Publications by authors named "Zaharie G"

Objective: Despite lack of evidence supporting efficacy, prophylactic fresh frozen plasma and Octaplas transfusions may be administered to very preterm infants to reduce bleeding risk. International variation in plasma transfusion practices in neonatal intensive care units (NICUs) is poorly understood, therefore, we aimed to describe neonatal plasma transfusion practice in Europe.

Design: Prospective observational study.

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  • Platelet transfusions are given to preterm infants to prevent bleeding, but recent studies showed higher risks of mortality and major bleeding with transfusions at a higher platelet count threshold of 50 × 10/L compared to 25 × 10/L.
  • A prospective observational study across 64 neonatal intensive care units in 22 European countries was conducted to assess current platelet transfusion practices, which included tracking transfusion rates, indications, and patient outcomes.
  • The findings indicated that the lower transfusion threshold of 25 × 10/L is being adopted in practice, though there's considerable variation in transfusion volumes and rates, highlighting the need for further research to optimize these practices.
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Importance: Red blood cell (RBC) transfusions are frequently administered to preterm infants born before 32 weeks of gestation in the neonatal intensive care unit (NICU). Two randomized clinical trials (Effects of Transfusion Thresholds on Neurocognitive Outcomes of Extremely Low-Birth-Weight Infants [ETTNO] and Transfusion of Prematures [TOP]) found that liberal RBC transfusion thresholds are nonsuperior to restrictive thresholds, but the extent to which these results have been integrated into clinical practice since publication in 2020 is unknown.

Objective: To describe neonatal RBC transfusion practice in Europe.

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Objectives: To survey practices of iron and recombinant human erythropoietin (rhEpo) administration to infants born preterm across Europe.

Study Design: Over a 3-month period, we conducted an online survey in 597 neonatal intensive care units (NICUs) of 18 European countries treating infants born with a gestational age of <32 weeks.

Results: We included 343 NICUs (response rate 56.

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  • Non-invasive cardiac output monitoring using electrical biosensing technology (EBT) allows for continuous monitoring of hemodynamic variables in neonates, helping to identify instability early for potential interventions.
  • The use of thoracic (TEBT) and whole body (WBEBT) monitoring methods has grown in neonatology, although TEBT is not a reliable measure of cardiac output, it may track changes in individual patients over time.
  • Recommendations suggest avoiding WBEBT for cardiac output monitoring and highlight the need for further research to address variations in technology and methodology before EBT can become routine in clinical practice.
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  • Family Integrated Care (FICare) has been effective in supporting sick neonates and their families, but its implementation is mostly limited to developed countries, prompting the need for adaptations to make it more widely applicable.
  • The RISEinFAMILY project is researching an adapted FICare model through a multinational trial involving several countries, including Spain, the UK, and Zambia, focusing on infant-family dyads in Neonatal Intensive Care Units.
  • The study aims to assess how well this new model can work in different cultural and socio-economic settings, while also comparing its effects on newborn outcomes, family mental health, and healthcare professional satisfaction against standard care methods.
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(1) Background: Neonates born to SARS-CoV-2 positive mothers are at risk of infection, as well as adverse outcomes due to the infection. The aim of our study was to analyze the impact of maternal SARS-CoV-2 infection on neonatal outcome. (2) Methods: We conducted a prospective, longitudinal study.

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(1) Background: Vascular endothelial growth factor (VEGF) is essential in vasculo- and angiogenesis due to its role in endothelial cell proliferation and migration. As a vascular proliferative factor, VEGF is one of the hallmarks of cancer and, in adult populations, the relationship between genetic polymorphism and neoplasm was widely investigated. For the neonatal population, only a few studies attempted to uncover the link between the genetic polymorphism of VEGF and neonatal pathology, especially related to late-onset complications.

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  • The study investigates the relationship between vitamin K levels and short-chain fatty acids in mother-newborn pairs, addressing the vitamin K deficiency commonly observed in newborns with sterile guts.
  • Blood samples were collected from 45 healthy mothers and their newborns, measuring various vitamin K-dependent proteins and SCFAs to assess vitamin K status.
  • Results showed significantly higher levels of undercarboxylated vitamin K-dependent proteins in newborns compared to mothers, while SCFAs were more prevalent in mothers, indicating potential fetal transfer of SCFAs and revealing a significant vitamin K deficiency in newborns at an extrahepatic level.
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Background: Preterm infants commonly receive red blood cell (RBC), platelet and fresh frozen plasma (FFP) transfusions. The aim of this Neonatal Transfusion Network survey was to describe current transfusion practices in Europe and to compare our findings to three recent randomised controlled trials to understand how clinical practice relates to the trial data.

Methods: From October to December 2020, we performed an online survey among 597 neonatal intensive care units (NICUs) caring for infants with a gestational age (GA) of <32 weeks in 18 European countries.

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(1) Background: Near-infrared spectroscopy (NIRS) is a non-invasive, easily performed method of monitoring brain oxygenation. The regional cerebral oxygen saturation (crSaO2) and the cerebral fractional tissue oxygen extraction (cFTOE) evaluated by NIRS provide more accurate information on brain oxygenation than the blood oxygen saturation. We investigated the effect of perinatal factors on cerebral oxygenation of preterm newborns.

