Selected Abstracts of the 13Th International Workshop on Neonatology
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www.jpnim.com Open Access eISSN: 2281-0692 Journal of Pediatric and Neonatal Individualized Medicine 2017;6(2):e060234 doi: 10.7363/060234 Published online: 2017 Oct 24 Abstracts Selected Abstracts of the 13th International Workshop on Neonatology THE POWER OF EPIGENETICS TWINS: IDENTICAL BUT DIFFERENT CAGLIARI (ITALY) • OCTOBER 25TH-28TH, 2017 The Workshop has been organized with the patronage of the Italian Society of Neonatology (SIN), the Italian Society of Pediatrics (SIP), the Italian DOHaD (Developmental Origins of Health and Disease) Society, the Italian Society of Preventive and Social Pediatrics (SIPPS), the Union of European Neonatal and Perinatal Societies (UENPS), the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC), the Union of Middle-Eastern and Mediterranean Pediatric Societies (UMEMPS), the European Association of Perinatal Medicine (EAPM) and lastly the Italian-Romanian Society of Pediatrics. WORKSHOP’S PRESIDENTS Vassilios Fanos (Cagliari, Italy), Ola D. Saugstad (Oslo, Norway), Gabriel Dimitriou (Patras, Greece), Michele Mussap (Genoa, Italy), Dorret I. Boomsma (Amsterdam, The Netherlands), Raf Sciot (Leuven, Belgium), Gavino Faa (Cagliari, Italy) WORKSHOP’S HONORARY PRESIDENTS Marin Burlea (Iasi, Romania), Enver Hasanoğlu (Ankara, Turkey), Salvatore Vendemmia (Aversa, Italy) WORKSHOP’S HONORARY COMMITTEE D. Ayres-de-Campo (Porto, Portugal), S. Bernasconi (Parma, Italy), D.I. Boomsma (Amsterdam, the Netherlands), M. Burlea (Iasi, Romania), G. Buonocore (Siena, Italy), G. Corsello (Palermo, Italy), P. Curatolo (Rome, Italy), G. Di Mauro (Aversa, Italy), G. Dimitriou (Patras, Greece), C. Fabris (Turin, Italy), V. Fanos (Cagliari, Italy), G. Finco (Cagliari, Italy), H. Hasanoğlu (Ankara, Turkey), A. Iuculano (Cagliari, Italy), G. Marseglia (Pavia, Italy), G.B. Melis (Cagliari, Italy), G. Mercuro (Cagliari, Italy), G. Monni (Cagliari, Italy), C. Moretti (Rome, Italy), D. Pisano (Cagliari, Italy), G. Remuzzi (Bergamo, Italy), C. Romagnoli (Rome, Italy), E. Saliba (Tours, France), O.D. Saugstad (Oslo, Norway), M. Stronati (Pavia, Italy), G. Trapani (Sanremo, Italy), S. Vendemmia (Aversa, Italy), A. Villani (Rome, Italy), G.V. Zuccotti (Milan, Italy) WORKSHOP’S INTERNATIONAL FACULTY E. Bertino (Turin Italy), G. Buonocore (Siena, Italy), L. Cataldi (Rome, Italy), G. Corsello (Palermo, Italy), C. Dani (Florence, Italy), G. Faa (Cagliari, Italy), V. Fanos (Cagliari, Italy), G.B. Melis (Cagliari, Italy), C. Moretti (Rome, Italy), F. Mosca (Milan, Italy), P. Paolillo (Rome, Italy), M. Stronati (Pavia, Italy) SATELLITE MEETINGS’ PRESIDENTS Rino Agostiniani (Pistoia, Italy), Dorret I. Boomsma (Amsterdam, The Netherlands), Ernesto Burgio (Palermo, Italy), Gabriel Dimitriou (Patras, Greece), Gavino Faa (Cagliari, Italy), Vassilios Fanos (Cagliari, Italy), Lucia MIgliore (Pisa, Italy), Michele Mussap (Genoa, Italy), Giovanni Ottonello (Cagliari, Italy), Denis Pisano (Cagliari, Italy), Melania Puddu (Cagliari, Italy), Ola D. Saugstad (Oslo, Norway), Raf Sciot (Leuven, Belgium), Gianfranco Trapani (Sanremo, Italy) 1/89 www.jpnim.com Open Access Journal of Pediatric and Neonatal Individualized Medicine • vol. 6 • n. 2 • 2017 HOW TO CITE In the first group the level of CP was 195.3 ± 3.91 mg/l, in the second group was 224.1 ± 5.9 mg/l, p [Abstract’s authors]. [Abstract’s title]. In: Selected Abstracts < 0.05; activities of Ct were 9.6 ± 0.37 µmol/min • l of the 13th International Workshop on Neonatology; Cagliari and 6.9 ± 0.31 µmol/min • l respectively, p < 0.05; (Italy); October 25-28, 2017. J Pediatr Neonat Individual Med. activities of GTP were 68.0 ± 3.83 UI/l and 107.1 ± 2017;6(2):e060234. doi: 10.7363/060234. 1.16 UI/l respectively, p < 0.05. The activity of G6PD in the first group constituted 1.9 ± 0.06 µmol/min • Hb, ABS 1 in the second group – 1.6 ± 0.04 µmol/min • Hb, p < 0.05; GR activities were 2.1 ± 0.07 µmol/min • Hb NEONATAL ACUTE KIDNEY INJURY AND OXI- and 2.3 ± 0.06 µmol/min • Hb respectively, p > 0.05. DATIVE STRESS CONCLUSION The imbalance of the presented components of pro- A. Babintseva, Y. Hodovanets, L. Agafonova, A. oxidant system and antioxidant defense system in Phrunza critically ill full-term newborns under conditions of pathological OS is one of the triggering mechanisms Department of Pediatrics, Neonatology and Perinatal Medicine, Bukovinian of a number of pathological reactions causing the State Medical University, Chernivtsi, Ukraine formation of renal injuries in early neonatal period. REFERENCES INTRODUCTION [1] Mutinati M, Pantaleo M, Roncetti M, Piccinno M, Rizzo A, Sciorsci RL. Newborns are especially prone to oxidative stress Oxidative stress in neonatology. A Review. Reprod Dom Anim. 2014;49:7-16. (OS) [1]. OS can exacerbate several neonatal [2] Saugstad OD. Oxygen and oxidative stress in bronchopulmonary conditions to the extent that Saugstad coined the dysplasia. J Perinatal Med. 2010;38(6):571-7. phrase “oxygen radical disease of neonatology” [3] Selewski DT, Charlton JR, Jetton JG, Guillet R, Mhanna MJ, Askenazi DJ, such as bronchopulmonary dysplasia, chronic Kent AL. Neonatal Acute Kidney Injury. Pediatrics. 