199 research outputs found
Routine Fetal Rhd Genotyping with Maternal Plasma: A Four-Year Experience in Belgium
peer reviewedBACKGROUND: The objective was to evaluate the diagnostic value of RHD fetal genotyping from the plasma of D- mothers as soon as 10 weeks' gestation in a routine clinical practice in Belgium. STUDY DESIGN AND METHODS: A prospective study was conducted between November 2002 and December 2006. DNA extraction was performed in an automated closed tube system. Fetal RHD/SRY genotypes were detected in the plasma of 563 pregnant mothers by real-time polymerase chain reaction (PCR) targeting multiple exons 4, 5, and 10 of the RHD gene and targeting an SRY gene sequence. These were compared to the D phenotypes determined in the 581 babies they delivered. RESULTS: By combining amplification of three exons, the concordance rate of fetal RHD genotypes in maternal plasma and newborn D phenotypes at delivery was 100 percent (99.8% including one unusual false-positive). The presence of nonfunctional RHD genes and the absence of a universal fetal marker, irrespective of fetal sex, did not influence the accuracy of fetal RhD status prediction. The RHD genotyping from 18 twin pregnancies was also assessed. Five weak D women were excluded from the RHD fetal genotyping prediction. Three discrepant results (0.5%) between predicted fetal genotype and cord blood phenotype were not confirmed by the baby phenotypes from venipuncture blood. CONCLUSION: Prenatal prediction of fetal RHD by targeting multiple exons from the maternal plasma with real-time PCR is highly sensitive and accurate. Over 4 years, this experience has highly modified our management of D- pregnant women
Research priorities in pediatric parenteral nutrition: a consensus and perspective from ESPGHAN/ESPEN/ESPR/CSPEN
We acknowledge all the authors of the ESPGHAN/ESPR/ESPEN/CSPEN pediatric
parenteral nutrition guidelines for their contributions and vote (Christian Braegger,
University Children’s Hospital, Zurich, Switzerland; Jiri Bronsky, University Hospital
Motol, Prague, Czech Republic; Cristina Campoy, Department of Paediatrics, School of
Medicine, University of Granada, Granada, Spain; Magnus Domellof, Department of
Clinical Sciences, Pediatrics, UmeĂĄ University, Sweden; Nicholas Embleton, Newcastle
University, Newcastle upon Tyne, UK; Mary Fewtrell, UCL Great Ormond Street
Institute of Child Health, London, UK; Natasa Fidler, University Medical Centre
Ljubljana, Ljubljana, Slovenia; Axel Franz, University Children’s Hospital, Tuebingen,
Germany; Oliver Goulet, University Sordonne-Paris-Cite; Paris-Descartes Medical
School, Paris, France; Corina Hartmann, Schneider Children’s Medical Center of Israel,
Petach Tikva, Israel and Carmel Medical Center, Israel; Susan Hill, Great Ormond Street
Hospital for Children, NHS Foundation Trust and UCL Institute of Child Health,
London, UK; Iva Hojsak, Children’s Hospital Zagreb, University of Zagreb School of
Medicine, University of J. J. Strossmayer School of Medicine Osijek, Croatia; Sylvia
Iacobelli, CHU La Reunion, Saint Pierre, France; Frank Jochum, Ev. Waldkrankenhaus
Spandau, Berlin, Germany; Koen Joosten, Department of Pediatrics and Pediatric
Surgery, Intensive Care, Erasmus MC Sophia Children’s Hospital, Rotterdam, The
Netherlands; Sanja Kolacek, Children’s Hospital, University of Zagreb School of
Medicine, Zagreb, Croatia; Alexandre Lapillone, Paris-Descartes University, Paris,
France; Szimonetta Lohner, Department of Pediatrics, University of Pecs, Pecs,
Hungary; Dieter Mesotten, KU Leuven, Leuven, Belgium; Walter Mihatsch, Ulm
University, Ulm, and Helios Hospital, Pforzheim, Germany; Francis Mimouni,
Department of Pediatrics, Division of Neonatology, The Wilf Children’s Hospital, the
Shaare Zedek Medical Center, Jerusalem, and the Tel Aviv University, Tel Aviv, Israel;
Christian Molgaard, Department of Nutrition, Exercise and Sports, University of
Copenhagen, and Paediatric Nutrition Unit, Rigshospitalet, Copenhagen, Denmark;
Sissel Moltu, Oslo University Hospital, Oslo, Norway; Antonia Nomayo, Ev.
