Antibiotic resistance has become an urgent and global issue, with 700,000 deaths attributable to multidrug-resistance occurring each year worldwide. The overuse of antibiotics, both in animal industry and in clinical settings, and the generated selective pressure, are the main factors implicated in the emergence of resistant strains. The Centers for Disease Control and Prevention (CDC) have pointed out that more than half of hospital patients receive an antibiotic during their stay, and nearly a third receive a broad-spectrum antibiotic. In neonatal units, previous antibiotic exposure to third-generation cephalosporin and carbapenem were identified as independent risk factors for infection caused by multi-drug resistant strains. While resistant ‘superbugs’ emerge, the arsenal to fight these microorganisms is progressively shrinking, as the number of newly discovered antibiotics approved by the Food and Drug administration each year is dropping. In face of global spread of antibiotic resistance and of the limited development of new drugs, policies and rules are under study by agencies (CDC, World Health Organization) and governments, in order to: i) facilitate and foster the discovery of new antibiotic compounds; ii) develop new, alternative therapies able to potentiate or modulate the host immune response or to abrogate the resistance and virulence factors in the microorganisms; and iii) prevent the emergence of resistance through antibiotic stewardship programs, educational programs, and reduction of antibiotic use in livestock; the field of neonatal medicine will need its own, newborn-tailored, antibiotic stewardship programs to be implemented in the NICUs. Proceedings of the 11 th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy) · October 26 th -31 st , 2015 · From the womb to the adult Guest Editors: Vassilios Fanos (Cagliari, Italy), Michele Mussap (Genoa, Italy), Antonio Del Vecchio (Bari, Italy), Bo Sun (Shanghai, China), Dorret I. Boomsma (Amsterdam, the Netherlands), Gavino Faa (Cagliari, Italy), Antonio Giordano (Philadelphia, USA)
抗生素耐药性已成为一个紧迫的全球性问题，全世界每年有70万人死于多药耐药性。在畜牧业和临床环境中过度使用抗生素以及产生的选择压力是导致耐药菌株出现的主要因素。美国疾病控制与预防中心(CDC)指出，超过一半的住院患者在住院期间接受了抗生素治疗，近三分之一的患者接受了广谱抗生素治疗。在新生儿病房，先前接触第三代头孢菌素和碳青霉烯类抗生素被确定为多重耐药菌株引起感染的独立危险因素。虽然出现了耐药的“超级细菌”，但随着美国食品和药物管理局每年批准的新发现抗生素数量不断下降，对抗这些微生物的武器库正在逐渐缩小。面对抗生素耐药性在全球蔓延和新药开发有限的情况，各机构(疾病预防控制中心、世界卫生组织)和各国政府正在研究政策和规则，以便:i)促进和促进发现新的抗生素化合物;Ii)开发新的替代疗法，能够增强或调节宿主免疫反应，或消除微生物中的耐药性和毒力因素;iii)通过抗生素管理计划、教育计划和减少抗生素在牲畜中的使用来防止耐药性的出现;新生儿医学领域将需要在新生儿重症监护病房实施自己的、针对新生儿的抗生素管理计划。第11届国际新生儿学与卫星会议会议记录·卡利亚里(意大利)·2015年10月26日-31日·从子宫到成人客座编辑:Vassilios Fanos(意大利卡利亚里)，Michele Mussap(意大利热那亚)，Antonio Del Vecchio(意大利巴里)，Bo Sun(中国上海)，Dorret I. Boomsma(荷兰阿姆斯特丹)，Gavino Faa(意大利卡利亚里)，Antonio Giordano(美国费城)
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When exposed to light, bilirubin undergoes photoisomerization which are water-soluble and can be excreted in bile and urine. Photoisomerization starts as soon as the lights turned on, and risk of bilirubin encephalopathy is lower in infants who receive phototherapy even in the same serum bilirubin levels. Blue light is absorbed most readily if bilirubin is in a tube, but skin penetration and albumin binding shift of the most effective light to blue-green region. However, there is no consensus on the most effective wavelength for phototherapy. The light sources used in conventional phototherapy are fluorescent bulbs, halogen lamps or light-emitting diodes (LED) with equally effective in reducing serum bilirubin levels. Fiberoptic devices are less effective. Despite higher irradiance in double or triple phototherapy, there is no superiority in clinical settings. Hyperthermia and skin rashes are higher when used super (high-intensity) LED devices. Watery loose stools may cause dehydration in preterm infants. Riboflavin loss and lipid peroxidation are prevented with using dark tubing or covering the line with aluminum foil. The consequences of light penetration into deep brain in newborn infants because of open wide fontanel and thin skull is unknown. Non-ocular light exposure and suppressed melatonin secretion may affect autonomic and behavioral disturbances. Phototherapy-induced hypocalcemia may be prevented by covering the head. Phototherapy does not effect ductal patency or reopening, its effect on the incidence of retinopathy of prematurity have yielded conflicting results. Neonatal phototherapy increases the risk of asthma and allergic disorders in older age groups. Aggressive (low-threshold) phototherapy increase mortality risk in small preterm infants less than 750 g at birth, which may be related to the reduced bilirubin with its antioxidant effects. In conclusion, phototherapy is not a treatment without side effects and overtreatment should be reevaluated in small preterm infants. Proceedings of the 11 th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy) · October 26 th -31 st , 2015 · From the womb to the adult Guest Editors: Vassilios Fanos (Cagliari, Italy), Michele Mussap (Genoa, Italy), Antonio Del Vecchio (Bari, Italy), Bo Sun (Shanghai, China), Dorret I. Boomsma (Amsterdam, the Netherlands), Gavino Faa (Cagliari, Italy), Antonio Giordano (Philadelphia, USA)
