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  • 1
    Online Resource
    Online Resource
    Cord Blood Biomarkers of Cardiac Dysfunction and Damage in Term Growth-Restricted Fetuses Classified by Severity Criteria
    S. Karger AG ; 2018
    In:  Fetal Diagnosis and Therapy Vol. 44, No. 4 ( 2018), p. 271-276
    Details
    In: Fetal Diagnosis and Therapy, S. Karger AG, Vol. 44, No. 4 ( 2018), p. 271-276
    Abstract: 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 To assess cardiovascular function and damage in term small-for-gestational-age (SGA) and intrauterine growth-restricted (IUGR) fetuses by echocardiography and biomarkers in cord blood. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 This was a cohort study including 60 normal fetuses and 47 term small fetuses subclassified as small for gestational age (SGA) with estimated fetal weight (EFW) between the 3rd and 9th centiles and normal fetoplacental Doppler ( 〈 i 〉 n 〈 /i 〉 = 14) or intrauterine growth restriction (IUGR, 〈 i 〉 n 〈 /i 〉 = 33) if EFW & #x3c;3rd centile or EFW & #x3c;10th centile together with cerebroplacental ratio & #x3c;5th and/or mean uterine artery pulsatility index & #x3e;95th centile. Fetal echocardiography included left myocardial performance index (MPI) and annular plane systolic excursion. Fetal B-type natriuretic peptide (BNP), troponin-I, heart-type fatty acid-binding proteins (H-FABP), and homocysteine concentrations were measured in cord blood collected at delivery. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Both SGA and IUGR cases presented echocardiographic signs of systolic and diastolic dysfunction with increased MPI (mean controls 0.43 [SD 0.12], SGA 0.47 [0.03] , and IUGR 0.57 [0.08], 〈 i 〉 p 〈 /i 〉 & #x3c; 0.01) and decreased mitral annular plane systolic excursion (controls 6.0 mm [1.0], SGA 5.5 mm [0.6] , and IUGR 4.9 mm [0.8], 〈 i 〉 p 〈 /i 〉 = 0 01). IUGR fetuses presented increased levels of cord blood BNP (controls 17.2 pg/mL [11.5], SGA 22.4 pg/mL [10.7] , and IUGR 31.2 pg/mL [26.8], 〈 i 〉 p 〈 /i 〉 & #x3c; 0.01). Troponin I was increased in both SGA and IUGR cases (controls 0.004 ng/mL [0.007], SGA 0.012 ng/mL [0.02] , and IUGR 0.018 ng/mL [0.05], 〈 i 〉 p 〈 /i 〉 & #x3c; 0.01). H-FABP and homocysteine showed similar values among groups. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Cardiac dysfunction and cell damage is a common feature of term SGA and IUGR fetuses despite of the severity criteria for perinatal outcome. Further research is needed to evaluate the potential long-term consequences on their cardiovascular system.
    Type of Medium: Online Resource
    ISSN: 1015-3837 , 1421-9964
    URL: Article
    DOI: 10.1159/000484315
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
    detail.hit.zdb_id: 1482292-1
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  • 2
    Online Resource
    Online Resource
    Sleep Disordered Breathing Is Highly Prevalent in Patients with Lung Cancer: Results of the Sleep Apnea in Lung Cancer Study
    S. Karger AG ; 2019
    In:  Respiration Vol. 97, No. 2 ( 2019), p. 119-124
    Details
    In: Respiration, S. Karger AG, Vol. 97, No. 2 ( 2019), p. 119-124
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Obstructive sleep apnea (OSA) has been linked to tumorigenesis and tumor progression. 〈 b 〉 〈 i 〉 Objectives: 〈 /i 〉 〈 /b 〉 The Sleep Apnea in Lung Cancer (SAIL) study (NCT02764866) was designed to determine the prevalence of OSA in patients with lung cancer. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Cross-sectional study including consecutive patients with newly diagnosed lung cancer. All patients were offered home sleep apnea testing (HSAT) and administered a sleep-specific questionnaire prior to initiating oncologic treatment. Sleep study-related variables, symptoms, and epidemiologic data as well as cancer related variables were recorded. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Eighty-three patients were enrolled in the SAIL study. Sixty-six completed HSAT. The mean age was 68 ± 11 years and 58% were male with a mean body mass index of 28.1 ± 5.4. Forty-seven percent were current smokers, 42% former smokers, and 11% never smokers with a median tobacco consumption of 51 pack-years. Fifty percent had COPD with a mean FEV1 of 83 ± 22.6% of predicted and a mean DLCO of 85.5 ± 20.1%. Adenocarcinoma was the most common histologic type (46.7%), followed by squamous cell (16.7%) and small cell (16.7%). Most patients were diagnosed at an advanced stage (65% in stages III–IV). The vast majority (80%) had OSA (apnea-hypopnea index [AHI] & #x3e; 5), and 50% had moderate to severe OSA (AHI & #x3e; 15) with a mean Epworth Sleepiness Score of 7.43 ± 3.85. Significant nocturnal hypoxemia was common (Median T90: 10.9% interquartile range 2.4–42.2). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Sleep apnea and nocturnal hypoxemia are highly prevalent in patients with lung cancer.