Waldkrankenhaus Spandau, Berlin, Germany; John Puntis, The General Infirmary at
Leeds, Leeds, UK; Arieh Riskin, Bnai Zion Medical Center, Rappaport Faculty of
Medicine, Technion, Haifa, Israel; Miguel Saenz de Pipaon, Department of
Neonatology, La Paz University Hospital, Red de Salud Materno Infantil y Desarrollo
e SAMID, Universidad Autonoma de Madrid, Madrid, Spain; Raanan Shamir, Schneider
Children’s Medical Center of Israel, Petach Tikva, Israel; Tel Aviv University, Tel Aviv,
Israel; Peter Szitanyi, General University Hospital, First Faculty of Medicine, Charles
University in Prague, Czech Republic; Merit Tabbers, Emma Children’s Hospital,
Amsterdam UMC, Amsterdam, The Netherlands; Chris van den Akker, Emma
Children’s Hospital, Amsterdam UMC, Amsterdam, The Netherlands; Hans van
Goudoever, Emma Children’s Hospital, Amsterdam UMC, Amsterdam, The Netherlands;
Sacha Verbruggen, Department of Pediatrics and Pediatric Surgery, Intensive
Care, Erasmus MC-Sophia Children’s Hospital, Rotterdam, The Netherlands; Cai Wei,
Shanghai Jiao Tong University, Shanghai, China; Weihui Yan, Department of
Gastroenterology and Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao
Tong University, Shanghai, China) and the members of the ESPR Section on Nutrition,
Gastroenterology and Metabolism (Fredrik Ahlsson, Uppsala University Children’s
Hospital and Department of Women’s and Children’s Health, Uppsala University,
Uppsala, Sweden; Sertac Arslanoglu, Division of Neonatology, Department of
Pediatrics, Istanbul Medeniyet University, Istanbul, Turkey; Wolfgang Bernhard,
Department of Neonatology, Children’s Hospital, Faculty of Medicine, Eberhard-Karls-
University, TĂĽbingen, Germany; Janet Berrington, Newcastle Neonatal Service,
Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK;
Signe Bruun, Hans Christian Andersen Hospital for Children and Adolescents, Odense
University Hospital, Odense, Denmark; Christoph Fusch, Department of Pediatrics, Paracelsus Medical School, General Hospital of Nuremberg, Nuremberg, Germany;
Shalabh Garg, South Tees Hospitals, Middlesborough, UK; Maria Gianni, Department
of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Ann
Hellstrom, Institute of Neuroscience and Physiology, Sahlgrenska Academy at
University of Gothenburg, Gothenburg, Sweden; Claus Klingenberg, Department of
Pediatrics and Adolescence Medicine, University Hospital of North Norway, Tromsø,
Norway; Helen Mactier, Neonatal Unit, Princess Royal Maternity Hospital, Glasgow,
UK; Neena Modi, Section of Neonatal Medicine, Department of Medicine, Chelsea and
Westminster Campus, Imperial College London, London, UK; Niels Rochow, Division
of Neonatology, Department of Pediatrics, McMaster University, Hamilton, Ontario,
Canada; Paola Rogerro, Department of Clinical Sciences and Community Health,
University of Milan, Milan, Italy; Umberto Simeoni, Division of Pediatrics, CHUV &
University of Lausanne, Lausanne, Switzerland; Atul Singhal, Paediatric Nutrition, UCL
Great Ormond Street Institute of Child Health, London, UK.; Ulrich Thome,
Department of Neonatology, Universitatsklinikum Leipzig, Leipzig, Germany; Anne
Twomey, Department of Neonatology, The National Maternity Hospital, Dublin,
Ireland; Mireille Vanpee, Karolinska University Hospital, Stockholm, Sweden; Gitte
Zachariassen, Hans Christian Andersen Hospital for Children and Adolescents,
Odense University Hospital, Odense, Denmark) for their vote.Parenteral nutrition is used to treat children that cannot be fully fed by the enteral route. While the revised ESPGHAN/
ESPEN/ESPR/CSPEN pediatric parenteral nutrition guidelines provide clear guidance on the use of parenteral nutrition in neonates,
infants, and children based on current available evidence, they have helped to crystallize areas where research is lacking or more
studies are needed in order to refine recommendations. This paper collates and discusses the research gaps identified by the
authors of each section of the guidelines and considers each nutrient or group of nutrients in turn, together with aspects around
delivery and organization. The 99 research priorities identified were then ranked in order of importance by clinicians and
researchers working in the field using a survey methodology. The highest ranked priority was the need to understand the
relationship between total energy intake, rapid catch-up growth, later metabolic function, and neurocognitive outcomes. Research
into the optimal intakes of macronutrients needed in order to achieve optimal outcomes also featured prominently. Identifying
research priorities in PN should enable research to be focussed on addressing key issues. Multicentre trials, better definition of
exposure and outcome variables, and long-term metabolic and developmental follow-up will be key to achieving this
Prevalence and mechanisms of resistance to carbapenems in Enterobacteriaceae
Objectives: To determine the point prevalence of carbapenem-non-susceptible Enterobacteriaceae (CNSE) and carbapenemase-producing Enterobacteriaceae (CPE) isolates among hospitalized patients in Belgium.
Methods: Twenty-four hospital-based laboratories prospectively collected 200 non-duplicated Enterobacteriaceae isolates from clinical specimens of hospitalized patients over a 2 month period. All isolates were screened locally for decreased susceptibility to carbapenem drugs using a disc diffusion method according to CLSI interpretative criteria. CNSE strains were referred centrally for confirmation of carbapenemase by phenotypic and molecular testing.
