Francesco Tandoi - Academia.edu (original) (raw)
Papers by Francesco Tandoi
Pediatric Gastroenterology, Hepatology & Nutrition, 2020
Purpose: To assess the association between birth weight and the development of functional gastroi... more Purpose: To assess the association between birth weight and the development of functional gastrointestinal disorders (FGIDs) in the first year of life. Methods: This is a secondary analysis of a prospective cohort multicenter study including neonates, consecutively enrolled at birth, and followed up for one year. At birth all infants were classified by birth weight as extremely low (ELBW), very low, or low when <1,000, <1,500, and <2,500 g, respectively, and by birth weight for gestational age as appropriate (AGA, weight in the 10-90th percentile), small (SGA, weight <10th percentile), and large (LGA, weight >90th percentile) for gestational age. FGIDs were classified according to the Rome III criteria and assessed at 1, 3, 6, and 12 months of life. Results: Among 1,152 newborns enrolled, 934 (81.1%) completed the study: 302 (32.3%) were preterm, 35 (3.7%) were ELBW, 104 (11.1%) were SGA, 782 (83.7%) were AGA, and 48 (5.1%) were LGA infants. Overall, throughout the first year of life, 718 (76.9%) reported at least one FGID. The proportion of infants presenting with at least one FGID was significantly higher in ELBW (97%) compared to LBW (74%) (p=0.01) and in LGA (85.4%) and SGA (85.6%) compared to AGA (75.2%) (p=0.0001). On multivariate analysis, SGA was significantly associated with infantile colic. Conclusion: We observed an increased risk of FGIDs in ELBW, SGA, and LGA neonates. Our results suggest that prenatal factors determining birth weight may influence the development of FGIDs in infants. Understanding the role of all potential risk factors may provide new insights and targeted approaches for FGIDs.
The Journal of Pediatrics, 2019
Objective To assess the prevalence of functional gastrointestinal disorders (FGIDs) in the first ... more Objective To assess the prevalence of functional gastrointestinal disorders (FGIDs) in the first year of life and the influence of different neonatal factors on development of FGIDs. Study design A prospective cohort multicenter study including neonates, consecutively enrolled at birth, and followed up until 1 year. Gestational age, neonatal antibiotic administration, duration of hospitalization, mode of delivery, birth weight, and feeding pattern were recorded. FGIDs were classified according to Rome III criteria and assessed at 1, 3, 6, and 12 months of life. Results Among 1152 newborns enrolled, 934 (81.1%) completed the study, 302 (32%) were newborns born preterm, 320 (34%) had neonatal antibiotics, and 718 (76.9%) had at least 1 FGID according to Rome III criteria (443 [47.4%] infantile colic, 374 [40.0%] regurgitation, 297 [31.8%] infant dyschezia, 248 [26.6%] functional constipation, and 34 [3.6%] functional diarrhea) throughout the first year of life. The proportion of infants born preterm presenting with FGIDs (86%) was significantly greater compared with infants born full term (72.5%) (c 2 = 21.3, P = .0001). On multivariate analysis, prematurity and neonatal use of antibiotics was significantly associated with at least 1 FGID. Conclusions We found a high rate FGIDs in infants, likely related to the population recruited, the long observation period, the diagnosis based on Rome III criteria, and parental reports. Preterm delivery and neonatal use of antibiotics in the first months of life are associated with an increased incidence of FGIDs, particularly infantile colic and regurgitation. In our population, cesarean delivery and feeding pattern at 1 month of life emerged as additional risk factors for infant dyschezia and functional diarrhea. Other neonatal factors associated with FGIDs need to be further explored.
