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Rodrigo R, Amir LH, Forster DA. Parents' Views on Prolonged Maternal Hospital Stay With Sick Newborn Infants in a Tertiary Neonatal Unit in Sri Lanka. Adv Neonatal Care 2024; 24:162-171. [PMID: 38545806 DOI: 10.1097/anc.0000000000001148] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
BACKGROUND Mothers of infants in most Sri Lankan neonatal units are required to be "inpatients" during the entirety of their infant's stay. This traditional practice is closely aligned to the relatively newer model of family-integrated care. PURPOSE Exploration of parent's views regarding the expectation for mothers to remain in hospital for the entire duration of their infant's neonatal unit stay. METHODS Cross-sectional study of parents of infants admitted to the University neonatal unit of Colombo North Teaching Hospital, Ragama, Sri Lanka, using self-administered questionnaires in 2017. RESULTS We found that 40% (19/48) of mothers and 43% (16/37) of fathers preferred that mothers traveled from home, rather than being inpatients continuously, in order to care for older children, receive psychological support from family, and also due to other practical inconveniences of living in the hospital. The main barriers to women being able to travel from home were the need to safely provide expressed human milk for their hospitalized infants and current hospital administrative and societal attitudes. IMPLICATIONS FOR PRACTICE AND RESEARCH We found that a considerable number of parents with infants in the neonatal intensive care unit in Sri Lanka would like the option of the mother being able travel from home, rather than being confined to hospital. To facilitate this option, changes in hospital protocols and further research into storage and transportation of expressed mother's milk will be required. Improving facilities in hospital and providing more opportunities for families to interact with infants in neonatal intensive care unit will encourage mothers to remain in hospital continuously.
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Affiliation(s)
- Ranmali Rodrigo
- Judith Lumley Centre, School of Nursing & Midwifery, La Trobe University, Bundoora, Melbourne, Victoria, Australia (Drs Rodrigo, Amir, and Forster); Department of Paediatrics, University of Kelaniya, Ragama, Sri Lanka (Dr Rodrigo); Department of Paediatrics, Mercy Hospital for Women, Heidelberg, Melbourne, Australia (Dr Rodrigo); and Midwifery and Maternity Services Research, The Royal Women's Hospital, Parkville, Melbourne, Australia (Dr Forster)
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Montaldo P, Burgod C, Herberg JA, Kaforou M, Cunnington AJ, Mejias A, Cirillo G, Miraglia Del Giudice E, Capristo C, Bandiya P, Kamalaratnam CN, Chandramohan R, Manerkar S, Rodrigo R, Sumanasena S, Krishnan V, Pant S, Shankaran S, Thayyil S. Whole-Blood Gene Expression Profile After Hypoxic-Ischemic Encephalopathy. JAMA Netw Open 2024; 7:e2354433. [PMID: 38306098 PMCID: PMC10837749 DOI: 10.1001/jamanetworkopen.2023.54433] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 12/06/2023] [Indexed: 02/03/2024] Open
Abstract
Importance Induced hypothermia, the standard treatment for hypoxic-ischemic encephalopathy (HIE) in high-income countries (HICs), is less effective in the low-income populations in South Asia, who have the highest disease burden. Objective To investigate the differences in blood genome expression profiles of neonates with HIE from an HIC vs neonates with HIE from South Asia. Design, Setting, and Participants This case-control study analyzed data from (1) a prospective observational study involving neonates with moderate or severe HIE who underwent whole-body hypothermia between January 2017 and June 2019 and age-matched term healthy controls in Italy and (2) a randomized clinical trial involving neonates with moderate or severe HIE in India, Sri Lanka, and Bangladesh recruited between August 2015 and February 2019. Data were analyzed between October 2020 and August 2023. Exposure Whole-blood RNA that underwent next-generation sequencing. Main Outcome and Measures The primary outcomes were whole-blood genome expression profile at birth associated with adverse outcome (death or disability at 18 months) after HIE in the HIC and South Asia cohorts and changes in whole-genome expression profile during the first 72 hours after birth in neonates with HIE and healthy controls from the HIC cohort. Blood samples for RNA extraction were collected before whole-body hypothermia at 4 time points (6, 24, 48, and 72 hours after birth) for the HIC cohort. Only 1 blood sample was drawn within 6 hours after birth for the South Asia cohort. Results The HIC cohort was composed of 35 neonates (21 females [60.0%]) with a median (IQR) birth weight of 3.3 (3.0-3.6) kg and gestational age of 40.0 (39.0-40.6) weeks. The South Asia cohort consisted of 99 neonates (57 males [57.6%]) with a median (IQR) birth weight of 2.9 (2.7-3.3) kg and gestational age of 39.0 (38.0-40.0) weeks. Healthy controls included 14 neonates (9 females [64.3%]) with a median (IQR) birth weight of 3.4 (3.2-3.7) kg and gestational age of 39.2 (38.9-40.4) weeks. A total of 1793 significant genes in the HIC cohort and 99 significant genes in the South Asia cohort were associated with adverse outcome (false discovery rate <0.05). Only 11 of these genes were in common, and all had opposite direction in fold change. The most significant pathways associated with adverse outcome were downregulation of eukaryotic translation initiation factor 2 signaling in the HIC cohort (z score = -4.56; P < .001) and aldosterone signaling in epithelial cells in the South Asia cohort (z score = null; P < .001). The genome expression profile of neonates with HIE (n = 35) at birth, 24 hours, 48 hours, and 72 hours remained significantly different from that of age-matched healthy controls in the HIC cohort (n = 14). Conclusions and Relevance This case-control study found that disease mechanisms underlying HIE were primarily associated with acute hypoxia in the HIC cohort and nonacute hypoxia in the South Asia cohort. This finding might explain the lack of hypothermic neuroprotection.
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Affiliation(s)
- Paolo Montaldo
- Centre for Perinatal Neuroscience, Department of Brain Sciences, Imperial College London, London, United Kingdom
- Department of Women's and Children's Health and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Constance Burgod
- Centre for Perinatal Neuroscience, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Jethro A. Herberg
- Section of Paediatric Infectious Disease and Centre for Paediatrics and Child Health, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Myrsini Kaforou
- Section of Paediatric Infectious Disease and Centre for Paediatrics and Child Health, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Aubrey J. Cunnington
- Section of Paediatric Infectious Disease and Centre for Paediatrics and Child Health, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Asuncion Mejias
- Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, Tennessee
- Center for Vaccines and Immunity, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio
| | - Grazia Cirillo
- Department of Women's and Children's Health and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Emanuele Miraglia Del Giudice
- Department of Women's and Children's Health and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Carlo Capristo
- Department of Women's and Children's Health and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Prathik Bandiya
- Department of Neonatology, Indira Gandhi Institute of Child Health, Bengaluru, India
| | | | - Rema Chandramohan
- Institute of Child Health, Department of Neonatology, Madras Medical College, Chennai, India
| | - Swati Manerkar
- Department of Neonatology, Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - Ranmali Rodrigo
- Department of Pediatrics, University of Kelaniya, Colombo, Sri Lanka
| | | | - Vaisakh Krishnan
- Centre for Perinatal Neuroscience, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Stuti Pant
- Centre for Perinatal Neuroscience, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Seetha Shankaran
- Neonatal-Perinatal Medicine, Wayne State University, Detroit, Michigan
| | - Sudhin Thayyil
- Centre for Perinatal Neuroscience, Department of Brain Sciences, Imperial College London, London, United Kingdom
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Burgod C, Mazlan M, Pant S, Krishnan V, Garegrat R, Montaldo P, Muraleedharan P, Bandiya P, Kamalaratnam CN, Chandramohan R, Manerkar S, Jahan I, Moni SC, Shahidullah M, Rodrigo R, Sumanasena S, Sujatha R, Sathyanathan BP, Joshi AR, Pressler RR, Bassett P, Shankaran S, Thayyil S. Duration of birth depression and neurodevelopmental outcomes after whole-body hypothermia for hypoxic ischemic encephalopathy in India, Sri Lanka and Bangladesh - an exploratory analysis of the HELIX trial. Lancet Reg Health Southeast Asia 2024; 20:100284. [PMID: 38234698 PMCID: PMC10794099 DOI: 10.1016/j.lansea.2023.100284] [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] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/01/2023] [Accepted: 09/11/2023] [Indexed: 01/19/2024]
Abstract
Background Effect of duration of birth depression on neurodevelopmental outcomes in low- and middle-income countries (LMICs) is not known. We examined the association of birth depression with brain injury, neurodevelopmental outcomes, and hypothermia after hypoxic ischemic encephalopathy (HIE) in south Asia. Methods We compared cerebral magnetic resonance (MR) at 2 weeks, and adverse outcomes (death or moderate or severe disability) at 18 months in 408 babies with moderate or severe HIE who had long birth depression (positive pressure ventilation (PPV) >10 min or Apgar score<6 at 10 min or cord pH < 7.0) and short birth depression (PPV for 5-10 min or Apgar score<6 at 5 min, but ≥6 at 10 min). Findings Long depression group (n = 201) had more severe HIE (32.8% versus 6.8%), mortality (47.5% versus 26.4%), death or disability at 18 months (62.2% versus 35.4%) (all p < 0.001), MR injury (Odds ratio; 95% CI) to basal ganglia (2.4 (1.3, 4.1); p = 0.003), posterior limb of internal capsule (2.3 (1.3, 4.3); p < 0.001) and white matter (1.7 (1.1, 2.7); p = 0.021), and lower thalamic N-acetylaspartate levels (7.69 ± 1.84 versus 8.29 ± 1.60); p = 0.031) than short depression group (n = 207). Three babies had no heartbeat at 5 min, of which 1 died and 2 survived with severe disability. No significant interaction between the duration of birth depression and whole-body hypothermia was seen for any of the MR biomarker or clinical outcomes. Interpretation Long birth depression was associated with more brain injury and adverse outcomes than short depression. Effect of hypothermia was not modified by duration of birth depression. Funding National Institute for Health Research.
