Umbilical Cord
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Elizabeth Blecharczyk ◽  
Lucy Lee ◽  
Krista Birnie ◽  
Arun Gupta ◽  
Alexis Davis ◽  

BACKGROUND: Umbilical-cord acidemia may indicate perinatal asphyxia and places a neonate at increased risk for hypoxic ischemic encephalopathy (HIE). Our specific aim was to develop a standardized clinical care pathway, ensuring timely identification and evaluation of neonates with umbilical-cord acidemia at risk for HIE. METHODS: A standardized clinical care pathway to screen inborn neonates ≥36 weeks with abnormal cord blood gases (a pH of ≤7.0 or base deficit of ≥10) for HIE was implemented in January 2016. Abnormal cord blood gases resulted in a direct notification from the laboratory to an on-call physician. Evaluation included a modified Sarnat examination, postnatal blood gas, and standardized documentation. The percentage of neonates in which physician notification, documented Sarnat examination, and postnatal blood gas occurred was examined for 6 months before and 35 months after implementation. RESULTS: Of 203 neonates with abnormal cord gases in the post–quality improvement (QI) period, physician notification occurred in 92%. In the post-QI period, 94% had a documented Sarnat examination, and 94% had postnatal blood gas, compared with 16% and 11%, respectively, of 87 neonates in the pre-QI period. In the post-QI period, of those evaluated, >96% were documented within 4 hours of birth. In the post-QI period, 15 (7.4%) neonates were cooled; 13 were in the NICU at time of identification, but 2 were identified in the newborn nursery and redirected to the NICU for cooling. CONCLUSIONS: A standardized screening pathway in neonates with umbilical-cord acidemia led to timely identification and evaluation of neonates at risk for HIE.

Chun-Chia Lin ◽  
Chung-Bin Huang ◽  
Jian-Chiou Su ◽  
Yu-Kung Chou ◽  
Kuo-Liang Chiang

Shaheen Shaheen ◽  
Ruchi Chauhan

A descriptive study was conducted to assess the level of knowledge regarding umbilical cord stem cell banking among staff nurses at selected Hospitals of Haridwar Uttrakhand A non-experimental research design was used assess the knowledge regarding umbilical cord stem cell banking among staff nurses. The sample consists of 104 staff nurses of selected hospitals who were available at the time of study. Purposive sampling technique was used for selection of samples. The data was collected using self-structured questionnaire. Results depicted that majority of staff nurses had inadequate knowledge regarding umbilical cord stem cell banking. The mean knowledge score was found to be 16.5±6.16. The results also indicated knowledge of staff nurses was found to be significant with years of experience of staff nurses. Hence the study concluded that knowledge of staff nurses were influenced by years’ experience

2021 ◽  
pp. 097321792110378
Sara Tagliani ◽  
Luca Casadio ◽  
Caterina Radice ◽  
Ivana Bruno ◽  
Giancarlo Piccinini ◽  

This article describes a case of severe hyperleukocytosis in a preterm infant with fetal inflammatory response syndrome (FIRS) associated with funisitis of umbilical cord and intrauterine inflammation. FIRS is a cause of leukocytosis in newborn, as well as leukemoid reaction in 21 trisomy, congenital leukemia, sepsis, and steroid prophylaxis. Inflammatory response syndrome is associated with high mortality, developmental impairment and complications of prematurity like intraventricular hemorrhage, chronic lung disease, periventricular leukomalacia, and sepsis.

