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Biomedical subjects

Styliani Andronikou

Publications and source records attributed to Styliani Andronikou.

11 recordsLinked to original sources
PubMed2006

The effect of intrauterine growth retardation on renal function in the first two months of life.

BACKGROUND: Children born with growth retardation (GR) have a smaller nephron number and are at increased risk for the development of renal disease and hypertension in adult life. Data on the immediate post-natal development of renal function in neonates born with GR are limited and data on the effects of aminoglycosides (AGs) on renal function in these infants are lacking. METHODS: This was a prospective study of 81 preterm neonates with a mean gestational age of 32.5 weeks, 40 born with GR (small for gestational age, SGA) and 41 without GR (appropriate for gestational age, AGA). The infants were classified into 4 groups. Groups A (n = 21) and B (n = 20) consisted of AGA and SGA neonates, respectively, who received AGs, and groups C (n = 20) and D (n = 20) of AGA and SGA neonates, respectively, who did not receive AG treatment. Indices of renal function were: serum creatinine (SeCr), the fractional excretion of sodium (FENa), potassium (FEK), phosphorus (FEP), magnesium and uric acid (FEUA), the urinary calcium/creatinine ratio and the transtubular potassium gradient (TTKG). RESULTS: No differences were observed in the parameters examined between SGA and AGA neonates who did not receive AGs. Conversely, SGA infants who received AGs after birth (group B) exhibited higher values of SeCr 2 months later. Specifically, their mean +/- SD value of SeCr (micromol/l) was 42 +/- 05 compared with 33 +/- 08 in group D, 35 +/- 04 in group A and 33 +/- 04 in group C (P < 0.01). These infants also had significantly higher values of TTKG than SGA infants without AG treatment (22 +/- 9 vs 13 +/- 3 in group D) and FEUA (60 +/- 23 vs 35 +/- 14 in group D). Their FENa and FEP were also inappropriately high despite having lower serum levels of Na and P. CONCLUSION: Preterm SGA infants who had no need of AG treatment after birth have similar renal functional maturation than AGA preterm infants at 2 months of life, but preterm SGA infants who received AGs had indications of impaired glomerular and tubular function at this age.

Aminoglycosides↗
PubMed2006

Kidney growth in small-for-gestational-age infants: Evidence of early accelerated renal growth.

BACKGROUND: Very few data are available on longitudinal renal growth in small for gestational age (SGA) infants born at term. The aim of this prospective study was to estimate comparatively the renal growth in SGA infants and in infants born appropriate for gestational age (AGA) during the first 2 years of life. METHODS: The study comprised groups of SGA and AGA infants with a gestational age (GA) of 36-41 weeks. The SGA group was classified into two subgroups of symmetrical and asymmetrical neonates according to the ponderal index. Serial renal ultrasonography (US) was performed at the ages of 41 weeks corrected age [GA (in weeks) plus age after birth (in weeks)] and at 3, 6, 12 and 24 months of chronological age and kidney length (KL) was related to other anthropometric indices. RESULTS: A total of 312 infants participated in the study out of which 197 were SGA, and a total number of 802 measurements were performed. The symmetrical SGA infants and, to a lesser degree, the asymmetrical SGA infants had smaller kidneys at birth compared with the AGA infants (P < 0.0001 and P < 0.001, respectively). The symmetrical SGA infants had a lower body weight (BW) (P < 0.001, P < 0.01) and crown-heel length (CHL) (P < 0.01, P < 0.05) than controls at the ages of 12 and 24 months of chronological age. The asymmetrical SGA infants had a lower BW (P < 0.01, P < 0.05) than controls at the ages of 12 and 24 months of chronological age. On the contrary, the KL in both SGA groups was not different from that of the AGA infants after the 41st week of corrected age and up to the 2nd year of life. CONCLUSION: SGA term infants had shorter KL at birth compared with AGA infants but a similar length from the 3rd to the 24th month of life. Early catch-up kidney growth was observed in both SGA groups and is more prominent in the symmetrical SGA infants. This observation may represent either an accelerated renal maturation process or early compensatory kidney hypertrophy in this group of infants.

Age Factors↗
PubMed2006

Myelination process in preterm subjects with periventricular leucomalacia assessed by magnetization transfer ratio.