2015;136(3):Е463-73. lung disease, respiratory distress syndrome, peri- ventricular leukomalacia, neonatal encephalopathy, ABS 2 retinopathy of prematurity, necrotizing enterocolitis, and acute kidney injury (AKI) [2]. The objective LIFE SUPPORT MANAGEMENT IN NEONATES of this research is to study different components of WITH SEVERE OR DISMAL PROGNOSIS: THE pro-oxidant system and antioxidant defense system OPINIONS OF DOCTORS AND NURSES IN in critically ill full-term newborns with and with- A TERTIARY-LEVEL NEONATAL INTENSIVE out AKI. CARE UNIT MATERIALS AND METHODS Fifty-seven critically ill full-term neonates were S. Casarotto1, R. Beghini1, M. Castellani1, E. selected in this study. The first group included 22 Bonafiglia1, R. Frassoldati1, S. Carlassara1, F. neonates with AKI, the second group included Carnevale2, P. Biban1 35 newborns without AKI. AKI was detected according to literature [3]. The level of oxidative 1Neonatal Intensive Care Unit (NICU), Verona University Hospital, Italy modification of proteins (OMP) and concentration 2Pediatric Intensive Care Unit, McGill University, Montreal, Canada of malondialdehyde (MDA) in erythrocytes as pro- oxidant markers were established. The concentration INTRODUCTION of ceruloplasmin (CR), activities of catalase (Ct) and Advances in fetal diagnosis and postnatal medical glutamyl transpeptidase (GTP) in plasma, activities care are increasingly improving survival and offering glucose-6-phosphate dehydrogenase (G6PD) and more hope of recovery, both in extremely premature glutathione reductase (GR) in erythrocytes as anti- babies and more mature infants born with severe oxidant markers were established. clinical conditions. Thus, health professionals and RESULTS parents are frequently challenged to make complex In the first group the level of OMP was 1.16 ± 0.02 and emotionally demanding decisions, which may optical density per milliliter of erythrocytes, in the ultimately affect whether a baby shall live or die [1, 2]. second group was 1.04 ± 0.02 optical density per MATERIALS AND METHODS milliliter of erythrocytes, p < 0.05. The concentrations An anonymous online, 48-item questionnaire was of MDA in erythrocytes were 25.1 ± 0.48 µmol/l and distributed to doctors and nurses of the NICU in 24.2 ± 0.39 respectively, p > 0.05. Verona, to find out about the opinions of health 2/89 Selected Abstracts of the 13th International Workshop on Neonatology • Cagliari (Italy) • October 25th-28th, 2017 Journal of Pediatric and Neonatal Individualized Medicine • vol. 6 • n. 2 • 2017 www.jpnim.com Open Access professionals regarding the adoption of end-of-life decisions in critically ill infants. RESULTS Among the 69 recruited health professionals, we found much uncertainty about who should make end-of-life decisions. For example, while about half of the health professionals considered the Director as the final decision-maker in the NICU setting, though after multidisciplinary meetings (56.5%), in the delivery room there was a greater degree of indecision, identifying either the physician on duty (29%), the medical and nursing team (23.2%), or the Director (33.3%). Conflicts of opinion as a result of end-of-life decisions were reported by 46% of the health professionals. In evaluating 3 clinical scenarios (any patient, extreme prematurity or severe encephalopathy), we observed Strong disagreement significantly different opinions between males and females. In particular, males either strongly disagreed Disagreement or agreed in providing supportive care in each case, Uncertainty while females were in disagreement or uncertain (Fig. 1). Of note, as the age and clinical experience Agreement of health professionals increased, uncertainty about life support decisions raised. Figure 1 (ABS 2). Example of orientation of males and females in life support decisions in extremely premature CONCLUSIONS babies. Managing life support in neonates with poor or dismal prognosis is very controversial. Lack of shared scientific criteria complicates the role of the health A. Buffa1, M.C. Pintus1, M. Lussu2, A. Noto1, V. professionals. Several uncertainties and difficulties Masile1, D. Manus1, R. Pintus1, A. Dessì1, V. Fanos1, in making end-of-life decisions by NICU health L. Atzori2 professionals clearly emerged from our questionnaire. Tight collaboration between the medical and nursing 1Neonatal Intensive Care Unit, Neonatal Pathology,