Clinical, biological and electroencephalographic monitoring of newborns with neurological risk in the Neonatal Intensive Care Unit

Doandes, Florina; Manea, Aniko-Maria; Lungu, Nicoleta; Cioboata, Daniela; Brandibur, Timea E.; Costescu, Oana; Hudisteanu, Anca; Boia, Eugen Radu; Boia, Marioara

doi:10.3892/etm.2021.10192

Cited by 11 publications

(11 citation statements)

References 45 publications

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“…Figure 5 shows a possible mechanism of action of Hpex. In light of the fact that flavonoids are antioxidant compounds [63] and that reactive oxygen species contribute to the development of cancer [64] and other chronic pathologies, such as cardiovascular disease [65,66], diabetes mellitus [67,68], endothelial dysfunction [69,70], or neurological pathologies [71], this study examined the antioxidant activity of the hydroalcoholic extract of H. purpurascens. A 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging assay was applied to evaluate the antioxidant activity of four extract concentrations (10, 25, 50, and 100 μg/mL).…”

Section: Discussionmentioning

confidence: 99%

“…Its remarkable antioxidant properties are due to the compounds that were found in H. purpurascens extract, which have been associated with the neutralization of oxygen-free species [72]. The antioxidant activity of flavonoids is mainly based on five mechanisms of action, as follows: (i) due to the -OH group in the structure of flavonoids, they interact directly In light of the fact that flavonoids are antioxidant compounds [63] and that reactive oxygen species contribute to the development of cancer [64] and other chronic pathologies, such as cardiovascular disease [65,66], diabetes mellitus [67,68], endothelial dysfunction [69,70], or neurological pathologies [71], this study examined the antioxidant activity of the hydroalcoholic extract of H. purpurascens. A 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging assay was applied to evaluate the antioxidant activity of four extract concentrations (10,25,50, and 100 µg/mL).…”

Section: Discussionmentioning

confidence: 99%

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Comparative Evaluation of the Potential Antitumor of Helleborus purpurascens in Skin and Breast Cancer

Pilut

Manea

Macaşoi

et al. 2022

Plants

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In the field of oncology, the plant kingdom has an inexhaustible supply of bioactive compounds. Phytochemical compounds isolated from Helleborus species have been found to be useful in various chronic diseases. This has brought Helleborus to the attention of medical researchers. H. purpurascens is a plant characteristic of the Carpathian area, known since ancient times for its beneficial effects. The aim of the study was to evaluate the flavonoids composition of a hydroalcoholic extract of H. purpurascens, as well as to assess its antioxidant activity and antitumor potential at the level of two healthy cell lines and four tumor cell lines. In addition, the expression of the genes involved in the apoptotic process (Bcl-2, Bad, and Bax) were evaluated. The results indicated that the extract has a high concentration of flavonoids, such as epicatechin, quercetin, and kaempferol. The extract has an increased antioxidant activity, very similar to that of the standard, ascorbic acid and cytotoxic effects predominantly in the breast cancer cell line, being free of cytotoxic effects in healthy cell lines. Underlying the cytotoxic effect is the induction of the process of apoptosis, which in the present study was highlighted by decreasing the expression of anti-apoptotic genes (Bcl-2) and increasing the expression of pro-apoptotic genes (Bad and Bax). In conclusion, the hydroalcoholic extract of H. purpurascens can be considered an important source for future medical applications in cancer therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparative Evaluation of the Potential Antitumor of Helleborus purpurascens in Skin and Breast Cancer

Pilut

Manea

Macaşoi

et al. 2022

Plants

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“…Liver enzymes, myocardial proteins, and other markers that assess end-organ damage are frequently measured in neonatal blood and may support outcome prediction. Changes in creatine and creatine kinase, lactate dehydrogenase, alanine aminotransferase, and c-reactive protein have all shown predictive value in the first 3 days of life [70][71][72][73], whereas Troponin-I levels within 6 h of birth distinguished mild NE from moderate-to-severe NE [74].…”

Section: Other Metabolic Markersmentioning

confidence: 99%

“…Moreover, aEEG monitoring has limited predictivity <6 h for mild NE [9]. Continuous and Discontinuous Normal Voltage were the predominant background patterns [73, 79], although excessive discontinuity and disrupted sleep-wake cycling are also common in these infants [79, 80]. By contrast, conventional EEG has higher accuracy, but requires resources and expertise that may not always be available in NICUs [81].…”

