Preterm Infant Skin Structure Is Qualitatively and Quantitatively Different From That of Term Newborns

Background The immature skin of preterm infants is uniquely vulnerable to pressure and chemical injury. We sought to qualitatively and quantitatively describe the histopathologic patterns of skin development in preterm infants. Methods Autopsy skin samples were examined for 48 liveborn preterm infants born at 18+ to 36 weeks, and control groups of term neonates and older infants/children. Quantitative variables included thickness of the stratum corneum, epidermis, and dermis. Qualitative features included stratum corneum, rete ridges, and hair follicles. Results Patterns of maturation were reproducible. Compact keratin appeared beginning at 21–22 weeks. Basketweave keratin appeared first around hair follicles, and then became more generalized from ∼28 weeks corrected gestational age (CGA) onward. Rete ridges began to appear at ∼30 weeks. Epidemal and dermal thickness increased with age. Infants who survived ≤7 days had thicker dermis than those who survived longer, even adjusted for CGA. Conclusions Skin development in preterm infants has reproducible milestones. Significant structural changes occurring around 28–30 weeks may improve barrier function, with implications for use of topical compounds such as chlorhexidine. The findings also highlight challenges in evaluating pressure injuries in preterm infants, and postnatal changes in skin parameters.

Download Full-text

Serum Endocan, Neuron-Specific Enolase and Ischemia-Modified Albumin Levels in Newborns with Partial Blood Exchange Transfusion

Combinatorial Chemistry & High Throughput Screening ◽

10.2174/1386207323999200820163525 ◽

2020 ◽

Vol 23 ◽

Author(s):

Erbu Yarci ◽

Cuneyt Tayman ◽

Ufuk Cakir ◽

Utku Serkant

Keyword(s):

Exchange Transfusion ◽

Neuronal Damage ◽

Neuron Specific Enolase ◽

Endothelial Damage ◽

Control Group ◽

Control Groups ◽

Term Neonates ◽

Blood Exchange ◽

Blood Exchange Transfusion ◽

And Control

Background:: Hyperviscosity of blood secondary to polycythemia results in increased resistance to blood flow and decrease in delivery of oxygen. Objective:: To evaluate whether serum endocan, NSE and IMA levels can be compared in terms of endothelial injury/ dysfunction and neuronal damage in term neonates with polycythemia who underwent PET. Methods:: 38 symptomatic polycythemic newborns having PET and 38 healthy newborns were included in the study. Blood samples for endocan, NSE and IMA were taken at only postnatal 24 hours of age in the control group and in polycytemia group just before PET, at 24 and 72 hours after PET. Results:: The polycythemia group had higher serum endocan(1073,4 ± 644,8 vs. 378,8 ± 95,9ng/ml; p<0.05), IMA(1,32 ± 0,34 vs.0,601 ± 0,095absorbance unit; p<0.05) and NSE(44,7 ± 4,3 vs. 26,91 ± 7,12μg/l; p<0.05) levels than control group before the PET procedure. At 24 hours after PET, IMA(0,656 ± 0,07 vs. 0,601 ± 0,095absorbance unit; p<0.05) and endocan(510,9 ± 228,6 vs. 378,8 ± 95,9ng/ml; p<0.05) levels were closer to the control group, being still statistically significant higher. NSE levels decreased to control group levels having no difference between the PET and control groups at 24 hours after PET (28,98 ± 6,5 vs. 26,91 ± 7,12μg/l; p>0.05). At 72 hours after PET the polycythemia and control groups did not differ statistically for IMA, endocan and NSE levels (p>0.05). Conclusion:: Serum endocan and IMA levels can be used as a biomarker for endothelial damage / dysfunction and tissue hypoxia in infants with symptomatic polycytemia.

Download Full-text

Distinguishing and Biochemical Phenotype Analysis of Epilepsy Patients Using a Novel Serum Profiling Platform

Brain Sciences ◽

10.3390/brainsci10080504 ◽

2020 ◽

Vol 10 (8) ◽

pp. 504

Author(s):

Jay S. Hanas ◽

James R. S. Hocker ◽

Christian Vannarath ◽

Betcy Evangeline ◽

Vasudevan Prabhakaran ◽

...

