Esta pesquisa avaliou o efeito da transferência passiva dos leucócitos do colostro na imunidade específica de bezerras recém-nascidas. Foram acompanhadas 20 bezerras Holandesas durante o período neonatal, distribuídas em dois grupos experimentais: grupo COL+ recebeu colostro fresco (4L) proveniente de suas respectivas mães; e grupo COL- recebeu colostro congelado e acelular (4L), oriundo de vacas doadoras de colostro. As avaliações foram realizadas antes da mamada do colostro (M0), 1-2 (M1), 7 (M2), 14 (M3), 21 (M4) e 28 dias pós-nascimento (M5). As bezerras foram submetidas ao exame clínico, seguido da colheita das amostras sanguíneas para realização de hemograma, imunofenotipagem e cultivo celular. Os dois grupos foram colostrados com colostro de igual qualidade com relação à concentração de imunoglobulinas (70-120 g/L). A concentração de células do colostro fresco fornecido ao grupo COL+ foi de 1.895.849 células/mL. Não foi possível encontrar diferenças para as funções vitais em relação aos grupos experimentais. O exame específico dos sistemas revelou um caso de broncopneumonia, três de inflamação umbilical e maior frequência de escore de fezes 3 no COL-. As alterações clínicas foram refletidas no eritrograma das bezerras, sendo encontrado menor valor médio para a taxa de hemoglobina (HGB) no COL- em M3. Em relação à idade, observou-se redução gradativa dos valores médios para He (hemácias), HGB, HCT (hematócrito) e índices hematimétricos no primeiro mês de vida. A frequência de bezerras anêmicas foi maior no grupo COL- nos momentos M4 e M5. Em relação ao leucograma, observou-se diferença entre os grupos para linfócitos no M0 e M2 com valores superiores no COL-. Em relação aos momentos foi possível detectar leucocitose por neutrofilia no M0 e M1, observando-se inversão da relação neutrófilo:linfócito a partir desses momentos. Os valores de CD45+CD45RO- foram maiores em M0 no COL-, além disso, observou-se aumento da expressão do marcador de memória celular CD45RO+ do M0 ao M1 nos dois grupos experimentais. O CD3+gamma-delta- aumentou no decorrer do estudo, em contrapartida as células CD3+gamma-delta+ foram menores em M5 com relação ao M0-M3. Foi detectado também aumento dos valores de CD14+MHCII+ no primeiro mês de vida indicando maturação das células apresentadoras de antígeno. Em relação à produção de citocinas pelas células mononucleares sanguíneas, foi possível identificar maior concentração de IFN-gamma em M4, quando as células do COL- foram estimuladas com S. aureus (1 mononuclear:10 bactérias inativadas). A concentração de IL-17 detectada a partir das células do COL+ foi maior em M3, quando as células foram estimuladas com ConA. Com base nos resultados obtidos, pode-se concluir que: a) bezerras COL- apresentaram maior frequência e intensidade de doenças que evoluíram para anemia da inflamação; b) bezerras COL- apresentaram maior número absoluto de linfócitos, representadas especialmente pela subpopulação CD3+gamma-delta+ nos episódios de maior frequência de diarreias; c) Linfócitos de memória CD45RO+ aumentaram após a colostragem em ambos os grupos, sugerindo que outros componentes acelulares do colostro podem apresentar papel fundamental no desenvolvimento da resposta imunológica de bezerras recém-nascidas; d) a subpopulação CD3+gamma-delta- e as células CD14+MHCII- e CD14+MHCII+ aumentaram durante o primeiro mês de vida, indicando maturação imunológica; e) as células mononucleares das bezerras não responderam ao Herpesvírus Bovino tipo 1, porém responderam aos estímulos bacterianos, especialmente para a Escherichia coli; a interpretação do leucograma em conjunto com a análise das variações apresentadas para as citocinas inflamatórias