Tomasz Szczapa

Green tea extract decreases starch digestion and absorption from a test meal in humans: a randomized, placebo-controlled crossover study

Green tea is known worldwide for its beneficial effects on human health. However, objective data evaluating this influence in humans is scarce. The aim of the study was to assess the impact of green tea extract (GTE) on starch digestion and absorption. The study comprised of 28 healthy volunteers, aged 19 to 28 years. In all subjects, a starch 13C breath test was performed twice. Subjects randomly ingested naturally 13C-abundant cornflakes during the GTE test (GTE 4 g) or placebo test. The cumulative percentage dose recovery (CPDR) was significantly lower for the GTE test than for the placebo test (median [interquartile range]: 11.4% [5.5–15.5] vs. 16.1% [12.7–19.5]; p = 0.003). Likewise, CPDR expressed per hour was considerably lower in each point of the measurement. In conclusion, a single dose of green tea extract taken with a test meal decreases starch digestion and absorption.

Use of Heliox in the Management of Neonates with Meconium Aspiration Syndrome

Background: Helium-oxygen mixture (heliox) ventilation has been known as an alternative treatment in patients with airway obstruction. Because of the physical properties of heliox, mechanical ventilation with this gas mixture may offer advantages in the management of respiratory failure associated with meconium aspiration syndrome (MAS). Objectives: The purpose of this pilot study was to assess the effect of short-term mechanical ventilation with heliox in newborns with MAS on vital signs, oxygenation, acid-base balance and respiratory function parameters. Methods: The study was carried out in newborns with respiratory failure requiring mechanical ventilation due to MAS. Eight patients were ventilated using pressure-controlled synchronized intermittent mandatory ventilation. Parameters of respiratory function, oxygenation, acid-base balance and vital signs were recorded at baseline, then twice during 1 h of heliox ventilation and finally twice during 1 h after switching back to air-oxygen ventilation. Results: Mechanical ventilation with heliox did not affect vital signs and the infants’ clinical condition remained stable during the study. Heliox ventilation was associated with a nonsignificant increase in tidal volume, minute ventilation and peak expiratory flow rate values. Mechanical ventilation with heliox allowed the use of significantly lower FiO2, with a significant decrease in alveolar-arterial oxygen tension difference and a decrease in the oxygenation index which was not statistically significant. There was also a significant increase in the PaO2/FiO2 ratio during heliox ventilation. Conclusions: Ventilation with a helium and oxygen mixture had a positive effect on the selected parameters of oxygenation, while its effects on other respiratory parameters were relatively small.

Vegetarian diet alters the assessment of exocrine pancreatic function with the use of fecal tests.

Vegetarian diets are becoming increasingly popular, yet the assessment of pancreatic function tests in vegetarians is sparse. Chronic pancreatitis and exocrine pancreatic insufficiency are more common than previously thought. Therefore, a means of accurately measuring pancreatic function in vegetarian subjects is needed. Direct pancreatic function tests, such as the secretincholecystokinin-test (SCT), have the highest sensitivity and specificity. However, they have some major disadvantages, including invasiveness and availability, which make them unsuited for routine use (1). Among the indirect tests, the measurement of fecal enzyme concentrations/activities is the easiest. Fecal elastase-1 is probably the most sensitive and specific of the indirect tests (2). However, there are no data regarding the specificity of these tests in vegetarians. In the current study we investigated the impact of vegetarian diet on the specificity of fecal tests of pancreatic function.

Comparison of cerebral tissue oxygenation values in full term and preterm newborns by the simultaneous use of two near-infrared spectroscopy devices: an absolute and a relative trending oximeter