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Affiliation(s)
- Constance Burgod
- Centre for Perinatal Neuroscience, Imperial College, London, United Kingdom
| | - Munirah Mazlan
- Centre for Perinatal Neuroscience, Imperial College, London, United Kingdom
| | - Stuti Pant
- Centre for Perinatal Neuroscience, Imperial College, London, United Kingdom
| | - Vaisakh Krishnan
- Centre for Perinatal Neuroscience, Imperial College, London, United Kingdom
| | - Reema Garegrat
- Centre for Perinatal Neuroscience, Imperial College, London, United Kingdom
| | - Paolo Montaldo
- Centre for Perinatal Neuroscience, Imperial College, London, United Kingdom
| | | | - Prathik Bandiya
- Neonatal Unit, Indira Gandhi Institute of Child Health, Bangalore, India
| | | | | | - Swati Manerkar
- Neonatal Unit and Radiology, Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - Ismat Jahan
- Neonatal Unit, Bangabandhu Sheikh Mujib Medical University, Bangladesh
| | - Sadeka C. Moni
- Neonatal Unit, Bangabandhu Sheikh Mujib Medical University, Bangladesh
| | | | | | | | - Radhika Sujatha
- Neonatal Unit, Sree Avittom Thirunal Hospital and Government Medical College, Thiruvananthapuram, India
| | | | - Anagha R. Joshi
- Neonatal Unit and Radiology, Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - Ronit R. Pressler
- Department of Neurophysiology, Great Ormond Street Hospital, United Kingdom
| | | | - Seetha Shankaran
- Department of Neonatal-Perinatal Medicine, Wayne State University, Detroit, MI, USA
- University of Texas at Austin, Dell Children's Hospital, Austin, USA
| | - Sudhin Thayyil
- Centre for Perinatal Neuroscience, Imperial College, London, United Kingdom
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Thayyil S, Montaldo P, Krishnan V, Ivain P, Pant S, Lally PJ, Bandiya P, Benkappa N, Kamalaratnam CN, Chandramohan R, Manerkar S, Mondkar J, Jahan I, Moni SC, Shahidullah M, Rodrigo R, Sumanasena S, Sujatha R, Burgod C, Garegrat R, Mazlan M, Chettri I, Babu Peter S, Joshi AR, Swamy R, Chong K, Pressler RR, Bassett P, Shankaran S. Whole-Body Hypothermia, Cerebral Magnetic Resonance Biomarkers, and Outcomes in Neonates With Moderate or Severe Hypoxic-Ischemic Encephalopathy Born at Tertiary Care Centers vs Other Facilities: A Nested Study Within a Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2312152. [PMID: 37155168 PMCID: PMC10167567 DOI: 10.1001/jamanetworkopen.2023.12152] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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] [Indexed: 05/10/2023] Open
Abstract
Importance The association between place of birth and hypothermic neuroprotection after hypoxic-ischemic encephalopathy (HIE) in low- and middle-income countries (LMICs) is unknown. Objective To ascertain the association between place of birth and the efficacy of whole-body hypothermia for protection against brain injury measured by magnetic resonance (MR) biomarkers among neonates born at a tertiary care center (inborn) or other facilities (outborn). Design, Setting, and Participants This nested cohort study within a randomized clinical trial involved neonates at 7 tertiary neonatal intensive care units in India, Sri Lanka, and Bangladesh between August 15, 2015, and February 15, 2019. A total of 408 neonates born at or after 36 weeks' gestation with moderate or severe HIE were randomized to receive whole-body hypothermia (reduction of rectal temperatures to between 33.0 °C and 34.0 °C; hypothermia group) for 72 hours or no whole-body hypothermia (rectal temperatures maintained between 36.0 °C and 37.0 °C; control group) within 6 hours of birth, with follow-up until September 27, 2020. Exposure 3T MR imaging, MR spectroscopy, and diffusion tensor imaging. Main Outcomes and Measures Thalamic N-acetyl aspartate (NAA) mmol/kg wet weight, thalamic lactate to NAA peak area ratios, brain injury scores, and white matter fractional anisotropy at 1 to 2 weeks and death or moderate or severe disability at 18 to 22 months. Results Among 408 neonates, the mean (SD) gestational age was 38.7 (1.3) weeks; 267 (65.4%) were male. A total of 123 neonates were inborn and 285 were outborn. Inborn neonates were smaller (mean [SD], 2.8 [0.5] kg vs 2.9 [0.4] kg; P = .02), more likely to have instrumental or cesarean deliveries (43.1% vs 24.7%; P = .01), and more likely to be intubated at birth (78.9% vs 29.1%; P = .001) than outborn neonates, although the rate of severe HIE was not different (23.6% vs 17.9%; P = .22). Magnetic resonance data from 267 neonates (80 inborn and 187 outborn) were analyzed. In the hypothermia vs control groups, the mean (SD) thalamic NAA levels were 8.04 (1.98) vs 8.31 (1.13) among inborn neonates (odds ratio [OR], -0.28; 95% CI, -1.62 to 1.07; P = .68) and 8.03 (1.89) vs 7.99 (1.72) among outborn neonates (OR, 0.05; 95% CI, -0.62 to 0.71; P = .89); the median (IQR) thalamic lactate to NAA peak area ratios were 0.13 (0.10-0.20) vs 0.12 (0.09-0.18) among inborn neonates (OR, 1.02; 95% CI, 0.96-1.08; P = .59) and 0.14 (0.11-0.20) vs 0.14 (0.10-0.17) among outborn neonates (OR, 1.03; 95% CI, 0.98-1.09; P = .18). There was no difference in brain injury scores or white matter fractional anisotropy between the hypothermia and control groups among inborn or outborn neonates. Whole-body hypothermia was not associated with reductions in death or disability, either among 123 inborn neonates (hypothermia vs control group: 34 neonates [58.6%] vs 34 [56.7%]; risk ratio, 1.03; 95% CI, 0.76-1.41), or 285 outborn neonates (hypothermia vs control group: 64 neonates [46.7%] vs 60 [43.2%]; risk ratio, 1.08; 95% CI, 0.83-1.41). Conclusions and Relevance In this nested cohort study, whole-body hypothermia was not associated with reductions in brain injury after HIE among neonates in South Asia, irrespective of place of birth. These findings do not support the use of whole-body hypothermia for HIE among neonates in LMICs. Trial Registration ClinicalTrials.gov Identifier: NCT02387385.
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Affiliation(s)
- Sudhin Thayyil
- Centre for Perinatal Neuroscience, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Paolo Montaldo
- Centre for Perinatal Neuroscience, Department of Brain Sciences, Imperial College London, London, United Kingdom
- Neonatal Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Vaisakh Krishnan
- Centre for Perinatal Neuroscience, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Phoebe Ivain
- Centre for Perinatal Neuroscience, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Stuti Pant
- Centre for Perinatal Neuroscience, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Peter J Lally
- Centre for Perinatal Neuroscience, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Prathik Bandiya
- Neonatal Unit, Indira Gandhi Institute of Child Health, Bengaluru, India
| | - Naveen Benkappa
- Neonatal Unit, Indira Gandhi Institute of Child Health, Bengaluru, India
| | | | | | - Swati Manerkar
- Neonatal Unit, Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - Jayshree Mondkar
- Neonatal Unit, Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - Ismat Jahan
- Neonatal Unit, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Sadeka C Moni
- Neonatal Unit, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | | | - Ranmali Rodrigo
- Department of Pediatrics, University of Kelaniya, Kelaniya, Sri Lanka
| | | | - Radhika Sujatha
- Neonatal Unit, Sree Avittom Thirunal Hospital, Government Medical College, Thiruvananthapuram, India
| | - Constance Burgod
- Centre for Perinatal Neuroscience, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Reema Garegrat
- Centre for Perinatal Neuroscience, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Munirah Mazlan
- Centre for Perinatal Neuroscience, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Ismita Chettri
- Centre for Perinatal Neuroscience, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | | | - Anagha R Joshi
- Department of Radiology, Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - Ravi Swamy
- Centre for Perinatal Neuroscience, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Kling Chong
- Department of Neuroradiology, Great Ormond Street Hospital, London, United Kingdom
| | - Ronit R Pressler
- Department of Neurophysiology, Great Ormond Street Hospital, London, United Kingdom
| | | | - Seetha Shankaran
- Division of Neonatal-Perinatal Medicine, Wayne State University, Detroit, Michigan
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Olivares-González L, Velasco S, Campillo I, Millán JM, Rodrigo R. Redox Status in Retinitis Pigmentosa. Adv Exp Med Biol 2023; 1415:443-448. [PMID: 37440070 DOI: 10.1007/978-3-031-27681-1_65] [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] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
Retinitis pigmentosa (RP) is the most common form of inherited retinal dystrophy characterized by the progressive loss of vision. It is a rare disease. Despite being a genetic disease, its progression is influenced by oxidative damage and chemokines and cytokines released by the activated immune cells (e.g., macrophages or microglia). The role of oxidative stress is very important in the retina. Rods are the main consumers of oxygen (O2), so they are constantly exposed to oxidative stress and lipid peroxidation. According to the oxidative hypothesis, after rod death in the early stages of the disease, O2 would accumulate in large quantities in the retina, producing hyperoxia and favoring the accumulation of reactive oxygen species and reactive nitrogen species that would cause oxidative damage to lipids, proteins, and DNA, exacerbating the process of retinal degeneration. Evidence shows alterations in the antioxidant-oxidant state in patients and in animal models of RP. In recent years, therapeutic approaches aimed at reducing oxidative stress have emerged as useful therapies to slow down the progression of RP. We focus this review on oxidative stress and its relationship with the progression of RP.
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Affiliation(s)
- L Olivares-González
- Pathophysiology and Therapies for Vision Disorders, Principe Felipe Research Center (CIPF), Valencia, Spain
- Joint Unit on Rare Diseases CIPF-La Fe, Valencia, Spain
| | - S Velasco
- Pathophysiology and Therapies for Vision Disorders, Principe Felipe Research Center (CIPF), Valencia, Spain
- Joint Unit on Rare Diseases CIPF-La Fe, Valencia, Spain
| | - I Campillo
- Pathophysiology and Therapies for Vision Disorders, Principe Felipe Research Center (CIPF), Valencia, Spain
- Joint Unit on Rare Diseases CIPF-La Fe, Valencia, Spain
| | - J M Millán
- Joint Unit on Rare Diseases CIPF-La Fe, Valencia, Spain
- Rare Diseases Networking Biomedical Research Centre (CIBERER), Madrid, Spain
- Molecular, Cellular and Genomic Biomedicine, Health Research Institute La Fe, Valencia, Spain
| | - R Rodrigo
- Pathophysiology and Therapies for Vision Disorders, Principe Felipe Research Center (CIPF), Valencia, Spain.
- Joint Unit on Rare Diseases CIPF-La Fe, Valencia, Spain.
- Rare Diseases Networking Biomedical Research Centre (CIBERER), Madrid, Spain.
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Abstract
Neonatal chylothorax is a rare presentation leading to significant respiratory distress, thus requiring timely diagnosis. A preterm neonate was resuscitated and ventilated, following which she clinically improved but subsequently developed respiratory distress with a right-sided pleural effusion. Interestingly, thoracentesis fluid appeared ‘milky’ with elevated triglycerides and lymphocytes, suggesting chylothorax. As fluid triglyceride level was lower than the established diagnostic criterion for chylothorax (1.24 mmol/L), a high fluid-to-serum triglyceride ratio was used as a surrogate diagnostic marker, later confirmed by lipoprotein electrophoresis. As observed in the index patient, a critically ill neonate would have a lower-than-average fat intake leading to less chylomicron production, thus lower triglyceride levels in chyle than expected, which may still fail to meet the amended cut-off limit. This case highlights the challenges in diagnosing neonatal chylothorax due to the lack of age-specific triglyceride levels in chyle and low oral fat intake in critically ill patients.
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Affiliation(s)
- Udara Dilrukshi Senarathne
- Department of Biochemistry, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka .,Department of Chemical Pathology, Colombo North Teaching Hospital, Ragama, Sri Lanka
| | - Ranmali Rodrigo
- Department of Paediatrics, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
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Thayyil S, Pant S, Montaldo P, Shukla D, Oliveira V, Ivain P, Bassett P, Swamy R, Mendoza J, Moreno-Morales M, Lally PJ, Benakappa N, Bandiya P, Shivarudhrappa I, Somanna J, Kantharajanna UB, Rajvanshi A, Krishnappa S, Joby PK, Jayaraman K, Chandramohan R, Kamalarathnam CN, Sebastian M, Tamilselvam IA, Rajendran UD, Soundrarajan R, Kumar V, Sudarsanan H, Vadakepat P, Gopalan K, Sundaram M, Seeralar A, Vinayagam P, Sajjid M, Baburaj M, Murugan KD, Sathyanathan BP, Kumaran ES, Mondkar J, Manerkar S, Joshi AR, Dewang K, Bhisikar SM, Kalamdani P, Bichkar V, Patra S, Jiwnani K, Shahidullah M, Moni SC, Jahan I, Mannan MA, Dey SK, Nahar MN, Islam MN, Shabuj KH, Rodrigo R, Sumanasena S, Abayabandara-Herath T, Chathurangika GK, Wanigasinghe J, Sujatha R, Saraswathy S, Rahul A, Radha SJ, Sarojam MK, Krishnan V, Nair MK, Devadas S, Chandriah S, Venkateswaran H, Burgod C, Chandrasekaran M, Atreja G, Muraleedharan P, Herberg JA, Kling Chong WK, Sebire NJ, Pressler R, Ramji S, Shankaran S. Hypothermia for moderate or severe neonatal encephalopathy in low-income and middle-income countries (HELIX): a randomised controlled trial in India, Sri Lanka, and Bangladesh. Lancet Glob Health 2021; 9:e1273-e1285. [PMID: 34358491 PMCID: PMC8371331 DOI: 10.1016/s2214-109x(21)00264-3] [Citation(s) in RCA: 112] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND Although therapeutic hypothermia reduces death or disability after neonatal encephalopathy in high-income countries, its safety and efficacy in low-income and middle-income countries is unclear. We aimed to examine whether therapeutic hypothermia alongside optimal supportive intensive care reduces death or moderate or severe disability after neonatal encephalopathy in south Asia. METHODS We did a multicountry open-label, randomised controlled trial in seven tertiary neonatal intensive care units in India, Sri Lanka, and Bangladesh. We enrolled infants born at or after 36 weeks of gestation with moderate or severe neonatal encephalopathy and a need for continued resuscitation at 5 min of age or an Apgar score of less than 6 at 5 min of age (for babies born in a hospital), or both, or an absence of crying by 5 min of age (for babies born at home). Using a web-based randomisation system, we allocated infants into a group receiving whole body hypothermia (33·5°C) for 72 h using a servo-controlled cooling device, or to usual care (control group), within 6 h of birth. All recruiting sites had facilities for invasive ventilation, cardiovascular support, and access to 3 Tesla MRI scanners and spectroscopy. Masking of the intervention was not possible, but those involved in the magnetic resonance biomarker analysis and neurodevelopmental outcome assessments were masked to the allocation. The primary outcome was a combined endpoint of death or moderate or severe disability at 18-22 months, assessed by the Bayley Scales of Infant and Toddler Development (third edition) and a detailed neurological examination. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, NCT02387385. FINDINGS We screened 2296 infants between Aug 15, 2015, and Feb 15, 2019, of whom 576 infants were eligible for inclusion. After exclusions, we recruited 408 eligible infants and we assigned 202 to the hypothermia group and 206 to the control group. Primary outcome data were available for 195 (97%) of the 202 infants in the hypothermia group and 199 (97%) of the 206 control group infants. 98 (50%) infants in the hypothermia group and 94 (47%) infants in the control group died or had a moderate or severe disability (risk ratio 1·06; 95% CI 0·87-1·30; p=0·55). 84 infants (42%) in the hypothermia group and 63 (31%; p=0·022) infants in the control group died, of whom 72 (36%) and 49 (24%; p=0·0087) died during neonatal hospitalisation. Five serious adverse events were reported: three in the hypothermia group (one hospital readmission relating to pneumonia, one septic arthritis, and one suspected venous thrombosis), and two in the control group (one related to desaturations during MRI and other because of endotracheal tube displacement during transport for MRI). No adverse events were considered causally related to the study intervention. INTERPRETATION Therapeutic hypothermia did not reduce the combined outcome of death or disability at 18 months after neonatal encephalopathy in low-income and middle-income countries, but significantly increased death alone. Therapeutic hypothermia should not be offered as treatment for neonatal encephalopathy in low-income and middle-income countries, even when tertiary neonatal intensive care facilities are available. FUNDING National Institute for Health Research, Garfield Weston Foundation, and Bill & Melinda Gates Foundation. TRANSLATIONS For the Hindi, Malayalam, Telugu, Kannada, Singhalese, Tamil, Marathi and Bangla translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Sudhin Thayyil
- Centre for Perinatal Neuroscience, Imperial College London, London, UK.
