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Sample records for asphyxia neonatorum

  1. 窒息新生儿脑干诱发电位的检测价值%The Value of Brainstem Auditory Evoked Potential in Asphyxia Neonatorum

    Institute of Scientific and Technical Information of China (English)

    李秋玲

    2011-01-01

    围生期窒息后可引起听神经通路细胞的缺血/再灌注损伤,从而影响听觉功能.脑干听觉诱发电位可反映脑神经和脑听觉通路不同部位所引起的生物电活动,因其客观、准确、重复性好、无损伤性、受干扰因素少而受到儿科工作者重视.对可能累及到中枢神经系统功能失调及听力障碍的儿科疾病具有早期诊断和判断预后的临床参考价值.%The ischemic reperfusion of injury of nerve cell in auditory pathway can be caued by perinatal asphyxia. And the injury can affect hearing. Brainstem auditory evoked potential can reflect the bioelectric activity of cranial nerves and cerebral auditory pathway. Because it have not only good objectivity, precision and reproducibility , but also it have no damage and few interference factors, brainstem auditory evoked potential was thought highly by pediatrician. It has the clinical reference value of early diagnosis and the judgment of prognosis in pediatrie disease of central dysautonomia and dysacusis.

  2. Acne neonatorum and familial hyperandrogenism.

    Science.gov (United States)

    Bekaert, C; Song, M; Delvigne, A

    1998-01-01

    We report a case of acne neonatorum developed in a boy since birth. His mother and his aunt had different signs of hyperandrogenism including acne and hirsutism. This case illustrates the correlation between acne neonatorum and familial hyperandrogenism. It shows the importance of the family history and the eventual clinical and serological presence of hyperandrogenism in the mother when confronted with acne neonatorum. PMID:9669129

  3. Preventing ophthalmia neonatorum

    Science.gov (United States)

    Moore, Dorothy L; MacDonald, Noni E

    2015-01-01

    The use of silver nitrate as prophylaxis for neonatal ophthalmia was instituted in the late 1800s to prevent the devastating effects of neonatal ocular infection with Neisseria gonorrhoeae. At that time – during the preantibiotic era – many countries made such prophylaxis mandatory by law. Today, neonatal gonococcal ophthalmia is rare in Canada, but ocular prophylaxis for this condition remains mandatory in some provinces/ territories. Silver nitrate drops are no longer available and erythromycin, the only ophthalmic antibiotic eye ointment currently available for use in newborns, is of questionable efficacy. Ocular prophylaxis is not effective in preventing chlamydial conjunctivitis. Applying medication to the eyes of newborns may result in mild eye irritation and has been perceived by some parents as interfering with mother-infant bonding. Physicians caring for newborns should advocate for rescinding mandatory ocular prophylaxis laws. More effective means of preventing ophthalmia neonatorum include screening all pregnant women for gonorrhea and chlamydia infection, and treatment and follow-up of those found to be infected. Mothers who were not screened should be tested at delivery. Infants of mothers with untreated gonococcal infection at delivery should receive ceftriaxone. Infants exposed to chlamydia at delivery should be followed closely for signs of infection. PMID:25838784

  4. Resistance pattern of bacterial agents causing ophtalmia neonatorum

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    Peymaneh Alizadeh Taheri

    2013-08-01

    Full Text Available Background: One of the most common infections in neonatal period is ophthalmia neo-natorum. In this study, the bacterial agents, drug resistance and susceptibility of bacteri-al agents were studied.Methods: In this study a total of 72 newborns with ophthalmia neonatorum admitted in Bahrami Hospital in Tehran during the years 2008-2011 were continuously enrolled in a case series, descriptive study. Demographic data, including age, sex, cause of admis-sion and culture of discharge from the eyes and its antibiogram, as well as experimental treatments and treatment outcomes were collected.Results: Forty four infants (61.1% were males and 28 (38.9% were females and the mean age on admission was 11.6±7.7 days. In 51 patients (70.8% the onset of ophthal-mia neonatorum was prior to admission. More than 56% of cases with ophthalmia neonatorum were associated with sepsis. On the other hand, positive blood culture was detected in 15.3% of cases. Among 72 neonates with ophthalmia neonatorum, 26 (36.1% had a positive culture of the eye discharge. The most common causes of bacterial agents were Staphylococcus aureus (46.1% (12 of 26 cases. Other causes included streptococcus species (23%, Pseudomonas (15.3%, E-coli (11.5% and Haemophilus influenza (3.8%. The most frequent causes of drug resistance were Ampicillin, Penici-llin, Cefixime, and Ceftazidime (100% resistance. The most sensiti-ve antibiotics were vancomycin and imipenem (100% sensitivity. Based on the conventional treatment, clinical response to local gentamicin was approximately 60%. Sulfacetamide was associated with no clinical response in 40% of cases.Conclusion: The antibiogram and clinical response to empiric treatment showed that resistance to ampicillin and some third generation of cephalosporine was 100%. Aminoglycosides’ sensitivity was more than 50% locally and systemically. Our recommendation is performing eye discharge culture before antibiotic treatment. More studies with numerous

  5. Pengetahuan dan Sikap Dukun Bayi Dalam Kaitannya Dengan Penyakit Tetanus Neonatorum di Kabupaten Indramayu

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    Mulyono Notosiswoyo

    2012-09-01

    Full Text Available Penyakit tetanus yaitu penyakit infeksi akut yang terjadi karena toksin yang dibuat dalam tubuh oleh basil Clostridium tetani, penyakit ini ditandai dengan kejang-kejang tonik, yang biasanya dimulai pada otot-otot kunyah, kemudian meluas ke otot-otot tubuh yang lain. Tetanus yang terjadi karena luka yang tercemar oleh basil tetanus disebut Tetanus Traumaticus dan tetanus yang tidak diketahui penyebabnya disebut Tetanus Idiopathica. Tetanus Neonatorum ialah tetanus yang terjadi pada bayi yang baru lahir. Penyakit Tetanus Neonatorum dapat terjadi karena alat perlengkapan pertolongan persalinan tidak steril, perawatan tali pusat tidak memenuhi staudar kesehatan atau tempat bersalin tidak bersih, sehingga basil C. tetani menyerang bayi yang baru lahir.

  6. Pengetahuan dan Sikap Dukun Bayi Dalam Kaitannya Dengan Penyakit Tetanus Neonatorum di Kabupaten Indramayu

    OpenAIRE

    Mulyono Notosiswoyo; Riyanto Martomijoyo; Sudibyo S.; Khoirul Naim

    2012-01-01

    Penyakit tetanus yaitu penyakit infeksi akut yang terjadi karena toksin yang dibuat dalam tubuh oleh basil Clostridium tetani, penyakit ini ditandai dengan kejang-kejang tonik, yang biasanya dimulai pada otot-otot kunyah, kemudian meluas ke otot-otot tubuh yang lain. Tetanus yang terjadi karena luka yang tercemar oleh basil tetanus disebut Tetanus Traumaticus dan tetanus yang tidak diketahui penyebabnya disebut Tetanus Idiopathica. Tetanus Neonatorum ialah tetanus yang terjadi pada bayi yang...

