Notes

[Preventing recidivism: as elementary as a trip?]
r years of experience.. · Perceptions of teleneonatology are especially high in smaller hospitals with well newborn nurseries..
 This study aimed to evaluate if adaptive responses of very preterm newborns to neonatal intensive care unit (NICU) daily nursing, specifically bathing and weighing procedures are associated with their neurodevelopment after 2 years.

 Twenty-six very preterm newborns, with a gestational age <32 weeks, were enrolled. Infants' adaptive responses to daily nursing were evaluated, at 30 to 32 to 35 postmenstrual age (PMA) weeks by an observational sheet. Neurodevelopment was assessed at 24 months of corrected age by the Bayley Scales of Infant and Toddler Development, third edition. Autonomic, motor, and self-regulatory responses to NICU nursing were analyzed by Spearman's correlation coefficient and multivariate linear regression with Bayley's cognitive, language, and motor scales.

 Significant (
 < 0.05) positive correlations of self-regulatory and autonomic responses to nursing with all Bayley's scales were found at 30- and 32-week PMA. At 35-week PMA, only self-regulatory responses had significant positive correlations with all Bayley's scales. When adjusted for birth weight and sex, the significant associations were confirmed only at 30- and 32-week PMA.

 Very preterm newborn adaptive responses to NICU daily nursing reveal to be positively related to forthcoming neurodevelopment 2 years later, as early as the 30-week PMA. Helping preterm babies to adapt to daily NICU nursing may promote their future neurobehavior.

· Preterm adaptation to nursing was studied.. · Adaptation positively relates to neurodevelopment.. · Such relation is detected since 30-week PMA..
· Preterm adaptation to nursing was studied.. · Adaptation positively relates to neurodevelopment.. · Such relation is detected since 30-week PMA..Glioblastoma (GBM) is one of the most common malignant tumors of the central nervous system that occurs in the brain and is a deadly disease. Despite the different approaches to the treatment of this malignancy, the discovery of new compounds with anti-cancer effects seems necessary. In this study, the selective toxicity effects of omega 3, 6 and 9 combinations on mitochondria isolated from U87MG human glioma cells and also human embryonic kidney 293 cells (HEK293) as normal control were investigated. The results indicated that the omega 3, 6 and 9 combinations significantly reduced succinate dehydrogenase (SDH) activity only in mitochondria isolated from U87MG human glioma cells. Additionally, exposure of mitochondria isolated from U87MG human glioma cells to this combination was associated with a selective increase in the level of reactive oxygen species (ROS), the collapse of the mitochondrial membrane potential (MMP), mitochondrial swelling and cytochrome c release. However, these effects were not observed in mitochondria isolated from HEK293 cells (as a normal group). According to results, it is proposed that the combination of omega 3, 6 and 9 could induce toxicity in U87MG human glioma cells through their mitochondria. This combination can be helpful as a complementary therapy in patients with GBM.Ursolic acid (UA), a pentacyclic triterpenoid and a phytochemical, is a potent inhibitory agent against proliferation of various tumors. Polyhydroxybutyrate nanoparticles (PHB NPs) are preferred in therapeutics due to their drug-stabilizing property and enhanced biological activity. In this study, PHB NPs were utilized to deliver and enhance the bioavailability of UA against cancer cells (HeLa). Further, molecular docking and dynamic studies were conducted to calculate the binding affinity and stability of UA at the active site of target protein (epidermal growth factor receptor-EGFR). The PHB NPs revealed the average size as 150-200 nm in TEM, which were used in subsequent experiments. The cytoplasmic uptake of nanoparticles was confirmed by florescent microscopy. The encapsulation potential of PHB NPs with UA was assessed by UV-visible spectrophotometer as 54%. Besides, the drug release behavior, cytotoxicity and the regulation of apoptosis were investigated in vitro. The cytotoxicity results revealed that the maximum efficiency of drug delivery was at 96th hour.The achievements of the last 15 years have essentially shaped the diagnostic methods and therapy of Neuromyelitis optica spectrum disorders (NMOSD) from discovery of aquaporin 4 antibodies and further development of diagnostic criteria the path has led to the approval of eculizumab and satralizumab as first disease modifying treatments in Europe. This article should give an overview on the present insights and future treatment options.
Antenatal diagnosis of placenta accreta spectrum (PAS) is critical to reduce maternal morbidity. While clinical outcomes of women with PAS have been extensively described, little information is available regarding the women who undergo cesarean delivery with a presumptive PAS diagnosis which is not confirmed by histopathologic examination. We sought to examine resource utilization and clinical outcomes of this group of women with a false-positive diagnosis of PAS.

Retrospective analysis of patients with prenatally diagnosed PAS cared for between 2015 and 2020 by our multidisciplinary PAS team. Maternal outcomes were examined. ML355 Univariate analysis was performed and a multivariate model was employed to compare outcomes between women with and without histopathologically confirmed PAS.

A total of 162 patients delivered with the pre-operative diagnosis of PAS. Of these, 146 (90%) underwent hysterectomy and had histopathologic confirmation of PAS. Thirteen women did not undergo the planned hysterectomy. Three .
Careful intraoperative evaluation of women with pre-operatively presumed PAS resulted in a 3/149 (2%) retrospectively unnecessary hysterectomy. Management of women with PAS in experienced centers benefits patients both in terms of resource utilization and avoidance of unnecessary maternal morbidity, understanding that our results are produced in a center of excellence for PAS. We also propose a management protocol to assist in the avoidance of unnecessary hysterectomy in women with the pre-operative diagnosis of PAS.
The aim of this study was to compare perinatal outcomes between patients with and without prenatal ultrasound markers predictive of complex gastroschisis.