IFN-gamma e IL-17 permitem afirmar que as bezerras apresentaram resposta inflamatória retardada e de menor magnitude no COL-. / This study evaluated the effect of leukocytes passive transference from bovine colostrum in specific immunity of newborn calves. During neonatal period, 20 Holstein calves were followed. Animals were distributed in two experimental groups: COL+ which received fresh colostrum (4L) from their mothers, and COL- which received frozen and acellular colostrum (4L) that came from donor cows. The evaluations were performed in the following moments: before colostrum intake (M0), 1-2 (M1), 7 (M2), 14 (M3), 21 (M4) and 28 days after birth (M5). Heifers were submitted to clinical examination. Then, blood samples were harvested for hemogram, immunophenotyping and cell culture. Both groups were fed with the same quality of colostrum (immunoglobulin concentration 70-120 g/L). The cell concentration of fresh colostrum that was provided to COL+ group was 1.895.849 cells/mL. It was not possible to detect differences in vital functions concerning the experimental groups. The system specific examination reveled one case of bronchopneumonia, three cases of umbilical inflammation and major rates of diarrhea score 3 in group COL-. Clinical alterations were reflected in calves erythrogram. It was found lower mean value for hemoglobin (HGB) in M3 for COL-. Regarding age, a gradual reduction in mean values for erythrocytes, HGB, HCT (hematocrit) and hematimetric rates were observed in the first month of life. The frequency of anemic heifers was higher in COL- group at moments M4 and M5. Regarding leukogram, it was observed difference between groups for lymphocytes in M0 and M2 with higher values in COL-. Concerning moments, it was possible to detect leukocytosis by neutrophilia from M0 up to M1 and inversion of neutrophil:lymphocyte relation from this moment. Values of CD45+CD45RO- was higher in M0 for COL-, furthermore, increase of cellular memory marker expression CD45RO+ was observed from M0 to M1 in both groups. The CD3+gamma-delta- increased during the study. On the other hand, CD3+gamma-delta+ were lower in M5 in relation to M0-M3. Increase of CD14+MHCII+ values were also detected in the first month of life, indicating maturation of antigen presenting cells. Regarding cytokine production by mononuclear cells of heifers blood, it was possible to identify higher concentration of IFN-gamma in M4 when cells of COL- were stimulated with S. aureus (1 mononuclear: 10 inactivated bacteria). The concentration of IL-17 detected from COL+ cells was higher in M3, when cells were stimulated with ConA. Based on these results, it can be concluded that: a) COL- heifers presented higher frequency and intensity of diseases that evolved to anemia of inflammation; b) COL- heifers presented higher lymphocyte absolute number, represented specially by CD3+gamma-delta+ subsets in episodes of higher frequency of diarrhea; c) memory lymphocytes CD45RO+ increased after colostrum intake in both groups, suggesting that other acellular colostrum components can present fundamental role in development of immunological response in newborn heifers; d) the subset of CD3+gamma-delta- and the cells CD14+MHCII- and CD14+MHCII+ increased during the first month of life, indicating immunological maturation; e) heifers mononuclear cells did not respond for herpes virus bovine type 1, however, responded for bacterial stimulus, specially Escherichia coli. The interpretation of leukogram with the variation of presented analyses for inflammatory cytokines IFN-gamma and IL-17, allow to state that heifers presented delayed inflammatory response and of lesser magnitude in COL-.

