In the first days of life, the newborns' intestinal microbiota develops simultaneously with the intestinal gut barrier and follows intestinal immunity. The mode of delivery shows significant impact on microbial development and, thus, the initiation of the tryptophan catabolism pathway. Further antibiotics (ATB) treatment of mothers before or during delivery affects the microbial and tryptophan metabolite composition of stool of the caesarean- and vaginal-delivered newborns. The determination of microbiome and levels of tryptophan microbial metabolites in meconium and stool can characterize intestinal colonization of a newborn. From 134 samples from the Central European Longitudinal Studies of Parents and Children: The Next Generation (CELSPAC: TNG) cohort study, 16S rRNA gene sequencing was performed, and microbial tryptophan metabolites were quantified using ultra-high-performance liquid chromatography with triple-quadrupole mass spectrometry. Microbial diversity and concentrations of tryptophan metabolites were significantly higher in stool compared to meconium. Treatment of mothers with ATB before or during delivery affects metabolite composition and microbial diversity in stool of vaginal- and caesarean-delivered newborns. Correlation of microbial and metabolite composition shows significant positive correlations of indol-3-lactic acid, N-acetyl-tryptophan and indol-3-acetic acid with Bifidobacterium, Bacteroides and Peptoclostridium. The positive effect of vaginal delivery on newborns' microbiome development is degraded when mother is treated with ATB before or during delivery. KEY POINTS: • Antibiotic treatment diminishes the positive effects of vaginal delivery. • Antibiotic treatment affects metabolite and microbial composition in newborns. • Bifidobacterium and Peptoclostridium could be the producer of indole-lactic acid.

• Klíčová slova
• Caesarean delivery, Kynurenine, Microbiome, Stool, Tryptophan catabolites, Vaginal delivery,
• MeSH
• antibakteriální látky * MeSH
• Bifidobacterium metabolismus   růst a vývoj   MeSH
• feces * mikrobiologie   chemie   MeSH
• indoly metabolismus   MeSH
• kyseliny indoloctové metabolismus   MeSH
• lidé MeSH
• longitudinální studie MeSH
• mekonium * mikrobiologie   chemie   MeSH
• novorozenec MeSH
• RNA ribozomální 16S * genetika   MeSH
• střevní mikroflóra * účinky léků   MeSH
• tryptofan * metabolismus   MeSH
• vysokoúčinná kapalinová chromatografie MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antibakteriální látky * MeSH
• indole-3-lactic acid MeSH Prohlížeč
• indoleacetic acid MeSH Prohlížeč
• indoly MeSH
• kyseliny indoloctové MeSH
• RNA ribozomální 16S * MeSH
• tryptofan * MeSH

Intrapartum antibiotic prophylaxis (IAP) is commonly used during C-section delivery and in Group B Streptococcus-positive women before vaginal delivery. Here, we primarily aimed to investigate the effect of IAP on the neonatal oral and fecal bacteriomes in the first week of life. In this preliminary study, maternal and neonatal oral swabs and neonatal fecal (meconium and transitional stool) swabs were selected from a pool of samples from healthy mother-neonate pairs participating in the pilot phase of CELSPAC: TNG during their hospital stay. The DNA was extracted and bacteriome profiles were determined by 16S rRNA amplicon sequencing (Illumina). In the final dataset, 33 mother-neonate pairs were exposed to antibiotics during C-section or vaginal delivery (cases; +IAP) and the vaginal delivery without IAP (controls, -IAP) took place in 33 mother-neonate pairs. Differences in alpha diversity (Shannon index, p=0.01) and bacterial composition (PERMANOVA, p<0.05) between the +IAP and -IAP groups were detected only in neonatal oral samples collected ≤48 h after birth. No significant differences between meconium bacteriomes of the +IAP and -IAP groups were observed (p>0.05). However, the IAP was associated with decreased alpha diversity (number of amplicon sequence variants, p<0.001), decreased relative abundances of the genera Bacteroides and Bifidobacterium, and increased relative abundances of genera Enterococcus and Rothia (q<0.01 for all of them) in transitional stool samples. The findings of this study suggest that exposure to IAP may significantly influence the early development of the neonatal oral and gut microbiomes. IAP affected the neonatal oral bacteriome in the first two days after birth as well as the neonatal fecal bacteriome in transitional stool samples. In addition, it highlights the necessity for further investigation into the potential long-term health impacts on children.

