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Ptak K, Olszewska M, Szymońska I, Olchawa-Czech A, Mól N, Rudek-Budzyńska A, Kukla K, Cisowska M, Sabat O, Grzyb A, Kwinta P. Should we be afraid of long-term cardiac consequences in children with multisystem inflammatory syndrome? Experience from subsequent waves of COVID-19. Eur J Pediatr 2024:10.1007/s00431-024-05528-0. [PMID: 38517518 DOI: 10.1007/s00431-024-05528-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/12/2024] [Accepted: 03/14/2024] [Indexed: 03/24/2024]
Abstract
The purpose of the study was to assess and compare short- and long-term cardiac complications of the multisystem inflammatory syndrome in children (MIS-C) by predominant severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants throughout the pandemic. The analysis of prospectively collected data comparing cardiac complications of MIS-C during and after hospitalization across the original/alpha, delta, and omicron waves. Cardiac complications were defined as cardiac failure with systolic function impairment or hypotension or abnormalities in echocardiographic findings (decrease in LVEF, FS, valvular insufficiency, pericardial effusion, or coronary artery abnormalities). A total of 120 patients with MIS-C admitted to the Children's Hospital of Krakow between November 1, 2020, and May 5, 2023, were included in the study (74 during original/alpha dominance, 31 delta, and 15 omicron). Patients in the omicron group were found to be younger than those in the alpha and delta groups (37 vs. 75 vs. 80 months, p = 0.03). The frequency of cardiac failure with systolic function impairment or hypotension was diagnosed more frequently in the original/alpha and delta groups than in the omicron group (44.59% vs. 41.94% vs. 13.33%, p = 0.08) also echocardiographic abnormalities changed, with rates of 60.8%, 35.5%, and 13.3% (p < 0.001) accordingly. The multivariable regression revealed an older age (OR = 1.19, 95% CI = 1.07-1.33, p = 0.002) as the only independent factors of cardiac failure with systolic function impairment or hypotension. In all patients, signs of cardiac failure resolved during the hospitalization. Moreover, in 98.3% of patients, all echocardiagraphic abnormalities resolved completely during the observation period. Conclusion: The cardiac complications of MIS-C appeared to advance less severely in younger children during the Omicron outbreak. In long-term observation, symptoms of cardiac failure resolve completely. Similarly, also echocardiographic abnormalities normalize in the vast majority of patients. What is Known: • Knowledge about the long-term cardiac complications of MIS-C is still evolving and uncertain. • The greatest concern of MIS-C is cardiac complications, including cardiac failure and coronary artery dilatation. What is New: • Long-term observations revealed complete resolution of cardiac complications in the vast majority of patients with MIS-C, irrespective of the dominant variant. • Cardiac complications of MIS-C were less common in younger children during subsequent pandemic waves in our patient population.
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Affiliation(s)
- Katarzyna Ptak
- Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland.
| | - Marta Olszewska
- Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Izabela Szymońska
- Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Anna Olchawa-Czech
- Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Nina Mól
- Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | | | - Kornelia Kukla
- Department of Pediatrics, University Children's Hospital, Krakow, Poland
| | - Marta Cisowska
- Department of Pediatrics, University Children's Hospital, Krakow, Poland
| | - Oliwia Sabat
- Department of Pediatrics, Jagiellonian University Medical College, Students' Scientific Group, Krakow, Poland
| | - Aleksandra Grzyb
- Department of Pediatrics, Jagiellonian University Medical College, Students' Scientific Group, Krakow, Poland
| | - Przemko Kwinta
- Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
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Mazurek-Durlak Z, Mularczyk K, Kwinta P, Lis G, Cichocka-Jarosz E. Omalizumab in the treatment of Morbihan syndrome in an adolescent girl - case report and literature review. Allergol Immunopathol (Madr) 2024; 52:23-31. [PMID: 38459887 DOI: 10.15586/aei.v52i2.978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 12/15/2023] [Indexed: 03/11/2024]
Abstract
Morbihan syndrome (MS) is characterized by solid facial edema, usually related to rosacea or acne vulgaris. The facial edema deforms the patient's features, can impair peripheral vision, and affects quality of life. Its pathophysiology remains unclear. The disease usually has a slow and chronic course. MS most commonly affects middle-aged Caucasian men with rosacea and is rare in people below 20 years of age. MS is a diagnosis of exclusion. There is no standard treatment for MS, though systemic isotretinoin and antihistamines are mainly used. We present the case of an adolescent girl with MS nonresponding to 19 months of isotretinoin treatment with add-on antihistamines. Therapy with monthly administration of omalizumab (anti-IgE) for 6 months was an effective therapeutic option, improving the quality of life. Our case is the second description of omalizumab use in Morbihan syndrome, the first in an adolescent.
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Affiliation(s)
- Zofia Mazurek-Durlak
- Faculty of Medicine, Department of Pediatrics, Jagiellonian University Medical College, 265, Wielicka Str. 30-663 Krakow, Poland;
| | - Katarzyna Mularczyk
- Faculty of Medicine, Department of Pediatrics, Jagiellonian University Medical College, 265, Wielicka Str. 30-663 Krakow, Poland
| | - Przemko Kwinta
- Faculty of Medicine, Department of Pediatrics, Jagiellonian University Medical College, 265, Wielicka Str. 30-663 Krakow, Poland
| | - Grzegorz Lis
- Faculty of Medicine, Department of Pediatrics, Jagiellonian University Medical College, 265, Wielicka Str. 30-663 Krakow, Poland
| | - Ewa Cichocka-Jarosz
- Faculty of Medicine, Department of Pediatrics, Jagiellonian University Medical College, 265, Wielicka Str. 30-663 Krakow, Poland
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Warchoł A, Kwinta P. Nutrition of Newborns with Hypoxic-Ischaemic Encephalopathy during Therapeutic Hypothermia - A Survey of Practice in Polish Neonatal Care Units. J Mother Child 2024; 28:8-13. [PMID: 38438129 PMCID: PMC10911959 DOI: 10.34763/jmotherandchild.20242801.d-23-00115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 02/04/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND The nutritional practice for newborns with hypoxic-ischaemic encephalopathy during therapeutic hypothermia differs among Polish neonatal care units, as no guidelines are provided. We assessed the prevailing procedures. MATERIAL AND METHODS Data was collected through an anonymous, web-based questionnaire. We surveyed aspects of the current nutritional practices and the reasoning behind the choice of the feeding strategy. RESULTS Thirty-one responses were obtained (31/33, 94%). Based on participants' estimations, 342 newborns are diagnosed with hypoxic-ischaemic encephalopathy and qualified for therapeutic hypothermia annually. Among them, almost ⅓ is fed exclusively parenterally, while 71% both ways-parenterally and enterally. In the vast majority of units, the introduction of enteral nutrition takes place during the first 48 hours of therapeutic hypothermia, and breast milk is primarily provided, although with substantial first feeding volume differentiation (an average of 2,9 ml/kg (0,3 - 10ml/kg)). Adverse events, such as necrotising enterocolitis, sepsis, and glycemia level disturbances that derive from the initiation of enteral nutrition, are difficult to estimate as no official statistics are provided. CONCLUSIONS The majority of newborns after hypoxic-ischaemic encephalopathy treated with therapeutic hypothermia are fed both parenterally and enterally during the procedure, predominantly with expressed or donor breast milk. However, due to the lack of nutritional guidelines, significant variability of nutritional strategies concerning initiation time, type and volume of enteral feeds given is noted. Therefore, further studies are required to clarify feeding recommendations.
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Affiliation(s)
- Aleksandra Warchoł
- Department of Paediatrics, Children's University Hospital, Jagiellonian University Medical College, Cracow, Poland
| | - Przemko Kwinta
- Department of Paediatrics, Children's University Hospital, Jagiellonian University Medical College, Cracow, Poland
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Sobczak A, Kowalik A, Homa M, Turalska P, Kwinta P. Changes in umbilical catheters' microstructure in vivo: A prospective study. J Vasc Access 2024; 25:158-164. [PMID: 35674147 DOI: 10.1177/11297298221100441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Umbilical vessels present after birth allow a unique central access for both venous and arterial catheterization, yet the catheterization complications can be misdiagnosed as the complications of prematurity per se. METHODS A prospective observational study of 41 used polyurethane umbilical catheters, both venous and arterial was conducted in a tertiary neonatal intensive care unit. The study consisted of bedside ultrasound imaging and post-removal microbiological and microstructural analysis to assess the in vivo catheters' changes and their clinical significance. RESULTS The study has shown that catheters' surface thrombosis and bacterial colonization happen more often within umbilical venous than within arterial catheters (31% vs 8% in both cases) and are inversely proportional to the patient's gestational age (thrombosis: Me: 28 weeks vs no thrombosis: 32 weeks; p = 0.05, bacterial colonization: 27 weeks vs no colonization: 30 weeks; p = 0.013), respectively. The clots formed near the catheter's tip are correlated with catheter's bacterial colonization. Chemical analysis with energy dispersive spectroscopy showed a higher calcium composition in used catheters (19.89% vs 0%, p = 0.016) and structure analysis in the scanning electron microscopy proved that within hours catheters become covered with an external coating of a constant thickness, not affected by the catheterization time. CONCLUSION The following observations give a better insight to the complex in vivo interactions and call for a more intense bedside-monitoring of the indwelling devices.
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Affiliation(s)
- Alina Sobczak
- Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
| | - Aleksandra Kowalik
- Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
| | - Marta Homa
- Center for High Temperature Studies, Foundry Research Institute, Kraków, Poland
| | - Patrycja Turalska
- Center for High Temperature Studies, Foundry Research Institute, Kraków, Poland
| | - Przemko Kwinta
- Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
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Moreira AG, Arora T, Arya S, Winter C, Valadie CT, Kwinta P. Leveraging transcriptomics to develop bronchopulmonary dysplasia endotypes: a concept paper. Respir Res 2023; 24:284. [PMID: 37968635 PMCID: PMC10648631 DOI: 10.1186/s12931-023-02596-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 11/07/2023] [Indexed: 11/17/2023] Open
Abstract
IMPACT Bronchopulmonary dysplasia has multiple definitions that are currently based on phenotypic characteristics. Using an unsupervised machine learning approach, we created BPD subclasses (e.g., endotypes) by clustering whole microarray data. T helper 17 cell differentiation was the most significant pathway differentiating the BPD endotypes. INTRODUCTION Bronchopulmonary dysplasia (BPD) is the most common complication of extreme prematurity. Discovery of BPD endotypes in an unbiased format, derived from the peripheral blood transcriptome, may uncover patterns underpinning this complex lung disease. METHODS An unsupervised agglomerative hierarchical clustering approach applied to genome-wide expression of profiling from 62 children at day of life five was used to identify BPD endotypes. To identify which genes were differentially expressed across the BPD endotypes, we formulated a linear model based on least-squares minimization with empirical Bayes statistics. RESULTS Four BPD endotypes (A, B,C,D) were identified using 7,319 differentially expressed genes. Across BPD endotypes, 5,850 genes had a p value < 0.05 after multiple comparison testing. Endotype A consisted of neonates with a higher gestational age and birthweight. Endotypes B-D included neonates between 25 and 26 weeks and a birthweight range of 640 to 940 g. Endotype D appeared to have a protective role against BPD compared to Endotypes B and C (36% vs. 62% vs. 60%, respectively). The most significant pathway focused on T helper 17 cell differentiation. CONCLUSION Bioinformatic analyses can help identify BPD endotypes that associate with clinical definitions of BPD.
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Affiliation(s)
- Alvaro G Moreira
- Department of Pediatrics, Division of Neonatology, University of Texas Health San Antonio, San Antonio, TX, USA.
| | - Tanima Arora
- Department of Pediatrics, Division of Neonatology, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Shreyas Arya
- Division of Neonatology, Dayton Children's Hospital, Cincinnati, OH, USA
| | - Caitlyn Winter
- Department of Pediatrics, Division of Neonatology, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Charles T Valadie
- Department of Pediatrics, Division of Neonatology, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Przemko Kwinta
- Neonatal Intensive Care Unit, Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
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Kowalik A, Cichocka-Jarosz E, Kwinta P. Atopic dermatitis and gestational age - is there an association between them? A review of the literature and an analysis of pathology. Postepy Dermatol Alergol 2023; 40:341-349. [PMID: 37545834 PMCID: PMC10399673 DOI: 10.5114/ada.2023.128999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 01/09/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction The connection between prematurity and atopic dermatitis (AD) is an intensively investigated topic with existing knowledge gaps. The last review with a meta-analysis in this field was published in 2018. Since then, there have been great advances in the comprehension of AD pathophysiology. Aim To update the knowledge and to discuss the recent findings in the field of AD and its association with prematurity in light of the newest publications. Material and methods An electronic search of Medline was conducted, limited to the last eleven years. The screening of the full version of English articles was performed to ensure the fulfilment of the selection criteria. Results Thirteen articles met the inclusion criteria, with a total of over 4 million participants. In the majority of the studies (n = 8), prematurity was associated with a lower risk of atopic dermatitis, although there were also publications (n = 5) that did not find an association between these factors. Conclusions According to this study, prematurity is associated with a lower risk of atopic dermatitis.
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Affiliation(s)
- Aleksandra Kowalik
- Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Ewa Cichocka-Jarosz
- Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Przemko Kwinta
- Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
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Ptak K, Szymońska I, Olchawa-Czech A, Kukla K, Cisowska M, Kwinta P. Comparison of the course of multisystem inflammatory syndrome in children during different pandemic waves. Eur J Pediatr 2023; 182:1647-1656. [PMID: 36719477 PMCID: PMC9887239 DOI: 10.1007/s00431-022-04790-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 12/19/2022] [Accepted: 12/27/2022] [Indexed: 02/01/2023]
Abstract
The purpose of this study is to assess the rate, clinical picture, and management of multisystem inflammatory syndrome in children (MIS-C) during the different COVID-19 variants of concern (VOC) domination periods. This was a retrospective analysis of prospectively collected data. The incidence and clinical picture of MIS-C during the original/Alpha (group 1) and Delta/Omicron (Group 2) variant domination periods were compared. Among 108 eligible patients, 74 (68.5%) were hospitalized during the group 1 domination period, and 34 (31.5%) were hospitalized during the group 2 domination period. The median (Me) patient ages were 76 months (interquartile range [IQR] 35-130) and 73 months (IQR 45-118), and 61% and 65% of patients were male, respectively. There was no significant difference in the presence of positive SARS-CoV 2 antibody test results (IgM or IgG) between the groups (84 vs. 90%; p = 0.54).No differences between groups were observed in fever duration prior to admission (Me [IQR]: 5 days [3-6] vs. 5 days [4-6]; p = 0.26) or the presence of mucocutaneous (95 vs. 100%; p = 0.41), circulatory (70.3 vs. 61.8%; p = 0.86), neurological (6.8 vs. 2.9%; p = 0.662), or gastrointestinal symptoms (84 vs. 79%; p = 0.59). Respiratory symptoms were more common in group 2 (70 vs. 91%; p = 0.015). The need for intensive care unit admission was similar in both groups (16.2 vs. 17.6%, p = 1.0). No deaths occurred in the entire cohort. The studied children were characterized by high C-reactive protein and procalcitonin levels, concentrations of ferritin within normal limits, lymphopenia, moderate hypoalbuminemia, and high B-type natriuretic peptide/brain natriuretic peptide (NT-proBNP) concentrations; however, there were no differences between the groups. Intravenous immunoglobulins were administered as a first-line treatment for almost all patients. There was no significant difference in corticosteroid administration between the groups (87% vs. 74%; p = 0.11); however, the summary dose of methylprednisolone was higher in group 2 (Me [IQR]″ 12.6 mg/kg [10.5-17.8] vs. 16.4 mg/kg [13.3-19.5]; p = 0.03). The median length of stay was 11 days [IQR]: [9-14] and 10 days [8-12], respectively (p = 0.065). CONCLUSION The clinical course of MIS-C is similar in subsequent pandemic waves; however, the incidence of MIS-C seems to be decreasing. WHAT IS KNOWN • The clinical picture of COVID-19 is evolving. Multisystem inflammatory syndrome in children (MIS-C) is a relatively new serious disease connected with SARS-CoV-2 infection, and in subsequent waves of the pandemic, new cases of the disease have been recorded. WHAT IS NEW • The clinical picture of MIS-C is not specific, but the course is still severe. • The incidence of MIS-C during the different pandemic waves is decreasing and the diagnosis in the period of lower prevalance is challenging.