| | - Stuti Pant
- Centre for Perinatal Neuroscience, Imperial College London, London, UK
| | - Paolo Montaldo
- Centre for Perinatal Neuroscience, Imperial College London, London, UK
| | - Deepika Shukla
- Centre for Perinatal Neuroscience, Imperial College London, London, UK
| | - Vania Oliveira
- Centre for Perinatal Neuroscience, Imperial College London, London, UK
| | - Phoebe Ivain
- Centre for Perinatal Neuroscience, Imperial College London, London, UK
| | | | - Ravi Swamy
- Perinatal Epidemiology Unit, Bengaluru, Karnataka, India
| | - Josephine Mendoza
- Centre for Perinatal Neuroscience, Imperial College London, London, UK
| | | | - Peter J Lally
- Centre for Perinatal Neuroscience, Imperial College London, London, UK
| | - Naveen Benakappa
- Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India
| | - Prathik Bandiya
- Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India
| | - Indramma Shivarudhrappa
- Perinatal Epidemiology Unit, Bengaluru, Karnataka, India; Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India; Institute of Obstetrics and Gynaecology and Government Hospital for Women and Children, Madras Medical College, Chennai, India
| | - Jagadish Somanna
- Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India
| | | | - Ankur Rajvanshi
- Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India
| | - Sowmya Krishnappa
- Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India
| | | | | | | | | | - Monica Sebastian
- Perinatal Epidemiology Unit, Bengaluru, Karnataka, India; Institute of Child Health, Madras Medical College, Chennai, India
| | | | - Usha D Rajendran
- Institute of Child Health, Madras Medical College, Chennai, India
| | | | - Vignesh Kumar
- Institute of Child Health, Madras Medical College, Chennai, India
| | | | - Padmesh Vadakepat
- Institute of Child Health, Madras Medical College, Chennai, India; Institute of Obstetrics and Gynaecology and Government Hospital for Women and Children, Madras Medical College, Chennai, India
| | - Kavitha Gopalan
- Institute of Child Health, Madras Medical College, Chennai, India
| | - Mangalabharathi Sundaram
- Institute of Obstetrics and Gynaecology and Government Hospital for Women and Children, Madras Medical College, Chennai, India
| | - Arasar Seeralar
- Institute of Obstetrics and Gynaecology and Government Hospital for Women and Children, Madras Medical College, Chennai, India
| | - Prakash Vinayagam
- Institute of Obstetrics and Gynaecology and Government Hospital for Women and Children, Madras Medical College, Chennai, India
| | - Mohamed Sajjid
- Institute of Obstetrics and Gynaecology and Government Hospital for Women and Children, Madras Medical College, Chennai, India
| | - Mythili Baburaj
- Perinatal Epidemiology Unit, Bengaluru, Karnataka, India; Institute of Obstetrics and Gynaecology and Government Hospital for Women and Children, Madras Medical College, Chennai, India
| | - Kanchana D Murugan
- Institute of Obstetrics and Gynaecology and Government Hospital for Women and Children, Madras Medical College, Chennai, India
| | | | | | - Jayashree Mondkar
- Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
| | - Swati Manerkar
- Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
| | - Anagha R Joshi
- Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
| | - Kapil Dewang
- Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
| | | | - Pavan Kalamdani
- Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
| | - Vrushali Bichkar
- Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
| | - Saikat Patra
- Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
| | - Kapil Jiwnani
- Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
| | | | - Sadeka C Moni
- Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Ismat Jahan
- Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | | | - Sanjoy K Dey
- Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Mst N Nahar
- National Institute of Neurosciences, Dhaka, Bangladesh
| | | | - Kamrul H Shabuj
- Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | | | | | | | | | | | - Radhika Sujatha
- Sree Avittom Thirunal Hospital and Government Medical College, Thiruvananthapuram, Kerala, India
| | - Sobhakumar Saraswathy
- Sree Avittom Thirunal Hospital and Government Medical College, Thiruvananthapuram, Kerala, India
| | - Aswathy Rahul
- Sree Avittom Thirunal Hospital and Government Medical College, Thiruvananthapuram, Kerala, India
| | - Saritha J Radha
- Sree Avittom Thirunal Hospital and Government Medical College, Thiruvananthapuram, Kerala, India
| | - Manoj K Sarojam
- Sree Avittom Thirunal Hospital and Government Medical College, Thiruvananthapuram, Kerala, India
| | - Vaisakh Krishnan
- Institute of Maternal and Child Health, Government Medical College, Kozhikode, Kerala, India
| | - Mohandas K Nair
- Institute of Maternal and Child Health, Government Medical College, Kozhikode, Kerala, India
| | - Sahana Devadas
- Vanivilas Hospital, Bangalore Medical College and Research Institute, Karnataka, India
| | - Savitha Chandriah
- Vanivilas Hospital, Bangalore Medical College and Research Institute, Karnataka, India
| | | | - Constance Burgod
- Centre for Perinatal Neuroscience, Imperial College London, London, UK
| | | | - Gaurav Atreja
- Centre for Perinatal Neuroscience, Imperial College London, London, UK
| | | | - Jethro A Herberg
- Section of Paediatric Infectious Disease, Imperial College London, London, UK
| | - W K Kling Chong
- Centre for Perinatal Neuroscience, Imperial College London, London, UK; Department of Neuroradiology, Great Ormond Street Hospital, London, UK
| | - Neil J Sebire
- Perinatal Pathology, National Institute for Health Research Biomedical Research Centre, Great Ormond Street Hospital for Children, University College London, London, UK
| | - Ronit Pressler
- Department of Neurophysiology, Great Ormond Street Hospital, London, UK
| | | | - Seetha Shankaran
- Neonatal-Perinatal Medicine, Wayne State University, Detroit, MI, USA
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Rodrigo R, Badanasinghe N, Abayabandara-Herath T, Forster DA, Amir LH. Bacterial Growth in Expressed Mother's Milk Stored and Transported Under Different Simulated Conditions in a Tropical Country. Breastfeed Med 2021; 16:300-308. [PMID: 33404292 DOI: 10.1089/bfm.2020.0334] [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] [Indexed: 11/13/2022]
Abstract
Background: Research on how storage and transport of expressed human milk in a tropical country affect the milk bacterial count is limited. Materials and Methods: A cross-sectional descriptive study of 50 mothers of infants in a Sri Lankan tertiary neonatal unit was performed. Expressed mother's milk was divided into three bottles and kept under varied environmental conditions to simulate different storage and transport methods. Initial bacterial culture of milk was performed <30 minutes after expression, with further cultures at predetermined times. Bottles A and B were stored at room temperature and in a cool bag for the first 6 hours, respectively, and then refrigerated; and bottle C was refrigerated for 24 hours, transported in a cool bag for 6 hours, and rerefrigerated until 72 hours. Total colony counts >105 colony-forming units (CFU)/mL of viable microorganisms or >104 CFU/mL of either Enterobacteriaceae or Staphylococcus aureus were considered positive. Results: Initial culture was positive in 30% (15/50) of samples; majority, 87% (13/15), of these were S. aureus. For bottle A, 26% (13/50), 36% (18/50), 34% (17/50), and 26% (13/50) of samples were positive at 4, 6, 24, and 72 hours, respectively. For bottle B, positive cultures were found in 26% (13/50) and 17% (8/47) of samples at 24 and 72 hours, respectively. For bottle C, results were similar to bottle B. Conclusions: Transportation of expressed mother's milk for 4 hours in a tropical climate using a low-cost cool bag, with refrigeration at other times, maintained acceptable bacterial counts for up to 72 hours after expression. Hygienic practices at collection are extremely important as most samples with significant bacterial growth were positive on initial culture.
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Affiliation(s)
- Ranmali Rodrigo
- Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.,Judith Lumley Centre, La Trobe University, Bundoora, VIC, Australia
| | | | | | - Della A Forster
- Judith Lumley Centre, La Trobe University, Bundoora, VIC, Australia.,Royal Women's Hospital, Parkville, VIC, Australia
| | - Lisa H Amir
- Judith Lumley Centre, La Trobe University, Bundoora, VIC, Australia
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SOTOMAYOR C, Bustos N, Nolte I, Berger S, Rodrigo R, Navis G, Bakker S. SUN-310 SERUM URIC ACID IS ASSOCIATED WITH POSTTRANSPLANTATION DIABETES IN KIDNEY TRANSPLANT RECIPIENTS: A PROSPECTIVE COHORT STUDY. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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10
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SOTOMAYOR C, Vodegel J, Groothof D, Eisenga M, Knobbe T, IJmker J, Lammers R, de Borst M, Berger S, Nolte I, Rodrigo R, Slart R, Navis G, Touw D, Bakker S. SUN-309 PLASMA CADMIUM AND RISK OF LATE GRAFT FAILURE AND KIDNEY FUNCTION DECLINE IN KIDNEY TRANSPLANT RECIPIENTS. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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11
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Vicencio F, Jiménez P, Huerta F, Cofré-Bolados C, Gutiérrez Zamorano S, Garcia-Diaz DF, Rodrigo R, Poblete-Aro C. Effects of physical exercise on oxidative stress biomarkers in hypertensive animals and non-diabetic subjects with prehypertension/hypertension: a review. Sport Sci Health 2019. [DOI: 10.1007/s11332-019-00561-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Rodrigo R, Rodrigo A, Liyanage N, Hatahagoda W, Hewavitharana U. Maternal Perception of Adequacy of Mother's Milk Among Mothers Giving Birth at a Teaching Hospital in Sri Lanka. J Hum Lact 2019; 35:171-180. [PMID: 29787682 DOI: 10.1177/0890334418773304] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND: Sri Lanka boasts high rates of early and exclusive breastfeeding. Perceived inadequacy of milk, a global problem, is the main cause for early cessation of breastfeeding. RESEARCH AIMS: The aims of this study are to (a) determine the prevalence, (b) identify the risk factors, and (c) ascertain the association that maternal psychological distress has with perceived inadequacy of milk (PIM), among mothers during the early postpartum period. Identifying and addressing modifiable risk factors for PIM may improve mothers' satisfaction with breastfeeding. METHODS: A cross-sectional descriptive study of mothers ( n = 249) during the first week after birth was conducted at Colombo North Teaching Hospital (Ragama, Sri Lanka) from May 1, 2016, to June 10, 2016. Participants were recruited when the infant was more than 24 hours but less than 7 days old. A self-administered questionnaire, including the six-item Kessler Psychological Distress Scale, was used. RESULTS: The majority of mothers (78%) perceived their milk quantity to be adequate. A family member telling mothers that their milk supply was low had the most significant associations with perceived inadequacy. Other associations were antenatal maternal complications and birth by cesarean section. Kessler scores indicating psychological distress occurred in 26% of all participating mothers, with a higher mean score in those with PIM. CONCLUSIONS: Sri Lankan family members should be educated further about normal patterns of milk production during the postpartum period. The authors recommend that PIM be included in screening tools for postpartum depression in Sri Lanka.
