Biomedical subjects
F Scopesi
Publications and source records attributed to F Scopesi.
7-ketocholesterol in human and adapted milk formulas.
In the last few years, a variety of experimental and clinical studies concerning the formation, metabolism, and cellular effects of cholesterol oxidation products (COPs) have been carried out. Nevertheless, a substantial lack of knowledge exists regarding the possible intake of these compounds by the newborn through human and/or adapted formula milk. As far as the pathological role of COPs is concerned, exhaustive studies have shown that since dietary COPs are cytotoxic and atherotoxic, they may lead to adverse effects on health. The aim of this study was to investigate the possible development of cholesterol oxidation in adapted formula and in human milk by comparing the main cholesterol oxidation biomarker (7-ketocholesterol) concentration in both. To do so, the total (bonded and free) 7-ketocholesterol content was measured in ten fresh human mature milk samples and in ten milk adapted formula samples by high performance liquid chromatography and diode array detection. The 7-ketocholesterol human milk content (0.7+/-0.3) was often below the quantifiable limit (0.5 microg/g of extracted lipids) while 7-ketocholesterol adapted milk concentrations were often above (3.6+/-4.0) this limit. The 7-ketocholesterol content of adapted formula samples was significantly higher as compared to human milk samples (P<0.05). This is the first study to provide data concerning the concentrations of cholesterol oxides in human milk and in formula milk. Our results clearly suggest that the manufacturing technologies employed and the nutrient extractive sources play a crucial role in the development of cholesterol oxides in the end product. Careful surveillance has to be paid in order to avoid alteration of bioactive properties of nutrients and/or development of potentially toxic derivative compounds.
Maternal dietary PUFAs intake and human milk content relationships during the first month of lactation.
Maternal dietary fatty acids (FFAs) intake and corresponding human milk composition relationships have been assessed throughout the first month of lactation in 34 lactating women consecutively enrolled. All mothers were on their habitual diet. Food records (95 items) were administered to the mothers, six-times during the first month of lactation (1 day after delivery, 4, 7, 14, 21, and 28 days after colostrum appearance) and referred to maternal dietary intake of the day before. Milk collected on day 1 was considered as colostrum, day 4 and 7 samples as transitional milk, and day 14, 21 and 28 samples as mature milk. Five gas chromatographic analyses were performed on each sample. Statistics were made using Friedman's and Pearson's test. Maternal dietary saturated fatty acids (SFAs) and monounsaturated fatty acids (MUFAs) were significantly related to the corresponding milk pattern in the phase of transitional milk (P<0.01), while total polyunsaturated (PUFAs) content was significantly related only to the mature milk (P<0.01); in this phase about 42% of the variations occurring in PUFAs milk content can be related to variation of maternal PUFAs dietary intake. The results in the present study provide evidence of the relationships between maternal diet and milk composition. The degree of correlation between maternal diet and PUFAs milk content increases throughout milk maturational process and reaches significance only in mature milk. This would imply that advancing lactation, milk PUFAs provision sources gradually shift from adipose tissue catabolism to maternal diet.
A randomised control study comparing the Infant Flow Driver with nasal continuous positive airway pressure in preterm infants.
OBJECTIVE: To compare the effectiveness of the Infant Flow Driver (IFD) with single prong nasal continuous positive airway pressure (nCPAP) in preterm neonates affected by respiratory distress syndrome. DESIGN: Randomised controlled study. PATIENTS: Between September 1997 and March 1999, 36 preterm infants who were eligible for CPAP treatment were randomly selected for either nCPAP or IFD and studied prospectively for changes in oxygen requirement and/or respiratory rate. The requirement for mechanical ventilation, complications of treatment, and effects on mid-term outcome were also evaluated. RESULTS: Use of the IFD had a significantly beneficial effect on both oxygen requirement and respiratory rate (p < 0.0001) when compared with nCPAP. Moreover, O(2) requirement and respiratory rate were significantly decreased by four hours (p < 0.001 and p < 0.03 respectively). The probability of remaining supplementary oxygen free over the first 48 hours of treatment was significantly higher in patients treated with the IFD than with nCPAP (p < 0.02). IFD treated patients had a higher success (weaning) rate (94% v 72 %) and shorter duration of treatment (49.3 (31) v 56 (29.7) hours respectively; mean (SD)), although the difference was not significant. CONCLUSIONS: IFD appears to be a feasible device for managing respiratory distress syndrome in preterm infants, and benefits may be had with regard to oxygen requirement and respiratory rate when compared with nCPAP. The trend towards reduced requirement for mechanical ventilation, shorter clinical recovery time, and shorter duration of treatment requires further evaluation in a multicentre randomised clinical trial.
