Impact of race and ethnicity on the outcome of preterm infants below 32 weeks gestation.

OBJECTIVES: To determine the impact of race/ethnicity on mortality and morbidity such as intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), bronchopulmonary dysplasia (BPD) and bacteriologically confirmed sepsis, assisted ventilation, surfactant administration, intrauterine growth retardation (IUGR), and patent ductus arteriosus (PDA) among very prematurely delivered infants. STUDY DESIGN: Retrospective study of a cohort of 1006 preterm neonates with gestational age ranging from 22 to 32 weeks discharged from the Neonatal Intensive Care Unit (NICU) between 1998 and 2001. Subgroup analysis according to gestational age (GA) (22 to 24, 25 to 28, and 29 to 32 weeks) and plurality (singleton and multiple) was performed using the chi(2) test and an analysis of variance. RESULTS: Of the 1006 infants, 54.3% were white, 21.7% black, 13.7% Hispanic, and 10.3% were classified as Other. Multiple births among white infants were approximately twice that in (42.4%) black infants (22.1%), and was also significantly higher than in the Hispanic (28.3%) and other race/ethnic groups (25.2%). Overall, a higher proportion of black infants were born with a GA 相似文献   

In vitro effects of hematopoietic growth factors on the proliferation, endoreplication, and maturation of human megakaryocytes

A liquid culture technique was used to study regulation of human megakaryocytopoiesis in vitro. Low-density cells from adult bone marrow were cultured in the presence of normal plasma, plasma from patients with aplastic marrows (AP), recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) and interleukin-3 (IL-3). Megakaryocytes (MK) were studied at day 10 of culture by a two-color staining technique using a pool of monoclonal antibodies for their identification and propidium iodide to label DNA. Their ploidy distribution was analyzed by flow cytometry. In some experiments cytoplasmic maturation was also studied by ultrastructural techniques. Normal plasma provides a low number of MK with a ploidy distribution including 8 N and 16 N MK. AP promoted in a dose-dependent manner proliferation of MK and some batches favored endoreplication. This effect was clearly demonstrated when ploidy distribution was compared between normal plasma and AP on parallel marrow cultures. However, ploidy distribution was shifted toward low values compared with uncultured MK. rhGM-CSF had no significant effect on these two parameters. In contrast, rhIL-3 from 0.1 U/mL to 100 U/mL had a proliferative effect but was unable to induce endoreplication. Furthermore, when associated with AP it totally abrogated the effect of AP on endoreplication because in most experiments more than 90% of MK were 2 N and 4 N. This effect was also observed when rhIL-3 was added after 7 days of culture (when it has little proliferative effects). Studies of the maturation of MK grown with rhIL-3 indicate that the majority were small mature cells synthesizing alpha-granules and demarcation membranes. The effect of AP on MK proliferation and endoreplication was not related to IL-6 because its IL-6 content was identical to that of normal plasma and its neutralization did not modify these parameters. In conclusion, this study indicates that liquid culture technique in association with flow cytometry could be a powerful tool in identifying the humoral regulators of human megakaryocytopoiesis.     

Unbound bilirubin measurements by a novel probe in preterm infants

Background: Hyperbilirubinemia occurs in over 80% of newborns and severe bilirubin toxicity can lead to neurological dysfunction and death, especially in preterm infants. Currently, the risk of bilirubin toxicity is assessed by measuring the levels of total serum bilirubin (TSB), which are used to direct treatments including immunoglobulin administration, phototherapy, and exchange transfusion. However, free, unbound bilirubin levels (Bf) predict the risk of bilirubin neurotoxicity more accurately than TSB.

Objective: To examine Bf levels in preterm infants and determine the frequency with which they exceed reported neurotoxic thresholds.

Methods: One hundred thirty preterm infants (BW 500–2000?g; GA 23–34 weeks) were enrolled and Bf levels measured during the first week of life by the fluorescent Bf sensor BL22P1B11-Rh. TSB and plasma albumin were measured by standard techniques. Bilirubin-albumin dissociation constants (K_d) were calculated based on Bf and plasma albumin.

Results: Five hundred eighty samples were measured during the first week of life, with an overall mean Bf of 13.6?±?9.0?nM. A substantial number of measurements exceeded potential toxic thresholds levels as reported in the literature. The correlation between Bf and TSB was statistically significant (r² 0.17), but this weak relationship was lost at high Bf levels. Infants <28-week gestations had more hearing screening failures than infants ≥28-week gestation.

