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Article ; Online: Renal versus cerebral saturation trajectories: the perinatal transition in preterm neonates.

Hoffman, Suma B / Magder, Laurence S / Viscardi, Rose M

2022 Volume 92, Issue 5, Page(s) 1437–1442

Abstract: Background: The aim of this study was to develop reference renal saturation (rSrO: Methods: This is a prospective cohort study of 57 inborn infants <12 h and <30 weeks gestation. rScO: Results: Median rSrO: Conclusions: We provide rSrO: ... ...

Abstract	Background: The aim of this study was to develop reference renal saturation (rSrO Methods: This is a prospective cohort study of 57 inborn infants <12 h and <30 weeks gestation. rScO Results: Median rSrO Conclusions: We provide rSrO Impact: This article depicts reference renal saturation curves during the perinatal transition in preterm infants. We show how renal saturation compares to cerebral saturation trends over time. We describe a peak and decline in renal saturation with increasing MAP, suggesting a renovascular response to blood pressure changes.
MeSH term(s)	Infant ; Pregnancy ; Female ; Infant, Newborn ; Humans ; Infant, Premature/physiology ; Oxygen ; Prospective Studies ; Spectroscopy, Near-Infrared ; Gestational Age ; Cerebrovascular Circulation/physiology ; Brain/blood supply
Chemical Substances	Oxygen (S88TT14065)
Language	English
Publishing date	2022-02-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	4411-8
ISSN	1530-0447 ; 0031-3998
ISSN (online)	1530-0447
ISSN	0031-3998
DOI	10.1038/s41390-022-01984-2
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Article ; Online: Mice Expressing Cosegregating Single Nucleotide Polymorphisms (D298G and N397I) in TLR4 Have Enhanced Responses to House Dust Mite Allergen.

Fink, Marc Y / Qi, Xiulan / Shirey, Kari Ann / Fanaroff, Rachel / Chapoval, Svetlana / Viscardi, Rose M / Vogel, Stefanie N / Keegan, Achsah D

Journal of immunology (Baltimore, Md. : 1950)

2022 Volume 208, Issue 9, Page(s) 2085–2097

Abstract: Asthma is a common and ubiquitous chronic respiratory disease that is associated with airway inflammation and hyperreactivity resulting in airway obstruction. It is now accepted that asthma is controlled by a combination of host genetics and environment ... ...

Abstract	Asthma is a common and ubiquitous chronic respiratory disease that is associated with airway inflammation and hyperreactivity resulting in airway obstruction. It is now accepted that asthma is controlled by a combination of host genetics and environment in a rather complex fashion; however, the link between sensing of the environment and development and exacerbation of allergic lung inflammation is unclear. Human populations expressing cosegregating D299G and T399I polymorphisms in the
MeSH term(s)	Allergens ; Animals ; Antigens, Dermatophagoides/immunology ; Asthma/genetics ; Asthma/pathology ; Inflammation ; Lipopolysaccharides ; Mice ; Polymorphism, Single Nucleotide ; Pulmonary Eosinophilia ; Pyroglyphidae ; Toll-Like Receptor 4/genetics
Chemical Substances	Allergens ; Antigens, Dermatophagoides ; Lipopolysaccharides ; Tlr4 protein, mouse ; Toll-Like Receptor 4
Language	English
Publishing date	2022-04-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	3056-9
ISSN	1550-6606 ; 0022-1767 ; 1048-3233 ; 1047-7381
ISSN (online)	1550-6606
ISSN	0022-1767 ; 1048-3233 ; 1047-7381
DOI	10.4049/jimmunol.2100926
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Article ; Online: Ureaplasma species: role in diseases of prematurity.

Viscardi, Rose M

Clinics in perinatology

2010 Volume 37, Issue 2, Page(s) 393–409

Abstract: There is accumulating epidemiologic and experimental evidence that intrauterine or postnatal infection with Ureaplasma species is a significant risk factor for adverse pregnancy outcomes and complications of extreme preterm birth such as bronchopulmonary ...