BACKGROUND: Magnetization transfer imaging assesses the myelination status of the brain. OBJECTIVES: To study the progress of myelination in children with periventricular leucomalacia (PVL) by measuring the magnetization transfer ratio (MTR) and to compare the MTR values with normal values. MATERIALS AND METHODS: Brain MTR in 28 PVL subjects (16 males, 12 females, gestational age 30.7+/-2.5 weeks, corrected age 3.1+/-2.9 years) was measured using a 3D gradient echo sequence (TR/TE 32/8 ms, flip angle 60 degrees, 4 mm/2 mm overlapping sections) without and with magnetization transfer prepulse and compared with normal values for preterm subjects. RESULTS: MTR of white-matter structures followed a monoexponential function model (y=A-B*exp(-x/C)) while the thalamus and caudate nucleus had a poor goodness of fit. MTR of the splenium of the corpus callosum reached a final value lower than normal (0.67 versus 0.70) at a younger age [t(99%) at 10.32 versus 18.90 months; P<0.05]. MTR of the normal-appearing occipital white matter and of the genu of the corpus callosum reached a normal final MTR but at a younger age than normal preterm infants [t(99%) at 8.51 versus 14.50 months and 12.51 versus 20.85 months, respectively]. CONCLUSION: In PVL subjects, myelination of the splenium is characterized by early arrest and deficient maturation. Accelerated myelination in unaffected white matter might suggest a compensatory process of reorganization.

Child, Preschool↗
PubMed2005

Breastfeeding and vitamin D status in Greece during the first 6 months of life.

UNLABELLED: Since no foods are vitamin D supplemented in Greece, vitamin D status was assessed in mothers at birth and their infants up to the first 6 months of life, while they were exclusively breast-fed. This was a prospective study. Full-terms (n =35) born during the summer-autumn months and their mothers were assigned to the summer group and the remainder (n =31) to the winter group. One week after birth, serum 25-hydroxyvitamin D (25OHD) was significantly lower in the winter-born than in the summer-born neonates (6.7+/-0.7 vs. 10.1+/-0.9 ng/ml, P <0.01). The respective levels of parathyroid hormone (iPTH) were 64.9+/-13.4 and 33.9+/-4.4 pg/ml (P <0.01). The mothers had serum 25OHD levels of 10.8+/-1.0 ng/ml and iPTH levels of 15.2+/-3.5 pg/ml in the winter and 12.9+/-1.3 ng/ml and 24.8+/-4.8 pg/ml in the summer. During the 6-month follow-up, a steady increase in circulating 25OHD (up to 19.4+/-2.8 ng/ml, P <0.0001) and a decrease in iPTH (to 26.8+/-3.5 pg/ml, P =0.10) were observed in the infants born in the winter. In the summer-born infants, serum 25OHD did not change but iPTH had increased significantly by the 3rd month (59.4+/-21.8, P <0.05). Serum calcium (Ca) increased within normal limits during the study period in both groups. Serum phosphorus (Pi) started higher in the winter group (7.43+/-0.38 vs. 6.27+/-0.23 mg/dl, P <0.01) but thereafter, it was similar in both groups. Total alkaline phosphatase (ALP) increased in both groups during the study (164+/-15 vs. 219+/-17 IU/l, P <0.05 and 189+/-14 vs. 288+/-35 IU/l, P <0.001, respectively). Serum osteocalcin (OC) decreased in the winter-born neonates (32.0+/-3.4 vs. 21.5+/-3.4 ng/ml, P <0.05) and did not change in the summer group (28.9+/-3.5 vs. 26.5+/-2.8 ng/ml). CONCLUSION: Neonates who are breast-fed exclusively during the first 6 months of life are in need of vitamin D supplementation irrespective of the season even in a sunny country like Greece where foods are not supplemented.

Adult↗
PubMed2005

Kidney development in the first year of life in small-for-gestational-age preterm infants.

