Superior mesenteric artery blood flow in infants of very preterm and very low birthweight and its related factors

Abstract Background Significant hemodynamic changes in preterm infants during early life could have consequences, especially on the intestinal blood flow. Alteration of superior mesenteric artery (SMA) blood flow may lead to impairment in gut function and feeding intolerance. Objectives To assess SMA blood flow velocity in very preterm and/or very low birth weight (VLBW) infants in early life and to elucidate the factors influencing them. Methods This is a cross-sectional study conducted in NICU at Cipto Mangunkusumo Hospital, Jakarta. Superior mesenteric artery (SMA) blood flow was evaluated by peak systolic velocity (PSV), end diastolic velocity (EDV), and resistive index (RI) measurement using Color Doppler US at < 48 hours after birth. Maternal and neonatal data that could be potentially associated with SMA blood flow were obtained. Bivariate analyses were conducted with a P value of < 0.05 considered significant. Results We examined 156 infants eligible for the study. PSV, EDV, and RI of SMA blood flow were not related to both gestational age and birth weight. Infant with small for gestational age (SGA) showed significantly lower EDV median [15.5 (range 0.0-32.8) vs 19.4 (range 0.0-113.0)] and higher RI [0.80 (range 0.58-1.00) vs 0.78 (range 0.50-1.00)] compared to appropriate for gestational age (AGA).  Infants born from mother with preeclampsia showed lower PSV median [(78.2 (range 32.0-163.0) vs 89.7 (range 29.2-357.0)]) and EDV [16.2 (range 0.0-48.5) vs 19.4 (range 0.0-113.0)] compared to without PE, while absent/reverse end-diastolic velocity (AREDV) revealed a lower EDV median [16.9 (range 0.0 – 32.4) vs 19.4 (range 0.0 – 113.0)] compared to no AREDV. Furthermore, infants with hs-PDA showed lower EDV median [16.2 (range 0.0-113.0) vs 19.4 (range 0.0-71.1)] but higher RI median [0.80 (range 0.50-1.00) vs 0.78 (range 0.55-1.00)] compared to non hs-PDA. No difference in SMA blood flow across other factors was observed

Karakterisasi dan skrining fitokimia senyawa dari fungi endofit daun sirsak (Annona muricata L)

Mikroba endofit adalah mikroba yang terdapat dalam sistem jaringan tumbuhan seperti biji, daun, bunga, ranting, dan akar tanpa menyebabkan gejala yang merugikan tanaman inang. Penggunaan fungi endofit sebagai sumber bahan baku obat secara ekonomis diperkirakan lebih efisien dibandingkan dengan menggunakan tumbuhan obat. Fungi endofit yang diperoleh dari daun sirsak lebih banyak karena memiliki luas permukaan yang luas dan memiliki lapisan kutikula yang tipis sehingga lebih banyak fungi endofit yang masuk dalam jaringan tanaman.Tujuan dari penelitian adalah untuk mengetahui fungi endofit dapat diisolasi dari daun sirsak (Annona muricata L), mengetahui karakteristik fungi endofit dari daun sirsak (Annona muricata L), mengetahui golongan senyawa metabolit sekunder yang terkandung dalam isolat fungi endofit daun sirsak (Annona muricata L). Hasil dari penelitian ini didapatkan 4 isolat fungi endofit dari daun sirsak. Karakterisasi dilakukan pada 4 isolat tersebut meliputi pengamatan makroskopis, mikroskopis, dan uji biokimia (uji hidrolisa amilum, kasein dan lemak). Selanjutnya dilakukan proses fermentasi dan dilakukan skrining fitokimia dengan menggunakan metode tabung. Skrining menunjukkan hasil positif pada golongan senyawa alkaloid dan saponin

Karakterisasi dan skrining fitokimia senyawa dari fungi endofit daun sirsak (Annona muricata L)

Mikroba endofit adalah mikroba yang terdapat dalam sistem jaringan tumbuhan seperti biji, daun, bunga, ranting, dan akar tanpa menyebabkan gejala yang merugikan tanaman inang. Penggunaan fungi endofit sebagai sumber bahan baku obat secara ekonomis diperkirakan lebih efisien dibandingkan dengan menggunakan tumbuhan obat. Fungi endofit yang diperoleh dari daun sirsak lebih banyak karena memiliki luas permukaan yang luas dan memiliki lapisan kutikula yang tipis sehingga lebih banyak fungi endofit yang masuk dalam jaringan tanaman.Tujuan dari penelitian adalah untuk mengetahui fungi endofit dapat diisolasi dari daun sirsak (Annona muricata L), mengetahui karakteristik fungi endofit dari daun sirsak (Annona muricata L), mengetahui golongan senyawa metabolit sekunder yang terkandung dalam isolat fungi endofit daun sirsak (Annona muricata L). Hasil dari penelitian ini didapatkan 4 isolat fungi endofit dari daun sirsak. Karakterisasi dilakukan pada 4 isolat tersebut meliputi pengamatan makroskopis, mikroskopis, dan uji biokimia (uji hidrolisa amilum, kasein dan lemak). Selanjutnya dilakukan proses fermentasi dan dilakukan skrining fitokimia dengan menggunakan metode tabung. Skrining menunjukkan hasil positif pada golongan senyawa alkaloid dan saponin

Datasheet1_Feeding intolerance scoring system in very preterm and very low birth weight infants using clinical and ultrasound findings.pdf

Very preterm infants are at a high risk of developing feeding intolerance; however, there are no widely accepted definitions of feeding intolerance. This study aimed to develop a scoring system for feeding intolerance in very preterm infants by combining clinical symptoms and ultrasonography (US) findings. This prospective cohort study included very preterm and/or very low birth weight infants. We defined feeding intolerance as the inability to achieve full feeding (150 ml/kg/day) by 14 days of life. The clinical findings included vomiting, abdominal distention, and gastric fluid color. US findings included intestinal peristaltic frequency, gastric residual volume, peak systolic velocity, and the resistive index of the superior mesenteric artery. We conducted multivariate analyses to evaluate the potential predictors and developed a scoring system to predict feeding intolerance. A total of 156 infants fulfilled the eligibility criteria; however, 16 dropped out due to death. The proportion of patients with feeding intolerance was 60 (42.8%). Based on the predictive ability, predictors of feeding intolerance were determined using data from the US at 5–7 days of age. According to multivariate analysis, the final model consisted of 5 predictors: abdominal distention (score 1), hemorrhagic gastric fluid (score 2), intestinal peristaltic movement ≤18x/2 min (score 2), gastric fluid residue >25% (score 2), and resistive index >0.785 (score 2). A score equal to or above 5 indicated an increased risk of feeding intolerance with a positive predictive value of 84.4% (95% confidence interval:73.9–95.0) and a negative predictive value of 76.8% (95% confidence interval:68.4–85.3). The scoring system had good discrimination (area under the receiver operating characteristic curve:0.90) and calibration (p = 0.530) abilities. This study developed an objective, accurate, easy, and safe scoring system for predicting feeding intolerance based on clinical findings, 2D US, and color Doppler US.</p