  7. A Swine Model of Neonatal Asphyxia

    OpenAIRE

    Cheung, Po-Yin; Gill, Richdeep S.; Bigam, David L.

    2011-01-01

    Annually more than 1 million neonates die worldwide as related to asphyxia. Asphyxiated neonates commonly have multi-organ failure including hypotension, perfusion deficit, hypoxic-ischemic encephalopathy, pulmonary hypertension, vasculopathic enterocolitis, renal failure and thrombo-embolic complications. Animal models are developed to help us understand the patho-physiology and pharmacology of neonatal asphyxia. In comparison to rodents and newborn lambs, the newborn piglet has been proven ...

  8. Nondrowning Asphyxia in Veterinary Forensic Pathology: Suffocation, Strangulation, and Mechanical Asphyxia.

    Science.gov (United States)

    McEwen, B J

    2016-09-01

    Asphyxia in a forensic context refers to death by rapid cerebral anoxia or hypoxia due to accidental or nonaccidental injury. Death due to nondrowning asphyxia can occur with strangulation, suffocation, and mechanical asphyxia, each of which is categorized based on the mechanism of injury. Individuals dying due to various types of asphyxia may or may not have lesions, and even those lesions that are present may be due to other causes. The interpretation or opinion that death was due to asphyxia requires definitive and compelling evidence from the postmortem examination, death scene, and/or history. Beyond the postmortem examination, pathologists may be faced with questions of forensic importance that revolve around the behavioral and physiological responses in animals subjected to strangulation, suffocation, or mechanical asphyxia to determine if the animal suffered. While there is no prescriptive answer to these questions, it is apparent that, because of physiological and anatomical differences between humans and animals, for some mechanisms of asphyxia, consciousness is maintained for longer periods and the onset of death is later in animals than that described for people. Veterinary pathologists must be cognizant that direct extrapolation from the medical forensic literature to animals may be incorrect. This article reviews the terminology, classification, mechanisms, and lesions associated with asphyxial deaths in companion animals and highlights significant comparative differences of the response to various types of asphyxia in animals and people. PMID:27084399

  9. Clinicoradiological correlation in birth asphyxia

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    Basavaraj Patil

    2015-06-01

    Full Text Available Background: Hypoxic Ischemic Encephalopathy (HIE is the most dreaded neurological disease of the new-born. Assessment of severity of HIE would help proper parent counseling and early institution of stimulation therapy for better development of the infant. Methods: This study was conducted between December 2012 and May 2014. 37 term neonates with perinatal asphyxia were the subjects. The cranial ultrasound, EEG and MRI findings of these babies are analysed and correlated with each other and with clinical staging and the neurological condition of the babies at discharge. Results: Among the 37 neonates, 21 were of HIE stage 2 and 16 were of stage 3. Sensitivity of EEG in detecting abnormality in the neurological condition according to our study is 76.9%, specificity 87.5%, positive predictive value 76.9%, negative predictive value 87.5%. Sensitivity of severe pattern of injury in MRI brain in detecting abnormality in neurological condition according to our study is 76.9%, specificity 91.6%, positive predictive value 83.3%, negative predictive value 88%. Involvement of both basal ganglia and cortex in MRI brain had statistically significant correlation with abnormal neurological condition at discharge in our study (P = 0.04. Conclusion: An abnormal EEG and MRI brain in a term new-born with Hypoxic Ischemic Encephalopathy (HIE is associated with poor neurological outcome. Involvement of basal ganglia/thalamus and cortex together in the MRI are predictors of abnormal outcome. [Int J Res Med Sci 2015; 3(3.000: 560-567

  10. Perinatal asphyxia in the term newborn

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    Roberto Antonucci

    2014-06-01

    Full Text Available Despite the important advances in perinatal care in the past decades, asphyxia remains a severe condition leading to significant mortality and morbidity. Perinatal asphyxia has an incidence of 1 to 6 per 1,000 live full-term births, and represents the third most common cause of neonatal death (23% after preterm birth (28% and severe infections (26%. Many preconceptional, antepartum and intrapartum risk factors have been shown to be associated with perinatal asphyxia. The standard for defining an intrapartum hypoxic-ischemic event as sufficient to produce moderate to severe neonatal encephalopathy which subsequently leads to cerebral palsy has been established in 3 Consensus statements. The cornerstone of all three statements is the presence of severe metabolic acidosis (pH < 7 and base deficit ≥ 12 mmol/L at birth in a newborn exhibiting early signs of moderate or severe encephalopathy. Perinatal asphyxia may affect virtually any organ, but hypoxic-ischemic encephalopathy (HIE is the most studied clinical condition and that is burdened with the most severe sequelae. The feasibility of providing neuroprotection after HIE has been proven by hypothermia therapy, which is able to reduce the risk of death or major neurodevelopmental disability. Many promising neuroprotective agents might contribute to reduce hypoxic-ischemic brain injury through different mechanisms of action, but further studies are required to confirm their efficacy. The prognosis is dependent on the severity of the perinatal asphyxia. Only a minority of infants with severe HIE survive without handicap. Proceedings of the International Course on Perinatal Pathology (part of the 10th International Workshop on Neonatology · October 22nd-25th, 2014 · Cagliari (Italy · October 25th, 2014 · The role of the clinical pathological dialogue in problem solving Guest Editors: Gavino Faa, Vassilios Fanos, Peter Van Eyken

  11. A Survey on Ophthalmia Neonatorum in Benin City, Nigeria (Emphasis on gonococcal ophthalmia

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    Enabulele Onaiwu

    2003-08-01

    Full Text Available The purpose of the study was to investigate the incidence of gonococcal ophthalmia neonatorum considering its ability to lead to childhood blindness through corneal ulceration and scarification. Eye swabs were obtained from 330 neonates of 1-5 days in the hospitals of study. Of these, 248 yielded growth and six bacterial genera were identified using standard techniques. Staphylococcus aureus was the most prevalent (60.5% while Neisseria gonorrhoeae accounted for 1.7%. Susceptibility patterns of bacterial isolates to four antibiotics were determined using Disk-diffusion tests. Staphylococcus aureus and Neisseria gonorrhoeae showed 62.5 and 100% susceptibility to Erythromycin while 66.7% of Escherichia coli and Klebsiella and 62.5% of Pseudomonas aeruginosa were susceptible to Gentamicin. The incidence of gonococcal ophthalmia neonatorum for the period of study was 8.9 (cases per 1,000 live births. Prevention is through ocular prophylaxis by the application of either 1% silver nitrate ophthalmic solution or 0.5% erythromycin ointment to the neonates? eyes some hours after birth. This would help to preserve vision and reduce to the barest minimum the incidence of childhood blindness.