Results: From February to April 2012, 158 of the 4564 screened Enterobacteriaceae isolates were categorized as non-susceptible to carbapenems, resulting in a point prevalence of CNSE of 3.5% (95% CI: 2.9%–4.2%; range per centre: 0.5%–8.5%). Of the 125 referred CNSE isolates, 11 Klebsiella pneumoniae isolates [OXA-48 (n=7), KPC type (n=3) and NDM type (n=1)], 1 OXA-48-positive Escherichia coli isolate and 1 KPC-positive Klebsiella oxytoca isolate were detected in eight hospitals. None of the 72 carbapenem-non-susceptible Enterobacter spp. isolates were confirmed as CPE. The minimal estimated point prevalence of CPE isolates was 0.28% (13/ 4564; 95% CI: 0.13%–0.44%) overall (range per centre: 0%–1.5%).
Conclusions: Despite the overall low prevalence of CNSE found in this study, the detection of CPE isolates in one-third of the participating centres raises concerns and highly suggests the spread and establishment of CPE in Belgian hospitals
Research priorities in pediatric parenteral nutrition: a consensus and perspective from ESPGHAN/ESPEN/ESPR/CSPEN
Parenteral nutrition is used to treat children that cannot be fully fed by the enteral route. While the revised ESPGHAN/ESPEN/ESPR/CSPEN pediatric parenteral nutrition guidelines provide clear guidance on the use of parenteral nutrition in neonates, infants, and children based on current available evidence, they have helped to crystallize areas where research is lacking or more studies are needed in order to refine recommendations. This paper collates and discusses the research gaps identified by the authors of each section of the guidelines and considers each nutrient or group of nutrients in turn, together with aspects around delivery and organization. The 99 research priorities identified were then ranked in order of importance by clinicians and researchers working in the field using a survey methodology. The highest ranked priority was the need to understand the relationship between total energy intake, rapid catch-up growth, later metabolic function, and neurocognitive outcomes. Research into the optimal intakes of macronutrients needed in order to achieve optimal outcomes also featured prominently. Identifying research priorities in PN should enable research to be focussed on addressing key issues. Multicentre trials, better definition of exposure and outcome variables, and long-term metabolic and developmental follow-up will be key to achieving this. Impact: The recent ESPGHAN/ESPEN/ESPR/CSPEN guidelines for pediatric parenteral nutrition provided updated guidance for providing parenteral nutrition to infants and children, including recommendations for practice.However, in several areas there was a lack of evidence to guide practice, or research questions that remained unanswered. This paper summarizes the key priorities for research in pediatric parenteral nutrition, and ranks them in order of importance according to expert opinion
Expression of Calmodulin and Myosin Light Chain Kinase during Larval Settlement of the Barnacle Balanus amphitrite
Barnacles are one of the most common organisms in intertidal areas. Their life cycle includes seven free-swimming larval stages and sessile juvenile and adult stages. The transition from the swimming to the sessile stages, referred to as larval settlement, is crucial for their survivor success and subsequent population distribution. In this study, we focused on the involvement of calmodulin (CaM) and its binding proteins in the larval settlement of the barnacle, Balanus ( = Amphibalanus) amphitrite. The full length of CaM gene was cloned from stage II nauplii of B. amphitrite (referred to as Ba-CaM), encoding 149 amino acid residues that share a high similarity with published CaMs in other organisms. Quantitative real-time PCR showed that Ba-CaM was highly expressed in cyprids, the stage at which swimming larvae are competent to attach and undergo metamorphosis. In situ hybridization revealed that the expressed Ba-CaM gene was localized in compound eyes, posterior ganglion and cement glands, all of which may have essential functions during larval settlement. Larval settlement assays showed that both the CaM inhibitor compound 48/80 and the CaM-dependent myosin light chain kinase (MLCK) inhibitor ML-7 effectively blocked barnacle larval settlement, whereas Ca2+/CaM-dependent kinase II (CaMKII) inhibitors did not show any clear effects. The subsequent real-time PCR assay showed a higher expression level of Ba-MLCK gene in larval stages than in adults, suggesting an important role of Ba-MLCK gene in larval development and competency. Overall, the results suggest that CaM and CaM-dependent MLCK function during larval settlement of B. amphitrite
Vulvovaginal Candidiasis: Prevalence of Different Candida Species in the Liege Region
peer reviewedWe calculated the prevalences of different yeast species isolated from more than 20,000 vulvovaginal specimens carried out at the CHR hospital in Liege. To assess the value of the observed relative frequencies, the culture results of 149 samples were confronted with those of a real-time PCR technique of fungal identification. With a prevalence close to 90%, Candida albicans remains the largely dominant species. In contrast with other teams, we observed no increase of the prevalences of Candida non-albicans species
Blood urea nitrogen during the first 2 weeks of life in VLBW infants receiving high protein intakes
Dramatic reduction of postnatal growth restriction after optimizing nutrition in extremely preterm infants
Dramatic reduction of postnatal growth restriction after optimizing nutrition in very low birth weight infants.
Metabolic acidosis during the first 2 weeks of life in VLBW infants receiving high protein intakes
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