuke Kusakabe, Tetsuo Maeda, Keigo Kimura, Sayuri Iwai, Keisuke Kawasaki, Yumiko Hori, Eiichi Morii, Yuzuru Kanakura, Tadashi Kimura, Kazunori Tomono
Staphylococcus aureus as a pathogen in human gestational membranes, a rather rare phenomenon, has recently been the focus of several researches. S. aureus forms biofilms on these membranes and potentially causes chorioamnionitis in pregnant women. We report a case of persistent methicillin-resistant S. aureus (MRSA) bacteremia owing to placental infection, causing chorioamnionitis and preterm birth. A 29-year-old Japanese woman at the 27th gestational week was diagnosed with acute promyelocytic leukemia and underwent all-trans retinoic acid therapy...
December 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Chloe Joynt, Po-Yin Cheung
Preterm neonates often have hypotension which may be due to various etiologies. While it is controversial to define hypotension in preterm neonates, various vasoactive medications are commonly used to provide the cardiovascular support to improve the blood pressure, cardiac output, or to treat shock. However, the literature on the systemic and regional hemodynamic effects of these antihypotensive medications in neonates is deficient and incomplete, and cautious translation of findings from other clinical populations and animal studies is required...
2018: Frontiers in Pediatrics
Jisha Mathew, Chandrakala Bada Shekarappa, Suman Padubidri Nanyam Rao
Objective: The study was to determine the correlation of Perfusion Index (PI) and Clinical Risk Index for Babies (CRIB) score, in assessing the severity of illness in sick neonates. Methods: This was a cross-sectional study conducted at a tertiary care Neonatal Intensive Care Unit (NICU). All eligible neonates, both term and preterm, admitted to the high-dependency unit of the NICU were included, after parental consent. Relevant details of history and examination were collected with a structured proforma...
April 18, 2018: Journal of Tropical Pediatrics
Anders Brunse, Päivi Worsøe, Susanne Elisabeth Pors, Kerstin Skovgaard, Per Torp Sangild
Preterm infants have increased risk of neonatal sepsis, potentially inducing brain injury, and they may benefit from early initiation of enteral milk feeding. Using preterm pigs as models, we hypothesized that early provision of bovine colostrum to parentally nourished newborns protects against sepsis and neuroinflammation during bloodstream infection. Preterm newborn pigs were administered 10 CFU/kg of intra-arterial Staphylococcus epidermidis (SE, an opportunistic pathogen often causing sepsis in preterm infants), followed by administration of total parenteral nutrition (TPN, SE + TPN, n = 15) or oral provision of bovine colostrum with supplementary parenteral nutrition (SE + COL, n = 14), and compared with uninfected, TPN-nourished controls (CON + TPN, n = 11)...
February 21, 2018: Shock
Anne-Sophie Smilga, Jarred Garfinkle, Pamela Ng, John Andersen, David Buckley, Darcy Fehlings, Adam Kirton, Ellen Wood, Esias van Rensburg, Michael Shevell, Maryam Oskoui
BACKGROUND: The goal of this study was to explore the association between neonatal infection and outcomes in children with cerebral palsy. METHODS: We conducted a retrospective cohort study using the Canadian CP Registry. Neonatal infection was defined as meeting one of the following criteria: (1) septicemia, (2) septic shock, or (3) administration of antibiotics for ≥10 days. Phenotypic profiles of children with cerebral palsy with and without an antecedent neonatal infection were compared...
March 2018: Pediatric Neurology
Kaashif Aqeeb Ahmad, Monica Michelle Bennett, Samiya Fatima Ahmad, Reese Hunter Clark, Veeral Nalin Tolia
OBJECTIVE: There are no large studies evaluating pulmonary haemorrhage (PH) in premature infants. We sought to quantify the clinical characteristics, morbidities and mortality associated with early PH. DESIGN: Data were abstracted from the Pediatrix Clinical Data Warehouse, a large de-identified data set. For incidence calculations, we included infants from 340 Pediatrix United States Neonatal Intensive Care Units from 2005 to 2014 without congenital anomalies. Infants <28 weeks' gestation with PH within 7 days of birth were then matched with two controls for birth weight, gestational age, gender, antenatal steroid exposure, day of life 0 or 1 intubation and multiple gestation...
January 2019: Archives of Disease in Childhood. Fetal and Neonatal Edition
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