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Affiliation(s)
- Katarzyna Ptak
- Department of Pediatrics, Jagiellonian University Medical College, ul. Wielicka 265, 30-663, Cracow, Poland.
| | - Izabela Szymońska
- Department of Pediatrics, Jagiellonian University Medical College, ul. Wielicka 265, 30-663, Cracow, Poland
| | - Anna Olchawa-Czech
- Department of Pediatrics, Jagiellonian University Medical College, ul. Wielicka 265, 30-663, Cracow, Poland
| | - Kornelia Kukla
- Department of Pediatrics, University Children's Hospital, Cracow, Poland
| | - Marta Cisowska
- Department of Pediatrics, University Children's Hospital, Cracow, Poland
| | - Przemko Kwinta
- Department of Pediatrics, Jagiellonian University Medical College, ul. Wielicka 265, 30-663, Cracow, Poland
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Olszewska M, Pointinger-Tomasik S, Kwinta P. Lung Ultrasound - Can it be Potentially Painful for a Newborn? jpr 2023. [DOI: 10.4274/jpr.galenos.2022.89106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
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Moreira A, Tovar M, Smith AM, Lee GC, Meunier JA, Cheema Z, Moreira A, Winter C, Mustafa SB, Seidner S, Findley T, Garcia JGN, Thébaud B, Kwinta P, Ahuja SK. Development of a peripheral blood transcriptomic gene signature to predict bronchopulmonary dysplasia. Am J Physiol Lung Cell Mol Physiol 2023; 324:L76-L87. [PMID: 36472344 PMCID: PMC9829478 DOI: 10.1152/ajplung.00250.2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/27/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Bronchopulmonary dysplasia (BPD) is the most common lung disease of extreme prematurity, yet mechanisms that associate with or identify neonates with increased susceptibility for BPD are largely unknown. Combining artificial intelligence with gene expression data is a novel approach that may assist in better understanding mechanisms underpinning chronic lung disease and in stratifying patients at greater risk for BPD. The objective of this study is to develop an early peripheral blood transcriptomic signature that can predict preterm neonates at risk for developing BPD. Secondary analysis of whole blood microarray data from 97 very low birth weight neonates on day of life 5 was performed. BPD was defined as positive pressure ventilation or oxygen requirement at 28 days of age. Participants were randomly assigned to a training (70%) and testing cohort (30%). Four gene-centric machine learning models were built, and their discriminatory abilities were compared with gestational age or birth weight. This study adheres to the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD) statement. Neonates with BPD (n = 62 subjects) exhibited a lower median gestational age (26.0 wk vs. 30.0 wk, P < 0.01) and birth weight (800 g vs. 1,280 g, P < 0.01) compared with non-BPD neonates. From an initial pool (33,252 genes/patient), 4,523 genes exhibited a false discovery rate (FDR) <1%. The area under the receiver operating characteristic curve (AUC) for predicting BPD utilizing gestational age or birth weight was 87.8% and 87.2%, respectively. The machine learning models, using a combination of five genes, revealed AUCs ranging between 85.8% and 96.1%. Pathways integral to T cell development and differentiation were associated with BPD. A derived five-gene whole blood signature can accurately predict BPD in the first week of life.
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Affiliation(s)
- Alvaro Moreira
- Department of Pediatrics, Neonatology Regenerative and Precision Medicine Laboratory, University of Texas Health Science Center at San Antonio, San Antonio, Texas
- Veterans Administration Center for Personalized Medicine, South Texas Veterans Health Care System, San Antonio, Texas
| | - Miriam Tovar
- Department of Pediatrics, Neonatology Regenerative and Precision Medicine Laboratory, University of Texas Health Science Center at San Antonio, San Antonio, Texas
- Veterans Administration Center for Personalized Medicine, South Texas Veterans Health Care System, San Antonio, Texas
| | - Alisha M Smith
- Veterans Administration Research Center for AIDS and HIV-1 Infection and Center for Personalized Medicine, South Texas Veterans Health Care System, San Antonio, Texas
- The Foundation for Advancing Veterans' Health Research, South Texas Veterans Health Care System, San Antonio, Texas
- Department of Microbiology, Immunology & Molecular Genetics, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Grace C Lee
- Veterans Administration Research Center for AIDS and HIV-1 Infection and Center for Personalized Medicine, South Texas Veterans Health Care System, San Antonio, Texas
- Pharmacotherapy Education and Research Center, School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas
- College of Pharmacy, The University of Texas at Austin, Austin, Texas
| | - Justin A Meunier
- Veterans Administration Research Center for AIDS and HIV-1 Infection and Center for Personalized Medicine, South Texas Veterans Health Care System, San Antonio, Texas
- Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Zoya Cheema
- Department of Pediatrics, Neonatology Regenerative and Precision Medicine Laboratory, University of Texas Health Science Center at San Antonio, San Antonio, Texas
- Veterans Administration Center for Personalized Medicine, South Texas Veterans Health Care System, San Antonio, Texas
| | - Axel Moreira
- Division of Critical Care, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas
| | - Caitlyn Winter
- Department of Pediatrics, Neonatology Regenerative and Precision Medicine Laboratory, University of Texas Health Science Center at San Antonio, San Antonio, Texas
- Veterans Administration Center for Personalized Medicine, South Texas Veterans Health Care System, San Antonio, Texas
| | - Shamimunisa B Mustafa
- Department of Pediatrics, Neonatology Regenerative and Precision Medicine Laboratory, University of Texas Health Science Center at San Antonio, San Antonio, Texas
- Veterans Administration Center for Personalized Medicine, South Texas Veterans Health Care System, San Antonio, Texas
| | - Steven Seidner
- Department of Pediatrics, Neonatology Regenerative and Precision Medicine Laboratory, University of Texas Health Science Center at San Antonio, San Antonio, Texas
- Veterans Administration Center for Personalized Medicine, South Texas Veterans Health Care System, San Antonio, Texas
| | - Tina Findley
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center at Houston and Children's Memorial Hermann Hospital, Houston, Texas
| | - Joe G N Garcia
- Department of Medicine, University of Arizona Health Sciences, Tucson, Arizona
| | - Bernard Thébaud
- Sinclair Centre for Regenerative Medicine, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Department of Pediatrics, Children's Hospital of Eastern Ontario (CHEO) and CHEO Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Przemko Kwinta
- Neonatal Intensive Care Unit, Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Sunil K Ahuja
- Veterans Administration Center for Personalized Medicine, South Texas Veterans Health Care System, San Antonio, Texas
- The Foundation for Advancing Veterans' Health Research, South Texas Veterans Health Care System, San Antonio, Texas
- Department of Microbiology, Immunology & Molecular Genetics, University of Texas Health Science Center at San Antonio, San Antonio, Texas
- Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas
- Department of Biochemistry and Structural Biology, University of Texas Health Science Center at San Antonio, San Antonio, Texas
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Ptak K, Szymońska I, Olchawa-Czech A, Baliga Z, Sawina M, Woźnica A, Kwinta P. Different Clinical Manifestations of Adenoviral Infection Confirmed Using Point-of-Care Testing in a Group of Hospitalized Children. Pediatr Rep 2022; 15:1-8. [PMID: 36649001 PMCID: PMC9844268 DOI: 10.3390/pediatric15010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/05/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Objective: A restrospective analysis of the clinical picture (inflammatory markers, characteristics of fever, comorbidities) in different clinical manifestations of human adenovirus (HAdV) infections confirmed using point-of-care testing in a group of hospitalized children. Material and Methods: A total of 135 children with confirmed HAdV infections were divided into three groups according to their clinical symptoms: Group A—respiratory (n = 57), Group B—gastrointestinal (n = 40), and Griup C—mixed (n = 38). Results: Respiratory and mixed HAdV-infected patients, as compared with gastrointestinal HAdV-infected patients, were younger (median value (Me) and interquartile range (IQR) (months): 17 (12−30) and 17 (12−27) vs. 30 (16−50), p = 0.04), had a longer duration of fever (days): 3 (1−5) and 3 (1−4) vs. 1 (1−2), p = 0.01), and had higher C-reactive protein values (mg/L): 29.2 (10.4−69.1) and 28.7 (10.8−49.1) vs. <5 (<5−20.6), p < 0.001). There were no correlations between CRP levels and patient’s age, fever duration, the occurrence of acute otitis media and lower respiratory tract infection, and antibiotic treatment before admission. Conclusions: Patients with respiratory HAdV infections have fevers more often, the duration of the fever prior to admission is longer, and CRP levels are higher.
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Affiliation(s)
- Katarzyna Ptak
- Department of Pediatrics, Jagiellonian University Medical College, 30-663 Cracow, Poland
- Correspondence: ; Tel.: +48-(12)-3339035
| | - Izabela Szymońska
- Department of Pediatrics, Jagiellonian University Medical College, 30-663 Cracow, Poland
| | - Anna Olchawa-Czech
- Department of Pediatrics, Jagiellonian University Medical College, 30-663 Cracow, Poland
| | - Zuzanna Baliga
- Faculty of Medicine, Jagiellonian University Medical College, 30-663 Cracow, Poland
| | - Marta Sawina
- Faculty of Medicine, Jagiellonian University Medical College, 30-663 Cracow, Poland
| | - Agata Woźnica
- Faculty of Medicine, Jagiellonian University Medical College, 30-663 Cracow, Poland
| | - Przemko Kwinta
- Department of Pediatrics, Jagiellonian University Medical College, 30-663 Cracow, Poland
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11
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Stopyra L, Kowalik A, Stala J, Majchrzak I, Szebla J, Jakosz M, Grzywaczewska K, Kwinta P. Characteristics of Hospitalized Pediatric Patients in the First Five Waves of the COVID-19 Pandemic in a Single Center in Poland-1407 Cases. J Clin Med 2022; 11:jcm11226806. [PMID: 36431283 PMCID: PMC9697870 DOI: 10.3390/jcm11226806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/30/2022] [Accepted: 11/16/2022] [Indexed: 11/19/2022] Open
Abstract
This is a single-center, prospective study that compared the clinical presentation and laboratory findings of hospitalized children during the first five waves of the COVID-19 pandemic. Data were collected, according to a standardized questionnaire, from 1407 children from 23 March 2020 to 30 April 2022. Significant differences in clinical courses were found among the five waves probably due to different SARS-CoV-2 variants. The median age was 95.8 months in the first wave versus 14.6-23 months in the others. The number of patients with upper respiratory infection was the highest in the fifth wave (74.4% versus 43.8-56.9% in the others) and for lower respiratory infection in the first wave (50.0% versus 16.4-32.5%). Gastroenterocolitis was more common in the fifth wave (24.4% versus 8.9-16.5%); neurological diagnoses appeared more frequently in the fourth wave (16.6% versus 0.6-9.9%), while anosmia and ageusia were higher in the fifth wave (13% versus 1.5-4%). Life-threatening courses were relatively rare. However, children with pneumonia, dehydration from high fever, gastrointestinal symptoms, loss of smell and taste, and neurological symptoms required hospitalization.
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Affiliation(s)
- Lidia Stopyra
- Department of Infectious Diseases and Pediatrics, Zeromski Specialist Hospital in Krakow, 30-931 Kraków, Poland
- Correspondence: ; Tel.: +48-126-229-513
| | - Aleksandra Kowalik
- Department of Pediatrics, Jagiellonian University Medical College, 30-663 Kraków, Poland
| | - Justyna Stala
- Department of Infectious Diseases and Pediatrics, Zeromski Specialist Hospital in Krakow, 30-931 Kraków, Poland
| | - Ida Majchrzak
- Department of Infectious Diseases and Pediatrics, Zeromski Specialist Hospital in Krakow, 30-931 Kraków, Poland
| | - Justyna Szebla
- Department of Infectious Diseases and Pediatrics, Zeromski Specialist Hospital in Krakow, 30-931 Kraków, Poland
| | - Mateusz Jakosz
- Department of Infectious Diseases and Pediatrics, Zeromski Specialist Hospital in Krakow, 30-931 Kraków, Poland
| | - Karolina Grzywaczewska
- Department of Infectious Diseases and Pediatrics, Zeromski Specialist Hospital in Krakow, 30-931 Kraków, Poland
| | - Przemko Kwinta
- Department of Pediatrics, Jagiellonian University Medical College, 30-663 Kraków, Poland
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12
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Olszewska M, Pointinger-Tomasik S, Kwinta P. Assessment of salivary cortisol concentrations for procedural pain monitoring in newborns. J Perinat Med 2022; 51:564-572. [PMID: 36282969 DOI: 10.1515/jpm-2022-0320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 09/24/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The study aimed to evaluate the usefulness of salivary cortisol (SC) for the assessment of procedural pain intensity in preterm and term newborns. METHODS Three groups of neonates (term, 370-416 weeks; moderate to late preterm, 320-366; and very preterm, <320) hospitalized in neonatal intensive care unit were assessed for the study. Response to nappy change, lung ultrasound (LUS), and blood sampling was analyzed. The intensity of pain was evaluated using continuous heart rate and blood oxygen saturation (SpO2) monitoring, Neonatal Infant Pain Scale (NIPS), and SC concentrations. Saliva samples were collected before and 20 min after the procedure's end. RESULTS Seventy-one infants were examined: 30 term, 21 moderate to late preterm, and 20 very preterm. SC has increased significantly in response to nappy change only in very preterm newborns (2.13 ng/mL [1.55-3.68] vs. 2.84 ng/mL [1.93-9.06], p = 0.01). LUS did not affect concentrations of SC in any group. Significant increase in SC was observed after blood sampling in term and very preterm infants (2.2 ng/mL [1.45-2.92] vs. 4.29 ng/mL [3.88-5.73], p = 0.002, and 1.88 ng/mL [1.47-4.13] vs. 5.3 ng/mL [3.42-8.02], p = 0.002, respectively). A significant correlation between values of SC increase and NIPS scores was found (Spearman's rank correlation coefficient [rs] = 0.31, p = 0.001). CONCLUSIONS We observed the increase in SC concentrations in response to painful stimulus. The presence of a correlation between NIPS scores and SC increase suggests that SC can be used as an objective parameter to assess pain in neonates.