O presente estudo avaliou o sistema oculomotor medido por movimentos oculares em bebês com diagnóstico de Displasia Broncopulmonar (DBP). Bebês com idade gestacional 37 semanas, dependentes de oxigênio em concentrações acima de 21% por mais de 28 dias foram incluídos no grupo DBP, bebês nascidos a Termo (idade gestacional > 37 semanas), não internados foram incluídos no grupo nascido a termo e bebês prematuros (idade gestacional < 37 semanas), que permaneceram internados e que não fizeram uso de oxigênio por mais de 10 dias foram incluídos no grupo prematuro. Os bebês dos três grupos tinham exame oftalmológico de biomicroscopia e de fundo de olho com resultados normais. Foram excluídos do estudo, bebês em uso de oxigênio sob ventilação mecânica e/ou drogas vasoativas, com diagnóstico de hemorragia intracraniana, retinopatia da prematuridade e malformações motoras e/ou neurológicas congênitas ou adquiridas identificadas no exame neonatal ou durante a estadia no berçário. Todos os bebês realizaram uma única avaliação binocular. As avaliações foram realizadas com os bebês sentados confortavelmente e eram compostas pela avaliação de quatro movimentos oculares: sacadas (SAC), perseguição lenta (PL), reflexo vestíbulo-ocular (RVO) e nistagmo optocinéticos (NOC). Os movimentos oculares foram transcritos em variável categórica (presente ou ausente) e para análise estatística foram feitas comparações entre o grupo DBP, grupo nascido a termo e grupo prematuro (Teste Cochran Q), para garantir a confiabilidade dos resultados apresentados durante a avaliação, 28% da amostra foi avaliada por três observadores e um teste de aderência X2 foi utilizado para medir a confiabilidade entre os três observadores. Durante o estudo foram avaliados 109 bebês, 107 foram incluídos no estudo, dois bebês, com IG < 37 semanas, foram excluídos por usarem oxigênio por um tempo igual há 15 dias. Dos 107 bebês avaliados, 23 foram inclusos no grupo DBP, 47 no grupo nascido a termo e 37 no grupo prematuro. Os bebês do grupo DBP tiveram IG média de 32 semanas ± 3 semanas, APGAR 1° minuto 6 ± 1, 5° minuto 8 ± 2, 37 dias em oxigênio ± 10 dias, na quantidade média de 2 L/min ± 0,5 L/min. O peso de nascimento, idade gestacional, APGAR NO 1° e 5° minutos do grupo nascido a termo, DBP e Prematuro diferem significativamente entre si (Teste Kruskal-Wallis p = 0.0000, 0.0000, 0.0000, 0.0013 e 0.0001, respectivamente). O grupo nascido a termo apresentou maiores valores quando comparado ao grupo DBP e prematuro. Bebês com DBP manifestam ausência de três dos quatro tipos de movimentos oculares medidos quando comparado com o grupo nascido a termo e prematuro (Teste Q Cochran onde Q > 2 e p, < 0,05) / This study evaluated the oculomotor system measured by eye movements in infants diagnosed with bronchopulmonary dysplasia (BPD). Infants 37 weeks gestational age, oxygen-dependent at concentrations above 21% for more than 28 days were included in the BPD group, term infants (gestational age > 37 weeks), not hospitalized were included in term groups and preterm infants (gestational age < 37 weeks), who remained hospitalized and did not use oxygen for more than 10 days were included in the premature group. The three groups of babies had eye examination and biomicroscopy of the fundus with normal results. Excluded from the study, babies on oxygen in mechanical ventilation and/ or vasoactive drugs; with a diagnosis of intracranial hemorrhage, retinopathy of prematurity, motor and/or neurological congenital or acquired malformations identified in neonatal or during the stay in the nursery. All infants made a single binocular assessment. The evaluations were conducted with babies seated comfortably and were composed by the evaluation of four eye movements: saccades (SAC), slow pursuit (PL), vestibuloocular reflex (VOR) and optokinetic nystagmus (NOC). Eye movements were transcribed into a categorical variable (present or absent) and statistical analysis were made between BPD group, term group and premature group (Cochran Q test) to ensure reliable of the results presented during the evaluation, 28 % of the sample was evaluated by three observers and an adherence X2 test was used to measure the reliable between three observers. During the study, 109 infants were evaluated, 107 were included in the study, two infants with GA < 37 weeks, were excluded by using oxygen for a time equal to 15 days. Of the 107 infants evaluated, 23 were included in the BPD group, 47 in the term group and 37 in the premature group. Babies in the BPD group had GA of 32 weeks ± 3 weeks, APGAR 1st minute 6 ± 1, 5th minutes 8 ± 2, 37 days ± 10 days in oxygen, in the median amount of 2 L / min ± 0.5 L / min. Birth weight, gestational age, APGAR score at 1st and 5th minutes from the term group, DBP and Premature differ significantly (Kruskal-Wallis test p = 0.0000, 0.0000, 0.0013 and 0.0001, respectively). The term group had higher values when compared to the BPD and premature. Babies with BPD manifest absence of three of the four types of eye movements measured when compared with the term group and preterm (Cochran Q test where Q > 2 and p < 0.05)

