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Biomarker preterm infants

Kai König, Katelyn J Guy, Claudia A Nold-Petry, Charles P Barfield, Geraldine Walsh, Sandra M Drew, Alex Veldman, Marcel F Nold, Dan M Casalaz
Bronchopulmonary dysplasia (BPD) is often complicated by pulmonary hypertension (PH). We investigated three biomarkers potentially suitable as screening markers for extremely preterm infants at risk of BPD-associated PH. In this prospective observational cohort study conducted in a tertiary neonatal intensive care unit, 83 preterm infants with BPD born <28 weeks gestation and still inpatients at 36 weeks corrected age received an echocardiogram and blood tests of B-type natriuretic peptide (BNP), troponin I, and YKL-40...
October 19, 2016: American Journal of Physiology. Lung Cellular and Molecular Physiology
Stephanie Prescott, Jessica Keim-Malpass
BACKGROUND: The incidence of hemodynamically significant patent ductus arteriosus (hsPDA) increases with decreasing gestational age and is associated with many common morbidities of extreme prematurity. Controversies remain surrounding the definition of hsPDA, the population of infants requiring treatment, the appropriate timing and method of treatment, and the outcomes associated with PDA and its therapies. PURPOSE: This integrative literature review focuses on diagnostic and treatment recommendations derived from the highest levels of evidence...
October 8, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Mandar S Joshi, Kelsey A Montgomery, Peter J Giannone, John A Bauer, Mina H Hanna
Preterm birth is associated with increased risks of morbidity and mortality along with increased healthcare costs. Advances in medicine have enhanced survival for preterm infants but the overall incidences of major morbidities have changed very little. Abnormal renal development is an important consequence of premature birth. Acute kidney injury (AKI) in the neonatal period is multifactorial and may increase lifetime risk of chronic kidney disease.Traditional biomarkers in newborns suffer from considerable confounders, limiting their use for early identification of AKI...
October 10, 2016: Pediatric Research
Cinzia Auriti, Marco Falcone, Maria Paola Ronchetti, Bianca Maria Goffredo, Sara Cairoli, Rosamaria Crisafulli, Fiammetta Piersigilli, Tiziana Corsetti, Andrea Dotta, Manjunath P Pai
High doses of micafungin are advocated in neonates with systemic candidiasis but limited pharmacokinetic (PK) and safety data are available to support their use. Eighteen preterm neonates and infants with systemic candidiasis, 3 with meningitis, were treated for at least 14 days with 8 to 15 mg/kg/day of intravenous micafungin. Plasma concentrations (4 measurements) were determined after the third dose and cerebrospinal-fluid (CSF) concentrations were also obtained in three patients. Population PK analyses were used to identify the optimal model and further validated using external data (n=5)...
October 3, 2016: Antimicrobial Agents and Chemotherapy
Serafina Perrone, Maria Luisa Tataranno, Simona Negro, Mariangela Longini, Maria Stefania Toti, Maria Gabriella Alagna, Fabrizio Proietti, Francesco Bazzini, Paolo Toti, Giuseppe Buonocore
BACKGROUND: Prenatal conditions of enhanced oxidative stress (OS) linked to inflammation or hypoxia have been associated with impaired fetal growth and preterm delivery. Little is known regarding biomarkers of OS in the cord blood of preterm infants and placental histological patterns. OBJECTIVES: To test the hypothesis that placental lesions indicating chorioamnionitis (CA) or vascular underperfusion (VU) are associated with increased OS in the offspring. METHODS: 120 neonates born below 29(+6) weeks of gestational age (GA) were enrolled...
October 2016: Placenta
D R Kommers, Mac Broeren, P Andriessen, S G Oei, L Feijs, S Bambang Oetomo
AIM: This study assessed the feasibility and obtrusiveness of measuring salivary oxytocin in preterm infants receiving Kangaroo care, because this is a period of maximal bonding or co-regulation. We also analysed possible influential determinants, including maternal oxytocin. METHODS: The saliva of preterm infants and their mothers was collected prior to, and during, Kangaroo care using cotton swabs and pooled into vials until sufficient volumes were obtained to measure oxytocin levels using a radioimmunoassay...
September 26, 2016: Acta Paediatrica
Andrew J McArdle, James Webbe, Kathleen Sim, Graham Parrish, Clive Hoggart, Yifei Wang, J Simon Kroll, Sunit Godambe, Aubrey J Cunnington
Carboxyhemoglobin levels in blood reflect endogenous carbon monoxide production and are often measured during routine blood gas analysis. Endogenous carbon monoxide production has been reported to be increased during sepsis, but carboxyhemoglobin levels have not been thoroughly evaluated as a biomarker of sepsis. We sought to determine whether carboxyhemoglobin levels were elevated during sepsis in a high risk population of premature neonates. We conducted a retrospective cohort study of 30 infants in two neonatal intensive care units using electronic medical and laboratory records...