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Affiliation(s)
- Marta Olszewska
- Department of Pediatrics, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | | | - Przemko Kwinta
- Department of Pediatrics, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
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13
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Cheema Z, Kwinta P, Moreira A, Tovar M, Mustafa SB. Big Data for Tiny Patients: A Precision Medicine Approach to Bronchopulmonary Dysplasia. Pediatr Ann 2022; 51:e396-e404. [PMID: 36215088 DOI: 10.3928/19382359-20220803-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Bronchopulmonary dysplasia (BPD) is the most common chronic lung disease of extreme prematurity. Despite more than 50 years of research, current treatments are ineffective, and clinicians are largely unable to accurately predict which neonates the condition will develop in. A deeper understanding of the molecular mechanisms underlying the characteristic arrest in lung development are warranted. Integrating high-fidelity technology from precision medicine approaches may fill this gap and provide the tools necessary to identify biomarkers and targetable pathways. In this review, we describe insights garnered from current studies using omics for BPD prediction and stratification. We conclude by describing novel programs that will integrate multi-omics in efforts to better understand and treat the pathogenesis of BPD. [Pediatr Ann. 2022;51(10):e396-e404.].
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14
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Knapp A, Jagła M, Madetko-Talowska A, Szewczyk K, Książek T, Końska K, Kwinta P. Paternal uniparental disomy of chromosome 2 resulting in a concurrent presentation of Crigler-Najjar syndrome type I and long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency. Am J Med Genet A 2022; 188:1848-1852. [PMID: 35199468 DOI: 10.1002/ajmg.a.62696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/27/2021] [Accepted: 01/28/2022] [Indexed: 11/06/2022]
Abstract
This is the first report of the concurrent development of long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency (LCHADD) and Crigler-Najjar syndrome type 1 (CNs1) inherited via uniparental disomy of chromosome 2, which are both autosomal recessive pathologies. Through an expanded newborn metabolic panel, a male infant was identified as having an acylcarnitine pattern typical for LCHADD, later confirmed to be caused by a well-characterized pathogenic variant in the HADHA gene located at 2p23. Prolonged non-hematologic jaundice requiring repetitive phototherapy prompted further genetic analysis, leading to the identification of another genetic abnormality consistent with CNs1, which was caused by a novel pathogenic variant in the UGT1A1 gene located at 2q37. The two identified point mutations in chromosome 2 were homozygous and present on separate arms, which indicated potential uniparental disomy. Microarray analysis of the genetic material from the patient and his parents confirmed paternal isodisomy of chromosome 2. Further studies are needed to identify other possible pathogenic variants located on the same defective chromosome, evaluate the combined effect of the two metabolic abnormalities, and plan the best possible treatment and care.
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Affiliation(s)
- Anna Knapp
- Department of Pediatrics, Chair of Pediatrics Jagiellonian University Medical College, Krakow, Poland
| | - Mateusz Jagła
- Department of Pediatrics, Chair of Pediatrics Jagiellonian University Medical College, Krakow, Poland
| | - Anna Madetko-Talowska
- University Children Hospital in Krakow, Krakow, Poland.,Department of Medical Genetics, Chair of Pediatrics Jagiellonian University Medical College, Krakow, Poland
| | - Katarzyna Szewczyk
- University Children Hospital in Krakow, Krakow, Poland.,Department of Medical Genetics, Chair of Pediatrics Jagiellonian University Medical College, Krakow, Poland
| | - Teofila Książek
- University Children Hospital in Krakow, Krakow, Poland.,Department of Medical Genetics, Chair of Pediatrics Jagiellonian University Medical College, Krakow, Poland
| | - Katarzyna Końska
- Department of Medical Genetics, Chair of Pediatrics Jagiellonian University Medical College, Krakow, Poland
| | - Przemko Kwinta
- Department of Pediatrics, Chair of Pediatrics Jagiellonian University Medical College, Krakow, Poland
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15
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Furtak A, Wędrychowicz A, Roztoczyńska D, Januś D, Orchel-Szastak K, Kwinta P, Starzyk JB. Assessment of the function and morphology of the thyroid gland in paediatric patients treated with enzyme replacement therapy due to selected storage diseases - preliminary results of our own research and a review of the literature. Pediatr Endocrinol Diabetes Metab 2022; 28:114-122. [PMID: 35399045 PMCID: PMC10214971 DOI: 10.5114/pedm.2022.112860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 11/15/2021] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Some storage diseases, caused by a deficiency of a specific enzyme, which results in the systemic accumulation of non-metabolized substances, can be treated with enzyme replacement therapy (ERT), which can protect many organs, including the endocrine system. AIM The aim of the study was to assess the function and morphology of the thyroid gland in children with storage diseases treated with ERT, and to review the literature. MATERIAL AND METHODS Eight patients were included in the study: 3 with Fabry disease (age: 17; 9.9; 10 years), 3 with Hunter's disease (12.3; 4.1; 9,3), and 2 with Pompe disease (6.8; 9,5). Thyroid function and morphology were assessed in each patient during ERT, and 4 of them were reassessed 27 months later. RESULTS One patient with Fabry disease had been treated for hypothyroidism due to autoimmune thyroiditis diagnosed before the study. The remaining patients had normal thyroid tests and negative anti-thyroid antibodies at first and second evaluation; however, in all reassessed patients a decrease in TSH value was noted. Among the remaining patients with Fabry disease, one had normal and a second had heterogeneous echogenicity of the thyroid during first assessment. In the second patient, normalisation of echogenicity was observed at reassessment. Both patients with Pompe disease assessed once had slightly heterogeneous thyroid echogenicity. In 3 patients with Hunter's disease in the first ultrasound examination, no abnormalities were found. In re-evaluation, 2 of them showed heterogeneous thyroid echogenicity. CONCLUSIONS We conclude that patients with storage diseases should undergo assessment of thyroid function and morphology before and during ERT.
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Affiliation(s)
- Aleksandra Furtak
- Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Pediatric Institute, Medical College, Jagiellonian University in Cracow, Poland
- Department of Pediatric and Adolescent Endocrinology, University Children’s Hospital in Cracow, Poland
| | - Anna Wędrychowicz
- Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Pediatric Institute, Medical College, Jagiellonian University in Cracow, Poland
- Department of Pediatric and Adolescent Endocrinology, University Children’s Hospital in Cracow, Poland
| | - Dorota Roztoczyńska
- Department of Pediatric and Adolescent Endocrinology, University Children’s Hospital in Cracow, Poland
| | - Dominika Januś
- Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Pediatric Institute, Medical College, Jagiellonian University in Cracow, Poland
- Department of Pediatric and Adolescent Endocrinology, University Children’s Hospital in Cracow, Poland
| | | | - Przemko Kwinta
- Department of Pediatric, University Children’s Hospital in Cracow, Poland
- Department of Pediatric, Chair of Pediatrics, Pediatric Institute, Medical College, Jagiellonian University in Cracow, Poland
| | - Jerzy B. Starzyk
- Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Pediatric Institute, Medical College, Jagiellonian University in Cracow, Poland
- Department of Pediatric and Adolescent Endocrinology, University Children’s Hospital in Cracow, Poland
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16
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Dudzik A, Nedza W, Końska K, Starzec K, Tomasik T, Grudzień A, Jagła M, Durlak W, Kwinta P. A novel mutation in MTM1 gene in newborn, resulting in centronuclear myopathy phenotype: a case report. Egypt J Med Hum Genet 2021. [DOI: 10.1186/s43042-021-00140-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The X-linked myotubular myopathy (XLMTM) is a rare congenital disease. Its main symptoms are hypotonia, dysmorphic facial features, respiratory failure, and feeding disorder.
Case presentation
This study reports on a male patient from Neonatal Intensive Care Unit, who presented symptoms of congenital myopathy. After eliminating many other possible causes, he was eventually proven to bear a c.197C>G, p.(Thr66Arg) MTM1 mutation, a variant of uncertain significance, never described in the literature before. Family of the patient underwent the same genetic tests that proved the mother to be the carrier of mutation.
Conclusion
The article is a first report on abovementioned, newly discovered mutation in MTM1 gene, with high probability leading to the centronuclear myopathy phenotype. It also summarizes the diagnostic process and current state of knowledge about the therapy and prognosis for children with XLMTM. The authors hope that the findings will contribute to the diagnostic process of subsequent patients.
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17
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Rubino CM, Polak M, Schröpf S, Münch HG, Smits A, Cossey V, Tomasik T, Kwinta P, Snariene R, Liubsys A, Gardovska D, Hornik CD, Bosheva M, Ruehle C, Litherland K, Hamed K. Pharmacokinetics and Safety of Ceftobiprole in Pediatric Patients. Pediatr Infect Dis J 2021; 40:997-1003. [PMID: 34533489 PMCID: PMC8505155 DOI: 10.1097/inf.0000000000003296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/16/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Ceftobiprole, the active moiety of the prodrug ceftobiprole medocaril, is an advanced-generation, broad-spectrum, intravenous cephalosporin, which is currently approved for the treatment of adults with hospital-acquired or community-acquired pneumonia. METHODS Noncompartmental pharmacokinetics and safety were analyzed from 2 recently completed pediatric studies, a single-dose, phase 1 study in neonates and infants up to 3 months of age (7.5 mg/kg) and a phase 3 study in patients 3 months to 17 years of age with pneumonia (10-20 mg/kg with a maximum of 500 mg per dose every 8 hours for up to 14 days). RESULTS Total ceftobiprole plasma concentrations peaked at the end of infusion. Half life (median ranging from 1.9 to 2.9 hours) and overall exposure (median AUC ranging from 66.6 to 173 μg•h/mL) were similar to those in adults (mean ± SD, 3.3 ± 0.3 hours and 102 ± 11.9 μg•h/mL, respectively). Calculated free-ceftobiprole concentrations in the single-dose study remained above a minimum inhibitory concentration (MIC) of 4 mg/L (fT > MIC of 4 mg/L) for a mean of 5.29 hours after dosing. In the pneumonia study, mean fT > MIC of 4 mg/L was ≥5.28 hours in all dose groups. Ceftobiprole was well tolerated in both studies. CONCLUSIONS Pharmacokinetic parameters of ceftobiprole characterized in the pediatric population were within the range of those observed in adults. In the pneumonia study, the lowest percentage of the dosing interval with fT > MIC of 4 mg/L was 50.8%, which suggests that pharmacokinetic-pharmacodynamic target attainment can be sufficient in pediatric patients. Ceftobiprole was well tolerated.
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Affiliation(s)
| | - Mark Polak
- West Virginia University School of Medicine, Department of Pediatrics, Morgantown, WV
| | - Sebastian Schröpf
- Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Hans Georg Münch
- Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Anne Smits
- Neonatal Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Veerle Cossey
- Neonatal Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Tomasz Tomasik
- Jagiellonian University Medical College, Department of Pediatrics, Cracow, Poland
| | - Przemko Kwinta
- Jagiellonian University Medical College, Department of Pediatrics, Cracow, Poland
| | - Rima Snariene
- Medical Faculty of Vilnius University, Neonatal Center of Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Arunas Liubsys
- Medical Faculty of Vilnius University, Neonatal Center of Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Dace Gardovska
- Children’s Clinical University Hospital, Riga Stradins University, Riga, Latvia
| | - Chi Dang Hornik
- Duke University Hospital, Department of Pediatrics, Durham, NC
| | - Miroslava Bosheva
- Medical University, University Multiprofile Hospital for Active Treatment “Sveti Georgi,” Plovdiv, Clinic of Pediatric and Genetic Diseases, Plovdiv, Bulgaria
| | | | | | - Kamal Hamed
- Basilea Pharmaceutica International Ltd., Basel, Switzerland
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18
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Mól N, Olchawa-Czech A, Szymońska I, Ptak K, Konarska K, Góreczny S, Kwinta P. Risk factors of cardiac insufficiency in children with multisystem inflammatory syndrome and COVID-19: A prospective cohort study. Kardiol Pol 2021; 79:1365-1367. [PMID: 34704607 DOI: 10.33963/kp.a2021.0144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 10/26/2021] [Indexed: 11/23/2022]
Affiliation(s)
- Nina Mól
- Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
| | - Anna Olchawa-Czech
- Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
| | - Izabela Szymońska
- Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
| | - Katarzyna Ptak
- Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
| | - Katarzyna Konarska
- Department of Pediatric Cardiology, University Children's Hospital, Jagiellonian University Medical College, Kraków, Poland
| | - Sebastian Góreczny
- Department of Pediatric Cardiology, University Children's Hospital, Jagiellonian University Medical College, Kraków, Poland
| | - Przemko Kwinta
- Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
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19
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Pyznar O, Mól N, Zasada M, Zasada W, Mazurek M, Kwinta P. Over-the-counter antipyretics use among children from Southeastern Poland. J Mother Child 2021; 25:35-43. [PMID: 34643352 PMCID: PMC8603847 DOI: 10.34763/jmotherandchild.20212501.d-20-00024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 05/10/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Over-the-counter (OTC) drugs are becoming increasingly popular. However, little is known about parents' practices concerning the use of OTC antipyretics in children. This paper aimed to study the habits and knowledge of parents regarding the use of OTC antipyretics in their offspring, considering the demographic and socioeconomic characteristics of the families. MATERIAL AND METHODS A multiple-purpose survey was conducted anonymously among 229 parents of patients hospitalised in the Department of Paediatrics, University Children's Hospital, Krakow. Each parent answered 23 questions regarding OTC antipyretics use in his/her hospitalised child throughout the whole child's life. The data was statistically analysed. RESULTS OTC antipyretics are administered to their children by 92% of parents. In the vast majority (87%), health care professionals or a leaflet were the sources of information on the drug and its dosage. Parents also used information from TV or the Internet (27%) and friends and family (30%), especially those in the younger age group. Families with high socioeconomic status were more likely to use health care professionals' advice for drug knowledge. Parents of children with allergic diseases made less use of nonmedical sources of knowledge. CONCLUSIONS The majority of parents use OTC antipyretic drugs in their children. However, a high percentage of people using nonmedical sources of information is of concern. It is necessary to educate caregivers and to build the parents' awareness that they take an active role in their child's treatment. It would be useful to create generally available recommendations for home treatment.
