Prenatal therapy with magnesium sulphate and intestinal obstruction due to meconium in preterm newborns.

INTRODUCTION: Magnesium sulphate (MgSO4) therapy has shown to be useful as a neurological protector in the preterm newborn below 32 weeks of gestation. The most documented adverse effect is cardiorespiratory failure, whereas its relationship with meconium obstruction is controversial. The main objective of this study was to analyse the possible association between prenatal MgSO4 therapy and meconium obstruction. PATIENTS AND METHODS: An analytical retrospective study was conducted on <32 weeks preterm babies admitted to a tertiary-level hospital (January 2016-December 2017). Epidemiological, prenatal and postnatal data on the outcomes were obtained, analysed and compared in both groups (exposed to MgSO4 and not exposed). RESULTS: The study included 201 patients (146 exposed and 55 non-exposed). There were no significant differences in the mean gestational age (28.4 ±â€¯2.2 vs. 28.7 ±â€¯2.8 weeks, respectively), or in the rest of epidemiological and perinatal variables. Prenatal corticosteroid therapy was more frequent in the MgSO4 group (75.9 vs. 53.7%; p = .002), and in the non-exposed group there were more multiple pregnancies (52.7 vs. 36.6%; p = .027), and female gender (56.4 vs. 37%; p = .013). There were no statistically significant differences in the presence of meconium obstruction (75.9% in exposed vs. 67.3% in non-exposed; p = .23), although repeated rectal stimulation was more frequent in the exposed group (43.2 vs. 27.9%; p = .08). Furthermore, there were no significant differences in the main cardiorespiratory variables: 1-min Apgar score (6.2 in MgSO4- exposed vs. 5.6 in non-exposed; p = .75), 5-min Apgar score (7.9 vs. 7.6; p = .31), advanced newborn resuscitation (26 vs. 31.5%; p = .44), maximum FiO2 (45.5 vs. 48; p = .58), and initial inotropic requirements (10.3 vs. 20.8%; p = .55). CONCLUSIONS: This study found no correlations between MgSO4 therapy and meconium obstruction or cardiorespiratory failure.

Terapia prenatal con sulfato de magnesio y obstrucción intestinal por meconio en recién nacidos pretérmino / Prenatal therapy with magnesium sulphate and intestinal obstruction due to meconium in preterm newborns

Introducción: El sulfato de magnesio (SMg) ha demostrado eficacia como neuroprotector en pretérminos < 32 semanas. Su efecto adverso más documentado es la depresión cardiorrespiratoria, siendo dudosa su relación con la obstrucción meconial. El objetivo principal del estudio es analizar la posible asociación entre el SMg antenatal y la obstrucción meconial. Pacientes y métodos: Estudio retrospectivo analítico, de neonatos < 32 semanas de edad gestacional ingresados en un hospital terciario (enero del 2016 a diciembre del 2017). Se recogieron datos epidemiológicos, perinatales y de evolución posnatal, comparando expuestos y no expuestos a SMg. Resultados: Se incluyeron 201 pacientes (146 recibieron SMg y 55 no). No existieron diferencias en la edad gestacional media (28,4 ± 2,2 vs. 28,7 ± 2,8 semanas, respectivamente), ni en el resto de variables epidemiológicas y perinatales, salvo en expuestos, la administración más frecuente de corticoides antenatales (75,9 vs. 53,7%; p = 0,002), y en no expuestos el parto múltiple (52,7 vs. 36,6%; p = 0,027), y el sexo femenino (56,4 vs. 37%; p = 0,013). No hubo diferencias significativas en la obstrucción meconial (75,9% expuestos vs. 67,3% no expuestos; p = 0,23), aunque la estimulación rectal repetida fue más frecuente en el grupo tratado (43,2 vs. 27,9%; (p = 0,08). Tampoco hubo diferencias en las principales variables de depresión cardiorrespiratoria: Apgar al primer minuto 6,2 vs. 5,6 en expuestos y no expuestos, respectivamente (p = 0,75) y a los cinco minutos 7,9 vs. 7,6 (p = 0,31), reanimación avanzada 26 vs. 31,5% (p = 0,44), FiO2 máxima 45,5 vs. 48 (p = 0,58) y necesidad inicial de inotrópicos 10,3 vs. 20,8% (p = 0,55). Conclusiones: El presente estudio no halló asociación entre la administración de SMg y la obstrucción meconial o la depresión cardiorrespiratoria. (AU)

