Microglial Cells Prevent Hemorrhage in Neonatal Focal Arterial Stroke

Perinatal stroke leads to significant morbidity and long-term neurological and cognitive deficits. The pathophysiological mechanisms of brain damage depend on brain maturation at the time of stroke. To understand whether microglial cells limit injury after neonatal stroke by preserving neurovascular integrity, we subjected postnatal day 7 (P7) rats depleted of microglial cells, rats with inhibited microglial TGFbr2/ALK5 signaling, and corresponding controls, to transient middle cerebral artery occlusion (tMCAO). Microglial depletion by intracerebral injection of liposome-encapsulated clodronate at P5 significantly reduced vessel coverage and triggered hemorrhages in injured regions 24 h after tMCAO. Lack of microglia did not alter expression or intracellular redistribution of several tight junction proteins, did not affect degradation of collagen IV induced by the tMCAO, but altered cell types producing TGFβ1 and the phosphorylation and intracellular distribution of SMAD2/3. Selective inhibition of TGFbr2/ALK5 signaling in microglia via intracerebral liposome-encapsulated SB-431542 delivery triggered hemorrhages after tMCAO, demonstrating that TGFβ1/TGFbr2/ALK5 signaling in microglia protects from hemorrhages. Consistent with observations in neonatal rats, depletion of microglia before tMCAO in P9 Cx3cr1(GFP/+)/Ccr2(RFP/+) mice exacerbated injury and induced hemorrhages at 24 h. The effects were independent of infiltration of Ccr2(RFP/+) monocytes into injured regions. Cumulatively, in two species, we show that microglial cells protect neonatal brain from hemorrhage after acute ischemic stroke. SIGNIFICANCE STATEMENT The pathophysiological mechanisms of brain damage depend on brain maturation at the time of stroke. We assessed whether microglial cells preserve neurovascular integrity after neonatal stroke. In neonatal rats, microglial depletion or pharmacological inhibition of TGFbr2/ALK5 signaling in microglia triggered hemorrhages in injured regions. The effect was not associated with additional changes in expression or intracellular redistribution of several tight junction proteins or collagen IV degradation induced by stroke. Consistent with observations in neonatal rats, microglial depletion in neonatal mice exacerbated stroke injury and induced hemorrhages. The effects were independent of infiltration of monocytes into injured regions. Thus, microglia protect neonatal brain from ischemia-induced hemorrhages, and this effect is consistent across two species.

Gastroschisis: determinants of neonatal outcome

This retrospective study elicits information regarding the dependence of neonatal outcome in gastroschisis upon: (1) the mode of delivery, (2) place of birth, (3) time for birth to surgery, (4) method of closure, (5) time from operation to commencement of first enteral feeds. The neonatal intensive care database from five major tertiary centres was used to identify 181 neonates with gastroschisis from 1990 to 2000. There were 8 deaths. There were no significant differences in outcome for infants delivered vaginally (102) versus Caesarean section (79), those born near the tertiary centre (133) as compared to infants born away (48), ones operated within 7 hours (125) compared with those operated after 7 hours (56), with delayed closure (30) versus primary closure (151). Neonates fed within 10 days of operation (85) had significantly lower incidence of sepsis, duration of TPN and hospital stay when compared to those fed after 10 days (96). Early commencement of feeds decreases the incidence of sepsis, duration of total parenteral nutrition (TPN) and hospital stay. Place of delivery, mode of delivery, time to surgery and type of closure do not influence neonatal outcome.

Neonatal neurodevelopment outcomes following tocolysis with glycerol trinitrate patches

Objective: The object of this study was to determine the effects of maternal tocolysis with glycerol trinitrate (GTN) patches on the neurodevelopment of infants. Study design: This was a randomized, multicenter, controlled trial comparing the efficacy of GTN patches with standard beta 2 agonist as tocolytic therapy. The previously reported outcomes of this study indicated no difference in neonatal mortality or morbidity to hospital discharge. One hundred fifty-six surviving infants from 2 Australian centers were psychometrically assessed using the Griffiths Mental development Scales (revised) at 18 months of age. Results: There was no difference in psychometric performance between those infants enrolled in either the GTN (81 infants) or beta 2 agonist (75 infants) arm of the study. Conclusion: This randomized trial supports no significant difference between GTN patches in comparison with standard beta 2 agonist for tocolytic therapy. The results underscore the association between premature labor and adverse infant outcomes. (c) 2006 Mosby, Inc. All rights reserved.