O presente trabalho teve como objetivo avaliar a influência da cesariana eletiva no eritrograma de bezerros neonatos da raça Nelore durante os primeiros trinta dias de vida. Os neonatos foram alocados em 3 grupos 8 bezerros obtidos por parto espontâneo (PE), 8 bezerros nascidos por cesariana, sem indução do parto (CSI) e 8 bezerros nascidos por cesariana, com indução do parto (CCI) pelo uso de 25 mg de Dexametasona, 24 horas antes do procedimento cirúrgico, pela via intramuscular. Os nascimentos ocorreram entre 282 e 292 dias de gestação. As amostras de sangue para a determinação do quadro eritrocitário foram colhidas por punção da veia jugular externa, utilizando-se Sistema Vacutainer&reg;. A determinação do eritrograma foi realizada no contador automatizado BC-2800 Vet Mindray&reg;. Os resultados obtidos evidenciam que a cesariana eletiva não influenciou o número de hemácias, das taxas de hemoglobina e nos valores do volume globular a crase sanguínea de bezerros na primeira semana de vida. Na primeira semana de vida observou-se, independentemente do grupo experimental uma diminuição no número de hemácias, das taxas de hemoglobina e nos valores do volume globular. Até os 5 dias de vida, os valores de Volume Corpuscular Médio (VCM) e de Hemoglobina Corpuscular Média (HCM) dos bezerros nascidos de partos espontâneos por via vaginal são estatisticamente menores do que os obtidos em bezerros nascidos de cesariana eletiva. A partir de 10 dias de vida observou-se, nos animais obtidos de parto espontâneo, uma rápida recuperação nos valores de hemácias, hemoglobina e volume globular, enquanto nos animais nascidos por cesariana (induzida e não induzida) não ocorria essa recuperação nas taxas de hemoglobina e nos valores do volume globular. Nos bezerros obtidos por cesariana observou-se que no período entre 10 e 30 dias de vida o Volume Corpuscular Médio (VCM) e a Hemoglobina Corpuscular Média (HCM) diminuíram, passando a apresentarem microcitose e hipocromia quando comparados com bezerros obtidos por parto espontâneo. Entre todos os grupos, os animais nascidos por cesariana sem indução apresentaram os valores com menor magnitude do início ao fim do período experimental. Os animais nascidos a termo demonstram uma capacidade de recuperação fisiológica mais apurada que dos animais nascidos por cesariana. / This study aimed to evaluate the influence of elective cesarean section in erythrogram of newborn calves of the Nellore breed for the first thirty days of life. Neonates were divided into 3 groups 8 calves obtained by spontaneous birth (PE), 8 calves born by caesarean section without labor induction (CSI) and 8 calves born by cesarean section with induction of labor (CCI) by the use of 25 mg of dexamethasone 24 hours before the surgical procedure, by the intra-muscular). Births occurred between 282 and 292 days of gestation. Blood samples for determining the erythrocyte frame were collected by puncture of the external jugular vein using Vacutainer &trade; System. The determination of erythrocyte was performed in the automated counter BC-2800 Vet Mindray&reg;. The results show that elective caesarean section did no affect the number of red blood cells, hemoglobin rates and values of the globular volume in the first week of life of calves. At this first week of life was observed, regardless of the experimental group a decrease in the number of red blood cells, hemoglobin rates and values of the globular volume. Until 5 days of age, the mean corpuscular volume values (MCV) and Mean Corpuscular Hemoglobin (MCH) of calves born from spontaneous vaginal deliveries are statistically lower than those obtained in calves born from elective cesarean section. From 10 days of life was observed in animals obtained by from spontaneous delivery, a quick recovery in the values of erythrocytes, hemoglobin and packed cell volume, whereas in animals born via caesarean section (induced and uninduced) did not occur such recovery in the rates of hemoglobin and packed cell volume values. In calves obtained by Caesarean section it was observed that in the period between 10 and 30 days of life Mean Corpuscular Volume (MCV) and Mean Corpuscular Hemoglobin (MCH) decreased, submitting a microcytic hypochromic when compared with calves obtained by spontaneous delivery. Among all groups, animals born by caesarean section without induction showed the values with lower magnitude from beginning to end of the trial period. Animals born at term show a more accurate physiological recovery capability in comparingson with animals born by Caesarean section.