当暴露在光线下时，胆红素发生光异构化，它是水溶性的，可以通过胆汁和尿液排出体外。光照一开，光异构化就开始了，即使在血清胆红素水平相同的情况下，接受光疗的婴儿患胆红素脑病的风险也较低。如果胆红素在管中，蓝光最容易被吸收，但皮肤穿透和白蛋白结合将最有效的光转移到蓝绿色区域。然而，对于光疗最有效的波长还没有达成共识。传统光疗中使用的光源有荧光灯泡、卤素灯或发光二极管(LED)，它们在降低血清胆红素水平方面同样有效。光纤设备的效率较低。尽管双重或三重光疗的辐照度较高，但在临床环境中没有优势。使用超级(高强度)LED设备时，高热和皮疹的发生率更高。水样稀便可能导致早产儿脱水。核黄素损失和脂质过氧化防止使用暗管或覆盖线与铝箔。由于新生儿囟门较宽，颅骨较薄，光线进入深部脑的后果尚不清楚。非眼光暴露和抑制褪黑激素分泌可能影响自主神经和行为障碍。通过遮盖头部可以预防光疗引起的低钙血症。光疗不影响导管的开放或重新开放，其对早产儿视网膜病变发生率的影响产生了相互矛盾的结果。新生儿光疗增加老年人群哮喘和过敏性疾病的风险。积极(低阈值)光疗增加出生时小于750克的小早产儿的死亡风险，这可能与胆红素的降低及其抗氧化作用有关。总之，光疗不是一种没有副作用的治疗方法，对小早产儿过度治疗应重新评估。第11届国际新生儿学与卫星会议会议记录·卡利亚里(意大利)·2015年10月26日-31日·从子宫到成人客座编辑:Vassilios Fanos(意大利卡利亚里)，Michele Mussap(意大利热那亚)，Antonio Del Vecchio(意大利巴里)，Bo Sun(中国上海)，Dorret I. Boomsma(荷兰阿姆斯特丹)，Gavino Faa(意大利卡利亚里)，Antonio Giordano(美国费城)
{"title":"Phototherapy in the newborn: what's new?","authors":"M. Yurdakök","doi":"10.7363/040255","DOIUrl":"https://doi.org/10.7363/040255","url":null,"abstract":"When exposed to light, bilirubin undergoes photoisomerization which are water-soluble and can be excreted in bile and urine. Photoisomerization starts as soon as the lights turned on, and risk of bilirubin encephalopathy is lower in infants who receive phototherapy even in the same serum bilirubin levels. Blue light is absorbed most readily if bilirubin is in a tube, but skin penetration and albumin binding shift of the most effective light to blue-green region. However, there is no consensus on the most effective wavelength for phototherapy. The light sources used in conventional phototherapy are fluorescent bulbs, halogen lamps or light-emitting diodes (LED) with equally effective in reducing serum bilirubin levels. Fiberoptic devices are less effective. Despite higher irradiance in double or triple phototherapy, there is no superiority in clinical settings. Hyperthermia and skin rashes are higher when used super (high-intensity) LED devices. Watery loose stools may cause dehydration in preterm infants. Riboflavin loss and lipid peroxidation are prevented with using dark tubing or covering the line with aluminum foil. The consequences of light penetration into deep brain in newborn infants because of open wide fontanel and thin skull is unknown. Non-ocular light exposure and suppressed melatonin secretion may affect autonomic and behavioral disturbances. Phototherapy-induced hypocalcemia may be prevented by covering the head. Phototherapy does not effect ductal patency or reopening, its effect on the incidence of retinopathy of prematurity have yielded conflicting results. Neonatal phototherapy increases the risk of asthma and allergic disorders in older age groups. Aggressive (low-threshold) phototherapy increase mortality risk in small preterm infants less than 750 g at birth, which may be related to the reduced bilirubin with its antioxidant effects. In conclusion, phototherapy is not a treatment without side effects and overtreatment should be reevaluated in small preterm infants. Proceedings of the 11 th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy) · October 26 th -31 st , 2015 · From the womb to the adult Guest Editors: Vassilios Fanos (Cagliari, Italy), Michele Mussap (Genoa, Italy), Antonio Del Vecchio (Bari, Italy), Bo Sun (Shanghai, China), Dorret I. Boomsma (Amsterdam, the Netherlands), Gavino Faa (Cagliari, Italy), Antonio Giordano (Philadelphia, USA)","PeriodicalId":51914,"journal":{"name":"Journal of Pediatric and Neonatal Individualized Medicine","volume":"4 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2015-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71290206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bronchiolitis is one of the major cause of mortality and morbidity during infancy, with high hospitalization rate during epidemic season for high risk infants during the first year of life. There is no specific therapy with proven efficacy apart hydration and hypertonic saline. Mild forms can be treated in outpatient setting avoiding a useless hospitalization. Enviromental prevention is crucial in hospital setting, in outpatient ambulatory and at home: for this purpose hand hygiene, tobacco exposure, breastfeeding must be emphasized with families and caregivers. Pharmacological prophylaxis uses a humanized monoclonal antibody (palivizumab) shown effective in reducing hospitalization rate in preterm infants < 35 weeks gestational age, infants with bronchopulmonary dysplasia and infants with congenital heart disease. During the last 2 years different recommandations and guidelines confirmed the importance of prophylaxis with palivizumab with some differences between Groups and Societies based on different healthcare systems. In any case it is important a good contact between hospital and all caregivers of these patients to reduce the viral exposure and increase the defense capability of high risk patients. Proceedings of the 11 th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy) · October 26 th -31 st , 2015 · From the womb to the adult Guest Editors: Vassilios Fanos (Cagliari, Italy), Michele Mussap (Genoa, Italy), Antonio Del Vecchio (Bari, Italy), Bo Sun (Shanghai, China), Dorret I. Boomsma (Amsterdam, the Netherlands), Gavino Faa (Cagliari, Italy), Antonio Giordano (Philadelphia, USA)
