The “Obese Asthma” in Children as a Distinct Clinical Phenotype: Review

Asthma, obesity, and irrational use of antibiotics early in a life can be considered to be the three epidemics of modern times, which encourage one another and whose base is the loss of bioavailability. Disruption of the intestinal microbiome early in the life is the basis for the development of metabolic diseases, allergic immunological diseases, and high mortality rate due to infection with resistant strains of bacteria. During the irrational use of penicillin and macrolides postnatally, the composition of the intestinal microbiota and its functions change 12–24 months after the antibiotics treatment, the settlement of advantage intestinal flora with probiotic microorganisms is delayed, the maturation of the intestinal mucosa is compromised. Respiratory and systemic inflammation is strongly influenced by the rich adipocyte metabolism so that the treatment of these children is complex, and their asthma often remains only partially controlled. The phenotype “obese asthma” is characterized by a steroid and bronchodilator resistance. Therapeutic solution could be the body weight reducing, vitamin D3 substitution, and antileukotriene application. The prophylactic therapy of this asthma, using macrolides for a long time, should be supported, mandatory, with the substitution of probiotic/synbiotic during, and at least 6–9 months after discontinuation of therapy with macrolide

The role of biochemical markers as early indicators of cardiac damage and prognostic parameters of perinatal asphyxia

Background/Aim. In recent years, the focus of interest of the scientific community is the application of heart markers as early indicators and prognostic parameters of perinatal asphyxia (PA). The aim of this study was to evaluate the significance of clinical application of heart markers in term newborns with perinatal asphyxia. Methods. During a 3- year period we analyzed 91 full-term newborns (55 with and 36 without perinatal asphyxia). In all the subjects within the first 24-48 h after birth, we simultaneously determined serum concentrations of cardiac troponin I, brain natriuretic peptide, MB fraction of creatine kinase (CK-MB) and Creactive protein. Results. In the group of full-term neonates with PA significantly higher levels of cardiac troponinI (p = 0.000), CK-MB fraction (p = 0.000), brain natriuretic peptide (p = 0.003) and C-reactive protein (p = 0.017) were found, compared to the group of healthy full-term newborns. In merged group (n = 91) cardiac troponin I level correlated with the fifth minute Apgar score (r = - 0.637, p = 0.000) and the serum lactate concentration in the first 12h after birth (r = 0.529, p = 0.000). Early increase in cardiac troponin I > 0.135 μg/L predicted the risk of death with the sensitivity of 84.6% and specificity of 85.9%, while the increase in CK-MB fraction, brain natriuretic peptide and C-reactive protein did not have a predictive value with respect to a mortality outcome. Conclusion. Among the tested cardiac markers, cardiac troponin I is the most sensitive and the only reliable early predictor of mortality in fullterm neonates with perinatal asphyxia

Can a presepsin (SCD14-ST) obtained from tracheal aspirate be a biomarker for early-onset neonatal sepsis

© 2020, University of Kragujevac, Faculty of Science. All rights reserved. In absence of clear clinical signs and clear definition, neonatal sepsis is still one of the major cause of morbidity and mortality. Most researchs in past time was directional on finding new biomarkers with greater sensitivity and specific-ity in detection of neonatal sepsis. The aim of our study was to investigate if presepsin obtained from tracheal asprate in intubated newborns, can be a novel biomarker of systemic bacterial infection. Our ‘’case control’’ study included 60 newborns, 11 with suspected neonatal sepsis. Tracheal aspirate for examination was taken in the usual toilets, in asep-tic conditions, by lavage with 2 ml of 0.9% NaCl in Mucus suction set. In the same day were mesured presepsin (blood), CRP, PCT, leukocytes and neutrophyls, as well as blood cul-ture. Our research showed higher levels for PCT and prese-psin (blood) in septic newborns, as well as in newborns with clinical signs of SIRS. Presepsin obtained from a tracheal aspirate had high score for septic newborns. As the coefficients of simple linear correlation showed, there was quantitative agreement between presepsin (blood) with presepsin (trache-al aspirate)-increase in the value of one leads to an increase in other. In conjunction with an already validated markers of infection, presepsin obtained from tracheal aspirate cam be turned on in diagnostic procedures

Thermophoresis or When Small Objects Meet Temperature Gradient: Numerous Applications