2021 ◽  
Vol 12 (12) ◽  
pp. 78-84
Maitreyi Ojha ◽  
Ashish Pradhan ◽  
Sudip Dutta ◽  
Anamika Jaiswal

Background: Early onset neonatal sepsis (EONS) is one of the important causes of morbidity and mortality in neonates. Its early diagnosis and prompt treatment is essential and any delay in the diagnosis can have serious consequences including neonatal death. Blood culture is the gold standard test for diagnosis of neonatal sepsis. Umbilical cord blood culture (UCBC) is a painless procedure and technically less challenging. We conducted this study to evaluate use of UCBC for the diagnosis of EONS and compared it with the results of peripheral venous blood culture (PVBC) reports. Aims and Objectives: The aim of the study was to evaluate UCBC for the diagnosis of EONS and compared it with the results of PVBC reports. Materials and Methods: This was a hospital-based prospective cohort study consisting of 100 neonates who were at risk of EONS. The study was conducted in the Department of Pediatrics Sikkim Manipal Institute of Medical Sciences Gangtok between January 2018 and December 2019. Neonates found to be at risk of development of EONS were included in this study on the basis of a predefined inclusion and exclusion criteria. Immediately after birth blood samples were collected from both umbilical cord and peripheral vein and were sent to bacteriology lab. Sensitivity, specificity, positive predictive value, and negative predictive value of both the samples were analyzed. Results: Out of 100 neonates in 32 (32%) EONS could be confirmed with positive sepsis screening results and/or demonstration of organisms on blood culture. Among the 32 neonates with EONS, 17 were found to be premature. The mean gestational age of newborns with EONS was found to be 35.2 weeks. The umbilical blood culture was found to have sensitivity and specificity of 100% and 74.4%, respectively, whereas peripheral vein blood culture was found to have sensitivity and specificity of 77.7% and 72.5%, respectively. The most common organism grown in our study was Escherichia coli. Conclusion: UCBC is painless and technically less challenging method of blood sampling. It has been found to have a higher sensitivity as well specificity for the diagnosis of EONS as compared to peripheral venous blood sample.

2021 ◽  
Vol 15 (1) ◽  
Huiping Li ◽  
Fang Yuan ◽  
Yaming Du ◽  
Tao Pan ◽  
Wanxin Wen ◽  

Abstract Background Progressive supranuclear palsy is a neurodegenerative condition that worsens over time. Given the lack of targeted treatments, patients with severe progressive supranuclear palsy have very low life expectancy. Case presentation We present a case of a 61-year-old Chinese man with severe progressive supranuclear palsy and treated with umbilical cord blood stem cells transplantation. After the umbilical cord blood stem cells therapy, his neurologic symptoms stopped deteriorating, his muscle rigidity was mildly improved, and he remains alive for more than 8 years. Conclusions Umbilical cord blood stem cells transplantation may be an alternative therapy for patients with severe progressive supranuclear palsy.

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4304
Yiming Dai ◽  
Jiming Zhang ◽  
Xiaojuan Qi ◽  
Zheng Wang ◽  
Minglan Zheng ◽  

Gestational exposure to manganese (Mn), an essential trace element, is associated with fetal and childhood physical growth. However, it is unclear which period of growth is more significantly affected by prenatal Mn exposure. The current study was conducted to assess the associations of umbilical cord-blood Mn levels with birth outcomes and childhood continuous physical development. The umbilical cord-blood Mn concentrations of 1179 mother–infant pairs in the Sheyang mini birth cohort were measured by graphite furnace atomic absorption spectrometry (GFAAS). The association of cord-blood Mn concentrations with birth outcomes, and the BMI z-score at 1, 2, 3, 6, 7 and 8 years old, were estimated separately using generalized linear models. The relationship between prenatal Mn exposure and BMI z-score trajectory was assessed with generalized estimating equation models. The median of cord-blood Mn concentration was 29.25 μg/L. Significantly positive associations were observed between Mn exposure and ponderal index (β, regression coefficient = 0.065, 95% CI, confidence interval: 0.021, 0.109; p = 0.004). Mn exposure was negatively associated with the BMI z-score of children aged 1, 2, and 3 years (β = −0.383 to −0.249, p < 0.05), while no significant relationships were found between Mn exposure and the BMI z-score of children at the age of 6, 7, and 8 years. Prenatal Mn exposure was related to the childhood BMI z-score trajectory (β = −0.218, 95% CI: −0.416, −0.021; p = 0.030). These results indicated that prenatal Mn exposure was positively related to the ponderal index (PI), and negatively related to physical growth in childhood, which seemed most significant at an early stage.