Abstract	There is accumulating epidemiologic and experimental evidence that intrauterine or postnatal infection with Ureaplasma species is a significant risk factor for adverse pregnancy outcomes and complications of extreme preterm birth such as bronchopulmonary dysplasia and intraventricular hemorrhage. In a cohort of very low birth weight infants, Ureaplasma spp were detected by culture or polymerase chain reaction in respiratory secretions, blood, or cerebrospinal fluid of almost half of the subjects, suggesting that this organism is the most common pathogen affecting this population. This review summarizes the evidence supporting the hypothesis that Ureaplasma-mediated inflammation in different compartments (intrauterine, lung, blood, or brain) during a common developmental window of vulnerability contributes to preterm labor and lung and brain injury. Appropriate methods for detecting these fastidious organisms and potential strategies to prevent or ameliorate the effects of Ureaplasma infection are discussed.
MeSH term(s)	Female ; Humans ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases/epidemiology ; Infant, Premature, Diseases/microbiology ; Infant, Premature, Diseases/prevention & control ; Infectious Disease Transmission, Vertical/prevention & control ; Inflammation/microbiology ; Pregnancy ; Pregnancy Complications, Infectious/epidemiology ; Pregnancy Complications, Infectious/microbiology ; Pregnancy Complications, Infectious/prevention & control ; Ureaplasma/isolation & purification ; Ureaplasma/pathogenicity ; Ureaplasma Infections/epidemiology ; Ureaplasma Infections/microbiology ; Ureaplasma Infections/prevention & control
Language	English
Publishing date	2010-03-11
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	193116-7
ISSN	1557-9840 ; 0095-5108
ISSN (online)	1557-9840
ISSN	0095-5108
DOI	10.1016/j.clp.2009.12.003
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Article ; Online: Secretory-IgA binding to intestinal microbiota attenuates inflammatory reactions as the intestinal barrier of preterm infants matures.

Mahdally, Sarah M / Izquierdo, Mariana / Viscardi, Rose M / Magder, Laurence S / Crowley, Helena M / Bafford, Andrea C / Drachenberg, Cinthia B / Farfan, Mauricio J / Fasano, Alessio / Sztein, Marcelo B / Salerno-Goncalves, Rosangela

Clinical and experimental immunology

2023 Volume 213, Issue 3, Page(s) 339–356

Abstract: Previous work has shown that Secretory-IgA (SIgA) binding to the intestinal microbiota is variable and may regulate host inflammatory bowel responses. Nevertheless, the impact of the SIgA functional binding to the microbiota remains largely unknown in ... ...

Abstract	Previous work has shown that Secretory-IgA (SIgA) binding to the intestinal microbiota is variable and may regulate host inflammatory bowel responses. Nevertheless, the impact of the SIgA functional binding to the microbiota remains largely unknown in preterm infants whose immature epithelial barriers make them particularly susceptible to inflammation. Here, we investigated SIgA binding to intestinal microbiota isolated from stools of preterm infants <33 weeks gestation with various levels of intestinal permeability. We found that SIgA binding to intestinal microbiota attenuates inflammatory reactions in preterm infants. We also observed a significant correlation between SIgA affinity to the microbiota and the infant's intestinal barrier maturation. Still, SIgA affinity was not associated with developing host defenses, such as the production of mucus and inflammatory calprotectin protein, but it depended on the microbiota shifts as the intestinal barrier matures. In conclusion, we reported an association between the SIgA functional binding to the microbiota and the maturity of the preterm infant's intestinal barrier, indicating that the pattern of SIgA coating is altered as the intestinal barrier matures.
MeSH term(s)	Infant, Newborn ; Humans ; Immunoglobulin A, Secretory/metabolism ; Gastrointestinal Microbiome ; Infant, Premature ; Intestines ; Inflammation
Chemical Substances	Immunoglobulin A, Secretory
Language	English
Publishing date	2023-02-21
Publishing country	England
Document type	Journal Article
ZDB-ID	218531-3
ISSN	1365-2249 ; 0009-9104 ; 0964-2536
ISSN (online)	1365-2249
ISSN	0009-9104 ; 0964-2536
DOI	10.1093/cei/uxad042
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Article ; Online: Altered Gut Microbiome and Fecal Immune Phenotype in Early Preterm Infants With Leaky Gut.

Lemme-Dumit, Jose M / Song, Yang / Lwin, Hnin Wai / Hernandez-Chavez, Claudia / Sundararajan, Sripriya / Viscardi, Rose M / Ravel, Jacques / Pasetti, Marcela F / Ma, Bing

Frontiers in immunology

2022 Volume 13, Page(s) 815046

Abstract: Intestinal barrier immaturity, or "leaky gut", is the proximate cause of susceptibility to necrotizing enterocolitis in preterm neonates. Exacerbated intestinal immune responses, gut microbiota dysbiosis, and heightened barrier injury are considered ... ...