Conclusions: Unbound (free) bilirubin values are extremely variable during the first week of life in preterm infants. A significant proportion of these values exceeded reported neurotoxic thresholds.     

代平颗粒对2型糖尿病大鼠血糖、血脂水平及骨骼肌Glut4 mRNA,IRS-1 mRNA表达的影响

目的:观察中药代平颗粒对2型糖尿病大鼠骨骼肌葡萄糖转运蛋白4( Glut4)、胰岛素受体底物1(IRS-1)基因表达的影响,初步探讨其降低血糖的分子机制.方法:雄性SD大鼠分为正常对照组(8只,普通饲料),其余大鼠采用高脂饲料喂养联合链脲佐菌素(STZ)尾静脉注射的方法造成2型糖尿病成膜大鼠(32只),分为模型组(M)、二甲双胍组(Met)、代平颗粒低剂量组(DL),代平颗粒高剂量组(DH),每组8只.经药物干预4周后检测各组大鼠空腹血糖( FBG)、血脂、空腹胰岛素(FINS)并计算胰岛素敏感指数(ISI),采用实时荧光定量PCR技术检测大鼠骨骼肌Glut4 mRNA,IRS-1 mRNA表达水平.结果:给药后4周,与M组FBG:( 20.55±5.50) mmol·L -1,ISI:(-6.05±0.29)比较,Met组FBG(14.75±3.90)mmol·L-1和DH组FBG(11.21±2.95) mmol·L-1均显著下降(P＜0.01),Met组ISI(-5.37±0.38)和DH组ISI(-5.38±0.37)均显著升高(P＜0.01);M组Glut4 mRNA(0.63±0.13)和IRS-1 mRNA (0.68±0.17)表达量分别为N组的63.3％,67.8％(P＜0.01);与M组比较,Met组Glut4 mRNA(0.95±0.19)表达量升高了31％ (P ＜0.01),IRS-1 mRNA (0.88±0.24)表达量无显著升高,DH组Glut4 mRNA(1.19±0.15)和IRS-1 mRNA(1.24±0.22)表达量,分别升高了88.9％,82.4％(P＜0.01).结论:代平颗粒具有降低2型糖尿病大鼠FBG效果,其作用机制之一与增加组织胰岛素敏感性,上调2型糖尿病大鼠骨骼肌中Glut4 mRNA和IRS-1 mRNA的表达,促进骨骼肌对葡萄糖的摄取和利用有关.     

Modified cAMP derivatives: powerful tools in heart research

Receptor-mediated changes in intracellular cyclic AMP concentration play critical role in the autonomic control of the heart, including regulation of a variety of ion channels via mechanisms involving protein kinase A, EPAC, or direct actions on cyclic nucleotide gated ion channels. In case of any ion channel, the actual signal transduction cascade can be identified by using properly modified cAMP derivatives with altered binding and activating properties. In this study we focus to structural modifications of cAMP resulting in specific activator and blocking effects on PKA or EPAC. Involvement of the cAMP-dependent signal transduction pathway in controlling rapid delayed rectifier K(+ ) current was studied in canine ventricular myocytes using these specific cAMP analogues. Adrenergic stimulation increased the density of I(Kr) in canine ventricular cells, which effect was mediated by a PKA-dependent but EPAC-independent pathway. It was also shown that intracellular application of large concentrations of cAMP failed to fully activate PKA comparing to the effect of isoproterenol, forskolin, or PDE-resistant cAMP derivatives. This difference was fully abolished following inhibition of phosphodiesterase by IBMX. These results are in line with the concept of compartmentalized release, action, and degradation of cAMP within signalosomes.     

