Platelet indices in SGA newborns.

PURPOSE: The current study objective was to compare blood platelet indices in full-term small-for-gestational-age newborns (SGA) and full-term appropriate-for-gestational-age newborns (AGA). MATERIALS/METHODS: We introduced to our study 61 SGA newborns (31 females and 30 males) and 70 eutrophic infants (32 females and 38 males). The SGA newborns were divided into two groups: those weighing less than the 5th centile: 35 infants (16 females and 19 males) and those between the 5th and 10th centiles: 26 infants (15 females and 11 males). Platelet indices were estimated in blood samples collected from the umbilical artery. RESULTS: SGA demonstrated a decreased count of blood platelets (238×103/µ) as compared with AGA (286×103/µL), p=0.0001. Platelet hematocrit (PTC) also showed differences in both groups (SGA=0.19% vs. AGA=0.22%; p=0.0005). Mean platelet volume (MPV) was higher in SGA (8.25fl) as compared with AGA (7.84fl); p=0.008. Large platelet count (LPLT) was higher in AGA 6.26% vs. SGA=4.75%; p=0.01. Platelet distribution width (PDW) was found to be nearly the same (SGA=47%, AGA=46%). PDW was higher in SGA newborns < 5th centile (43%) as compared with SGA infants between the 5th and 10th centiles (52%); p=0.008. CONCLUSIONS: A decreased blood platelet count, platelet hematocrit and large metabolically active platelet count, which in addition to reduced synthesis and excessive consumption of coagulation factors in states of hiperclotting is characteristic of IUGR, enhances the possibility of bleeding complications and increases the risk of infections. From a clinical point of view, it is important to take into consideration the degree of intrauterine hypotrophy during the evaluation of hemostatic disorders.

Does prematurity affect platelet indices?

PURPOSE: The current study objective was to compare blood platelet indices in preterm newborns (PTN) and full term newborns (FTN). MATERIALS AND METHODS: We introduced to our study 51 PTN (25 females, 26 males) and 55 FTN (25 females, 30 males). Platelet indices were estimated in blood samples collected from the umbilical artery. RESULTS: PTN demonstrated a decreased count of blood platelets (197 x 103/microL) as compared to FTN (287 x 103/microL), p=0.0001. Platelet hematocrit (PCT) also showed substantial differences in both groups (PTN=0.16% vs. FTN=0.22%; p=0.001). Mean platelet volume (MPV) was found to be nearly the same (PTN=8.02 fl, FTN=7.79 fl). Platelet distribution width (PDW) was higher in PTN (50.64%) than in FTN (46.54%), p=0.021. Large platelet count (LPLT) was diminished in PTN (5.23%) in comparison with FTN (6.12 %). CONCLUSIONS: A decreased count of blood platelets, platelet hematocrit and increased platelet distribution width may result from a low gestational age or a dysfunction of megakaryocytes and the placenta. Blood platelet indices may be vital in the diagnosis of haemostatic disorders.

Expression of FasR, Fas-L and Bcl-2 in CD4+ and CD8+ subpopulations of T lymphocytes in the cord blood of healthy full-term newborns, is gender of influence?

PURPOSE: The expression of FasR, Fas-L and Bcl-2 on CD4+ and CD8+ T lymphocytes subpopulations from the cord blood were assayed. The results in blood from boys and girls were analyses separately and compared. MATERIAL AND METHODS: Twenty four full-term newborns: 13 females and 11 males were included into the study. Blood from the umbilical vein was collected immediately after cutting the umbilical cord. The staining with monoclonal antibodies against CD4, CD8, FasR, Fas-L and Bcl-2 was performed within 2 hours after collection and followed with flow cytometry acquisition and analysis. RESULTS: The percentage of CD4+ and CD8+ T lymphocytes and CD4+:CD8+ ratio was within normal range. The expression of FasR, Fas-L was higher on CD4+ T lymphocytes than on CD8+ T lymphocytes (10,36% vs 6,79% and 6,66% vs 5,63% respectively). The expression of Bcl-2 was comparable (91,9% and 93,75% respectively). The comparison between males and females showed higher percentage of CD4+ lymphocytes on lymphocytes from girls' blood (56% vs 38,69%, p=0.0003). The expression of FasR and Fas-L on CD4+ T lymphocytes was higher on CD4+ T lymphocytes from girls' blood (13,8% vs 7,53% and 6,8% vs 6,52% respectively) but without statistical significance. Bcl-2 expression was higher on CD4+ T lymphocytes from boys' blood (99,65% vs 89,7%) but without statistical significance. Similar pattern of FasR, Fas-L and Bcl-2 expression was noted on CD8+ T lymphocytes analysed separately for girls' and boys' blood origin cells. The difference in Bcl-2 expression was more prominent than on CD4+ T lymphocytes and reached statistical significance. CONCLUSIONS: The lymphocytes from cord blood of boys showed the more immature immunophenotype than T lymphocytes from cord blood of girls'. Impaired apoptosis (as a consequence of low expression of FasR, Fas-L) in neonatal cells may contribute to prolonged inflammation in newborns after oxidative stress or infection.