Keyword(s):

Patient Group ◽

Structural Changes ◽

Control Group ◽

Ionization Mass ◽

Epilepsy Patient ◽

Control Groups ◽

Serum Profiling ◽

Phenotype Analysis ◽

Symptomatic Epilepsy ◽

And Control

Diagnosis of non-symptomatic epilepsy includes a history of two or more seizures and brain imaging to rule out structural changes like trauma, tumor, infection. Such analysis can be problematic. It is important to develop capabilities to help identify non-symptomatic epilepsy in order to better monitor and understand the condition. This understanding could lead to improved diagnostics and therapeutics. Serum mass peak profiling was performed using electrospray ionization mass spectrometry (ESI-MS). A comparison of sera mass peaks between epilepsy and control groups was performed via leave one [serum sample] out cross-validation (LOOCV). MS/MS peptide analysis was performed on serum mass peaks to compare epilepsy patient and control groups. LOOCV identified significant differences between the epilepsy patient group and control group (p = 10−22). This value became non-significant (p = 0.10) when the samples were randomly allocated between the groups and reanalyzed by LOOCV. LOOCV was thus able to distinguish a non-symptomatic epilepsy patient group from a control group based on physiological differences and underlying phenotype. MS/MS was able to identify potential peptide/protein changes involved in this epilepsy versus control comparison, with 70% of the top 100 proteins indicating overall neurologic function. Specifically, peptide/protein sera changes suggested neuro-inflammatory, seizure, ion-channel, synapse, and autoimmune pathways changing between epilepsy patients and controls.

Download Full-text

Time to regain birth weight - a marker to predict the severity of retinopathy of prematurity?

BMC Pediatrics ◽

10.1186/s12887-021-03027-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ajay Anvekar ◽

Sam Athikarisamy ◽

Shripada Rao ◽

Andy Gill ◽

Elizabeth Nathan ◽

...

Keyword(s):

Preterm Infants ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Oxygen Therapy ◽

Control Groups ◽

Gestational Age At Birth ◽

And Control ◽

Type 1 Rop ◽

Age At Birth

Abstract Background Poor weight gain in the first few weeks of life has been studied as a predictor of retinopathy of prematurity (ROP). Our aim was to assess whether time taken to regain birthweight (BW) be used as an additional marker to identify infants with type 1 ROP. Methods In this retrospective study, preterm infants (< 27 weeks gestational age at birth) born during the period from 1/1/2010–31/12/2015 at a tertiary neonatal intensive care unit in Australia were included. Twenty-seven preterm infants with Type 1 ROP were identified. Controls (No ROP or ROP other than type 1) were matched with cases on gestational age at birth and BW (1:4 ratio). Data were collected from the database and medical records. Results The median (IQR) gestational age for Type 1 ROP and control groups were 24 (24–26) and 25 (24–26) weeks respectively and median (IQR) BW for Type 1 ROP and control groups were 675 (635–810) and 773 (666–884) grams respectively. Preterm infants with Type 1 ROP were more likely to be small for gestational age (SGA) (18.5% vs 3.7%, p = 0.015) and had increased weeks on oxygen therapy (median 11.9 vs 9.1, p = 0.028). Time to regain BW was longer in preterm infants with type 1 ROP than controls but did not reach statistical significance (median 9 vs 7 days, OR 1.08, 95% CI 1.00–1.17, p = 0.059) adjusted for SGA and duration of oxygen therapy. The area under the curve from the time to regain BW model with adjustment for SGA and duration of oxygen therapy was 0.73 (95% CI 0.62–0.83). Conclusion We hypothesize that time to regain BW has potential to aid prediction of Type 1 ROP and this warrants further investigation in a larger prospective study.

Download Full-text

The science of the COAG coordinated care trials

Australian Journal of Primary Health ◽

10.1071/py03033 ◽

2003 ◽

Vol 9 (3) ◽

pp. 109 ◽

Cited By ~ 4

Author(s):

Peter W Harvey ◽

Peter J McDonald

Keyword(s):