Breakfast habits and factors influencing food choices at breakfast in relation to socio-demographic and family factors among European adolescents. The HELENA Study

Breakfast consumption has been shown to be an important indicator of a healthy lifestyle. Little is known however about factors influencing breakfast consumption and food choices at breakfast in adolescents. The aim of the present study was therefore to describe breakfast habits, and factors influencing food choices at breakfast within the framework of the EU-funded HELENA Study, in 3528 adolescents from ten European cities. Additionally, socio-demographic differences in breakfast habits and in influencing factors were investigated. Half of the adolescents (and fewer girls than boys) indicated being regular breakfast consumers. Girls with mothers with a high level of education, boys from 'traditional' families and boys who perceived low family affluence were positively associated with breakfast consumption. Boys whose parents gave encouragement and girls whose peers ate healthily were more likely to be regular breakfast consumers. 'Hunger', 'taste', 'health concerns' and 'parents or guardian' were the most important influences on the adolescents' food choices at breakfast. Adolescents from southern Europe and girls reported to be more influenced by personal and socio-environmental factors. Socio-demographic differences, in particular regional and gender differences, need to be considered in discussions surrounding the development of nutritional intervention programs intended for adolescents.     

Changes in diagnostic and therapeutic standards of acute pancreatitis in clinical practice. Epidemiologic analysis of data from a regional center of internal medicine and surgery

Epidemiological data analysis of a tertiary (regional) medical and surgical center. Diagnostic and therapeutic standards of patients with acute pancreatitis have changed significantly in the last few decades. Progress in laboratory and imaging diagnostics and achievements in experimental research resulted in a significant modification of the guidelines related to the care of pancreatitic patients. The aim was to analyse and compare the data of patients with acute pancreatitis treated in 1996 (period I) and 2004 (period II) at the Departments of Internal Medicine and Surgery, University of Szeged, to evaluate the concordance with international guidelines during medical and surgical treatment. RESULTS: The authors analysed the clinical data of 126 and 124 patients, respectively, with acute pancreatitis observed during the two periods. An increase in the incidence of biliary acute pancreatitis, more frequent use of antibiotics, a higher frequency of therapeutic endoscopies (papillotomy and biliary stone extraction), the general application of ultrasonography-guided fine needle aspiration and bacterial culturing in cases of suspected infected necrosis, and higher effectiveness in complex surgical and supportive management of infected necrosis cases were detected in period II. CONCLUSION: Although most of the achievements suggested in international guidelines on medical/endoscopic and surgical treatment of acute pancreatitis have been implemented during the observation period, no significant changes in the morbidity and mortality data of patients were found.     

Insufficient etiological workup of COVID-19-associated acute pancreatitis: A systematic review

BACKGROUND Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection, mostly causing respiratory symptoms, is also known to affect the gastrointestinal tract. Several case reports hypothesize that SARS-CoV-2 could be an etiological factor in acute pancreatitis(AP).AIM To assess all the available evidence in the literature relating to coronavirus disease 2019(COVID-19) and AP.METHODS We performed a systematic review of the available literature on the topic. The systematic search was conducted on 15 May 2020 on MEDLINE, EMBASE, CENTRAL, Web of Science and Scopus with a search key using the terms "amylase," "lipase," "pancr*," "COVID-19" and synonyms. Due to the low quality and poor comparability of the studies, a meta-analysis was not performed.RESULTS Six case reports and two retrospective cohorts were included, containing data on eleven COVID-19 patients with AP. Five patients had AP according to the Atlanta classification. Other publications did not provide sufficient information on the diagnostic criteria. Most cases were considered SARS-CoV-2-induced, while several established etiological factors were not investigated. We were able to identify other possible causes in most of them.CONCLUSION We strongly highlight the need for adherence to the guidelines during a diagnostic and etiological workup, which could alter therapy.     

Influence of TiO2 Nanoparticles on the Resistance of Cementitious Composite Materials to the Action of Fungal Species

The development of mold films on the cement surfaces of buildings is a health and safety problem for the population, aesthetic but also in terms of their durability. The use of specific performance of cementitious composites containing TiO₂ nanoparticles, photoactivated by UV radiation, can be a viable solution to mitigate to eliminate these problems. The experimental studies presented aim to analyze the capacity to inhibit the development of mold type Aspergillus and Penicillium on the surface of composite materials with nano-TiO₂ content and the identification of the optimal range of nanomaterial addition. The identification and analysis of the inhibition halo (zone with a biological load of maximum 1–10 colonies of microorganisms) confirmed the biocidal capacity of the cementitious composites, but also indicated the possibility that an excess of TiO₂ nanoparticles in the mixture could induce a development of cell resistance, which would be unfavorable both in terms of behavior and in terms of cost.