Objective: To verify if the noise caused by sucking and swallowing mechanisms interferes in the quality of transient evoked otoacoustic emissions (TEOAE) in neonates with and without risk indicators for hearing loss by comparing the responses without sucking with situations of non-nutritive sucking, breast-feeding nutritive sucking and bottle-feeding nutritive sucking. Methods: a study carried out with 53 neonates (13 with risk indicators for hearing loss), evaluated with TEOAE, at rest and in three different cases: non-nutritive sucking, breast-feeding nutritive sucking and bottle-feeding nutritive sucking. Results: Studying the different types of sucking, it was found that the greater incidence of failure occurred at the frequency of 2000 Hz for all the three types of sucking. An increase in the noise intensity was observed in all frequencies during the capture of TEOAE in the left ear in all types of sucking studied. At 1400, 2000, 2800, and 4000 Hz, the signal to noise ratio decreased in the left ear during sucking. In breast-feeding nutritive sucking, the noise levels were lower at 1400 Hz and the signal to noise ratio was higher at the same frequency as well as at 2000 Hz. When neonates were compared regarding the presence or not of risk indicators for hearing loss, the seconds during non-sucking situation showed higher amplitude of TEOAE at the frequencies of 700, 1000, 2000, and 4000 Hz, and at 1000 and 4000 Hz during sucking. In both groups, a decrease in the amplitude of TEOAE and in the noise at 700 Hz during sucking was observed. At the other frequencies, the noise level increased in the sucking situation. There was no change in the signal to noise ratio between the conditions of sucking and nonsucking at 700 and 1000 Hz. At 1400 Hz, the sucking impaired the signal to noise ratio causing absence of response. At 2000, 2800, and 4000 Hz, the signal to noise ratio remained greater than 6 dB. Conclusions: The evaluation of TEOAE during sucking can be performed in neonates with and without risk indicators for hearing loss, since the criteria of presence/absence are achieved in at least three frequencies studied. / Objetivo:verificar se os ruídos provocados pelo mecanismo de sucção/deglutiçãointerferem na amplitude das Emissões Otoacústicas Evocadas Transientes(EOAETs) em neonatos com e sem indicadores de risco para perda auditiva, comparando as respostas sem sucção com as situações de sucção não nutritiva,sucção nutritiva no peito materno e em sucção nutritiva em mamadeira. Métodos:estudo realizado com 53 neonatos (13 com indicadores de risco para deficiência auditiva), avaliados com EOAETs, em repouso e em três situações de sucção:sucção não nutritiva, sucção nutritiva no peito materno e sucção nutritiva na mamadeira. Resultados: em 700, 1000, 2000 e 4000 Hz a amplitude foi maior no grupo sem indicadores de risco, e na situação de sucção, apenas em 1000 e 4000Hz. Em 700 Hz observou-se diminuição na amplitude das EOAETs e do ruído, quando mensuradas durante a sucção. O nível de ruído aumentou em sucção. Em 700 e 1000 Hz não houve variação da relação sinal/ruído entre as duas situações. Em 1400 Hz a sucção prejudicou a relação sinal/ruído, provocando ausência de respostas. Em 2000, 2800 e 4000 Hz a variável se manteve superior a seis dB. Constatou-se na freqüência de 2000 Hz maior ocorrência de falha durante a sucção. Analisando a variável ruído, em todas as freqüências houve aumento de sua intensidade durante a avaliação das EOAETs em sucção na orelha esquerda. Em 1400, 2000, 2800 e 4000 Hz houve interferência também na relação sinal/ruído, que diminuiu na orelha esquerda, durante a sucção. Encontrou-se níveis de ruído menores em 1400 Hz, durante a avaliação das EOAETs em sucção nutritiva no peito, e relação sinal/ruído maior na mesma freqüência e em 2000 Hz. Conclusões: A avaliação das EOAETs durante a sucção pode ser executada em neonatos com e sem indicadores de risco para deficiência auditiva, já que os critérios de presença/ausência são atingidos em pelo menos três freqüências analisadas e as alterações produzidas com esta estratégia não prejudicam as respostas ao ponto de evidenciar resultados falso/positivos.

