scholarly journals Postnatal Corticosteroids for Prevention and Treatment of Chronic Lung Disease in the Preterm Newborn

2012 ◽  
Vol 2012 ◽  
pp. 1-12 ◽  
Author(s):  
Sachin Gupta ◽  
Kaninghat Prasanth ◽  
Chung-Ming Chen ◽  
Tsu F. Yeh
Keyword(s):  
Muscle Tone ◽  
Neonatal Morbidity ◽  
Airway Disease ◽  
Preterm Neonates ◽  
Childhood And Adolescence ◽  
Reactive Airway Disease ◽  
Prevention And Treatment ◽  
Harmful Effects

Despite significant progress in the treatment of preterm neonates, bronchopulmonary dysplasia (BPD) continues to be a major cause of neonatal morbidity. Affected infants suffered from long-term pulmonary and nonpulmonary sequel. The pulmonary sequels include reactive airway disease and asthma during childhood and adolescence. Nonpulmonary sequels include poor coordination and muscle tone, difficulty in walking, vision and hearing problems, delayed cognitive development, and poor academic achievement. As inflammation seems to be a primary mediator of injury in pathogenesis of BPD, role of steroids as antiinflammatory agent has been extensively studied and proven to be efficacious in management. However, evidence is insufficient to make a recommendation regarding other glucocorticoid doses and preparations. Numerous studies have been performed to investigate the effects of steroid. The purpose of this paper is to evaluate these studies in order to elucidate the beneficial and harmful effects of steroid on the prevention and treatment of BPD.

scholarly journals Case Report: Clostridium neonatale Bacteremia in a Preterm Neonate With Necrotizing Enterocolitis

2021 ◽  
Vol 9 ◽  
Author(s):  
Nadim Cassir ◽  
Isabelle Grandvuillemin ◽  
Manon Boxberger ◽  
Priscilla Jardot ◽  
Farid Boubred ◽  
...  
Keyword(s):  
Necrotizing Enterocolitis ◽  
Potential Role ◽  
Preterm Neonate ◽  
Gastrointestinal Disorder ◽  
Etiologic Agent ◽  
Preterm Neonates ◽  
Environmental Cleaning ◽  
Life Threatening

Necrotizing enterocolitis is a life-threatening acquired gastrointestinal disorder among preterm neonates and is associated with a high mortality rate and long-term neurodevelopmental morbidity. No etiologic agent has been definitively established; nonetheless, the most implicated bacteria include members of the Clostridium genus. We reported here on a case of Clostridium neonatale bacteremia in a preterm neonate with necrotizing enterocolitis, providing more information regarding the potential role of this bacterium in pathogenesis of necrotizing enterocolitis. We emphasized the sporulating form of C. neonatale that confers resistance to disinfectants usually applied for the hospital environmental cleaning. Further works are needed to establish the causal relationship between the occurrence of NEC and the isolation of C. neonatale, with promising perspectives in terms of diagnostic and therapeutic management.

The Role of Immunomodulators and Biologics in the Medical Management of Stricturing Crohn’s Disease

2019 ◽  
Vol 14 (4) ◽  
pp. 557-566 ◽  
Author(s):  
Iago Rodríguez-Lago ◽  
Javier P Gisbert
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Balloon Dilation ◽  
Endoscopic Balloon Dilation ◽  
Inflammatory Lesions ◽  
Prevention And Treatment ◽  
Inflammatory Changes ◽  
Endoscopic Balloon

Abstract Crohn’s disease is a progressive and disabling inflammatory disease involving the gastrointestinal tract. It usually produces inflammatory lesions in the ileocolonic region, but up to half of patients will also develop complications such as strictures in the long term. Indeed, a proportion of patients have progression of the disease with the development of stricturing lesions because there are no drugs that effectively prevent or reverse established fibrosis, and hence these patients are usually treated with surgery or endoscopic balloon dilation. Fibrotic lesions are always associated with some degree of inflammatory changes, but there is little evidence supporting the use of medical therapy in this context. Here, we discuss the most important findings on the possible use of immunomodulators or biologics in the prevention and treatment of intestinal strictures in Crohn’s disease patients. Recent evidence demonstrates that these drugs may also be effective in treating lesions with high levels of collagen deposition, and thus might, at least in some patients, reduce the progression of the disease and bowel damage, and further avoid the need for surgery and a disabling course in the long term.

