Neonatal respiratory distress syndrome (NRDS) is a consequence of immaturity at birth and it is still associated with relatively high mortality rate. The aim of this study was to identify the factors associated with the occurrence of fatal outcome in newborns with neonatal respiratory distress syndrome.The research was designed as a case-control study nested in a retrospective cohort, and it enrolled newborns treated during 2015 at Pediatric Clinic of Clinical Center in Kragujevac. Diagnosis of NRDS and decision about the treatment were left at the discretion of attending pediatricians. The cases were patients with fatal outcome, while controls were randomly selected from the pool of survivors and matched with each case by gender in a ratio of 4:1.
The study included 371 newborns, of whom 201 (54.2%) were male and 170 (45.8%) female. Lethal outcome occurred in 36 newborns (9,7%). Significant association was found between death and APGAR score (ORadjusted: 0.516, 95% CI: 0.322-0.827), weight on delivery (ORadjusted: 0.996, 95% CI: 0.993-0.999), duration of hospitalization (ORadjusted: 0.901, 95% CI: 0.835-0.972) and mechanical ventilation (ORadjusted: 165.256, 95% CI: 7.616-3585.714).
Higher gestational age, higher birth weight, higher APGAR score and longer duration of hospitalization were singled out as protective factors, while use of mechanical ventilation increased the risk of death. Major limitations of the study were retrospective nature and relatively small number of identified cases. Postponing delivery and delivery in institution with neonatal intensive care unit are crucial for survival of newborns with NRDS.
Background: Drug-drug interactions are defined as modifications of the drug action that result from the simultaneous administration of another individual drug or several drugs. Nowadays, potential drug-drug interactions (DDIs) are most frequently detected and analyzed using personal digital assistant software programs (online interaction checker tools).
Objective: To determine the risk factors for the emergence of all drug-drug interactions in surgical patients with particular emphasis on clinically significant interactions.
Patients and methods: This was a retrospective cohort analysis of patients treated at the Surgical Clinic of the Clinical Center Kragujevac. Three interaction checkers were used to reveal drug-drug interactions: Medscape, Epocrates and Micromedex.
Results: The study included total of 200 patients, aged 58.54±17.08 years. Average number of drug-drug interactions per patient was between 10.50±9.10 (Micromedex) and 18.75±17.14 (Epocrates). Number of prescribed drugs, antidepressive therapy, antiarrhythmic therapy, number of pharmacological/therapeutic subgroups (2nd level of ATC classification) prescribed, delirium or dementia, diabetes, heart failure, and number of physicians who prescribed drugs to single patient were identified as risk factors for drug-drug interactions while length of hospitalization in days and age of patient in years emerged as protective factors.
Conclusion: Drug-drug interactions are relatively common in surgical patients and predisposed by factors such as number of prescribed drugs or drug group per patient, number of physicians who prescribed drugs, antidepressive therapy, antiarrhythmic therapy, presence of delirium or dementia, diabetes and heart failure. On the other hand, prolonged hospitalization and higher age are factors that reduce the risk of interactions in surgical patients.
New complexes of copper(II) with S-alkenyl derivatives of thiosalicylic acid (alkenyl = propenyl-(L1), isobutenyl-(L2)) have been synthesized and characterized by microanalysis, infrared spectra, magnetic measurements, and by NMR spectra. The cytotoxic activity of two newly synthesized precursor S-alkenyl derivatives of thiosalicylic acid were tested using an MTT colorimetric technique on HCT-116 human colon carcinoma cells. The cytotoxic effect of the copper(II)- complexes were higher compared to the cytotoxicity of the corresponding ligand (for concentrations from 31.25 to 250 μM). Copper(II)-complexes showed a slightly lower cytotoxicity compared to cisplatin. Complexes of copper(II) with S-alkenyl derivatives of thiosalicylic acid (at concentrations from 250 to 1000 μM) had a cytotoxic effect on HCT-116 cells compared to cisplatin.
New platinum(IV)-complexes with S-alkyl derivatives of thiosalicylic acid (alkyl = benzyl-(L1), methyl-(L2), ethyl-(L3), propyl-(L4), butyl-(L5)) have been synthesized and characterized by microanalysis, infrared spectroscopy, and 1H and 13C NMR spectroscopy. Th e bidentate S,O ligand precursor, the S-butyl derivative of thiosalicylic acid (S-bu-thiosal), was prepared, and its crystal structure was determined. Single crystals suitable for X-ray measurements were obtained by slow crystallization from a DMSO-water system. S-bu-thiosal crystallized in a P21/c space group of a monoclinic crystal system with a = 8.0732 (3) Å, b = 19.6769 (4) Å, c = 8.2291 (3) Å and Z = 4. S-bu-thiosal also has a coplanar geometry.