Orientador: Everardo Magalhães Carneiro / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-26T17:22:21Z (GMT). No. of bitstreams: 1 Goncalves_LucianaMateus_M.pdf: 1375240 bytes, checksum: fe3cbb519b479a70d1a3fcd2f6fd3b82 (MD5) Previous issue date: 2015 / Resumo: incidência do diabetes mellitus tipo 2 vem crescendo em todo o mundo, e a estimativa para os próximos anos é que continue aumentando. Dentro desse panorama, destacamos estudos relacionados com substâncias classificadas como desreguladores endócrinos, caracterizados tanto por alterar a síntese, liberação e ação de hormônios bem como atuar sobre receptores hormonais. Dentre os desreguladores endócrinos, alguns apresentam potencial obesogênico e diabetogênico, como é o caso do Bisfenol A (BPA). Estudos demonstram que o BPA, substância utilizada na manufatura do plástico policarbonato e resina epóxi, possui ação sobre receptores de estrógeno. Devido sua ampla aplicação em itens utilizados cotidianamente, estamos constantemente expostos ao BPA desde o desenvolvimento fetal. O objetivo desse estudo foi investigar o efeito da exposição de ilhotas pancreáticas de camundongos neonatos ao BPA. Foram utilizadas ilhotas de neonatos (4 a 6 dias de vida) cultivadas por 48 horas com 0,1nM de BPA para avaliar: 1) secreção de insulina; 2) expressão gênica; 3) conteúdo proteico. Os resultados foram analisados pelo teste t-Student, com nível de significância p<0,05. A secreção de insulina induzida por glicose ou solução de KCl 40 mM foi prejudicada nas ilhotas tratadas com BPA. O conteúdo total de insulina, assim como a expressão dos genes da insulina não foram alterados. Houve redução tanto da expressão gênica como do conteúdo proteico de conexina 36 nas ilhotas tratadas. O BPA reduziu a expressão gênica da subunidade beta 2 do canal de cálcio do tipo L e o conteúdo proteico das subunidades kir6.2 e sur1 do canal de potássio ATP-dependente. O conteúdo de vamp2 e sintaxina 1A também foi menor nas ilhotas tratadas. Concluímos que a exposição das ilhotas de neonatos ao BPA na concentração e tempo utilizados promove alterações dos mecanismos moleculares envolvidos na secreção de insulina / Abstract: Type 2 diabetes is increasing worldwide. Recently, studies have shown the diabetogenic effects of some chemical components used in packages of food and beverages. An obsesogenic and diabetogenic substance is the bisphenol A (BPA), used in manufacture of polycarbonate plastic and epoxy resin. Our exposure to this substance may begin during fetal development and in the first hours of life still in hospital. The aim of this study was to investigate the effects of BPA in islets from newborn mice. Neonate pancreatic islets (4-6 days) were isolate by collagenase method and were cultured with BPA (0.1 nM) for 48 hours, and then used to evaluate: 1) insulin secretion; 2) gene expression; 3) protein content. The results were analyzed by Student t-test, p<0.05. We observed a reduced insulin secretion in response to both glucose and 40 mM KCl solution. However, total insulin content and Ins1/Ins2 gene expression was not altered. On the other hand, connexin 36 gene and protein expression were decreased. Another genes involved with b-cell maturation were unchanged. Furthermore, BPA decreased gene expression of beta 2 subunit of L-type calcium channel. Protein content of K-ATP channel (kir6.2 and sur1), vamp2 and syntaxin 1A were also reduced. We concluded that 0.1 nM BPA exposure for 48 h alters molecular mechanisms involved with insulin secretion from newborn islets in culture / Mestrado / Fisiologia / Mestra em Biologia Funcional e Molecular

Advances in technology have lowered the limits of viability in premature births to 24 weeks of gestation. This brought forth a new population of children, who are born 3-4 months early and spent considerable amounts of time in neonatal intensive care unit (NICU), instead of sterile environment of mother’s womb. Besides, other problems associated with prematurity, these children often undergo invasive procedures resulting in mucosal inflammation and/ or injury by feeding tubes, endotracheal tubes, and prolonged IV catheter. To test whether “ex-preemie-infants” were different than “term-infants” with regard to their immunity, preterm infants (< 32 weeks) and term infants (control) at the corrected age of 9-12 months were analyzed for their resting and stimulated immune responses. Preterm infants had a significant Th1 skewed response, higher number of activated and functionally competent T cells compared to term infants. The critical role of neonatal environmental exposure on immune system development is imminent; nevertheless detailed mechanistic studies on pathways are warranted.