  12. A case report of Traumatic Asphyxia

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    B Sah

    2015-06-01

    Full Text Available Traumatic asphyxia is a condition presenting with cervicofacial cyanosis and edema, subconjunctival hemorrhage, and petechial hemorrhages of the face, neck, and upper chest that occurs due to a compressive force to the thoracoabdominal region.In this case report a 52 years old lady who was brought to the mortuary because of death due to traumatic asphyxia as a result of being stampeded by her own cows upon her chest was discussed. Congestion on both the conjunctiva, cyanosis on chin and adjacent upper left side of neck found with a well demarcated area observed between the cyanosed area over face and the normal area of neck. Hematoma was present in the chin and the adjacent neck region.Apart from quickly eliminating organ pathologies and initiation of supportive therapy in a case of traumatic asphyxia, possibility of formation of hematoma in neck after few hours of getting injured should also be considered, as this type of hematoma may contribute to the cause of death.DOI: http://dx.doi.org/10.3126/jcmsn.v10i3.12777 Journal of College of Medical Sciences-Nepal, 2014, Vol-10, No-3, 51-55

  13. Correlation between Nonreassuring Patterns in Fetal Cardiotocography and Birth Asphyxia

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    Fatemeh Abbasalizadeh

    2015-07-01

    Full Text Available Objective: Cardiotocography is a tool for assessing the fetus during labor and identification the risk of asphyxia. Abnormal cardiotocography can induce stress on the physician and mother and can result in their deciding to terminate the pregnancy and the complications of an emergency cesarean section. The purpose of this study was the evaluation of the correlation between non-reassuring patterns in fetal cardiotocography and birth asphyxia. Materials and methods: In a cross-sectional analytic study, 324 term pregnant women were included, and the association between non-reassuring patterns in cardiotocography (fetal tachycardia, fetal bradycardia, absent or minimal baseline variability, and absence of acceleration and periodic or episodic deceleration and birth asphyxia were assessed. Results: Birth asphyxia existed in 10 newborns; in all cases mild hypoxic ischemic encephalopathy was observed. Within the non-reassuring cardiotocography patterns, baseline fetal heart variability and periodic or episodic deceleration had a significant relationship with birth asphyxia. Most asphyxia cases had occurred in absent and minimal baseline fetal heart rate (FHR variability (R = 0.49, P < 0.001. In periodic or episodic decelerations, most asphyxia cases occurred in recurrent late decelerations with normal baseline variability and variable decelerations with shoulders or overshoots (R = 0.42, P = 0.014. Conclusion: With regard to the findings of the present study, we can use non-reassuring cardiotocographic patterns, especially absent and minimal baseline FHR variability and periodic or episodic decelerations, in prediction of birth asphyxia. But it seems that most birth asphyxias occur in normal cardiotocographs.

  14. First Attempt to Implement Ophthalmia Neonatorum Prophylaxis in Angola: Microorganisms, Efficacy, and Obstacles

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    Isabel Alexandre

    2015-01-01

    Full Text Available Purpose. To determine the efficacy of povidone-iodine (P-I prophylaxis for ophthalmia neonatorum (ON in Angola and to document maternal prevalence and mother-to-child transmission rates. Methods. Endocervical samples from mothers n=317 and newborn conjunctival smears n=245 were analysed by multiplex polymerase chain reaction (PCR for Chlamydia trachomatis (CT, Neisseria gonorrhoeae (NG, and Mycoplasma genitalium (MG. Newborns were randomized into a noninterventional group and an interventional group that received a drop of P-I 2.5% bilaterally after conjunctival smear collection. Mothers were trained to identify signs of ON and attend a follow-up visit. Results. Forty-two newborns had ocular pathology, and 11 (4.4% had clinical signs of ON at the time of delivery. Maternal PCR was positive for MG n=19, CT n=8, and NG n=2. Six newborns were positive for CT n=4, MG n=2, and NG n=1. Mother-to-child transmission rates were 50% for CT and NG and 10.5% for MG. Only 16 newborns returned for follow-up. Conclusions. Lack of maternal compliance prevented successful testing of prophylactic P-I efficacy in ON prevention. Nevertheless, we documented the prevalence and mother-to-child transmission rates for CT, NG, and MG. These results emphasize the need to develop an effective Angolan educational and prophylactic ON program.

  15. Correlation between Nonreassuring Patterns in Fetal Cardiotocography and Birth Asphyxia

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    Fatemeh Abbasalizadeh; Shamci Abbasalizadeh; Shabnam Pouraliakbar; Parvin Bastani

    2015-01-01

    Objective: Cardiotocography is a tool for assessing the fetus during labor and identification the risk of asphyxia. Abnormal cardiotocography can induce stress on the physician and mother and can result in their deciding to terminate the pregnancy and the complications of an emergency cesarean section. The purpose of this study was the evaluation of the correlation between non-reassuring patterns in fetal cardiotocography and birth asphyxia. Materials and methods: In a cross-sectional anal...

  16. ASPHYXIA AND DEVELOPMENTAL OUTCOME IN HIGH RISK INFANTS

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    Valentina DUKOVSKA

    2010-04-01

    Full Text Available Asphyxia is a risk factor that is very often related to neuro-developmental issues in high risk infants and equally affects preterm and term infants, however its outcome on the developed brain differs from the outcome on the preterm brain.In preterm infants, asphyxia usually exerts a hemorrhagic or ischaemic event and periventricular leukomalacia.In term infants, asphyxia leads to cerebral edema and atrophy of the brain, which may later lead to hypoxic ischaemic encephalopathy (HIE.The number of term infants with HIE who have survived is lower than those of preterm infants, while the percentage of term infants with HIE who have neuro-developmental issues is higher. Preemies face more problems in their motor development as a result of the brain damage, while term infants suffer from encephalopathy and their cognitive abilities are more affected.We have conducted a study about the effects that asphyxia has on the developmental outcomes in high risk infants. In our study, we did a longitudinal developmental follow-up of 30 high risk infants and an evaluation of their developmental outcome using the Griffiths Mental Development Scales, from the 4th month of life until the end of the 36th month. First, we found that high risk infants had a much lower developmental outcome than the control group during the trial. Finally, we found that asphyxia makes a difference in the developmental outcome of preterm infants without asphyxia who have a very low birth weight, the preterm infants with asphyxia, and the term infants with HIE-II.