Structural Changes ◽

Service Providers ◽

Health Care Systems ◽

Scientific Research ◽

South Australia ◽

Organisational Change ◽

Health Service Delivery ◽

Coordinated Care ◽

Control Groups ◽

And Control

Objectives: To explicate the organisational change agenda of the COAG coordinated care trials within the Australian health system and to illuminate the role of science in this process. Methods and Results: This article briefly outlines the COAG coordinated care trial aims and the effect of the trial as a change initiative in rural South Australia. It is proposed that although the formal trial outcomes are still not clear, the trial had significant impact upon health service delivery in some sites. The trial involved standard research methods with control and intervention groups and with key hypotheses being tested to compare the costs and service utilization profile of intervention and control groups. Formal results indicate that costs were not significantly different between intervention and control groups across all sites, but that the trial, nonetheless, had a powerful impact on the attitude and behaviours of service providers in the rural trial on Eyre Peninsula in particular. Some of the key structural changes now in place are outlined. Conclusions: The COAG trial has had many and varied impacts upon those organisations and individual providers involved with it. It is argued here that since successive initiatives had been implemented before final evaluation results were published, other agendas were served by the trial apart from those of standard scientific research and hypothesis testing. That is, the main impact of the coordinated care trial in Eyre Region at least has been change by stealth, and not through scientific research and demonstration. Implications: The COAG trials have set in train a series of structural and procedural changes in the methods of delivery and management of primary health care systems; changes that are embodied in the Enhanced Primary Care packages (EPC) and other initiatives recently introduced by the Commonwealth Government. These changes have occurred and are occurring across the system without formal evidence as to their efficacy, suggesting that other financial motives are driving these new approaches apart from the goal of improving health outcomes for consumers. Also, if science is to be used in this way to drive policy and procedural change ahead of actual outcome evidence, it is important that we examine the more subtle agendas of such research projects in future if the integrity of the scientific method is to be maintained. The occurrence of such phenomena questions the very foundation of scientific endeavour and weakens the application of scientific principles in the arena of social and political science.

Download Full-text

Early neonatal morbidities in late preterm compared to term neonates born in a tertiary care private hospital

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20200680 ◽

2020 ◽

Vol 7 (3) ◽

pp. 565

Author(s):

Yogesh P. Mehta ◽

Manjusha Bhicurao Naik ◽

Kinnera Putrevu

Keyword(s):

Preterm Infants ◽

Tertiary Care ◽

Full Term ◽

Late Preterm ◽

Term Infants ◽

Term Neonates ◽

Late Preterm Infants ◽

Increased Risk ◽

Preterm Babies ◽

Term Newborns

Background: Late preterm babies, born between 34 completed weeks of gestation through 36 weeks 6/7 gestation, tend to be physiologically less mature than term infants, subjecting them to an increased risk of developing various morbidities. Limited information is available regarding the current scenario in India. Therefore, the objective of this study was to understand and compare the early morbidities in late preterm newborns with those in full term babies in a tertiary hospital in India.Methods: The current prospective, observational study consisted of total 150 babies divided into two groups equally; late preterm neonates born between 34 and 36 weeks of gestation and full-term neonates. Weight (at birth, at 72 hours), heart rate, temperature and respiratory parameters were noted of all babies. The newborns were examined for respiratory morbidities, ability to breastfeed, hypoglycemia, hypothermia, neonatal jaundice and signs of sepsis. The need for resuscitation, admission to neonatal intensive care unit (NICU) and parenteral nutrition was also assessed. Data was expressed as mean±SD and was analyzed using the Student ‘t’ and Mann Whitney U tests.Results: The mean length and weight at birth in late preterm babies was significantly lesser than term newborns. Late preterm babies were found to have significantly higher incidence of complications like hyperbilirubinemia (62.7% vs 13.3%), respiratory morbidities (16% vs 4%), poor feeding, hypothermia, hypoglycemia, and sepsis compared to term newborns (p<0.01).Conclusions: Late preterm infants are at a higher risk than term infants for a number of neonatal complications. Initiatives imparting special care to late preterm infants are required in order to lower the morbidities endured by this population.

Download Full-text

Cue-Based Feeding and Short-Term Health Outcomes of Premature Infants in Newborn Intensive Care Units(NICU) : A None-Randomized Trial

10.21203/rs.3.rs-509074/v1 ◽

2021 ◽

Author(s):

samane Sefatbaqa ◽

Yadollah Zahedpasha ◽

Marzieh Hasanpour ◽

Karimollah Hajian Tilaki ◽

Mohammad Reza Zarkesh ◽

...

