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https://www.readbyqxmd.com/read/29671605/effects-of-budesonide-and-surfactant-in-preterm-fetal-sheep
#1
T Brett Kothe, Emily Royse, Matthew W Kemp, Augusto F Schmidt, Fabrizio Salomone, Masatoshi Saito, Haruo Usuda, Shimpei Watanabe, Gabrielle C Musk, Alan H Jobe, Noah H Hillman
BACKGROUND: Mechanical ventilation causes lung injury and systemic inflammatory responses in preterm sheep, and is associated with bronchopulmonary dysplasia (BPD) in preterm infants. Budesonide added to surfactant decreased BPD by 20% in infants. OBJECTIVE: Determine the effects of budesonide and surfactant on injury from high tidal volume (VT) ventilation in preterm lambs. METHODS: Ewes at 125 {plus minus} 1 day GA had fetal surgery to expose fetal head and chest with placental circulation intact...
April 19, 2018: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/29574785/resident-alveolar-macrophages-are-master-regulators-of-arrested-alveolarization-in-experimental-bronchopulmonary-dysplasia
#2
Tatiana V Kalymbetova, Balachandar Selvakumar, José Alberto Rodríguez-Castillo, Miša Gunjak, Christina Malainou, Miriam Ruth Heindl, Alena Moiseenko, Cho-Ming Chao, István Vadász, Konstantin Mayer, Jürgen Lohmeyer, Saverio Bellusci, Eva Böttcher-Friebertshäuser, Werner Seeger, Susanne Herold, Rory E Morty
Trophic functions for macrophages are emerging as key mediators of developmental processes; including bone, vessel, and mammary gland development. Yolk sac-derived macrophages mature in the distal lung shortly after birth. Myeloid-lineage macrophages are recruited to the lung and are activated under pathological conditions. These pathological conditions include bronchopulmonary dysplasia (BPD), a common complication of preterm birth characterized by stunted lung development, where formation of alveoli is blocked...
March 25, 2018: Journal of Pathology
https://www.readbyqxmd.com/read/29526138/comparison-between-two-doses-of-betamethasone-administration-with-12-hours-vs-24-hours-intervals-on-prevention-of-respiratory-distress-syndrome-a-randomised-trial
#3
Maryam Kashanian, Nooshin Eshraghi, Narges Sheikhansari, Arash Bordbar, Elahehsadat Khatami
The purpose of the present study was to compare the effect of a two-dose administration of betamethasone with 12 hours interval vs. 24 hours interval on neonatal respiratory distress syndrome (RDS). The study was performed as a randomised clinical trial on 201 pregnant women with a gestational age of 26-34 weeks. In one group 12 mg of betamethasone every 12 hours for two doses and in the other group 12 mg of betamethasone every 24 hours for two doses were prescribed intramuscularly. There were no significant differences between the two groups according to maternal age, parity, gravidity, BMI, neonatal sex, need to surfactant, NICU admission, NICU stay, neonatal death, neonatal sepsis and Apgar score at minutes 1 and 5, but the gestational age at the beginning of the study and delivery receiving complete course of betamethasone and neonatal weight were lower in 24 hours group...
March 12, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29505915/the-influence-of-betamethasone-on-fetal-heart-rate-variability-obtained-by-non-invasive-fetal-electrocardiogram-recordings
#4
Kim M J Verdurmen, Guy J J Warmerdam, Carlijn Lempersz, Alexandra D J Hulsenboom, Joris Renckens, Jeanne P Dieleman, Rik Vullings, Judith O E H van Laar, S Guid Oei
BACKGROUND: Betamethasone is widely used to enhance fetal lung maturation in case of threatened preterm labour. Fetal heart rate variability is one of the most important parameters to assess in fetal monitoring, since it is a reliable indicator for fetal distress. AIM: To describe the effect of betamethasone on fetal heart rate variability, by applying spectral analysis on non-invasive fetal electrocardiogram recordings. STUDY DESIGN: Prospective cohort study...
March 2, 2018: Early Human Development
https://www.readbyqxmd.com/read/29460323/clinical-guidelines-for-prevention-and-management-of-preterm-birth-a-systematic-review
#5
Nancy Medley, Borna Poljak, Silvia Mammarella, Zarko Alfirevic
BACKGROUND: Clinical practice guidelines (CPG) endorse multiple strategies to prevent or manage preterm birth (PTB). OBJECTIVES: To summarise CPG recommendations for PTB and identify areas of international consensus. SEARCH STRATEGY: In June 2017 we searched for all CPG relavant to PTB without language restrictions. SELECTION CRITERIA: CPG were eligible if the following criteria were met. i.The guideline was published or current from June 2013...