  17. Asphyxia from the eyes of the obstetrician

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    Alessandra Meloni

    2014-06-01

    Full Text Available Nowadays it is well recognized that there are multiple potential pathways causing hypoxic-ischemic events that may lead to cerebral palsy in term infants. The signs and symptoms of neonatal encephalopathy may range from mild to severe, depending on nature and timing of brain injury. The incidence of cerebral palsy has not changed over the last 30 years and one of the obstetricians’challenge is how to recognize babies at intrapartum risk both before and during labour. A detailed description of prepartum and intrapartum risk factors is available. A close surveillance of labour and intrapartum time should be mandatory as the valuation of all available data from obstetrical examination, cardiotocography, ultrasound and labour progression to reach the correct diagnosis with the lowest possible rate of error. The close monitoring should not exclude a humanized and compliant attitude versus labouring women and their families. We analysed the Cagliari Neonatal Intensive Care Unit (NICU activity during the last four years considering 22 asphyxiated babies (coming from 9 different hospitals who underwent hypothermia treatment. The main result was that the need to resuscitation procedures at birth correlates with adverse outcomes. Asphyxia still remains a matter of great concern also as medico legal claims. Considering that neonatal encephalopathy is a heterogeneous condition, it is unlikely that it will be eradicated. However, a comprehensive evaluation of all risk factors and of intrapartum surveillance available tools may reduce as much as possible adverse events.Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy · October 22nd-25th, 2014 · The last ten years, the next ten years in Neonatology Guest Editors: Vassilios Fanos, Michele Mussap, Gavino Faa, Apostolos Papageorgiou

  18. Asphyxia from the eyes of the neonatologist

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    Paolo Gancia

    2014-06-01

    Full Text Available The perinatal asphyxia occurs at a frequency of 4-6‰ in developed countries The hypoxic-ischemic encephalopathy (HIE has an incidence of 0.5-2‰, and is a frequent cause of death and severe disability. Cerebral hypothermia is a well-established therapy of HIE, and its benefits have been described by systematic reviews and meta-analyses of numerous controlled clinical trials. Authors describe their experience in implementation of cerebral hypotermia in a Neonatal Intensive Care Unit, the creation of a network to perform neurophysiologic study of asphyxiated infants ≥ 35 weeks gestation, potential hypothermia candidates. Neurodevelopmental prognosis of HIE infants is of paramount importance for parents. To improve the quality of prognosis and communication with the parents, two studies have been undertaken. First, EEG and magnetic resonance imaging (MRI relationships analysis showed that the severity of the background EEG is associated with the severity and location of MRI lesion patterns in infants treated with hypothermia because of HIE. The second study aims to elucidate the relationships between MRI patterns and neurodevelopmental assessment by Griffiths scales. We found that neuroimaging findings correlate significantly with overall neurodevelopmental assessment at 12 and 24 months of life; in particular, this correlation is significant for the loco-motor and psycho-social sides. These instrumental data, with the EEG evaluation and clinical data, allow the neonatologist to predict quite precisely the neurological outcome of an infant. Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy · October 22nd-25th, 2014 · The last ten years, the next ten years in Neonatology Guest Editors: Vassilios Fanos, Michele Mussap, Gavino Faa, Apostolos Papageorgiou

  19. Circulatory responses to asphyxia differ if the asphyxia occurs in utero or ex utero in near-term lambs.

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    Kristina S Sobotka

    Full Text Available A cornerstone of neonatal resuscitation teaching suggests that a rapid vagal-mediated bradycardia is one of the first signs of perinatal compromise. As this understanding is based primarily on fetal studies, we investigated whether the heart rate and blood pressure response to total asphyxia is influenced by whether the animal is in utero or ex utero.Fetal sheep were instrumented at ∼ 139 days of gestation and then asphyxiated by umbilical cord occlusion until mean arterial blood pressure decreased to ∼ 20 mmHg. Lambs were either completely submerged in amniotic fluid (in utero; n = 8 throughout the asphyxia or were delivered and then remained ex utero (ex utero; n = 8 throughout the asphyxia. Heart rate and arterial blood pressure were continuously recorded.Heart rate was higher in ex utero lambs than in utero lambs. Heart rates in in utero lambs rapidly decreased, while heart rates in ex utero lambs initially increased following cord occlusion (for ∼ 1.5 min before they started to decrease. Mean arterial pressure initially increased then decreased in both groups.Heart rate response to asphyxia was markedly different depending upon whether the lamb was in utero or ex utero. This indicates that the cardiovascular responses to perinatal asphyxia are significantly influenced by the newborn's local environment. As such, based solely on heart rate, the stage and severity of a perinatal asphyxic event may not be as accurate as previously assumed.

  20. A Study on Birth Asphyxia at Tertiary Health Centre

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    Ekta A Dalal

    2013-08-01

    Methodology: This was the cross sectional study conducted in the tertiary care centre of Ahmedabad on the full term babies with birth asphyxia. The maternal, fetal and newborn correlates were recorded according to predesigned proforma. Results: There were total 401 (6.6% babies born with apgar score of less than 7 at one minute and among them, 320 (79.8% were full term babies and 81 (20.2% were preterm babies. Among the babies 52.5% were male, 56.9% were primigravida, and only 41.9% had antenatal care present, 42.2% had MSL and 47.2% were small for date babies. Conclusion: Birth asphyxia is common the babies of the mother who had not received proper antenatal care. Maternal anaemia, primipara, meconium stained liquor babies have more chances of getting birth asphyxia. [Natl J Med Res 2013; 3(4.000: 374-376

  1. Perinatal asphyxia: CNS development and deficits with delayed onset

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    MarioHerrera-Marschitz

    2014-03-01

    Full Text Available Perinatal asphyxia constitutes a prototype of obstetric complications occurring when pulmonary oxygenation is delayed or interrupted. The primary insult relates to the duration of the period lacking oxygenation, leading to death if not re-established. Re-oxygenation leads to a secondary insult, related to a cascade of biochemical events required for restoring proper function. Perinatal asphyxia interferes with neonatal development, resulting in long-term deficits associated to mental and neurological diseases with delayed clinical onset, by mechanisms not yet clarified.In the experimental scenario, the effects observed long after perinatal asphyxia have been explained by over expression of sentinel proteins, such as poly(ADP-ribose polymerase-1 (PARP-1, competing for NAD+ during re-oxygenation, leading to the idea that sentinel protein inhibition constitutes a suitable therapeutic strategy. Asphyxia induces transcriptional activation of pro-inflammatory factors, in tandem with PARP-1 overactivation, and pharmacologically induced PARP-1 inhibition also down-regulates the expression of proinflammatory cytokines. Nicotinamide has been proposed as a suitable PARP-1 inhibitor. Its effect has been studied in an experimental model of global hypoxia in rats. In that model, the insult is induced by immersing rat foetuses into a water bath for various periods of time. Following asphyxia, the pups are delivered, treated, and nursed by surrogate dams, pending further experiments. Nicotinamide rapidly distributes into the brain following systemic administration, reaching steady state concentrations sufficient to inhibit PARP-1 activity for several hours, preventing several of the long-term consequences of perinatal asphyxia, supporting the idea that it constitutes a lead for exploring compounds with similar or better pharmacological profiles.