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Affiliation(s)
- Ranmali Rodrigo
- 1 Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Asiri Rodrigo
- 1 Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Nisansala Liyanage
- 2 University Psychiatry Unit, Colombo North Teaching Hospital, Ragama, Sri Lanka
| | - Wathsala Hatahagoda
- 2 University Psychiatry Unit, Colombo North Teaching Hospital, Ragama, Sri Lanka
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Rodrigo R, Amir LH, Forster DA. Review of guidelines on expression, storage and transport of breast milk for infants in hospital, to guide formulation of such recommendations in Sri Lanka. BMC Pediatr 2018; 18:271. [PMID: 30107831 PMCID: PMC6092763 DOI: 10.1186/s12887-018-1244-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 08/06/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Sick newborns in neonatal units who are unable to breastfeed are fed expressed breast milk. In Sri Lanka, most mothers stay in hospital throughout baby's stay to provide this milk freshly. In other countries mothers go home, express breast milk at home and bring it to hospital. There are concerns about the safety of transported expressed milk if used in a tropical middle-income country. The aim of this paper is to compare and contrast advice offered by different hospitals and organizations on how to express, store and transport breast milk safely. METHODS We assessed guidelines used by hospital staff of the four Level 3 neonatal units in Melbourne, Australia, National Health Service UK, guidelines and training manuals of the Human Milk Banking Association of North America, the World Health Organization and an information leaflet from Family Health Bureau, Sri Lanka. Information on breast milk expression, storage and transport provided by the guidelines were tabulated under seven topics: general information; container for milk collection; hand expression; using a pump for expression; storage; thawing / warming; and transport of expressed breast milk. The AGREE II tool was used to assess the guidelines written for hospital staff. RESULTS There was considerable agreement on most recommendations provided by these sources, but no single source covered all topics in full. Most recommend hand expression as the initial method for expressing of breast milk, followed by breast pump use, except the Sri Lankan recommendations which strongly discourages the use of breast pumps. Durations of storage under various conditions are generally similar in the different recommendations. Most guidelines recommend a 'cool box' or container with ice or freezer packs for transportation of milk. CONCLUSION A single document containing recommendations on all aspects of expressing, storing and transporting breast milk should be available for each unit, with the same basic information for mothers and the healthcare staff and further technical details for staff if required. The Sri Lankan recommendations need to be updated based on current worldwide practices and further studies are needed to establish a safe method of transport of expressed breast milk in Sri Lanka.
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Affiliation(s)
- Ranmali Rodrigo
- Department of Paediatrics, University of Kelaniya, 6 Thalagolla Road, Ragama, 11010 Sri Lanka
- Judith Lumley Centre, La Trobe University, 215 Franklin Street, Melbourne, VIC 3000 Australia
| | - Lisa H. Amir
- Judith Lumley Centre, La Trobe University, 215 Franklin Street, Melbourne, VIC 3000 Australia
| | - Della A. Forster
- Judith Lumley Centre, La Trobe University, 215 Franklin Street, Melbourne, VIC 3000 Australia
- Royal Women’s Hospital, Locked Bag 300, Parkville, VIC 3052 Australia
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Thayyil S, Oliveira V, Lally PJ, Swamy R, Bassett P, Chandrasekaran M, Mondkar J, Mangalabharathi S, Benkappa N, Seeralar A, Shahidullah M, Montaldo P, Herberg J, Manerkar S, Kumaraswami K, Kamalaratnam C, Prakash V, Chandramohan R, Bandya P, Mannan MA, Rodrigo R, Nair M, Ramji S, Shankaran S. Hypothermia for encephalopathy in low and middle-income countries (HELIX): study protocol for a randomised controlled trial. Trials 2017; 18:432. [PMID: 28923118 PMCID: PMC5604260 DOI: 10.1186/s13063-017-2165-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 08/29/2017] [Indexed: 11/10/2022] Open
Abstract
Background Therapeutic hypothermia reduces death and disability after moderate or severe neonatal encephalopathy in high-income countries and is used as standard therapy in these settings. However, the safety and efficacy of cooling therapy in low- and middle-income countries (LMICs), where 99% of the disease burden occurs, remains unclear. We will examine whether whole body cooling reduces death or neurodisability at 18–22 months after neonatal encephalopathy, in LMICs. Methods We will randomly allocate 408 term or near-term babies (aged ≤ 6 h) with moderate or severe neonatal encephalopathy admitted to public sector neonatal units in LMIC countries (India, Bangladesh or Sri Lanka), to either usual care alone or whole-body cooling with usual care. Babies allocated to the cooling arm will have core body temperature maintained at 33.5 °C using a servo-controlled cooling device for 72 h, followed by re-warming at 0.5 °C per hour. All babies will have detailed infection screening at the time of recruitment and 3 Telsa cerebral magnetic resonance imaging and spectroscopy at 1–2 weeks after birth. Our primary endpoint is death or moderate or severe disability at the age of 18 months. Discussion Upon completion, HELIX will be the largest cooling trial in neonatal encephalopathy and will provide a definitive answer regarding the safety and efficacy of cooling therapy for neonatal encephalopathy in LMICs. The trial will also provide important data about the influence of co-existent perinatal infection on the efficacy of hypothermic neuroprotection. Trial registration ClinicalTrials.gov, NCT02387385. Registered on 27 February 2015. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2165-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sudhin Thayyil
- Centre for Perinatal Neuroscience, Imperial College London, London, UK.
| | - Vania Oliveira
- Centre for Perinatal Neuroscience, Imperial College London, London, UK
| | - Peter J Lally
- Centre for Perinatal Neuroscience, Imperial College London, London, UK
| | - Ravi Swamy
- Centre for Perinatal Neuroscience, Imperial College London, London, UK
| | - Paul Bassett
- Stats Consultancy, Amersham, Buckinghamshire, UK
| | | | | | | | | | - Arasar Seeralar
- Institute of Obstetrics & Gynecology, Madras Medical College, Chennai, India
| | - Mohammod Shahidullah
- Neonatal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Paolo Montaldo
- Centre for Perinatal Neuroscience, Imperial College London, London, UK
| | - Jethro Herberg
- Paediatric Infectious Diseases, Imperial College London, London, UK
| | - Swati Manerkar
- Lokmanya Tilak Municipal Medical College, Sion, Mumbai, India
| | | | | | - Vinayagam Prakash
- Institute of Obstetrics & Gynecology, Madras Medical College, Chennai, India
| | - Rema Chandramohan
- Institute of Child Health, Egmore, Madras Medical College, Chennai, India
| | - Prathik Bandya
- Indira Gandhi Institute of Child health, Bangalore, India
| | | | | | - Mohandas Nair
- Institute of Maternal and Child Health, Government Medical College Calicut, Calicut, India
| | | | - Seetha Shankaran
- Neonatal-Perinatal Medicine, Wayne State University, Detroit, MI, USA
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El-Maarry MR, Groussin O, Thomas N, Pajola M, Auger AT, Davidsson B, Hu X, Hviid SF, Knollenberg J, Güttler C, Tubiana C, Fornasier S, Feller C, Hasselmann P, Vincent JB, Sierks H, Barbieri C, Lamy P, Rodrigo R, Koschny D, Keller HU, Rickman H, A’Hearn MF, Barucci MA, Bertaux JL, Bertini I, Besse S, Bodewits D, Cremonese G, Da Deppo V, Debei S, De Cecco M, Deller J, Deshapriya JDP, Fulle M, Gutierrez PJ, Hofmann M, Ip WH, Jorda L, Kovacs G, Kramm JR, Kührt E, Küppers M, Lara LM, Lazzarin M, Lin ZY, Lopez Moreno JJ, Marchi S, Marzari F, Mottola S, Naletto G, Oklay N, Pommerol A, Preusker F, Scholten F, Shi X. Surface changes on comet 67P/Churyumov-Gerasimenko suggest a more active past. Science 2017; 355:1392-1395. [DOI: 10.1126/science.aak9384] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 03/06/2017] [Indexed: 11/02/2022]
Affiliation(s)
- M. Ramy El-Maarry
- Physikalisches Institut, Universität Bern, 3012 Bern, Switzerland
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO 80301, USA
| | - O. Groussin
- Aix Marseille Université, CNRS, Laboratoire d’Astrophysique de Marseille, UMR 7326, 13388 Marseille, France
| | - N. Thomas
- Physikalisches Institut, Universität Bern, 3012 Bern, Switzerland
| | - M. Pajola
- NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - A.-T. Auger
- Aix Marseille Université, CNRS, Laboratoire d’Astrophysique de Marseille, UMR 7326, 13388 Marseille, France
| | - B. Davidsson
- Jet Propulsion Laboratory, Pasadena, CA 91109, USA
| | - X. Hu
- Max-Planck-Institut für Sonnensystemforschung, 37077 Göttingen, Germany
| | - S. F. Hviid
- Deutsches Zentrum für Luft- und Raumfahrt (DLR), Institut für Planetenforschung, 12489 Berlin, Germany
| | - J. Knollenberg
- Deutsches Zentrum für Luft- und Raumfahrt (DLR), Institut für Planetenforschung, 12489 Berlin, Germany
| | - C. Güttler
- Max-Planck-Institut für Sonnensystemforschung, 37077 Göttingen, Germany
| | - C. Tubiana
- Max-Planck-Institut für Sonnensystemforschung, 37077 Göttingen, Germany
| | - S. Fornasier
- LESIA, Observatoire de Paris, PSL Research University, CNRS, Université Paris Diderot, Sorbonne Paris Cité, UPMC Université Paris 06, Sorbonne Universités, Meudon Principal Cedex 92195, France
| | - C. Feller
- LESIA, Observatoire de Paris, PSL Research University, CNRS, Université Paris Diderot, Sorbonne Paris Cité, UPMC Université Paris 06, Sorbonne Universités, Meudon Principal Cedex 92195, France
| | - P. Hasselmann
- LESIA, Observatoire de Paris, PSL Research University, CNRS, Université Paris Diderot, Sorbonne Paris Cité, UPMC Université Paris 06, Sorbonne Universités, Meudon Principal Cedex 92195, France
| | - J.-B. Vincent
- Deutsches Zentrum für Luft- und Raumfahrt (DLR), Institut für Planetenforschung, 12489 Berlin, Germany
| | - H. Sierks
- Max-Planck-Institut für Sonnensystemforschung, 37077 Göttingen, Germany
| | - C. Barbieri
- Department of Physics and Astronomy, University of Padova, 35122 Padova, Italy
| | - P. Lamy
- Laboratoire d’Astrophysique de Marseille, UMR 7326 CNRS & Université Aix-Marseille, 13388 Marseille Cedex 13, France
| | - R. Rodrigo
- Centro de Astrobiología, Instituto Nacional de Técnica Aeroespacial, 28850 Torrejón de Ardoz, Madrid, Spain
- International Space Science Institute, 3012 Bern, Switzerland
| | - D. Koschny
- Operations Department, European Space Astronomy Centre/ESA, P.O. Box 78, 28691 Villanueva de la Cañada, Madrid, Spain
| | - H. U. Keller
- Deutsches Zentrum für Luft- und Raumfahrt (DLR), Institut für Planetenforschung, 12489 Berlin, Germany
- Institut für Geophysik und Extraterrestrische Physik, Technische Universität Braunschweig, 38106 Braunschweig, Germany
| | - H. Rickman
- Department of Physics and Astronomy, Uppsala University, Box 516, 75120 Uppsala, Sweden
- Polish Academy of Sciences, Space Research Center, 00716 Warsaw, Poland
| | - M. F. A’Hearn
- Department of Astronomy, University of Maryland, College Park, MD 20742, USA
| | - M. A. Barucci
- LESIA, Observatoire de Paris, PSL Research University, CNRS, Université Paris Diderot, Sorbonne Paris Cité, UPMC Université Paris 06, Sorbonne Universités, Meudon Principal Cedex 92195, France
| | - J.-L. Bertaux
- Laboratoire Atmosphères, Milieux, Observations Spatiales (LATMOS), CNRS–Université de Versailles Saint-Quentin-en-Yvelines–Institut Pierre Simon Laplace, 78280 Guyancourt, France
| | - I. Bertini