BACKGROUND: Small-for-gestational-age (SGA) infants have been reported to have a significantly reduced number of nephrons that could be a risk factor for development of hypertension later in life. OBJECTIVE: To evaluate kidney size prospectively in relation to other anthropometric parameters during the first year of life in SGA babies. MATERIALS AND METHODS: The babies in the study were 31-36 weeks' gestational age (GA) at birth and were matched with control preterm infants of similar GA, but appropriate for gestational age (AGA). The SGA infants were further classified as symmetrical and asymmetrical according to the anthropometric parameters. RESULTS: The total number of measurements in symmetrical SGA preterm infants was 324, in asymmetrical SGA preterm infants 295, and in AGA infants 536. In symmetrical SGA preterm infants (31-36 weeks' GA) mean kidney length (+/- SD) of 56+/-4 mm was significantly different from the controls (58.9+/-4.6 mm) up to 6 months' chronological age (P < 0.05). In the asymmetrical SGA preterm infants, mean kidney length (45.3+/-4.0 mm) was significantly different from the controls (48.2+/-4.4 mm) up to 40 weeks' corrected age. At 1 year chronological age, all preterm infants (symmetrical and asymmetrical SGA and AGA) had similar mean kidney length (61.6+/-4.6, 62.8+/-4.3, and 62.3+/-4.0 mm, respectively). The ratio of kidney length to crown-to-heel length was similar in all preterm groups. CONCLUSIONS: Kidney length in preterm SGA infants (symmetrical and asymmetrical) follows closely the other auxological parameters during the first year of life.

Birth Weight↗
PubMed2005

Magnetization transfer ratio in the brain of preterm subjects: age-related changes during the first 2 years of life.

To study the progress of myelination in preterm-born subjects by measuring the MT ratio (MTR) from birth, up to 24 months of corrected age. One hundred twenty-five preterm subjects (64 males and 61 females of gestational age 33+/-2.4 weeks with chronologic and corrected age of 9.3+/-5.1 and 7.7+/-5.1 months, respectively) with normal brain MR using classic sequences were further evaluated for MTR by using a three-dimensional gradient-echo sequence (TR=32/TE=8/flip angle=6 degrees 4 mm/2 mm overlapping sections) with and without magnetization transfer prepulse. The magnetization transfer ratio was calculated as: MTR=(SIo-SIm)/SIox100%, where SIm refers to signal intensity from an image acquired with a MT prepulse and SIo the signal intensity from the image acquired without a MT prepulse. MTR increased asymptotically in the genu (R2=0.85) and splenium (R2=0.85) of the corpus callosum, the white matter of the frontal lobe (R2=0.91) and occipital lobe (R2=0.82), thalamus (R2=0.86), caudate nucleus (R2=0.67) and putamen (R2=0.71), reaching the 95% of the final value at the corrected age 18.7, 17.7, 15.6, 12.9, 10.4, 9.2 and 6.4 months, respectively. This study shows age-related changes of the brain MTR and provides data that may be useful to assess disturbances in the progress of myelination.

Age Factors↗
PubMed2004

Pituitary gland signal in pre-term infants during the first year of life: an MRI study.

Our purpose was to determine the pituitary gland signal of premature neonates and infants. We retrospectively measured, in a midline sagittal T1-weighted MRI scan, the pituitary signal of 121 premature infants (mean gestational age: 32.8 weeks, mean chronological age: 6.9 months, mean corrected age: 5.2 months). The relative signal intensity of the adenohypophysis and neurohypophysis was measured as (A-V)/V and (P-V)/V, respectively (where A, P, V are the mean signal intensities of the adenohypophysis, neurohypophysis and vermis white matter, respectively). On visual inspection the adenohypophysis was rated relative to the vermis white matter (VWM) and scored as hyperintense (grade 3), isointense (grade 2) and hypointense (grade 1). (A-V)/V and (P-V)/V had a negative correlation with chronological age (r=-0.38, r=-0.35, respectively, P<0.01) and corrected age (r=-0.42, r=-0.40, respectively, P<0.01). The (A-V)/V was different in the three grade groups; significant difference was found between grades 3 and 2 and grades 3 and 1. The adenohypophysis was bright in 93% of babies under 2 months of chronological age. In five babies of mean gestational age 29.1 weeks a hyperintense adenohypophysis was observed at 2.9-3.7 months of chronological age (corrected age 0.37-2 months). We conclude that in pre-term babies the adenohypophysis appears in hypersignal that may persist up to 2 months of corrected age. The adenohypophyseal and neurohypophyseal signals decrease with age.