  2. Environmental Enrichment Decreases Asphyxia-Induced Neurobehavioral Developmental Delay in Neonatal Rats

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    Peter Kiss; Gyongyver Vadasz; Blanka Kiss-Illes; Gabor Horvath; Andrea Tamas; Dora Reglodi; Miklos Koppan

    2013-01-01

    Perinatal asphyxia during delivery produces long-term disability and represents a major problem in neonatal and pediatric care. Numerous neuroprotective approaches have been described to decrease the effects of perinatal asphyxia. Enriched environment is a popular strategy to counteract nervous system injuries. The aim of the present study was to investigate whether enriched environment is able to decrease the asphyxia-induced neurobehavioral developmental delay in neonatal rats. Asphyxia was...

  3. Obstetric interventions and perinatal asphyxia in growth retarded term infants

    DEFF Research Database (Denmark)

    Langhoff-Roos, J; Lindmark, G

    1997-01-01

    BACKGROUND: The monitoring of fetal growth during pregnancy is usually justified because of the increased perinatal risk of these babies. METHODS: In 1552 infants from the Scandinavian Small for Gestational Age Study the need for obstetric interventions, risk of fetal asphyxia and immediate...... neonatal outcome at term have been studied in relation to different types of fetal growth retardation, including sub-groups with low ponderal index or low amount of subcutaneous fat. RESULTS: The need for obstetric intervention indicated by suspected fetal asphyxia before or during labor was increased 3...

  4. Long-Term Cognitive Outcomes of Birth Asphyxia and the Contribution of Identified Perinatal Asphyxia to Cerebral Palsy.

    Science.gov (United States)

    Pappas, Athina; Korzeniewski, Steven J

    2016-09-01

    Neonatal encephalopathy among survivors of presumed perinatal asphyxia is recognized as an important cause of cerebral palsy (CP) and neuromotor impairment. Recent studies suggest that moderate to severe neonatal encephalopathy contributes to a wide range of neurodevelopmental and cognitive impairments among survivors with and without CP. Nearly 1 of every 4 to 5 neonates treated with hypothermia has or develops CP. Neonatal encephalopathy is diagnosed in only approximately 10% of all cases. This article reviews the long-term cognitive outcomes of children with presumed birth asphyxia and describes what is known about its contribution to CP. PMID:27524454

  5. Arterial blood gas analysis and electrolyte determination in neonates with asphyxia

    Institute of Scientific and Technical Information of China (English)

    Zi-Mei Sun

    2015-01-01

    Objective:To explore the value of arterial blood gas analysis and electrolyte determination in the diagnosis of neonatal asphyxia.Methods: A total of 100 neonates with asphyxia who were admitted in our department from March, 2013 to March, 2014 were included in the study and divided into the mild asphyxia group and the severe asphyxia group according to Apgar scoring. Moreover, 50 normal neonates were served as the control group and used for comparative analysis. AVL blood-gas analyzer was used to detect the levels of pH, PaO2, HCO3-, BE, PaCO2, K+, Na+, Cl-, and Ca2+.Results:The concentrations of pH, PaO2, HCO3-, and BE in the severe asphyxia group were significantly lower than those in the mild asphyxia group and the control group, while PaCO2 level was significantly higher than that in the mild asphyxia group and the control group. The comparison of the various indicators between the control group and the mild asphyxia group was not statistically significant. The comparison of serum K+, Na+,and Cl- levels among the control group, the mild asphyxia group, and the severe asphyxia group was not statistically significant. The serum Ca2+ level in the severe asphyxia group was significantly lower than that in the mild asphyxia group and the control group, while the comparison between the mild asphyxia group and the control group was also statistically significant.Conclusions:Blood gas analysis and electrolyte determination to the arterial blood in neonates can compensate for the insufficiency of Apgar scoring and provide an objective evidence for the diagnosis of neonatal asphyxia and the estimation of severity degree. Clinical combination with Apgar scoring is of great significance in enhancing the diagnosis of neonatal asphyxia and the accuracy of severity evaluation.

  6. Severe myocardial injury and extracorporeal membrane oxygenation following perinatal asphyxia

    OpenAIRE

    P Benson Ham; Pinkal Patel; Linda J. Wise; Christian Walters; Stansfield, Brian K.

    2015-01-01

    Perinatal asphyxia is a common cause of morbidity and mortality in the newborn and is associated with myocardial injury in a significant proportion of cases. Biomarkers, echocardiography, and rhythm disturbances are sensitive indicators of myocardial ischemia and may predict mortality. We present a case of severe myocardial dysfunction immediately after delivery managed with extracorporeal membrane oxygenation (ECMO) and discuss the role of cardiac biomarkers, echocardiography, electrocardiog...

  7. Severe myocardial injury and extracorporeal membrane oxygenation following perinatal asphyxia

    Directory of Open Access Journals (Sweden)

    P. Benson Ham

    2015-05-01

    Full Text Available Perinatal asphyxia is a common cause of morbidity and mortality in the newborn and is associated with myocardial injury in a significant proportion of cases. Biomarkers, echocardiography, and rhythm disturbances are sensitive indicators of myocardial ischemia and may predict mortality. We present a case of severe myocardial dysfunction immediately after delivery managed with extracorporeal membrane oxygenation (ECMO and discuss the role of cardiac biomarkers, echocardiography, electrocardiography, and ECMO in the asphyxiated newborn.

  8. Somatosensory evoked potentials and outcome in perinatal asphyxia.

    OpenAIRE

    Gibson, N A; Graham, M.; Levene, M I

    1992-01-01

    Somatosensory evoked potentials (SEP) can be measured in the term newborn infant and given an index of function in the areas of the brain most likely to be damaged in perinatal asphyxia. We studied the median nerve SEP in 30 asphyxiated term infants over the course of their encephalopathy and until discharge from the neonatal unit. Three types of response were noted: normal waveform, abnormal waveform, or absence of cortical response. Follow up of the survivors was undertaken at a mean age of...

  9. [Deaths during asphyxia induced to escalate sexual experience. Case reports].

    Science.gov (United States)

    Okłota, Magdalena; Niemcunowicz-Janica, Anna; Sackiewicz, Adam; Ptaszyńska-Sarosiek, Iwona; Szeremeta, Michał

    2010-01-01

    The authors present two cases of deaths resulting from asphyxia of one of the partners in the act of intercourse to escalate their experience. The first case involved a heterosexual intercourse, in which a 30-year-old woman was led to state of hypoxia through choking and closing respiratory orifices. The other case represented a homosexual intercourse between two men, in which the victim's hands and legs were tied. Moreover, the partner put an open knot around the victim's neck and was holding it controlling the state of asphyxia, while performing an anal intercourse. Both presented victims practiced such paraphilia-associated behaviors in the past. The fact of sexual intercourse was confirmed in both cases by genetic analysis of the man's anus and the woman's oral cavity and vagina. This resulted in finding the genetic material of their partners. Escalating of sexual experience through inducing asphyxia of the nervous system is extremely dangerous and may result in death of one of the sexual partners, what has been proven by the present investigation. PMID:21863736

  10. Cerebellar cytokine expression in a rat model for fetal asphyctic preconditioning and perinatal asphyxia

    DEFF Research Database (Denmark)

    Vlassaks, Evi; Brudek, Tomasz; Pakkenberg, Bente; Gavilanes, Antonio W D

    2014-01-01

    effects of perinatal asphyxia and fetal asphyctic preconditioning on the inflammatory cytokine response in the cerebellum. Fetal asphyxia was induced at embryonic day 17 by clamping the uterine vasculature for 30 min. At term birth, global perinatal asphyxia was induced by placing the uterine horns in...... saline for 19 min. Pro- and anti-inflammatory cytokine expression were assessed by real-time PCR and immunohistochemistry in cerebella of newborn rats. We found that tumor necrosis factor alpha and interleukin-10 mRNA were increased 12 h after fetal asphyxia, while the inflammatory cytokine response was...