毛细支气管炎是婴幼儿死亡和发病的主要原因之一，高危婴儿出生后1年的住院率在流行季节较高。除了水合和高渗盐水外，没有特定的治疗方法证明有效。轻度形式可以在门诊治疗，避免无用的住院治疗。环境预防在医院环境、门诊门诊和家庭环境中至关重要:为此目的，必须向家庭和照料者强调手卫生、烟草接触、母乳喂养。药理学预防使用人源化单克隆抗体(帕利珠单抗)，该抗体显示可有效降低< 35孕周的早产儿、支气管肺发育不良婴儿和先天性心脏病婴儿的住院率。在过去的2年中，不同的建议和指南证实了帕利珠单抗预防的重要性，但基于不同医疗保健系统的群体和社会之间存在一些差异。在任何情况下，重要的是医院和这些患者的所有护理人员之间的良好联系，以减少病毒暴露，提高高危患者的防御能力。第11届国际新生儿学与卫星会议会议记录·卡利亚里(意大利)·2015年10月26日-31日·从子宫到成人客座编辑:Vassilios Fanos(意大利卡利亚里)，Michele Mussap(意大利热那亚)，Antonio Del Vecchio(意大利巴里)，Bo Sun(中国上海)，Dorret I. Boomsma(荷兰阿姆斯特丹)，Gavino Faa(意大利卡利亚里)，Antonio Giordano(美国费城)
{"title":"Prevention of bronchiolitis from the hospital to home: enviromental and pharmacological strategies","authors":"A. Dotta","doi":"10.7363/040242","DOIUrl":"https://doi.org/10.7363/040242","url":null,"abstract":"Bronchiolitis is one of the major cause of mortality and morbidity during infancy, with high hospitalization rate during epidemic season for high risk infants during the first year of life. There is no specific therapy with proven efficacy apart hydration and hypertonic saline. Mild forms can be treated in outpatient setting avoiding a useless hospitalization. Enviromental prevention is crucial in hospital setting, in outpatient ambulatory and at home: for this purpose hand hygiene, tobacco exposure, breastfeeding must be emphasized with families and caregivers. Pharmacological prophylaxis uses a humanized monoclonal antibody (palivizumab) shown effective in reducing hospitalization rate in preterm infants < 35 weeks gestational age, infants with bronchopulmonary dysplasia and infants with congenital heart disease. During the last 2 years different recommandations and guidelines confirmed the importance of prophylaxis with palivizumab with some differences between Groups and Societies based on different healthcare systems. In any case it is important a good contact between hospital and all caregivers of these patients to reduce the viral exposure and increase the defense capability of high risk patients. Proceedings of the 11 th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy) · October 26 th -31 st , 2015 · From the womb to the adult Guest Editors: Vassilios Fanos (Cagliari, Italy), Michele Mussap (Genoa, Italy), Antonio Del Vecchio (Bari, Italy), Bo Sun (Shanghai, China), Dorret I. Boomsma (Amsterdam, the Netherlands), Gavino Faa (Cagliari, Italy), Antonio Giordano (Philadelphia, USA)","PeriodicalId":51914,"journal":{"name":"Journal of Pediatric and Neonatal Individualized Medicine","volume":"477 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2015-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71290542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adverse obstetric outcomes are determinants of neonatal mortality and serious morbidity, often leading to neurologic and developmental alterations in early childhood and/or adult life. Several studies have focused the relationships between maternal inflammation and diseases and those conditions. The role of oral inflammation and gingival diseases as factors with potential maternal and fetal detrimental effects on the outcomes of pregnancy is a relatively new area of investigation that has attracted a lot of interest and research in the last twenty years. The new evidences now strongly support a role for maternal infection and inflammation of the genital tract, as well as inflammation from sites distant from the pelvis, in the etiology of preterm birth. The aim of the present paper is to outline and summarize the current knowledge about the relations between oral biofilms, periodontal inflammation and the pathogenic mechanisms linking periodontal diseases with adverse pregnancy outcomes, concluding with some practical advices for clinicians on the prevention and control of the oral inflammation and the related adverse outcomes in pregnant patients. Proceedings of the 11 th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy) · October 26 th -31 st , 2015 · From the womb to the adult Guest Editors: Vassilios Fanos (Cagliari, Italy), Michele Mussap (Genoa, Italy), Antonio Del Vecchio (Bari, Italy), Bo Sun (Shanghai, China), Dorret I. Boomsma (Amsterdam, the Netherlands), Gavino Faa (Cagliari, Italy), Antonio Giordano (Philadelphia, USA)
不良产科结果是新生儿死亡率和严重发病率的决定因素，往往导致儿童早期和/或成年生活的神经和发育改变。几项研究集中在母体炎症和疾病以及这些疾病之间的关系。口腔炎症和牙龈疾病对妊娠结局的潜在不利影响是一个相对较新的研究领域，在过去的二十年中引起了很多关注和研究。新的证据现在有力地支持了产妇感染和生殖道炎症，以及远离骨盆部位的炎症在早产病因学中的作用。本文就口腔生物膜与牙周炎症的关系、牙周病与妊娠不良结局的致病机制等方面的研究进展进行综述，并对临床医生预防和控制妊娠患者口腔炎症及相关不良结局提出一些建议。第11届国际新生儿学与卫星会议会议记录·卡利亚里(意大利)·2015年10月26日-31日·从子宫到成人客座编辑:Vassilios Fanos(意大利卡利亚里)，Michele Mussap(意大利热那亚)，Antonio Del Vecchio(意大利巴里)，Bo Sun(中国上海)，Dorret I. Boomsma(荷兰阿姆斯特丹)，Gavino Faa(意大利卡利亚里)，Antonio Giordano(美国费城)