DOAJ (DOAJ: Directory of Open Access Journals), Oct 23, 2012
The approach to research on gender differences in an evolutionary context has always been complex... more The approach to research on gender differences in an evolutionary context has always been complex. Many factors, from those initially linked to preliminary considerations about the differences between the sexes in different historical and cultural moments have often influenced studies of this type. Gender Medicine, consolidated in the United States as a research field since the 1980s, studies the way in which membership in gender, male or female, affects the development and impact of disease and response to therapy. We can say that this is a new, transverse dimension of Medicine that assesses gender differences in physiology and pathophysiology of many clinical diseases, with the aim of reaching treatment decisions based on evidence in both men and women. In an historical moment focused on the individualization/personalization of care, among the objectives that modern health care has been given, there is this research aimed at identifying as early as possible gender-related diseases with the aim of identifying causes and possible methods of intervention. It leads to defining a kind of Medicine, a recent branch of biomedical science, that focuses on recognizing and analyzing the differences arising from the belonging to a gender, male or female, from several aspects: organic, functional, psychological, pharmacological, social and cultural. A gender approach to Medicine can reduce the level of error in medical practice, promote therapeutic appropriateness, improve and customize therapies and generate savings for healthcare systems. These effects have been demonstrated for adults and need to be confirmed during infancy and childhood. The purpose of this discipline is to innovate and guarantee everyone, man or woman, newborn and children, the best possible treatment based on scientific evidence.
Pediatric Research, 2004
Background: Interleukin-6 (IL-6) and C reactive protein (CRP) are frequently detectable in amniot... more Background: Interleukin-6 (IL-6) and C reactive protein (CRP) are frequently detectable in amniotic fluid (AF). While CRP seems to be excreted by the fetal kidneys and probably by the lungs, IL-6 is an inflammatory cytokine produced by activated macrophages and lymphocytes which gain access to the amniotic cavity during intrauterine infection. IL-6 and other proinflammatory cytokines are also found in bronchoalveolar lavage of ventilated infants and in the urine of children with urinary tract infection. However, no information is available on the urinary IL-6 (uIL-6) content of neonates. Methods: Urine and blood samples were obtained from consecutive neonates in the first week of life. Urine was collected using sterile cotton flock. After centrifugation of the flock, urinary CRP (uCRP) was put in sterile tubes and sent immediately to the laboratory. Urinary CRP and uIL-6 were measured with a commercially available ELISA test. The sensitivity of the assay was below 10% for both measurements. The uCRP and uIL-6 values were normalized for the urinary creatinine content of every single probe. Spearman rank correlation was used for statistical purposes. Results: Serum and urinary CRP and IL-6 were measured in 15 infants. MeanϮSD gestational age at delivery and birth weight were 33.3Ϯ3.8 weeks and 1789Ϯ794 grams, respectively. Serum and uCRP was detectable in all samples with a median (range) serum concentration of 2830.2 ng/mL (113.3-187171) and 4.76 ng/mL (0.83-58.73) in the urine. No correlation was found between serum CRP and uCRP concentration. IL-6 was present in 14 (93.3%) blood samples and in 9 (60%) urine samples. The median (range) concentration of IL-6 was 3.6 pg/ml (0-542.5) in serum and 0.48 pg/ml (0-39.5) in urine, respectively. A significant correlation was found between serum IL-6 and uIL-6 (rϭ0.56; pϽ0.05). No correlation was found between uCRP and IL-6 in serum and urine. Conclusion: IL-6 can be present in neonatal urine at birth. This suggests that fetal urine could be another source of amniotic fluid IL-6 during intrauterine inflammatory processes.
Pediatric Research, 2004
Background: Hyperglycemia occurs frequently in very premature infants receiving total parenteral ... more Background: Hyperglycemia occurs frequently in very premature infants receiving total parenteral nutrition (TPN). Commonly, the glucose infusion rates in TPN exceed the patient's glucose needs. In adult intensive care patients, accompanying hyperglycemia was associated with increased mortality. Since premature infants also represent a high-risk population, preventing hyperglycemia while providing sufficient energy intake may likewise reduce the risk of an adverse outcome. Objective: To determine whether hyperglycemia in infants receiving standard TPN is primarily due to differences in their ability to suppress hepatic glucose production when presented with a high rate of exogenous glucose or to failure of the infant's disposal rate to match the intake. Design/Methods: 11 clinically stable infants (962Ϯ49 g; 26.7Ϯ0.4 wks) were studied on day 4Ϯ1 of life while receiving TPN as ordered by the attending physician. Glucose production rate (GPR) was measured during an 8 h period of stable blood glucose using isotope dilution of [6,6-2H2]glucose. Multiple regression analysis was used to determine the effects of infusion rate of glucose, lipids and amino acids, residual GPR, gestational age and birth weight on blood glucose concentration. Results: Range and median (within parenthesis) for each parameter : Blood glucose 5.3-12.6 (7.1) mM; Total glucose appearance rate (Ra) 8.9-13.1 (10.9) mg/kg min of which glucose infusion was 7.3-11.3 (9.5) mg/kg min and residual GPR 0.1-1.5 (1.4) mg/kg min; Infusion rate of lipids was 0.6-2.7 (2.1) mg/kg min and of amino acids 1.6-2.2 (2.0) mg/kg min. Glucose Ra explained 58% of the variation in blood glucose concentration (pϽ0.007), of which the glucose infusion rate accounted for the major part, 49% (pϽ0.02) and GPR for only 9% (pϽ0.05); gestational age explained 9% while infusion rates of amino acids and lipids, and birth weight did not affect blood glucose concentration. GPR was suppressed by 80% (assuming a normal glucose turnover rate of 6 mg/kg min). Conclusion: In premature infants receiving TPN, the infusion rate of glucose is the strongest predictor of hyperglycemia, while residual GPR and gestational age have marginal impact. A potential clinical implication of these results is that a reduction of the glucose infusion rate while maintaining adequate supply of lipids and amino acids will reduce the incidence of hyperglycemia without compromising energy and protein balance. Grants: NIHRO1-HD37957-05; GCRCNIHHO1-RR-001888.
