1,721,002 research outputs found
Biomarkers of oxidative stress in fetal and neonatal diseases
No full textOxidative stress (OS) is strongly involved in the pathogenesis of many fetal and newborn diseases. A low efficient antioxidant systems in preterm babies are not able to counteract the harmful effects of free radicals (FRs), leading to "FRs-related disease" of newborns promoting cellular, tissue and organ damages. The dangerous effects of FRs are linked to their property of being very unstable molecules and their ability to react with lipids, proteins, polysaccharides, nucleic acids, causing functional alterations within the cell, until cell death. OS is difficult to be measured in vivo, because FRs have a very short half-life. Actually, measurements of lipid peroxidation reach high specificity and sensitivity with the discovery of stable compounds, isoprostanes. Recent studies evaluating the damaging effects of FRs in the perinatal period, have observed a direct relation between the degree of OS and the severity of oxidative damage in the course of pregnancy and in perinatal period, with an interesting predictive role of OS biomarkers for diseases resulting from oxidative injury. The validation of a biomarker profile for early identification of newborns at high risk of OS, will pave the way to new clinical preventative or therapeutic approaches to reduce the prevalence of neonatal disability
New pharmacologic and therapeutic approaches for hypoxic-ischemic encephalopathy in the newborn
No full textHypoxic-ischemic encephalopathy is still an important cause of neonatal mortality and long-term disabilities. The understanding of the differential responses to hypoxia-ischemia as an initial insult leading to cellular degeneration in brain has opened the way to develop new pharmacologic and therapeutic approaches. Due to the complex pathophysiology, therapies can target early pathways such as oxidative stress, inflammation and apoptosis or delayed pathways such as the privation of growth factors and cell death. Pharmacological interventions should start at different points of time according to their mechanisms of action. The association of moderate hypothermia with neuroprotective drugs may decrease cell injury and optimize endogenous repair. More basic science research focusing on the mechanisms of injury are required. Moreover, clinical trials are needed to detect safely and effectiveness drugs and to establish the optimal time of action for each on
Use of fetal analgesia during prenatal surgery
No full textObjective: Recent progresses in fetal surgery have raised concern on fetal pain, its long-term consequences and the risks of sudden fetal movements induced by pain. In several studies, surgeons have directly administered opioids to the fetus, while others have considered sufficient the maternally administered analgesics. We performed a review of the literature to assess the state of the art. Methods: We performed a PubMed search to retrieve the papers that in the last 10 years reported studies of human fetal surgery and that described whether any fetal analgesia was administered. Results: We retrieved 34 papers. In three papers, the procedure did not hurt the fetus, being performed on fetal annexes, in two papers, it was performed in the first half of pregnancy, when pain perception is unlikely. In 10 of the 29 remaining papers, fetal surgery was performed using direct fetal analgesia, while in 19, analgesia was administered only to the mother. In most cases, fetal direct analgesia was obtained using i.m. opioids, and muscle relaxant. Rare drawbacks on either fetuses or mothers due to fetal analgesia were reported. Conclusion: Fetal direct analgesia is performed only in a minority of cases and no study gives details about fetal reactions to pain. More research is needed to assess or exclude its possible long-term drawbacks, as well as the actual consequences of pain during surger
Ruolo dello stress ossidativo nel danno cerebrale e diagnosi precoce dell’insorgenza di emorragia intraventricolare
No full textBrain damage and oxidative stress in the perinatal period: melatonin as a neuroprotective new drug
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