  11. Correlation between serumβ2 microglobulin and early kidney injury post neonatal asphyxia

    Institute of Scientific and Technical Information of China (English)

    Jun-Xia Liu; Hui-Qin Wang; Na Zhang; Wei-Na Lu; Xin Zhang

    2016-01-01

    Objective:To investigate serumβ2 microglobulin and neonatal asphyxia early renal damage correlation.Methods:A total of 84 suffocation full-term newborns in our hospital from 2012 March to 2014 November. According to the Apgar standards, divided into severe asphyxia group (n=36) and mild asphyxia group (n=48), and selected 40 cases of full-term newborn, observed blood and urinaryβ2-MG, albumin (Alb) blood urea nitrogen (BUN), creatinine (Cr) level.Results:severe asphyxia groupβ2-MG (6.02±0.96) mg/L was the highest, followed by mild asphyxia group, lowest in the control group; severe asphyxia group Alb, BUN and Cr were (22.15±6.17) mg/L, (10.01±1.84) mmol/L and (120.16±28.13)μmol/L, significantly higher than the mild asphyxia group and the control group; Mild asphyxia group and the control group Alb, BUN and Cr were not statistically significant; three groups birth 48 h,β2-MG, Alb, serum BUN and Cr showed significant differences, in which the severe asphyxia groupβ2-MG, Alb, BUN and Cr were the highest, and lowest in the control group; Severe asphyxia group was the highestβ2-MG, (7.12±1.32) mg/L; serumβ2-MG were positively associated with urineβ2-MG.Conclusion: Serumβ2-2 microglobulin in judging neonatal asphyxia early renal damage is more sensitive, and has clinical practical value.

  12. Cardiovascular Alterations and Multiorgan Dysfunction After Birth Asphyxia.

    Science.gov (United States)

    Polglase, Graeme R; Ong, Tracey; Hillman, Noah H

    2016-09-01

    The cardiovascular response to asphyxia involves redistribution of cardiac output to maintain oxygen delivery to critical organs such as the adrenal gland, heart, and brain, at the expense of other organs such as the gut, kidneys and skin. This redistribution results in reduced perfusion and localized hypoxia/ischemia in these organs, which, if severe, can result in multiorgan failure. Liver injury, coagulopathy, bleeding, thrombocytopenia, renal dysfunction, and pulmonary and gastrointestinal injury all result from hypoxia, underperfusion, or both. Current clinical therapies need to be considered together with therapeutic hypothermia and cardiovascular recovery. PMID:27524448

  13. Effect of therapeutic hypothermia on chromosomal aberration in perinatal asphyxia

    Directory of Open Access Journals (Sweden)

    Bahubali D Gane

    2016-01-01

    Full Text Available Introduction: Perinatal asphyxia is a major cause for neonatal mortality and morbidity around the world. The reduction of O2results in the generation of reactive oxygen species which interact with nucleic acid and make alteration in the structure and functioning of the genome. We studied the effect of therapeutic hypothermia on chromosomes with karyotyping. Subjects and Methods: Babies in the hypothermia group were cooled for the first 72 h, using gel packs. Rectal temperature of 33–34°C was maintained. Blood sample was collected after completion of therapeutic hypothermia for Chromosomal analysis. It was done with IKAROS Karyotyping system, Metasystems, based on recommendations of International system of human cytogenetic nomenclature. Results: The median chromosomal aberration was lower in hypothermia [2(0-5] than control group [4(1-7] and chromatid breakage was commonest aberration seen. Chromosomal aberration was significantly higher in severe encephalopathy group than moderate encephalopathy group. Conclusion: We conclude that the TH significantly reduces DNA damage in perinatal asphyxia.

  14. Virtopsy versus autopsy in unusual case of asphyxia: case report.

    Science.gov (United States)

    Aquila, I; Falcone, C; Di Nunzio, C; Tamburrini, O; Boca, S; Ricci, P

    2013-06-10

    We report the case of a 70-year-old woman found dead in her apartment in the South of Italy in February 2011. The detailed data showed that the victim was affected by familiar-type paranoid schizophrenia. This finding was confirmed by the discovery of antipsychotic and tricyclic antidepressant drugs in the house and the deposition of her psychiatric therapist. Before the autopsy, a multislice computed tomography (MSCT) scanning of the thoracic and facial maxillo-cervical area was performed that has allowed anatomical identification and diagnosis of a mechanical obstruction as the cause of death. The autopsy has showed the presence of materials obstructing the trachea totally. Histological and toxicological investigations were carried out on the victim. The toxicological investigation has shown the presence of metabolites of tricyclic antidepressants and antipsychotics in the blood and urine. The histology showed the presence of foreign-origin materials (starch fibres) inside the pulmonary alveolus. The cause of death was asphyxia due to obstruction by food-origin material. In this case the radiological data have been compared with the autopsy and toxicological and histological data. The comparison of results has shown that MSCT scanning may aid in identification of occlusion and then in determination of the cause of death. In conclusion, MSCT scanning can be proposed in the cases of suspected asphyxia, as the screening procedure of first instance to produce preliminary information useful to rapidly develop the successive autopsy performance. PMID:23582265

  15. Infecção por Clostridium tetani no recém-nascido: revisão sobre o tétano neonatorum

    Directory of Open Access Journals (Sweden)

    Andréia Patrícia Gomes

    2011-12-01

    Full Text Available A despeito de ser uma doença imunoprevenível, o tétano permanece ceifando vidas em diferentes regiões do planeta. Se para a doença de origem acidental a ocorrência de novos casos reflete a insuficiente imunização da população, no caso do tétano neonatorum o problema tem dupla natureza: a precária cobertura vacinal dos adultos e as dificuldades de acesso ao pré-natal de qualidade, situação agudizada pela extrema gravidade da moléstia nesta faixa etária, cuja letalidade pode chegar a 80%. Deste modo, ainda que seja importante o reconhecimento precoce do tétano no recém-nato para seu pronto e adequado tratamento, o aspecto de maior relevância é, indubitavelmente, a implementação de adequadas medidas de profilaxia e controle. Com base nestas premissas, propõe-se, neste artigo, uma atualização sobre o tétano neonatorum, enfatizando-se, com mais vigor, o tratamento e a prevenção da moléstia.