Abstract. The aim of this study is to compare a two-wavelength light emitting diode–based tissue oximeter (INVOS), which is designed to show trends in tissue oxygenation, with a four-wavelength laser–based oximeter (FORE-SIGHT), designed to deliver absolute values of tissue oxygenation. Simultaneous values of cerebral tissue oxygenation (StO2) are measured using both devices in 15 term and 15 preterm clinically stable newborns on the first and third day of life. Values are recorded simultaneously in two periods between which oximeter sensor positions are switched to the contralateral side. Agreement between StO2 values before and after the change of sensor position is analyzed. We find that mean cerebral StO2 values are similar between devices for term and preterm babies, but INVOS shows StO2 values spread over a wider range, with wider standard deviations than shown by the FORE-SIGHT. There is relatively good agreement with a bias up to 3.5% and limits of agreement up to 11.8%. Measurements from each side of the forehead show better repeatability for the FORE-SIGHT monitor. We conclude that performance of the two devices is probably acceptable for clinical purposes. Both performed sufficiently well, but the use of FORE-SIGHT may be associated with tighter range and better repeatability of data.

Heliox for mechanically ventilated newborns with bronchopulmonary dysplasia

Objective We assessed the safety and studied the influence of short-term helium–oxygen (heliox) mechanical ventilation (MV) on respiratory function, gas exchange and oxygenation in infants with bronchopulmonary dysplasia (BPD) or at high risk for BPD. Design A pilot, time-series study. Setting Neonatal intensive care unit. Patients Infants with severe BPD who required MV. Interventions MV with helium–oxygen and air–oxygen mixtures. Main outcome measures Respiratory parameters, acid–base balance, oxygenation and vital signs were recorded at five time points: initially during MV with air–oxygen, after 15 and 60 min of helium–oxygen MV, and 15 and 60 min after return to air–oxygen MV. Results 15 infants with BPD were enrolled. Helium–oxygen MV was well tolerated and was associated with a statistically significant increase in tidal volume, dynamic compliance and peak expiratory flow rate. An improvement in oxygenation and a decrease in fraction of inspired oxygen was also observed. During helium–oxygen MV there was a significant decrease in the oxygenation index and alveolar–arterial oxygen tension difference. The PaO2/fraction of inspired oxygen (FiO2) ratio increased significantly during helium–oxygen ventilation. A decrease in PaCO2 and an increase in pH were also observed during helium–oxygen administration, however this was not statistically significant. After ventilation with helium–oxygen was discontinued, the infants’ respiratory function and oxygenation deteriorated and supplemental oxygen requirements increased accordingly. Conclusions Helium–oxygen MV is safe and resulted in improvement of respiratory function and oxygenation in infants with severe BPD requiring MV.

Disordered eating attitudes during pregnancy in mothers of newborns requiring Neonatal Intensive Care Unit admission: a case control study

Abstract Objective: The aim of the study was to assess disordered eating attitudes and other related factors in mothers of newborns requiring Neonatal Intensive Care Unit (NICU) admission compared to those of mothers who delivered healthy infants. Methods: An anonymous self-report study conducted among 199 mothers of newborns hospitalized in NICU, and a control group of 127 mothers of healthy newborns. Eating Attitudes Test-26 (EAT-26) and a survey regarding other perinatal health issues were used. Results: Women in the study group (SG) gained significantly less weight during pregnancy when compared to control group (CG; p = 0.001). There were fewer women with appropriate pre-gestational BMI in the SG (p = 0.052). Women who feared weight-gain during pregnancy were younger (p < 0.001) and had higher EAT-26 scores (p < 0.001). Women with EAT-26 scores >20 smoked significantly more often during their last pregnancy in the SG (p = 0.010). Cesarean section was more frequent in the SG (p = 0.017). Conclusions: Disordered eating attitudes in gestation may significantly influence the pregnancy outcomes and newborns’ health. Hence, it is vital for perinatal counseling and obstetrical care to focus on these issues to facilitate early diagnosis and intervention.