Abstract	Intestinal barrier immaturity, or "leaky gut", is the proximate cause of susceptibility to necrotizing enterocolitis in preterm neonates. Exacerbated intestinal immune responses, gut microbiota dysbiosis, and heightened barrier injury are considered primary triggers of aberrant intestinal maturation in early life. Inordinate host immunity contributes to this process, but the precise elements remain largely uncharacterized, leaving a significant knowledge gap in the biological underpinnings of gut maturation. In this study, we investigated the fecal cytokine profile and gut microbiota in a cohort of 40 early preterm infants <33-weeks-gestation to identify immune markers of intestinal barrier maturation. Three distinct microbiota types were demonstrated to be differentially associated with intestinal permeability (IP), maternal breast milk feeding, and immunological profiles. The
MeSH term(s)	Cytokines/genetics ; Gastrointestinal Microbiome/physiology ; Humans ; Infant, Newborn ; Infant, Premature ; Milk, Human ; Phenotype
Chemical Substances	Cytokines
Language	English
Publishing date	2022-02-23
Publishing country	Switzerland
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2022.815046
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Article ; Online: Assessment of Neonatal Intensive Care Unit Sound Exposure Using a Smartphone Application.

Capriolo, Christine / Viscardi, Rose M / Broderick, Karen A / Nassebeh, Sepideh / Kochan, Michael / Solanki, Nina S / Leung, Jocelyn C

American journal of perinatology

2020 Volume 39, Issue 2, Page(s) 189–194

Abstract: Objective: This study aimed to determine the impact of neonatal intensive care unit (NICU) design and environmental factors on neonatal sound exposures. We hypothesized that monitoring with a smartphone application would identify modifiable ... ...

Abstract	Objective: This study aimed to determine the impact of neonatal intensive care unit (NICU) design and environmental factors on neonatal sound exposures. We hypothesized that monitoring with a smartphone application would identify modifiable environmental factors in different NICU design formats. Study design: Minimum, maximum, and peak decibel (dB) recordings were obtained using the Decibel X phone app, and the presence of noise sources was recorded in each patient space at three NICUs over a 6-month period (December 2017 to May 2018). Data were analyzed by Student's Results: All recordings in the three NICUs exceeded the American Academy of Pediatrics (AAP) recommended <45 dB level. The maximum and peak dB were highest in the open pod format level III NICU. Conversations/music alone and combined with other factors contributed to increased sound exposure. Sound exposure varied by day/night shift, with higher day exposures at the level III hybrid and open pod NICUs and higher night exposures at the level IV SFR NICU. Conclusion: Although sound exposure varied by NICU design, all recordings exceeded the AAP recommendation due, in part, to potentially modifiable environmental factors. A smartphone application may be useful for auditing NICU sound exposure in quality improvements efforts to minimize environmental sound exposure. Key points: · Smartphone application was used to assess NICU sound exposure.. · All cases of sound exposure exceed recommendations.. · A smartphone application was used to identify modifiable factors..
MeSH term(s)	Communication ; Environmental Monitoring ; Equipment and Supplies, Hospital ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal/organization & administration ; Maryland ; Mobile Applications ; Noise, Occupational/adverse effects ; Personnel Staffing and Scheduling ; Smartphone
Language	English
Publishing date	2020-07-23
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	605671-4
ISSN	1098-8785 ; 0735-1631
ISSN (online)	1098-8785
ISSN	0735-1631
DOI	10.1055/s-0040-1714679
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Article ; Online: Highly Specialized Carbohydrate Metabolism Capability in

Ma, Bing / Sundararajan, Sripriya / Nadimpalli, Gita / France, Michael / McComb, Elias / Rutt, Lindsay / Lemme-Dumit, Jose M / Janofsky, Elise / Roskes, Lisa S / Gajer, Pawel / Fu, Li / Yang, Hongqiu / Humphrys, Mike / Tallon, Luke J / Sadzewicz, Lisa / Pasetti, Marcela F / Ravel, Jacques / Viscardi, Rose M

mBio

2022 Volume 13, Issue 3, Page(s) e0129922

Abstract: Leaky gut," or high intestinal barrier permeability, is common in preterm newborns. The role of the microbiota in this process remains largely uncharacterized. We employed both short- and long-read sequencing of the 16S rRNA gene and metagenomes to ... ...