Does renal carcinoma affect the expression of P-selectin on platelets?

We studied changes in the expression of P-selectin on the blood platelet plasma membrane. The aim of the study was to determine the influence of renal carcinoma on P-selectin expression associated with changes in platelet morphology. Venous blood was collected from 30 patients with renal carcinoma and from 24 control subjects for cytometric analysis and to evaluate platelet morphology. P-selectin being the CD62P receptor on blood platelets was marked by anti-CD61/62P MoAb, and the results were presented as the percentage of CD62P-positive cells. Changes in the expression of the CD62P on the platelet plasma membrane during activation were investigated by flow cytometry in a comparative study of in vivo activation and in vitro platelet reactivity. Platelet activation reflected by P-selectin expression was higher in the group of patients (4.45 +/-1.96), compared to control (2.48 +/-1.66) (p < 0.05). However, adenosine diphosphate [ADP] -stimulated platelet reactivity in renal cancer patients increased only by 0.24% (p > 0.05), while following activation by thrombin by 0.54% (p < 0.05). Moreover, a higher (4.72 +/-2.02), statistically significant percentage of platelets with P-selectin expression was found in patients with disseminated neoplastic changes in renal parenchyma, compared to patients with a single localized neoplastic lesion (4.17 +/-1.89) (p < 0.05). A statistically significant difference was noted in the platelet count and anisocytosis in renal cancer patients. Renal cancer enhances P-selectin expression. It is due to the presence of intensified thrombinogenesis and other platelet agonists in the blood.

Amlodipine besylate induced acute interstitial nephritis.

Adverse effects of amlodipine besylate, a widely used antihypertensive medication, include peripheral edema, flushing, headache, pruritus, and rash. An adverse renal effect attributable to the medication has hitherto not been reported in the literature. We herein report a case of amlodipine besylate induced acute interstitial nephritis.

[The phenotype characteristics of cord blood lymphocytes in premature neonates]. / Ekspresja receptorów powierzchniowych na limfocytach krwi pepowinowej wczesniaków.

It has been observed high risk of infections in neonates as a result from lymphocytes immaturity. It is connected to phenotype differences of lymphocytes between neonates and adults. This high susceptibility to infections is especially high in premature neonates. With the use of flow cytometry we have evaluated the phenotype of cord blood lymphocytes in premature neonates. In comparison to results of healthy newborns we have observed significant decrease in CD7+, CD3+, CD4+, CD25+, CD57+ lymphocytes an increase in total number of CD8+ cells as well as alteration in CD4/CD8 ratio. Our results suggest deeply damage of cellular immunity in preterm infants.

The concentration of alpha 1-antitrypsin in the maternal serum after delivery of normal and small for gestational age infants.

BACKGROUND: alpha 1-antitrypsin (A-1-AT) is an acute-phase protein. It is present in plasma and other extracellular fluids and in human trophoblastic tissue. It accounts for 80 to 90 per cent of antiprotease reactions occurring in plasma. It has the ability to greatly affect enzyme activity and plays an important role in immunomodulatory processes. MATERIALS AND METHODS: The purpose of the study was to determine the plasma concentration of A-1-AT in mothers giving birth to hypotrophic (small for gestational age, SGA), and eutrophic (appropriate for gestational age, AGA) infants. 33 women who gave birth to SGA infants and 36 women who gave birth to AGA infants participated in the study. The control group consisted of 30 non-pregnant women who were of reproductive age. All women gave birth at term. To measure A-1-AT concentration, we used the diffusion method described by Mancini et al. RESULTS: The highest concentration of A-1-AT (379 mg/dl) was found in women giving birth to SGA infants, compared with 345 mg/dl for women giving birth to AGA infants. In the control group, the concentration was found to be 270 mg/dl. CONCLUSIONS: Statistical analysis of the results showed a significant difference between the two groups of women gave birth and between each parturient compared with control subjects. Increasing concentration of A-1-AT in the plasma of women in labor may be the result of an acute phase reaction triggered by the stress during parturition. Additionally, increased concentrations of A-1-AT in women who gave birth to SGA rather than AGA infants suggest that it may play a role in the processes of intrauterine growth retardation (IUGR).