A prospective cohort of 98 patients with isolated fetal gastroschisis underwent antenatal ultrasound and delivered in a tertiary referral center. Patients were classified according to eight ultrasonographic markers predictive of complexity, and perinatal outcomes were assessed accordingly. The primary outcome was the presence of fetal growth restriction and staged SILO reduction postnatally.

Of all fetuses, 54.1% (n = 53) displayed ultrasonographic markers predictive of complexity at 32.7 ± 4.3 weeks of gestation. Gastric dilatation was the most frequent marker followed by extra-abdominal bowel dilatation. The presence of ultrasound markers predictive of complexity, was not associated with intrauterine growth restriction but its absence was less associated with staged SILO reduction of the abdominal wall postnatally with a RR of 0.79 (CI95% 0.17-0.53) to unify criteria, establish cut-off points and the optimal moment to measure these markers.
Spontaneous intestinal perforation (SIP) occurs commonly in extremely low gestational age newborns (ELGANs; < 30 weeks GA). Early, concurrent neonatal use of indomethacin (Neo_IN) and hydrocortisone (Neo_HC), is a known risk for SIP. Mothers in premature labor often receive indomethacin (Mat_IN) for tocolysis and steroids (Mat_S) for fetal maturation. Coincidentally, ELGANs may receive Neo_IN or Neo_HC within the first week of life. There is limited data on the effect of combined exposures to maternal and neonatal medications. We hypothesized that proximity exposure to these medications may increase the risk of SIP.

We reviewed the medical records of ELGANS from June 2014 to December 2019 at a single Level III NICU. We compared antenatal and postnatal indomethacin and steroid use between neonates with and without SIP. Chi-Square, Student's t-test, Fisher's Exact test, and Mann-Whitney U tests were used for analysis.

Among 417 ELGANs, SIP was diagnosed in 23; predominantly neonates <26 weeks GA (n = 21/126, 16.7%). Risk factors analysis focused on this GA cohort in which SIP was most prevalent. Mat_IN administration within two days of delivery increased SIP risk (OR 3.00, 95%Cl 1.25-7.94, p=0.036). Neo_HC was not independently associated with SIP (p=0.38). A higher proportion of SIP group had close temporal exposure of Mat_IN and Neo_HC compared to the non-SIP group, though not statistically significant (14% v. 7%, p=0.24).

Peripartum Mat_IN was associated with increased risk for SIP in this small study sample. Larger studies are needed to further delineate SIP risk from the interaction of peripartum maternal medication with early postnatal therapies and disease pathophysiology.
Peripartum Mat_IN was associated with increased risk for SIP in this small study sample. Larger studies are needed to further delineate SIP risk from the interaction of peripartum maternal medication with early postnatal therapies and disease pathophysiology.
To evaluate the correlation between the oxygen index (OI) and the oxygen saturation index (OSI, measured by pulse oximetry and noninvasively) in neonates with acute respiratory failure and to predict the OI from the OSI.

A retrospective cohort study was conducted in neonates requiring invasive mechanical ventilation who had arterial blood gas between 2018 to 2019 at a neonatal intensive care unit. The correlation between OI and OSI was analyzed by using the Pearson correlation coefficient.

A total of 636 measurements from 68 neonates (35 preterm and 33 terms) were recruited into the study. There was a strong correlation between the OI and the OSI (r = 0.90) in all neonates. The correlation between the OI and the OSI in persistent pulmonary hypertension of the newborn, congenital cyanotic heart disease, and other causes of respiratory failure also showed a strong correlation (r = 0.88, 0.93, and 0.88, respectively). The correlation was strong in neonates with an oxygen saturation less than 85% (r = 0.88), those with oxygen saturation ranging from 85% to 95% (r = 0.87), and also in preterm and term infants (gestational age < 28, 28-34, 34-36, and ≥ 37 weeks, r = 0.87, 0.92, 0.89, and 0.90, respectively). There were strong accuracy measures of the OI for OI cutoffs of 5, 10, 15, and 20 (area under the curve > 0.85). The equation relating the OI and OSI was represented by OI = (2.3 × OSI) - 4.

The OSI has a strong correlation with the OI, is a reliable assessor of the severity of respiratory failure in neonates without arterial sampling, and has high accuracy when the OI < 40.
The OSI has a strong correlation with the OI, is a reliable assessor of the severity of respiratory failure in neonates without arterial sampling, and has high accuracy when the OI less then 40.
The coronavirus disease 2019 (COVID-19) pandemic is associated with fewer deliveries and premature births; however, the impact of this pandemic on the well-baby nursery (WBN) is unknown.

To evaluate the impact of the COVID-19 pandemic on infants admitted to the WBN by comparing pandemic and pre-pandemic cohorts.

We performed a retrospective study of infants admitted to a WBN during the pandemic period (March 18, 2020-to-March 17, 2021) and compared them to those during the pre-pandemic period (March 18, 2019-to-March 17, 2020). Maternal (age, parity, gestation, method of delivery, and COVID-19 status) and neonatal (sex, weight, Apgar score, feeding pattern, urine toxicology, and neonatal intensive care unit [NICU] admission) data were collected and compared between the two periods. The results were statistically analyzed, and significance was set at P < 0.05.

There were 824 and 859 WBN admissions during the pandemic and pre-pandemic periods, respectively; a 4% decrease in WBN admissions during the pandemic period.
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