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Affiliation(s)
- Olga Pyznar
- Department of Paediatrics, University Children’s Hospital, Krakow, Poland, E-mail:
| | - Nina Mól
- Department of Paediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Magdalena Zasada
- Department of Paediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Wojciech Zasada
- Institute of Cardiology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Małgorzata Mazurek
- Department of Paediatrics, University Children’s Hospital, Krakow, Poland
| | - Przemko Kwinta
- Department of Paediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
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20
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Gilarska M, Wolińska D, Kwinta P. 24-hour blood pressure monitoring and renal function evaluation at the predicted term of delivery in prematurely born children. Folia Med Cracov 2021; 61:5-20. [PMID: 34882660 DOI: 10.24425/fmc.2021.138947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
B a c k g r o u n d: The cause of the increased risk of hypertension in children born prematurely is still unclear. The aim of this study was to analyze the results of blood pressure monitoring and the levels of variety of kidney function markers at the 40-42 weeks postmenstrual age in children born prematurely and to compare them with the values obtained from full-term newborns. The analysis of the differences in the observed parameters could be used to assess the risk of developing hypertension in preterm infants in the following years of life. M e t h o d o l o g y: Prospective cohort study included 37 children born prematurely (<35 weeks of gestation) and 20 full-term newborns. The 24-hour ambulatory blood pressure measurement, serum cystatin C and thrombomodulin levels, urine Neutrophil Gelatinase-Associated Lipocalin (NGAL) concentration, renal ultrasound and bioelectrical impedance were performed. R e s u l t s: Analysis of the blood pressure monitoring reveled lower values of diastolic (DBP) and mean blood pressure (MAP) in the preterm group (DBP: 47.69 ± 4.79 vs. 53.96 ± 5.3 mmHg; p <0.01; MAP 64 ± 6.7 vs. 68 ± 6 mmHg; p = 0.02), however the preterm children were significantly smaller at the time of evaluation. Moreover, the pulse pressure was significantly higher in the preterm group (44 ± 7.8 vs. 39.4 ± 5.7 mmHg; p = 0.017). In the preterm group serum cystatin C level was lower (1.397 ± 0.22 vs. 1.617 ± 0.22 mg/l; p <0.01) and NGAL urine concentration was higher (57 ± 84 vs 15 ± 21 ng/ml; p = 0.04). There was substantial difference in body composition between groups - the total body water was lower in the preterm group (75.6 ± 13 vs. 82 ± 8%; p = 0.015). C o n c l u s i o n: At the predicted date of birth, preterm newborns show significant differences in blood pressure profile, body weight composition, and levels of cystatin C and NGAL compared to full-term babies.
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Affiliation(s)
- Maja Gilarska
- Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
| | - Dagmara Wolińska
- Department of Pediatrics, University Children Hospital, Kraków, Poland
| | - Przemko Kwinta
- Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland.
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21
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Olchawa-Czech A, Ptak K, Szymońska I, Kwinta P. Severe enterovirus infections in infants <3 months of age and the importance of medical history. J Mother Child 2021; 24:37-44. [PMID: 33548163 PMCID: PMC8258841 DOI: 10.34763/jmotherandchild.20202403.2022.d-20-00007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background Enteroviral infections in infants <3 months of age are frequent and under-diagnosed even though they can be life-threatening. Properly conducted subjective examination, which is repeatedly neglected, plays a key role in the diagnosis and treatment of these infections. Materials and methods Analyses included children <3 months of age with confirmed enterovirus infection, hospitalised in the Department of Paediatrics from January 2019 to February 2020. Infections were confirmed by reverse transcription polymerase chain reaction in the cerebrospinal fluid using Neuro9 FTD set and in the stool using PB-03/Neuro; antibodies were determined in one patient. Results This study presents a detailed description of three cases with confirmed enterovirus infection and a positive epidemiological history. The cases involve viral sepsis, myocarditis with arrhythmia and circulatory failure, and meningitis with seizures. In addition, the details of 10 patients hospitalised in the Children’s Clinic with a confirmed enterovirus infection are presented. Based on these cases, a significant influence of family history-taking on the diagnosis and implementation of appropriate treatment was found. Conclusion In most of the analysed cases, family history of viral infection was positive. In patients with the most severe course of the enterovirus infection, accurate epidemiological history is extremely important, and the suspicion of viral infection and securing appropriate materials for testing may significantly speed up the diagnosis in the newborn and help to implement an appropriate treatment.
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Affiliation(s)
- Anna Olchawa-Czech
- Faculty of Medicine, Institute of Paediatrics, Jagiellonian University Medical College, Cracow, Poland
| | - Katarzyna Ptak
- Faculty of Medicine, Institute of Paediatrics, Jagiellonian University Medical College, Cracow, Poland
| | - Izabela Szymońska
- Faculty of Medicine, Institute of Paediatrics, Jagiellonian University Medical College, Cracow, Poland
| | - Przemko Kwinta
- Faculty of Medicine, Institute of Paediatrics, Jagiellonian University Medical College, Cracow, Poland
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Sobczak A, Dudzik A, Kruczek P, Kwinta P. Ultrasound Monitoring of Umbilical Catheters in the Neonatal Intensive Care Unit-A Prospective Observational Study. Front Pediatr 2021; 9:665214. [PMID: 33996700 PMCID: PMC8119780 DOI: 10.3389/fped.2021.665214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 04/12/2021] [Indexed: 01/22/2023] Open
Abstract
Introduction: Umbilical catheterization provides a quick yet demanding central line that can lead to complications seen nowhere else. The aim of our study was to determine whether the repeated ultrasound scanning can influence the catheterization time, prevent some of the catheter-related complications, support the decision-making process and allow prolonged catheterization in patients without an alternative central access route. Methods: A prospective observational study was performed in a tertiary neonatal intensive care unit. A total of 129 patients and 194 umbilical catheters (119 venous and 75 arterial) were analyzed with a total of 954 scans. Ultrasound screening consisted of 1) assessing the catheter tip, location, movability, and surface and 2) analyzing the catheter trajectory. The outcome variables were defined as 1) catheter dislocation and 2) associated thrombosis. Results: Dislocation of catheter throughout the whole catheterization period was observed in 68% (81/119) of UVCs and 23% (17/75) of UACs. Thrombotic complications were observed in 34.5% (41/119) of UVCs and 12% (9/75) of UACs. 1/3 of UAC-associated thrombi were visible only after catheter removal. 51% (61/119) of UVC patients and 8% (6/75) of UAC patients made a clinical decision regarding the obtained catheter image. Conclusion: Bedside ultrasound imaging of catheters supports the decision-making process related to the catheterization duration, shortening the time if abnormalities are detected and allowing a safer prolonged UC stay when an alternative central line cannot be inserted.
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Affiliation(s)
- Alina Sobczak
- Neonatal Intensive Care Unit, Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
| | - Aleksandra Dudzik
- Neonatal Intensive Care Unit, Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
| | - Piotr Kruczek
- Neonatal Intensive Care Unit, Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
| | - Przemko Kwinta
- Neonatal Intensive Care Unit, Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
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Grudzień A, Jagła M, Klimek M, Knapp A, Kwinta P. Longitudinal assessment of cardiac function in extremely low birth weight children at 7 and 11 years of age: implications for adult medicine. Kardiol Pol 2021; 79:539-545. [PMID: 34125927 DOI: 10.33963/kp.15916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 06/08/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND The long-term impact of extreme prematurity on cardiac structure and function has not been fully evaluated. AIMS The aim of the study was to assess cardiac condition at 11 years of age in a local cohort of extremely low birth weight (ELBW) children born between 2002 and 2004 and to compare it to a previous study in the same group at 7 years of age. METHODS Sixty-four children with ELBW (median birth weight of 890 g) and 36 children born at full term underwent echocardiography and physical examination. RESULTS M-mode echocardiography parameters, expressed as z-scores for body surface area (mean [SD]), showed significant differences in left ventricular end-diastolic dimension (-1.01 [0.91] vs 0.35 [0.71]; P < 0.001), left ventricular end-systolic dimension (-0.29 [0.92] vs 0.57 [0.65]; P < 0.001), aorta dimension (0.63 [1.14] vs 1.63 [1.30]; P < 0.001), and left atrial dimension (-1.75 [0.97] vs -0.01 [0.86]; P < 0.001) between the study group and controls at 11 years of age. Fractional shortening (FS) and ejection fraction (EF) were higher in the ELBW children than in their full-term counterparts (33.6 [5.5] vs 30.8 [4.34]; P = 0.009 and 0.63 [0.07] vs 0.58 [0.06]; P = 0.005, respectively) at a mean age of 11 years. CONCLUSIONS The ELBW children had smaller hearts than full-term controls at both 7 and 11 years of age. The FS and EF were elevated in the group of 11-year-old ELBW children. We observed comparable progress in cardiac growth (approximately 20%) in premature and full-term children over a 4-year study period.
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Affiliation(s)
- Andrzej Grudzień
- Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
| | - Mateusz Jagła
- Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
| | - Małgorzata Klimek
- Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
| | - Anna Knapp
- Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
| | - Przemko Kwinta
- Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland.
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Zasada M, Madetko-Talowska A, Revhaug C, Rognlien AGW, Baumbusch LO, Książek T, Szewczyk K, Grabowska A, Bik-Multanowski M, Józef Pietrzyk J, Kwinta P, Didrik Saugstad O. Transcriptome analysis reveals dysregulation of genes involved in oxidative phosphorylation in a murine model of retinopathy of prematurity. Pediatr Res 2020; 88:391-397. [PMID: 32053824 DOI: 10.1038/s41390-020-0793-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 12/22/2019] [Accepted: 01/22/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Retinal gene expression pattern is severely altered after exposition to hyperoxia in mice with oxygen-induced retinopathy (OIR), a common model of retinopathy of prematurity. Gene ontology and signaling pathway analyses may add new insights into a better understanding of the pathogenesis of this disease. METHODS Seven-day-old C57BL/6J mice (n = 60) were exposed to 75% oxygen for 5 days and then recovered in room air. The controls (n = 60) were kept in the normoxic conditions. Retinas were harvested immediately following hyperoxia, during the phase of maximal neovascularization, and at the time of neovascularization regression. The retinal RNA samples were evaluated for gene expression using mouse gene expression microarrays. DAVID annotation tools were used for gene ontology and pathway analyses. RESULTS The most significantly enriched signaling pathways during the neovascularization phase of OIR were: focal adhesion; ECM-receptor interaction; PI3K-Akt; oxidative phosphorylation; and Alzheimer's, Parkinson's and Huntington's disease signaling pathways. Genes involved in apoptosis, cell proliferation, cell differentiation, and immune responses were associated with neovascularization regression. CONCLUSIONS Performed analyses revealed the possible involvement of various signaling pathways in OIR pathomechanism, mostly specific to the OIR phase. Dysregulation of genes involved in oxidative phosphorylation may have an impact on neovascularization development.
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Affiliation(s)
- Magdalena Zasada
- Department of Paediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Anna Madetko-Talowska
- Department of Medical Genetics, Jagiellonian University Medical College, Krakow, Poland
| | - Cecilie Revhaug
- Department of Paediatric Research, Oslo University Hospital Rikshospitalet, Oslo, Norway.,University of Oslo, Oslo, Norway
| | - Anne Gro W Rognlien
- Department of Paediatric Research, Oslo University Hospital Rikshospitalet, Oslo, Norway.,University of Oslo, Oslo, Norway
| | - Lars O Baumbusch
- Department of Paediatric Research, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Teofila Książek
- Department of Medical Genetics, Jagiellonian University Medical College, Krakow, Poland
| | - Katarzyna Szewczyk
- Department of Medical Genetics, Jagiellonian University Medical College, Krakow, Poland
| | - Agnieszka Grabowska
- Department of Medical Genetics, Jagiellonian University Medical College, Krakow, Poland
| | | | - Jacek Józef Pietrzyk
- Department of Paediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Przemko Kwinta
- Department of Paediatrics, Jagiellonian University Medical College, Krakow, Poland.
| | - Ola Didrik Saugstad
- Department of Paediatric Research, Oslo University Hospital Rikshospitalet, Oslo, Norway.,University of Oslo, Oslo, Norway
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25
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Pieczarkowski S, Kowalska-Deptuch K, Kwinta P, Wędrychowicz A, Tomasik P, Stochel-Gaudyn A, Fyderek K. Serum concentrations of fibrosis markers in children with inflammatory bowel disease. Folia Med Cracov 2020; 60:61-74. [PMID: 32658213 DOI: 10.24425/fmc.2020.133487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND STUDY AIMS The aim of the study was to assess the usefulness of serum concentrations of YKL-40/ CHI3L1 (a 40-kilodalton glycoprotein also referred to as chitinase 3 like- 1 - CHI3L1) and PIIINP (N-terminal propeptide of type III procollagen), markers of fibrosis, in the monitoring of inflammatory processes and fibrosis in children with inflammatory bowel disease (IBD). PATIENTS AND METHODS In 60 patients (41 with Crohn's disease (CD), 19 with ulcerative colitis (UC)) concentrations of investigated parameters were measured at baseline (day 0), after 3 and after 6-8 weeks of pharmacological treatment. RESULTS PIIINP concentrations were significantly higher in CD patients compared to UC (baseline results: median concentrations 1013.73 vs 78.30 ng/mL; P = 0.06 for the Kruskall-Wallis test; results at 6-8 weeks: 1076.48 vs 53.10 ng/mL, P = 0.01). Fibrosis was clearly present in patients with CD and its severity increased (reflected by both YKL-40/ CHI3L1 and PIIINP concentrations) in 6-8 weeks of follow up, regardless of the treatment used during that time. In patients with UC the levels of YKL-40/CHI3L1 and PIIINP were lower at baseline and further decreased after 6-8 weeks (median concentrations were respectively: 39.5 ng/mL vs 24.7 ng/mL and 78.3 ng/mL vs 53.1 ng/mL). CONCLUSION Fibrosis was more severe in CD than in UC patients. The marker that more accurately reflected these differences was PIIINP.