[Levels of alpha-2-macroglobulin in blood serum of women giving birth to hypotrophic and eutrophic newborns]. / Stezenie alfa-2-makroglobuliny w surowicy krwi kobiet rodzacych noworodki hipotroficzne i eutroficzne.

We tested the concentration of alpha-2-macroglobulin in sera of 33 women bearing eutrophic newborns, 36 women bearing hypotrophic newborns and 30 healthy not pregnant women in reproductive age. The concentration of this inhibitor was measured using radial immunodiffusion method according to Mancini et al. We found distinct decrease of alpha-2-macroglobulin concentration in sera of bearing women. In women bearing eutrophic newborns we found 154 mg/dl, in women bearing hypo-trophic newborns 171 mg/dl whereas in controls 250 mg/dl. We have noted statistically significant differences between tested groups to controls and between investigated groups. Taking under consideration the role of alpha-2-macroglobulin as the modulator of immune system as well as the activity of several cytokins, therefore one can suppose that alpha-2-M may affect on cellular growth developed foetus in intrauterine.

[The concentration of alpha-2-antiplasmin in sera of women in post partum]. / Stezenie alfa-2-antyplazminy w surowicy krwi rodzacych kobiet.

Alpha-2-antiplasmin is a main inhibitor of plasmin and play a crucial role in regulation of intravascular fibrinolysis. It is important to know, in pregnant women as well in the immediate post partum period the activation of hemostasis takes place and is observed thrombotic incidences. In our studies we have included 33 pregnant women whose delivered eutrophic newborns alpha-2-AP 7.79 mg/dl and 36 pregnant women whose delivered small-for-date newborns, alpha-2-AP 7.49 mg/dl. We found no significant statistically differences between tested groups and in comparison to control group 6.0 mg/dl. The presented results seems to indicate, the determination of concentration of alpha-2-AP in sera of women in immediate post partum period does not reflect the changes in the mechanisms of fibrinolytic system in the course of the partum.

The concentration of alpha-1-antichymotrypsin in blood serum of women in labour.

Concentration of alpha-1-antichymotrypsin (A-1-ACT) in blood serum of parturient women was determined. The investigation was conducted in 33 women bearing eutrophic newborns and 36 women bearing hypotrophic newborns. The control group consisted of 30 healthy non-pregnant women in reproductive age. Concentrations of A-1-ACT were determined using the radial immunodiffusion method according to Mancini et al. Maximal concentration of A-1-ACT determined in group I was three times higher than minimal concentration. Maximal concentration of A-1-ACT determined in group II was two times higher than minimal concentration. In the control group, the difference between minimal and maximal concentrations of A-1-ACT was inconsiderable. The lack of statistically significant differences between these three groups suggests that labour stress does not influence serum concentrations of this inhibitor. The importance of A-1-ACT in the placental tissue may be connected with immunological mechanisms that assure development and maintenance of pregnancy.

[Serine protease inhibitors in newborns. IV. Levels of alpha-2-macroglobulin in serum of eutrophic and hypotrophic newborns and their mothers]. / Inhibitory proteaz serynowych u noworodków. IV. Stezenie alfa-2-makroglobuliny w surowicy krwi noworodków eutroficznych i hipotroficznych oraz ich matek.

It is accepted that alpha-2-M may serve as an important factor for the regulation of homeostasis. For these reasons it is valuable to determine its concentration in some clinical conditions. We have found that the level of alpha-2-M is evidently higher in hypotrophic newborns than in neutrophic newborns. It is interesting to note that the mothers of hypotrophic newborns also exhibit increased concentration of alpha-2-M in comparison to the mothers of eutrophic newborns. No differences were observed in concentration of this inhibitor between mothers and this newborns in both groups. Taking under consideration these findings it seems there is an inverse relationship between cord serum alpha-2-M concentrations and birth weight of newborns. Probably the increase of this inhibitor may reflect in some extent its function as moderating factor high susceptibility hypotrophic newborns for infections since alpha-2-M plays so crucial role in inflammatory processes.

