Surfactant administration methods for premature newborns: LISA vs. INSURE comparative analysis

INTRODUCTION

Respiratory Distress Syndrome (RDS) is the most common respiratory disorder among premature infants. The use of surfactant has significantly reduced respiratory complications and mortality. There are two conventional methods for administering surfactant: Intubate-Surfactant-Extubate (INSURE) and Less Invasive Surfactant Administration (LISA). This study aims to compare the effects of surfactant administration using these two methods on the treatment outcomes of premature newborns.

MATERIALS AND METHODS

In this retrospective cohort study, we included 100 premature newborns with RDS and spontaneous breathing who were admitted to the Neonatal Intensive Care Unit of Besat Hospital in Sanandaj city in 2021. Exclusion criteria comprised congenital anomalies and the needing for intubation for resuscitation at birth. The outcomes of epmericaly trated with two methods were compared: the LISA (50 neonates) and the INSURE (50 neonates). Our interesting outcomes were needing for mechanical ventilation, duration of ventilation, pneumothorax, pulmonary hemorrhage, severe retinopathy, CPAP duration, and bronchopulmonary dysplasia. Finally, we entered the data into STATA-14 statistical software and analyzed it using chi-square and t-tests.

RESULTS

In this study, 69% of the neonates were boys. The LISA group exhibited significantly lower rates of need for mechanical ventilation (P = 0.003) and ventilation duration (P < 0.001) compared to the INSURE group. Conversely, there were no significant differences between the two groups (P > 0.05) in terms of pneumothorax, pulmonary hemorrhage, severe retinopathy, CPAP duration, and bronchopulmonary dysplasia rates.

CONCLUSION

The results of this study suggest that the LISA method is a safe and non-invasive approach for surfactant administration. Notably, it resulted in a reduced need for mechanical ventilation and decreased ventilation duration compared to the INSURE method.

Novel mouse models based on intersectional genetics to identify and characterize plasmacytoid dendritic cells

Plasmacytoid dendritic cells (pDCs) are the main source of type I interferon (IFN-I) during viral infections. Their other functions are debated, due to a lack of tools to identify and target them in vivo without affecting pDC-like cells and transitional DCs (tDCs), which harbor overlapping phenotypes and transcriptomes but a higher efficacy for T cell activation. In the present report, we present a reporter mouse, pDC-Tom, designed through intersectional genetics based on unique Siglech and Pacsin1 coexpression in pDCs. The pDC-Tom mice specifically tagged pDCs and, on breeding with Zbtb46^GFP mice, enabled transcriptomic profiling of all splenic DC types, unraveling diverging activation of pDC-like cells versus tDCs during a viral infection. The pDC-Tom mice also revealed initially similar but later divergent microanatomical relocation of splenic IFN⁺ versus IFN^- pDCs during infection. The mouse models and specific gene modules we report here will be useful to delineate the physiological functions of pDCs versus other DC types.

Microstructural examination and mechanical characterization of Ti/HA and Ti/SiO2 functionally graded materials fabricated at different loading rates

Functionally graded material (FGM) is a heterogeneous composite material that consists of two or more constituent phases with continuous changes in the microstructure from one material to another with adjustable through thickness properties. FGMs are utilized in medical applications, such as dental implants, due to their excellent mechanical and tribological properties. In this study, the powder metallurgy method (PMM) is used to produce Titanum/Hydroxyapatite (Ti/HA) and Titanum/Silicon dioxide (Ti/SiO2) FGM samples. A new designed blender is employed to mix the particles constituting the FGM samples. The mixed particles are then compacted at different strain rates from quasi static loading, using a universal testing apparatus, to dynamic loadings, using a drop hammer and a split Hopkinson bar. The effect of strain rate on mechanical properties and microstructure of specimens is studied by conducting various tests such as indentation and compression tests and by microstructural examinations using scanning electron microscopy (SEM). The results showed that the relative density of fabricated specimens was increased with the increase of the strain rate. The highest relative density for the Ti/HA composite was achieved for the specimens produced by the split Hopkinson bar. For both of Ti/HA and Ti/SiO2 FGMs the maximum indentation force and indentation energy, obtained from the load-penetration depth curve, and the ultimate strength, obtained from the compressive stress-strain curve, were increased with the increase in strain rate. The results also indicated that the increase in volume fraction of reinforcing ceramic particles (HA or SiO2) led to the decrease of the maximum indentation force and indentation energy.

Determination and Diversity of Bovine Coccidia in Zabol, East of Iran

The present study was designed to investigate the prevalence of Eimeria spp. in Zabol, east of Iran. The samples were examined microscopically for the presence of oocysts from February 2015 to December 2016. Out of 196 cattle, 124 (63.26%) were identified to be positive for Eimeria species. Eight species of Eimeria were found as follows: E. bovis (42.54%), E. zuernii (38.67%), E. subspherica (5.52%), E. brasiliensis (4.97%), E. ellipsoidalis (4.41%), E. cylindrical (1.65%), E. pellita (1.65%), and E. wyomingensis (0.55%). Multiple infections with two or three species were identified in 56 (45.16%) and 2 (1.61%) cases, respectively. The infection rate was observed to be higher in calves (75%) as compared to adult cattle (59.02%). The prevalence of Eimeria was greater in female cattle (67.94%). The highest prevalence and mean number of oocysts were observed in winter (69%) and autumn (209.09), respectively. All the faecal samples had an oocysts per gram of feces (OPG) less than 1000. The prevalence of infection and mean OPG were directly correlated with rainfall and relative humidity and inversely correlated with temperature. Considering the high prevalence of bovine coccidiosis in Zabol, increasing awareness of farmers and veterinarians regarding the economic importance of bovine coccidiosis should be regarded as an important factor in preventing and controlling the infection.

Problems of providing services to people affected by HIV/AIDS: service providers and recipients perspectives

This qualitative study aimed to identify the health-care problems of people living with HIV (PLHIV) in 2 large cities: Tehran and Kermanshah. Two main groups of stakeholders - service providers (policy-makers, managers, physicians and counsellors) and service recipients (PLHIV and their relatives) - participated in focus group discussions and in-depth interviews. We identified 24 themes covering the major health problems of PLHIV, including: incomplete and inadequate coverage of health-care services; patients' substance abuse; patients' fear of stigma; occupational burnout of certain service providers; patients' dissatisfaction with some of the services provided by counselling centres/clinics; medical staff's failure to observe confidentiality; and patients' lack of access to required specialized services. The problems and needs identified can inform the design and implementation of health programmes in our country and elsewhere in the Eastern Mediterranean Region.