• Klíčová slova
• 16S rRNA, Antibiotics, Diversity, Infant, Microbiome, Mother, Next-generation sequencing,
• MeSH
• antibakteriální látky * aplikace a dávkování   MeSH
• antibiotická profylaxe * metody   MeSH
• Bacteria genetika   klasifikace   izolace a purifikace   účinky léků   MeSH
• císařský řez MeSH
• dospělí MeSH
• feces * mikrobiologie   MeSH
• lidé MeSH
• mekonium mikrobiologie   MeSH
• novorozenec MeSH
• RNA ribozomální 16S genetika   MeSH
• střevní mikroflóra účinky léků   MeSH
• těhotenství MeSH
• ústa * mikrobiologie   MeSH
• vedení porodu MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antibakteriální látky * MeSH
• RNA ribozomální 16S MeSH

In the last decade there has been a dramatic increase in the availability and abuse of synthetic cathinones - new amphetamine-like stimulants. Even though their abuse during pregnancy could have serious adverse effects on the fetus, cathinones are not readily included in neonatal toxicological screenings. Meconium (first neonatal stool) is the specimen of choice to reveal long term drug exposure, however as it is a highly complex matrix, the sample preparation is a critical step before the instrumental analysis. The aim of this work was to develop a suitable meconium sample extraction technique using the advantages of salting-out assisted liquid-liquid extraction (SALLE) and using only MS-friendly organic ammonium salts. We further developed and validated liquid chromatography tandem-mass spectrometry method for the determination of 'traditional' stimulants (methamphetamine, amphetamine, MDMA) and cathinones (mephedrone, methylenedioxypyrovalerone (MDPV), α-pyrrolidinopentiophenone (α-PVP), methylone, butylone, flephedrone, and naphyrone). Matrix-matched calibration was prepared in the concentration range 10-2000 ng/g. The limits of quantification were determined as 10 ng/g, recoveries ranged from 48.2% to 94.3% and the matrix effect was between 60.2% and 101.4%. Accuracy (86.1-114.5%) and precision (4.9-14.9%) were determined and all validation criteria were met for all analytes except for naphyrone. Finally, our analytical method was tested on a set of real meconium samples, which were found positive for amphetamine, methamphetamine and methylone, thus demonstrating the validity of the method.

• Klíčová slova
• Amphetamines, Cathinones, Liquid chromatography tandem-mass spectrometry, Meconium, SALLE, Salting out assisted liquid-liquid extraction,
• MeSH
• amfetaminy analýza   MeSH
• amoniové sloučeniny chemie   MeSH
• extrakce kapalina-kapalina metody   MeSH
• komplikace těhotenství diagnóza   MeSH
• lidé MeSH
• limita detekce MeSH
• mekonium chemie   MeSH
• novorozenec MeSH
• odhalování abúzu drog metody   MeSH
• poruchy spojené s užíváním psychoaktivních látek diagnóza   MeSH
• stimulanty centrálního nervového systému analýza   MeSH
• studie proveditelnosti MeSH
• tandemová hmotnostní spektrometrie metody   MeSH
• těhotenství MeSH
• vysokoúčinná kapalinová chromatografie metody   MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• validační studie MeSH
• Názvy látek
• amfetaminy MeSH
• amoniové sloučeniny MeSH
• stimulanty centrálního nervového systému MeSH

Meconium aspiration syndrome (MAS) in newborns is characterized mainly by respiratory failure due to surfactant dysfunction and inflammation. Previous meta-analyses did not prove any effect of exogenous surfactant treatment nor glucocorticoid administration on final outcome of children with MAS despite oxygenation improvement. As we supposed there is the need to intervene in both these fields simultaneously, we evaluated therapeutic effect of combination of exogenous surfactant and selective inhibitor of NF-kappaB (IKK-NBD peptide). Young New Zealand rabbits were instilled by meconium suspension and treated by surfactant alone or surfactant in combination with IKK-NBD, and oxygen-ventilated for 5 h. PaO(2)/FiO(2), oxygenation index, oxygen saturation and ventilation efficiency index were evaluated every hour; post mortem, total and differential leukocyte counts were investigated in bronchoalveolar lavage fluid (BALF) and inflammatory, oxidative and apoptotic markers were assessed in lung tissue homogenates. Exogenous surfactant combined with IKK-NBD improved oxygenation, reduced neutrophil count in BALF and levels of IL-1beta, IL-6, p38 MAPK and caspase 3 in comparison with surfactant-only therapy. It seems that inhibition of inflammation may be strong supporting factor in surfactant treatment of MAS.