Abstract	"Leaky gut," or high intestinal barrier permeability, is common in preterm newborns. The role of the microbiota in this process remains largely uncharacterized. We employed both short- and long-read sequencing of the 16S rRNA gene and metagenomes to characterize the intestinal microbiome of a longitudinal cohort of 113 preterm infants born between 24
MeSH term(s)	Bifidobacterium/genetics ; Carbohydrate Metabolism ; Enterocolitis, Necrotizing/microbiology ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; RNA, Ribosomal, 16S/genetics
Chemical Substances	RNA, Ribosomal, 16S
Language	English
Publishing date	2022-06-13
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	2557172-2
ISSN	2150-7511 ; 2161-2129
ISSN (online)	2150-7511
ISSN	2161-2129
DOI	10.1128/mbio.01299-22
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Article ; Online: Point-of-Care Ultrasound to Confirm Umbilical Line Placement: Impact of a Simulation Enhanced Curriculum on Neonatal Intensive Care Unit Provider Competency.

Kochan, Michael J / Kim, Jane S / Hoffman, Suma B / Mola, Sara J / Kim, Jae H / Viscardi, Rose M

Simulation in healthcare : journal of the Society for Simulation in Healthcare

2020 Volume 16, Issue 5, Page(s) 303–310

Abstract: Introduction: Neonatal intensive care unit (NICU) provider point-of-care ultrasound (POCUS) procedural competency for umbilical line placement confirmation has not been defined, and the necessary training to achieve competency has not been previously ... ...

Abstract	Introduction: Neonatal intensive care unit (NICU) provider point-of-care ultrasound (POCUS) procedural competency for umbilical line placement confirmation has not been defined, and the necessary training to achieve competency has not been previously studied. This study's objective was to test the hypothesis that a simulation-enhanced curriculum will improve NICU providers' POCUS competency to confirm umbilical line placement. Methods: Neonatal intensive care unit providers without prior ultrasound experience were randomized to a curriculum with or without simulation-based training. Competency for catheter detection, tip localization, and scan interpretation on patients was determined using learning curve-cumulative summation, a specific statistical tool designed to indicate when a predefined level of performance is reached. Differences in success rates were analyzed by χ2 test. Results: Two thirds (22/33) of participants completed 10 scans. Three (simulation) and 1 (control) attained catheter detection competency (P = 0.28). The simulation group was more successful for catheter detection (81% vs. 69%, P = 0.04) and scan interpretation (61% vs. 48%, P = 0.04). Success did not differ by umbilical vessel location, provider role, or duration of NICU experience. Conclusions: A simulation-enhanced POCUS curriculum improved catheter detection rate and scan interpretation, but there was no difference in procedural competency between groups on ultrasound scans performed on patients with umbilical catheters. We speculate that more than 10 scans may be needed for NICU providers to obtain POCUS competency.
MeSH term(s)	Curriculum ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Point-of-Care Systems ; Simulation Training ; Ultrasonography
Language	English
Publishing date	2020-10-16
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2223429-9
ISSN	1559-713X ; 1559-2332
ISSN (online)	1559-713X
ISSN	1559-2332
DOI	10.1097/SIH.0000000000000501
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Article ; Online: Cerebral autoregulation in premature infants during the first 96 hours of life and relationship to adverse outcomes.

Hoffman, Suma B / Cheng, Yun-Ju / Magder, Laurence S / Shet, Narendra / Viscardi, Rose M

Archives of disease in childhood. Fetal and neonatal edition

2018 Volume 104, Issue 5, Page(s) F473–F479

Abstract: Objective: To test the hypothesis that impaired cerebral autoregulation (ICA) increases the susceptibility of premature infants to adverse outcomes, we determined the relationship of ICA and cerebral reactivity (CR) measured in the first 96 hours of ... ...

