122 research outputs found
Plasma levels of osteopontin from birth to adulthood
Aim
Osteopontin (OPN) has been investigated as a biomarker for cancer and nonmalignant diseases during the last decades. Data about OPN as a potential biomarker in childhood diseases are still sparse, and reference values are not available in children. We aimed to establish reference values for children from birth to young adulthood and evaluate whether there are ageâ, genderâ, and weightâspecific differences.
Method
Umbilical cord blood and blood plasma samples of 117 children were collected in the Children's Hospital of Saarland University in Homburg/Saar. OPN levels were measured by ELISA, and statistical analysis was performed using SPSS software.
Results
Neonates, infants, toddlers, young children, adolescents, and adults were divided into the following six age groups: newborns (birth), infancy and toddlers (0â24 months), early childhood (3â6 years), middle childhood (7â11 years), adolescence (12â18 years), and adults (> 18 years). Highest blood OPN levels were found in the group of 0â1 years of age. OPN blood levels declined significantly with age (Spearman r = â0.874; P < 0.001).
Conclusion
Our work is the first prospective and systematic study analyzing OPN cord blood and blood plasma levels in children of all ages. It is the first study yielding reference values for different age groups from birth to young adulthood. Our data give insight on how OPN in umbilical cord blood and OPN in blood plasma are physiologically influenced during childhood development and growth with high OPN levels after birth and a constant ageârelated decline until the age of 14, when OPN levels reach similar values to those measured in adults
Novel modified Peyton's approach for knowledge retention on newborn life support training in medical students
Aim
We sought to improve retention of neonatal resuscitation skills by modifying step 3 through additional functional verbalisation in Peyton's fourâstep approach (P4S).
Methods
Newborn life support (NLS) training was performed in a simulationâbased setting. In contrast to the traditional approach, students taught with the modified approach were requested to explain every step of their performance in Peyton's step 3. A total of 123 students were allocated into both experimental groups. Students were then assessed by megacode on day four (initial assessment) and 6 months (followâup assessment).
Results
Both groups showed similar scorings in the initial, followâup assessment and in mean change. On initial megacode, time to start with initial inflation and postâresuscitation care was significantly faster in the control group. All showed a significant loss of performance irrespective of modification in step 3 in the followâup assessment. Only time until start with postâresuscitation care shows a significant group difference in mean change between initial and followâup with increasing time in the control and decreasing time span in intervention group.
Conclusion
Both methods showed equal levels of knowledge acquisition and longâterm decline in NLS performances. Verbalisation in step 3 influenced speed of applied NLS performance
Serum cytokines MCP-1 and GCS-F as potential biomarkers in pediatric inflammatory bowel disease
Background
Inflammatory bowel diseases (IBDs) with the subtypes ulcerative colitis (UC) and Crohn disease (CD), are chronic autoimmune inflammatory disorders of the gastrointestinal tract.
Cytokines are associated with the development and progression in pediatric IBD. We measured cytokine levels in pediatric IBD patients to assess their potential function as biomarkers in disease assessment.
Method
In this prospective cohort study, we enrolled 33 children with IBD. All patients were in stable
remission for 3 months on enrollment. Patients who developed a relapse within six months
after enrollment were classified as relapsers. Blood sampling was performed at enrolment
and for relapsers in relapse and post-relapse. Serum concentrations of 14 cytokines, chemokines and growth factors (IL-1α, IL-1ÎČ, IL-6, IL-12p40, IP-10, TNF-α, IFN-Îł, IL-10, IL-8,
MIP-1α, MCP-1, MCP-3, G-CSF, GM-CSF) were measured simultaneously using multiplex
bead-based sandwich immunoassay on Luminex 100 system.
Results
MCP-1 was significantly higher in CD patients compared to UC patients at each disease
stage: stable remission (P<0.048), unstable remission (P<0.013), relapse (P<0.026) and
post-relapse (P<0.024). G-CSF was significantly increased in UC patients developing a
relapse and in post-relapse stage compared to UC patients in remission (P<0.02 and
p<0.03, respectively).
Conclusion
MCP-1 showed potential as a diagnostic biomarker in CD patients independent of disease
activity as it was able to discriminate between subtypes of pediatric IBD. In UC patients, G-CSF was significantly elevated in relapsers indicating its use and role as a potential prognostic biomarker
Patterns of volatile organic compounds in excrements of preterm neonates
Background: As neonates are susceptible for many diseases, establishing noninvasive diagnostic methods is desirable. We hypothesized that volatile organic
compounds (VOCs) could be successfully measured in diaper samples.
Methods: We performed a feasibility study to investigate whether ambient airindependent headspace measurements of the VOC profiles of diapers from premature infants can be conducted using ion mobility spectrometer coupled with
multi-capillary columns (B & S Analytik GmbH).
Results: We analysed 39 diapers filled with stool (n = 10) or urine (n = 20) respectively, using empty diapers as a control (n = 9). A total of 158 different VOCs
were identified, and we classified the content of the diapers (urine or stool) according to their VOC profiles with a significance level of p<0.05.