Pediatric Research, 2004
Background: Human milk (HM) is believed to improve feeding tolerance in very low birth weight (VL... more Background: Human milk (HM) is believed to improve feeding tolerance in very low birth weight (VLBW) infants compared to formula feeding thereby accelerating early enteral feeding advancement. Objective: The present secondary analysis of a controlled randomized trial was to investigated whether human milk accelerates early enteral feeding advancement compared to formula feeding. Methods: In 129 VLBW infants non-pasteurized HM was fed whenever available and fortification was started after 100ml/kg/day had been achieved. Early enteral feeding advancement was performed following a strict feeding protocol. If HM was not available, hydrolyzed protein or standard protein preterm formula were fed. The hypothesis was tested (Mann-Whitney test) that infants who received Ն10% of HM achieved full feeds faster than infants for whom HM was not available (Ͻ10%). Multiple regression backward selection analysis was performed to analyze the effect of the available HM volume measured as percentage of total feeding volume on the time to achieve full feeds. Other variables whose effects were analyzed in the model were birth weight, gestational age, age at starting milk feeds, type of formula, prenatal Betametason treatment, umbilical artery ph, and Apgar scores. Data is shown as median (p25-p75). Results: 42 Infants received Ն10% of HM (75%(37-96%)) and 87 infants Ͻ10% HM (0% (0-0%)). Infants with Ն10%HM infants were significantly more mature (gestational age 29.4 (27.1-31.0) vs. 27.0 (25.2-29.3) weeks; pϭ0.012), but there was no significant difference with regard to birth weight (980 (740-1280)g vs. 870 (695-1190)g; pϭ0.40), first day of milk feeding (day 3 (2-4) vs. 3 (2-5); pϭ0.96), and the age at full feeds (day 14 (12-21) vs. 15 (12-24); pϭ0.37). Multiple linear regression analysis confirmed this result since HM (pϭ0.82) was not associated with the time to achieve full feeds, in opposition to birth weight (pϽ0.001), type of formula (pϽ0.011), age at starting milk feds (pϽ0.001) and prenatal Betametason treatment (pϭ0.03). Conclusion: The data did not support the hypothesis that human milk increases early enteral feeding tolerance. Randomized trials in VLBW infants are required to analyze hypothesized beneficial effects of properly fortified human milk.