  16. TIME COURSE MODIFICATIONS INDUCED BY PERINATAL ASPHYXIA IN RAT CNS

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    Francisco Capani

    2015-04-01

    Full Text Available Perinatal asphyxia (PA induced short and long term biochemical, synaptic, cytoskeletal and astrocytes alterations that has been associated with neuronal cell death following hypoxia . The lack of knowledge about the mechanisms underlying this dysfunction prompted us to investigate the changes in the synapse and neuronal cytoskeleton and related structures. For this study we used a well established murine model of PA. Full-term pregnant rats were rapidly decapitated and the uterus horns were placed in a water bath at 37 °C for different time of asphyxia. When their physiological conditions improved, they were given to surrogate mothers. One month, four month, 6 month and 18 month after PA rats were included in this study. Modifications were analyzed using photooxidation with phalloidin-eosin, conventional electron microscopy (EM, inmunocytochemistry and ethanolic phosphotungstic acid (E-PTA staining combining with electron tomography and 3-D reconstruction techniques and molecular biology studies. After one month of the PA insult, an increase in the F-actin staining in neostriatum and hippocampus synapses was observed using correlative fluorescent electron microscopy for phalloidin-eosin. Mushroom-shaped spines showed the most consistent staining. Strong alterations in the dendrite and astroglial cytoskeleton were found at four months of PA (1. After six months of PA, postsynaptic densities (PSDs of the rat neostriatum are highly modified . We observed an increment of PSDs thickness related with the duration and severity of the hypoxic insult. In addition, PSDs showed and increase in the ubiquitination level. Using 3-d reconstruction and electron tomography we observed showed clear signs of damage in the asphyctic PSDs. These changes are correlated with intense staining for ubiquitin (2. Finally, in 18 months old rat was observed a reduction in the number of synapses in the PA animals related with a decrease in BDNF staining.(3 Using protocols

  17. A Rare and Serious Syndrome That Requires Attention in Emergency Service: Traumatic Asphyxia

    Directory of Open Access Journals (Sweden)

    Gultekin Gulbahar

    2015-01-01

    Full Text Available Traumatic asphyxia is a rare syndrome caused by blunt thoracoabdominal trauma and characterized by cyanosis, edema, and subconjunctival and petechial hemorrhage on the face, neck, upper extremities, and the upper parts of the thorax. Traumatic asphyxia is usually diagnosed by history and inspection; however, the patient should be monitored more closely due to probable complications of thoracoabdominal injuries. Treatment is conservative, but the prognosis depends on the severity of the associated injuries. Herein we present a traumatic asphyxia due to an elevator accident in a 32-year-old male patient and discuss the diagnosis, treatment, and prognosis by reviewing the relevant literature.

  18. Localized intestinal perforations as a potential complication of brain hypothermic therapy for perinatal asphyxia.

    Science.gov (United States)

    Nishizaki, Naoto; Maiguma, Atsuko; Obinata, Kaoru; Okazaki, Tadaharu; Shimizu, Toshiaki

    2016-08-01

    Brain hypothermic therapy (BHT) is becoming a frequently used standard of care for perinatal asphyxia. Although cardiovascular side effects, coagulation disorders, renal impairment, electrolyte abnormalities, impaired liver function, opportunistic infections, and skin lesions are well-known adverse effects of BHT in newborns, little information is available on the clinical features of intestinal perforation-related BHT. We herein report a case of therapeutic brain cooling for perinatal asphyxia complicated by localized intestinal perforation. In practice, the neonatologist should be aware that intestinal perforation in an infant with perinatal asphyxia is possible, particularly following BHT. PMID:26445344

  19. Gastroesophageal manometry and 24-hour double pH monitoring in neonates with birth asphyxia

    Institute of Scientific and Technical Information of China (English)

    Mei Sun; Wei-Lin Wang; Wei Wang; De-Liang Wen; Hui Zhang; Yu-Kun Han

    2001-01-01

    @@ INTRODUCTION Birth asphyxia may lead to disturbances of gastroenteric motility of newborn infants[1.2] . The change of gut pressure and reflux are the major manifestations of the motor disturbance [3-9] . To evaluate the effects of perinatal asphyxia on the gastroenteric motility, gastric and esophageal pressure and double pH were measured in a group of asphyxiated newborns. And. their pathophysiological and anatomical effects on gastroenteric function were discussed.

  20. The Behaviour of Protein Carbonyls in Newborns with Birth Respiratory Distress and Asphyxia

    OpenAIRE

    Zaharie, Gabriela; Antonia POPESCU; BLAGA, LIGIA; Melinda MATYAS

    2009-01-01

    Objective: A prospective study was carried out in premature newborns with respiratory distress syndrome (RDS) and asphyxia at birth in order to identify and analyze the effects of RDS on proteins. Material and Methods: Protein peroxidation was studied using the Reznick spectrophotometric method. The study group included 14 premature newborns with respiratory distress and asphyxia at birth. The control group included 13 newborns that were born on term, eutrophic and healthy. The determinations...

  1. Electroencephalogram abnormalities in full term infants with history of severe asphyxia

    Directory of Open Access Journals (Sweden)

    Susanti Halim

    2016-11-01

    Full Text Available ingtool used to determine developmental and electrical problemsin the brain. A history of severe asphyxia is a risk factor for thesebrain problems in infants.Objective To evaluate the prevalence of abnormal EEGs infull term neonates and to assess for an association with severeasphyxia, hypoxic ischemic encephalopathy (HIE, and spontaneousdelivery.Methods This cross-sectional study was conducted at thePediatric Outpatient Department of Sanglah Hospital, Denpasar,from November 2013 to January 2014. Subjects were fullterminfants aged 1 month who were delivered and/or hospitalized atSanglah Hospital. All subjects underwent EEG. The EEGs wereinterpreted by a pediatric neurology consultant, twice, with aweek interval between readings. Clinical data were obtainedfrom medical records. Association between abnormal ECG andsevere asphyxia were analyzed by Chi-square and multivariablelogistic analyses.Results Of 55 subjects, 27 had a history of severe asphyxia and 28were vigorous babies. Forty percent (22/55 of subjects had abnormalEEG findings, 19/22 of these subjects having history of severeasphyxia, 15/22 had history of hypoxic-ischemic encephalopathy(HIE, and 20/22 were delievered vaginally. There were strongcorrelations between the prevalence of abnormal EEG and historyof severe asphyxia, HIE, and spontaneous delivery.Conclusion Prevalence of abnormal EEG among full-term neonatesreferred to neurology/growth development clinic is around40%, with most of them having a history of severe asphyxia. AbnormalEEG is significantly associated to severe asphyxia, HIE, andspontaneous delivery.

  2. Connexin Hemichannel Blockade Is Neuroprotective after Asphyxia in Preterm Fetal Sheep

    Science.gov (United States)

    Davidson, Joanne O.; Drury, Paul P.; Green, Colin R.; Nicholson, Louise F.; Bennet, Laura; Gunn, Alistair J.