This mini review discusses the phenomenon of thermophoresis, also known as the thermophoretic effect. Thermophoretic effect arises from the combination of a temperature gradient and particles of very small dimensions, on the order of magnitude of the mean free path of the molecules of the surrounding gas. Despite being a little-known effect, it is critical to many physical and chemical processes and for characterising the properties of nanostructured materials that could be used in industry for sensing applications. A description and definition of otherwise very similar thermophoresis terms is provided, as well as a brief overview of the literature on this topic, with a focus on research in the twenty-first centur

Mesenchymal stem cells attenuate acute liver failure by promoting expansion of regulatory T cells in an indoleamine 2,3-dioxygenase-dependent manner

© 2020, University of Kragujevac, Faculty of Science. All rights reserved. The influence of mesenchymal stem cells (MSCs) on the phenotype and function of CD4+CD49b+FoxP3-regulatory cells has not been elucidated. We used Concanavalin A (ConA)-and α-galactosylceramide (α-GalCer)-induced acute liver injury to estimate the effects of MSCs on liver-infiltrating CD4+CD49b+FoxP3-regulatory cells. MSCs significantly reduced ConA-and α-GalCer-mediated liver injury in C57BL/6 mice, as demonstrated by biochemical tests, reduced influx of inflammatory CD4+ T cells, and increased presence of CD4+CD49b+FoxP3-regulatory cells in the injured livers. The number of CD4+CD49b+FoxP3-regulatory cells was also significantly increased in α-GalCer-treated mice that received MSC-derived condi-tioned medium (MSC-CM). The presence of 1-methyltryp-tophan, a specific inhibitor of indoleamine 2,3-dioxygenase (IDO), in MSC-CM completely abrogated the hepatopro-tective effect of MSCs and significantly decreased the total number of liver-infiltrated CD4+CD49b+FoxP3-regulatory cells, indicating the crucial importance of MSC-derived IDO for the expansion of CD4+CD49b+FoxP3-regulatory cells and the consequent MSC-dependent attenuation of acute liver injury

Clinical and laboratory differences between Epstein–Barr and cytomegalovirus infectious mononucleosis in children

© 2016, Serbia Medical Society. All rights reserved. Introduction Infective mononucleosis is most commonly caused by Epstein–Barr virus (EBV), and in smaller percentage by cytomegalovirus (CMV). Objective The aim of this paper was to determine the clinical and laboratory differences between EBV and CMV infectious mononucleosis in children. Methods Cohort retrospective analytical research was conducted. We used data from medical history in six years period and monitored anamnestic data, frequency of inspection and palpation obtained data during physical examination, several laboratory tests, abdomen ultrasonography examination finding and emergence of disease complications. Statistical processing of data has been performed using SPSS 20. Results Total number of examined children was 137, out of which 85.4% were with EBV and 14.6% with CMV infection. Affected children were most commonly younger than eight years. Boys were affected more often. There was no difference in frequency of high temperature, sore throat, bad breath, and respiratory symptomatology between examined children. Differences were discovered in frequency of stomachaches, eyelid swelling, skin rash and fatigue. Differences were not proven in the frequency of angina, lymphadenopathy and splenohepatomegaly between the groups. Values of transaminases and lactic dehydrogenases significantly decreased after seven days of hospitalization in both groups. In children with EBV, values of transaminases declined faster than in children with CMV. Anemia and bacterial superinfection of pharynx were most common disease complications. Thrombocytopenia was more common in children with CMV infection. Average duration of hospitalization was 6.7 days. Conclusion In children with CMV abdominal pain, eyelid swelling, skin rash, fatigue and thrombocytopenia were more common. In children with EBV values of transaminases declined significantly faster

Anthropometric study of the facial index in the population of Central Serbia

The aim of this study was to determine the craniofacial parameters in the population of the central part of Serbia. The research was conducted on 700 persons (360 males and 340 females), aged 18-65 years, selected randomly. The measured parameters were morphological facial height and breadth. The standard spreading caliper with scale was used for the measurement of facial parameters. There were significant differences in the facial parameters of male compared to female subjects in all observed parameters. The mean value of the morphological facial height in the study population was 116.8 mm ± 7.28, maximum facial breadth 124.12 mm ± 8.44, while the mean value of the total facial index was 93.68 ± 6.86. The total facial index was calculated according to the formula and the obtained results were analyzed statistically using the t-test. The dominant phenotype in the studied population was leptoprosopic. The data obtained in our study may be useful in anthropological research, forensics, genetic research, as well as in medical clinical practice