Pediatric Research, 2004
Background: Interleukin-6 (IL-6) and C reactive protein (CRP) are frequently detectable in amniot... more Background: Interleukin-6 (IL-6) and C reactive protein (CRP) are frequently detectable in amniotic fluid (AF). While CRP seems to be excreted by the fetal kidneys and probably by the lungs, IL-6 is an inflammatory cytokine produced by activated macrophages and lymphocytes which gain access to the amniotic cavity during intrauterine infection. IL-6 and other proinflammatory cytokines are also found in bronchoalveolar lavage of ventilated infants and in the urine of children with urinary tract infection. However, no information is available on the urinary IL-6 (uIL-6) content of neonates. Methods: Urine and blood samples were obtained from consecutive neonates in the first week of life. Urine was collected using sterile cotton flock. After centrifugation of the flock, urinary CRP (uCRP) was put in sterile tubes and sent immediately to the laboratory. Urinary CRP and uIL-6 were measured with a commercially available ELISA test. The sensitivity of the assay was below 10% for both measurements. The uCRP and uIL-6 values were normalized for the urinary creatinine content of every single probe. Spearman rank correlation was used for statistical purposes. Results: Serum and urinary CRP and IL-6 were measured in 15 infants. MeanϮSD gestational age at delivery and birth weight were 33.3Ϯ3.8 weeks and 1789Ϯ794 grams, respectively. Serum and uCRP was detectable in all samples with a median (range) serum concentration of 2830.2 ng/mL (113.3-187171) and 4.76 ng/mL (0.83-58.73) in the urine. No correlation was found between serum CRP and uCRP concentration. IL-6 was present in 14 (93.3%) blood samples and in 9 (60%) urine samples. The median (range) concentration of IL-6 was 3.6 pg/ml (0-542.5) in serum and 0.48 pg/ml (0-39.5) in urine, respectively. A significant correlation was found between serum IL-6 and uIL-6 (rϭ0.56; pϽ0.05). No correlation was found between uCRP and IL-6 in serum and urine. Conclusion: IL-6 can be present in neonatal urine at birth. This suggests that fetal urine could be another source of amniotic fluid IL-6 during intrauterine inflammatory processes.
La Pediatria medica e chirurgica : Medical and surgical pediatrics, Jan 22, 2017
Introduction of solid foods is a fundamental step in the development of an individual. There are ... more Introduction of solid foods is a fundamental step in the development of an individual. There are many implications that weaning contains not only on a nutritional plan, but also on the contingent and long-term health of an individual. Over time this nutritional passage has evolved through the acquisition of new knowledge about maturation of anatomical and neurosensory structures involved in all the phases of such a complex process. The understanding of a maturing taste of infant and cultural changes is another key to understand the evolution of introduction of solid foods in infants. What is contained in this text encapsulates thus the evolutionary path of weaning in recent years, showing current trends in the light of cultural changes and new scientific acquisitions.
Pediatric Gastroenterology, Hepatology & Nutrition, 2020
Purpose: To assess the association between birth weight and the development of functional gastroi... more Purpose: To assess the association between birth weight and the development of functional gastrointestinal disorders (FGIDs) in the first year of life. Methods: This is a secondary analysis of a prospective cohort multicenter study including neonates, consecutively enrolled at birth, and followed up for one year. At birth all infants were classified by birth weight as extremely low (ELBW), very low, or low when <1,000, <1,500, and <2,500 g, respectively, and by birth weight for gestational age as appropriate (AGA, weight in the 10-90th percentile), small (SGA, weight <10th percentile), and large (LGA, weight >90th percentile) for gestational age. FGIDs were classified according to the Rome III criteria and assessed at 1, 3, 6, and 12 months of life. Results: Among 1,152 newborns enrolled, 934 (81.1%) completed the study: 302 (32.3%) were preterm, 35 (3.7%) were ELBW, 104 (11.1%) were SGA, 782 (83.7%) were AGA, and 48 (5.1%) were LGA infants. Overall, throughout the first year of life, 718 (76.9%) reported at least one FGID. The proportion of infants presenting with at least one FGID was significantly higher in ELBW (97%) compared to LBW (74%) (p=0.01) and in LGA (85.4%) and SGA (85.6%) compared to AGA (75.2%) (p=0.0001). On multivariate analysis, SGA was significantly associated with infantile colic. Conclusion: We observed an increased risk of FGIDs in ELBW, SGA, and LGA neonates. Our results suggest that prenatal factors determining birth weight may influence the development of FGIDs in infants. Understanding the role of all potential risk factors may provide new insights and targeted approaches for FGIDs.