scholarly journals A study of the causes leading to the liquidation of agricultural enterprises

2009 ◽  
Vol 3 (5-6) ◽  
pp. 123-127
Author(s):  
Annamária Kotormán
Keyword(s):  
Crisis Management ◽  
Agricultural Production ◽  
Equity Capital ◽  
Economic Knowledge ◽  
Share Capital ◽  
Agricultural Enterprises ◽  
Prevention And Treatment ◽  
Harmful Effects ◽  
Term Maintenance

The viability of agricultural enterprises is of paramount importance. Their liquidation has harmful effects on broad strata of society. The aim of my research is therefore to analyze the leading causes of liquidation of agricultural enterprises. The research was led on 17 agricultural enterprises. This may help in the prevention and treatment of their insolvency. The research results show that a long-term agricultural production is not sustainable with a low equity capital. For the long-term maintenance it is necessary that the investors establish the enterprise with a capital according to the type of the production.The loan can not replacethe entrepreneursown resources,it is only complementaryto it.Theownersof agriculturalbusinessesshould strive to ensurethatthe paid-up share capital is kept in the firm, because in case of payment difficulties, this can be an adequate financial provision. Companies with financial problems can avoid liquidation if the crisis is detected in time by the leaders. However, the owners must organize the management of the enterprise so that it should have the necessary technical and economic knowledge. With an appropriate management, and use of means of crisis management, the liquidation of the enterprise can be prevented.

scholarly journals Obesity and its role in the development of metabolic syndrome in children

2020 ◽  
Vol 65 (2) ◽  
pp. 125-132
Author(s):  
L. M. Panasenko ◽  
J. V. Nefedova ◽  
T. V. Kartseva ◽  
M. I. Cherepanova
Keyword(s):  
Metabolic Syndrome ◽  
Childhood Obesity ◽  
Children And Adolescents ◽  
Psychosocial Health ◽  
Childhood And Adolescence ◽  
Short Term ◽  
Treatment Methods ◽  
The Metabolic Syndrome ◽  
Prevention And Treatment

The health basis and correct lifestyle habits, including proper nutrition, are formed in the childhood and adolescence. An excess or deficiency of certain nutrients can cause chronic forms of alimentary-dependent pathology. Childhood obesity results in both short-term and long-term unfavorable effects on physical and psychosocial health. The article presents modern ideas about the pathogenesis of the metabolic syndrome in children and adolescents, diagnostic, prevention and treatment methods.

scholarly journals Doxapram Use for Apnoea of Prematurity in Neonatal Intensive Care

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
S. A. Prins ◽  
S. J. A. Pans ◽  
M. M. van Weissenbruch ◽  
F. J. Walther ◽  
S. H. P. Simons
Keyword(s):  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Periventricular Leukomalacia ◽  
Ductus Arteriosus ◽  
Neonatal Morbidity ◽  
Preterm Neonates ◽  
Short Term ◽  
Prospective Trials ◽  
Care Outcome

Apnoea of prematurity is treated with noninvasive respiratory therapy and methylxanthines. For therapy unresponsive apnoea doxapram is often prescibed in preterm neonates. The duration, dosage and route of administration of doxapram together with its efficacy was evaluated in two Dutch neonatal intensive care. Outcome concerning short-term safety and neonatal morbidity were evaluated. During 5 years, 122 of 1,501 admitted newborns <32 weeks of gestational age received doxapram. 64.8% of patients did not need intubation after doxapram. 25% of treated neonates were <27 weeks of gestation. A positive response to doxapram therapy on apnoea was associated with longer duration of doxapram usage (P<0.001), lower mean doses (P<0.003), and less days of intensive care (median 33 versus 42 days;P<0.002). No patients died during doxapram therapy. Incidence of necrotizing enterocolitis, intraventricular hemorrhage, periventricular leukomalacia, retinopathy of prematurity, persistent ductus arteriosus, or worsening of pulmonary condition did not increase during doxapram therapy. Doxapram is frequently used for apnoea of prematurity, despite a lack of data on short-term efficacy and long-term safety. Until efficacy and safety are confirmed in prospective trials, doxapram should be used with caution.

scholarly journals Reference: The role of corticosteroids in a preterm infant with lung pathology in the first three months of life.