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Affiliation(s)
- Stanisław Pieczarkowski
- Department of Pediatrics, Gastroenterology and Nutrition, Jagiellonian University Medical College Kraków, Poland
| | - Kinga Kowalska-Deptuch
- Department of Pediatrics, Gastroenterology and Nutrition, Jagiellonian University Medical College Kraków, Poland.
| | - Przemko Kwinta
- Department of Pediatrics, Jagiellonian University Medical College Kraków, Poland
| | - Andrzej Wędrychowicz
- Department of Pediatrics, Gastroenterology and Nutrition, Jagiellonian University Medical College Kraków, Poland
| | - Przemysław Tomasik
- Department of Clinical Biochemistry, Jagiellonian University Medical College Kraków, Poland
| | - Anna Stochel-Gaudyn
- Department of Pediatrics, Gastroenterology and Nutrition, Jagiellonian University Medical College Kraków, Poland
| | - Krzysztof Fyderek
- Department of Pediatrics, Gastroenterology and Nutrition, Jagiellonian University Medical College Kraków, Poland
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26
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Zasada M, Madetko-Talowska A, Revhaug C, Rognlien AGW, Baumbusch LO, Książek T, Szewczyk K, Grabowska A, Bik-Multanowski M, Józef Pietrzyk J, Kwinta P, Saugstad OD. Short- and long-term impact of hyperoxia on the blood and retinal cells' transcriptome in a mouse model of oxygen-induced retinopathy. Pediatr Res 2020; 87:485-493. [PMID: 31578039 PMCID: PMC7033041 DOI: 10.1038/s41390-019-0598-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 09/04/2019] [Accepted: 09/06/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND We aimed to identify global blood and retinal gene expression patterns in murine oxygen-induced retinopathy (OIR), a common model of retinopathy of prematurity, which may allow better understanding of the pathogenesis of this severe ocular prematurity complication and identification of potential blood biomarkers. METHODS A total of 120 C57BL/6J mice were randomly divided into an OIR group, in which 7-day-old pups were maintained in 75% oxygen for 5 days, or a control group. RNA was extracted from the whole-blood mononuclear cells and retinal cells on days 12, 17, and 28. Gene expression in the RNA samples was evaluated with mouse gene expression microarrays. RESULTS There were 38, 1370 and 111 genes, the expression of which differed between the OIR and control retinas on days 12, 17, and 28, respectively. Gene expression in the blood mononuclear cells was significantly altered only on day 17. Deptor and Nol4 genes showed reduced expression both in the blood and retinal cells on day 17. CONCLUSION There are sustained marked changes in the global pattern of gene expression in the OIR mice retinas. An altered expression of Deptor and Nol4 genes in the blood mononuclear cells requires further investigation as they may indicate retinal neovascularization.
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Affiliation(s)
- Magdalena Zasada
- 0000 0001 2162 9631grid.5522.0Department of Paediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Anna Madetko-Talowska
- 0000 0001 2162 9631grid.5522.0Department of Medical Genetics, Jagiellonian University Medical College, Krakow, Poland
| | - Cecilie Revhaug
- 0000 0004 0389 8485grid.55325.34Department of Paediatric Research, Oslo University Hospital Rikshospitalet, Oslo, Norway ,0000 0004 1936 8921grid.5510.1University of Oslo, Oslo, Norway
| | - Anne Gro W. Rognlien
- 0000 0004 0389 8485grid.55325.34Department of Paediatric Research, Oslo University Hospital Rikshospitalet, Oslo, Norway ,0000 0004 1936 8921grid.5510.1University of Oslo, Oslo, Norway
| | - Lars O. Baumbusch
- 0000 0004 0389 8485grid.55325.34Department of Paediatric Research, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Teofila Książek
- 0000 0001 2162 9631grid.5522.0Department of Medical Genetics, Jagiellonian University Medical College, Krakow, Poland
| | - Katarzyna Szewczyk
- 0000 0001 2162 9631grid.5522.0Department of Medical Genetics, Jagiellonian University Medical College, Krakow, Poland
| | - Agnieszka Grabowska
- 0000 0001 2162 9631grid.5522.0Department of Medical Genetics, Jagiellonian University Medical College, Krakow, Poland
| | - Miroslaw Bik-Multanowski
- 0000 0001 2162 9631grid.5522.0Department of Medical Genetics, Jagiellonian University Medical College, Krakow, Poland
| | - Jacek Józef Pietrzyk
- 0000 0001 2162 9631grid.5522.0Department of Paediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Przemko Kwinta
- Department of Paediatrics, Jagiellonian University Medical College, Krakow, Poland.
| | - Ola Didrik Saugstad
- 0000 0004 0389 8485grid.55325.34Department of Paediatric Research, Oslo University Hospital Rikshospitalet, Oslo, Norway ,0000 0004 1936 8921grid.5510.1University of Oslo, Oslo, Norway
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27
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Miklaszewska M, Korohoda P, Drożdż D, Zachwieja K, Tomasik T, Moczulska A, Korzeniecka-Kozerska A, Kwinta P. eGFR values and selected renal urine biomarkers in preterm neonates with uncomplicated clinical course. ADV CLIN EXP MED 2019; 28:1657-1666. [PMID: 31851790 DOI: 10.17219/acem/110317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Diagnosing acute kidney injury (AKI) in preterm newborns, who are particularly susceptible to renal damage, is a serious challenge as there is no definite consensus about the diagnostic criteria. OBJECTIVES The objective of this study was to measure the values for selected urinary biomarkers and estimated glomerular filtration rate (eGFR) among a population of preterm infants with uncomplicated clinical course as well as to determine whether these markers depend on birth weight (BW), gestational age (GA), postnatal age (PNA), or gender. MATERIAL AND METHODS The prospective study was carried out in neonatal intensive care unit (NICU). The evaluation included 57 children that were divided into 3 categories according to BW: low birth weight (LBW) - 1501-2500 g (22 infants); very low birth weight (VLBW) - 1000-1500 g (25 infants); and extremely low birth weight (ELBW) - 750-999 g (10 infants). Urine samples were collected daily between the 4th and 28th day of life for measurements of creatinine (Cr), neutrophil gelatinase-associated lipocalin (NGAL), osteopontin (OPN), and human kidney injury molecule 1 (hKIM1). RESULTS The values of the 3 urine tubular biomarkers, serum creatinine and eGFR were taken in substantially healthy preterm infants with normal kidney function at 4 time intervals during the neonatal period. Their correlations were determined and a multivariable regression analysis was carried out with respect to BW, GA, PNA, and gender. Trends of the studied markers in terms of PNA and BW were also assessed with the Jonckheere-Terpstra test. CONCLUSIONS Glomerular and tubular function in preterm neonates during the 1st month of life is significantly influenced by BW, GA, PNA, and gender.
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Affiliation(s)
- Monika Miklaszewska
- Department of Pediatric Nephrology and Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Przemysław Korohoda
- Department of Electronics, Faculty of Computer Science, Electronics and Telecommunications, AGH University of Science and Technology, Kraków, Poland
| | - Dorota Drożdż
- Department of Pediatric Nephrology and Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Katarzyna Zachwieja
- Department of Pediatric Nephrology and Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Tomasz Tomasik
- Department of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Anna Moczulska
- Department of Pediatric Nephrology and Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | | | - Przemko Kwinta
- Department of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
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28
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Jagła M, Grudzień A, Starzec K, Tomasik T, Zasada M, Kwinta P. Lung ultrasound in the diagnosis of neonatal respiratory failure prior to patient transport. J Clin Ultrasound 2019; 47:518-525. [PMID: 31361036 DOI: 10.1002/jcu.22766] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 07/07/2019] [Accepted: 07/14/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE Lung ultrasound (LUS) at the point-of-care is a new method that is increasingly used in neonatology. The aim of this study was to determine the utility of the addition of LUS prior to the interhospital transport of neonates with respiratory failure. METHODS LUS was performed on 50 newborns with respiratory failure prior to transport to a tertiary neonatal intensive care unit. We analyzed the performance of LUS for diagnosing the cause of respiratory failure, the concordance between LUS, chest X-ray (CXR) and final clinical diagnosis, and the impact of LUS on clinical decision making before transport. RESULTS LUS sensitivity for the diagnosis of respiratory distress syndrome was 91.3% (95%CI: 70.5-98.5%), and specificity was 92.6% (95%CI: 74.2-98.7%), whereas sensitivity and specificity of CXR were 69.6% (95%CI: 47.0-85.9%) and 81.5% (95%CI: 61.2-92.9%), respectively. For the recognition of pneumothorax (PTX) LUS had a sensitivity of 83.3% (95%CI: 36.5-99.1%) and a specificity of 100% (95%CI: 89.9-100%). For CXR, sensitivity was 16.7% (95%CI: 0.01-63.5%) and specificity was 97.7% (95%CI: 86.4-99.9%). The agreement between LUS and CXR in diagnosing the cause of respiratory failure was substantial (κ of 0.57 [95%CI: 0.40-0.74]) and the agreement between LUS and the final clinical diagnosis was very good (κ of 0.86 [95%CI: 0.74-0.98]). In 42% of the patients, a LUS examination prior to transport indicated the need for endotracheal tube repositioning or PTX decompression. CONCLUSION LUS may be a reliable imaging technique for differentiating the causes of respiratory failure before neonatal transport. Use of LUS may optimize the care of infants during transport.
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Affiliation(s)
- Mateusz Jagła
- Neonatal Ambulance Team, Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Andrzej Grudzień
- Neonatal Ambulance Team, Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Katarzyna Starzec
- Neonatal Ambulance Team, Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Tomasz Tomasik
- Neonatal Ambulance Team, Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Magdalena Zasada
- Neonatal Ambulance Team, Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Przemko Kwinta
- Neonatal Ambulance Team, Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
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29
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Szymońska I, Wentrys Ł, Jagła M, Olszewska M, Wasilewska W, Smykla B, Kwinta P. Lung ultrasound reduces the number of chest X-rays in newborns with pneumothorax. Dev Period Med 2019; 23. [PMID: 31654995 PMCID: PMC8522409 DOI: 10.34763/devperiodmed.20192303.172177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Aim of the study: To determine the impact of lung ultrasonography as an imaging method used to diagnose and monitor newborns with symptomatic pneumothorax and to assess the risk factors for pneumothorax and the outcomes in newborns with symptomatic pneumothorax. PATIENTS AND METHODS Material and methods: A single-centre retrospective study enrolled patients born after 32 weeks of gestation, with a diagnosis of pneumothorax in the first week of life. The 118 patients who were included in the study were divided into two groups. Group A (51 infants) comprised those children who were treated between 2007 and 2010, while group B (n=67) those from the years 2013 to 2016. The children from group A were monitored with repeated chest X-rays. Those from group B received repeated lung ultrasonography supported by chest X-ray in those cases where there was diagnostic uncertainty. Comparison was made between the groups with respect to pneumothorax risk factors, treatment methods and the use of imaging during the period of treatment. The statistical analysis used χ2, Mann-Whitney and Student's t-tests. RESULTS Results: There were no significant demographic or clinical differences between the two groups. Both the use of nCPAP (nasal continuous positive airway pressure) (p<0.001) and diagnosed perinatal asphyxia (p=0.036) were higher in group B. Congenital pneumonia occurred more often in group A (p=0.041). Earlier detection of pneumothorax (p=0.001) and shorter hospital stay (p=0.03) were observed in group B. However, the total number of imaging (lung ultrasound and chest X-ray combined) was higher (p<0.001) in group B. CONCLUSION Conclusion: This study confirmed the usefulness of lung ultrasound in monitoring newborns with pneumothorax, moreover significantly limiting X-ray radiation.
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Affiliation(s)
- Izabela Szymońska
- Department of Pediatrics, Jagiellonian University Collegium Medicum, Kraków, Poland,Izabela SzymońskaDepartment of Pediatrics, Jagiellonian University Collegium Medicum, ul. Wielicka 265, 30-663 Kraków, Poland Mobile phone: +48 692-410-440 fax: (+48 12) 658-44-46
| | - Łukasz Wentrys
- Department of Pediatrics, Jagiellonian University Collegium Medicum, Kraków, Poland
| | - Mateusz Jagła
- Department of Pediatrics, Jagiellonian University Collegium Medicum, Kraków, Poland
| | - Marta Olszewska
- Department of Pediatrics, Jagiellonian University Collegium Medicum, Kraków, Poland
| | - Weronika Wasilewska
- Department of Pediatrics, Jagiellonian University Collegium Medicum, Kraków, Poland
| | - Barbara Smykla
- Department of Pediatrics, Jagiellonian University Collegium Medicum, Kraków, Poland
| | - Przemko Kwinta
- Department of Pediatrics, Jagiellonian University Collegium Medicum, Kraków, Poland
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30
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Gilarska M, Raaijmakers A, Zhang ZY, Staessen JA, Levtchenko E, Klimek M, Grudzień A, Starzec K, Allegaert K, Kwinta P. Extremely Low Birth Weight Predisposes to Impaired Renal Health: A Pooled Analysis. Kidney Blood Press Res 2019; 44:897-906. [PMID: 31536985 DOI: 10.1159/000502715] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 08/14/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND A number of studies examined the association between preterm delivery and kidney size and function later in life. However, the number of cases in published cohort studies is low. This study was aimed at performing a multicenter collaboration to pool data to obtain more accurate results to quantify the extent of renal impairment in former extremely low birth weight (ELBW; <1,000 g) children. METHODOLOGY We performed a subject-level meta-analysis to pool data from Cracow (64 cases/34 controls) and Leuven (93 cases/87 controls). We assessed and analyzed cystatin C, estimated glomerular filtration rate (eGFR), ultrasound kidney length, and blood pressure (BP) in 11-year-old ELBW children compared with controls born at term. The prevalence of hypertension (HT) and prehypertension (preHT) in both groups was also analyzed. RESULTS The study group comprised 157 former ELBW children (gestational age 23-33 weeks and birth weight 430-1,000 g) and 123 children born at term. Former ELBW children had lower mean eGFR (100.62 ± 16.53 vs. 111.89 ± 15.26 mL/min/1.73 m2; p < 0.001), smaller absolute kidney length (8.56 ± 0.78 vs. 9.008 ± 0.73 cm; <0.001), and higher systolic (111.8 ± 9.8 vs. 107.2 ± 9.07 mm Hg; p = 0.01) and diastolic (68.6 ± 6.8 vs. 66.3 ± 7.7 mm Hg; p = 0.03) BP. Smaller renal size in former ELBW children was positively associated with lower birth weight, shorter gestational age, and severity of perinatal complications (intraventricular hemorrhage, length of stay, mechanical ventilation, and oxygen therapy). CONCLUSION ELBW is associated with lower eGFR and a high frequency of preHT and HT.
