Leukotrienes, free oxygen radicals, tumor necrosis factor‐alpha, and inflammatory mediators play major roles in the development of necrotizing enterocolitis (NEC). Rhus coriaria (RC: sumac) extracts may enhance cell viability by reinforcing defenses against free radical species in several progressive diseases as well as inflammatory diseases. The aim of the present study was to evaluate the effects of RC in a rat NEC model in terms of intestinal damage. Newborn pups were separated into three groups: control, NEC, and NEC treated with RC. Mortality and clinical sickness scores were evaluated. At the end of the study, ileum and proximal colon were obtained from all rats and histopathological and immunohistochemical studies were performed. In this study, the anti‐inflammatory, antioxidant, immunomodulatory, and anti‐apoptotic activities of RC were demonstrated in a rat NEC model, which suggests RC as a promising treatment option for preventing intestinal tissue damage. Practical applications Free oxygen radicals, tumor necrosis factor‐alpha, and inflammatory mediators play major roles in the development of NEC. Intestinal tissue damage is caused by necrosis and apoptosis as a result of intestinal inflammation and release of pro‐inflammatory cytokines. Anti‐inflammatory, antioxidant, immunomodulatory, and anti‐apoptotic activities of RC are especially due to its phenolic compounds. In this study, the anti‐inflammatory, antioxidant, immunomodulatory, and anti‐apoptotic activities of RC were demonstrated in a rat NEC model. RC can suggest as a new treatment option for preventing intestinal injury.
Background: Infants fed breast milk are known to have lower rates of childhood obesity. However, there is evidence suggesting an increased risk of obesity in infants who receive milk from a diabetic mother. The aim of this study was to investigate the calorie and macronutrient content of colostrum in mothers with gestational diabetes mellitus (GDM). Methods: This prospective, controlled study included mothers who had diagnosis of GDM and a control group of mothers without GDM who delivered at term. Colostrum samples were analyzed for macronutrients (fat, protein, and carbohydrate) and calorie content using a human milk analyzer (Miris, Uppsala, Sweden). Results: A total of 92 colostrum samples were analyzed, 31 in the GDM group and 61 in the non-GDM group. The carbohydrate content of colostrum in the GDM group was higher compared with the non-GDM group (p = 0.004). The calorie, fat, and protein contents of colostrum were similar between the groups (p > 0.05). Multiple regression analysis indicated that having GDM was significantly related to carbohydrate content. Conclusion: The colostrum of GDM mothers had higher carbohydrate content. This might be one of the factors explaining the relationship between diabetic breast milk and infantile obesity.
Pulse oximetry is commonly used to monitor arterial oxygen saturation and heart rate during the transition period and reference intervals have been determined. However, the effect of the change in arterial oxygen saturation on tissue oxygenation does not seem to be the same. So, a non-invasive method for monitoring cerebral or regional tissue oxygenation will be potentially useful for vulnerable infants. This study aims to evaluate the effectiveness of cerebral autoregulation in the first 10 min after delivery in term and late preterm newborns without resuscitation requirement. Cerebral tissue oxygen saturation was measured in the first 10 min after birth with near-infrared spectroscopy (NIRS) from the left forehead. Peripheral oxygen saturation was measured with pulse oximetry from the right hand and cerebral fractional tissue oxygen extraction was calculated. Nineteen late preterms and 20 term infants were included in the study. There was no statistically significant difference between median cerebral tissue oxygen saturation and cerebral fractional tissue oxygen extraction values of late preterm and term infants (p < 0.001). There was a strong inverse relationship between cerebral tissue oxygen saturation and cerebral fractional tissue oxygen extraction (p < 0.001). In late preterm infants similar to term infants, arterial oxygen saturation and cerebral tissue oxygen saturation increased with time, but inverse reduction of cerebral fractional tissue oxygen extraction showed the presence of an active autoregulation in the brain. This can be interpreted as the ability of the brain to protect itself from hypoxia by regulating oxygen uptake during normal fetal-neonatal transition process. A larger scale multi-center randomized control trial is now needed to further inform practice.
To assess the effects of delayed cord clamping (DCC) at birth on newborns diagnosed with intrauterine growth restriction (IUGR). This prospective, randomized, controlled study included newborns diagnosed with IUGR during pregnancy follow-up and born at a gestational age of ≥28 weeks. Early cord clamping (ECC) was performed immediately after birth, whereas DCC was performed 60 s postdelivery. The ECC and DCC groups were compared based on cord blood and 24-h venous hematocrit levels, polycythemia rates, and clinical complications associated with polycythemia. A total of 96 newborns, 48 in each group, were analyzed. Gestational weeks, birth weight, Apgar score, delivery mode, and maternal features were similar between the groups (P > .05). At 24 h postnatally, hematocrit values were significantly higher in the DCC group (61.27% ± 5.93%) compared to the ECC group (57.42% ± 7.10%) (P = .005). The 24-h polycythemia rate was also higher in the DCC group (31.3% vs. 12.5%, P = .02). Partial exchange transfusion (PET) was required for one neonate in the DCC group (2.1%). The rates of respiratory distress, phototherapy-requiring jaundice, hypoglycemia within the first two days, intensive care admission, and need for close monitoring were similar between the groups (P > .05). In neonates with IUGR, delayed cord clamping for 60 s at birth led to increased venous hematocrit levels and a higher polycythemia rate. Larger studies are warranted to clarify whether DCC influences the need for PET and the frequency or severity of polycythemia-associated clinical complications.