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Investigative Ophthalmology & Visual... Jan 2022To explore whether oxidative stress and premature senescence occur in the anterior segment of acute primary angle-closure (APAC) eyes after increased intraocular...
PURPOSE
To explore whether oxidative stress and premature senescence occur in the anterior segment of acute primary angle-closure (APAC) eyes after increased intraocular pressure.
METHODS
The eye samples of 21 APAC patients, 22 age-related cataract patients, and 10 healthy donors were included. Aqueous humor (AqH), iris, and anterior lens capsule samples were collected. The levels of oxidative stress markers and senescence-associated secretory phenotype (SASP)-related cytokines in AqH were estimated using relevant reagent kits and multiplex bead immunoassay technique. The intensity of relevant markers in anterior segment tissues was examined by immunofluorescence- and senescence-associated β-galactosidase (SA-β-gal) staining.
RESULTS
Oxidative stress marker levels elevated significantly in the AqH of APAC eyes. Reactive oxygen species (ROS) and 8-hydroxydeoxyguanosine levels were positively correlated with preoperative peak intraocular pressure and age, whereas reduced glutathione/oxidized glutathione (GSH/GSSH) ratio was negatively correlated with both parameters. The levels of several SASP-related cytokines were markedly increased. ROS and malondialdehyde levels were positively correlated with the levels of some SASP-related cytokines, whereas superoxide dismutase level and GSH/GSSH ratio showed an opposite trend. The number of cells positive for oxidative mitochondrial DNA damage and apoptosis-related markers increased in the iris and anterior lens capsule of the APAC group. Senescence-associated markers (p16, p21, and p53) and SA-β-gal activity were increased in the iris of the APAC group.
CONCLUSIONS
Oxidative stress and premature senescence occurred in the anterior segment of APAC patients, suggesting that they may be involved in the development of pathological changes in the anterior segment of APAC eyes.
Topics: Acute Disease; Anterior Eye Segment; Cellular Senescence; Female; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Male; Middle Aged; Oxidative Stress; Prospective Studies; Retrospective Studies; Tomography, Optical Coherence
PubMed: 35077549
DOI: 10.1167/iovs.63.1.34 -
Journal of Perinatology : Official... Jan 2020To evaluate the association of ibuprofen exposure with the risk of bronchopulmonary dysplasia (BPD) in extremely premature infants.
OBJECTIVE
To evaluate the association of ibuprofen exposure with the risk of bronchopulmonary dysplasia (BPD) in extremely premature infants.
STUDY DESIGN
This was a retrospective study of all extremely premature infants admitted to a tertiary unit from 2016 to 2018.
RESULTS
A total of 203 extremely premature infants were included in this study. The rate of BPD was significantly higher in infants with early exposure to ibuprofen (42.5%) compared to infants with no exposure (21.6%, P = 0.001). After adjusting for covariates, the risk of BPD was associated independently with ibuprofen exposure (odds ratios (OR) 2.296, 95% confidence interval (CI): 1.166-4.522, p = 0.016). Further analysis showed a trend towards higher risk of BPD in infants with successful patent ductus arteriosus (PDA) closure after ibuprofen treatment (32.3%) compared to non-treated infants (20.2%, p = 0.162).
CONCLUSION
Our findings suggest that ibuprofen exposure may contribute to the occurrence of BPD in extremely preterm infants.
Topics: Anti-Inflammatory Agents, Non-Steroidal; Birth Weight; Bronchopulmonary Dysplasia; Confounding Factors, Epidemiologic; Ductus Arteriosus, Patent; Female; Gestational Age; Humans; Ibuprofen; Infant, Extremely Premature; Infant, Newborn; Male; Pulmonary Surfactants; Regression Analysis; Retrospective Studies; Risk Factors
PubMed: 31391526
DOI: 10.1038/s41372-019-0444-4 -
Acta Orthopaedica Jul 2023Premature physeal closure (PPC) is a common and concerning complication to distal femoral fractures as the distal growth plate accounts for 70% of the growth of the...
BACKGROUND AND PURPOSE
Premature physeal closure (PPC) is a common and concerning complication to distal femoral fractures as the distal growth plate accounts for 70% of the growth of the femur. The literature is not unanimous in determining the risk factors of PPC, and the epidemiological characterization of these fractures is limited. Our aim was to calculate the population-based incidence and investigate risk factors for PPC in these fractures.
