Publications by authors named "Sindelar R"

Collagen type VI (COL6) is an important component of the extracellular matrix (EM) and may have a major role in lung development and disease. Studies on COL6 expression during lung development are mainly based on animal models. The aim of the study was to define COL6 expression pattern in lung parenchyma in infants with different lung maturational stages.

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Aim: To evaluate if increased survival and new ventilation strategies were accompanied by a changed incidence of bronchopulmonary dysplasia (BPD) in Sweden over a decade.

Methods: Data from two Swedish population-based studies of live-born infants with gestational ages (GA) 22-26 weeks, born during 2004-2007 (n=702) and 2014-2016 (n=885), were compared for survival, any BPD, moderate BPD, severe BPD, and BPD/severe BPD or death at 36 weeks postmenstrual age (PMA). Ventilation strategies and interventions were analysed.

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Background: Invasive ventilation of infants born before 24 weeks of gestation is critical for survival and long-term respiratory outcomes, but currently there is a lack of evidence to guide respiratory management. We aimed to compare respiratory mechanics and gas exchange in ventilated extremely preterm infants born before and after 24 weeks of gestation.

Methods: Secondary analysis of two prospective observational cohort studies, comparing respiratory mechanics and indices of gas exchange in ventilated infants born at 22-24 weeks of gestation (N=14) compared to infants born at 25-27 weeks (N=37).

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Four methane-oxidizing bacteria, designated as strains WSC-6, WSC-7, SURF-1, and SURF-2, were isolated from Saddle Mountain Creek in southwestern Oklahoma, USA, and the Sanford Underground Research Facility (SURF) in Lead, South Dakota, USA. The strains were Gram-negative, motile, short rods that possessed intracytoplasmic membranes characteristic of type I methanotrophs. All four strains were oxidase-negative and weakly catalase-positive.

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Background: This multicentre, international, retrospective study aimed to investigate whether respiratory system reactance ( ) assessed by respiratory oscillometry on day 7 of life is associated with respiratory outcomes in preterm infants below 32 weeks gestational age (GA).

Methods: Sinusoidal pressure oscillations (2-5 cmHO peak-to-peak, 10 Hz) were superimposed on the positive end-expiratory pressure. We assessed the association of z-score with the duration of respiratory support using linear regression and with bronchopulmonary dysplasia (BPD) using logistic regression.

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Article Synopsis
  • The study focuses on the role of Goblet cells and the marker REG4 in necrotizing enterocolitis (NEC) among preterm infants, comparing biopsies from infants with NEC to those without.
  • Results show that REG4 expression was significantly lower in infants with NEC, suggesting a potential link between Goblet cell dysfunction and NEC risk.
  • However, the study also indicates that the maturity of the infants may influence REG4 expression, complicating the interpretation of the results.
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Coordination compounds, like iron(II) triazole complexes, exhibit spin crossover (SCO) behavior at around room temperature. Therefore, they are interesting for a variety of possible applications, and it is convenient to integrate them into polymers. Due to a reduction of the iron content and thus also Fe content in the sample through integration in polymers, Mössbauer measurements are only possible with greater difficulty or very long measurement times without expensive enrichment of the samples with Fe.

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  • An international survey was conducted across 560 neonatal intensive care units (NICUs) in 24 European countries to assess the usage of lung ultrasound (LU), revealing significant variability in adoption rates (20%-98%).
  • Most NICUs (76%) use LU for clinical reasons, primarily to diagnose respiratory issues and manage acute conditions.
  • Key barriers to LU implementation include lack of experience in technical skills and image interpretation, with suggestions for improvement involving specific training courses and a standardized international guideline.
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Patient-triggered modes of ventilation are currently the standard of practice in the care of term and preterm infants. Maintaining spontaneous breathing during mechanical ventilation promotes earlier weaning and possibly reduces ventilator-induced diaphragmatic dysfunction. A further development of assisted ventilation provides support in proportion to the respiratory effort and enables the patient to have full control of their ventilatory cycle.