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Affiliation(s)
- Maja Gilarska
- Department of Pediatrics, Jagiellonian University Medical College, Cracow, Poland
| | - Anke Raaijmakers
- Department of Development and Regeneration, University of Leuven, Leuven, Belgium.,Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Zhen-Yu Zhang
- Department of Cardiovascular Sciences, Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, University of Leuven, Leuven, Belgium
| | - Jan A Staessen
- Department of Cardiovascular Sciences, Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, University of Leuven, Leuven, Belgium
| | - Elena Levtchenko
- Department of Development and Regeneration, University of Leuven, Leuven, Belgium.,Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Małgorzata Klimek
- Department of Pediatrics, Jagiellonian University Medical College, Cracow, Poland
| | - Andrzej Grudzień
- Department of Pediatrics, Jagiellonian University Medical College, Cracow, Poland
| | - Katarzyna Starzec
- Department of Pediatrics, Jagiellonian University Medical College, Cracow, Poland
| | - Karel Allegaert
- Department of Development and Regeneration, University of Leuven, Leuven, Belgium.,Intensive Care and Department of Pediatric Surgery and Department of Pediatrics, Division of Neonatology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Przemko Kwinta
- Department of Pediatrics, Jagiellonian University Medical College, Cracow, Poland,
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Zasada M, Suski M, Bokiniec R, Szwarc-Duma M, Borszewska-Kornacka MK, Madej J, Bujak-Giżycka B, Madetko-Talowska A, Revhaug C, Baumbusch LO, Saugstad OD, Pietrzyk JJ, Kwinta P. Comparative two time-point proteome analysis of the plasma from preterm infants with and without bronchopulmonary dysplasia. Ital J Pediatr 2019; 45:112. [PMID: 31445514 PMCID: PMC6708124 DOI: 10.1186/s13052-019-0676-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 07/05/2019] [Indexed: 11/10/2022] Open
Abstract
Background In this study, we aimed to analyze differences in plasma protein abundances between infants with and without bronchopulmonary dysplasia (BPD), to add new insights into a better understanding of the pathogenesis of this disease. Methods Cord and peripheral blood of neonates (≤ 30 weeks gestational age) was drawn at birth and at the 36th postmenstrual week (36 PMA), respectively. Blood samples were retrospectively subdivided into BPD(+) and BPD(−) groups, according to the development of BPD. Results Children with BPD were characterized by decreased afamin, gelsolin and carboxypeptidase N subunit 2 levels in cord blood, and decreased galectin-3 binding protein and hemoglobin subunit gamma-1 levels, as well as an increased serotransferrin abundance in plasma at the 36 PMA. Conclusions BPD development is associated with the plasma proteome changes in preterm infants, adding further evidence for the possible involvement of disturbances in vitamin E availability and impaired immunological processes in the progression of prematurity pulmonary complications. Moreover, it also points to the differences in proteins related to infection resistance and maintaining an adequate level of hematocrit in infants diagnosed with BPD.
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Affiliation(s)
- Magdalena Zasada
- Department of Pediatrics, Jagiellonian University Medical College, Cracow, Poland
| | - Maciej Suski
- Chair of Pharmacology, Jagiellonian University Medical College, Cracow, Poland
| | - Renata Bokiniec
- Neonatal and Intensive Care Department, Medical University of Warsaw, Warsaw, Poland
| | - Monika Szwarc-Duma
- Neonatal and Intensive Care Department, Medical University of Warsaw, Warsaw, Poland
| | | | - Józef Madej
- Chair of Pharmacology, Jagiellonian University Medical College, Cracow, Poland
| | - Beata Bujak-Giżycka
- Chair of Pharmacology, Jagiellonian University Medical College, Cracow, Poland
| | - Anna Madetko-Talowska
- Department of Medical Genetics, Jagiellonian University Medical College, Cracow, Poland
| | - Cecilie Revhaug
- Department of Pediatric Research, Oslo University Hospital, Oslo, Norway.,University of Oslo, Oslo, Norway
| | - Lars O Baumbusch
- Department of Pediatric Research, Oslo University Hospital, Oslo, Norway
| | - Ola D Saugstad
- Department of Pediatric Research, Oslo University Hospital, Oslo, Norway. .,University of Oslo, Oslo, Norway.
| | - Jacek Józef Pietrzyk
- Department of Pediatrics, Jagiellonian University Medical College, Cracow, Poland
| | - Przemko Kwinta
- Department of Pediatrics, Jagiellonian University Medical College, Cracow, Poland
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Sobczak A, Tomasik T, Zając A, Klasa B, Kruczek P, Kwinta P. New features of aplasia cutis congenita type 5 - Skin atrophy associated with respiratory insufficiency and multiple intestinal atresia caused by the early death of twin fetus. Pediatr Neonatol 2019; 60:473-474. [PMID: 30316734 DOI: 10.1016/j.pedneo.2018.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 06/13/2018] [Accepted: 09/19/2018] [Indexed: 10/28/2022] Open
Affiliation(s)
- Alina Sobczak
- Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Tomasz Tomasik
- Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Andrzej Zając
- Department of Pediatric Surgery, Jagiellonian University Medical College, Krakow, Poland
| | - Barbara Klasa
- Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Piotr Kruczek
- Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Przemko Kwinta
- Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland.
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Panek M, Mavrikis J, Kwinta P. [What should be changed in Polish neonatal units in order to implement Family-Centered Care?]. Dev Period Med 2019. [PMID: 31280249 PMCID: PMC8522366 DOI: 10.34763/devperiodmed.20192302.125130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The progress that has been made in neonatology is associated with an increasing number of painful procedures constantly being performed on the neonate. Additionally, prolonged hospitalization of premature neonates in NICUs isolates the family from their child. Parents may state that they do not have any parental feelings and cannot communicate with their newborns. The FCC (Family-Centered Care) initiative responded to emerging reports about the adverse consequences ensuing from the lack of parental access to hospitalized children. The FCC should be understood as care based on partner relations between families and health professionals, which is supposed to lead to health and well-being for both the children and their parents. The FCC should become standard practice in all neonatal intensive care units.
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Affiliation(s)
- Magdalena Panek
- Zakład Zdrowia Matki i Dziecka, Wydział Nauk o Zdrowiu Uniwersytet Jagielloński Collegium Medicum w Krakowie, KrakowiePolska,Magdalena Panek Oddział Patologii i Intensywnej Terapii Noworodka Klinika Chorób Dzieci, Katedra Pediatrii Uniwersytet Jagielloński Collegium Medicum ul. Wielicka 265, 30-663 Kraków, tel. (12) 333-90-36
| | - Judene Mavrikis
- Klinika Chorób Dzieci Katedry Pediatrii, Uniwersytet Jagielloński Collegium Medicum w Krakowie, KrakowiePolska
| | - Przemko Kwinta
- Klinika Chorób Dzieci Katedry Pediatrii, Uniwersytet Jagielloński Collegium Medicum w Krakowie, KrakowiePolska
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Sobczak A, Klepacka J, Amrom D, Żak I, Kruczek P, Kwinta P. Umbilical catheters as vectors for generalized bacterial infection in premature infants regardless of antibiotic use. J Med Microbiol 2019; 68:1306-1313. [PMID: 31274401 DOI: 10.1099/jmm.0.001034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Introduction. Umbilical catheterization offers unique vascular access that is only possible in the neonatal setting due to unobstructed umbilical vessels from foetal circulation. With the cut of the umbilical cord, two arteries and a vein are dissected, allowing quick and painless catheterization of the neonate. Unfortunately, keeping the umbilical access sterile is challenging due to its mobility and necrosis of the umbilical stump, which makes it a perfect model for vessel catheter colonization analysis.Aim. The aim of this study was to evaluate bacterial colonization of the umbilical catheter, with a focus on the difference between various sections of the catheter, the duration of catheterization, patient status and gestational age.Methodology. We performed bacterial cultures for 44 umbilical catheters, analysing the superficial and deep parts of the catheter separately, and revealed colonization in one-third of cases.Results. One hundred per cent of the colonization occurred in preterm infants, with a shift towards extreme prematurity. The catheters were mainly colonized by coagulase-negative staphylococci. The majority of catheters presented with superficial colonization dominance, and there were no cases of deep colonization. The bacterial strains and their resistance were consistent between the catheter's proximal and distal parts, as well as positive blood cultures. The patients with the most intense bacterial catheter colonization presented with sepsis around removal time or a couple of days later, especially if they were extremely premature and exhibited very low birth weight. Catheterization time did not play a major role.Conclusion. Umbilical catheters are vectors for skin microflora transmission to the bloodstream via biofilm formation, regardless of antibiotic use and the duration of catheterization, especially in preterm neonates.
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Affiliation(s)
- Alina Sobczak
- Neonatal Intensive Care Unit, Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
| | - Joanna Klepacka
- Microbiology Department, University Children's Hospital, Kraków, Poland
| | - Dalia Amrom
- Jagiellonian University Medical College, Kraków, Poland
| | - Iwona Żak
- Microbiology Department, University Children's Hospital, Kraków, Poland
| | - Piotr Kruczek
- Neonatal Intensive Care Unit, Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
| | - Przemko Kwinta
- Neonatal Intensive Care Unit, Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
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Dutsch-Wicherek M, Trzebuniak I, Szymońska I, Młynarski D, Kobos J, Wicherek Ł, Kwinta P. Bilateral pseudocyst of the auricles in a 4-week neonate-case report and world literature review. Int J Pediatr Otorhinolaryngol 2019; 122:1-5. [PMID: 30921629 DOI: 10.1016/j.ijporl.2019.03.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 03/18/2019] [Accepted: 03/19/2019] [Indexed: 11/26/2022]
Abstract
Pseudocyst of the auricle is a rare, idiopathic disease clinically manifesting as a painless edema of the upper-lateral parts of the auricle. Due to the rarity of the disease, auricular pseudocyst is often misdiagnosed. The confirmation of a diagnosis of auricular pseudocyst is most commonly made on the basis of clinical manifestations. The etiology of the disease remains unknown, and this frequently hinders both proper diagnosis and prevention. We report a case of a 4-week neonate admitted to the Department of Pediatrics, Rheumatology and Environmental Diseases of the Chair of Pediatry, Jagiellonian University, Medical College in Krakow with bilateral pseudocyst with very early presentation that was less prominent after birth and well presented in the second week of life. The surgical treatment was successful. One month after treatment the infant was admitted again to the hospital with hypertension and edema of feet and hands. Treatment with amlodipine was implemented resulting in a normalization of blood pressure. The diagnosis of pseudohypoaldosteronism type I was confirmed.
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Affiliation(s)
- Magdalena Dutsch-Wicherek
- Jagiellonian University, Department of Pediatric Otolaryngology, Krakow, 31-501, ul. Wielicka 265, Poland.
| | - Izabela Trzebuniak
- Jagiellonian University, Department of Pediatrics, Rheumatology and Environmental Diseases, Poland
| | - Izabela Szymońska
- Jagiellonian University, Department of Pediatrics, Rheumatology and Environmental Diseases, Poland
| | - Damian Młynarski
- Jagiellonian University, Department of Pediatrics, Rheumatology and Environmental Diseases, Poland
| | - Józef Kobos
- Department of Histology & Embriology, Chair of Anatomy & Histology Medical University of Lodz, Poland
| | - Łukasz Wicherek
- Department of Obstetrics and Gynecology, Medical Center for Postgraduate Education (CMKP), Warsaw, Poland
| | - Przemko Kwinta
- Jagiellonian University, Department of Pediatrics, Rheumatology and Environmental Diseases, Poland
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36
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Zasada M, Suski M, Bokiniec R, Szwarc-Duma M, Borszewska-Kornacka MK, Madej J, Bujak-Gizycka B, Madetko-Talowska A, Revhaug C, Baumbusch LO, Saugstad OD, Pietrzyk JJ, Kwinta P. An iTRAQ-Based Quantitative Proteomic Analysis of Plasma Proteins in Preterm Newborns With Retinopathy of Prematurity. Invest Ophthalmol Vis Sci 2019; 59:5312-5319. [PMID: 30398622 DOI: 10.1167/iovs.18-24914] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Retinopathy of prematurity (ROP) is a vision-threatening complication of a premature birth, in which the etiology still remains unclear. Importantly, the molecular processes that govern these effects can be investigated in a perturbed plasma proteome composition. Thus, plasma proteomics may add new insights into a better understanding of the pathogenesis of this disease. Methods The cord and peripheral blood of neonates (≤30 weeks gestational age) was drawn at birth and at the 36th postmenstrual week (PMA), respectively. Blood samples were retrospectively subdivided into ROP(+) and ROP(-) groups, according to the development of ROP. Results The quantitative analysis of plasma proteome at both time points revealed 30 protein abundance changes between ROP(+) and ROP(-) groups. After standardization to gestational age, children who developed ROP were characterized by an increased C3 complement component and fibrinogen level at both analyzed time points. Conclusions Higher levels of the complement C3 component and fibrinogen, present in the cord blood and persistent to 36 PMA, may indicate a chronic low-grade systemic inflammation and hypercoagulable state that may play a role in the development of ROP.
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Affiliation(s)
- Magdalena Zasada
- Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Maciej Suski
- Chair of Pharmacology, Jagiellonian University Medical College, Krakow, Poland
| | - Renata Bokiniec
- Neonatal and Intensive Care Department, Medical University of Warsaw, Warsaw, Poland
| | - Monika Szwarc-Duma
- Neonatal and Intensive Care Department, Medical University of Warsaw, Warsaw, Poland
| | | | - Józef Madej
- Chair of Pharmacology, Jagiellonian University Medical College, Krakow, Poland
| | - Beata Bujak-Gizycka
- Chair of Pharmacology, Jagiellonian University Medical College, Krakow, Poland
| | - Anna Madetko-Talowska
- Department of Medical Genetics, Jagiellonian University Medical College, Krakow, Poland
| | - Cecilie Revhaug
- Department of Pediatric Research, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - Lars O Baumbusch
- Department of Pediatric Research, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - Ola D Saugstad
- Department of Pediatric Research, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - Jacek Józef Pietrzyk
- Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Przemko Kwinta
- Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
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37
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Jagła M, Szymońska I, Starzec K, Kwinta P. Impact of early glycemic variability on mortality and neurologic outcome of very low birth weight infants: Data from a continuous glucose monitoring system. Dev Period Med 2019. [PMID: 30954975 PMCID: PMC8522338 DOI: 10.34763/devperiodmed.20192301.0714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Background: Glycemic variability (GV) has been a matter of interest in recent years. However, glycemic variability in preterm infants has not been adequately investigated. Objectives: To evaluate the impact of glycemic variability obtained from continuous glucose monitoring on mortality and neurologic outcomes: grade 3 or 4 intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), and retinopathy of prematurity (ROP) requiring treatment among very low birth weight infants. PATIENTS AND METHODS Material and methods:A prospective, single-center, open cohort study enrolled 74 very low birth weight infants with a mean birthweight of 1066 g (+/-267). A continuous glucose monitoring system (CGM) was used to measure glucose during the first week of life. The impact of glycemic variability (standard deviation SD; coefficient of variation CV; and mean amplitude of glucose excursion MAGE) on mortality and neurologic outcomes of infants was evaluated. RESULTS Results: Univariate analysis revealed that glycemic variability occurring during the first week of life was not be associated with mortality before term-equivalent age and PVL. Higher GV was associated with grade 3 or 4 IVH (CV p=0.025; MAGE p=0.032) and ROP requiring treatment (SD p=0.019; CV p=0.026; MAGE=0.029). However, logistic regression models did not show a significant association between GV occurring during the first week of life and grade 3 or 4 IVH (MAGE OR 2.64; 95% CI 0.71-9.92) or ROP requiring treatment (MAGE OR 1.74; 95% CI 0.57-5.32). CONCLUSION Conclusions: Further prospective studies are needed to fully investigate the impact of GV on mortality and morbidity in premature infants. The potential benefits of reducing glucose blood fluctuations in VLBW infants need to be addressed.