The Journal of Pediatrics, 2019
Objective To assess the prevalence of functional gastrointestinal disorders (FGIDs) in the first ... more Objective To assess the prevalence of functional gastrointestinal disorders (FGIDs) in the first year of life and the influence of different neonatal factors on development of FGIDs. Study design A prospective cohort multicenter study including neonates, consecutively enrolled at birth, and followed up until 1 year. Gestational age, neonatal antibiotic administration, duration of hospitalization, mode of delivery, birth weight, and feeding pattern were recorded. FGIDs were classified according to Rome III criteria and assessed at 1, 3, 6, and 12 months of life. Results Among 1152 newborns enrolled, 934 (81.1%) completed the study, 302 (32%) were newborns born preterm, 320 (34%) had neonatal antibiotics, and 718 (76.9%) had at least 1 FGID according to Rome III criteria (443 [47.4%] infantile colic, 374 [40.0%] regurgitation, 297 [31.8%] infant dyschezia, 248 [26.6%] functional constipation, and 34 [3.6%] functional diarrhea) throughout the first year of life. The proportion of infants born preterm presenting with FGIDs (86%) was significantly greater compared with infants born full term (72.5%) (c 2 = 21.3, P = .0001). On multivariate analysis, prematurity and neonatal use of antibiotics was significantly associated with at least 1 FGID. Conclusions We found a high rate FGIDs in infants, likely related to the population recruited, the long observation period, the diagnosis based on Rome III criteria, and parental reports. Preterm delivery and neonatal use of antibiotics in the first months of life are associated with an increased incidence of FGIDs, particularly infantile colic and regurgitation. In our population, cesarean delivery and feeding pattern at 1 month of life emerged as additional risk factors for infant dyschezia and functional diarrhea. Other neonatal factors associated with FGIDs need to be further explored.
DOAJ (DOAJ: Directory of Open Access Journals), Oct 23, 2012
The approach to research on gender differences in an evolutionary context has always been complex... more The approach to research on gender differences in an evolutionary context has always been complex. Many factors, from those initially linked to preliminary considerations about the differences between the sexes in different historical and cultural moments have often influenced studies of this type. Gender Medicine, consolidated in the United States as a research field since the 1980s, studies the way in which membership in gender, male or female, affects the development and impact of disease and response to therapy. We can say that this is a new, transverse dimension of Medicine that assesses gender differences in physiology and pathophysiology of many clinical diseases, with the aim of reaching treatment decisions based on evidence in both men and women. In an historical moment focused on the individualization/personalization of care, among the objectives that modern health care has been given, there is this research aimed at identifying as early as possible gender-related diseases with the aim of identifying causes and possible methods of intervention. It leads to defining a kind of Medicine, a recent branch of biomedical science, that focuses on recognizing and analyzing the differences arising from the belonging to a gender, male or female, from several aspects: organic, functional, psychological, pharmacological, social and cultural. A gender approach to Medicine can reduce the level of error in medical practice, promote therapeutic appropriateness, improve and customize therapies and generate savings for healthcare systems. These effects have been demonstrated for adults and need to be confirmed during infancy and childhood. The purpose of this discipline is to innovate and guarantee everyone, man or woman, newborn and children, the best possible treatment based on scientific evidence.
Pediatric Research, 2004
Background: Interleukin-6 (IL-6) and C reactive protein (CRP) are frequently detectable in amniot... more Background: Interleukin-6 (IL-6) and C reactive protein (CRP) are frequently detectable in amniotic fluid (AF). While CRP seems to be excreted by the fetal kidneys and probably by the lungs, IL-6 is an inflammatory cytokine produced by activated macrophages and lymphocytes which gain access to the amniotic cavity during intrauterine infection. IL-6 and other proinflammatory cytokines are also found in bronchoalveolar lavage of ventilated infants and in the urine of children with urinary tract infection. However, no information is available on the urinary IL-6 (uIL-6) content of neonates. Methods: Urine and blood samples were obtained from consecutive neonates in the first week of life. Urine was collected using sterile cotton flock. After centrifugation of the flock, urinary CRP (uCRP) was put in sterile tubes and sent immediately to the laboratory. Urinary CRP and uIL-6 were measured with a commercially available ELISA test. The sensitivity of the assay was below 10% for both measurements. The uCRP and uIL-6 values were normalized for the urinary creatinine content of every single probe. Spearman rank correlation was used for statistical purposes. Results: Serum and urinary CRP and IL-6 were measured in 15 infants. MeanϮSD gestational age at delivery and birth weight were 33.3Ϯ3.8 weeks and 1789Ϯ794 grams, respectively. Serum and uCRP was detectable in all samples with a median (range) serum concentration of 2830.2 ng/mL (113.3-187171) and 4.76 ng/mL (0.83-58.73) in the urine. No correlation was found between serum CRP and uCRP concentration. IL-6 was present in 14 (93.3%) blood samples and in 9 (60%) urine samples. The median (range) concentration of IL-6 was 3.6 pg/ml (0-542.5) in serum and 0.48 pg/ml (0-39.5) in urine, respectively. A significant correlation was found between serum IL-6 and uIL-6 (rϭ0.56; pϽ0.05). No correlation was found between uCRP and IL-6 in serum and urine. Conclusion: IL-6 can be present in neonatal urine at birth. This suggests that fetal urine could be another source of amniotic fluid IL-6 during intrauterine inflammatory processes.