Near Term Computer Management Strategy For Hospitality Managers and Computer System Vendors

In his dialogue - Near Term Computer Management Strategy For Hospitality Managers and Computer System Vendors - by William O'Brien, Associate Professor, School of Hospitality Management at Florida International University, Associate Professor O’Brien initially states: “The computer revolution has only just begun. Rapid improvement in hardware will continue into the foreseeable future; over the last five years it has set the stage for more significant improvements in software technology still to come. John Naisbitt's information electronics economy¹ based on the creation and distribution of information has already arrived and as computer devices improve, hospitality managers will increasingly do at least a portion of their work with software tools.” At the time of this writing Assistant Professor O’Brien will have you know, contrary to what some people might think, the computer revolution is not over, it’s just beginning; it’s just an embryo. Computer technology will only continue to develop and expand, says O’Brien with citation. “A complacent few of us who feel “we have survived the computer revolution” will miss opportunities as a new wave of technology moves through the hospitality industry,” says ‘Professor O’Brien. “Both managers who buy technology and vendors who sell it can profit from strategy based on understanding the wave of technological innovation,” is his informed opinion. Property managers who embrace rather than eschew innovation, in this case computer technology, will benefit greatly from this new science in hospitality management, O’Brien says. “The manager who is not alert to or misunderstands the nature of this wave of innovation will be the constant victim of technology,” he advises. On the vendor side of the equation, O’Brien observes, “Computer-wise hospitality managers want systems which are easier and more profitable to operate. Some view their own industry as being somewhat behind the times… They plan to pay significantly less for better computer devices. Their high expectations are fed by vendor marketing efforts…” he says. O’Brien warns against taking a gamble on a risky computer system by falling victim to un-substantiated claims and pie-in-the-sky promises. He recommends affiliating with turn-key vendors who provide hardware, software, and training, or soliciting the help of large mainstream vendors such as IBM, NCR, or Apple. Many experts agree that the computer revolution has merely and genuinely morphed into the software revolution, informs O’Brien; “…recognizing that a computer is nothing but a box in which programs run.” Yes, some of the empirical data in this article is dated by now, but the core philosophy of advancing technology, and properties continually tapping current knowledge is sound.

Does prenatal diagnosis modify neonatal treatment and early outcome of children with esophageal atresia?

International audience

Risk Factors for Neonatal Sepsis and Method for Reduction of Blood Culture Contamination

Background False-positive blood cultures findings may lead to a falsely increased morbidity and increased hospital costs. Method The survey was conducted as retrospective - prospective study and included 239 preterm infants (born before 37 weeks of gestation) who were treated in Neonatal Intensive Care Unit (NICU) in Institute for Child and Youth Health Care of Vojvodina during one year (January 1st, 2012 to December 31st, 2012). The retrospective part of the study focused on examination of incidence of neonatal sepsis and determination of risk factors. In the prospective part of the study infants were sub-divided into two groups: Group 1- infants hospitalized in NICU during the first 6 months of the study; blood cultures were taken by the ‘’clean technique’’ and checklists for this procedure were not taken. Group 2- neonates hospitalized in NICU during last 6 months of the study; blood cultures were taken by ‘’sterile technique’’ and checklists for this procedure were taken. Results The main risk factors for sepsis were prelabor rupture of membranes, low gestational age, low birth weight, mechanical ventilation, umbilical venous catheter placement, and abdominal drainage. Staphylococcus aureus and coagulase negative Staphylococcus were the most frequently isolated microorganisms in false-positive blood samples. Conclusions Education of employees, use of checklists and sterile sets for blood sampling, permanent control of false positive blood cultures, as well as regular and routine monthly reports are crucial for successful reduction of contamination rates.

Near-infrared spectroscopic study of basic aluminum sulfate and nitrate

The tridecameric Al-polymer [AlO4Al12(OH)24(H2O)12]7+ was prepared by forced hydrolysis of Al3+ up to an OH/Al molar ratio of 2.2. Under slow evaporation crystals were formed of Al13-nitrate. Upon addition of sulfate the tridecamer crystallised as the monoclinic Al13-sulfate. These crystals have been studied using near-infrared spectroscopy and compared to Al2(SO4)3.16H2O. Although the near-infrared spectra of the Al13-sulfate and nitrate are very similar indicating similar crystal structures, there are minor differences related to the strength with which the crystal water molecules are bonded to the salt groups. The interaction between crystal water and nitrate is stronger than with the sulfate as reflected by the shift of the crystal water band positions from 6213, 4874 and 4553 cm–1 for the Al13 sulfate towards 5925, 4848 and 4532 cm–1 for the nitrate. A reversed shift from 5079 and 5037 cm–1 for the sulfate towards 5238 and 5040 cm–1 for the nitrate for the water molecules in the Al13 indicate that the nitrate-Al13 bond is weakened due to the influence of the crystal water on the nitrate. The Al-OH bond in the Al13 complex is not influenced by changing the salt group due to the shielding by the water molecules of the Al13 complex.