Telemedicine will not keep us apart in COVID-19 pandemic

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Neonatal lung ultrasonography score after surfactant in preterm infants: A prospective observational study

Objective: To assess changes in neonatal lung ultrasonography score (nLUS) after surfactant administration in preterm infants with respiratory distress syndrome (RDS). Working Hypothesis: The reduction of nLUS score before (nLUSpre), 2 hours (nLUS2h), and 12 hours (nLUS12h) after surfactant administration to identify patients who will not need a second treatment. Study Design and Setting: Prospective observational study in the tertiary neonatal intensive care unit. Patients Selection: Forty-six preterm neonates with RDS of 32 weeks median gestational age (IQR 30-33) and mean birth weight of 1650 \ub1 715 g. Methodology: Lung ultrasonography was performed before, 2 hours, and 12 hours after surfactant administration in preterm infants with RDS needing surfactant treatment. Resulting nLUS was analyzed. Results: The Wilcoxon signed-rank test demonstrated an nLUS lowering after 2 hours (P <.001) and 12 hours (P <.001) from surfactant administration. Sixteen newborns required surfactant retreatment with median gestational age of 32 weeks (IQR 29-33) and mean birth weight of 1519 \ub1 506 g.The receiver operating characteristic analysis for the nLUS2h yielded an area under the curve of 0.80 (95% confidence interval, 0.76-0.85; P <.001). A nLUS2h 657 showed a sensitivity of 94% and a specificity of 60% for needing a second treatment with surfactant. Conclusions: In preterm infants with RDS requiring surfactant treatment, nLUS evaluated 2 hours after surfactant administration can be used to identify patients who will not need a second treatment

Impact of chorioamnionitis on maternal and fetal levels of proinflammatory S100A12

Histologic chorioamnionitis (HCA) may lead to the fetal inflammatory response syndrome (FIRS). The aim of this pilot study was to evaluate S100A12, a marker of innate immune activation, in mothers with or without HCA and in their infants. Concentrations of S100A12, interleukin 6 (IL-6), and C-reactive protein (CRP) were evaluated in maternal, cord, and neonatal blood of very preterm infants. Histologic examinations of the placenta and umbilical cords were performed. The 48 mother-neonate pairs enrolled were subdivided into two groups: HCA group (N = 15) and control group without HCA (N = 33). Maternal S100A12 levels were similar between HCA and control group. Similarly, S100A12 concentrations in cord and neonatal blood did not differ between the groups. However, high S100A12 concentrations were detected in cord and neonatal blood of two out of three neonates exposed to HCA associated with advanced funisitis. Concentrations of IL-6 and CRP were higher in maternal blood of the HCA group compared with controls (p < 0.05, p < 0.001; respectively), but no differences in cord or neonatal blood was found. Conclusion:S100A12 did neither identify mothers with HCA nor very preterm infants exposed to HCA. It is currently unknown if S100A12 may identify neonates with FIRS.What is known:\u2022 Histologic chorioamnionitis (HCA) may lead to the fetal inflammatory response syndrome (FIRS).\u2022 S100A12 represents an early, sensitive, and specific diagnostic marker of inflammatory processes.What is new:\u2022 S100A12 did neither identify mothers with HCA nor very preterm infants exposed to HCA.\u2022 It is currently still unclear if S100A12 has a potential in identifying preterm infants with FIRS

No higher risk of respiratory symptoms in Italian rheumatological patients under IL-6R-inhibitor therapy in SARS-CoV-2 pandemic

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