Henoch-Schönlein purpura associated with Strongyloides stercoralis infection

© 2016, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved. Introduction. Henoch-Schönlein purpura (HSP) is a small blood vessel vasculitis, which usually manifests during child-hood. The exact cause of the disease is unknown. Case report. We reported a 14-year-old girl who had been admitted to our clinic due to the appearance of red macules on her extremities and face, vomiting, and pain in the abdomen and joints. The patient was initially diagnosed with Henoch-Schönlein purpura. At the end of the fourth week of illness, larvae of Strongyloides stercoralis were detected in stool samples. The patient was therefore treated with mebendazole, after which all symptoms permanently withdrew. About a month later laboratory examinations were repeated demonstrating increasing signs of renal damage. Kidney biopsy was per-formed, showing mesangioproliferative glomerulonephritis with crescents and IgA and C3 positive staining in the mesangium. Upon reviewing the clinical presentation, biochemically demonstrated progressive renal damage and biopsy results, the patient was diagnosed with HSP nephritis. Conclusion. The time course of the disease and present knowledge concerning the pathogenic mechanisms of HSP suggest that Strongyloides stercoralis infection could have caused HSP in the presented patient, which was complicated by nephritis

The role of biochemical markers as early indicators of cardiac damage and prognostic parameters of perinatal asphyxia

Background/Aim. In recent years, the focus of interest of the scientific community is the application of heart markers as early indicators and prognostic parameters of perinatal asphyxia (PA). The aim of this study was to evaluate the significance of clinical application of heart markers in term newborns with perinatal asphyxia. Methods. During a 3- year period we analyzed 91 full-term newborns (55 with and 36 without perinatal asphyxia). In all the subjects within the first 24-48 h after birth, we simultaneously determined serum concentrations of cardiac troponin I, brain natriuretic peptide, MB fraction of creatine kinase (CK-MB) and Creactive protein. Results. In the group of full-term neonates with PA significantly higher levels of cardiac troponinI (p = 0.000), CK-MB fraction (p = 0.000), brain natriuretic peptide (p = 0.003) and C-reactive protein (p = 0.017) were found, compared to the group of healthy full-term newborns. In merged group (n = 91) cardiac troponin I level correlated with the fifth minute Apgar score (r = - 0.637, p = 0.000) and the serum lactate concentration in the first 12h after birth (r = 0.529, p = 0.000). Early increase in cardiac troponin I > 0.135 μg/L predicted the risk of death with the sensitivity of 84.6% and specificity of 85.9%, while the increase in CK-MB fraction, brain natriuretic peptide and C-reactive protein did not have a predictive value with respect to a mortality outcome. Conclusion. Among the tested cardiac markers, cardiac troponin I is the most sensitive and the only reliable early predictor of mortality in fullterm neonates with perinatal asphyxia

The significance of second generation cardiac troponin I in early screening of hypoxic-ischemic encephalopathy after perinatal asphyxia

Introduction: In the last few years the use of cardiac troponin I and T, as diagnostic and prognostic factors of ischemic myocardial injury both in adult and neonatal medicine has been of great interest. Objective: The objective of our research was to investigate the significance of cardiac troponin I (cTnI) as an early indicator of the presence and severity of hypoxic-ischemic encephalopathy (HIE) in newborns. Methods: We analyzed 55 term newborns with HIE diagnosed based on clinical findings and ultrasonographic examination of the central nervous system. Serum concentration of cTnlultra was determined by immunoenzyme method during the first 24-48 hours after birth, and the obtained findings were compared with the values of identical parameter in 36 healthy term newborns. Results: During the first 24-48 hrs after birth, serum concentration of cTnl-ultra was significantly higher (p<0.0005) in term newborns with HIE (0.135±0.207 ug/l) and median (0.07,0.01-006 μg/1) in comparison to control group (0.0183±0.026 ug/l and median 0.01 (0.01-0.01 μg/l), with the cTnl-ultra level rising proportionally to the clinical HIE stages. The increase of cTnl-ultra of <0.12 μg/l indicated the development of significant cerebral damage with the sensitivity of 75% and specificity of 72.2%, while the cTnl-ultra level of <0.13 μg/l was a significant mortality predictor with sensitivity of 76.9% and specificity of 73.8%. Conclusion: The second generation cardiac troponin I assay highly correlates with clinical and ultrasonographic findings in neonates with HIE, so that it can be used as a significant diagnostic and prognostic indicator of this pathological condition