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Signa Vitae

A Journal In Intensive Care And Emergency Medicine

Tag: newborn (Page 1 of 2)

Proinflammatory cytokines in a newborn: a literature review

Abstract

Inflammation is a protective response to infection or injury. The inflammatory response is controlled primarily by cytokines, which are endogenous mediators of the immune system. Cytokines are produced by various different cell types in response to multiple types of stimuli and have overlapping biologic activity. Cytokines also are directly involved in the activation of cells at the inflammatory site. Movement of leukocytes to the inflammatory site is directed along a chemotactic gradient, where the strongest concentration of chemoattractants is at the site of inflammation. Cytokines are involved at each step of this process and act both locally and systemically to initiate, maintain, and finally resolve the inflammatory response. The interplay among these proinflammatory cytokines, antiinflammatory cytokines, and naturally occurring cytokine inhibitors determines the inflammatory response and its effectiveness. Because of the immaturity of the immune system of newborn cytokine is specific. Tumor necrosis factor- (TNF-) and interleukin-6 (IL-6) amplify the immune response through activation of the cytokine cascade and the production of other proinflammatory cytokines and chemokines. In a group of proinflammatory cytokines TNF- and IL-6 have undoubtedly significant role in the cytokine cascades of physiological and pathophysiological responses.

Key words: interleukin-6, tumor necrosis factor-alpha, newborn

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Coagulation disorders in premature infants – case report

Abstract

Hemorrhagic disease of the newborn, with incidence 1% to 2% of newborn babies is often a serious problem and urgent condition in pediatric intensive care unit. Article describes a case of coagulation disorder in premature infant and the management of that case.

Key words: newborn, hemorrhagic disease, coagulation disorder

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The role of nitric oxide in apoptosis modulation in newborns with pneumonia

Abstract

Introduction. Nitric oxide (NO) is an important diagnostic marker and mediator in the inflammatory process, which plays a key role in the mechanism of programmed cell death, thus, forming the basis of many pathological diseases.

Methods. The study involved 73 newborns with pneumonia (moderate severity in 44 neonates (group 1), severe pneumonia in 29 (group 2)). The intensity of neutrophil apoptosis and necrosis was determined by flow cytometry, whereas nitric oxide metabolites were measured by spectrophotometry.

Results. The level of nitric oxide metabolites (NO2+NO3) in newborns with pneumonia was higher than in healthy children (16.93 (15.82; 17.79) μmol/ml) and correlated with disease severity (in group 1 – 22.65 (21.42; 23.40) μmol/ml in group 2 – 26.82 (25.81; 27.91) μmol/ml). The level of NO3 increased moderately, while NO2 generation was more intense, exceeding control indexes in both groups (рc1<0.001; рc2<0.001; р12<0.001).

The occurrence of intensive neutrophil apoptosis was revealed in newborns with pneumonia of moderate severity (рc1<0.001), while necrosis prevailed in severe pneumonia (рc2<0.001).

Inverse correlation (R=-0.63; р<0.05) was found between the level of nitric oxide metabolites and neutrophil apoptosis; and direct correlation (R=0.68; р<0.05) was revealed between NO metabolites and neutrophil necrosis indices.

Conclusions. Increased generation of nitric oxide metabolites, that directly correlated with disease severity in newborns with pneumonia, was found. NO2 has multidirectional effects on neutrophil apoptosis and necrosis, leading to toxic accumulation of neutrophils in the organism, thus enhancing the inflammatory and intoxication process that impact disease severity.

Key words: nitric oxide, apoptosis, necrosis, neutrophils, pneumonia, newborn

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Clonidine for neonatal abstinence syndrome: a single neonatology department’s experience

Abstract

Clonidine has been shown effective in reducing sympathetic hyperactivity in neonatal abstinence syndrome (NAS). The aim of this study was to analyze clinical and laboratory characteristics of a group of newborns treated with clonidine for NAS due to maternal drug addiction and due to withdrawal from opioid analgesic therapy. Only one full–term newborn presented with metabolic acidosis and hyperkalemia; in others no clinical or laboratory adverse effects were detected. This report emphasizes the importance of alertness to potential adverse effects of clonidine therapy, and discusses possible pathophysiological aspects of hyperkalemia and metabolic acidosis during treatment for NAS.

Key words: newborn, sympathetic hyperactivity, metabolic acidosis, hyperkalemia

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Uncommon manifestations of neonatal group b Streptococcus infection: case report and literature review

Abstract

Streptococcus agalactiae, also called Group B Streptococcus (GBS), is a common pathogen in the neonatal period that can cause early- and late-onset infections. The most common manifestations are bacteremia without an apparent focus of infection, pneumonia and meningitis. Additionally, GBS can rarely cause early- and late-onset infections with uncommon manifestations. If they go unrecognized, they may lead to inappropriate treatment and increased neonatal morbidity and mortality. In this article, a case report of an infant with early-onset GBS bullous impetigo is presented together with a short review of other uncommon manifestations of GBS infection.

Key words: Streptococcus agalactiae, infection, newborn

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