2021 ◽  
Author(s):  
Femi Adeniyi
Keyword(s):  
Bronchopulmonary Dysplasia ◽  
Scientific Evidence ◽  
Extensive Study ◽  
Preterm Neonates ◽  
Lung Pathology ◽  
Selective Treatment ◽  
Term Outcome ◽  
Long Term Outcome

Corticosteroids are helpful in the treatment of preterm neonates at risk of bronchopulmonary dysplasia (BPD). However, its usefulness depends on patient selection, the timing of intervention with a corticosteroid, and choice of corticosteroid. In making these clinical choices, one must consider both short and long-term outcomes. Although corticosteroid use has been available for decades in preterm neonatal care, many aspects of corticosteroid use are unresolved due to limited research. Corticosteroids cause upregulation of anti-inflammatory, inhibiting pro-inflammatory mediators at the genomic level. Furthermore, the benefits of using corticosteroids should outweigh the known risks. Here we will discuss the current literature to guide clinical practice—a literature search for evidence through the clinical database on EMBASE, Medline, PubMed, and Cochrane. The keywords are bronchopulmonary dysplasia, corticosteroids, and prematurity.Limitations.There is bias due to limited research available to provide a high level of scientific evidence on the use of different modes of administration, other agents compared to the systemic use of dexamethasone. Conclusion.The consensus in the prevention of BPD is selective treatment after one week of life with dexamethasone. There is limited evidence to suggest the role of prophylaxis hydrocortisone in preventing BPD and advise to be considered in centers with a high risk of BPD. An extensive study into prophylaxis hydrocortisone for prevention of BDP and long-term outcome appears to be promising.The role of instilled steroids with surfactants at birth appears promising in the single-center study. A multicentre double-blinded randomized intratracheal budesonide use at delivery will be valuable.

scholarly journals The Association Between the 5Cs and Anxiety—Insights From Three Countries: Portugal, Slovenia, and Spain

2021 ◽  
Vol 12 ◽  
Author(s):  
Ana Kozina ◽  
Diego Gomez-Baya ◽  
Margarida Gaspar de Matos ◽  
Gina Tome ◽  
Nora Wiium
Keyword(s):  
Youth Development ◽  
Short Form ◽  
Risky Behaviors ◽  
Anxiety Scale ◽  
Childhood And Adolescence ◽  
Anxiety Prevention ◽  
Educational Framework ◽  
Short And Long Term

Several of the most frequent psychological difficulties in childhood and adolescence are related to anxiety and lead to numerous short- and long-term negative outcomes in emotional, social, and academic domains. Empirical evidence consistently shows that the 5Cs (competence, caring, confidence, connection, and character) of Positive Youth Development (PYD) are positively related to adolescents’ contribution to self, family, and society as well as negatively related to risky behaviors and emotional difficulties, such as anxiety. Thus, the PYD can be one of the models that informs prevention programs. To provide contextualized, data-driven support for prevention efforts, we have analyzed the predictive value of the 5Cs for anxiety and anxiety dimensions using three different convenience youth samples from Portugal (N = 384, 46.6% female), Slovenia (N = 449, 69% females), and Spain (N = 768; 60.5% females). To assess the 5Cs, we used the same short form of the PYD scale in all samples (Geldhof et al., 2013) and different anxiety measures across samples: the Multidimensional Anxiety Scale for Children (MASC) in Portugal, the Lestvica anksioznosti za otroke in mladostnike anxiety scale (LAOM) in Slovenia and the Generalized Anxiety Disorder-7 (GAD-7) in Spain. The findings show significant associations of PYD and anxiety across all three contexts with all three different anxiety measures used. The associations vary across countries emphasizing the need to further research the role of contexts in anxiety prevention. Despite variations the results do indicate that connection is negatively associated with anxiety in all three contexts using the three anxiety measures, while confidence is a negative predictor and caring is a positive predictor of anxiety in Slovenia and Spain. Implications for practice within an educational framework for adolescents and youth are discussed, together with public policy recommendations.