• MeSH
• králíci MeSH
• mediátory zánětu antagonisté a inhibitory   metabolismus   MeSH
• mekonium * MeSH
• náhodné rozdělení MeSH
• NF-kappa B antagonisté a inhibitory   metabolismus   MeSH
• novorozená zvířata MeSH
• plicní surfaktanty farmakologie   terapeutické užití   MeSH
• poškození plic chemicky indukované   farmakoterapie   metabolismus   MeSH
• zvířata MeSH
• Check Tag
• králíci MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• mediátory zánětu MeSH
• NF-kappa B MeSH
• plicní surfaktanty MeSH

• MeSH
• cystická fibróza komplikace   diagnóza   MeSH
• lidé MeSH
• mekonium * MeSH
• novorozenec MeSH
• střevní obstrukce etiologie   MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• Publikační typ
• dopisy MeSH
• komentáře MeSH

We report a case of meconium pseudocyst evaluated by prenatal MR imaging. The unusual features were its huge size, the absence of meconium peritonitis, and its development late in fetal life. The case also demonstrates a possible diagnostic pitfall since it suggests that rapid deterioration of a mechanically compensated bowel obstruction may occur, potentially occurring only after an MRI study has been performed.

• MeSH
• atrézie střev komplikace   diagnóza   MeSH
• cysty diagnóza   etiologie   MeSH
• dospělí MeSH
• ileum abnormality   MeSH
• lidé MeSH
• magnetická rezonanční tomografie * MeSH
• mekonium * MeSH
• nemoci plodu diagnóza   MeSH
• novorozenec nedonošený MeSH
• novorozenec MeSH
• prenatální diagnóza * MeSH
• těhotenství MeSH
• ultrasonografie prenatální MeSH
• volvulus intestini komplikace   diagnóza   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

BACKGROUND: Ultrafast T2-weighted (T2-W) MRI sequences are currently considered a routine technique for fetal MR imaging. Limited experience exists with fetal T1-weighted (T1-W) imaging techniques. OBJECTIVE: To determine MRI patterns of some fetal abdominal or haemorrhagic disorders with particular respect to the diagnostic value of T1-W images. MATERIALS AND METHODS: In addition to standard T2-W single-shot sequences, T1-W single-shot and/or multislice sequences were employed in 25 MR examinations performed in 23 fetuses between 20 and 36 weeks of gestation for more detailed assessment of liver, meconium-filled digestive tract, haemorrhage, or further characterization of a fetal abdominal mass. Diagnostic value and presence of motion artefacts on T1-W images was recorded in each case. RESULTS: T1-W images enabled superior delineation of fetal liver and large intestine. They provided additional diagnostic information in 9 (39%) of 23 fetuses. One false-positive and one false-negative MRI diagnosis of malrotation anomaly were encountered. Use of single-shot T1-W sequences reduced the occurrence of motion artefacts in 64%. CONCLUSION: Our results suggest that the specific signal properties of methaemoglobin, meconium and liver are sufficiently important for T1-W sequences to become a routine part of fetal MRI protocols when dealing with digestive tract anomalies, diaphragmatic and abdominal wall defects, intraabdominal masses, and fetal haemorrhage.

• MeSH
• břicho abnormality   MeSH
• druhý trimestr těhotenství MeSH
• játra abnormality   MeSH
• krvácení diagnóza   MeSH
• lidé MeSH
• magnetická rezonanční tomografie * MeSH
• mekonium MeSH
• prenatální diagnóza metody   MeSH
• retrospektivní studie MeSH
• těhotenství MeSH
• třetí trimestr těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The authors present a case of cystic fibrosis in a newborn. The first symptom of cystic fibrosis in this case was meconium ileus. They describe correct diagnostic method of ileus in newborn, consecutive operation and last but not least they show necessity of follow-up investigations to verification of cystic fibrosis.

