Effect of recombinant human erythropoietin administration on lipid peroxidation and antioxidant enzyme(s) activities in preterm infants.

In the present investigation, we studied the effect of recombinant human erythropoietin (r-HuEPO) on serum malondialdehyde (MDA) as an index of lipid peroxidation, related to iron-catalyzed free radical reaction and erythrocyte superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPX) activities in very-low-birth weight (VLBW) infants. Forty premature infants, at gestational ages were less than 33 weeks and birthweights were less than 1,500 g, were enrolled in the study. The study population was randomly divided into 2 groups. Twenty infants in Group 1 (treatment group) were given r-HuEPO, and 20 infants in Group 2 served as the control. r-HuEPO treatment (750 U/kg a week) was initiated on the 10th day of life and continued for 6 weeks. Preterm infants given erythrocyte transfusions during the study were excluded from the results. Serum ferritin and MDA levels, and erythrocyte superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPX) activities were analyzed at the end of the first week of life (at the beginning of the study). Subsequently, serum ferritin, and MDA levels were measured at the end of the 3rd and the 6th week. SOD, CAT, and GPX activities in the hemolysate were analyzed at the end of the 4th week. Six infants in the control group and 1 infant in the r-HuEPO group received transfusions through the end of the study, and these infants were excluded from the results. Significantly decreased serum ferritin concentrations were found in the r-HuEPO group compared to those in the control group both at the end of the 3rd and the 6th week (P &#60; 0.05, and P &#60; 0.01, respectively). In addition, serum MDA levels were also significantly reduced in Group 1 compared to control both at the end of the 3rd and the 6th week (P &#60; 0.01 and P &#60; 0.05, respectively). A good correlation was found between serum MDA and ferritin levels in Group 1. When the 2 groups were compared with respect to activities of SOD, CAT, and GPX at the end of the 4th week, no differences were observed. Our findings in this study show that administration of r-HuEPO significantly decreases lipid peroxidation, but does not affect erythrocyte antioxidant enzyme(s) activities in preterm infants. The mechanism responsible for the r-HuEPO-induced decrease in lipid peroxidation may concern inhibition to iron-catalyzed free radical reactions.&#60;/P&#62;</p

The effect of L-carnitine on platelet activating factor concentration in the immature rat model of hypoxic-ischemic brain injury.

Recent data suggested that platelet-activating factor (PAF) could play a pathophysiologically important role in the progression of hypoxic-ischemic brain injury. We investigated brain tissue PAF concentration in the hypoxic-ischemic brain of immature rats. Endogenous PAF concentration in brain tissue showed a marked increase in hypoxic-ischemic pups (Group 1, 85.6 +/- 15.5 pg/mg protein) when compared to that of the control (9.1 +/- 3.1 pg/mg protein). In addition, we studied the effects of pretreatment with L-carnitine (5 days and 2 h before the hypoxia) on endogenous PAF concentration in the hypoxic-ischemic brain. Endogenous PAF concentration in the short-term pretreatment group (Group 2, 81.6 +/- 9.7 pg/mg protein) was not different than in Group 1 rat pups. However, a significantly decreased PAF concentration was found in the group of pups that received carnitine pretreatment for 5 days (Group 3, 30.5 +/- 11.0 pg/mg protein). These results indicate that PAF is an important mediator in the immature rat model of cerebral hypoxic-ischemic injury. The suppressor effect of L-carnitine on PAF production may give new insight into the treatment of hypoxic-ischemic brain injury.</p

Gastroesophageal reflux (GER) in preterms: current dilemmas and unresolved problems in diagnosis and treatment

WOS: 000209048700001PubMed ID: 23692780Gastroesophageal reflux (GER) is a common physiologic phenomenon in preterm infants. Many infants remain asymptomatic, and the diagnosis of GER is difficult since clinical signs and symptoms are nonspecific. Diagnosis can also be difficult due to technical limitations. None of the currently available agents has been proven to prevent regurgitation. The efficacy and safety of gastroesophageal reflux disease (GERD) therapy have not been studied systematically in preterm infants. Therefore, clinicians must consider the risks and benefits of therapy. Preventive measures should be the first-line intervention. Prone, head upward and left-side positioning may reduce symptoms, but infants must be discharged home in the supine position. Thickening of feeds may be harmful in preterm infants. Frequent small-amount or continuous-drip feeding, short-term trial of hypoallergenic formula and probiotics are among the proposed treatments. Infants with severe symptoms and those who do not respond to the conservative and medical treatment need further diagnostic evaluation and very rarely a Nissen fundoplication