Pediatric Research, 2004
Background: Hyperglycemia occurs frequently in very premature infants receiving total parenteral ... more Background: Hyperglycemia occurs frequently in very premature infants receiving total parenteral nutrition (TPN). Commonly, the glucose infusion rates in TPN exceed the patient's glucose needs. In adult intensive care patients, accompanying hyperglycemia was associated with increased mortality. Since premature infants also represent a high-risk population, preventing hyperglycemia while providing sufficient energy intake may likewise reduce the risk of an adverse outcome. Objective: To determine whether hyperglycemia in infants receiving standard TPN is primarily due to differences in their ability to suppress hepatic glucose production when presented with a high rate of exogenous glucose or to failure of the infant's disposal rate to match the intake. Design/Methods: 11 clinically stable infants (962Ϯ49 g; 26.7Ϯ0.4 wks) were studied on day 4Ϯ1 of life while receiving TPN as ordered by the attending physician. Glucose production rate (GPR) was measured during an 8 h period of stable blood glucose using isotope dilution of [6,6-2H2]glucose. Multiple regression analysis was used to determine the effects of infusion rate of glucose, lipids and amino acids, residual GPR, gestational age and birth weight on blood glucose concentration. Results: Range and median (within parenthesis) for each parameter : Blood glucose 5.3-12.6 (7.1) mM; Total glucose appearance rate (Ra) 8.9-13.1 (10.9) mg/kg min of which glucose infusion was 7.3-11.3 (9.5) mg/kg min and residual GPR 0.1-1.5 (1.4) mg/kg min; Infusion rate of lipids was 0.6-2.7 (2.1) mg/kg min and of amino acids 1.6-2.2 (2.0) mg/kg min. Glucose Ra explained 58% of the variation in blood glucose concentration (pϽ0.007), of which the glucose infusion rate accounted for the major part, 49% (pϽ0.02) and GPR for only 9% (pϽ0.05); gestational age explained 9% while infusion rates of amino acids and lipids, and birth weight did not affect blood glucose concentration. GPR was suppressed by 80% (assuming a normal glucose turnover rate of 6 mg/kg min). Conclusion: In premature infants receiving TPN, the infusion rate of glucose is the strongest predictor of hyperglycemia, while residual GPR and gestational age have marginal impact. A potential clinical implication of these results is that a reduction of the glucose infusion rate while maintaining adequate supply of lipids and amino acids will reduce the incidence of hyperglycemia without compromising energy and protein balance. Grants: NIHRO1-HD37957-05; GCRCNIHHO1-RR-001888.