No description available.

Advances in technology have lowered the limits of viability in premature births to 24 weeks of gestation. This brought forth a new population of children, who are born 3-4 months early and spent considerable amounts of time in neonatal intensive care unit (NICU), instead of sterile environment of mother’s womb. Besides, other problems associated with prematurity, these children often undergo invasive procedures resulting in mucosal inflammation and/ or injury by feeding tubes, endotracheal tubes, and prolonged IV catheter. To test whether “ex-preemie-infants” were different than “term-infants” with regard to their immunity, preterm infants (< 32 weeks) and term infants (control) at the corrected age of 9-12 months were analyzed for their resting and stimulated immune responses. Preterm infants had a significant Th1 skewed response, higher number of activated and functionally competent T cells compared to term infants. The critical role of neonatal environmental exposure on immune system development is imminent; nevertheless detailed mechanistic studies on pathways are warranted.

Introduction: Assessing brain maturation in preterm neonates is essential for the health of the neonates. Machine learning methods have been introduced as a prospective assessment tool for neonatal electroencephalogram(EEG) signals. Explainable methods are essential in the medical field, and more research regarding explainability is needed in the field of using machine learning for neonatal EEG analysis. Methodology: This thesis develops an explainable machine learning model that estimates postmenstrual age in very preterm neonates from EEG signals and investigates the importance of the features used in the model. Dual-channel EEG signals had been collected from 14 healthy preterm neonates of postmenstrual age spanning 25 to 32 weeks. The signals were converted to amplitude-integrated EEG (aEEG) and a list of features was extracted from the signals. A regression tree model was developed and the feature importance of the model was assessed using permutation importance and Shapley additive explanations. Results: The model had an RMSE of 1.73 weeks (R2=0.45, PCC=0.676). The best feature was the mean amplitude of the lower envelope of the signal, followed by signal time spent over 100 µV. Conclusion: The model is performing comparably to human experts, and as it can be improved in multiple ways, this result indicates a promising outlook for explainable machine learning model applications in neonatal EEG analysis.

Urinary tract infections (UTI) in neonates are caused by many types of risk factors such as increased length of maternal labor, physiologic maternal conditions, prematurity, and decreased birth weight. Identification of potential risk factors for UTI in neonates can lead to rapid assessment and early interventions to treat urinary infection in the neonate before it transitions to a severe or life-threatening condition, such as a kidney infection or septicemia. The primary purpose of this literature review was to examine risk factors predisposing neonates to UTI. The secondary purpose was to identify if length of time to drug therapy used to treat UTI in neonates decreased complications and recurrence in the preterm infant. A comprehensive literature review was performed using research articles available from 2007 to 2021 regarding the factors influencing the occurrence of urinary tract infections in neonates. Databases used to search for articles include EBSCOhost databases, Medical Literature On-Line (Medline), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Google Scholar. Searches used a combination of the following terms: ‘UTI’, OR ‘urinary tract infection’, AND ‘neonates’, OR ‘infants’, ‘risk factors’. Of the articles reviewed, 15 met the inclusion criteria and answered the research questions. Two studies showed circumcision in male infants increases the risk of urinary tract infection in infants. Two studies revealed vesicourethral reflux in female infants compared to male infants increases the risk of UTIs. One article suggested women with longer labor (>24 hours) from onset had an increased likelihood of the newborn having a UTI within the first week of life. Preliminary data suggests there are significant precursors and risk factors that can be identified to diagnosis UTIs early and having them treated promptly. All the reviewed articles focused on collection of urine samples within hours of birth and physiologic findings of a UTI can decrease the length of stay and costs related to infection treatment. Antibiotic therapy being administered empirically due to rapid assessment of risk factors for UTI in the neonate decreases time to treatment by three to five days, which improves health outcomes. Rapid assessment and diagnosis of UTI is of value for preventable measures to be ordered sooner to avoid repeat and resistant UTIs in the neonate.