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  • - The study examines surgical approaches to treating patent ductus arteriosus (PDA) in extremely premature infants (born <26 weeks), focusing on two large Swedish hospitals over six years.
  • - Results showed that one hospital performed PDA surgery more frequently and at an earlier age, yet both centers had similar survival rates for infants, but different outcomes in terms of bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP).
  • - The earlier surgical intervention was linked to lower severe BPD rates but higher severe ROP rates, indicating a complex relationship between treatment timing and clinical outcomes in extremely preterm infants.
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Background: Collagen type IV alpha 1 chain (COL4A1) in the basement membrane is an important component during lung development, as suggested from animal models where COL4A1 has been shown to regulate alveolarization and angiogenesis. Less is known about its role in human lung development. Our aim was to study COL4A1 expression in preterm infants with different lung maturational and clinical features.

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Article Synopsis
  • - This research investigates different mechanical ventilation strategies for infants with severe bronchopulmonary dysplasia (BPD) to improve care and clinical trial design.
  • - A secondary analysis of data from 78 infants across 14 centers used clustering techniques to categorize ventilator settings into three distinct approaches based on specific physiological measures.
  • - The findings show significant differences in ventilation settings among the identified clusters, suggesting a need for further studies to link these practices to BPD clinical outcomes.
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We synthesized iron(II)-triazole spin crossover compounds of the type [Fe(atrz)]X and incorporated and deposited them on electrospun polymer nanofibers. For this, we used two separate electrospinning methods with the goal of obtaining polymer complex composites with intact switching properties. In view of possible applications, we chose iron(II)-triazole-complexes that are known to exhibit spin crossover close to ambient temperature.

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Unlabelled: Previous studies suggest that Paneth cells are involved in NEC development. Defensin alpha 6 (DEFA6) and guanylate cyclase activator 2A (GUCA2A) are selective protein markers of Paneth cells. The objective was to explore DEFA6 and GUCA2A expression in intestinal tissue samples from newborn infants with and without NEC.

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Article Synopsis
  • BPD is the most common late complication in extremely premature infants, necessitating coordinated care from neonatal intensive care to outpatient services.
  • A survey of 18 academic centers revealed significant differences in how interdisciplinary teams are structured and operate in both inpatient and outpatient settings.
  • Further research is essential to improve long-term outcomes for infants with severe BPD through optimized interdisciplinary care.
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Lung immaturity and acute respiratory failure are the major problems in the care of extremely preterm infants. Most infants with gestational age (GA) 22-24 weeks will need mechanical ventilation and many will depend on some type of respiratory support, invasive and non-invasive for extended periods. There is ongoing gap in knowledge regarding optimal respiratory support and applying strategies that are effective in more mature populations is not easy or even suitable because lung maturation differs in smaller infants.

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Patent ductus arteriosus is the most common cardiovascular condition in preterm infants. There is a significant uncertainty about when and how to close ductus arteriosus in preterm infants due to a high spontaneous closure rate even in very immature preterm infants. Diagnosis and management of patent ductus arteriosus remain a challenge for both neonatologists and pediatric cardiologists.

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  • Researchers studied fluid intake in extremely preterm infants (born at 22-26 weeks) during their first week of life, comparing a restrictive approach to a more liberal one.
  • The liberal group had a significantly higher total fluid intake but showed no differences in weight loss, sodium levels, or major health issues compared to the restrictive group.
  • The study concluded that varying fluid allowances in this early period did not lead to important differences in health outcomes for these vulnerable infants.
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Survival of preterm newborn infants have increased steadily since the introduction of surfactant treatment and antenatal steroids. In the absence of randomized controlled trials on ventilatory strategies in extremely preterm infants, we present ventilatory strategies applied during the initial phase and the continued ventilatory care as applied in three centers with proactive prenatal and postnatal management and well documented good outcomes in terms of mortality and morbidity in this cohort of infants.

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