2016: PloS One
Dawid Szpecht, Katarzyna Wiak, Anna Braszak, Marta Szymankiewicz, Janusz Gadzinowski
Proinflammatory cytokines are essential mediators and indicators of an inflammatory process occurring in the body. Their physiological role is to stimulate the immune response, yet their excessive propagation and interaction with cells outside the immune system may be linked to the risk of organ damage. This is specifically important in the case of immature tissues of fetuses and prematurely born infants. Analysis of the concentrations of specific cytokines in different compartments makes it possible to assess the risk of premature birth, preterm rupture of the membranes, and to determine an existing intrauterine infection...
August 19, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
R J Madoglio, L M S S Rugolo, C S Kurokawa, M P A Sá, J C Lyra, L C O Antunes
Although oxidative stress and inflammation are important mechanisms in the pathophysiology of preeclampsia and preterm diseases, their contribution to the respiratory prognosis of premature infants of hypertensive mothers is not known. Our objective was to determine the levels of oxidative stress and inflammation markers in the airways of premature infants born to hypertensive and normotensive mothers, in the first 72 h of life, and to investigate whether they are predictors of bronchopulmonary dysplasia (BPD)/death...
August 1, 2016: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
Christine Henriksen, Astrid N Almaas, Ane C Westerberg, Christian A Drevon, Per O Iversen, Britt Nakstad
UNLABELLED: The study is a follow-up of a randomized, double-blinded, placebo-controlled trial of supplementation with docosahexaenoic acid (DHA) and arachidonic acid (AA) to 129 very low birth weight (VLBW; birth weight <1500 g) infants fed human milk. The main hypothesis was that supplementation would affect growth, metabolic markers, and cognitive function. The secondary aim was to describe predictors of metabolic markers and cognitive status at follow-up. Ninety-eight children met for 8-year follow-up with anthropometric measures, blood biomarkers, and cognitive testing...
September 2016: European Journal of Pediatrics
Mariane Bertagnolli, Anne Monique Nuyt, Bernard Thébaud, Thuy Mai Luu
: SummaryPreterm birth is associated with alteration of the vascular tree that can result in disease states such as bronchopulmonary dysplasia and retinopathy of prematurity during the neonatal period and emphysema and hypertension in adulthood. Studies have suggested a potential role for endothelial progenitor cells in the pathophysiology of prematurity-related complications involving blood vessels; however, this knowledge has never been synthesized. We conducted a systematic review of the published data to examine the characteristics of endothelial progenitor cells in relation to preterm birth in humans...
July 27, 2016: Stem Cells Translational Medicine
Ravi S Misra, Soumyaroop Bhattacharya, Heidie L Huyck, Jyh-Chiang E Wang, Christopher G Slaunwhite, Sharleen L Slaunwhite, Terry R Wightman, Shelley Secor-Socha, Sara K Misra, Timothy P Bushnell, Ann-Marie Reynolds, Rita M Ryan, Sally A Quataert, Gloria S Pryhuber, Thomas J Mariani
RATIONALE: Emerging data suggest an important role for T lymphocytes in the pathogenesis of chronic lung disease in preterm infants. Comprehensive assessment of the lymphocyte transcriptome may identify biomarkers and mechanisms of disease. METHODS: Small volume peripheral blood samples were collected from premature infants enrolled with consent in the Prematurity and Respiratory Outcomes Program (PROP), at the time of discharge from the hospital. Blood samples were collected at two sites and shipped to a central laboratory for processing...
October 2016: Journal of Immunological Methods
Kelly Mercier, Susan McRitchie, Wimal Pathmasiri, Andrew Novokhatny, Rajesh Koralkar, David Askenazi, Patrick D Brophy, Susan Sumner
BACKGROUND: Acute kidney injury (AKI) staging has been developed in the adult and pediatric populations, but these do not yet exist for the neonatal population. Metabolomics was utilized to uncover biomarkers of normal and AKI-associated renal function in preterm infants. The study comprised 20 preterm infants with an AKI diagnosis who were matched by gestational age and gender to 20 infants without an AKI diagnosis. METHODS: Urine samples from pre-term newborn infants collected on day 2 of life were analyzed using broad-spectrum nuclear magnetic resonance (NMR) metabolomics...