- Department of Physics and Astronomy, University of Padova, 35122 Padova, Italy
| | - S. Besse
- Operations Department, European Space Astronomy Centre/ESA, P.O. Box 78, 28691 Villanueva de la Cañada, Madrid, Spain
| | - D. Bodewits
- Department of Astronomy, University of Maryland, College Park, MD 20742, USA
| | - G. Cremonese
- Istituto Nazionale di Astrofisica, Osservatorio Astronomico di Padova, 35122 Padova, Italy
| | - V. Da Deppo
- Consiglio Nazionale delle Ricerche–Istituto di Fotonica e Nanotecnologie, Unità Organizzativa di Supporto, Padova Luxor, 35131 Padova, Italy
| | - S. Debei
- Department of Industrial Engineering, University of Padova, 35131 Padova, Italy
| | | | - J. Deller
- Max-Planck-Institut für Sonnensystemforschung, 37077 Göttingen, Germany
| | - J. D. P. Deshapriya
- LESIA, Observatoire de Paris, PSL Research University, CNRS, Université Paris Diderot, Sorbonne Paris Cité, UPMC Université Paris 06, Sorbonne Universités, Meudon Principal Cedex 92195, France
| | - M. Fulle
- INAF, Osservatorio Astronomico di Trieste, 34014 Trieste, Italy
| | - P. J. Gutierrez
- Instituto de Astrofísica de Andalucía (CSIC), c/ Glorieta de la Astronomía s/n, 18008 Granada, Spain
| | - M. Hofmann
- Max-Planck-Institut für Sonnensystemforschung, 37077 Göttingen, Germany
| | - W.-H. Ip
- Graduate Institute of Astronomy, National Central University, Chung-Li 32054, Taiwan
| | - L. Jorda
- Aix Marseille Université, CNRS, Laboratoire d’Astrophysique de Marseille, UMR 7326, 13388 Marseille, France
| | - G. Kovacs
- Max-Planck-Institut für Sonnensystemforschung, 37077 Göttingen, Germany
| | - J.-R. Kramm
- Max-Planck-Institut für Sonnensystemforschung, 37077 Göttingen, Germany
| | - E. Kührt
- Deutsches Zentrum für Luft- und Raumfahrt (DLR), Institut für Planetenforschung, 12489 Berlin, Germany
| | - M. Küppers
- Operations Department, European Space Astronomy Centre/ESA, P.O. Box 78, 28691 Villanueva de la Cañada, Madrid, Spain
| | - L. M. Lara
- Instituto de Astrofísica de Andalucía (CSIC), c/ Glorieta de la Astronomía s/n, 18008 Granada, Spain
| | - M. Lazzarin
- Department of Physics and Astronomy, University of Padova, 35122 Padova, Italy
| | - Z.-Yi Lin
- Graduate Institute of Astronomy, National Central University, Chung-Li 32054, Taiwan
| | - J. J. Lopez Moreno
- Instituto de Astrofísica de Andalucía (CSIC), c/ Glorieta de la Astronomía s/n, 18008 Granada, Spain
| | - S. Marchi
- Solar System Exploration Research, Virtual Institute, Southwest Research Institute, Boulder, CO 80302, USA
| | - F. Marzari
- Department of Physics and Astronomy, University of Padova, 35122 Padova, Italy
| | - S. Mottola
- Deutsches Zentrum für Luft- und Raumfahrt (DLR), Institut für Planetenforschung, 12489 Berlin, Germany
| | - G. Naletto
- Consiglio Nazionale delle Ricerche–Istituto di Fotonica e Nanotecnologie, Unità Organizzativa di Supporto, Padova Luxor, 35131 Padova, Italy
- Department of Information Engineering, University of Padova, 35131 Padova, Italy
- Centro di Ateneo di Studi ed Attivitá Spaziali “Giuseppe Colombo” (CISAS), University of Padova, 35131 Padova, Italy
| | - N. Oklay
- Deutsches Zentrum für Luft- und Raumfahrt (DLR), Institut für Planetenforschung, 12489 Berlin, Germany
| | - A. Pommerol
- Physikalisches Institut, Universität Bern, 3012 Bern, Switzerland
| | - F. Preusker
- Deutsches Zentrum für Luft- und Raumfahrt (DLR), Institut für Planetenforschung, 12489 Berlin, Germany
| | - F. Scholten
- Deutsches Zentrum für Luft- und Raumfahrt (DLR), Institut für Planetenforschung, 12489 Berlin, Germany
| | - X. Shi
- Max-Planck-Institut für Sonnensystemforschung, 37077 Göttingen, Germany
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Navarro-Navarro A, Salom D, Martínez-Toldos JJ, Udaondo P, Fernández-Martínez C, Gutiérrez-Arias L, Hervás A, Rodrigo R. The diabetic retinopathy clinical research network analysis of the cost-effectiveness of aflibercept, bevacizumab and ranibizumab for the treatment of diabetic macular oedema and its application in Spain. ACTA ACUST UNITED AC 2017; 92:245-246. [PMID: 28215618 DOI: 10.1016/j.oftal.2016.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 12/14/2016] [Accepted: 12/17/2016] [Indexed: 11/25/2022]
Affiliation(s)
- A Navarro-Navarro
- Servicio de Oftalmología, Hospital de Manises, Manises, Valencia, España.
| | - D Salom
- Servicio de Oftalmología, Hospital de Manises, Manises, Valencia, España
| | - J J Martínez-Toldos
- Servicio de Oftalmología, Hospital General Universitario de Elche, Elche, Alicante, España
| | - P Udaondo
- Servicio de Oftalmología, Hospital Universitario La Fe, Valencia, España
| | - C Fernández-Martínez
- Servicio de Oftalmología, Hospital General Universitario de Elche, Elche, Alicante, España
| | - L Gutiérrez-Arias
- Servicio de Oftalmología, Hospital de Manises, Manises, Valencia, España
| | - A Hervás
- Servicio de Oftalmología, Hospital de Manises, Manises, Valencia, España
| | - R Rodrigo
- Grupo de Biomedicina Molecular, Celular y Genómica, Instituto de Investigación Sanitaria La Fe, Valencia, España
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Fornasier S, Mottola S, Keller HU, Barucci MA, Davidsson B, Feller C, Deshapriya JDP, Sierks H, Barbieri C, Lamy PL, Rodrigo R, Koschny D, Rickman H, A’Hearn M, Agarwal J, Bertaux JL, Bertini I, Besse S, Cremonese G, Da Deppo V, Debei S, De Cecco M, Deller J, El-Maarry MR, Fulle M, Groussin O, Gutierrez PJ, Güttler C, Hofmann M, Hviid SF, Ip WH, Jorda L, Knollenberg J, Kovacs G, Kramm R, Kührt E, Küppers M, Lara ML, Lazzarin M, Moreno JJL, Marzari F, Massironi M, Naletto G, Oklay N, Pajola M, Pommerol A, Preusker F, Scholten F, Shi X, Thomas N, Toth I, Tubiana C, Vincent JB. Rosetta’s comet 67P/Churyumov-Gerasimenko sheds its dusty mantle to reveal its icy nature. Science 2016; 354:1566-1570. [DOI: 10.1126/science.aag2671] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 10/27/2016] [Indexed: 11/03/2022]
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Affiliation(s)
- R. Brito
- Laboratory of Oxidative Stress and Nephrotoxicity, Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile
| | - G. Castillo
- Laboratory of Oxidative Stress and Nephrotoxicity, Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile
| | - J. González
- Laboratory of Oxidative Stress and Nephrotoxicity, Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile
| | - N. Valls
- Laboratory of Oxidative Stress and Nephrotoxicity, Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile
| | - R. Rodrigo
- Laboratory of Oxidative Stress and Nephrotoxicity, Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile
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Fulle M, Corte VD, Rotundi A, Weissman P, Juhasz A, Szego K, Sordini R, Ferrari M, Ivanovski S, Lucarelli F, Accolla M, Merouane S, Zakharov V, Epifani EM, Moreno JJL, Rodríguez J, Colangeli L, Palumbo P, Grün E, Hilchenbach M, Bussoletti E, Esposito F, Green SF, Lamy PL, McDonnell JAM, Mennella V, Molina A, Morales R, Moreno F, Ortiz JL, Palomba E, Rodrigo R, Zarnecki JC, Cosi M, Giovane F, Gustafson B, Herranz ML, Jerónimo JM, Leese MR, Jiménez ACL, Altobelli N. DENSITY AND CHARGE OF PRISTINE FLUFFY PARTICLES FROM COMET 67P/CHURYUMOV–GERASIMENKO. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/2041-8205/802/1/l12] [Citation(s) in RCA: 118] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Cui Z, Chow DL, Wu L, Lazar D, Rodrigo R, Olutoye O, Olutoye O. High performance liquid chromatography–tandem mass spectrometric assay of dexmedetomidine in plasma, urine and amniotic fluid samples for pregnant ewe model. J Chromatogr B Analyt Technol Biomed Life Sci 2014; 961:13-9. [DOI: 10.1016/j.jchromb.2014.04.037] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Revised: 03/23/2014] [Accepted: 04/19/2014] [Indexed: 10/25/2022]
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Gwee A, Rodrigo R, Casalaz D, Ritz N, Curtis N. Infants born in Australia to mothers from countries with a high prevalence of tuberculosis: to BCG or not to BCG? In reply. Med J Aust 2014; 200:149-50. [PMID: 24528424 DOI: 10.5694/mja13.11367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 11/26/2013] [Indexed: 11/17/2022]
Affiliation(s)
- Amanda Gwee
- Royal Children's Hospital, Melbourne, VIC, Australia.
| | | | - Dan Casalaz
- Mercy Hospital for Women, Melbourne, VIC, Australia
| | - Nicole Ritz
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Nigel Curtis
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
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Gwee A, Rodrigo R, Casalaz D, Ritz N, Curtis N. Infants born in Australia to mothers from countries with a high prevalence of tuberculosis: to BCG or not to BCG? Med J Aust 2013; 199:324-6. [PMID: 23992183 DOI: 10.5694/mja13.10107] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 05/15/2013] [Indexed: 11/17/2022]
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Parra-Cordero M, Rodrigo R, Barja P, Bosco C, Rencoret G, Sepúlveda-Martinez A, Quezada S. Prediction of early and late pre-eclampsia from maternal characteristics, uterine artery Doppler and markers of vasculogenesis during first trimester of pregnancy. Ultrasound Obstet Gynecol 2013; 41:538-544. [PMID: 22807133 DOI: 10.1002/uog.12264] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/06/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To develop a predictive model for pre-eclampsia using clinical, biochemical and ultrasound markers during the first trimester of pregnancy. METHODS This was a nested case-control study within a pre-eclampsia screening project that involved 5367 asymptomatic pregnant women undergoing routine transvaginal uterine artery (UtA) Doppler at 11 + 0 to 13 + 6 weeks. Following exclusions, there were 70 pregnant women who later developed pre-eclampsia and 289 control patients enrolled during the first trimester who had serum or plasma samples taken at enrolment available for the purposes of this study. Of these, 17 pregnancies were diagnosed with early-onset (delivery < 34 weeks) pre-eclampsia and 53 with late-onset (delivery ≥ 34 weeks) pre-eclampsia. The lowest, highest and mean of left and right UtA pulsatility indices (PI) were calculated. Blood samples were stored at -84 °C until biochemical analysis for markers of vasculogenesis was performed. The distributions of the lowest UtA-PI and the biochemical markers were adjusted for maternal characteristics, expressed as multiples of the median (MoM), and compared between groups. Logistic regression analysis was used to evaluate if any variable was significantly associated with pre-eclampsia. RESULTS Pregnancies that later developed pre-eclampsia were associated with higher maternal prepregnancy body mass index. An increased lowest UtA-PI was significantly associated with both early- and late-onset disease. Placental growth factor (PlGF) MoM was significantly reduced in women who later developed early- or late-onset pre-eclampsia compared with controls (median (interquartile range), 0.69 (0.33-1.46) and 1.10 (0.39-1.56), respectively, vs 1.19 (0.65-1.84), P < 0.05). Different combined models were generated by logistic regression analysis, and the detection rate with a fixed 10% false-positive rate was 47% and 29% for early- and late-onset pre-eclampsia, respectively. CONCLUSION Pregnancies that later developed early or late pre-eclampsia were characterized by impaired placentation and an anti-angiogenic state during the first trimester of pregnancy. Regression models which include maternal characteristics, UtA Doppler and PlGF can apparently predict approximately half of pregnancies that will be complicated by early-onset pre-eclampsia. We believe more research in several areas is needed to aid in the creation of a better and more population-specific screening test for pre-eclampsia during the first trimester of pregnancy.
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Affiliation(s)
- M Parra-Cordero
- Fetal Medicine Unit, University of Chile Hospital, Santiago, Chile.