Introduction: Magnesium sulphate (MgSO4) therapy has shown to be useful as a neurological protector in the preterm newborn below 32 weeks of gestation. The most documented adverse effect is cardiorespiratory failure, whereas its relationship with meconium obstruction is controversial. The main objective of this study was to analyse the possible association between prenatal MgSO4 therapy and meconium obstruction. Patients and methods: An analytical retrospective study was conducted on < 32 weeks preterm babies admitted to a tertiary-level hospital (January 2016-December 2017). Epidemiological, prenatal and postnatal data on the outcomes were obtained, analysed and compared in both groups (exposed to MgSO4 and not exposed). Results: The study included 201 patients (146 exposed and 55 non-exposed). There were no significant differences in the mean gestational age (28.4 ± 2.2 vs. 28.7 ± 2.8 weeks, respectively), or in the rest of epidemiological and perinatal variables. Prenatal corticosteroid therapy was more frequent in the MgSO4 group (75.9 vs. 53.7%; p = .002), and in the non-exposed group there were more multiple pregnancies (52.7 vs. 36.6%; p = .027), and female gender (56.4 vs. 37%; p = .013). There were no statistically significant differences in the presence of meconium obstruction (75.9% in exposed vs. 67.3% in non-exposed; p = .23), although repeated rectal stimulation was more frequent in the exposed group (43.2 vs. 27.9%; p = .08). Furthermore, there were no significant differences in the main cardiorespiratory variables: 1-minute Apgar score (6.2 in MgSO4- exposed vs. 5.6 in non-exposed; p = .75), 5-minutes Apgar score (7.9 vs. 7.6; p = .31), advanced newborn resuscitation (26 vs. 31.5%; p = .44), maximum FiO2 (45.5 vs. 48; p = .58), and initial inotropic requirements (10.3 vs. 20.8%; p = .55). Conclusions: This study found no correlations between MgSO4 therapy and meconium obstruction or cardiorespiratory failure. (AU)

Skin Barrier Function in Psoriasis and Atopic Dermatitis: Transepidermal Water Loss and Temperature as Useful Tools to Assess Disease Severity.

Multiple diagnostic tools are used to evaluate psoriasis and atopic dermatitis (AD) severity, but most of them are based on subjective components. Transepidermal water loss (TEWL) and temperature are skin barrier function parameters that can be objectively measured and could help clinicians to evaluate disease severity accurately. Thus, the aims of this study are: (1) to compare skin barrier function between healthy skin, psoriatic skin and AD skin; and (2) to assess if skin barrier function parameters could predict disease severity. A cross-sectional study was designed, and epidermal barrier function parameters were measured. The study included 314 participants: 157 healthy individuals, 92 psoriatic patients, and 65 atopic dermatitis patients. TEWL was significantly higher, while stratum corneum hydration (SCH) (8.71 vs. 38.43 vs. 44.39 Arbitrary Units (AU)) was lower at psoriatic plaques than at uninvolved psoriatic skin and healthy controls. Patients with both TEWL > 13.85 g·m-2h-1 and temperature > 30.85 °C presented a moderate/severe psoriasis (psoriasis area severity index (PASI) ≥ 7), with a specificity of 76.3%. TEWL (28.68 vs. 13.15 vs. 11.60 g·m-2 h-1) and temperature were significantly higher, while SCH (25.20 vs. 40.95 vs. 50.73 AU) was lower at AD eczematous lesions than uninvolved AD skin and healthy controls. Patients with a temperature > 31.75 °C presented a moderate/severe AD (SCORing Atopic Dermatitis (SCORAD) ≥ 37) with a sensitivity of 81.8%. In conclusion, temperature and TEWL values may help clinicians to determine disease severity and select patients who need intensive treatment.

[Prenatal therapy with magnesium sulphate and intestinal obstruction due to meconium in preterm newborns]. / Terapia prenatal con sulfato de magnesio y obstrucción intestinal por meconio en recién nacidos pretérmino.

INTRODUCTION: Magnesium sulphate (MgSO4) therapy has shown to be useful as a neurological protector in the preterm newborn below 32 weeks of gestation. The most documented adverse effect is cardiorespiratory failure, whereas its relationship with meconium obstruction is controversial. The main objective of this study was to analyse the possible association between prenatal MgSO4 therapy and meconium obstruction. PATIENTS AND METHODS: An analytical retrospective study was conducted on < 32 weeks preterm babies admitted to a tertiary-level hospital (January 2016-December 2017). Epidemiological, prenatal and postnatal data on the outcomes were obtained, analysed and compared in both groups (exposed to MgSO4 and not exposed). RESULTS: The study included 201 patients (146 exposed and 55 non-exposed). There were no significant differences in the mean gestational age (28.4 ± 2.2 vs. 28.7 ± 2.8 weeks, respectively), or in the rest of epidemiological and perinatal variables. Prenatal corticosteroid therapy was more frequent in the MgSO4 group (75.9 vs. 53.7%; p = .002), and in the non-exposed group there were more multiple pregnancies (52.7 vs. 36.6%; p = .027), and female gender (56.4 vs. 37%; p = .013). There were no statistically significant differences in the presence of meconium obstruction (75.9% in exposed vs. 67.3% in non-exposed; p = .23), although repeated rectal stimulation was more frequent in the exposed group (43.2 vs. 27.9%; p = .08). Furthermore, there were no significant differences in the main cardiorespiratory variables: 1-minute Apgar score (6.2 in MgSO4- exposed vs. 5.6 in non-exposed; p = .75), 5-minutes Apgar score (7.9 vs. 7.6; p = .31), advanced newborn resuscitation (26 vs. 31.5%; p = .44), maximum FiO2 (45.5 vs. 48; p = .58), and initial inotropic requirements (10.3 vs. 20.8%; p = .55). CONCLUSIONS: This study found no correlations between MgSO4 therapy and meconium obstruction or cardiorespiratory failure.