[Flow cytometric analysis of cord blood lymphocytes]. / Ocena populacji limfocytów krwi pepowinowej metoda cytometrii przeplywowej.

It has been observed that immunological reactivity of neonatal leukocytes is diminished. It seems to result from lymphocytes immaturity. In the present study we have evaluated the phenotype of cord blood lymphocytes with the use of flow cytometry. In neonates we have observed the increase in the absolute number of CD1a and CD7 positive lymphocytes as well as CD2, CD3, CD4, CD8, CD16, CD19 and CD20 positive, while number of CD57 positive cells was significantly decreased. The ratios of CD4/CD8 and T/B lymphocytes were similar to the corresponding ratios observed in adults. Our results have shown the presence of immature lymphocyte population as well quantitative depletion of subpopulation of CD57 cells, what may pose an increased risk of infection in neonates. Nevertheless, increased number of T and B lymphocytes with mature phenotype along with normal ratio of lymphocyte subpopulations and increased number of CD16 positive cells (NK cells), may explain phenomenon of good health among majority of newborns.

Persistent exit-site/tunnel infection and subcutaneous cuff removal in PD patients.

The purpose of our study was to investigate catheter outcome of persistent exit-site/tunnel infections (ESI/TIs) in peritoneal dialysis (PD) patients. The patients underwent removal of subcutaneous cuff due to persistent ESI/TI from January 1989 to December 1996 in a tertiary referral university hospital. Two hundred and twenty-three patients (138 male, 85 female) underwent 244 double-cuff coiled Swan neck catheter implantations surgically. Twenty-nine patients (11.8%) had persistent ESI/TI for more than 6 months with the same organism. Sixteen patients (52%) underwent subcutaneous cuff excision. Thirteen (48%) patients refused and were managed conservatively. Two hundred and forty-three episodes of ESI/TI were observed over 4970 patient-months with a rate of 0.58 episodes/patient/year. Twenty-nine patients (11.8%) had persistent ESI/TI with S. aureus in 19, Pseudomonas aeruginosa in 9 (31%), and Serratia marcescens in one (3%) patient. Fourteen (88%) persistent ESI/TIs resolved after subcutaneous cuff excision. None of the patients with ESI/TI responded to conservative treatment. ESI/TI-related peritonitis decreased from 11 episodes to 5 episodes after cuff excision. In contrast, episodes of peritonitis increased from one to 9 with conservative management during a follow-up of mean 18 months (4-38 months). Four (31%) catheters were lost in the conservative group, while 3 (19%) were lost after cuff excision. ESI/TI-related peritonitis decreased after subcutaneous cuff excision but increased with conservative management for ESI/TI. ESI/TI resolved in 88% of the patients after cuff excision, while none resolved with conservative treatment.

[Concentration of the complement component (C3) in blood sera of small-for-gestational age newborns and their mothers]. / Stezenie trzeciego skladnika dopelniacza (C3) w surowicy krwi noworodków hipotroficznych i ich matek.

36 small-for-dates newborn were introduced to our studies. The concentrations of C3 in sera of newborns were at 65% mean values found in sera their mothers. We have compared the concentrations of C3 in sera of newborns and their mothers and did not find no correlation. These data may indicate this component does not penetrate through placenta.

[Concentration of C3 in sera of small for gestational age newborns in relation to sex and degree of hypotrophy]. / Stezenie C3 w surowicy krwi noworodków z zespolem hipotrofii wewnatrzmacicznej w zaleznosci od plci i stopnia hipotrofii.

36 small-for-date newborns both sexes with body weight below 10 percentiles were included to our studies. To control group we have enrolled 33 newborns in the same fetal age. We conducted the present study to address whether fetal hypotrophy induce or not decrease of the concentration of C3 in sera of these newborns. Despite of our expectations we have found there is increase C3 in sera in relation to the degree of hypotrophy. We have noted the concentration of C3 is not related to the sex both small-for-date newborns and newborns.