[2,3 diphosphoglycerate in preterm newborns].
BACKGROUND: It has been largely shown that during the first month of life, in the preterm neonate Hb levels and Hct percentages rapidly decrease, high HbF concentration persists and a high oxygen affinity occurs. Data are needed to establish the level at which 2,3 dyphosphoglycerate (2,3 DPG) interacts with the regulation of oxygen affinity. SUBJECTS AND METHODS: 24 samples, from eight uncomplicated preterm newborns (34.1 +/- 1.83 GW, 1869 +/- +/- 291 BW) obtained at the same time as those required for the clinical management of the infants, were collected on the 2nd, 7th and 14th day of life. Blood gases, total hemoglobin and hematocrit were obtained from 0.3 ml arterialised capillary blood. Assays of 2,3 DPG were made separately on 0.4 ml venous blood. RESULTS: As expected tHb concentration and Hct percentages significantly decreased from day 2 to day 14 in all eight cases. On the contrary 2,3 DPG and p50 values remained stable. Subsequently throughout the study period all neonates had an increased 2,3 DPG/Hb ratio that was significantly related with p50 at standard conditions (p < 0.05). CONCLUSIONS: Stable 2,3 DPG concentrations during all study period have been detected. The subsequent significant increased 2.3 DPG/Hb, ratio related to increased p50 values, could have a key role in a physiological mechanism aimed to ensure adequate oxygen delivery to the tissues and to counteract the higher oxygen affinity of fetal hemoglobin. A wider sample is needed to validate this hypothesis.
Dietary nucleotide supplementation raises erythrocyte 2, 3-diphosphoglycerate concentration in neonatal rats.
The present study was designed to test if dietary intake of nucleotides increases erythrocyte 2,3-diphosphoglycerate (2,3-DPG) in neonatal rats. To this end, rat pups were fed a nucleotide-supplemented formula (S, n = 14) from d 9 until d 16 after birth. The results were compared with those obtained from a group of breast-fed pups (C, n = 14) and a group of pups artificially fed with nucleotide-free formula (NS, n = 14). Neonatal weight, 2,3-DPG concentration, hematocrit (Hct) and hemoglobin concentration (Hb) were determined before the experiment (d 9) and after 7 d of treatment (d 16). In all groups, 2,3-DPG concentration was greater at d 16 than d 9, and the increase was greater in the S group than in the NS group. Alterations in neonatal weight, Hct and Hb concentration did not differ among the groups. On d 16 the 2, 3-DPG/Hb ratio, reflecting the affinity of hemoglobin for oxygen, was significantly higher in the C and S groups than in the NS group. We conclude that in neonatal rats, dietary nucleotides increase erythrocyte 2,3-DPG concentration. Studies need to be conducted in humans to assess the effect of this increase on both neonatal peripheral hemodynamics and metabolism in this species.
Pregnancy-induced hypertension, antihypertensive drugs and the development of fetal behavioural states.