{"title":"Oral environment, inflammation and preterm birth","authors":"S. Abati, A. Villa, I. Cetin","doi":"10.7363/040239","DOIUrl":"https://doi.org/10.7363/040239","url":null,"abstract":"Adverse obstetric outcomes are determinants of neonatal mortality and serious morbidity, often leading to neurologic and developmental alterations in early childhood and/or adult life. Several studies have focused the relationships between maternal inflammation and diseases and those conditions. The role of oral inflammation and gingival diseases as factors with potential maternal and fetal detrimental effects on the outcomes of pregnancy is a relatively new area of investigation that has attracted a lot of interest and research in the last twenty years. The new evidences now strongly support a role for maternal infection and inflammation of the genital tract, as well as inflammation from sites distant from the pelvis, in the etiology of preterm birth. The aim of the present paper is to outline and summarize the current knowledge about the relations between oral biofilms, periodontal inflammation and the pathogenic mechanisms linking periodontal diseases with adverse pregnancy outcomes, concluding with some practical advices for clinicians on the prevention and control of the oral inflammation and the related adverse outcomes in pregnant patients. Proceedings of the 11 th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy) · October 26 th -31 st , 2015 · From the womb to the adult Guest Editors: Vassilios Fanos (Cagliari, Italy), Michele Mussap (Genoa, Italy), Antonio Del Vecchio (Bari, Italy), Bo Sun (Shanghai, China), Dorret I. Boomsma (Amsterdam, the Netherlands), Gavino Faa (Cagliari, Italy), Antonio Giordano (Philadelphia, USA)","PeriodicalId":51914,"journal":{"name":"Journal of Pediatric and Neonatal Individualized Medicine","volume":"4 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2015-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71290644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Respiratory syncytial virus (RSV) is the most important pathogen in the etiology of respiratory infections in early life. 50% of children are affected by RSV within the first year of age, and almost all children become infected within two years. Numerous retrospective and prospective studies linking RSV and chronic respiratory morbidity show that RSV bronchiolitis in infancy is followed by recurrent wheezing after the acute episod. According to some authors a greater risk of wheezing in children with a history of RSV bronchiolitis would be limited to childhood, while according to others this risk would be extended into adolescence and adulthood. To explain the relationship between RSV infection and the development of bronchial asthma or the clinical pathogenetic patterns related to a state of bronchial hyperreactivity, it has been suggested that RSV may cause alterations in the response of the immune system (immunogenic hypothesis), activating directly mast cells and basophils and changing the pattern of differentiation of immune cells present in the bronchial tree as receptors and inflammatory cytokines. It was also suggested that RSV infection can cause bronchial hyperreactivity altering nervous airway modulation, acting on nerve fibers present in the airways (neurogenic hypothesis). The benefits of passive immunoprophylaxis with palivizumab, which seems to represent an effective approach in reducing the sequelae of RSV infection in the short- and long-term period, strengthen the implementation of prevention programs with this drug, as recommended by the national guidelines of the Italian Society of Neonatology. Proceedings of the 11 th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy) · October 26 th -31 st , 2015 · From the womb to the adult Guest Editors: Vassilios Fanos (Cagliari, Italy), Michele Mussap (Genoa, Italy), Antonio Del Vecchio (Bari, Italy), Bo Sun (Shanghai, China), Dorret I. Boomsma (Amsterdam, the Netherlands), Gavino Faa (Cagliari, Italy), Antonio Giordano (Philadelphia, USA)
呼吸道合胞病毒(RSV)是早期呼吸道感染最重要的病原。50%的儿童在一岁以内感染呼吸道合胞病毒，几乎所有儿童都在两年内感染。许多回顾性和前瞻性研究将呼吸道合胞病毒与慢性呼吸道疾病联系起来，表明婴儿期呼吸道合胞病毒细支气管炎急性发作后伴有反复喘息。根据一些作者的说法，有呼吸道合流病毒细支气管炎病史的儿童喘息的风险更大，这将限于儿童时期，而根据其他人的说法，这种风险将延伸到青春期和成年期。为了解释RSV感染与支气管哮喘发展之间的关系或与支气管高反应性状态相关的临床发病模式，有人认为RSV可能引起免疫系统反应的改变(免疫原性假说)，直接激活肥大细胞和嗜碱性细胞，并改变支气管树中作为受体和炎症细胞因子的免疫细胞的分化模式。也有人认为RSV感染可引起支气管高反应性，改变神经气道调节，作用于气道中的神经纤维(神经源性假说)。帕利珠单抗被动免疫预防的好处，似乎是减少短期和长期RSV感染后遗症的有效方法，加强了该药物预防方案的实施，正如意大利新生儿学会国家指南所推荐的那样。第11届国际新生儿学与卫星会议会议记录·卡利亚里(意大利)·2015年10月26日-31日·从子宫到成人客座编辑:Vassilios Fanos(意大利卡利亚里)，Michele Mussap(意大利热那亚)，Antonio Del Vecchio(意大利巴里)，Bo Sun(中国上海)，Dorret I. Boomsma(荷兰阿姆斯特丹)，Gavino Faa(意大利卡利亚里)，Antonio Giordano(美国费城)
{"title":"Perinatal respiratory infections and long term consequences","authors":"L. Indinnimeo, V. Vittori","doi":"10.7363/040235","DOIUrl":"https://doi.org/10.7363/040235","url":null,"abstract":"Respiratory syncytial virus (RSV) is the most important pathogen in the etiology of respiratory infections in early life. 50% of children are affected by RSV within the first year of age, and almost all children become infected within two years. Numerous retrospective and prospective studies linking RSV and chronic respiratory morbidity show that RSV bronchiolitis in infancy is followed by recurrent wheezing after the acute episod. According to some authors a greater risk of wheezing in children with a history of RSV bronchiolitis would be limited to childhood, while according to others this risk would be extended into adolescence