ABSTRACT
Preterm neonates are at high risk of infectious and inflammatory diseases which require antibiotic treatment. Antibiotics influence neonatal gut microbiome development, and intestinal dysbiosis has been associated with delayed gastrointestinal transit. Neonates who take less time to pass meconium have a better tolerance to enteral feeding. We analyzed the effect of neonatal antibiotic treatment on the stool pattern and oral tolerance in 106 preterm infants < 33 weeks gestational age. Neonates were classified in 3 groups according to neonatal antibiotic (ABT) treatment days: no antibiotics, 3−7 d ABT, and ≥8 d ABT. Preterm infants from the ≥8 d ABT group took longer to pass meconium and to start green and yellow stools, took longer to reach 100 and 150 mL/kg/day, and reached reduced volumes in enteral feeds at day of life 14 and 28 than infants from no ABT and 3−7 d ABT groups. Multiple linear regression models showed that neonatal antibiotic treatment, birth weight, invasive mechanical ventilation, surfactant, enteral feeding start day, neonatal parenteral nutrition, and neonatal fasting days are associated with the stool pattern and oral tolerance in preterm infants.
ABSTRACT
Resumen Antecedentes: La ventilación mecánica continúa siendo una herramienta esencial en el cuidado de los recién nacidos prematuros. Hay evidencia de que la ventilación limitada por volumen (VLV) tiene ventajas sobre ventilación limitada por presión (VLP). Objetivo: Determinar la evolución clínica y gasométrica en los recién nacidos pretérmino en VLV en comparación con VLP. Material y métodos: Fue una investigación observacional y analítica en una unidad de cuidados intensivos neonatales, donde se incluyeron 80 recién nacidos ≤ 32 semanas de gestación y ≤ 1,000 g al nacimiento divididos en dos grupos. Resultados: Se observó diferencia estadísticamente significativa en días de ventilación, favoreciendo a VLV (p = 0.002); en las variables hipoxemia e hipocarbia, que son directamente afectadas por el modo ventilatorio, se encontró menor grado de afectación en VLV pero sin diferencia estadística. Se encontró en el grupo de pacientes con VLV menor acidosis respiratoria (p = 0.05) y menor requerimiento de fracción inspirada de oxígeno (FIO2) (p = 0.04). Conclusión: Al igual que la literatura, nuestros resultados comprueban beneficios como disminución de días de ventilación, disminución de acidosis y necesidades menores de FIO2 con el uso de VLV.
Abstract Background: Mechanical ventilation continues to be an essential tool in the care of premature newborns, there is evidence that volume-limited ventilation (VLV) has advantages over pressure-limited ventilation (VLP). Objective: To determine the clinical and gasometric evolution in newborns I preterm VLV compared to VLP. Material and methods: It was an observational and analytical research in a neonatal intensive care unit, where 80 newborns were included ≤ 32 weeks of gestation and ≤ 1000 grams at birth divided into two groups. Results: Statistically significant difference was observed in ventilation days, favouring VLV (p=0.002); in hypoxemia and hypocarbia variables, which are directly affected by ventilatory mode, lower degree of affection was found in VLV but without statistical difference. It was found in the group of patients with VLV lower respiratory acidosis (p=0.05), and lower FIO2 requirements (p=0.04). Conclusion: Like literature, our results prove benefits such as decreased ventilation days, decreased acidosis and lower needs of FIO2 with the use of VLV.
Subject(s)
Biomarkers, Tumor/genetics , Carcinoma in Situ/genetics , Melanoma/genetics , Mutation , Promoter Regions, Genetic , Skin Neoplasms/genetics , Telomerase/genetics , Carcinoma in Situ/classification , Carcinoma in Situ/pathology , Humans , Melanoma/classification , Melanoma/pathology , Prognosis , Skin Neoplasms/classification , Skin Neoplasms/pathologyABSTRACT
The use of NGS in clinical practice for precision diagnosis requires a quality starting material. Despite the broadly established use of formalin-fixed paraffin-embedded (FFPE) samples in molecular testing, these usually have low-quality DNA. We established a method to determine the suitability of melanoma FFPE samples for an amplicon-based NGS custom panel analysis. DNA was extracted from unstained melanoma samples and wide local excision samples. Amplicon-based libraries were constructed and tested using time and quality parameters as variables. Time elapsed from sample retrieval >7 years, a quality control value > 5.63 and a DNA integrity value < 2.05 indicated samples were not suitable. A decision tree is provided with rate of samples suitable for analysis according to the combination of these parameters.