In 21 pregnancies complicated by pregnancy-induced hypertension (PIH) which was treated by antihypertensive drugs (labetalol, nifedipine), fetal behavioural recordings (quiet state, C1F; active state, C2F; no coincidence, NOC) and Doppler measurements of blood flow velocity in the umbilical artery (UA) (resistance index, RI) were made on two occasions (27-32 and 33-36 weeks of gestation). Data were compared to those of a control group of normally grown fetuses (n = 96); in 15 cases we were able to match fetuses from the study group for age (+/- 1 week) and weight (+/- 150 g) at birth with fetales from a control group. It was the aim of this study to investigate if there are disturbances in the development of fetal behavioural states and if possible disturbances are due to poor fetal growth or to antihypertensive therapy. Our results show that in PIH treated by antihypertensive drugs, there are disturbances in the development of fetal behavioural states with higher percentages of NOC and C1F, lower percentages of C2F, and higher UA RI values. These disturbances are mainly due to coexisting placental impairment and poor fetal growth rather than to nifedipine or labetalol therapy, although these drugs may cause some redistribution of states.
Behavioural development and Doppler velocimetry in relation to perinatal outcome in small for dates fetuses.
Twenty-two small for dates (SFD) fetuses and 96 fetuses from uncomplicated pregnancies were monitored on two occasions between 27 and 32 weeks and the second time between 33 and 36 weeks of gestation by studying the development of behavioural states (coincidence 1F and 2F; no coincidence) and umbilical artery Doppler waveform patterns (UA; Resistance Index, RI). Data were related to neurological outcome at 8 months after birth. The purpose of this study was to investigate if the development of behavioural state is disturbed in SFD fetuses and if SFD fetuses who needed to be delivered early and/or had abnormal neurological outcome showed different state development and RI than SFD fetuses delivered later in pregnancy or with normal neurological outcome. Finally, we studied if there was a relationship between state development and RI. At 27-32 weeks of gestation the percentage of coincidence 2F (C2F%) was lower and the percentage of coincidence 1F (C1F%) and no coincidence (NOC%) were higher in the SFD fetuses than in the control group. At 33-36 weeks C2F% was lower and NOC% was higher but not statistically different (P = 0.2 and P = 0.07, respectively). SFD fetuses who needed to be delivered early had poorer state development than SFD fetuses at lower risk and infants who were abnormal at 8 months of life showed a higher C1F% and lower C2F% at 27-32 weeks. There were significant correlations between RI on the one hand and NOC% (r = 0.62) and C2F% (r = -0.48) on the other hand at 27-32 weeks in the subgroup with abnormal neurological outcome. In conclusion, in SFD fetuses there are disturbances in the development of behavioural states as well in the distribution of the periods of coincidence (with a decrease in C2F% and an increase in C1F%). Poorest state development is present in SFD fetuses at highest risk and in this group there appears to be a significant relationship between the degree of utero-placental insufficiency (RI) and disturbances in behavioural development.
Doppler velocimetry and behavioural state development in relation to perinatal outcome in pregnancies complicated by gestational diabetes.
Seventy-one pregnancies complicated by gestational diabetes and 100 healthy pregnancies were monitored on two occasions (between 27th-32nd and 33rd-36th week of gestation) by behavioural state analysis (1F coincidence; 2F coincidence) and umbilical artery Doppler velocimetry (UA) (Resistance Index, RI). The purpose of our study was to determine if the development of behavioural states and Doppler velocimetry: (1) differ between normal and gestational diabetic cases; (2) in gestational diabetic cases, are they related to the degree of abnormality of the maternal oral glucose tolerance test (OGTT)?; and (3) are they predictors of perinatal outcome? (i.e. emergency caesarean section; low Apgar scores; respiratory distress syndrome; neonatal hypoglycaemia and neurological abnormality in the neonate and/or at 4 months of age). Our findings suggest that: (1) results on behavioral state development and Doppler velocimetry were significantly different in gestational diabetic cases; (2) infants of women with gestational diabetes who are neurologically abnormal during the newborn period, had a poor development of coincidence 2F during fetal life and had neonatal hypoglycaemia more often than infants with a normal neurological outcome; (3) in cases with abnormal neurological outcome, the maternal diabetes was more severe than in those cases with normal outcome.
Neonatal respiratory distress syndrome screening by behavioural state and umbilical artery Doppler velocimetry.
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