Section: Electrophysiological Monitoringmentioning

confidence: 99%

Prognostic Neurobiomarkers in Neonatal Encephalopathy

Wassink¹,

Harrison²,

Dhillon³

et al. 2022

Dev Neurosci

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Therapeutic hypothermia is now standard-care for infants with moderate-severe neonatal encephalopathy (NE), and improves brain damage on neuroimaging, and neurodevelopmental outcomes. Critically, for effective neuroprotection, hypothermia should be started within 6 h from birth. There is compelling evidence to suggest that a proportion of infants with mild NE have material risk of developing brain damage and poor outcomes. This cohort is increasingly being offered therapeutic hypothermia, despite lack of trial evidence for its benefit. In current practice, infants need to be diagnosed within 6 h of birth for therapeutic treatment, compared to retrospective NE grading in the pre-hypothermia era. This presents challenges as NE is a dynamic brain disorder that can worsen or resolve over time. Neurological symptoms of NE can be difficult to discern in the first few hours after birth, and confounded by analgesics and anesthetic treatment. Using current enrolment criteria, a significant number of infants with NE that would benefit from hypothermia are not treated, and vice versa, infants are receiving mild hypothermia when its benefit will be limited. Better biomarkers are needed to further improve management and treatment of these neonates. In the present review, we examine the latest research, and highlight a central limitation of most current biomarkers: that their predictive value is consistently greatest after most neuroprotective therapies are no longer effective.

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“…Low Apgar scores, and abnormal findings on cord blood gases, neurological examination, biochemical markers, electroencephalogram (EEG), amplitude-integrated EEG (aEEG), and magnetic resonance imaging (MRI) are predictors of poor prognosis in infants with HIE. 2,[3][4][5] A combination of parameters provides more reliable prognostic information 6,7 than an isolated parameter.…”

mentioning

confidence: 99%

Does abnormal Doppler on cranial ultrasound predict disability in infants with hypoxic‐ischaemic encephalopathy? A systematic review

Rath

Rao

Suryawanshi

et al. 2022

Develop Med Child Neuro

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Aim: To evaluate whether abnormal resistive index or cerebral blood flow velocity (CBFV) on cranial ultrasound predicts disability (≥1 year) in infants with hypoxicischaemic encephalopathy (HIE). Method:This was a systematic review and meta-analysis of studies comparing developmental outcomes of infants with HIE with normal versus abnormal resistive index or CBFV.Results: Twenty-six studies were included (pre-therapeutic hypothermia era, 20; therapeutic hypothermia era, six). Data from 15 studies (pre-therapeutic hypothermia, 10; therapeutic hypothermia, five) were available for meta-analysis. Pooled sensitivity and specificity, summary area under the receiver operating characteristic curve, and diagnostic odds ratio of resistive index or CBFV for predicting 'death or severe disability' were as follows. Pre-therapeutic hypothermia era: 0.83 (95% confidence interval [CI] 0.45-0.97) and 0.92 (95% CI 0.74-0.98), 0.94 (95% CI 0.92-0.96), 54 (95% CI 7-391). Therapeutic hypothermia era (measurements before therapeutic hypothermia): 0.62 (95% CI 0.41-0.80) and 0.96 (95% CI 0.88-0.99), 0.93 (95% CI 0.89-0.94), 23 (95% CI 6-91). Therapeutic hypothermia era (measurements during/ after therapeutic hypothermia): 0.51 (95% CI 0.24-0.78) and 0.83 (95% CI 0.73-0.90), 0.81 (95% CI 0.78-0.85), 5 (95% CI 2-13). Overall Grading of Recommendations Assessment, Development and Evaluation (GRADE) rating of evidence was 'low' or 'very low'.Interpretation: Low-level evidence suggests that abnormal resistive index or CBFV can predict death or disability with high sensitivity and specificity in infants with HIE who are not cooled. The specificity of these tests was high when performed before starting cooling in infants who received therapeutic hypothermia.

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Clinical, biological and electroencephalographic monitoring of newborns with neurological risk in the Neonatal Intensive Care Unit

Cited by 11 publications

References 45 publications

Comparative Evaluation of the Potential Antitumor of Helleborus purpurascens in Skin and Breast Cancer

Comparative Evaluation of the Potential Antitumor of Helleborus purpurascens in Skin and Breast Cancer

Prognostic Neurobiomarkers in Neonatal Encephalopathy

Does abnormal Doppler on cranial ultrasound predict disability in infants with hypoxic‐ischaemic encephalopathy? A systematic review

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