2021 ◽  
Vol 14 (12) ◽  
pp. 1828-1833
Yan Fu ◽  
Guang-Hui He ◽  
Song Chen ◽  
Zhao-Hui Gu ◽  

AIM: To assess the protective effect of human umbilical cord mesenchymal stem cell exosomes (hucMSC-Exs) in a diabetic rat model by using a variety of retinal bioassays. METHODS: hucMSCs were subjected to differential ultracentrifugation for the collection of exosomes, and transmission electron microscopy (TEM), nanoparticle tracking analysis (NTA) using a NanoSight analysis system and Western blotting (WB) were used to analyze the expression of surface marker proteins such as CD63, CD9 and Calnexin. Streptozotocin (STZ) was injected into the intraperitoneal cavity to establish a diabetic model. Rats were divided into a normal group, diabetic group and hucMSC-Ex group. Fundus fluorescein angiography (FFA), optical coherence tomography (OCT) and other live imaging methods were used to observe the fundus of the rats. Finally, the eyeballs of rats from each group were collected for hematoxylin-eosin (HE) staining to further analyze the retinal structure. RESULTS: Through TEM, NTA and WB, we successfully isolated hucMSC-Exs. Subsequent FFA and OCT confirmed that hucMSC-Exs effectively prevented early retinal vascular damage and thickening of the retina. Finally, HE staining of rat retinal sections revealed that exosomes effectively alleviated retinal structure disruption caused by diabetes. CONCLUSION: hucMSC-Exs have a protective effect on the retina in diabetic rat through FFA, OCT and HE staining.

2021 ◽  
Vol 22 (23) ◽  
pp. 12842
Shahd Horie ◽  
Hector Gonzalez ◽  
Jack Brady ◽  
James Devaney ◽  
Michael Scully ◽  

Background: Ventilator-induced lung injury (VILI) frequently worsens acute respiratory distress syndrome (ARDS) severity. Human mesenchymal stem/stromal cells (MSCs) offer considerable therapeutic promise, but the key impediments of clinical translation stem from limitations due to cell source and availability, and concerns regarding the loss of efficacy following cryopreservation. These experiments compared the efficacy of umbilical-cord-derived MSCs (UC-MSCs), a readily available and homogenous tissue source, to the previously more widely utilised bone-marrow-derived MSCs (BM-MSCs). We assessed their capacity to limit inflammation, resolve injury and enhance repair in relevant lung mechanical stretch models, and the impact of cryopreservation on therapeutic efficacy. Methods: In series 1, confluent alveolar epithelial layers were subjected to cyclic mechanical stretch (22% equibiaxial strain) and wound injury, and the potential of the secretome from BM- and UC-derived MSCs to attenuate epithelial inflammation and cell death, and enhance wound repair was determined. In series 2, anesthetized rats underwent VILI, and later received, in a randomised manner, 1 × 107 MSCs/kg intravenously, that were: (i) fresh BM-MSCs, (ii) fresh UC-MSCs or (iii) cryopreserved UC-MSCs. Control animals received a vehicle (PBS). The extent of the resolution of inflammation and injury, and repair was measured at 24 h. Results: Conditioned medium from BM-MSCs and UC-MSCs comparably decreased stretch-induced pulmonary epithelial inflammation and cell death. BM-MSCs and UC-MSCs comparably enhanced wound resolution. In animals subjected to VILI, both fresh BM-MSCs and UC-MSCs enhanced injury resolution and repair, while cryopreserved UC-MSCs comparably retained their efficacy. Conclusions: Cryopreserved UC-MSCs can reduce stretch-induced inflammation and cell death, enhance wound resolution, and enhance injury resolution and repair following VILI. Cryopreserved UC-MSCs represent a more abundant, cost-efficient, less variable and equally efficacious source of therapeutic MSC product.

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