and adulthood. To explain the relationship between RSV infection and the development of bronchial asthma or the clinical pathogenetic patterns related to a state of bronchial hyperreactivity, it has been suggested that RSV may cause alterations in the response of the immune system (immunogenic hypothesis), activating directly mast cells and basophils and changing the pattern of differentiation of immune cells present in the bronchial tree as receptors and inflammatory cytokines. It was also suggested that RSV infection can cause bronchial hyperreactivity altering nervous airway modulation, acting on nerve fibers present in the airways (neurogenic hypothesis). The benefits of passive immunoprophylaxis with palivizumab, which seems to represent an effective approach in reducing the sequelae of RSV infection in the short- and long-term period, strengthen the implementation of prevention programs with this drug, as recommended by the national guidelines of the Italian Society of Neonatology. Proceedings of the 11 th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy) · October 26 th -31 st , 2015 · From the womb to the adult Guest Editors: Vassilios Fanos (Cagliari, Italy), Michele Mussap (Genoa, Italy), Antonio Del Vecchio (Bari, Italy), Bo Sun (Shanghai, China), Dorret I. Boomsma (Amsterdam, the Netherlands), Gavino Faa (Cagliari, Italy), Antonio Giordano (Philadelphia, USA)","PeriodicalId":51914,"journal":{"name":"Journal of Pediatric and Neonatal Individualized Medicine","volume":"4 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2015-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71290398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. D. Renzo, E. Picchiassi, G. Coata, G. Clerici, E. Brillo
The placenta has traditionally been considered as an asexual organ. Thus, most of the studies focusing on the placenta have not taken the sex of the embryo into account. However, as trophoblast cells originate from the embryo, they reflect fetal sex as either XX or XY, allowing for possible sex differences in placental biochemistry, function, and signaling. The placenta is a temporary organ performing the functions of many adult organs for the growing fetus. The placenta plays a key role in fetal growth and development, it is designed for exchange of oxygen, nutrients, antibodies, hormonal compounds and waste products between the mother and fetus and may carry significant information about the pregnancy. The placenta is considered also a major endocrine organ being responsible for synthesizing vast quantities of hormones and cytokines that have important effects on both maternal and fetal physiology. The investigation of placenta and its functions helps to identify molecular mechanisms that have both early- and long-term effects on health of the fetus. Gender differences were observed in the placenta at multiple levels: epigenetic modifications of DNA, gene expression, protein expression and immune function. Proceedings of the 11 th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy) · October 26 th -31 st , 2015 · From the womb to the adult Guest Editors: Vassilios Fanos (Cagliari, Italy), Michele Mussap (Genoa, Italy), Antonio Del Vecchio (Bari, Italy), Bo Sun (Shanghai, China), Dorret I. Boomsma (Amsterdam, the Netherlands), Gavino Faa (Cagliari, Italy), Antonio Giordano (Philadelphia, USA)
传统上，胎盘被认为是无性器官。因此，大多数关于胎盘的研究都没有考虑到胚胎的性别。然而，由于滋养细胞起源于胚胎，它们反映胎儿性别为XX或XY，因此在胎盘生化、功能和信号传导方面可能存在性别差异。胎盘是一个临时器官，为正在发育的胎儿执行许多成人器官的功能。胎盘在胎儿的生长发育中起着关键作用，它被设计用于在母亲和胎儿之间交换氧气、营养物质、抗体、激素化合物和废物，并可能携带有关妊娠的重要信息。胎盘也被认为是一个主要的内分泌器官，负责合成大量的激素和细胞因子，这些激素和细胞因子对母体和胎儿的生理都有重要影响。胎盘及其功能的研究有助于确定对胎儿健康有早期和长期影响的分子机制。在胎盘中观察到多个层面的性别差异:DNA的表观遗传修饰、基因表达、蛋白质表达和免疫功能。第11届国际新生儿学与卫星会议会议记录·卡利亚里(意大利)·2015年10月26日-31日·从子宫到成人客座编辑:Vassilios Fanos(意大利卡利亚里)，Michele Mussap(意大利热那亚)，Antonio Del Vecchio(意大利巴里)，Bo Sun(中国上海)，Dorret I. Boomsma(荷兰阿姆斯特丹)，Gavino Faa(意大利卡利亚里)，Antonio Giordano(美国费城)
{"title":"Is there a sex of the placenta","authors":"G. D. Renzo, E. Picchiassi, G. Coata, G. Clerici, E. Brillo","doi":"10.7363/040246","DOIUrl":"https://doi.org/10.7363/040246","url":null,"abstract":"The placenta has traditionally been considered as an asexual organ. Thus, most of the studies focusing on the placenta have not taken the sex of the embryo into account. However, as trophoblast cells originate from the embryo, they reflect fetal sex as either XX or XY, allowing for possible sex differences in placental biochemistry, function, and signaling. The placenta is a temporary organ performing the functions of many adult organs for the growing fetus. The placenta plays a key role in fetal growth and development, it is designed for exchange of oxygen, nutrients, antibodies, hormonal compounds and waste products between the mother and fetus and may carry significant information about the pregnancy. The placenta is considered also a major endocrine organ being responsible for synthesizing vast quantities of hormones and cytokines that have important effects on both maternal and fetal physiology. The investigation of placenta and its functions helps to identify molecular mechanisms that have both early- and long-term effects on health of the fetus. Gender