PATIENTS AND METHODS
In this register-based study, between 2014 and 2021, 70 children with distal femoral physeal fractures presented to our hospital. Demographic data, and fracture- and treatment-related details were collected using the Kids' Fracture Tool. A directed acyclic graph (DAG) was constructed to determine confounding factors used in the risk analysis.
RESULTS
Physeal fractures of the distal femur occurred with an annual incidence of 6/105 children, and a resulting PPC occurred in 16/70 (23%) with an annual incidence of 1.3/105 children. In multivariable analysis, dislocation exceeding 10 mm was a risk factor for PPC (OR 6.3, CI 1.4-22).
CONCLUSION
One-fourth of distal femoral physeal fractures developed PPC. Greater dislocation and higher injury energy were significant risk factors, whereas choice of fracture treatment was not an independent risk factor. All patients with PPC belonged in the age group 11-16 years.
Topics: Child; Humans; Adolescent; Growth Plate; Femoral Fractures, Distal; Tibial Fractures; Epiphyses; Risk Factors; Femur; Retrospective Studies; Femoral Fractures; Salter-Harris Fractures
PubMed: 37449728
DOI: 10.2340/17453674.2023.13654 -
Child's Nervous System : ChNS :... Feb 2021To evaluate neurological development of completely healthy children with anterior fontanelle premature closure via Denver Developmental Screening Test II and to compare...
PURPOSE
To evaluate neurological development of completely healthy children with anterior fontanelle premature closure via Denver Developmental Screening Test II and to compare the results with control group.
METHOD AND RESULTS
The records of 140 patients applied to Mersin University Pediatric Neurology Outpatient Clinic between 2011 and 2019 with the complaint of premature closure of the anterior fontanelle were retrospectively reviewed. Patients with microcephaly, craniosynostosis, infection, sequelae of hypoxia-ischemia, metabolic disorders, intracranial hemorrhage, epilepsy, endocrine problems, and dysmorphic features were excluded from the study. Sixty-six completely healthy children with anterior fontanelle premature closure were included in the study. Denver Developmental Screening Test II was performed by the same developmental specialist to the children with premature closure of the anterior fontanelle as well as to the healthy control group. For each child included in the case and the control group, 90% of the values for each development area were calculated and recorded. Then, the results were compared. Denver II Developmental Screening Test (p < 0.001) and gross motor subtest (p < 0.001) results showed statistically significant retardation in the case group compared with the control group.
CONCLUSIONS
The study was the first study in the literature on the gross motor development of children with premature closure of anterior fontanelle, and it has been found significantly undeveloped compared with the control group, and it has been concluded that similar patients should be evaluated from this view point in pediatric neurology department.
Topics: Child; Cranial Fontanelles; Craniosynostoses; Humans; Infant; Intracranial Hemorrhages; Retrospective Studies
PubMed: 32737565
DOI: 10.1007/s00381-020-04846-6 -
Expert Opinion on Drug Discovery Jan 2023Chronic wounds are a major drain on healthcare resources and can lead to substantial reductions in quality of life for those affected. Moreover, they often precede... (Review)
Review
INTRODUCTION
Chronic wounds are a major drain on healthcare resources and can lead to substantial reductions in quality of life for those affected. Moreover, they often precede serious events such as limb amputations and premature death. In the long run, this burden is likely to escalate with an ageing population and lifestyle diseases such as obesity. Thus far, the identification of beneficial therapeutics against chronic wounds have been hindered by the lack of an ideal chronic wound animal model. Although animal models of delayed healing have been developed, none of these models fully recapitulate the complexity of the human chronic wound condition. Furthermore, most animals do not develop chronic wounds. Only the thoroughbred racehorse develops chronic ulcers.
AREAS COVERED
In this review, the different characteristics of chronic wounds that highlight its complexity are described. In addition, currently available models reflecting different aspects of chronic wound pathology and their relevance to human chronic wounds are discussed. This article concludes by listing relevant features representative of an ideal chronic wound model. Additionally, alternative approaches for the development of chronic wound models are discussed.