February 20, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29421328/the-effect-of-a-single-anti-vascular-endothelial-growth-factor-injection-on-neonatal-growth-and-organ-development-in-vivo-study
#6
Sina Khalili, Yulia Shifrin, Jingyi Pan, Jaques Belik, Kamiar Mireskandari
Retinopathy of prematurity (ROP) is one of the leading causes of blindness in preterm Infants. Anti-vascular endothelial growth factor (VEGF) is emerging as a promising treatment, but there is insufficient evidence on their safety. We investigate the effect of systemic anti-VEGF in rat pups with equivalent maturity to a 32 week neonate. A single dose of either anti-VEGF antibody (n = 7) or saline (control group; n = 6) was administered to newborn rats intra-peritoneally on the first day of life. 14 days' post treatment, the serum concentration of anti-VEGF was measured and the brain, lung, heart, kidney and liver were harvested and weighed...
April 2018: Experimental Eye Research
https://www.readbyqxmd.com/read/29408744/the-use-of-antenatal-fetal-magnetic-resonance-imaging-in-the-assessment-of-patients-at-high-risk-of-preterm-birth
#7
REVIEW
L Story, J Hutter, T Zhang, A H Shennan, M Rutherford
Preterm birth, defined as birth occurring prior to 37 weeks gestation is a common obstetric complication affecting 8% of pregnancies and is associated with significant morbidity and mortality. Infection/inflammation has been implicated in both the aetiology of preterm birth itself and associated neonatal pulmonary and neurological morbidity. Treatment options are currently limited to prolongation of the pregnancy using cervical cerclage, pessaries or progesterone or administration of drugs including steroids to promote lung maturity and neuroprotective agents such as magnesium sulphate, the timing of which are highly critical...
March 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29356563/oxytocin-receptor-antagonist-atosiban-in-the-threat-of-preterm-birth-does-it-have-any-effect-on-breastfeeding-in-the-term-newborn
#8
Lucía López Gómez, Miguel A Marín Gabriel, Begoña Encinas, Juan J de la Cruz Troca, Belén Rodríguez Marrodán
AIM: Oxytocin is a hormone involved in the mechanism of breastfeeding, uterine contractions, and social relationships. Atosiban (competitive oxytocin antagonist) is one of the most commonly used tocolytics for the threat of preterm labor in Europe. The aim of this study is to determinate if the administration of atosiban has any influence in the type of feeding in the term newborn at discharge. The secondary objective is to verify its effectiveness for the prevention of preterm delivery and in the possibility of applying treatment to complete lung maturation...
March 2018: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
https://www.readbyqxmd.com/read/29337448/-obstetrics
#9
Véronique Othenin-Girard, Noémie Bouchet, Riccardo E Pfister, Olivier Baud, Nicole Jastrow, Agnès Ditisheim, Nadia Berkane, Begoña Martinez De Tejada
During the past year, we have renewed interest in old well-known problems. New studies and guidelines have been issued about lung maturation in cases of preterm delivery after 37 weeks of gestation. Short term benefits have been proven but the number of cases needed to treat to prevent one case of respiratory complications is high and with possible neurological long-term effects. Also, several studies have shown the benefits of including the ultrasound measurement of the inferior segment of the uterus in order to attempt vaginal delivery after caesarean section with the lowest risk for uterine rupture, while others studies have shown the best procedure to close the uterus during cesarean section...
January 10, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29274832/extremely-preterm-fetal-sheep-lung-responses-to-antenatal-steroids-and-inflammation
#10
Kevin Visconti, Paranthaman Senthamaraikannan, Matthew W Kemp, Masatoshi Saito, Boris W Kramer, John P Newnham, Alan H Jobe, Suhas G Kallapur
BACKGROUND: The efficacy of antenatal steroids for fetal lung maturation in the periviable period is not fully understood. OBJECTIVE: We sought to determine the lung maturational effects of antenatal steroids and inflammation in early gestation sheep fetuses, similar to the periviable period in human beings. STUDY DESIGN: Date-mated ewes with singleton fetuses were randomly assigned to 1 of 4 treatment groups (n = 8/group): (1) maternal intramuscular injection of betamethasone; (2) intraamniotic lipopolysaccharide; (3) betamethasone + lipopolysaccharide; and (4) intraamniotic + intramuscular saline (controls)...