• MeSH
• cystická fibróza diagnóza   MeSH
• lidé MeSH
• mekonium * MeSH
• novorozenec MeSH
• střevní obstrukce etiologie   patologie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• kazuistiky MeSH

OBJECTIVES: Enterolithiasis (multiple calcifications of intraluminal meconium) is a rare, prenatal ultrasonographic finding. In this study, our aim was to evaluate the prenatal diagnostic features and discuss the management of the patients. METHODS: The data of two cases of prenatally diagnosed fetal enterolithiasis were collected from ultrasound scan, magnetic resonance imaging (MRI) and neonatal or postnatal autopsy records. The findings were evaluated in both prenatal and postnatal periods. Chromosomal analysis was performed in one case. An evaluation of primary and secondary malformations was done. Coexisting anomalies were searched for via radiology, neonatal surgery and histopathology. RESULTS: Malformations in two cases (both males) with partial and complete urorectal septum malformation (URSM) sequence were described. The absence of an anal opening and presence of a fistula between the urinary and gastrointestinal tract were common findings. These features were considered as primary malformations contributing to the formation of enterolithiasis. Secondary anomalies (urinary and gastrointestinal system malformations, pulmonary hypoplasia, genital and other coexisting anomalies) were evaluated. CONCLUSIONS: The prenatal detection of enterolithiasis carries a poor prognosis. Most of the previously reported cases were invariably associated with major fetal malformations of the urinary and gastrointestinal tract. It is a warning sign for large bowel obstruction with or without enterourinary fistula. Therefore, adequate gastrointestinal and urologic studies must be undertaken after birth for the final diagnosis. There is a high mortality rate in the reported cases, mostly attributed to associated anomalies, and all survivors required neonatal surgery. It is important to differentiate the partial from the full URSM sequence because the prognosis in the partial URSM sequence is generally good, with long-term survival being common.

• MeSH
• dospělí MeSH
• kalcinóza diagnóza   MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• mekonium chemie   diagnostické zobrazování   MeSH
• močové ústrojí abnormality   MeSH
• nemoci plodu diagnóza   diagnostické zobrazování   MeSH
• nemoci střev diagnóza   MeSH
• nemoci u dvojčat diagnóza   diagnostické zobrazování   MeSH
• oligohydramnion diagnostické zobrazování   MeSH
• prenatální diagnóza * MeSH
• rektum abnormality   MeSH
• střeva abnormality   MeSH
• těhotenství MeSH
• ultrasonografie prenatální MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH

OBJECTIVE: A review of meconium pathophysiology and its contribution to the incidence of postnatal neurological handicap. DESIGN: Reviewed article. SETTING: Department of Gynaecology and Obstetrics, Charles University and Faculty Hospital Plzen, Czech Republic. SUBJECT AND METHOD: Meconium can be a cause of infant neurological handicap. Two main pathogenetic pathways are mentioned. 1. Meconium (and its components: bile acids) may have a direct vasoconstrictive effect on umbilical and placental vessels. This way still remains controversial. 2. Meconium as a possible cause of intraamniotic infection results in a release of fetal cytokines (TNF alpha, IL-1 beta, IL-6), which can damage myelinogenesis in periventricular white matter. RESULTS: Meconium in premature labour is a higher risk factor compared to term delivery. 41% of premature infants were diagnosed as having CP when meconium was present compared to 10% in the same group with clear amniotic fluid. The incidence in term pregnancy with meconium present is 0.4% compared to 0.3% in a population without any obstetrical risk. CONCLUSION: Ultrasonographically found periventricular leukomalacia is the most reliable sign of subsequent cerebral palsy or other neurological sequelae.

• MeSH
• chorioamnionitida etiologie   MeSH
• chronické poškození mozku etiologie   MeSH
• lidé MeSH
• mekonium * MeSH
• mozková obrna etiologie   MeSH
• novorozenec MeSH
• periventrikulární leukomalacie etiologie   MeSH
• placenta krevní zásobení   MeSH
• plodová voda * MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• přehledy MeSH