differences were observed in the placenta at multiple levels: epigenetic modifications of DNA, gene expression, protein expression and immune function. Proceedings of the 11 th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy) · October 26 th -31 st , 2015 · From the womb to the adult Guest Editors: Vassilios Fanos (Cagliari, Italy), Michele Mussap (Genoa, Italy), Antonio Del Vecchio (Bari, Italy), Bo Sun (Shanghai, China), Dorret I. Boomsma (Amsterdam, the Netherlands), Gavino Faa (Cagliari, Italy), Antonio Giordano (Philadelphia, USA)","PeriodicalId":51914,"journal":{"name":"Journal of Pediatric and Neonatal Individualized Medicine","volume":"4 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2015-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71290585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The complexity of care needs that characterize economically advanced societies requires a systemic approach to the organization of health services so as to enable them to meet the diverse health needs of the population, in line with their economic sustainability. The proper functioning of the service network is related to the ability to change our way of thinking and to the development of health services by adapting them to the rapid and profound changes characterizing the social fabric. The current organization of the maternity facilities network in Italy shows strong regional differences and raises many concerns when we analyze the data in the tenth Report on Births in Italy, prepared by the Statistics Office with 2011 data from the information flow of the Certificate of Attendance at Childbirth (CeDAP). This survey is the richest national source of health, epidemiological, and socio-demographic information on births, and therefore represents a very important tool for health planning, at both a national and, especially, a regional level Proceedings of the 11 th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy) · October 26 th -31 st , 2015 · From the womb to the adult Guest Editors: Vassilios Fanos (Cagliari, Italy), Michele Mussap (Genoa, Italy), Antonio Del Vecchio (Bari, Italy), Bo Sun (Shanghai, China), Dorret I. Boomsma (Amsterdam, the Netherlands), Gavino Faa (Cagliari, Italy), Antonio Giordano (Philadelphia, USA) .
{"title":"Births in Italy: a neonatologist’s view","authors":"R. Agostiniani","doi":"10.7363/040221","DOIUrl":"https://doi.org/10.7363/040221","url":null,"abstract":"The complexity of care needs that characterize economically advanced societies requires a systemic approach to the organization of health services so as to enable them to meet the diverse health needs of the population, in line with their economic sustainability. The proper functioning of the service network is related to the ability to change our way of thinking and to the development of health services by adapting them to the rapid and profound changes characterizing the social fabric. The current organization of the maternity facilities network in Italy shows strong regional differences and raises many concerns when we analyze the data in the tenth Report on Births in Italy, prepared by the Statistics Office with 2011 data from the information flow of the Certificate of Attendance at Childbirth (CeDAP). This survey is the richest national source of health, epidemiological, and socio-demographic information on births, and therefore represents a very important tool for health planning, at both a national and, especially, a regional level Proceedings of the 11 th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy) · October 26 th -31 st , 2015 · From the womb to the adult Guest Editors: Vassilios Fanos (Cagliari, Italy), Michele Mussap (Genoa, Italy), Antonio Del Vecchio (Bari, Italy), Bo Sun (Shanghai, China), Dorret I. Boomsma (Amsterdam, the Netherlands), Gavino Faa (Cagliari, Italy), Antonio Giordano (Philadelphia, USA) .","PeriodicalId":51914,"journal":{"name":"Journal of Pediatric and Neonatal Individualized Medicine","volume":"4 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2015-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71290176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Filippa, R. Frassoldati, G. Talucci, F. Ferrari
Preterm infants are at greater risk for long-term morbidities, a problem representing also a growing public health concern. Early experiences can affect infants’ brain development, especially if conducted during critical periods of important growth. Early interventions involving parents in preterm infants care improve developmental outcomes for preterm infants, minimizing also the stress of the Neonatal Intensive Care Unit (NICU) environment. Mother-infant separation and alteration of maternal care soon after birth can lead to a wide array of adverse physiological, emotional and behavioural consequences that can persist throughout life. It’s suggested that Maternal Vocal Intervention (MVI) in NICU, as a specific form of environmental and interactional enrichment, as part of an individualized care and as a tool to involve families in early care of preterm infants, may be adopted by the health community as a standard of care.