    Type of Medium: Online Resource
    ISSN: 0025-7931 , 1423-0356
    URL: Article
    DOI: 10.1159/000492273
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2019
    detail.hit.zdb_id: 1464419-8
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  • 3
    Online Resource
    Online Resource
    Lung Ultrasound Scores Progress Differently in Extreme and Very Preterm Infants after Birth: A Multicentre Prospective Study
    S. Karger AG ; 2022
    In:  Neonatology Vol. 119, No. 5 ( 2022), p. 558-566
    Details
    In: Neonatology, S. Karger AG, Vol. 119, No. 5 ( 2022), p. 558-566
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 The lung ultrasound score (LUS) has been suggested to predict moderate-severe bronchopulmonary dysplasia (msBPD) in preterm infants. We aimed to assess LUS evolution after birth in preterm infants and the effect of gestational age. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 This multicentre prospective observational study was performed with newborns born before 33 weeks of gestation. We created two groups: group 1 (23–27 weeks) and group 2 (28–32 weeks). We compared LUSs between the groups from birth until 36 weeks of postmenstrual age, and we estimated the LUS evolution in each group with a linear multilevel mixed-effects regression model. The effects of the need for surfactant or an msBPD diagnosis were also studied. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 We included 339 patients: 122 (36%) in group 1 and 217 (64%) in group 2. The infants in group 1 showed a steady progression in the LUS from birth until 4 weeks of age and a subsequent decrease; the infants in group 2 showed a progressive decrease in the LUS throughout the study. This progression varied significantly in the first weeks of life in infants who required surfactant at birth and after the first week of life in the patients diagnosed with msBPD. 〈 b 〉 〈 i 〉 Discussion/Conclusions: 〈 /i 〉 〈 /b 〉 Extremely preterm infants showed persistently high LUSs during the first weeks of life, regardless of the progression to msBPD. In this group, the infants who did not require surfactant at birth exhibited an increase in their LUSs after the first week until their values were equal to the remaining infants in their group.