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Affiliation(s)
- Mateusz Jagła
- Chair of Pediatrics, Jagiellonian University Medical College, Krakow, Poland,Mateusz Jagła Katedra Pediatrii, Uniwersytet Jagielloński Collegium Medicum, ul. Wielicka 265, 30-663 Kraków, Poland Phone: +48 606-669-663 Fax: +(48 12) 658-44-46
| | - Izabela Szymońska
- Chair of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Katarzyna Starzec
- Chair of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Przemko Kwinta
- Chair of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
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38
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Mól N, Zasada M, Kwinta P. Does type of feeding affect body composition in very low birth weight infants? - A prospective cohort study. Pediatr Neonatol 2019; 60:135-140. [PMID: 29784603 DOI: 10.1016/j.pedneo.2018.04.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 09/18/2017] [Accepted: 04/30/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The aim of the study was to analyse body composition of preterm infants fed with either breast milk or formula compared to a control group of full-term newborns. METHODS Fifty-three newborns were enrolled: a group of 34 very low birth weight (VLBW) preterm newborns subdivided into a formula-fed (n = 23; group A) and breast milk-fed (n = 11; group B) group, and a control group of 19 full-term infants (group C). Their body composition was assessed by a bioelectrical impedance analysis (BIA) either at the estimated time of birth in the VLBW group or during the 1st week of life in the full-term group. RESULTS There was no difference in body weight or length between any of the three studied groups. However, we discovered that fat free mass (% FFM) was lower (83.5% vs. 85.5%; p < 0.01), while fat mass (% FM) was higher (16.4% vs.14.5%; p < 0.01) in group A compared to full-term newborns. There were no such differences in FFM (84.3% vs. 85.5%; p = 0.13) or FM (15.7% vs. 14.5%; p = 0.13) between group B and control. CONCLUSION To sum up, the VLBW infants fed with breast milk shared similar body composition with the full-term infants, while the formula-fed VLBW developed higher amounts of adipose tissue and lower amounts of fat-free mass. This is the first study to expose differences in fat tissue content attributed to type of provided nutrition, which has become significant as early as estimated time of birth despite the comparable weight.
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Affiliation(s)
- Nina Mól
- Department of Paediatrics, Institute of Paediatrics, Faculty of Medicine, Jagiellonian University Medical College, Wielicka 265, 30-663, Krakow, Poland.
| | - Magdalena Zasada
- Department of Paediatrics, Institute of Paediatrics, Faculty of Medicine, Jagiellonian University Medical College, Wielicka 265, 30-663, Krakow, Poland
| | - Przemko Kwinta
- Department of Paediatrics, Institute of Paediatrics, Faculty of Medicine, Jagiellonian University Medical College, Wielicka 265, 30-663, Krakow, Poland
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Szymońska I, Jagła M, Starzec K, Kwinta P. Glycemic variability in continuous glucose monitoring negatively correlates with gestational age in very low birth weight infants. J Matern Fetal Neonatal Med 2019; 33:3041-3043. [PMID: 30614329 DOI: 10.1080/14767058.2019.1566313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Introduction: High glycemic variability is commonly observed in intensive care patients, both in pediatrics and adults. The aim of the study was to evaluate the correlation between gestational age and glycemic variability in cohort of very low birth infants.Patients and methods: A prospective, single-center, open cohort study enrolled 74 very low birth weight infants with a mean birth weight of 1066 g. Continuous glucose monitoring system (Guardian Real-Time CGM®, Medtronic, Northridge, CA, USA) was used to measure glucose levels. Spearman's rank correlation coefficients were calculated for glycemic variability indices and gestational age. Multiple linear regression analyses were used to assess the adjusted effect of multiple glycemic variability variables.Results: The correlations between all calculated glycemic variability indices and gestational age were negative. In multiple regression analysis, all glycemic variability indices negatively correlated with gestational age and positively correlated with mean interstitial fluid glucose concentration.Conclusions: Glycemic variability in very low birth weight infants correlates with gestational age and mean glucose concentrations.
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Affiliation(s)
- Izabela Szymońska
- Department of Pediatrics, Jagiellonian University Collegium Medicum, Poland, Kraków
| | - Mateusz Jagła
- Department of Pediatrics, Jagiellonian University Collegium Medicum, Poland, Kraków
| | - Katarzyna Starzec
- Department of Pediatrics, Jagiellonian University Collegium Medicum, Poland, Kraków
| | - Przemko Kwinta
- Department of Pediatrics, Jagiellonian University Collegium Medicum, Poland, Kraków
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Ptak K, Cichocka-Jarosz E, Kwinta P. [Chronic cough in children]. Dev Period Med 2019; 22. [PMID: 30636230 PMCID: PMC8522820 DOI: 10.34763/devperiodmed.20182204.329340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Coughing is one of the most common patient complaints at physicians' office. The majority of children experience 5 to 8 episodes of cough lasting about a week throughout the year. Episodes of cough which last longer than 4 weeks, defined as a chronic cough, result in serious parental concern, impaired quality of life, increased number of medical consultations and the adverse effects of inappropriately used medications. Overall, a chronic cough is not only a serious health problem, but also a social one. The article presented below summarizes our current knowledge on the pathophysiology of chronic cough, the latest diagnostics and most recent measurement and monitoring methods as well as recommendations for therapeutic proceedings. In order to emphasize the distinct pathophysiology of chronic cough we use a new term: cough hypersensitivity syndrome. We point out the necessity of the concurrent implementation of more than one cough monitoring method for its more adequate evaluation. This article in addition presents the diagnostic and therapeutic algorithms in the treatment of a chronic cough which shorten the time to make a proper diagnosis, enable the introduction of adequate treatment, and ultimately improve the patients' quality of life. We present new therapeutic strategies, which are based on regulating the activity of vagal afferent nerves and modifying the neurotransmiters' transmission in the brainstem and midbrain.
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Affiliation(s)
- Katarzyna Ptak
- Klinika Chorób Dzieci, Uniwersytecki Szpital Dziecięcy wKrakowie, Polska
| | - Ewa Cichocka-Jarosz
- Klinika Chorób Dzieci Katedry Pediatrii, Uniwersytet Jagielloński Collegium Medicum, KrakowiePolska, Ewa Cichocka Jarosz Klinika Chorób Dzieci Katedry Pediatrii UJ CM ul. Wielicka 265, 30-663 Kraków tel. (+48 12) 658-20-11 wewn. 1655
| | - Przemko Kwinta
- Klinika Chorób Dzieci Katedry Pediatrii, Uniwersytet Jagielloński Collegium Medicum, KrakowiePolska
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41
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Revhaug C, Zasada M, Rognlien AGW, Günther CC, Grabowska A, Książek T, Madetko-Talowska A, Szewczyk K, Bik-Multanowski M, Kwinta P, Pietrzyk JJ, Baumbusch LO, Saugstad OD. Pulmonary vascular disease is evident in gene regulation of experimental bronchopulmonary dysplasia. J Matern Fetal Neonatal Med 2019; 33:2122-2130. [PMID: 30428746 DOI: 10.1080/14767058.2018.1541081] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: To examine the gene expression regarding pulmonary vascular disease in experimental bronchopulmonary dysplasia in young mice. Premature delivery puts babies at risk of severe complications. Bronchopulmonary dysplasia (BPD) is a common complication of premature birth leading to lifelong affection of pulmonary function. BPD is recognized as a disease of arrested alveolar development. The disease process is not fully described and no complete cure or prevention is known. The focus of interest in the search for treatment and prevention of BPD has traditionally been at airspace level; however, the pulmonary vasculature is increasingly acknowledged in the pathology of BPD. The aim of the investigation was to study the gene expression in lungs with BPD with regards to pulmonary vascular disease (PVD).Methods: We employed a murine model of hyperoxia-induced BPD and gene expression microarray technique to determine the mRNA expression in lung tissue from young mice. We combined gene expression pathway analysis and analyzed the biological function of multiple single gene transcripts from lung homogenate to study the PVD relevant gene expression.Results: There were n = 117 significantly differentially regulated genes related to PVD through down-regulation of contractile elements, up- and down-regulation of factors involved in vascular tone and tissue-specific genes. Several genes also allowed for pinpointing gene expression differences to the pulmonary vasculature. The gene Nppa coding for a natriuretic peptide, a potent vasodilator, was significantly down-regulated and there was a significant up-regulation of Pde1a (phosphodiesterase 1A), Ptger3 (prostaglandin e receptor 3), and Ptgs1 (prostaglandin-endoperoxide synthase one).Conclusion: The pulmonary vasculature is affected by the arrest of secondary alveolarization as seen by differentially regulated genes involved in vascular tone and pulmonary vasculature suggesting BPD is not purely an airspace disease. Clues to prevention and treatment may lie in the pulmonary vascular system.
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Affiliation(s)
- Cecilie Revhaug
- Department of Pediatric Research, University of Oslo, Oslo, Norway.,Department of Pediatric Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Magdalena Zasada
- Department of Pediatrics, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Anne Gro W Rognlien
- Department of Pediatric Research, University of Oslo, Oslo, Norway.,Department of Pediatric Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | | | - Agnieszka Grabowska
- Department of Medical Genetics, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Teofila Książek
- Department of Medical Genetics, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Anna Madetko-Talowska
- Department of Medical Genetics, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Katarzyna Szewczyk
- Department of Medical Genetics, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Mirolaw Bik-Multanowski
- Department of Medical Genetics, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Przemko Kwinta
- Department of Pediatrics, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Jacek J Pietrzyk
- Department of Pediatrics, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.,Department of Medical Genetics, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Lars O Baumbusch
- Department of Pediatric Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Ola D Saugstad
- Department of Pediatric Research, University of Oslo, Oslo, Norway.,Department of Pediatric Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway
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Revhaug C, Bik-Multanowski M, Zasada M, Rognlien AGW, Günther CC, Ksiązek T, Madetko-Talowska A, Szewczyk K, Grabowska A, Kwinta P, Pietrzyk JJ, Baumbusch LO, Saugstad OD. Immune System Regulation Affected by a Murine Experimental Model of Bronchopulmonary Dysplasia: Genomic and Epigenetic Findings. Neonatology 2019; 116:269-277. [PMID: 31454811 DOI: 10.1159/000501461] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Accepted: 06/11/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Bronchopulmonary dysplasia (BPD) is a common cause of abrupted lung development after preterm birth. BPD may lead to increased rehospitalization, more severe and frequent respiratory infections, and life-long reduced lung function. The gene regulation in lungs with BPD is complex, with various genetic and epigenetic factors involved. OBJECTIVES The aim of this study was to examine the regulatory relation between gene expression and the epigenome (DNA methylation) relevant for the immune system after hyperoxia followed by a recovery period in air using a mouse model of BPD. METHODS Newborn mice pups were subjected to an immediate hyperoxic condition from birth and kept at 85% O2 levels for 14 days followed by a 14-day period in room air. Next, mice lung tissue was used for RNA and DNA extraction with subsequent microarray-based assessment of lung transcriptome and supplementary methylome analysis. RESULTS The immune system-related transcriptomeregulation was affected in mouse lungs after hyperoxia. A high proportion of genes relevant in the immune system exhibited significant expression alterations, e.g., B cell-specific genes central to the cytokine-cytokine receptor interaction, the PI3K-AKT, and the B cell receptor signaling pathways. The findings were accompanied by significant DNA hypermethylation observed in the PI3K-AKT pathway and immune system-relevant genes. CONCLUSIONS Oxygen damage could be partly responsible for the increased susceptibility and abnormal response to respiratory viruses and infections seen in premature babies with BPD through dysregulated genes.
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Affiliation(s)
- Cecilie Revhaug
- Department of Pediatric Research, Oslo University Hospital Rikshospitalet and University of Oslo, Oslo, Norway,
| | - Miroslaw Bik-Multanowski
- Department of Medical Genetics, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Magdalena Zasada
- Department of Pediatrics, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Anne Gro W Rognlien
- Department of Pediatric Research, Oslo University Hospital Rikshospitalet and University of Oslo, Oslo, Norway
| | | | - Teofila Ksiązek
- Department of Medical Genetics, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Anna Madetko-Talowska
- Department of Medical Genetics, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Katarzyna Szewczyk
- Department of Medical Genetics, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Agnieszka Grabowska
- Department of Medical Genetics, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Przemko Kwinta
- Department of Pediatrics, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Jacek J Pietrzyk
- Department of Medical Genetics, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland.,Department of Pediatrics, Institute of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Lars O Baumbusch
- Department of Pediatric Research, Oslo University Hospital Rikshospitalet and University of Oslo, Oslo, Norway
| | - Ola D Saugstad
- Department of Pediatric Research, Oslo University Hospital Rikshospitalet and University of Oslo, Oslo, Norway
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43
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Walentowicz-Sadlecka M, Dziobek K, Grabiec M, Sadlecki P, Walentowicz P, Mak P, Szymankiewicz M, Kwinta P, Dutsch-Wicherek M. The analysis of human leukocyte antigen-G level in patients with endometrial cancer by Western blot technique. Am J Reprod Immunol 2018; 81:e13070. [DOI: 10.1111/aji.13070] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 10/27/2018] [Accepted: 11/06/2018] [Indexed: 11/30/2022] Open
Affiliation(s)
- Małgorzata Walentowicz-Sadlecka
- Department of Obstetrics and Gynecology, L. Rydygier Collegium Medicum in Bydgoszcz; Nicolaus Copernicus University; Bydgoszcz Poland
| | - Konrad Dziobek
- Center of Oncology; M. Sklodowska-Curie Memorial Institute, Krakow Branch; Kraków Poland
| | - Marek Grabiec
- Department of Obstetrics and Gynecology, L. Rydygier Collegium Medicum in Bydgoszcz; Nicolaus Copernicus University; Bydgoszcz Poland
| | - Pawel Sadlecki
- Department of Obstetrics and Gynecology, L. Rydygier Collegium Medicum in Bydgoszcz; Nicolaus Copernicus University; Bydgoszcz Poland
| | - Pawel Walentowicz
- Department of Obstetrics and Gynecology, L. Rydygier Collegium Medicum in Bydgoszcz; Nicolaus Copernicus University; Bydgoszcz Poland
| | - Paweł Mak
- Department of Analytical Biochemistry, Faculty of Biochemistry, Biophysics and Biotechnology; Jagiellonian University; Krakow Poland
| | - Maria Szymankiewicz
- Department of Obstetrics and Gynecology, L. Rydygier Collegium Medicum in Bydgoszcz; Nicolaus Copernicus University; Bydgoszcz Poland
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44
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Jagła M, Szymońska I, Starzec K, Gach O, Włodarczyk A, Kwinta P. Defining Glycemic Variability in Very Low-Birthweight Infants: Data from a Continuous Glucose Monitoring System. Diabetes Technol Ther 2018; 20:725-730. [PMID: 30239225 DOI: 10.1089/dia.2018.0168] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Glucose variability (GV) is a matter of interest for researches in recent years. It is connected with oxidative stress, which is crucial in the development of multiple complication of prematurity. However, glycemic variability in preterm infants was poorly investigated. This study aims to investigate glycemic variability obtained from a continuous glucose monitoring (CGM) system in a cohort of very low-birthweight (VLBW) infants. METHODS A prospective, single-center, open cohort study enrolled 74 VLBW infants with a mean birthweight of 1066 g and median gestational age of 28 weeks. A CGM system (Guardian Real-Time CGM®, Medtronic, Northridge, CA) was used to measure interstitial glucose concentration. The glycemic variability was calculated using EasyGV. RESULTS Most glycemic variability indices in VLBW infants showed log-normal distribution and for these, geometric mean ÷/ × geometric standard deviation (GSD) was calculated: M-value 2.28 (÷/ × 1.82), mean amplitude of glycemic excursions (MAGE) 1.89 (÷/ × 1.34), average daily risk ratio (ADRR) 2.22 (÷/ × 2.56), lability index 0.46 (÷/ × 1.71), J-index 0.46 (÷/ × 1.71), low blood glucose index 2.05 (÷/ × 1.66), high blood glucose index 1.11 (÷/ × 2.44), continuous overlapping net glycemic action (CONGA) 5.54 (÷/ × 1.16), mean of daily differences (MODD) 1.23 (÷/ × 1.38), and coefficient of variation 1.15 (÷/ × 1.31). Only SD of glucose concentration showed a normal distribution: arithmetic mean 1.24 (+/-0.37). ADRR, J-index, MODD, CONGA, and MAGE are moderately to strongly correlated with SD. CONCLUSIONS In our cohort of VLBW infants, almost all glycemic variability indices showed skewed positive distribution. The natural central tendency measure for the log-normally distributed data is the geometric mean and for statistical variation is the GSD.
