NSAIDs, both indomethacin and celecoxib, are effective in treating BS. The latter has demonstrated benefits on severity of GI tract involvement and decreasing in hyperfiltration. However, the safety profile of celecoxib may, in the future, allow for its use as first drug for the treatment of BS. In patients who develop proteinuria, enalapril was effective in reducing it. Thus, it is suggested to start the treatment with celecoxib and if necessary replacing it by ACEi. This study PLX3397 manufacturer has some limitations, such as the small number of patients and lack of a genetic assessment. Randomized, larger and controlled studies are needed to
confirm the present data. However, it is a rare disease, and the present study had one of the largest series in the literature. The authors declare no conflicts of interest. “
“The superiority of human milk (HM) feeding in preterm newborns (PNs) is well documented. HM has an important impact on brain growth and development, even when it buy ZD6474 does not promote great weight gain, supporting the concept that the optimal postnatal growth of PNs is not yet known.1, 2, 3, 4 and 5 Regarding the supply of proteins, not only
the quantity but also the quality is important for proper growth. The amino acid composition of formulas and additives to human milk using bovine protein has reduced quality in relation to HM,6, 7, 8 and 9 which is considered the gold standard. The protein fraction of cow’s milk has a predominance of casein, which has high content of the amino acid phenylalanine.10 Although it is an essential amino acid in children receiving cow’s milk protein, plasma levels of this amino acid are high (close to those associated with metabolism defects).11, 12 and 13 The increased intake and plasma levels of phenylalanine results in the inhibition of the enzyme tyrosinase, and subsequent conversion, through hydroxylation, of phenylalanine into tyrosine, increasing tyrosine availability. This increase
can cause a deleterious effect on brain development, leading to consequences such as sleep disturbance, GNAT2 memory deficits, and attention and concentration deficits.14, 15, 16 and 17 While the optimal nutrition for PNs is unknown, neonatologists should be committed to what appears to be ideal, which does not result in changes in the short-term, and provides better long-term development. In this context, supplementing HM with an additive containing a protein homologous to that of HM appears to be a suitable alternative for protein supply, while maintaining safe plasma levels of phenylalanine.18, 19 and 20 Considering this hypothesis, this study aimed to comparatively analyze plasma levels of phenylalanine in PNs fed banked human milk (BHM) plus the commercial additive FM85 (Fortified Milk 85, Nestlé, São Paulo, Brazil) and PNs fed with BHM plus an additive derived from the HM itself, after removal of fat and lactose in evaporated or lyophilized forms.