    Type of Medium: Online Resource
    ISSN: 1661-7800 , 1661-7819
    URL: Article
    DOI: 10.1159/000525187
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2022
    detail.hit.zdb_id: 2403535-X
    SSG: 12
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  • 4
    Online Resource
    Online Resource
    The Effect of Morbidity and Sex on Postnatal Growth of Very Preterm Infants: A Multicenter Cohort Study
    S. Karger AG ; 2019
    In:  Neonatology Vol. 115, No. 4 ( 2019), p. 348-354
    Details
    In: Neonatology, S. Karger AG, Vol. 115, No. 4 ( 2019), p. 348-354
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Extrauterine growth restriction is common in the preterm infant, and it is associated with poor neurodevelopment. Nutrition plays an important role in postnatal growth, but growth is also influenced by other factors like co-morbidity, and, also, there might be sex differences. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 This is a cohort study including preterm infants & #x3c; 32 weeks at birth ( 〈 i 〉 n 〈 /i 〉 = 21,825) from the Spanish Neonatal Network database. The effect of sex and morbidity (patent ductus arteriosus, bronchopulmonary dysplasia, necrotizing enterocolitis and late-onset sepsis) on weight gain as well as linear and head growth from birth to discharge/death was assessed with linear regression models adjusted by gestational age and 〈 i 〉 Z 〈 /i 〉 -scores at birth. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The 4 selected morbidities had an independent effect on all 6 growth parameters studied, which was greater in the case of necrotizing enterocolitis: changes in weight, length and head 〈 i 〉 Z 〈 /i 〉 -scores were –0.60 (95% CI: –0.66 to –0.55), –0.62 (95% CI: –0.70 to –0.54) and –0.63 (95% CI: –0.71 to –0.56), respectively. Weight gain and linear growth were overall more affected than head growth. Girls lost slightly more weight 〈 i 〉 Z 〈 /i 〉 -scores (–0.03; 95% CI: –0.06 to –0.002) than boys after adjustment by morbidity. There were no significant gender differences regarding linear and head growth velocity (cm/week), although girls lost more head 〈 i 〉 Z 〈 /i 〉 -scores (–0.14; 95% CI: –0.18 to –0.10). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Main co-morbidities associated with prematurity have an impact on postnatal growth. Head growth is less affected than length and weight. Girls are at slightly higher risk of postnatal weight and head restriction after adjustment by morbidity.
    Type of Medium: Online Resource
    ISSN: 1661-7800 , 1661-7819
    URL: Article
    DOI: 10.1159/000497221
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2019
    detail.hit.zdb_id: 2403535-X
    SSG: 12
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  • 5
    Online Resource
    Online Resource
    Growth Differentiation Factor 15 Is Superior to Troponin I in the Evaluation of Kidney Transplant Candidates
    S. Karger AG ; 2022
    In:  American Journal of Nephrology Vol. 53, No. 2-3 ( 2022), p. 118-128
    Details
    In: American Journal of Nephrology, S. Karger AG, Vol. 53, No. 2-3 ( 2022), p. 118-128
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Pretransplant cardiac troponin I (cTNI) has demonstrated its predicting value in survival after kidney transplant. Growth differentiation factor 15 (GDF-15) is a biomarker currently studied as a predictor of mortality and cardiovascular events (CVE) in different scenarios. The aim of this study was to compare the utility of these two biomarkers in the prediction of events after kidney transplant. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We included 359 kidney transplants performed in our center between 2005 and 2015. cTNI and GDF-15 were measured on stored serum samples obtained pretransplant. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Median GDF-15 was 5,346.4 pg/mL, and cTNI was 5.6 ng/L. After follow-up, 77 (21.5%) patients died, and the incidence of cerebrovascular accident (CVA), acute coronary syndrome (ACS), and major adverse CVEs (MACE) was 6.38%, 12.68%, and 20.56%, respectively. Patients were stratified in tertiles according to GDF-15 and cTNT levels. By multivariate cox regression analysis including both biomarkers and different clinical characteristics, we found a significant relation between GDF-15 and mortality, CVAs, and MACE (highest tertile hazard ratio [HR] 2.2 95% confidence interval [CI] [1.2–4.1], 〈 i 〉 p 〈 /i 〉 = 0.01, HR 9.7 CI 95% [2.2–43.1], 〈 i 〉 p 〈 /i 〉 = 0.003 and HR 2.7 CI 95% [1.4–5.1], 〈 i 〉 p 〈 /i 〉 = 0.002). On the contrary, posttransplant ACS was related to cTNI (highest cTNI tertile HR 3.2 CI 95% [1.5–7.3], 〈 i 〉 p 〈 /i 〉 = 0.003). 〈 b 〉 〈 i 〉 Discussion: 〈 /i 〉 〈 /b 〉 Our study indicates the potential utility of GDF-15 as a mortality and CVE predictor after kidney transplant and its superiority compared to cTNI. By contrast, probably due to its tissue specificity, cardiac troponin showed a stronger correlation with acute coronary events. Although more studies are needed to confirm our findings, these two molecules could be used in conjunction with other tools to predict adverse events after transplant and ideally find strategies to minimize them.
    Type of Medium: Online Resource
    ISSN: 0250-8095 , 1421-9670
    URL: Article
    DOI: 10.1159/000521781
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2022
    detail.hit.zdb_id: 1468523-1
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