EXPERT OPINION
Delayed models of healing, including the streptozotocin diabetic model, skin flap model and magnet-induced IR models have emerged. While these models have been widely adopted for preclinical therapeutic testing, their relevance towards human chronic wounds remains debatable. In particular, current delayed healing models often fail to fully incorporate the key characteristics of chronic ulcers. Ultimately, more representative models are required to expedite the advancement of novel therapeutics to the clinic.
Topics: Animals; Humans; Quality of Life; Ulcer; Wound Healing; Models, Animal; Streptozocin; Chronic Disease
PubMed: 36573018
DOI: 10.1080/17460441.2023.2158809 -
Frontiers in Pharmacology 2021: To systematically review the efficacy and safety of oral Acetaminophen for premature infants with patent ductus arteriosus (PDA). : Databases including Ovid, EMbase,... (Review)
Review
: To systematically review the efficacy and safety of oral Acetaminophen for premature infants with patent ductus arteriosus (PDA). : Databases including Ovid, EMbase, Pubmed, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINHAL), China National Knowledge Infrastructure (CNKI), Chinese Biomedical Database (CBM), WanFang Data, China Science and Technology Journal Database were searched to collect the randomized controlled trials (RCTs) about Acetaminophen for premature infants with PDA from inception to January 1, 2021. Quality assessment was performed through bias risk evaluation according to the Cochrane Handbook 5.1.0, and then the homogeneous studies were analyzed using Revman 5.4 software. : A total of 16 RCTs were included, which were divided into for four subgroups: subgroup I (oral acetaminophen vs. oral ibuprofen, 13 RCTs), subgroup II (oral acetaminophen vs. intravenous indomethacin, 1 RCT), subgroup III (oral acetaminophen intravenous ibuprofen, 1 RCT), and subgroup IV (oral acetaminophen intravenous placebo, 1 RCT). In subgroup I, There was no significant difference in the ductal closure rate after the first course of drug administration [typical relative risk (RR) 0.97, 95% confidence interval (CI) 0.90 to 1.05], the accumulated ductal closure rate after two course of treatment (RR 0.96, 95% CI 0.91-1.02), and mortality (RR 1.06, 95% CI 0.75-1.49) between treatment with oral acetaminophen versus oral ibuprofen ( 0.05); compared with oral ibuprofen, oral acetaminophen was associated with a significant reduction in the incidence of gastrointestinal bleeding/stool occult blood positive (RR 0.51, 95% CI 0.32 to 0.82)and oliguria (RR 0.62, 95% CI 0.42-0.91) ( < 0.05). : The meta analysis approves the facts that there is no significant difference in the efficacity in premature infants with PDA between oral acetaminophen and buprofen or indometacin, but compared to ibuprofen, oral acetaminophen may decrease the incidence of oliguria and gastrointestinal bleeding. More reliable conclusions should be made through large-size, multi-center, well-designed RCTs.
PubMed: 35115919
DOI: 10.3389/fphar.2021.696417 -
Interventional Cardiology Clinics Jul 2024Transcatheter ductal closure has proven to be safe and effective to occlude the patent ductus arteriosus (PDA) in premature infants. We have developed a robust... (Review)
Review
Transcatheter ductal closure has proven to be safe and effective to occlude the patent ductus arteriosus (PDA) in premature infants. We have developed a robust multidisciplinary PDA program. After gaining experience performing transcatheter ductal closure in the cardiac catheterization laboratory, we transitioned to performing the procedure at the patient's bedside in the neonatal intensive care unit using echocardiographic guidance. The bedside approach has the potential to expand this therapy to patients who currently undergo expectant PDA management because of lack of availability of this therapy, and allow for earlier referral, which will reduce time of exposure to this pathologic shunt.
Topics: Humans; Ductus Arteriosus, Patent; Infant, Newborn; Infant, Premature; Cardiac Catheterization; Septal Occluder Device; Echocardiography
PubMed: 38839169
DOI: 10.1016/j.iccl.2024.02.001 -
Journal of Pediatric Nursing 2023Mothers of premature infants are in the risk group for having psychological symptoms and attachment-interaction difficulties. Preventing these maternal risks is...
BACKGROUND
Mothers of premature infants are in the risk group for having psychological symptoms and attachment-interaction difficulties. Preventing these maternal risks is essential for providing optimal care and health opportunities for infants, consequently improving developmental outcomes.