March 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29229321/the-role-of-aspirin-heparin-and-other-interventions-in-the-prevention-and-treatment-of-fetal-growth-restriction
#11
REVIEW
Katie M Groom, Anna L David
Fetal growth restriction and related placental pathologies such as preeclampsia, stillbirth, and placental abruption are believed to arise in early pregnancy when inadequate remodeling of the maternal spiral arteries leads to persistent high-resistance and low-flow uteroplacental circulation. The consequent placental ischaemia, reperfusion injury, and oxidative stress are associated with an imbalance in angiogenic/antiangiogenic factors. Many interventions have centered on the prevention and/or treatment of preeclampsia with results pertaining to fetal growth restriction and small-for-gestational-age pregnancy often included as secondary outcomes because of the common pathophysiology...
February 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29191292/long-term-childhood-outcomes-after-interventions-for-prevention-and-management-of-preterm-birth
#12
REVIEW
Sarah R Murray, Sarah J Stock, Jane E Norman
Globally, preterm birth rates are rising and have a significant impact on neonatal morbidity and mortality. Preterm birth remains difficult to prevent and a number of strategies for preterm birth prevention (progesterone, cervical pessaries, cervical cerclage, tocolytics, and antibiotics) have been identified. While some of these show more promise, there is a paucity of evidence regarding the long-term effects of these strategies on childhood outcomes. Strategies used to improve the health of babies if born preterm, such as antenatal magnesium sulfate for fetal neuroprotection and antenatal corticosteroids for fetal lung maturation, show evidence of short-term benefit but lack large-scale follow-up data of long-term childhood outcomes...
December 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/29181000/prenatal-administration-of-betamethasone-causes-changes-in-the-t-cell-receptor-repertoire-influencing-development-of-autoimmunity
#13
Anna Gieras, Christina Gehbauer, David Perna-Barrull, Jan Broder Engler, Ines Diepenbruck, Laura Glau, Simon A Joosse, Nora Kersten, Stefanie Klinge, Hans-Willi Mittrücker, Manuel A Friese, Marta Vives-Pi, Eva Tolosa
Prenatal glucocorticoids are routinely administered to pregnant women at risk of preterm delivery in order to improve survival of the newborn. However, in half of the cases, birth occurs outside the beneficial period for lung development. Glucocorticoids are potent immune modulators and cause apoptotic death of immature T cells, and we have previously shown that prenatal betamethasone treatment at doses eliciting lung maturation induce profound thymocyte apoptosis in the offspring. Here, we asked if there are long-term consequences on the offspring's immunity after this treatment...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/29138038/low-dose-betamethasone-acetate-for-fetal-lung-maturation-in-preterm-sheep
#14
Augusto F Schmidt, Matthew W Kemp, Judith Rittenschober-Böhm, Paranthaman S Kannan, Haruo Usuda, Masatoshi Saito, Lucy Furfaro, Shimpei Watanabe, Sarah Stock, Boris W Kramer, John P Newnham, Suhas G Kallapur, Alan H Jobe
BACKGROUND: Antenatal steroids are standard of care for women who are at risk of preterm delivery; however, antenatal steroid dosing and formulation have not been evaluated adequately. The standard clinical 2-dose treatment with betamethasone-acetate+betamethasone-phosphate is more effective than 2 doses of betamethasone-phosphate for the induction of lung maturation in preterm fetal sheep. We hypothesized that the slowly released betamethasone-acetate component induces similar lung maturation to betamethasone-phosphate+betamethasone-acetate with decreased dose and fetal exposure...
January 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29138031/mortality-and-pulmonary-outcomes-of-extremely-preterm-infants-exposed-to-antenatal-corticosteroids
#15
Colm P Travers, Waldemar A Carlo, Scott A McDonald, Abhik Das, Edward F Bell, Namasivayam Ambalavanan, Alan H Jobe, Ronald N Goldberg, Carl T D'Angio, Barbara J Stoll, Seetha Shankaran, Abbot R Laptook, Barbara Schmidt, Michele C Walsh, Pablo J Sánchez, M Bethany Ball, Ellen C Hale, Nancy S Newman, Rosemary D Higgins
BACKGROUND: Antenatal corticosteroids are given primarily to induce fetal lung maturation but results from meta-analyses of randomized controlled trials have not shown mortality or pulmonary benefits for extremely preterm infants although these are the infants most at risk of mortality and pulmonary disease. OBJECTIVE: We sought to determine if exposure to antenatal corticosteroids is associated with a lower rate of death and pulmonary morbidities by 36 weeks' postmenstrual age...
