Validazione e applicazioni cliniche della metodica NIRA (Near Infrared Reflectance Analysis) per la valutazione del contenuto nutrizionale del latte materno in terapia intensiva neonatale

Phase 1: To validate Near-Infrared Reflectance Analysis (NIRA) as a fast, reliable and suitable method for routine evaluation of human milk’s nitrogen and fat content. Phase 2: To determine whether fat content, protein content and osmolality of HM before and after fortification may affect gastroesophageal reflux (GER) in symptomatic preterm infants. Patients and Methods: Phase 1: 124 samples of expressed human milk (55 from preterm mothers and 69 from term mothers) were used to validate NIRA against traditional methods (Gerber method for fat and Kjeldhal method for nitrogen). Phase 2: GER was evaluated in 17 symptomatic preterm newborns fed naïve and fortified HM by combined pH/intraluminal-impedance monitoring (pH-MII). HM fat and protein content was analysed by a Near-Infrared-Reflectance-Analysis (NIRA). HM osmolality was tested before and after fortification. GER indexes measured before and after fortification were compared, and were also related with HM fat and protein content and osmolality before and after fortification. Results: Phase 1: · A strong agreement was found between traditional methods’ and NIRA’s results (expressed as g/100 g of milk), both for fat and nitrogen content in term (mean fat content: NIRA=2.76; Gerber=2.76; mean nitrogen content: NIRA=1.88; Kjeldhal =1.92) and preterm (mean fat content: NIRA=3.56; Kjeldhal=3.52; mean nitrogen content: NIRA=1.91; Kjeldhal =1.89) mother’s milk. · Nitrogen content of the milk samples, measured by NIRA, ranged from 1.18 to 2.71 g/100 g of milk in preterm milk and from 1.48 to 2.47 in term milk; fat content ranged from 1.27 to 6.23 g/100 g of milk in preterm milk and from 1.01 to 6.01 g/100 g of milk in term milk. Phase 2: · An inverse correlation was found between naïve HM protein content and acid reflux index (RIpH: p=0.041, rho=-0.501). · After fortification, osmolality often exceeded the values recommended for infant feeds; furthermore, a statistically significant (p<.05) increase in non acid reflux indexes was observed. Conclusions: NIRA can be used as a fast, reliable and suitable tool for routine monitoring of macronutrient content of human milk. Protein content of naïve HM may influence acid GER in preterm infants. A standard fortification of HM may worsen non acid GER indexes and, due to the extreme variability in HM composition, may overcome both recommended protein intake and HM osmolality. Thus, an individualized fortification, based on the analysis of the composition of naïve HM, could optimize both nutrient intake and feeding tolerance.

Development and optimization of graphic user interfaces (GUIs) for infrared spectrometers at the Telescopio Nazionale Galileo

This Phd thesis was entirely developed at the Telescopio Nazionale Galileo (TNG, Roque de los Muchachos, La Palma Canary Islands) with the aim of designing, developing and implementing a new Graphical User Interface (GUI) for the Near Infrared Camera Spectrometer (NICS) installed on the Nasmyth A of the telescope. The idea of a new GUI for NICS has risen for optimizing the astronomers work through a set of powerful tools not present in the existing GUI, such as the possibility to move automatically, an object on the slit or do a very preliminary images analysis and spectra extraction. The new GUI also provides a wide and versatile image display, an automatic procedure to find out the astronomical objects and a facility for the automatic image crosstalk correction. In order to test the overall correct functioning of the new GUI for NICS, and providing some information on the atmospheric extinction at the TNG site, two telluric standard stars have been spectroscopically observed within some engineering time, namely Hip031303 and Hip031567. The used NICS set-up is as follows: Large Field (0.25'' /pixel) mode, 0.5'' slit and spectral dispersion through the AMICI prism (R~100), and the higher resolution (R~1000) JH and HK grisms.