METHODS
In this study, we aimed to understand how mothers experienced prematurity within four processes retrospectively: (a) the mother's hospitalization after birth, (b) the infant's hospitalization in the Neonatal Intensive Care Unit (NICU), (c) after discharge, and (d) in early childhood. We adopted Max van Manen's phenomenology of practice and interviewed nine mothers whose children were born premature and reached early childhood.
FINDINGS
The themes were as follows: (a) incomplete mother; (b) facing prematurity, uncertainty, natural touch barrier, facing reductive social response, and NICU friendship; (c) being on the alert, a period of complete closure, and fighting with the reductive social response; (d) association to prematurity and (cannot) overcome the difficulties. We expressed the mothers' overall experiences through the metaphor "living with a birthmark." This metaphor represents the longitudinal effects of prematurity. As much as it is apparent and painful at first, it fades over time, and the pain lessens, but the effects of the birthmark remain in early childhood. The birthmark becomes a part of the mother-baby relationship.
CONCLUSIONS AND PRACTICE IMPLICATIONS
Our study contributes to premature infant care and health literature by highlighting the longitudinal experiences of mothers on prematurity.
Topics: Child, Preschool; Infant, Newborn; Female; Infant; Child; Humans; Mothers; Turkey; Retrospective Studies; Mother-Child Relations; Infant, Premature; Intensive Care Units, Neonatal
PubMed: 36682260
DOI: 10.1016/j.pedn.2023.01.002 -
Skeletal Radiology Mar 2023The objective of this paper is to explore sources of diagnostic error in musculoskeletal oncology and potential strategies for mitigating them using case examples. As... (Review)
Review
The objective of this paper is to explore sources of diagnostic error in musculoskeletal oncology and potential strategies for mitigating them using case examples. As musculoskeletal tumors are often obvious, the diagnostic errors in musculoskeletal oncology are frequently cognitive. In our experience, the most encountered cognitive biases in musculoskeletal oncologic imaging are as follows: (1) anchoring bias, (2) premature closure, (3) hindsight bias, (4) availability bias, and (5) alliterative bias. Anchoring bias results from failing to adjust an early impression despite receiving additional contrary information. Premature closure is the cognitive equivalent of "satisfaction of search." Hindsight bias occurs when we retrospectively overestimate the likelihood of correctly interpreting the examination prospectively. In availability bias, the radiologist judges the probability of a diagnosis based on which diagnosis is most easily recalled. Finally, alliterative bias occurs when a prior radiologist's impression overly influences the diagnostic thinking of another radiologist on a subsequent exam. In addition to cognitive biases, it is also important for radiologists to acknowledge their feelings when making a diagnosis to recognize positive and negative impact of affect on decision making. While errors decrease with radiologist experience, the lack of application of medical knowledge is often the primary source of error rather than a deficiency of knowledge, emphasizing the need to foster clinical reasoning skills and assist cognition. Possible solutions for reducing error exist at both the individual and the system level and include (1) improvement in knowledge and experience, (2) improvement in clinical reasoning and decision-making skills, and (3) improvement in assisting cognition.
Topics: Humans; Retrospective Studies; Cognition; Diagnostic Errors; Bias; Medical Oncology
PubMed: 36048252
DOI: 10.1007/s00256-022-04166-7 -
Frontiers in Pediatrics 2020The patent ductus arteriosus (PDA) is the most commonly found cardiac condition in neonates. While there have been several studies and thousands of publications on the... (Review)
Review
The patent ductus arteriosus (PDA) is the most commonly found cardiac condition in neonates. While there have been several studies and thousands of publications on the topic, the decision to treat the PDA is still strongly debated among cardiologists, surgeons, and neonatologists. This is in part due to the shortage of long-term benefits with the interventions studied. Practice variations still exist within sub-specialties and centers. This article briefly summarizes the history, embryology and histology of the PDA. It also succinctly discusses the hemodynamic significance of a PDA which builds the framework to review all the available literature on PDA closure in premature infants, though not a paradigm shift just yet; it introduces transcatheter PDA closure (TCPC) as a possible armament to the clinician for this age-old problem.
PubMed: 33643964
DOI: 10.3389/fped.2020.590578