{"title":"Mothers singing and speaking to preterm infants in NICU","authors":"M. Filippa, R. Frassoldati, G. Talucci, F. Ferrari","doi":"10.7363/040238","DOIUrl":"https://doi.org/10.7363/040238","url":null,"abstract":"Preterm infants are at greater risk for long-term morbidities, a problem representing also a growing public health concern. Early experiences can affect infants’ brain development, especially if conducted during critical periods of important growth. Early interventions involving parents in preterm infants care improve developmental outcomes for preterm infants, minimizing also the stress of the Neonatal Intensive Care Unit (NICU) environment. Mother-infant separation and alteration of maternal care soon after birth can lead to a wide array of adverse physiological, emotional and behavioural consequences that can persist throughout life. It’s suggested that Maternal Vocal Intervention (MVI) in NICU, as a specific form of environmental and interactional enrichment, as part of an individualized care and as a tool to involve families in early care of preterm infants, may be adopted by the health community as a standard of care.","PeriodicalId":51914,"journal":{"name":"Journal of Pediatric and Neonatal Individualized Medicine","volume":"4 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2015-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71290495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nutrition plays a major role in maternal and child health and it is widely recognized that optimum nutrition in early life is the foundation for long-term health. A healthy maternal dietary pattern, along with adequate maternal body composition, metabolism and placental nutrient supply, reduces the risk of maternal, fetal and long-term effects in the offspring. While undernutrition is mainly an issue of low-income countries, malnutrition, due to poor quality diet, is becoming a global health problem.Preconceptional counseling of women of childbearing age should spread awareness of the importance of maternal nutrition before and during pregnancy and should promote a cultural lifestyle change, in favor of a healthy weight before conceiving and balanced healthy diet with high-quality foods consumption. Supplementation and/or fortification can make a contribution when recommended micronutrient intakes are difficult to be met through food alone. In industrialized countries, although a balanced diet is generally accessible, a switch to a high-fat and low-quality diet has led to inadequate vitamin and mineral intake during pregnancy. Evidence do not support a routine multiple micronutrient supplementation but highlights the importance of an individualized approach, in order to recognize nutritional deficiencies of individuals, thus leading to healthful dietary practices prior to conception and eventually to tailored supplementation. Proceedings of the 11th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy) · October 26th-31st, 2015 · From the womb to the adultGuest Editors: Vassilios Fanos (Cagliari, Italy), Michele Mussap (Genoa, Italy), Antonio Del Vecchio (Bari, Italy), Bo Sun (Shanghai, China), Dorret I. Boomsma (Amsterdam, the Netherlands), Gavino Faa (Cagliari, Italy), Antonio Giordano (Philadelphia, USA)
营养在孕产妇和儿童健康中起着重要作用，人们普遍认识到，生命早期的最佳营养是长期健康的基础。健康的产妇饮食模式，加上适当的产妇身体组成、新陈代谢和胎盘营养供应，可减少对产妇、胎儿和后代的长期影响的风险。虽然营养不足主要是低收入国家的问题，但由于饮食质量差而导致的营养不良正在成为一个全球性的健康问题。对育龄妇女的孕前咨询应传播对孕前和孕期孕产妇营养重要性的认识，并应促进文化生活方式的改变，有利于怀孕前的健康体重和均衡的健康饮食和高质量的食物消费。当仅通过食物难以满足推荐的微量营养素摄入量时，补充剂和/或强化可起作用。在工业化国家，虽然均衡的饮食通常是可以获得的，但转向高脂肪和低质量的饮食导致怀孕期间维生素和矿物质摄入不足。证据不支持常规的多种微量营养素补充，但强调了个体化方法的重要性，以便认识到个人的营养缺乏，从而在怀孕前养成健康的饮食习惯，并最终进行量身定制的补充。第11届国际新生儿学与卫星会议论稿·卡利亚里(意大利)·2015年10月26 -31日·从子宫到成人特约编辑:Vassilios Fanos(意大利卡利亚里)，Michele Mussap(意大利热那亚)，Antonio Del Vecchio(意大利巴里)，Bo Sun(中国上海)，Dorret I. Boomsma(荷兰阿姆斯特丹)，Gavino Faa(意大利卡利亚里)，Antonio Giordano(美国费城)
{"title":"The importance of maternal nutrition for health","authors":"I. Cetin, A. Laoreti","doi":"10.7363/040220","DOIUrl":"https://doi.org/10.7363/040220","url":null,"abstract":"Nutrition plays a major role in maternal and child health and it is widely recognized that optimum nutrition in early life is the foundation for long-term health. A healthy maternal dietary pattern, along with adequate maternal body composition, metabolism and placental nutrient supply, reduces the risk of maternal, fetal and long-term effects in the offspring. While undernutrition is mainly an issue of low-income countries, malnutrition, due to poor quality diet, is becoming a global health problem.Preconceptional counseling of women of childbearing age should spread awareness of the importance of maternal nutrition before and during pregnancy and should promote a cultural lifestyle change, in favor of a healthy weight before conceiving and balanced healthy diet with high-quality foods consumption. Supplementation and/or fortification can make a contribution when recommended micronutrient intakes are difficult to be met through food alone. In industrialized countries, although a balanced diet is generally accessible, a switch to a high-fat and low-quality diet has led to inadequate vitamin and mineral intake during