Pharmacokinetics of levodopa and personalized therapy in Parkinson’s disease

2020 ◽  
Vol 18 (5) ◽  
pp. 36-41
Author(s):  
A. A. TAPPAKHOV ◽  
◽  
T. E. POPOVA ◽  
T. G. GOVOROVA ◽  
Yu. I. KHABAROVA ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Biological Activity ◽  
Personalized Therapy ◽  
Motor Fluctuations ◽  
Dopa Decarboxylase ◽  
Type B ◽  
Prevention And Treatment

The article provides a review of the pharmacokinetics of levodopa and personalized therapy for Parkinson’s disease. We analyzed the methods used to prolong the action of levodopa using peripheral inhibitors of DOPA decarboxylase, catechol-O-methyltransferase inhibitors, and monoamine oxidase type B inhibitors. The influence of levodopa metabolites with their own biological activity in the possible progression of the disease is emphasized. The role of determining the concentration of levodopa in blood plasma is discussed, as well as the concept of «continuous dopamine stimulation» for the prevention and treatment of side effects of long-term levodopa therapy, such as drug dyskinesias, motor and non-motor fluctuations. The article also provides an overview of the modern forms of levodopa that are currently being investigated.

How Should Physicians Approach the Problems of Their Patients?

PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 928-931
Author(s):  
Paul S. Bellet
Keyword(s):  
Emergency Department ◽  
Airway Disease ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Pediatric Residents ◽  
Reactive Airway Disease ◽  
Reactive Airway

During a recent seminar with pediatric residents to discuss the role of empathy in the doctor-patient relationship, the following dialogue occurred. Resident: It is fine and terrific to talk about how useful empathy can be, but it does not work when children with reactive airway disease have parents who continue to smoke. I feel strongly that people should not smoke. When these children wheeze, their parents bring them to the Emergency Department and we have to see them and deal with the same problem over and over again. Physician: Have you talked to the parents to try and understand their feelings about smoking and whether they believe it influences their child's wheezing?

Prediction of preterm birth: the role cervical assessment by ultrasound and cervico-vaginal biomarkers

2020 ◽  
Author(s):  
Giuseppe Rizzo ◽  
Ilenia Mappa Mappa ◽  
Victoria Bitsadze ◽  
Jamilya Khizroeva ◽  
Alexander Makatsariya
Keyword(s):  
Preterm Birth ◽  
Neonatal Morbidity ◽  
Cervical Length ◽  
Fetal Fibronectin ◽  
Neonatal Deaths ◽  
A Value ◽  
Increased Risk ◽  
Asymptomatic Women

Preterm delivery (PTB) is one of the most common and serious complications of pregnancy. PTB accounts for approximately 70% of neonatal deaths and is a major cause of neonatal morbidity including respiratory distress syndrome, necrotising enterocolitis and long-term neurological disabilities. Prevention of PTB and its complications include identification among symptomatic women those at high risk of immediate delivery requiring prenatal corticosteroids administration. Transvaginal ultrasonographic evaluation of the cervical length (CL) is predictive of PTB and a value 15 mm identifies among symptomatic women approximately 70% of women who will deliver within one week. In the range of CL within 15 and 30 mm biomarkers n cervical-vaginal fluids (fetal fibronectin, phosphorylated insulin-like growth factor protein-1, placental alpha-microglobulin-, cytokines) and other ultrasonographic cervical variables (posterior cervical angle, elastography) improve the identification of women at risk, In asymptomatic women CL can be applied as screening and has been proposed as a universal screening during the second trimester in singleton gestations. The finding of a CL25mm is associated with an increased risk of subsequent PTB with a sensitivity between 30 and 60% that is improved with the combination of biomarkers. Asymptomatic women with a CL 25mm should be offered vaginal progesterone treatment for the prevention of preterm birth and neonatal morbidity. The role of cerclage and pessary is still controversial. In this review we discuss the evidence-based role of ultrasonographic cervical assessment and cervicovaginal biomarkers in the prediction of PTB in symptomatic and asymptomatic women

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