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Affiliation(s)
- Mateusz Jagła
- 1 Institute of Pediatrics, Jagiellonian University Collegium Medicum, Kraków, Poland
| | - Izabela Szymońska
- 1 Institute of Pediatrics, Jagiellonian University Collegium Medicum, Kraków, Poland
| | - Katarzyna Starzec
- 1 Institute of Pediatrics, Jagiellonian University Collegium Medicum, Kraków, Poland
| | - Olga Gach
- 1 Institute of Pediatrics, Jagiellonian University Collegium Medicum, Kraków, Poland
| | - Aneta Włodarczyk
- 2 Chair of Econometrics and Statistics, Faculty of Management, Czestochowa University of Technology , Czestochowa, Poland
| | - Przemko Kwinta
- 1 Institute of Pediatrics, Jagiellonian University Collegium Medicum, Kraków, Poland
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45
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Mól N, Zasada M, Tomasik P, Klimasz K, Kwinta P. Evaluation of irisin and visfatin levels in very low birth weight preterm newborns compared to full term newborns-A prospective cohort study. PLoS One 2018; 13:e0204835. [PMID: 30261060 PMCID: PMC6160155 DOI: 10.1371/journal.pone.0204835] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 09/14/2018] [Indexed: 12/30/2022] Open
Abstract
Premature infants represent one of the groups with increased risk for metabolic syndrome. Our study is the first one to evaluate irisin and visfatin levels, associated with the metabolic syndrome, both in blood of preterm and full-term infants, as well as in the breastmilk of their mothers. A total of 72 newborns was enrolled in the study, including 53 very low birth weight preterm infants and a control group of 19 term infants. The levels of irisin and visfatin were determined by a commercial enzyme-linked immunoabsorbent assay both in the baby serum and maternal milk twice, first during the 1st week of life and then 4 weeks later. Preterm infants had significantly lower serum irisin levels compared to the term infants. Overall, serum irisin level during the 1st week of life was positively correlated with several anthropometric measurements at birth, as well as during 5th weeks of age. In contrast, serum visfatin levels during 5th week of life were negatively correlated with z-scores of birth weight, weight and head circumference during 5th week of age. We found a strong negative correlation between serum irisin and serum visfatin levels at both analyzed time points. The level of milk visfatin was significantly higher in the mothers of the preterm group during 5th week of life. In conclusion, our results provide further evidence that irisin and visfatin may play physiologic roles in development of both preterm and full-term newborns during their first month after birth. Observed differences in irisin and visfatin serum and breastmilk concentrations during the earliest stages of life may contribute to development of catch up growth, but also, they might eventually lead to a higher risk for metabolic syndrome in prematurely born children in later years.
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Affiliation(s)
- Nina Mól
- Department of Paediatrics, Institute of Paediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
- * E-mail:
| | - Magdalena Zasada
- Department of Paediatrics, Institute of Paediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Przemysław Tomasik
- Department of Clinical Biochemistry, Institute of Paediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Katarzyna Klimasz
- Department of Clinical Biochemistry, Institute of Paediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Przemko Kwinta
- Department of Paediatrics, Institute of Paediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
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46
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Kościelniak BK, Mól N, Kwinta P, Sztefko K, Tomasik PJ. Plasma Free Fatty Acids and their Binding Proteins in Preterm Infants. Ann Nutr Metab 2018; 73:113-120. [PMID: 30045009 DOI: 10.1159/000491435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 06/19/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS The objective of the study was to evaluate the circulating concentrations of plasma free fatty acids (FFA), fatty acid binding proteins: FABP-1 and FABP-4 in preterm infants depending on different feeding protocol. METHODS A total of 43 premature infants (≤34 weeks) were enrolled in the study, and divided into 3 subgroups: nursed while staying in the department (53%), breast-fed only during the first 24 h (16%), and formulafed from the beginning (31%). The control group consisted of 12 healthy, full-term, breast-fed newborns. Blood samples were collected after delivery and 1 month later. We measured plasma concentrations of FFA, FABP-1, and FABP-4. RESULTS FFA plasma concentrations were significantly lower in preterm babies when compared to control group (p = 0.003) in the prenatal period. After 1 month, a significant decrease in FFA concentration was noted in all groups of preterm babies independently from feeding protocol. After a month, breast-fed preterm infants and controls had significantly lower FABP-1 levels than preterm formula-fed infants (all p < 0.05), while the highest concentrations of FABP-4 were noted in formula-fed preterm infants when compared to breast-fed preterm infants and the control group (all p < 0.05). CONCLUSIONS Prematurity is connected with disturbances in plasma FFA concentrations. FABP-1, as well as FABP-4, plasma levels in preterm infants depend on feeding protocol.
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Affiliation(s)
- Barbara K Kościelniak
- Departament of Clinical Biochemistry, Faculty of Medicine, Jagiellonian University, Cracow, Poland
| | - Nina Mól
- Department of Pediatrics, Chair of Pediatrics, Faculty of Medicine, Jagiellonian University, Cracow, Poland
| | - Przemko Kwinta
- Department of Pediatrics, Chair of Pediatrics, Faculty of Medicine, Jagiellonian University, Cracow, Poland
| | - Krystyna Sztefko
- Departament of Clinical Biochemistry, Faculty of Medicine, Jagiellonian University, Cracow, Poland
| | - Przemysław J Tomasik
- Departament of Clinical Biochemistry, Faculty of Medicine, Jagiellonian University, Cracow, Poland
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47
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Kwinta P, Bokiniec R, Bik-Multanowski M, Gunther CC, Grabowska A, Książek T, Madetko-Talowska A, Szewczyk K, Szwarc-Duma M, Borszewska-Kornacka MK, Baumbusch LO, Revhaug C, Saugstad OD, Pietrzyk JJ. Comparison of whole genome expression profile between preterm and full-term newborns. Ginekol Pol 2018; 88:434-441. [PMID: 28930370 DOI: 10.5603/gp.a2017.0080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 08/06/2017] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Evaluate the time dependent expression of genes in preterm neonates and verify the influence of ontogenic maturation and the environmental factors on the gene expression after birth. MATERIAL AND METHODS The study was carried out on 20 full-term newborns and 62 preterm newborns (mean birth weight = 1002 [g] (SD: 247), mean gestational age = 27.2 weeks (SD: 1.9)). Blood samples were drawn from all the study participants at birth and at the 36th week postmenstrual age from the preterm group to assess whole genome expression in umbilical cord blood and in peripheral blood leukocytes, respectively. (SurePrint G3 Human Gene Expression v3, 8x60K Microarrays (Agilent)). RESULTS A substantial number of genes was found to be expressed differentially at the time of birth and at 36 PMA in comparison to the term babies with more genes being down-regulated than up-regulated. However, the fold change in the majority of cases was < 2.0. Extremely preterm and very preterm infants were characterized by significantly down-regulated cytokine and chemokine related pathways. The number of down-regulated genes decreased and number of up-regulated genes increased at 36 PMA vs. cord blood. There were no specific gene expression pathway profiles found within the groups of different gestational ages. CONCLUSIONS Preterm delivery is associated with a different gene expression profile in comparison to term delivery. The gene expression profile changes with the maturity of a newborn measured by the gestational age.
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Affiliation(s)
- Przemko Kwinta
- Katedra Pediatrii Klinika Chorób Dzieci Uniwerystet Jagielloński Collegium Medicum, Poland.
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48
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Abstract
BACKGROUND Irisin is a newly discovered myokine with anti-obesity properties. The delivery of irisin with the breast milk or formula is an emerging concept that myokine present at human milk influences postnatal energy balance and developmental parameters. The aim of the study was to evaluate irisin concentration in breast milk of mothers with term and preterm babies and in infant formulas. METHODS A total of 49 lactating mothers were enrolled in the study: 31 mothers of very low birth weight preterm infants and 18 mothers of term infants. Milk samples were collected twice: during the first week after delivery and after 4 weeks of delivery. Irisin concentration was determined using ELISA kits both in human milk and in samples of 14 different infant formulas. RESULTS There were no differences in milk irisin levels between preterm and full-term milk samples during both the 1st and the 4th week after delivery. There were also no differences in irisin concentration between transitional milk and mature milk in both tested groups. Irisin concentrations in preterm and full-term milk were significantly higher than in formulas during 30 days period after delivery. A significant increase of irisin concentration in natural milk 4 weeks post-delivery in comparison to 1st week after delivery was observed (mean difference 0.362 μg/ml; p=0.0063). CONCLUSIONS This study provides evidence that irisin is present in infant formulas, although in less amount than in human milk. Further research is needed to assess, if children fed with infant formulas may disadvantage from lower irisin supply.
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Affiliation(s)
- Nina Mól
- Department of Paediatrics, Institute of Paediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland -
| | - Przemysław Tomasik
- Department of Clinical Biochemistry, Institute of Paediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Katarzyna Klimasz
- Department of Clinical Biochemistry, Institute of Paediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Magdalena Zasada
- Department of Paediatrics, Institute of Paediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Przemko Kwinta
- Department of Paediatrics, Institute of Paediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
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49
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Sobczak A, Kruczek P, Homa M, Kwinta P. A new microscopic insight into the thrombogenicity of umbilical catheters. Thromb Res 2018; 168:80-82. [PMID: 29936402 DOI: 10.1016/j.thromres.2018.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 05/31/2018] [Accepted: 06/08/2018] [Indexed: 12/25/2022]
Affiliation(s)
- Alina Sobczak
- Neonatal Intensive Care Unit, Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland.
| | - Piotr Kruczek
- Neonatal Intensive Care Unit, Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland.
| | - Marta Homa
- Centre for High Temperature Studies, Foundry Research Institute, Kraków, Poland.
| | - Przemko Kwinta
- Neonatal Intensive Care Unit, Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland.
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50
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Drożdż T, Kwinta P, Kordon Z, Sztefko K, Rudziński A, Zachwieja K, Miklaszewska M, Czarnecka D, Drożdż D. [B-type natriuretic peptide as a marker of cardiac dysfunction in children with chronic kidney disease]. Pol Merkur Lekarski 2018; 44:171-176. [PMID: 29775443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
UNLABELLED Left ventricular hypertrophy is the most common organ damage in children with chronic kidney disease (CKD). AIM The aim of the study was to assess the usefulness of B-type natriuretic peptide (BNP) as a marker of heart injury in children with CKD. MATERIALS AND METHODS We included 66 children (41 boys and 25 girls) aged 0.7 to 18.6 (median 11.6) years with CKD stage 1-5. The concentrations of urea, creatinine, cystatin C and BNP in blood serum were assessed, and the estimated glomerular filtration rate (eGFR) was calculated from the Schwartz and Filler formulas. Patients were divided into groups depending on the CKD stage [group 1: CKD stages 1 + 2 (GFR> 60 ml/min/1.73 m2), group 2: stage 3 (GFR = 30-59 ml/min/1.73 m2), group 3: CKD stage 4 (GFR 15-29 ml/min/ 1.73 m2), group 4 - stage 5 (dialyzed children)]. On the basis of echocardiography, the left ventricular mass (LVM) was calculated, which was indexed for height (left ventricular mass index, LVMI). Left ventricular hypertrophy (LVH) was diagnosed if the LVMI value was > 95th percentile for sex and age. RESULTS Depending on the CKD stage the median BNP concentrations for group 1, group 2, group 3, and group 4 were 2.5 pg/ml, 6.0 pg/ml, 9.3 pg/ml and 18.0 pg/ml, and the LVH prevalence 27.3%, 33.3%, 60.0% and 63.6% , respectively. Significant correlations between BNP concentration and LVH expressed by LVMI (R=0.256, p=0.038), creatinine (R=0.453, p<0.001), cystatin (R=0.494, p<0.001) and eGFR (R=-0.473, p<0.001) were found. CONCLUSIONS In children with chronic kidney disease, BNP is an indicator of heart failure correlating with renal function parameters and left ventricular mass index.
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Affiliation(s)
- Tomasz Drożdż
- Jagiellonian University Medical College, Cracow, Poland: I Department of Cardiology, Interventional Electrocardiology and Hypertension
| | - Przemko Kwinta
- Jagiellonian University Medical College, Cracow, Poland: Department of Pediatrics
| | - Zbigniew Kordon
- Jagiellonian University Medical College, Cracow, Poland: Department of Pediatric Cardiology
| | - Krystyna Sztefko
- Jagiellonian University Medical College, Cracow, Poland: Department of Clinical Biochemistry
| | - Andrzej Rudziński
- Jagiellonian University Medical College, Cracow, Poland: Department of Pediatric Cardiology
| | - Katarzyna Zachwieja
- Jagiellonian University Medical College, Cracow, Poland: Department of Pediatric Nephrology and Hypertension
| | - Monika Miklaszewska
- Jagiellonian University Medical College, Cracow, Poland: Department of Pediatric Nephrology and Hypertension
| | - Danuta Czarnecka
- Jagiellonian University Medical College, Cracow, Poland: I Department of Cardiology, Interventional Electrocardiology and Hypertension
| | - Dorota Drożdż
- Jagiellonian University Medical College, Cracow, Poland: Department of Pediatric Nephrology and Hypertension
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