pregnancy. Evidence do not support a routine multiple micronutrient supplementation but highlights the importance of an individualized approach, in order to recognize nutritional deficiencies of individuals, thus leading to healthful dietary practices prior to conception and eventually to tailored supplementation. Proceedings of the 11th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy) · October 26th-31st, 2015 · From the womb to the adultGuest Editors: Vassilios Fanos (Cagliari, Italy), Michele Mussap (Genoa, Italy), Antonio Del Vecchio (Bari, Italy), Bo Sun (Shanghai, China), Dorret I. Boomsma (Amsterdam, the Netherlands), Gavino Faa (Cagliari, Italy), Antonio Giordano (Philadelphia, USA)","PeriodicalId":51914,"journal":{"name":"Journal of Pediatric and Neonatal Individualized Medicine","volume":"4 1","pages":"1-11"},"PeriodicalIF":0.4,"publicationDate":"2015-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71290162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maternal nutrition during pregnancy and lactation influences the growth and potential development of the fetus and contributes to the maturity of a healthy baby. The lack of sufficient calories, of macro- and micronutrients, can lead to deficiencies in building materials for the development and growth of the fetus: moreover there is growing evidence that the maternal nutritional status can alter the epigenetic state of the fetal genome, therefore alterations in nutrition during crucial periods of fetal development may result in developmental adaptations that permanently change the physiology, the metabolism of the offspring, and, as a consequence, predispose these individuals to diseases as adults. In this review we collected indications for the recommended intake of calories and nutrients for a healthy diet during pregnancy and lactation, also analyzing some nutritional choices that may increase the risk of nutritional deficiencies and the way to prevent them. Pregnancy-related dietary changes should begin prior to conception, with appropriate modifications throughout pregnancy and lactation, and appropriate supplementation of vitamins and minerals. Proceedings of the 11 th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy) · October 26 th -31 st , 2015 · From the womb to the adult Guest Editors: Vassilios Fanos (Cagliari, Italy), Michele Mussap (Genoa, Italy), Antonio Del Vecchio (Bari, Italy), Bo Sun (Shanghai, China), Dorret I. Boomsma (Amsterdam, the Netherlands), Gavino Faa (Cagliari, Italy), Antonio Giordano (Philadelphia, USA)
孕期和哺乳期母亲的营养影响胎儿的生长和潜在发育，有助于健康婴儿的成熟。缺乏足够的热量、宏量营养素和微量营养素会导致胎儿发育和生长所需的建筑材料不足。此外，越来越多的证据表明，母亲的营养状况可以改变胎儿基因组的表观遗传状态，因此，在胎儿发育的关键时期，营养的改变可能导致发育适应，从而永久改变后代的生理和新陈代谢，并因此使这些个体在成年后易患疾病。在这篇综述中，我们收集了孕期和哺乳期健康饮食中推荐摄入的卡路里和营养素的适应症，并分析了一些可能增加营养缺乏风险的营养选择和预防方法。与怀孕有关的饮食改变应在怀孕前开始，在整个怀孕和哺乳期间进行适当的修改，并适当补充维生素和矿物质。第11届国际新生儿学与卫星会议会议记录·卡利亚里(意大利)·2015年10月26日-31日·从子宫到成人客座编辑:Vassilios Fanos(意大利卡利亚里)，Michele Mussap(意大利热那亚)，Antonio Del Vecchio(意大利巴里)，Bo Sun(中国上海)，Dorret I. Boomsma(荷兰阿姆斯特丹)，Gavino Faa(意大利卡利亚里)，Antonio Giordano(美国费城)
{"title":"Nutrition in pregnancy and lactation: how a healthy infant is born","authors":"F. Mecacci, Sara Biagioni, S. Ottanelli, G. Mello","doi":"10.7363/040236","DOIUrl":"https://doi.org/10.7363/040236","url":null,"abstract":"Maternal nutrition during pregnancy and lactation influences the growth and potential development of the fetus and contributes to the maturity of a healthy baby. The lack of sufficient calories, of macro- and micronutrients, can lead to deficiencies in building materials for the development and growth of the fetus: moreover there is growing evidence that the maternal nutritional status can alter the epigenetic state of the fetal genome, therefore alterations in nutrition during crucial periods of fetal development may result in developmental adaptations that permanently change the physiology, the metabolism of the offspring, and, as a consequence, predispose these individuals to diseases as adults. In this review we collected indications for the recommended intake of calories and nutrients for a healthy diet during pregnancy and lactation, also analyzing some nutritional choices that may increase the risk of nutritional deficiencies and the way to prevent them. Pregnancy-related dietary changes should begin prior to conception, with appropriate modifications throughout pregnancy and lactation, and appropriate supplementation of vitamins and minerals. Proceedings of the 11 th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy) · October 26 th -31 st , 2015 · From the womb to the adult Guest Editors: Vassilios Fanos (Cagliari, Italy), Michele Mussap (Genoa, Italy), Antonio Del Vecchio (Bari, Italy), Bo Sun (Shanghai, China), Dorret I. Boomsma (Amsterdam, the Netherlands), Gavino Faa (Cagliari, Italy), Antonio Giordano (Philadelphia, USA)","PeriodicalId":51914,"journal":{"name":"Journal of Pediatric and Neonatal Individualized Medicine","volume":"4 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2015-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71290475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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