January 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29129516/is-there-a-potential-link-between-vitamin-d-and-pulmonary-morbidities-in-preterm-infants
#16
Yang Yang, Yun Feng, Xu Chen, Xiao-Nan Mao, Jing-Han Zhang, Li Zhao, You-Yan Zhao, Rui Cheng
BACKGROUND: There hasn't been conclusive proof about the association between vitamin D and pulmonary morbidities of prematurity. METHODS: 106 preterm infants were retrospectively included into this study. Clinical data and blood samples of all the patients were collected within 24 h of admission. RESULTS: (1) Respiratory distress syndrome (RDS) patients were mainly concentrated in "≤30 weeks" stage when compared with other two gestational age groups...
November 9, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29104474/association-of-surfactant-protein-with-expression-of-hoxa5-and-hoxb5-in-rabbit-fetal-lung
#17
Sung-Hoon Chung, Chong-Woo Bae
Hox genes regulate organ formation and identity of the embryo, and expressed in specific temporo-spatial patterns in the developing embryo. We compared the expression levels of the Hoxa5 , Hoxb5 , surfactant protein (SP)-A , and SP-B genes in immature and mature rabbit fetal lung tissues, and to uncover roles for Hoxa5, Hoxb5, SP-A, and SP-B. Cesarean sections were performed after rabbits were divided into two groups of 30-31 days of gestation (term group, n = 24) and 26-27 days of gestation (preterm group, n = 24)...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/29079144/society-for-maternal-fetal-medicine-smfm-consult-series-44-management-of-bleeding-in-the-late-preterm-period
#18
Cynthia Gyamfi-Bannerman
Third-trimester bleeding is a common complication arising from a variety of etiologies, some of which may initially present in the late preterm period. Previous management recommendations have not been specific to this gestational age window, which carries a potentially lower threshold for delivery. The purpose of this document is to provide guidance on management of late preterm (34 0/7-36 6/7 weeks of gestation) vaginal bleeding. The following are Society for Maternal-Fetal Medicine recommendations: (1) we recommend delivery at 36-37 6/7 weeks of gestation for stable women with placenta previa without bleeding or other obstetric complications (GRADE 1B); (2) we do not recommend routine cervical length screening for women with placenta previa in the late preterm period due to a lack of data on an appropriate management strategy (GRADE 2C); (3) we recommend delivery between 34 and 37 weeks of gestation for stable women with placenta accreta (GRADE 1B); (4) we recommend delivery between 34 and 37 weeks of gestation for stable women with vasa previa (GRADE 1B); (5) we recommend that in women with active hemorrhage in the late preterm period, delivery should not be delayed for the purpose of administering antenatal corticosteroids (GRADE 1B); (6) we recommend that fetal lung maturity testing should not be used to guide management in the late preterm period when an indication for delivery is present (GRADE 1B); and (7) we recommend that antenatal corticosteroids should be administered to women who are eligible and are managed expectantly if delivery is likely within 7 days, the gestational age is between 34 0/7 and 36 6/7 weeks of gestation, and antenatal corticosteroids have not previously been administered (GRADE 1A)...
January 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29022513/discrepancies-in-animal-models-of-preterm-birth
#19
Clarence R Manuel, Charles R Ashby, Sandra E Reznik
BACKGROUND: Preterm birth (PTB) is a multifactorial syndrome occurring before the 37th week of full-term pregnancy [1]. Babies delivered preterm experience short-term and long-term complications affecting multiple organ systems, and serious maternal complications include hemorrhage and infection. Each year, an estimated 15 million babies are born preterm, and complications from prematurity are the leading cause of death among children up to 5 years of age [2]. With another increase in PTB rates over the last several years, the United States continues to have the highest incidence of any industrialized country [3]...
October 12, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28920101/potential-therapeutic-targets-in-nrf2-dependent-protection-against-neonatal-respiratory-distress-disease-predicted-by-cdna-microarray-analysis-and-bioinformatics-tools
#20
Hye-Youn Cho, Xuting Wang, Jianying Li, Douglas A Bell, Steven R Kleeberger
Hyperoxia exposure of newborn rodents has served as a model for bronchopulmonary dysplasia (BPD) phenotypes found in a sub-population of human premature infants. We previously demonstrated that Nrf2 modulates molecular events during saccular-to-alveolar lung maturation and also has a protective role in the pathogenesis of hyperoxia-induced acute lung injury, mortality, arrest of saccular-to-alveolar transition, and lung injury, using Nrf2 -deficient and wild-type neonate mice. In this review, we describe how whole-genome transcriptome analyses can identify the means through which Nrf2 transcriptionally modulates organ injury and morphology, cellular growth/proliferation, vasculature development, and immune response during BPD-like pathogenesis...
December 2016: Current Opinion in Toxicology
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