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Sierks H, Lamy P, Barbieri C, Koschny D, Rickman H, Rodrigo R, A'Hearn MF, Angrilli F, Barucci MA, Bertaux JL, Bertini I, Besse S, Carry B, Cremonese G, Da Deppo V, Davidsson B, Debei S, De Cecco M, De Leon J, Ferri F, Fornasier S, Fulle M, Hviid SF, Gaskell RW, Groussin O, Gutierrez P, Ip W, Jorda L, Kaasalainen M, Keller HU, Knollenberg J, Kramm R, Kührt E, Küppers M, Lara L, Lazzarin M, Leyrat C, Lopez Moreno JJ, Magrin S, Marchi S, Marzari F, Massironi M, Michalik H, Moissl R, Naletto G, Preusker F, Sabau L, Sabolo W, Scholten F, Snodgrass C, Thomas N, Tubiana C, Vernazza P, Vincent JB, Wenzel KP, Andert T, Pätzold M, Weiss BP. Images of asteroid 21 Lutetia: a remnant planetesimal from the early Solar System. Science 2011; 334:487-90. [PMID: 22034428 DOI: 10.1126/science.1207325] [Citation(s) in RCA: 152] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Images obtained by the Optical, Spectroscopic, and Infrared Remote Imaging System (OSIRIS) cameras onboard the Rosetta spacecraft reveal that asteroid 21 Lutetia has a complex geology and one of the highest asteroid densities measured so far, 3.4 ± 0.3 grams per cubic centimeter. The north pole region is covered by a thick layer of regolith, which is seen to flow in major landslides associated with albedo variation. Its geologically complex surface, ancient surface age, and high density suggest that Lutetia is most likely a primordial planetesimal. This contrasts with smaller asteroids visited by previous spacecraft, which are probably shattered bodies, fragments of larger parents, or reaccumulated rubble piles.
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Affiliation(s)
- H Sierks
- Max-Planck-Institut für Sonnensystemforschung, Max-Planck-Strasse 2, 37191 Katlenburg-Lindau, Germany.
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25
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Pellicer B, Herraiz S, Cauli O, Rodrigo R, Asensi M, Cortijo J, Serra V, Morcillo E, Felipo V, Simón C, Pellicer A. Haemodynamic effects of long-term administration of sildenafil in normotensive pregnant and non-pregnant rats. BJOG 2011; 118:615-23. [PMID: 21244618 DOI: 10.1111/j.1471-0528.2010.02839.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the effects of chronic administration of sildenafil citrate on healthy pregnant rats. DESIGN In vivo animal experimental study. SETTING Fundación IVI-Instituto Universitario IVI, Valencia, Spain. SAMPLE Pregnant and non-pregnant Wistar rats exposed to chronic administration of sildenafil. METHODS Placental cross-barrier and feto-maternal relationship levels, maternal blood pressure, and haemodymamic effects on uterine arteries were evaluated. The effect of growth on weight and fetal tissues, and on perinatal outcome, was investigated. MAIN OUTCOME MEASURES Maternal blood pressure, blood viscosity, vascular indices of uterine arteries and fetal ductus venosus, plasmatic levels of sildenafil, embryo/fetal and litter weights, perinatal/postnatal survival rates. RESULTS Sildenafil citrate crossed the placenta. The maternal and fetal levels of sildenafil, and its metabolite desmethyl-sildenafil, demonstrated a positive linear correlation in treated pregnant animals versus controls; a selective maternal hypotensive effect without changes in uterine vascular resistance was noted on days E8 and E11 (embryonic day). The lower pulsatility index of the ductus venosus on day E18 suggests fetal overflow at the end of the pregnancy. Effects on offspring were placental and liver enlargement, and increased fetal weight gain in the second half of pregnancy (irrespective of liver enlargement) and at birth. Perinatal and postnatal survival rates in the sildenafil group remained unaltered. No haemodynamic effects were evident in non-pregnant animals. CONCLUSIONS In normotensive rats, sildenafil appears to have a selective effect at the onset of pregnancy, implying increased fetal blood supply, and increased fetal weight, and placental and liver enlargement, but no increased perinatal mortality.
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Affiliation(s)
- B Pellicer
- Hospital de Manises, C/Roses s/n, Manises, Valencia, Spain.
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Bosco C, Buffet C, Díaz E, Rodrigo R, Morales P, Barja P, Terra R, Parra-Cordero M. VEGF in the muscular layer of placental blood vessels: immuno-expression in preeclampsia and intrauterine growth restriction and its association with the antioxidant status. Cardiovasc Hematol Agents Med Chem 2010; 8:87-95. [PMID: 20184549 DOI: 10.2174/187152510791170951] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2009] [Accepted: 12/24/2009] [Indexed: 11/22/2022]
Abstract
The pathophysiology of preeclampsia (PE), a disorder occurring in 5% of all pregnancies, remains largely unknown, but early placental hypoxia and oxidative stress are known to be involved in the mechanism of the syndrome. Maternal plasma and placental tissue samples were collected from PE, intrauterine growth restriction (IUGR), and normotensive pregnant patients. The immunohistochemical expression of vascular endothelial growth factor (VEGF), malondialdehyde (MDA) production and the activity of antioxidant enzymes (superoxide dismutase, catalase and glutathione peroxidase GSH-Px) were determined in the placental tissue. F2-isoprostane concentration and the ferric reducing ability of plasma (FRAP) were determined in maternal plasma. We found that the PE and IUGR groups showed a higher expression of VEGF in the muscular layer of fetal chorionic vessels. In addition, increased plasma F2 isoprostane levels and a significant reduction of FRAP in the plasma of PE women, as well as a lower activity of SOD in PE placentas and a higher activity of GSH-Px in IUGR placentas were found. Additionally, lower PlGF and higher sFlt1 levels were observed in the maternal plasma of PE and IUGR than control. We concluded that in a hypoxic environment, the placenta expresses VEGF in the muscular layer of fetal vessels. The development of PE could be related to the increased expression of VEGF, with decreased placental SOD activity and a decrease of both plasma F2-isoprostane and FRAP levels. In turn, the development of IUGR could be related to the association of decreased plasma FRAP levels and increased placental GSH-Px activity.
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Affiliation(s)
- C Bosco
- Anatomy and Developmental Biology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Chile. .
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Keller HU, Barbieri C, Koschny D, Lamy P, Rickman H, Rodrigo R, Sierks H, A’Hearn MF, Angrilli F, Barucci MA, Bertaux JL, Cremonese G, Da Deppo V, Davidsson B, De Cecco M, Debei S, Fornasier S, Fulle M, Groussin O, Gutierrez PJ, Hviid SF, Ip WH, Jorda L, Knollenberg J, Kramm JR, Kührt E, Küppers M, Lara LM, Lazzarin M, Moreno JL, Marzari F, Michalik H, Naletto G, Sabau L, Thomas N, Wenzel KP, Bertini I, Besse S, Ferri F, Kaasalainen M, Lowry S, Marchi S, Mottola S, Sabolo W, Schröder SE, Spjuth S, Vernazza P. E-Type Asteroid (2867) Steins as Imaged by OSIRIS on Board Rosetta. Science 2010; 327:190-3. [DOI: 10.1126/science.1179559] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- H. U. Keller
- Max Planck Institute for Solar System Research, Katlenburg-Lindau, Germany
| | | | - D. Koschny
- European Space and Technology Centre, Noordwijk, Netherlands
| | - P. Lamy
- Laboratoire d'Astrophysique de Marseille, Université de Provence, Marseille, France
| | - H. Rickman
- Institute för Astronomi och Rymdfysik, Uppsala, Sweden
- Polish Academy of Sciences Space Research Center, Warsaw, Poland
| | - R. Rodrigo
- Instituto de Astrofísica de Andalucía–Consejo Superior de Investigaciones Científicas, Granada, Spain
| | - H. Sierks
- Max Planck Institute for Solar System Research, Katlenburg-Lindau, Germany
| | | | | | | | - J.-L. Bertaux
- Services d’Aéronomie de CNRS, Verrières le Buisson, France
| | | | - V. Da Deppo
- Consiglio Nazionale delle Ricerche-Istituto Nazionale per la Fisica della Materia, Luxor, Padova, Italy
| | - B. Davidsson
- Department of Physics and Astronomy, Uppsala University, Uppsala, Sweden
| | | | - S. Debei
- University of Padova, Padova, Italy
| | | | - M. Fulle
- International School for Advanced Studies, Trieste, Italy
| | - O. Groussin
- Laboratoire d'Astrophysique de Marseille, Université de Provence, Marseille, France
| | - P. J. Gutierrez
- Instituto de Astrofísica de Andalucía–Consejo Superior de Investigaciones Científicas, Granada, Spain
| | - S. F. Hviid
- Max Planck Institute for Solar System Research, Katlenburg-Lindau, Germany
| | - W.-H. Ip
- National Central University, Jhongli City, Taiwan
| | - L. Jorda
- Laboratoire d'Astrophysique de Marseille, Université de Provence, Marseille, France
| | | | - J. R. Kramm
- Max Planck Institute for Solar System Research, Katlenburg-Lindau, Germany
| | - E. Kührt
- German Aerospace Center, Berlin, Germany
| | - M. Küppers
- European Space Astronomy Centre (ESAC), Madrid, Spain
| | - L.-M. Lara
- Instituto de Astrofísica de Andalucía–Consejo Superior de Investigaciones Científicas, Granada, Spain
| | | | - J. Lopez Moreno
- Instituto de Astrofísica de Andalucía–Consejo Superior de Investigaciones Científicas, Granada, Spain
| | | | - H. Michalik
- Institute of Computer and Network Engineering, Braunschweig, Germany
| | | | - L. Sabau
- Instituto Nacional de Técnica Aérospacial, Torrejon de Ardoz, Spain
| | - N. Thomas
- Physikalisches Institut der Universität Bern, Switzerland
| | - K.-P. Wenzel
- European Space and Technology Centre, Noordwijk, Netherlands
| | - I. Bertini
- Instituto de Astrofísica de Andalucía–Consejo Superior de Investigaciones Científicas, Granada, Spain
| | - S. Besse
- Laboratoire d'Astrophysique de Marseille, Université de Provence, Marseille, France
| | - F. Ferri
- University of Padova, Padova, Italy
| | | | - S. Lowry
- University of Kent, Canterbury, UK
| | | | - S. Mottola
- German Aerospace Center, Berlin, Germany
| | - W. Sabolo
- Instituto de Astrofísica de Andalucía–Consejo Superior de Investigaciones Científicas, Granada, Spain
| | - S. E. Schröder
- Max Planck Institute for Solar System Research, Katlenburg-Lindau, Germany
| | - S. Spjuth
- Max Planck Institute for Solar System Research, Katlenburg-Lindau, Germany
| | - P. Vernazza
- European Space and Technology Centre, Noordwijk, Netherlands
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Gómez-Pinedo U, Rodrigo R, Cauli O, Herraiz S, Garcia-Verdugo JM, Pellicer B, Pellicer A, Felipo V. cGMP modulates stem cells differentiation to neurons in brain in vivo. Neuroscience 2009; 165:1275-83. [PMID: 19958812 DOI: 10.1016/j.neuroscience.2009.11.046] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2009] [Revised: 10/11/2009] [Accepted: 11/19/2009] [Indexed: 10/20/2022]
Abstract
During brain development neural stem cells may differentiate to neurons or to other cell types. The aim of this work was to assess the role of cGMP (cyclic GMP) in the modulation of differentiation of neural stem cells to neurons or non-neuronal cells. cGMP in brain of fetuses was reduced to 46% of controls by treating pregnant rats with nitroarginine-methylester (L-NAME) and was restored by co-treatment with sildenafil.Reducing cGMP during brain development leads to reduced differentiation of stem cells to neurons and increased differentiation to non-neuronal cells. The number of neurons in the prefrontal cortex originated from stem cells proliferating on gestational day 14 was 715+/-14/mm(2) in control rats and was reduced to 440+/-29/mm(2) (61% of control) in rats treated with L-NAME. In rats exposed to L-NAME plus sildenafil, differentiation to neurons was completely normalized, reaching 683+/-11 neurons/mm(2). In rats exposed to sildenafil alone the number of cells labelled with bromodeoxyuridine (BrdU) and NeuN was 841+/-16/mm(2). In prefrontal cortex of control rats 48% of the neural stem cells proliferating in gestational day 14 differentiate to neurons, but only 24% in rats exposed to L-NAME. This was corrected by sildenafil, 40% of cells differentiate to neurons. Similar results were obtained for neurons proliferating during all developmental period. Treatment with L-NAME did not reduce the total number of cells labelled with BrdU, further supporting that L-NAME reduces selectively the differentiation of stem cells to neurons. Similar results were obtained in hippocampus. Treatment with L-NAME reduced the differentiation of neural stem cells to neurons, although the effect was milder than in prefrontal cortex. These results support that cGMP modulates the fate of neural stem cells in brain in vivo and suggest that high cGMP levels promote its differentiation to neurons while reduced cGMP levels promote differentiation to non-neuronal cells.