Keyword(s):

Intensive Care ◽

Health Outcomes ◽

Preterm Infants ◽

Control Group ◽

Phase Lag ◽

Control Groups ◽

Short Term ◽

The Mean ◽

Newborn Intensive Care ◽

And Control

Abstract Background: Feedings based on behavioral cues is a method relying on infants’ behavioral expressions of readiness to feed. The objective of this interventional study was to determine the effect of cue-based feeding on the short-term health outcomes of preterm infants.Methods: This quasi-experimental study utilized a historical or phase lag design. It involved 60 preterm infants admitted to an Iranian referral hospital’s Level III-Newborn Intensive Care Unit (NICU) from June 2018 until January 2019. The experimental group (n=30) received a three-step intervention of offering behavioral-cue-based oral (BCBO) feedings: Step 1 – One BCBO feeding every twelve hours for three days; Step 2 - Two BCBO feedings every 12 hours for three days; and Step 3 – All feedings as BCBO feedings for three days. The control group received standard care feedings. Group difference data were analyzed with SPSS version 16 using descriptive and inferential statistics.Results: The infants’ mean weight at time of discharge for the intervention and control groups were 1492.79 ± 21.65 gr and 1395.71 ± 17.61 gr (P = .003) respectively. The mean durations of achieving full oral feedings in the intervention and control groups were 17 ± 6 and 20 ± 11 days, respectively (P = .19). The mean frequencies of hypoxia were 1 ± 1.54 and 5 ± 9.31 respectively (P = .03) and of gavage feedings 725 ± 584 and 1846 ± 2097 respectively (P = .009). No apnea events were reported for the intervention group; the frequency of apnea in the control group was 1 ± 2.11 (P = .16).Conclusion: The findings indicate that cue-based feeding is beneficial for preterm infants. Therefore, it is recommended that nurses employ cue-based feeding in the NICU.Trial Registration: IRCT20170828035962N2. Registered, 27 /05/ 2018- Prospectively registered, https://www.irct.ir/trial/27024.

Download Full-text

A COMPARATIVE OBSERVATIONAL STUDY TO EVALUATE THE EFFECTIVENESS OF INTRAVENOUS IMMUNOGLOBULINS IN THE MANAGEMENT OF NEONATAL SEPSIS IN PRE-TERM AND TERM NEONATES

International Journal of Advanced Research ◽

10.21474/ijar01/13003 ◽

2021 ◽

Vol 9 (06) ◽

pp. 220-224

Author(s):

Mohd Fazil ◽

◽

Nabila Saher Faroza ◽

Amena Husna ◽

Ayesha Ghori ◽

...

Keyword(s):

Observational Study ◽

Hospital Stay ◽

Neonatal Sepsis ◽

Morbidity And Mortality ◽

Research Centre ◽

Control Group ◽

Study Group ◽

Control Groups ◽

Term Neonates ◽

And Control

Introduction: Neonatal sepsis is still one of the major causes of morbidity and mortality in neonates, effective adjunctive treatments such as addition of IVIG to standard antibiotic treatment is needed. Neonates conceived <32 weeks of gestation are immune deficient of immunoglobulins when compared to neonates conceived at full term. Aims and Objectives: This study has been attempted to assess and compare the effectiveness of IVIG in addition with antibiotics to improve the therapeutic consequence of NNS in preterm and term neonates. Materials and Methods: A prospective observational study was conducted, in which 80 neonates were enrolled. Both preterm and term neonates with sepsis were randomly assigned into study and control groups at neonatal intensive care unit, Owaisi Hospital & Research Centre,Hyderabad, India. Study-group was given IVIG in addition to standard treatment. The test group was treated only with the standard antibiotics. Results: In our study, both the study and control-groups were practically identical based on baseline characteristics. The addition of IVIG as an adjuctive therapy is effective in management of NNS as the study group is found to have less duration of hospital stay when compared to that of control group and was statistically significant. The mortality rate was also found to be less in study group and the difference between the two groups is found to be stastically significant. Conclusion: Low levels of immunoglobulins in preterm as well as in term neonates results in increased morbidity and mortality in NNS. Use of IVIG along with the antibiotics and other supportive therapy can improve the outcomes such as hospital stay and mortality.

Download Full-text

The effect of intensive fattening of bulls with a high-concentrate diet on ruminal mucosa – a morphometric study

Acta Veterinaria Brno ◽

10.2754/avb201180030275 ◽

2011 ◽

Vol 80 (3) ◽

pp. 275-279 ◽

Cited By ~ 7

Author(s):

Julius Černík ◽

Eva Štercová ◽

Jan Šterc ◽

Petr Fictum ◽

Jiří Luňáček ◽

...