Age Factors↗
PubMed2004

Comparison of misoprostol and dinoprostone for elective induction of labour in nulliparous women at full term: a randomized prospective study.

BACKGROUND: The objective of this randomized prospective study was to compare the efficacy of 50 mcg vaginal misoprostol and 3 mg dinoprostone, administered every nine hours for a maximum of three doses, for elective induction of labor in a specific cohort of nulliparous women with an unfavorable cervix and more than 40 weeks of gestation. MATERIAL AND METHODS: One hundred and sixty-three pregnant women with more than 285 days of gestation were recruited and analyzed. The main outcome measures were time from induction to delivery and incidence of vaginal delivery within 12 and 24 hours. Admission rate to the neonatal intensive care unit within 24 hours post delivery was a secondary outcome. RESULTS: The induction-delivery interval was significantly lower in the misoprostol group than in the dinoprostone group (11.9 h vs. 15.5 h, p < 0.001). With misoprostol, more women delivered within 12 hours (57.5% vs. 32.5%, p < 0.01) and 24 hours (98.7% vs. 91.4%, p < 0.05), spontaneous rupture of the membranes occurred more frequently (38.8% vs. 20.5%, p < 0.05), there was less need for oxytocin augmentation (65.8% vs. 81.5%, p < 0.05) and fewer additional doses were required (7.5% vs. 22%, p < 0.05). Although not statistically significant, a lower Caesarean section (CS) rate was observed with misoprostol (7.5% vs. 13.3%, p > 0.05) but with the disadvantage of higher abnormal fetal heart rate (FHR) tracings (22.5% vs. 12%, p > 0.05). From the misoprostol group more neonates were admitted to the intensive neonatal unit, than from the dinoprostone group (13.5% vs. 4.8%, p > 0.05). One woman had an unexplained stillbirth following the administration of one dose of dinoprostone. CONCLUSIONS: Vaginal misoprostol, compared with dinoprostone in the regimens used, is more effective in elective inductions of labor beyond 40 weeks of gestation. Nevertheless, this is at the expense of more abnormal FHR tracings and more admissions to the neonatal unit, indicating that the faster approach is not necessarily the better approach to childbirth.

Adult↗
PubMed2002

Renal venous thrombosis in an infant with predisposing thrombotic factors: color Doppler ultrasound and MR evaluation.

We report a case of a neonate with hereditary thrombophilia presenting with renal venous thrombosis (RVT). Early color Doppler findings of RVT were lacking venous flow, and the arterial diastolic flow was reversed. This very high-resistance arterial flow is for the first time described in neonatal RVT. Magnetic resonance imaging showed low signal intensity of the renal pyramids on T1- and T2-weighted images, suggesting acute hemorrhage. After intravenous contrast injection, persistent cortical enhancement was observed along with lack of medullary enhancement. Despite the progressive reestablishment of some venous drainage, the kidney showed atrophy and loss of function.

Causality↗
PubMed2002

Neonatal bacteraemia: a population-based study.

The aims of this study were to explore the incidence of neonatal bacteraemia and identify the risk factors among neonatal intensive care unit (NICU) patients. The study included 3339 neonates admitted to the NICU of Ioannina University Hospital, North-Western Greece, during the 10-y period 1989-98. Logistic regression was used to assess the contribution of different risk factors to bacteraemia. A diagnosis of bacteraemia was made in 90 neonates (2.7%), 10 of whom (11%) died. Gram-negative bacilli, coagulase-negative Staphylococci and Streptococci were the most common pathogens: 42%, 34% and 17%, respectively. Premature rupture of membranes was the main risk factor for early-onset sepsis (relative risk 6.28) and respiratory distress syndrome was the main risk factor for late-onset sepsis (relative risk 5.70). The relative size of neonates for their gestational age did not appear to influence the risk of infection. Case fatality was higher for early- than for late-onset sepsis (relative risk 6.59). In conclusion, certain conditions were confirmed to predispose patients to neonatal bacteraemia; neonatal morbidity and mortality can be reduced by intervening to control these predisposing factors.

Bacteremia↗