July 19, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Livio Provenzi, Lorenzo Giusti, Monica Fumagalli, Hilarj Tasca, Francesca Ciceri, Giorgia Menozzi, Fabio Mosca, Francesco Morandi, Renato Borgatti, Rosario Montirosso
Very preterm (VPT) infants are hospitalized in the Neonatal Intensive Care Unit (NICU) and exposed to varying levels of skin-breaking procedures (pain-related stress), even in absence of severe clinical conditions. Repeated and prolonged pain exposure may alter hypothalamic-pituitary-adrenal (HPA) axis reactivity in VPT infants. During the post-discharge period, altered HPA axis reactivity has been documented in response to non-social stressors, using salivary cortisol as a biomarker. However, little is known about the effects of NICU pain-related stress on subsequent HPA axis reactivity to socio-emotional stress in infants...
October 2016: Psychoneuroendocrinology
Ravi Mangal Patel, Erin K Meyer, John A Widness
Red blood cell (RBC) transfusion is a common and lifesaving therapy for anemic neonates and infants, particularly among those born prematurely or undergoing surgery. However, evidence-based indications for when to administer RBCs and adverse effects of RBC transfusion on important outcomes including necrotizing enterocolitis, survival, and long-term neurodevelopmental impairment remain uncertain. In addition, blood-banking practices for preterm and term neonates and infants have been largely developed using studies from older children and adults...
October 2016: Transfusion Medicine Reviews
Angelica Dessì, Roberta Pintus, Silvia Marras, Flaminia Cesare Marincola, Anna De Magistris, Vassilios Fanos
INTRODUCTION: Necrotizing enterocolitis (NEC) is a serious inflammation of the bowel that most often affects premature infants. The exact cause of NEC is still poorly understood but investigators believe that these different factors can play an important role: prematurity and immaturity of the intestine of the preterm newborns, differences in the intestinal bacterial colonization and an abnormal immune response. Since the early symptoms of NEC are often rather non-specific, the diagnosis of NEC can be difficult...
July 22, 2016: Expert Review of Molecular Diagnostics
Anita Bhandari, Christopher Carroll, Vineet Bhandari
It has been suggested that pediatric acute respiratory distress syndrome (PARDS) may be a different entity, vis-à-vis adult acute respiratory distress syndrome (ARDS), based on its epidemiology and outcomes. A more pediatric-specific definition of PARDS to include the subgroup of patients with underlying lung (and heart) disease has been proposed. Epidemiological data suggest that up to 13% of the children with ARDS have a history of prematurity and/or underlying chronic lung disease. However, the specific contribution of bronchopulmonary dysplasia (BPD), the most common chronic lung disease in infants, to the development of PARDS is not known...
2016: Frontiers in Pediatrics
Rebecca Caesar, Roslyn N Boyd, Paul Colditz, Giovani Cioni, Robert S Ware, Kaye Salthouse, Julie Doherty, Maxine Jackson, Leanne Matthews, Tom Hurley, Anthony Morosini, Clare Thomas, Laxmi Camadoo, Erica Baer
INTRODUCTION: Over 80% of very preterm (<32 weeks) and very low birthweight (<1500 g) infants will have either typical development (TD) or mild developmental delay (MDD) in multiple domains. As differentiation between TD and MDD can be difficult, infants with MDD often miss opportunities for intervention. For many clinicians, the ongoing challenge is early detection of MDD without over servicing the population. This study aims to: (1) identify early clinical biomarkers for use in this population to predict and differentiate between TD and MDD at 24 months corrected age...
2016: BMJ Open
Lili He, Nehal A Parikh
Nearly 10% of premature infants are born very preterm at 32weeks gestational age or less in the United States. Up to 35% of these very preterm survivors are at risk for cognitive and behavioral deficits. Yet accurate diagnosis of such deficits cannot be made until early childhood. Resting-state fMRI provides noninvasive assessment of the brain's functional networks and is a promising tool for early prognostication. In our present study, we enrolled a cohort of very preterm infants soon after birth and performed resting state fMRI at 32, 39 and additionally at 52weeks postmenstrual age...
July 2016: Early Human Development
Min Zhang, Xinting Zhang, Junying Zhang
BACKGROUND: Necrotizing enterocolitis (NEC) is the most commonly acquired gastrointestinal emergency among neonates. However, the present diagnosis methods of NEC are non-specific and do not provide sufficient insight into the early discrimination. Fecal calprotectin (FC) is an intestinal-specific biomarker and has been used to differentiate different intestinal diseases. The aim of this study is to evaluate the value of FC as an early indicator for the identification of NEC. METHODS: A total of 40 preterm infants were recruited, including 17 cases with NEC and 23 normal preterm infants...
2016: Clinical Laboratory
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