Abstract	Objective: To test the hypothesis that impaired cerebral autoregulation (ICA) increases the susceptibility of premature infants to adverse outcomes, we determined the relationship of ICA and cerebral reactivity (CR) measured in the first 96 hours of life to the outcome of grade 3 or 4 intraventricular haemorrhage (IVH) and/or death within 1 month. Setting: Single-centre level IV neonatal intensive care unit. Patients: Neonates 24-29 weeks' gestation less than 12 hours old with invasive blood pressure monitoring. Design: Cerebral saturations and mean arterial blood pressure were recorded every 30 s for 96 hours. For each 10 min epoch, the correlation coefficient (r) was calculated for mean arterial blood pressure versus cerebral saturations. The epoch was considered to have ICA if r>0.5 and CR if r<0. Results: Sixty-one subjects were included. During the first 96 hours, ICA occurred 17.6% and CR occurred 41% of recorded time. In those without adverse outcomes, ICA decreased and CR increased by postnatal day (p<0.05). Adjusted for birth weight and gestational age, those with IVH and those who died spent more time with ICA and less time with CR (p<0.05) over the entire recording period. Those with IVH had 1.5-fold increase in time with ICA on day 2 (p=0.021), and decrease in time with CR on day 3 (p=0.036). Compared with survivors, non-survivors spent more time with ICA on days 3 and 4 (p<0.005), and less with CR on day 3 (p=0.032). Conclusion: ICA and CR vary by postnatal day and these patterns are associated with adverse outcomes.
MeSH term(s)	Blood Pressure Determination/methods ; Cerebral Hemorrhage/diagnosis ; Cerebral Hemorrhage/etiology ; Cerebral Hemorrhage/physiopathology ; Cerebrovascular Circulation/physiology ; Female ; Gestational Age ; Homeostasis/physiology ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases/diagnosis ; Infant, Newborn, Diseases/etiology ; Infant, Newborn, Diseases/physiopathology ; Infant, Premature/physiology ; Infant, Premature, Diseases/diagnosis ; Infant, Premature, Diseases/etiology ; Infant, Premature, Diseases/physiopathology ; Intensive Care Units, Neonatal/statistics & numerical data ; Male ; Monitoring, Physiologic/methods ; Oxygen Consumption/physiology ; Spectroscopy, Near-Infrared/methods ; Time Factors ; United States
Keywords	covid19
Language	English
Publishing date	2018-11-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2007331-8
ISSN	1468-2052 ; 1359-2998
ISSN (online)	1468-2052
ISSN	1359-2998
DOI	10.1136/archdischild-2018-315725
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Article ; Online: The Objective Use of Pulse Oximetry to Predict Respiratory Support Transition in Preterm Infants: An Observational Pilot Study.

Mascoll-Robertson, Kemi K / Viscardi, Rose M / Woo, Hyung C

Respiratory care

2016 Volume 61, Issue 4, Page(s) 416–422

Abstract: Background: Preterm infants often require some form of respiratory support with supplemental oxygen and are monitored by continuous pulse oximetry (SpO2 ). The study objective was to determine whether the histogram distribution of SpO2 over a 24-h ... ...

Abstract	Background: Preterm infants often require some form of respiratory support with supplemental oxygen and are monitored by continuous pulse oximetry (SpO2 ). The study objective was to determine whether the histogram distribution of SpO2 over a 24-h period will predict readiness for weaning respiratory support in preterm infants. We hypothesize that infants with ≥15% of time spent with SpO2 <86% before transitioning from CPAP or high-flow nasal cannula (HFNC) to low-flow nasal cannula, oxyhood, or room air are more likely to fail transitioning. Methods: The SpO2 histograms were downloaded daily for 31 infants, 24-32 weeks gestational age, before transition from CPAP or HFNC to low-flow nasal cannula, oxyhood, or room air. The SpO2 histogram downloads were continued for each infant for 1 week after transition or when the infant reached 36 weeks postmenstrual age or when SpO2 monitoring was discontinued. Failure was defined as an increase in respiratory support within 72 h of transitioning. We compared the percentage of time for each SpO2 quintile for the 24-h periods before and immediately following CPAP/HFNC transitioning between groups. Results: Twenty-four subjects transitioned successfully, but 7 subjects failed. Two of 7 subjects (28.6%) who failed transition experienced SpO2 <86% ≥15% of the time pretransition compared with none in the success group (P = .045). The failure group experienced SpO2 <86% 10.7 ± 11.9% of time pre-wean compared with 3.3 ± 4.7% of time in the success group (P = .02). In contrast, infants who were successfully weaned tended to experience a greater percentage of time with SpO2 >95% compared with the failure group, both pre-wean (54.3 ± 36.1% vs. 33 ± 27.7%, P = .16) and post-wean (52 ± 35.4% vs. 27.4 ± 27.7%, P = .10). Conclusions: These data suggest that pulse oximetry histograms may be useful in assessing CPAP/HFNC support transition readiness.
MeSH term(s)	Female ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature/physiology ; Male ; Monitoring, Physiologic/methods ; Oximetry/methods ; Oximetry/statistics & numerical data ; Oxygen/blood ; Pilot Projects ; Predictive Value of Tests ; Respiration, Artificial/methods ; Ventilator Weaning
Chemical Substances	Oxygen (S88TT14065)
Keywords	covid19
Language	English
Publishing date	2016-04
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	603252-7
ISSN	1943-3654 ; 0098-9142 ; 0020-1324
ISSN (online)	1943-3654
ISSN	0098-9142 ; 0020-1324
DOI	10.4187/respcare.04102
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