The status of women and of maternal and perinatal health in Turkey

WOS: 000289862600002PubMed ID: 21534333Turkey has improved the status of women and the maternal and perinatal health statistics in the last decades. However, discrepancies between urban rural and east-other regions continue, with some improvements. The education of girls is promoted and maternal age at marriage and at first delivery has increased. Birth control measures are increasingly used. Fertility rates decreased to 2.16 children per fertile woman. Antenatal care standards have improved, and achievement of deliveries by health care personnel and postnatal mother/newborn care has increased to 90%. The maternal death rate decreased to 19.5 in 100,000 pregnants. However, uneducated women marry earlier and have a higher risk of dying from pregnancy-related causes. Perinatal mortality decreased to 19 in 1,000 deliveries. Neonatal mortality rate decreased to 13 in 1,000 live deliveries. Uneducated mothers living in rural areas and having more children receive less antenatal and postnatal care and are more likely to lose their newborn. The major causes of neonatal deaths are prematurity and congenital abnormalities

Turkish Neonatal Society guideline on enteral feeding of the preterm infant

WOS: 000484450300011PubMed ID: 31236024Early initiation of enteral feeding with the own mother's milk and prevention of postnatal growth failure is the target of nutrition in preterm infants. Together with total parenteral nutrition, mouth care and minimal enteral nutrition is started with colostrum in the very early hours of life in small preterm infants. Expressed mother's milk is given via a gastric tube and gradually increased in accordance with the gestational age/birth weight and the risk factors. For infants born heavier than 1000 grams, the aim is to reach total enteral feeding at the end of first week, and at the end of the second week for infants weighing less than 1000 grams. Supporting mothers in milk expression and kangaroo mother care, promoting non-nutritive feeding, appropriate fortification of mother' milk, and initiating and advancing breastfeeding as soon as the infant is ready are all crucial. Donor mother milk, and as a second choice, preterm formula is advised if the mother's milk is not available. Individualized post-discharge nutrition decisions can be taken in accordance with the actual growth at the time of discharge. The goal is optimal neuro developmental achievement together with the prevention of long-term metabolic problems. Late preterm infants, which constitute the majority of preterm infants, also need close nutritional attention and follow-up

Investigation of maternal melatonin effect on the hippocampal formation of newborn rat model of intrauterine cortical dysplasia

WOS: 000284470700019PubMed ID: 20461523Objectives Cortical dysplasia is a cortical malformation resulting from any developmental defects during different periods of development. This study aims to investigate the hippocampal histopathological alterations in the neonates with cortical dysplasia due to the prenatal exposure to carmustine (1,3-bis (2-chloroethyl)-1-nitrosoure; BCNU) and the possible effects of prophylaxis with melatonin, a neuroprotective agent. Methods Wistar albino female rats were randomly divided into four experimental groups; control, melatonin-treated, BCNU-exposed and BCNU-exposed+melatonin-treated. Light microscopy and immunohistochemistry were carried out on the newborn hippocampus. Results Histopathology of hippocampus from the control and melatonin-treated groups showed continuity of migration and maturation as patognomonic signs of the normal newborn hippocampus. Hippocampal cortex from the newborns exposed in utero to BCNU showed the histology of early embryonic hippocampal formation with immuno-histochemical increase in the number of nestin positive cells and decreases in the immunoreactivity of glial fibrillary acidic protein (GFAP) and synaptophysin. These findings indicate a significant delay in hippocampal maturation, migration, and synaptogenesis. Intrauterine treatment of BCNU-exposed rats with melatonin resulted in histopathological features almost similar to control group. Conclusion It has been concluded that cortical dysplasia induced by intrauterine BCNU administration results in delayed hippocampal maturation, which is successfully restored by intrauterine melatonin treatment

Both parents of neonatal intensive care unit patients are at risk of depression

WOS: 000341416500010PubMed ID: 24911852Postpartum depression is a serious disorder that can be seen not only in mothers but also in fathers; therefore, it negatively affects the whole family. Hospitalization in the neonatal intensive care unit (NICU) is a stress factor for the parents and contributes to depression. We aimed to detect the frequency of postpartum depression and the contributing risk factors in parents of NICU patients. The Edinburgh Postnatal Depression Scale was used for mothers and the Beck Depression Inventory was performed for fathers in the 2nd and 6th weeks after delivery. At the 2nd week, maternal depression frequency was found as 38.3%, with a mean score [ms] of 10.97 +/- 6.93. At the 6th week, maternal depression frequency was 33.3% (ms: 9.57 +/- 5.78). Paternal depression was 11.7% (ms= 7.13 +/- 7.35) at the 2nd week and 10.0% (ms: 6.50 +/- 5.79) at the 6th week. The frequency of maternal depression remained stable, but mean maternal depression scores were decreased at the 6th week compared to the 2nd week (p=0.023). However, paternal depression scores were similar in both periods (p=0.428). The infants' disease severity at admission to the NICU, as shown by SNAPPE-II risk scores, was positively correlated with Edinburgh depression scores of the mothers at the postnatal 2nd week, but not at the 6th week. In conclusion, NICU stay of high-risk infants may cause depression in their mothers and fathers, even in the absence of any previous risk factor. Although at a lower rate than in mothers, fathers may also suffer from depression. Parental depression screening and whole family support during NICU hospitalization are strongly recommended