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Affiliation(s)
- U Gómez-Pinedo
- Laboratorio de Morfologia Celular, Centro de Investigacion Principe Felipe, Avda. Autopista del Saler, Valencia, Spain
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García-Larsen V, Chinn S, Rodrigo R, Amigo H, Bustos P, Rona RJ. Relationship between oxidative stress-related biomarkers and antioxidant status with asthma and atopy in young adults: a population-based study. Clin Exp Allergy 2009; 39:379-86. [PMID: 19187326 DOI: 10.1111/j.1365-2222.2008.03163.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIM Enhanced oxidative stress has been described in adults who suffer from symptoms of asthma and poor lung function. This study assessed the relation between markers of oxidative stress and antioxidant status and lung function, symptoms of asthma, atopy and bronchial hyperresponsiveness (BHR) in young adults. METHODS A sub-sample of 589 individuals aged 22-28 years, selected from a total of 1232 included in a survey assessing early and current risk factors for chronic diseases, participated in the study. Participants were from an agricultural area of Chile, responded to a Spanish version of the European Community Respiratory Health Survey questionnaire, were skin tested to eight allergens, and challenged with methacholine to assess BHR. Five hundred and eighty-five individuals had measures of plasma biomarkers ferric reducing ability of plasma, uric acid, protein carbonyls and 564 had 8-iso-prostaglandin F(2alpha) (8-iso-PGF(2alpha)) assessed. RESULTS All participants had detectable plasma 8-iso-PGF(2alpha) and carbonyl levels. There was no indication for an association between markers of antioxidant status or oxidative stress with any of the outcomes studied. CONCLUSION The levels of oxidative stress-related biomarkers and antioxidant status in plasma may not be related to asthma in the general population in the absence of more severe symptoms or exacerbations.
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Affiliation(s)
- V García-Larsen
- Respiratory Epidemiology & Public Health Group, National Heart & Lung Institute, Imperial College London, Manresa Road, London, U.K.
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Cachorro VE, Toledano C, Prats N, Sorribas M, Mogo S, Berjón A, Torres B, Rodrigo R, de la Rosa J, De Frutos AM. The strongest desert dust intrusion mixed with smoke over the Iberian Peninsula registered with Sun photometry. ACTA ACUST UNITED AC 2008. [DOI: 10.1029/2007jd009582] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Yang JW, Kang SU, Engidawork E, Rodrigo R, Felipo V, Lubec G. Mass Spectrometrical Analysis of Galectin Proteins in Primary Rat Cerebellar Astrocytes. Neurochem Res 2006; 31:945-55. [PMID: 16804752 DOI: 10.1007/s11064-006-9100-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2006] [Accepted: 06/08/2006] [Indexed: 10/24/2022]
Abstract
Galectins are a family of animal lectins with specificity for beta-galactosides and are involved in a host of cellular activities, ranging from development to cancer. The molecules are expressed by neural and non-neural cells intracellularly as well as extracellularly. Using two-dimensional gel electrophoresis coupled to tandem mass spectrometry, the present work aimed to identify and characterize galectins in primary rat cerebellar astrocytes. The protein-chemical method identified nine spots representing two members of the galectin family, namely galectin-1 and galectin-3. These findings suggest that high abundant expression of galectin in astrocytes is limited to the two abundant galectin family members. As these family members are linked to human astrocytic tumors, their reliable detection in astrocytes by proteomic techniques would enable us to further understand their role in neural development, injury, and regeneration in general and astrocytoma in particular.
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Affiliation(s)
- J W Yang
- Department of Paediatrics, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
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Bosco C, Parra M, Barja P, Rodrigo R, Fernández V, Suarez M, Muñoz H. Increased immunohistochemical expression of thrombomodulin at placental perivascular myofibroblast in severe preeclampsia (PE). Histol Histopathol 2006; 20:1045-55. [PMID: 16136486 DOI: 10.14670/hh-20.1045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The presence of pro-coagulant and anti-coagulant components of the placental vascular endothelium and syncytiotrophoblast are essential for homeostasis. Vascular endothelium prevents blood clot formation in vivo by involving a cell surface thrombin-binding glycoprotein, thrombomodulin (TM), that activates plasma anti-coagulant protein C. The TM levels increase during pregnancy, but the fibrinolytic capacity diminishes. Since vascular lesions with placental coagulation disorders can be associated with preeclampsia (PE), we hypothesized that TM expression in the stem villous vasculature and syncytiotrophoblast of the placenta are impaired in PE. Plasma and placental tissue samples were collected from PE (n=12) and normotensive pregnant patients (n=11). Patient's gestational age was 35.7+/-1.2 (normotensive) and 30.6+/-1.5 weeks (PE). Blood samples were drawn 30 min before delivery. Serum PAI-1 and PAI-2 antigens were determined by enzyme-linked immunoabsorbent assay (ELISA). A monoclonal antibody specific for TM was used for immunohistochemical tissue staining (ABC) and the staining was quantified by semi quantitative scores. Results show no intensity differences at the apical syncytiotrophoblast between the two groups. However, in preeclamptic placenta, TM expression diminished in the endothelium of the stem villi arteries and increased in the perivascular and stromal myofibroblats in cases of severe PE. TM changes were associated with an increased PAI-1/PAI-2 ratio. It is suggested that in severe PE, the decreased placental blood flow may be due to structural and functional impairment of the endothelium of the stem villi vessels and the surrounding perivascular and stromal myofibroblast, by increasing TM expression which may modulate fetal blow flow in the villous tree.
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Affiliation(s)
- C Bosco
- Anatomy and Development Biology Program, Molecular and Clinical Pharmacology Program and Pathology Program, ICBM Faculty of Medicine, University of Chile, Santiago.
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Fulchignoni M, Ferri F, Angrilli F, Ball AJ, Bar-Nun A, Barucci MA, Bettanini C, Bianchini G, Borucki W, Colombatti G, Coradini M, Coustenis A, Debei S, Falkner P, Fanti G, Flamini E, Gaborit V, Grard R, Hamelin M, Harri AM, Hathi B, Jernej I, Leese MR, Lehto A, Lion Stoppato PF, López-Moreno JJ, Mäkinen T, McDonnell JAM, McKay CP, Molina-Cuberos G, Neubauer FM, Pirronello V, Rodrigo R, Saggin B, Schwingenschuh K, Seiff A, Simões F, Svedhem H, Tokano T, Towner MC, Trautner R, Withers P, Zarnecki JC. In situ measurements of the physical characteristics of Titan's environment. Nature 2005; 438:785-91. [PMID: 16319827 DOI: 10.1038/nature04314] [Citation(s) in RCA: 545] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2005] [Accepted: 10/11/2005] [Indexed: 11/08/2022]
Abstract
On the basis of previous ground-based and fly-by information, we knew that Titan's atmosphere was mainly nitrogen, with some methane, but its temperature and pressure profiles were poorly constrained because of uncertainties in the detailed composition. The extent of atmospheric electricity ('lightning') was also hitherto unknown. Here we report the temperature and density profiles, as determined by the Huygens Atmospheric Structure Instrument (HASI), from an altitude of 1,400 km down to the surface. In the upper part of the atmosphere, the temperature and density were both higher than expected. There is a lower ionospheric layer between 140 km and 40 km, with electrical conductivity peaking near 60 km. We may also have seen the signature of lightning. At the surface, the temperature was 93.65 +/- 0.25 K, and the pressure was 1,467 +/- 1 hPa.
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Affiliation(s)
- M Fulchignoni
- LESIA, Observatoire de Paris, 5 Place Janssen, 92195 Meudon, France. [2
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Rodrigo R, Jover R, Candela A, Compañ A, Sáez-Valero J, Erceg S, Felipo V. Bile duct ligation plus hyperammonemia in rats reproduces the alterations in the modulation of soluble guanylate cyclase by nitric oxide in brain of cirrhotic patients. Neuroscience 2005; 130:435-43. [PMID: 15664700 DOI: 10.1016/j.neuroscience.2004.09.027] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2004] [Indexed: 11/19/2022]
Abstract
Modulation of soluble guanylate cyclase (sGC) by nitric oxide (NO) is altered in brain from cirrhotic patients. The aim of this work was to assess whether an animal model of cirrhosis, bile duct ligation, alone or combined with diet-induced hyperammonemia for 7-10 days reproduces the alterations in NO modulation of sGC found in brains from cirrhotic patients. sGC activity was measured under basal conditions and in the presence of NO in cerebellum and cerebral cortex of the following groups of rats: controls, bile duct ligation without or with hyperammonemia and hyperammonemia without bile duct ligation. In cerebellum activation of sGC by NO was significantly lower in bile duct ligated rats with (12 +/- five-fold) or without (14 +/- six-fold) hyperammonemia than in control rats (23 +/- seven-fold). In cerebral cortex activation of sGC by NO was higher in rats with bile duct ligation with hyperammonemia (124 +/- 30-fold) but not without hyperammonemia (59 +/- 15-fold) than in control rats (66 +/- 11-fold). The combination of bile duct ligation and hyperammonemia reproduces the alterations in the modulation of soluble guanylate cyclase by NO found in cerebral cortex and cerebellum of cirrhotic patients while bile duct ligation or hyperammonemia alone reproduces the effects in cerebellum but not in cerebral cortex.
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Affiliation(s)
- R Rodrigo
- Laboratory of Neurobiology, Fundación Valenciana de Investigaciones Biomédicas, Amadeo de Saboya 4, 46010 Valencia, Spain
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Clark GR, Manske RHF, Palenik GJ, Rodrigo R, MacLean DB, Baczynskyj L, Gracey DEF, Saunders JK. Structure of cancentrine: a novel dimeric benzylisoquinoline alkaloid. J Am Chem Soc 2002. [DOI: 10.1021/ja00719a049] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Araya J, Rodrigo R, Orellana M, Rivera G. Red wine raises plasma HDL and preserves long-chain polyunsaturated fatty acids in rat kidney and erythrocytes. Br J Nutr 2001; 86:189-95. [PMID: 11502232 DOI: 10.1079/bjn2001369] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The effects of red wine and ethanol on plasma lipoproteins and the fatty acid composition of kidney lipids and erythrocytes phospholipids were studied. Lipid peroxidation is one of the main deleterious effects of oxidant attack on biomolecules, due to the disruption of the structural integrity of membranes. The vulnerability of the kidney to oxidative damage has been partly attributed to its high content of long-chain polyunsaturated fatty acids. Antioxidants, such as flavonoids, would be a means of reducing the risk of oxidative damage to membranes. Nutritional sources rich in antioxidants, including those provided by wine, are expected to attenuate the effects of oxidative challenges. Adult rats were fed red wine rich in flavonols, ethanol (125 ml/l), or alcohol-free red wine. The control group drank water. After 10 weeks, blood samples served to measure plasma lipoproteins and antioxidant capacity. Kidney lipids and erythrocyte phospholipids were extracted. The samples were assayed by GLC. Energy intake did not differ between all the groups, but the weight gain of the ethanol group was less than the other three groups. Blood HDL and triacylglycerols were increased by both ethanol and red wine. Ethanol decreased arachidonic and docosahexaenoic acids in both kidney lipids and erythrocyte phospholipids, as compared with either water, red wine or alcohol-free red wine groups. These results indicate that non-alcoholic components of red wine could contribute to avoiding the unfavourable effects of ethanol on plasma lipoproteins, kidney lipids and membrane erythrocyte phospholipids.
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Affiliation(s)
- J Araya
- Departamento de Nutrición, Facultad de Medicina, Universidad de Chile, Independencia 1027, Casilla 13898, Correo 21, Santiago, Chile.
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Orellana B M, Guajardo V, Araya J, Thieleman L, Rodrigo R. Oxidative stress, microsomal and peroxisomal fatty acid oxidation in the liver of rats treated with acetone. Comp Biochem Physiol C Toxicol Pharmacol 2001; 128:503-9. [PMID: 11301292 DOI: 10.1016/s1532-0456(01)00171-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Parameters of oxidative stress, microsomal cytochrome P450 activity and peroxisomal fatty acid oxidation were studied in liver of rats following acetone (1% v/v) consumption for 7 days. Acetone treatment increased the activity of catalase and decreased the activities of superoxide dismutase (SOD) and glutathione peroxidase (GTPx), but did not significantly modify the liver content of malondialdehyde (MDA) and reduced glutathione. Also, acetone increased the total content of cytochrome P450, the microsomal lauric acid hydroxylation, aminopyrine N-demethylation and the peroxisomal beta-oxidation of palmitoyl CoA. These effects were similar to those found previously in starved and ethanol-treated rats, supporting the hypothesis that ketone bodies would be the common inducer of microsomal and peroxisomal fatty acid oxidation in these metabolic states.