Heliox augmented mechanical ventilation in the treatment of premature infants with respiratory distress syndrome

OBJECTIVE The aim of the study was to assess the influence of mechanical ventilation with helium-oxygen mixture (heliox) on basic vital signs, oxygenation, acid-base balance and respiratory mechanics in newborns with respiratory distress syndrome (RDS), previously treated with surfactant. MATERIAL AND METHODS The study was carried out in preterm newborns with respiratory failure requiring mechanical ventilation due to RDS, requiring Fi02>0.4 after a single dose of surfactant. Patients were ventilated using PC-SIMV Parameters of mechanical ventilation, respiratory function, oxygenation, acid-base balance and vital signs were recorded at baseline, one hour during and one hour after heliox ventilation. RESULTS Ten newborns with RDS were enrolled in the study Mechanical ventilation with heliox did not affect vital signs and patient general condition remained stable during and after ventilation with heliox. Mechanical ventilation with heliox was associated with a statistically significant increase in tidal volume (mean 5.48 vs. 6.55 ml/kg). There were no significant changes in minute ventilation and peak expiratory flow rate. Mechanical ventilation with heliox allowed the use of significantly lower fractions of inspired oxygen (mean 0.55 vs. 0.35), with a significant decrease in the oxygenation index (mean 8.77 vs. 5.02) and alveolar-arterial oxygen tension difference (mean 263.81 vs. 113.28 mm Hg). After ventilation with this gas mixture was stopped, the patients required higher Fi02, 01 and AaD02 levels increased. CONCLUSIONS Mechanical ventilation with heliox was safe, improved oxygenation and caused an increase in tidai, volume in newborns with RDS previously treated with surfactant.

PO-0650 The Influence Of Disordered Eating Attitudes On Pregnancy And Neonatal Outcomes

Background and aim Nutritional status of the mother in the periconceptional and gestational period can influence the course of pregnancy and newborn health. The aim of our study was to identify and assess the prevalence of disordered eating attitudes in mothers of newborns requiring neonatal intensive care admission compared to those of mothers who delivered healthy infants requiring only normal care in a large maternity hospital. Methods An anonymous self-report study was conducted among 199 mothers of newborns hospitalised in a Neonatal Intensive Care Unit, and a control group of 127 mothers of healthy newborns who “roomed in” with their mothers. An EAT-26 (Eating Attitudes Test-26) questionnaire and a survey regarding the pregnancy, neonatal outcomes and other health related behaviours were used in the study. Results Women with EAT-26 scores >20 smoked significantly more often during their last pregnancy in the study group (p = 0,010). There were fewer women with appropriate pre-gestational BMI in the study group (p = 0.052) and they gained less weight during pregnancy (p = 0.001). Women who feared weight gain during pregnancy were younger (p < 0.001) and had higher EAT-26 scores (p < 0.001). Caesarean section was more frequent in the study group (p = 0.017). Conclusions Perinatal public health education must focus on issues related to eating disorders since the awareness of these issues among obstetricians may improve the outcomes of pregnancy and newborns’ health.

PO-0764 Maternal Smoking And The Risk Of Bronchopulmonary Dysplasia (bpd) In The Very Low Birth Weight (vlbw) Preterm Infants

Background and aim Among other risk factors the intrauterine smoke exposure has been suggested to influence BPD development. The aim of the study was to analyse the prevalence of BPD as well as other related variables in a group of preterm infants born by smoking and non-smoking women. Methods A retrospective analysis based on medical records was performed. Data of VLBW preterm newborns <32 weeks gestational age, born during one year and hospitalised in the neonatal intensive care unit of a tertiary perinatal centre were collected and statistically analysed using Mann-Whitney and Pearson’s Chi-square tests. Results Analysis included 185 newborns. Mothers admitted smoking in 22 cases (12%). Gestational age and birth weight were similar in both groups (28 vs 27.5 weeks and 1203 g vs 1108 g, p > 0.05). BPD prevalence did not differ significantly between both groups (36% vs 39%, p > 0.05). Among newborns in the smoking group there was a higher mortality (27% vs 18%, p > 0.05) but this was not statistically significant. There were no significant differences between groups in the need for surfactant therapy (36% vs 43%, p > 0.05) or the length of mechanical ventilation (mean 15.6 vs 12.9 days, p > 0.05). Conclusion Smoking was not confirmed as a definite risk factor of BPD in this study. This may be due to the multifactorial pathogenesis of the disease but possibly also associated with the methodology that was based on mothers’ declaration regarding smoking without a laboratory screening.