BACKGROUND: Kangaroo mother care (KMC) is a cornerstone of preterm infant management. The purpose of this study was to estimate the effectiveness of daily prolonged KMC in very preterm infants and its influence on neonatal morbidity and short-term outcomes, and breastfeeding optimization. METHODS: Research included 52 very preterm infants. According to the KMC duration newborns were divided into two groups; Group1 of 22 infants (42.3%) – KMC lasted more than 3 hours/day, Group 2 of 30 infants (57.7%) – KMC lasted less than 3 hours/day. RESULTS: Nosocomial sepsis occurred less frequently in Group 1 versus Group 2 (OR = 10.50; 95% CI 1.23–89.67, p = 0.012). Incidences of BPD, NEC, IVH I–II grades, the duration of parenteral nutrition, and growth parameters have not been different between groups (p > 0.05). Breastfeeding rates at discharge prevailed in Group 1 (OR = 3.70; 95% CI 1.16–11.86, p = 0.025). The most important factors for nosocomial sepsis: combination of parenteral nutrition duration and daily prolonged KMC, as a preventing factor (p = 0.002). Combination of the neonatal intensive care unit (NICU) treatment duration, type of enteral feeding, and mother’s age add as factors that have important influence on breastfeeding prolongation (p = 0.009). CONCLUSION: Nosocomial infection prevention and breastfeeding optimization are profitable outcomes of daily prolonged KMC in very preterm infants. No significant differences in the BPD, NEC, IVH I–II grades incidences, duration of parenteral nutrition, and growth parameters were found between studied groups. Combination of long-lasting KMC and short-term parenteral nutritionis a significant factor for nosocomial sepsis prophylaxis.
Introduction: In children with asthma, endothelial dysfunction signs are observed, and their extent depends on the severity of the disease. These changes are also present in remission. High level of soluble Vascular Cell Adhesion Molecule-1 (sVCAM-1) expression causes active adhesion of inflammatory cells and can indicate direct endothelium participation in development and supporting of chronic inflammation. Bronchial asthma (BA) is characterised by airways chronic inflammation. A special role in this inflammatory process formation is played by development of endothelial dysfunction. The aim of the study was to evaluate endothelial state in children with clinically stable and exacerbated asthma. Material and methods: 91 children with persistent asthma were examined. Among them there were 40 patients with mild persistent (group I), 34 subjects with moderate persistent (group II) and 17 individuals with severe persistent (group III) asthma. 20 healthy children were selected as controls. The serum levels of sVCAM-1 were determined by enzyme-linked immunosorbent assay (ELISA). The ultrasound assessment of endothelium-dependent flow-mediated dilation of the brachial artery (FMD%) has been made. Ultrasonography has been used for investigation of the intima-media thickness (I-M) complex. Data analysis was performed with the Statsoft Statistica Version 8 (Tulsa, OK). Results: The serum levels of sVCAM-1 were significantly increased in the patients with asthma exacerbation (p < 0.001) and remission (p < 0.001), compared with the controls. The index of FMD% was significantly diminished in the patients of I, II, III group with exacerbation (p < 0.001) and stayed lower in the subjects with asthma in remission (p < 0.001), compared with the controls. The thickness of I-M complex was significantly increased in the patients of I, II, III group, compared with the controls (p < 0.001). The endothelium parameter levels: sVCAM-1 (H = 56.11, p = 0.0001), FMD% (H = 43.20, p = 0.0000), the thickness of I-M complex (H = 49.37, p = 0.0000) depend on the severity of the disease. Correlations between the endothelium and pulmonary function parameters were proved (p < 0.05). Conclusions: Endothelial dysfunction in children with asthma was determined. Dependence of severity of the disease on functional state of the vascular endothelium was proved.
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