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Affiliation(s)
- M Orellana B
- ICBM Programa de Farmacología Molecular y Clínica, Facultad de Medicina, Universidad de Chile, Santiago 7 70086, Casilla, Chile.
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Thielemann LE, Bosco C, Rodrigo R, Orellana M, Videla LA. Effects of bromoethylamine on antioxidant capacity, lipid peroxidation, and morphological characteristics of rat liver. J Biochem Mol Toxicol 2000; 13:47-52. [PMID: 9890447 DOI: 10.1002/(sici)1099-0461(1999)13:1<47::aid-jbt6>3.0.co;2-v] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Administration of bromoethylamine (BEA, 1.2 mmol/kg) to fed rats induced a significant diminution in the activity of hepatic superoxide dismutase (at 1 h after treatment), catalase, and glutathione peroxidase and in the content of nonprotein sulfhydryls (at 15 h after treatment). The content of thiobarbituric acid reactants by the liver was enhanced by 1.9 times over control values (at 3 h). Light microscopy studies revealed that BEA (72 h after treatment) induced periportal fatty accumulation, focal liver cell necrosis, and diffuse inflammatory infiltrates, in addition to hypertrophic Kupffer cells and mitotic hepatocytes. Also, hypertrophic middle tunic or hypertrophic smooth muscle layers of arterioles was observed in the periportal space, with dilated sinusoidal capillaries and free macrophage infiltration. It is concluded that BEA induces a derangement in the antioxidant status of the liver with the consequent lipid peroxidation response, which may constitute a significant hepatotoxic mechanism of the haloaklylamine.
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Affiliation(s)
- L E Thielemann
- Programa de Farmacología Molecular y Clínica, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago
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Abstract
In the liver, seven days of bile duct ligation (BDL) decreases the cytochrome P-450 content and the UDP-glucuronyl transferase activity. Also, a decrease in the water soluble antioxidant mechanism reflected in the activities of the enzymes superoxide dismutase (SOD), catalase and the glutathione peroxidase (GTPx) was found in the liver but not in the kidney. Despite an increase in the amount of the GSH in the liver, increased lipid peroxidation is produced in the BDL rats, as indicated by the levels of malondialdehyde (MDA). The kidney responded in a different way to cholestasis, decreasing only the UDP-glucuronyl transferase activity and increasing the levels of GSH and MDA. In the red blood cells the activity of the antioxidant enzymes SOD, GTPx and catalase and the content of GSH were not modulated by cholestasis. In conclusion, disturbance of the oxidant-antioxidant balance might be responsible for cholestatic liver injury and impaired renal function in BDL rats.
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Affiliation(s)
- M Orellana
- ICBM Programa de Farmacología Molecular y Clínica, Facultad de Medicina, Universidad de Chile, Santiago.
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Molina-Cuberos GJ, López-Moreno JJ, Rodrigo R, Lara LM. Chemistry of the galactic cosmic ray induced ionosphere of Titan. ACTA ACUST UNITED AC 1999. [DOI: 10.1029/1998je001001] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abstract
BACKGROUND The pathophysiology of renal impairments occurring in obstructive jaundice has been extensively studied, but the underlying mechanism of these derangements remains unclear. The aim of the present study was to investigate the time-related morphological and functional changes occurring in the kidneys of rats undergoing obstructive jaundice. METHODS Histological examination, renal function assessment and determination of (Na + K)-ATPase activity were performed in the kidneys of rats 7, 14, and 21 days following bile duct ligation (BDL) or sham operation (sham). RESULTS Glomerular filtration rate was unaffected by BDL throughout the period of the study. Tubular effects occurred at days 7 and 14, being more marked at day 7, and consisted of an increase of about twice in the fractional excretion of sodium and chloride, paralleled by a decreased proximal and distal tubular reabsorption of sodium of about 50 and 40%, respectively. Natriuresis was consistent with augmentation of osmolar clearance but it was not associated with changes in the activity of renal (Na+ + K+)-ATPase. The ability to dilute urine was impaired at days 14 and 21 after BDL. Additionally, these effects were accompanied by decreased tubulointerstitial fibrosis and vasodilation of inner medullary capillaries. At day 21, the parameters of tubular function in BDL and sham groups were not significantly different. CONCLUSIONS These data support the view that raised natriuresis taking place in the initial 2 weeks following BDL is due mainly to tubular effects. The contribution of hemodynamic, paracrine and humoral mediators is discussed.
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Affiliation(s)
- R Rodrigo
- Programa de Farmacología Molecular, Facultad de Medicina, Universidad de Chile, Santiago de Chile.
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Orellana M, Rodrigo R, Thielemann L, Jiménez P, Valdés E. Modulation of peroxisomal and microsomal fatty acid oxidation by acetone. A comparative study between liver and kidney. Comp Biochem Physiol B Biochem Mol Biol 1998; 121:407-16. [PMID: 9972312 DOI: 10.1016/s0305-0491(98)10134-7] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The effect of acetone consumption on some microsomal and peroxisomal activities was studied in rat kidney and these results were compared with data from former investigations in liver. Acetone increased the microsomal lauric acid hydroxylation, the aminopyrine N-demethylation catalyzed by cytochrome P450 and the microsomal UDP-glucuronyltransferase activity. Also, acetone increased the peroxisomal beta-oxidation of palmitoyl CoA and catalase activities in kidney. These studies suggest that acetone is a common inducer of the microsomal and peroxisomal fatty acid oxidation, as previously shown in both starved and ethanol treated rats. Our results support the hypothesis that microsomal fatty acid omega-hydroxylation results in the generation of substrates being supplied for peroxisomal beta-oxidation. We propose that the final purpose of these linked fatty acid oxidations could be the catabolism of fatty acids or the generation of a substrate for the synthesis of glucose from fatty acids. This pathway would be triggered by acetone treatment in a similar way in liver and kidney.
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Affiliation(s)
- M Orellana
- ICBM, Programa de Farmacología Molecular y Clínica, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
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Abstract
1. Microsomal P450 and peroxisomal fatty acid oxidation activities were studied in liver of rats after long-term ethanol consumption. 2. Ethanol increased the microsomal lauric acid omega-hydroxylation and the aminopyrine N-demethylation catalyzed by cytochrome P450. 3. Ethanol increased peroxisomal beta-oxidation of palmitoyl CoA and catalase activity in liver. 4. Both microsomal and peroxisomal activities behaved in a coordinate way in the liver of rats with long-term ethanol consumption. 5. These results would support a role of microsomal omega-hydroxylation and peroxisomal beta-oxidation of fatty acids in an extramitochondrial pathway of lipid oxidation in the liver.
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Affiliation(s)
- M Orellana
- ICBM, Programa de Farmacología, Molecular Y Clínica, Facultad de Medicina, Universidad de Chile, Santiago.
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Rodrigo R, Thielemann L, Olea M, Muñoz P, Cereceda M, Orellana M. Effect of ethanol ingestion on renal regulation of water and electrolytes. Arch Med Res 1998; 29:209-18. [PMID: 9775453] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Ethanol may alter the homeostasis of water and electrolytes before the occurrence of liver damage able to explain these disorders. How the kidney may become involved in water diuresis or sodium and potassium retention has not been well elucidated. During the last decade, an increasing body of evidence has guided interest toward the relevance of the biochemical basis of ethanol-induced injury to the kidney. Multiple functional abnormalities of renal tubules may be associated with ethanol-induced changes in membrane composition and lipid peroxidation of these epithelial cells. Ethanol interferes with the carrier function by decreasing (Na+K)-ATPase activity, but this activity is enhanced by chronic exposure. Recently, it was reported that ethanol oxidation by the kidney is favored in chronic ethanol-treated rats, thereby suggesting a pathogenic role for acetaldehyde in the nephrotoxic effect of ethanol ingestion. Also, increased reactive oxygen species, partly generated from acetaldehyde oxidation, may contribute to the occurrence of oxidative stress. The pathophysiology of renal regulation of water and electrolytes of alcoholic disease is analyzed on the basis of recent advances in our knowledge concerning the biochemical effects of ethanol on the kidney.
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Affiliation(s)
- R Rodrigo
- Programa de Farmacología Molecular y Clínica, Instituto de Ciencias Biomédicas, Santiago, Chile
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Orellana M, Valdés E, Fernández J, Rodrigo R. Effects of chronic ethanol consumption on extramitochondrial fatty acid oxidation and ethanol metabolism by rat kidney. Gen Pharmacol 1998; 30:719-23. [PMID: 9559324 DOI: 10.1016/s0306-3623(97)00342-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
1. We evaluated the effects of chronic ethanol consumption on microsomal and peroxisomal fatty acid oxidation and on ethanol oxidation by the kidney. 2. When mature rats were fed 20% ethanol for 10 weeks, an increase in alcohol dehydrogenase and catalase activities were observed in the kidney. 3. Renal microsomal and peroxisomal oxidation of fatty acids also increased by the treatment, but total cytochrome P450 content did not. 4. We concluded that chronic ethanol consumption results in an increased extramitochondrial disposition of fatty acids and ethanol oxidation by the kidney.
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Affiliation(s)
- M Orellana
- ICBM, Programa Farmacologia Molecular Y Clínica, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
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Rodrigo R, Thielemann L, Orellana M. Acute and chronic effect of ethanol on (Na + K)-ATPase activity and cyclic AMP response to vasopressin in rat papillary collecting duct cells. Gen Pharmacol 1998; 30:663-7. [PMID: 9559316 DOI: 10.1016/s0306-3623(97)00380-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
1. We evaluated the effects of ethanol on (Na + K)-ATPase activity and cAMP response to vasopressin in native and cultured rat papillary collecting duct (PCD) cells. 2. A significant increase in (Na + K)-ATPase and Mg(2+)-ATPase activities was found in PCD cells either isolated from chronic ethanol-fed rats or cultured in the presence of ethanol. 3. Acute treatment with ethanol resulted in a biphasic effect on the activity of (Na + K)-ATPase, which was enhanced below 1% ethanol and inhibited at higher concentrations. 4. Chronic ethanol treatment did not change the cAMP response of PCD cells to vasopressin. Acutely, in turn, this response was enhanced by ethanol per se. 5. It is suggested that the antinatriuretic effect of ethanol could be at least in part mediated by a (Na + K)-ATPase enhancement in PCD cells. Acutely, ethanol could normalize water balance by its peripheral effects on distal nephron.
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Affiliation(s)
- R Rodrigo
- Departamento de Medicina Experimental, Facultad de Medicina, Universidad de Chile, Santiago, Chile
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Abstract
1. We evaluated the effects of chronic ethanol consumption on the kinetic properties of renal (Na + K)-ATPase and compared them with acute inhibition by ethanol in vitro. 2. When adult rats were fed 20% ethanol for 10 weeks, renal (Na + K)-ATPase activity increased but the sensitivity of the enzyme to ethanol inhibition in vitro was not altered. 3. Vmax was increased by ethanol consumption, whereas K0.5 and nH were not changed. The kinetic parameters of Mg(2+)-ATPase were not affected under the same conditions. 4. We concluded that ethanol-induced tolerance or enhancement of renal (Na + K)-ATPase or both can be explained on the basis of an increase in Vmax.
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Affiliation(s)
- R Rodrigo
- Departamento de Medicina Experimental, Facultad de Medicina, Universidad de Chile, Santiago, Chile
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Bosco C, Rodrigo R, Diaz S, Borax J. Renal effects of chronic exposure to malathion in Octodon degus. Comp Biochem Physiol C Pharmacol Toxicol Endocrinol 1997; 118:247-53. [PMID: 9440252 DOI: 10.1016/s0742-8413(97)00140-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We studied the effects of chronic exposure to malathion in the kidney of Octodon degus, a caviomorph whose habitat may be exposed to pesticides currently used in Chilean agriculture. A group of adult female animals received malathion (200 ppm) as sole drinking fluid for 90 days. Kidneys showed signs of histologic damage, marked by hyperplasia and hypertrophy of tubular cells. Exposed animals had unchanged glomerular filtration rates and renal handling of sodium and chloride, but a significant increase in fractional excretion of potassium resulted from this treatment. The activities of Na+/K(+)-ATPase and Mg(2+)-ATPase in renal cortex and outer medulla were not affected by malathion exposure. This study provides evidence of both morphologic and functional renal damage elicited by chronic exposure of O. degus to a low dose of malathion. Morphologic alterations in glomerulus were accompanied by either morphologic and functional impairments of the distal nephron.
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Affiliation(s)
- C Bosco
- Department of Experimental Morphology, Faculty of Medicine, University of Chile, Santiago, Chile
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