Effects of red blood cell transfusion on neonatal cerebral hemodynamics: a TD-NIRS and DCS study

Anemia is a common problem in preterm neonates, and red blood cell transfusion (RBCT) is used to improve oxygen delivery. In order to limit the risk of possible complications new strategies to minimize the need for RBCTs are needed, as assessment of hemoglobin concentration in blood ([Hb]) alone appears to be an inadequate biomarker. In this study, we search for hemodynamic and metabolic thresholds to help define the need of RBCT in anemic newborns. The effect of RBCTs on cerebral tissue oxygen saturation (StO2) and blood flow (measured as Blood Flow Index, BFI) was estimated using a non-invasive hybrid diffuse optical device that combines Time Domain NIRS (TD-NIRS) and Diffuse Correlation Spectroscopy (DCS) techniques (BabyLux device). We enrolled 18 clinically stable neonates receiving RBCT at Neonatal Intensive Care Unit (NICU) of Ospedale Maggiore Policlinico in Milan. Tissue oxygen extraction (TOE) and the cerebral metabolic rate of oxygen consumption index (CMRO2I) were computed, the Wilkinson signed rank test for paired data was performed to compare data before and after RBCT. Preliminary results are in accordance with previous publications as regards cerebral oxygenation: a significant increase in StO2 (from 56.62 ± 5.20% to 63.85 ± 4.95%, p<0.05) and reduction in TOE (from 41.35 ± 5.9 % to 31.04 ±5.41%, p<0.05) were observed. The response in cerebral blood flow was smaller (only 10%) but also more variable, so conclusions regarding the effect of transfusion on cerebral oxygen metabolism are still uncertain

Unrecognised diaphragmatic hernia in a refugee child: An incidental diagnosis

A 4-year-old boy from Syria was evaluated at the emergency department because of an upper airway viral illness. His physical examination showed a significant intensity reduction of all heart sounds in the absence of any other pathological signs. As the child was affected with Down's syndrome and had suffered thoracic and abdominal trauma because of bombardments, a diaphragmatic hernia was immediately suspected and was confirmed through a simple chest X-ray. A careful clinical examination is crucial in refugee children and adolescents, as several medical and surgical disorders could have escaped previously

Haemolytic-uraemic syndrome with bacteraemia caused by a new hybrid Escherichia coli pathotype

We describe a new atypical Shiga-toxin-producing Escherichia coli (STEC) responsible for a severe episode of haemolytic–uraemic syndrome in an adult with a relapse associated with bacteraemia. This STECs train of serotype O80:H2 harboured stx2c and stx2d gene subtypes, the rare eae ɛ variant and a ColV plasmid with a conserved virulence plasmidic region involved in virulence of human and avian extraintestinal pathogenic E. coli. This atypical hybrid pathotype, which represents a new threat, is a further demonstration that STEC may be a recipient for extraintestinal virulence factors and raises again the question of antibiotic therapy during STEC infection

Effect of durum wheat genotype and environment on the heat-damage of dried pasta

The influence of the environment and genotype on the concentration of some semolina components involved in the Maillard Reaction (MR) during high temperature (HT) drying of pasta was determined in six varieties of durum wheat grown at two contrasting locations for two consecutive years. The extent of MR in HT dried pasta as determined by furosine level was found to be significantly related (r = 0.68; p < 0.05) with the amount of reducing sugars. Moreover, the susceptibility to MR appeared to be strictly dependent on \u3b1-amylase activity in both kernel (r = 0.70; p < 0.01) and semolina (r = 0.62; p < 0.01). The extent of MR showed a high heritability value, suggesting that genetic manipulation can be used to reduce the susceptibility to MR and preserve the nutritional value of wheat in HT dried pasta

Preparation of wheat resistant starch : treatment of gels and DSC characterization

A suitable thermal treatment of gels of various starch varieties was assessed to achieve the formation of resistant starch (i.e. amylose crystals). On the basis of DSC data, the yield of amylose crystals and their thermal stability did not seem correlated with the amylose content of the starch. This last parameter may not therefore be referred to as the only factor that defines a resistant starch promising starch variety