Conclusions: We have developed a novel method to study headspace VOC profiles of biosamples using ion mobility spectrometry coupled with multi-capillary
columns. Using this method, we have characterized the VOC profiles of stool
and urine of preterm neonates. Future studies are warranted to characterize specific VOC profiles in infections and other diseases of the preterm neonate, thus
establishing quick and noninvasive diagnostics in the routine care of the highly
vulnerable preterm and term neonates
Osteopontin im Kindesalter bei Kindern mit und ohne Tumorerkrankung : Erstellung altersspezifischer Referenzweerte fĂŒr Osteopontin in Liquor und Blutplasma
Osteopontin im Kindesalter bei Kindern mit und ohne Tumorerkrankung : Erstellung altersspezifischer Referenzweerte fĂŒr Osteopontin in Liquor und Blutplasma
Serum vascular endothelial growth factor is a potential biomarker for acute mountain sickness
Background: Acute mountain sickness (AMS) is the most common disease caused by hypobaric hypoxia (HH) in high-altitude (HA) associated with high mortality when progressing to high-altitude pulmonary edema (HAPE) and/or high-altitude cerebral edema (HACE). There is evidence for a role of pro- and anti-inflammatory cytokines in development of AMS, but biological pathways and molecular mechanisms underlying AMS remain elusive. We aimed to measure changes in blood cytokine levels and their possible association with the development of AMS.Method: 15 healthy mountaineers were included into this prospective clinical trial. All participants underwent baseline normoxic testing with venous EDTA blood sampling at the Bangor University in United Kingdom (69 m). The participants started from Beni at an altitude of 869 m and trekked same routes in four groups the Dhaulagiri circuit in the Nepali Himalaya. Trekking a 14-day route, the mountaineers reached the final HA of 5,050 m at the Hidden Valley Base Camp (HVBC). Venous EDTA blood sampling was performed after active ascent to HA the following morning after arrival at 5,050 m (HVBC). A panel of 21 cytokines, chemokines and growth factors were assessed using Luminex system (IL-1ÎČ, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p40, IL-1ra, sIL-2Rα, IFN-Îł, TNF-α, MCP-1, MIP-1α, MIP-1ÎČ, IP-10, G-CSF, GM-CSF, EGF, FGF-2, VEGF, and TGF-ÎČ1).Results: There was a significant main effect for the gradual ascent from sea-level (SL) to HA on nearly all cytokines. Serum levels for TNF-α, sIL-2Rα, G-CSF, VEGF, EGF, TGF-ÎČ1, IL-8, MCP-1, MIP-1ÎČ, and IP-10 were significantly increased at HA compared to SL, whereas levels for IFN-Îł and MIP-1α were significantly decreased. Serum VEGF was higher in AMS susceptible versus AMS resistant subjects (p < 0.027, main effect of AMS) and increased after ascent to HA in both AMS groups (p < 0.011, main effect of HA). Serum VEGF increased more from SL values in the AMS susceptible group than in the AMS resistant group (p < 0.049, interaction effect).Conclusion: Cytokine concentrations are significantly altered in HA. Within short interval after ascent, cytokine concentrations in HH normalize to values at SL. VEGF is significantly increased in mountaineers suffering from AMS, indicating its potential role as a biomarker for AMS
Bedside Measurement of Volatile Organic Compounds in the Atmosphere of Neonatal Incubators Using Ion Mobility Spectrometry
Background: Early and non-invasive diagnosis of common diseases is of great
importance in the care of preterm infants. We hypothesized that volatile organic
compounds (VOC) can be successfully measured in the neonatal incubator atmosphere.
Methods: This is a feasibility study to investigate whether the discrimination of occupied
and unoccupied neonatal incubators is possible by bedside measurement of volatile
organic compounds (VOCs) on the neonatal intensive care unit. VOC profiles were
measured in the incubator air using ion mobility spectrometry coupled to multi-capillary
columns (BreathDiscovery B&S Analytik GmbH, Dortmund, Germany).
Results: Seventeen incubators occupied by preterm infants (50 measurements) and
nine unoccupied neonatal incubators were sampled, using 37 room air measurements
as controls. Three VOC signals that allow the discrimination between occupied and
unoccupied incubators were identified. The best discrimination was reached by peak
P20 exhibiting a sensitivity, specificity, positive predictive value and negative predictive
value of 94.0, 88.9, 97.3, and 72.3%, respectively. Use of a decision tree improved these
values to 100.0, 88.9, 98.0, and 100.0%, respectively.
Discussion: A bedside method that allows the characterization of VOC profiles in
the neonatal incubator atmosphere using ion mobility spectrometry was established.
Occupied and unoccupied incubators could be discriminated by characterizing VOC
profiles. This technique has the potential to yield results within minutes. Thus, future
studies are recommended to test the hypothesis that VOCs within neonatal incubators
are useful biomarkers for non-invasive diagnostics in preterm neonates
Pott's puffy tumor: a need for interdisciplinary diagnosis and treatment
Pottâs puffy tumor (PPT) is an infection of the frontal sinus with subperiosteal and intracranial abscess formation and one of the rare entities in pediatrics. We present a series of four cases of PPT that occurred in two children (6 and 9 years) and in two young adults (17 and 19 years). All patients were treated by an interdisciplinary team of pediatric, neurosurgical, ENT, radiological, and neuroradiological specialists. Antibiotic treatment was combined with single endoscopic surgery in one case and combined endoscopic sinus surgery with an open transcranial approach to drain intracranial abscess formation in three cases. It is important to be aware that PPT occurs in children with the finding of intracranial abscess formation. Therefore, a close interdisciplinary cooperation for successful treatment is needed in this rare disease
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