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In some recent hypotheses, the ovary has been indicated as a source of insulin-like growth factor (IGF)-I, with synthesis regulated from local steroidal and non-steroidal substances. We measured IGF-I concentrations in both serum and follicular fluid of women undergoing in-vitro fertilization (IVF) and embryo transfer, in both induced and spontaneous cycles. It was found that serum and follicular IGF-I concentrations were correlated with follicular morphology, oocyte maturity, steroid concentrations and clinical characteristics of IVF cycles. In addition, we measured IGF-I concentrations in both peripheral and ovarian circulation to gain further detailed information on the contribution of the ovary to IGF-I production. The results of our study support the hypothesis that follicular IGF-I is probably derived by diffusion from peripheral circulation and that local production appears unlikely.

Background. Inhaled nitric oxide (INO) might favour the prevention of bronchopulmonary dysplasia (BPD) in preterm infants through its anti-inflammatory action, regulatory effect in pulmonary angiogenesis, and minimising lung injury through a reduction in oxygen and ventilatory requirements.Objectives. To test the hypothesis that INO therapy can decrease the incidence of BPD and death in preterm infants with RDS; to evaluate the possible predictive factors of response to INO therapy.Study design. Preterm infants (less than 30 weeks of gestation) received during the first week of life INO, or nothing, if they presented severe RDS (FiO2 >0.50 and a/APO2 <0.15), despite mechanical ventilation and surfactant treatment. Then, to evidence possible differences, the treated infants were classified as non responders and responders.Results. Twenty infants were enrolled in the INO therapy group and 20 in the control group. BPD and death were lees frequent in the INO group than in the control group (50 vs. 90%, p=0.016). A birth weight lower than 750 grams had a significant predictive value for the failure to respond to INO therapy (OR 12; 95% C.I. 1,3 - 113.3).Conclusions. Inhaled NO decreases the incidence of BPD and death in preterm infants with severe RDS without adverse effects. The birth weight may influence the response of preterm infants to INO therapy.

BACKGROUND: PDA is a common complication of prematurity that frequently requires surgical or medical treatment. The most widely employed medical therapy for closure of PDA is indomethacin followed by intravenous ibuprofen. Oral ibuprofen has recently been investigated as an effective and safe alternative for PDA closure.AIM: The aim of our study was to compare oral and intravenous administrations with regard to efficacy and safety for treatment of PDA in preterm infants.DESIGN/METHODS: We studied 12 infants (gestational age, 23 to 32 weeks) who had echocardiographycally confirmed PDA. The infants were randomly assigned to receive three oral doses of ibuprofen lysine or three intravenous doses of ibuprofen lysine, 10 mg/Kg followed by 5 mg/Kg after 24 and 48 h. Every child underwent cranial ultrasonography before and after each ibuprofen dose. The rate of ductal closure, the need for additional treatment, side effects and complications were recorded.RESULT: Six patients were assigned to oral and six to intravenous ibuprofen treatment. The two groups were well matched for birth weight, gestational age, antenatal steroids, surfactant treatment and respiratory status at the enrolment in the study. There were no significant differences in age of starting therapy. In both groups the rate of PDA closure was 100% and there was no reopening of the ductus 7 and 21 days after closure had been achieved. There were no significant differences in the levels of serum creatinine and urine output before and after treatment with oral or intravenous ibuprofen. We did not observe any significant bleeding tendency neither feeding intolerance in our patients. No significant differences between the groups were observed in with regard to frequency of BPD, IVH, NEC and ROP.CONCLUSIONS: Compared with intravenous ibuprofen treatment, oral ibuprofen is an effective and safe alternative for PDA closure in preterm infants.

In some recent hypotheses, the ovary has been indicates as a source of insulin-like growth factor (IGF)-I, with synthesis regulated from local steroidal and non-steroida substances. We measured IGF-I concentrations in both serum and follicular fluid of women undergoing in-vitro fertilization (IVF) and embryo transfer, in both induced and spontaneous cycles. It was found that serum anc follicular IGF-I concentrations were correlated with follicular morphology, oocyte maturity, steroid concentrations and clinical characteristics of IVF cycles In addition, we measured IGF-I concentrations in bott peripheral and ovarian circulation to gain further detailed information on the contribution of the ovary tc IGF-I production. The results of our study support to hypothesis that follicular IGF-I is probably derived by diffusion from peripheral circulation and that local produc tion appears unlikely.