Pediatric Research, 2004
Background: Human milk (HM) is believed to improve feeding tolerance in very low birth weight (VL... more Background: Human milk (HM) is believed to improve feeding tolerance in very low birth weight (VLBW) infants compared to formula feeding thereby accelerating early enteral feeding advancement. Objective: The present secondary analysis of a controlled randomized trial was to investigated whether human milk accelerates early enteral feeding advancement compared to formula feeding. Methods: In 129 VLBW infants non-pasteurized HM was fed whenever available and fortification was started after 100ml/kg/day had been achieved. Early enteral feeding advancement was performed following a strict feeding protocol. If HM was not available, hydrolyzed protein or standard protein preterm formula were fed. The hypothesis was tested (Mann-Whitney test) that infants who received Ն10% of HM achieved full feeds faster than infants for whom HM was not available (Ͻ10%). Multiple regression backward selection analysis was performed to analyze the effect of the available HM volume measured as percentage of total feeding volume on the time to achieve full feeds. Other variables whose effects were analyzed in the model were birth weight, gestational age, age at starting milk feeds, type of formula, prenatal Betametason treatment, umbilical artery ph, and Apgar scores. Data is shown as median (p25-p75). Results: 42 Infants received Ն10% of HM (75%(37-96%)) and 87 infants Ͻ10% HM (0% (0-0%)). Infants with Ն10%HM infants were significantly more mature (gestational age 29.4 (27.1-31.0) vs. 27.0 (25.2-29.3) weeks; pϭ0.012), but there was no significant difference with regard to birth weight (980 (740-1280)g vs. 870 (695-1190)g; pϭ0.40), first day of milk feeding (day 3 (2-4) vs. 3 (2-5); pϭ0.96), and the age at full feeds (day 14 (12-21) vs. 15 (12-24); pϭ0.37). Multiple linear regression analysis confirmed this result since HM (pϭ0.82) was not associated with the time to achieve full feeds, in opposition to birth weight (pϽ0.001), type of formula (pϽ0.011), age at starting milk feds (pϽ0.001) and prenatal Betametason treatment (pϭ0.03). Conclusion: The data did not support the hypothesis that human milk increases early enteral feeding tolerance. Randomized trials in VLBW infants are required to analyze hypothesized beneficial effects of properly fortified human milk.
Pediatric Research, 2004
Background: Interleukin-6 (IL-6) and C reactive protein (CRP) are frequently detectable in amniot... more Background: Interleukin-6 (IL-6) and C reactive protein (CRP) are frequently detectable in amniotic fluid (AF). While CRP seems to be excreted by the fetal kidneys and probably by the lungs, IL-6 is an inflammatory cytokine produced by activated macrophages and lymphocytes which gain access to the amniotic cavity during intrauterine infection. IL-6 and other proinflammatory cytokines are also found in bronchoalveolar lavage of ventilated infants and in the urine of children with urinary tract infection. However, no information is available on the urinary IL-6 (uIL-6) content of neonates. Methods: Urine and blood samples were obtained from consecutive neonates in the first week of life. Urine was collected using sterile cotton flock. After centrifugation of the flock, urinary CRP (uCRP) was put in sterile tubes and sent immediately to the laboratory. Urinary CRP and uIL-6 were measured with a commercially available ELISA test. The sensitivity of the assay was below 10% for both measurements. The uCRP and uIL-6 values were normalized for the urinary creatinine content of every single probe. Spearman rank correlation was used for statistical purposes. Results: Serum and urinary CRP and IL-6 were measured in 15 infants. MeanϮSD gestational age at delivery and birth weight were 33.3Ϯ3.8 weeks and 1789Ϯ794 grams, respectively. Serum and uCRP was detectable in all samples with a median (range) serum concentration of 2830.2 ng/mL (113.3-187171) and 4.76 ng/mL (0.83-58.73) in the urine. No correlation was found between serum CRP and uCRP concentration. IL-6 was present in 14 (93.3%) blood samples and in 9 (60%) urine samples. The median (range) concentration of IL-6 was 3.6 pg/ml (0-542.5) in serum and 0.48 pg/ml (0-39.5) in urine, respectively. A significant correlation was found between serum IL-6 and uIL-6 (rϭ0.56; pϽ0.05). No correlation was found between uCRP and IL-6 in serum and urine. Conclusion: IL-6 can be present in neonatal urine at birth. This suggests that fetal urine could be another source of amniotic fluid IL-6 during intrauterine inflammatory processes.
La Pediatria medica e chirurgica : Medical and surgical pediatrics, Jan 22, 2017
Introduction of solid foods is a fundamental step in the development of an individual. There are ... more Introduction of solid foods is a fundamental step in the development of an individual. There are many implications that weaning contains not only on a nutritional plan, but also on the contingent and long-term health of an individual. Over time this nutritional passage has evolved through the acquisition of new knowledge about maturation of anatomical and neurosensory structures involved in all the phases of such a complex process. The understanding of a maturing taste of infant and cultural changes is another key to understand the evolution of introduction of solid foods in infants. What is contained in this text encapsulates thus the evolutionary path of weaning in recent years, showing current trends in the light of cultural changes and new scientific acquisitions.