Keyword(s):

Stratum Corneum ◽

Morphometric Analysis ◽

Experimental Period ◽

Lower Degree ◽

Morphometric Study ◽

Control Group ◽

Control Groups ◽

Veterinary Pathology ◽

And Control ◽

Experimental Group

The aim of the study was to identify the effect of fattening of experimental Simmental bulls (a total of 10 animals) with a high-concentrate diet on ruminal mucosa and dimensions of ruminal papillae, and to assess the intensity of keratinization of papillary epithelium. The experimental period lasted from weaning to slaughter (359 days). Histopathological and morphometric examinations of ruminal mucosa indicated that the ruminal papillae of bulls from the experimental group were better developed (long with a lower degree of keratinization) compared to the control group. Significant differences between the experimental and control groups were found in the length of ruminal papillae (p = 0.005), width of stratum corneum (p = 0.034) and degree of mucosal keratinization on the surface of ruminal papillae (p = 0.014). Conclusive results of morphometric analysis prove the facility of the use of morphometrics as a method useful for veterinary pathology, mainly for the accuracy of the histological diagnosis.

Download Full-text

What We Don't Know About Water Beds and Apneic Preterm Infants

PEDIATRICS ◽

10.1542/peds.68.2.306 ◽

1981 ◽

Vol 68 (2) ◽

pp. 306-307

Author(s):

Anneliese F. Korner

Keyword(s):

Preterm Infants ◽

Control Groups ◽

Per Se ◽

Apnea Of Prematurity ◽

And Control

In recent years, we undertook two studies1,2 that showed that gently oscillating water beds significantly reduced apnea in preterm infants diagnosed as having apnea of prematurity. In the first study, randomly assigned experimental and control groups were used; in the second study, each infant served as its own control on and off the water bed. With one exception, all infants experienced less apnea on the water bed. From these two studies, it was not clear whether it was the continuous, irregular oscillations of the water bed that reduced apnea or whether it was the water bed per se that produced this effect.

Download Full-text

Cue-based feeding and short-term health outcomes of premature infants in newborn intensive care units: a non-randomized trial

BMC Pediatrics ◽

10.1186/s12887-021-03077-1 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Sefatbaqa Samane ◽

Zahed Pasha Yadollah ◽

Hasanpour Marzieh ◽

Hajian - Tilaki Karimollah ◽

Zarkesh Mohammad Reza ◽

...

Keyword(s):

Intensive Care ◽

Health Outcomes ◽

Preterm Infants ◽

Control Group ◽

Phase Lag ◽

Control Groups ◽

Short Term ◽

The Mean ◽

Newborn Intensive Care ◽

And Control

Abstract Background Feedings based on behavioral cues is a method relying on infants’ behavioral expressions of readiness to feed. The objective of this interventional study was to determine the effect of cue-based feeding on the short-term health outcomes of preterm infants. Methods This quasi-experimental study utilized a historical or phase lag design. It involved 60 preterm infants admitted to an Iranian referral hospital’s Level III-Newborn Intensive Care Unit (NICU) from April 2017 until January 2018. The experimental group (n = 30) received a three-step intervention of offering behavioral-cue-based oral (BCBO) feedings: Step 1 – One BCBO feeding every 12 hours for 3 days; Step 2 - Two BCBO feedings every 12 h for 3 days; and Step 3 – All feedings as BCBO feedings for 3 days. The control group received standard care feedings. Group difference data were analyzed with SPSS version 16 using descriptive and inferential statistics. Results The infants’ mean weight at time of discharge for the intervention and control groups were 1492.79 ± 21.65 g and 1395.71 ± 17.61 g (P = .003) respectively. The mean durations of achieving full oral feedings in the intervention and control groups were 17 ± 6 and 20 ± 11 days, respectively (P = .19). The mean frequencies of hypoxia were 1 ± 1.54 and 5 ± 9.31 respectively (P = .03) and of gavage feedings 725 ± 584 and 1846 ± 2097 respectively (P = .009). No apnea events were reported for the intervention group; the frequency of apnea in the control group was 1 ± 2.11 (P = .16). Conclusion The findings indicate that cue-based feeding is beneficial for preterm infants. Therefore, it is recommended that nurses employ cue-based feeding in the NICU. Trial registration IRCTID: IRCT20170828035962N2. Registered 27 may 2018 – Retrospectively registered, https://en.irct.ir/trial/27024.

Download Full-text