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Polymorphism of insulin-like growth factor 2 (IGF2) is known to play a role in cell development. Only the paternal IGF2 copy is active, while the copy inherited from the mother is inactive. This study aimed to explore whether maternal and paternal factors influence IGF2 polymorphism in newborns with intrauterine growth restriction (IUGR) compared to appropriate for gestational age (AGA).

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The present study provides our clinical experience regarding the imaging diagnosis, management and postnatal outcome of neonates prenatally suspected of having developed ovarian cysts. This multicenter observational study included patients diagnosed prenatally with fetal ovarian cysts and follow-up in the postnatal period. Descriptive statistics were used to render the information regarding the prenatal imaging aspect of the fetal pelvic masses using ultrasound and/or MRI, prenatal surveillance and postnatal neonate's immediate outcome, indications leading to surgery and pathologic aspect.

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Background: An early form of preeclampsia is rare. Abnormal placentation, placental perfusion disorders, and inflammatory cytokine release will have an effect on the fetus and newborn.

Material And Methods: The study group consisted of preterm newborns whose mothers had a history of preeclampsia and a gestational age of between 30 weeks and 34 weeks + 6 days.

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Fetal cardiac rhabdomyomas should trigger the awareness of a potential coexisting tuberous sclerosis complex that can lead to a poor neurological outcome. This condition is not only uncommon but can be easily unrecognized prenatally in the absence of a meticulous neurosonogram and MRI. We emphasize that careful consideration of all prenatal facilities is required to confirm the diagnosis of tuberous sclerosis complex as early as possible during pregnancy.

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Severe acute respiratory distress syndrome with coronavirus 2 (SARS-CoV-2) infection affected pregnant women during the pandemic. Immunological particularity of this population and the increased need for medical assistance placed this population in a high-risk category for SARS-Cov-2 infection. Owing to high contamination risk and limited studies regarding vertical transmission, the labor and delivery of positive women required particular conditions.

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Unlabelled: Differences in sex development (DSD) are often correlated with a genetic etiology. This study aimed to assess the etiology of DSD patients following a protocol of genetic testing.

Materials And Methods: This study prospectively investigated a total of 267 patients with DSD who presented to Clinical Emergency Hospital for Children Cluj-Napoca between January 2012 and December 2019.

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Background: Transdiagnostic interventions delivered for children and adolescents show promising results. In order to increase access to treatment, recent developments in technology have led to alternatives to face-to-face interventions. Transdiagnostic Internet-delivered interventions can be effective for adult anxiety and depressive disorders, but research is more limited regarding the efficacy of such treatments for young populations diagnosed with anxiety and or depressive disorders.

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Fetal inflammatory response syndrome is associated with increased neonatal morbidity and mortality. The aim of the present study was to evaluate the dynamics of the plasmatic value of pro-inflammatory cytokines: tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and neutrophil activating peptide 78 (ENA-78) and the anti-inflammatory cytokine IL-10 in the first and third day of life and the correlation with neonatal morbidities and mortality. The current research was designed as a prospective case control study included 80 neonates hospitalized at the 3rd level Neonatal Intensive Care Unit (NICU), 1st Gynecology Clinic, County Emergency Hospital, Cluj-Napoca, Romania.

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Background: Genetic testing has become a standardized practice in the diagnosis of patients with global developmental delay/intellectual disability (GDD/ID). The aim of this study is to observe the frequency of recurrent copy number variations (CNVs) in patients diagnosed with GDD/ID, using MLPA technique.

Methods: A total of 501 paediatric patients with GDD/ID were analysed using SALSA MLPA probemix P245 Microdeletion Syndromes-1A, and the technical steps were performed according to the MRC Holland MLPA general protocol.

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Epidermolysis bullosa is a rare form of genodermatosis produced by different gene mutations. The junctional form of the disease (JEB-PA) can associate pyloric atresia, renal abnormalities, and aplasia cutis congenita. A case of a male preterm newborn with suspicion of digestive tube malformation at fetal ultrasound and who was born by cesarian section.

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  • Down syndrome (DS) is associated with a significant risk of developing acute leukemia, particularly acute myeloid leukemia (AML) in neonates, highlighting the role of chromosome 21 in blood cell development.
  • A nationwide study in Romania focused on rare cases of transient leukemia and acute leukemia in children with DS, analyzing data from three major pediatric hematology centers using statistical methods.
  • Results showed that CD45 positive leukemia is the more aggressive form commonly diagnosed in DS, stressing the need for increased awareness among pediatricians and neonatologists regarding hematological issues in these patients.
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Twin-to-twin transfusion syndrome (TTTS) is the consequence of vascular anastomoses of the shared placenta of monochorionic twin pregnancies. Both circulating inter-twin blood flow and vasoactive mediators imbalance cause hypovolemia in the donor and hypervolemia in the recipient fetus. If left untreated, TTTS has a high perinatal mortality rate and adverse long-term outcomes mainly cardiovascular and neurological.

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Premature newborns have a number of oxidative stress-inducing disorders. Antioxidant defense is deficient in premature newborns. Hydrogen donors can be used to evaluate the non-enzymatic antioxidant defense.

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