    2014-01-01

    Asphyxia around the time of preterm birth is associated with neurodevelopmental disability. In this study, we tested the hypothesis that blockade of connexin hemichannels would improve recovery of brain activity and reduce cell loss after asphyxia in preterm fetal sheep. Asphyxia was induced by 25 min of complete umbilical cord occlusion in preterm fetal sheep (103–104 d gestational age). Connexin hemichannels were blocked by intracerebroventricular infusion of mimetic peptide starting 90 min after asphyxia at a concentration of 50 µM/h for one hour followed by 50 µM/24 hour for 24 hours (occlusion-peptide group, n = 6) or vehicle infusion for controls (occlusion-vehicle group, n = 7). Peptide infusion was associated with earlier recovery of electroencephalographic power after asphyxia compared to occlusion-vehicle (p<0.05), with reduced neuronal loss in the caudate and putamen (p<0.05), but not in the hippocampus. In the intragyral and periventricular white matter, peptide administration was associated with an increase in total oligodendrocyte numbers (p<0.05) and immature/mature oligodendrocytes compared to occlusion-vehicle (p<0.05), with a significant increase in proliferation (p<0.05). Connexin hemichannel blockade was neuroprotective and reduced oligodendrocyte death and improved recovery of oligodendrocyte maturation in preterm fetuses after asphyxia. PMID:24865217

  3. Traumatic asphyxia due to blunt chest trauma: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Sertaridou Eleni

    2012-08-01

    Full Text Available Abstract Introduction Crush asphyxia is different from positional asphyxia, as respiratory compromise in the latter is caused by splinting of the chest and/or diaphragm, thus preventing normal chest expansion. There are only a few cases or small case series of crush asphyxia in the literature, reporting usually poor outcomes. Case presentation We present the case of a 44-year-old Caucasian man who developed traumatic asphyxia with severe thoracic injury and mild brain edema after being crushed under heavy auto vehicle mechanical parts. He remained unconscious for an unknown time. The treatment included oropharyngeal intubation and mechanical ventilation, bilateral chest tube thoracostomies, treatment of brain edema and other supportive measures. Our patient’s outcome was good. Traumatic asphyxia is generally under-reported and most authors apply supportive measures, while the final outcome seems to be dependent on the length of time of the chest compression and on the associated injuries. Conclusion Treatment for traumatic asphyxia is mainly supportive with special attention to the re-establishment of adequate oxygenation and perfusion; treatment of the concomitant injuries might also affect the final outcome.

  4. Connexin hemichannel blockade is neuroprotective after asphyxia in preterm fetal sheep.

    Directory of Open Access Journals (Sweden)

    Joanne O Davidson

    Full Text Available Asphyxia around the time of preterm birth is associated with neurodevelopmental disability. In this study, we tested the hypothesis that blockade of connexin hemichannels would improve recovery of brain activity and reduce cell loss after asphyxia in preterm fetal sheep. Asphyxia was induced by 25 min of complete umbilical cord occlusion in preterm fetal sheep (103-104 d gestational age. Connexin hemichannels were blocked by intracerebroventricular infusion of mimetic peptide starting 90 min after asphyxia at a concentration of 50 µM/h for one hour followed by 50 µM/24 hour for 24 hours (occlusion-peptide group, n = 6 or vehicle infusion for controls (occlusion-vehicle group, n = 7. Peptide infusion was associated with earlier recovery of electroencephalographic power after asphyxia compared to occlusion-vehicle (p<0.05, with reduced neuronal loss in the caudate and putamen (p<0.05, but not in the hippocampus. In the intragyral and periventricular white matter, peptide administration was associated with an increase in total oligodendrocyte numbers (p<0.05 and immature/mature oligodendrocytes compared to occlusion-vehicle (p<0.05, with a significant increase in proliferation (p<0.05. Connexin hemichannel blockade was neuroprotective and reduced oligodendrocyte death and improved recovery of oligodendrocyte maturation in preterm fetuses after asphyxia.

  5. Clinical significance of determination of cord blood S100B protein contents in neonates with intrauterine asphyxia

    International Nuclear Information System (INIS)

    Objective: To study the clinical significance of determination of cord blood S100B protein (a specific neural glia protein reflecting CNS injury) in neonates with intrauterine asphyxia. Methods: Cord blood S100B protein contents were measured with ELISA in (1) 41 neonates from normal vaginal delivery (2) 48 neonates from caesarean section without asphyxia and (3) 36 caesarean section neonates with intrauterine asphyxia. Results: Cord blood S100B protein contents in neonates with intrauterine asphyxia were significantly higher than those in the other 2 groups (P0.05). Conclusion: Cord blood S100B protein is a uesful indicator for the diagnosis of neonatal asphyxia and identification of brain damage following neonatal asphyxia. (authors)

  6. Long lasting cerebellar alterations after perinatal asphyxia in rats.

    Science.gov (United States)

    Campanille, Verónica; Saraceno, G Ezequiel; Rivière, Stéphanie; Logica, Tamara; Kölliker, Rodolfo; Capani, Francisco; Castilla, Rocío

    2015-07-01

    The developing brain may be particularly vulnerable to injury before, at and after birth. Among possible insults, hypoxia suffered as a consequence of perinatal asphyxia (PA) exhibits the highest incidence levels and the cerebellar circuitry appears to be particularly susceptible, as the cellular makeup and the quantity of inputs change quickly during days and weeks following birth. In this work, we have used a murine model to induce severe global PA in rats at the time of birth. Short-term cerebellar alterations within this PA model have been previously reported but whether such alterations remain in adulthood has not been conclusively determined yet. For this reason, and given the crucial cerebellar role in determining connectivity patterns in the brain, the aim of our work is to unveil long-term cerebellum histomorphology following a PA insult. Morphological and cytological neuronal changes and glial reaction in the cerebellar cortex were analyzed at postnatal 120 (P120) following injury performed at birth. As compared to control, PA animals exhibited: (1) an increase in molecular and granular thickness, both presenting lower cellular density; (2) a disarrayed Purkinje cell layer presenting a higher number of anomalous calbindin-stained cells. (3) focal swelling and marked fragmentation of microtubule-associated protein 2 (MAP-2) in Purkinje cell dendrites and, (4) an increase in glial fibrillary acidic protein (GFAP) expression in Bergmann cells and the granular layer. In conclusion, we demonstrate that PA produces long-term damage in cellular histomorphology in rat cerebellar cortex which could be involved in the pathogenesis of cognitive deficits observed in both animals and humans. PMID:26116983

  7. Using uterine activity to improve fetal heart rate variability analysis for detection of asphyxia during labor.

    Science.gov (United States)

    Warmerdam, G J J; Vullings, R; Van Laar, J O E H; Van der Hout-Van der Jagt, M B; Bergmans, J W M; Schmitt, L; Oei, S G

    2016-03-01

    During labor, uterine contractions can cause temporary oxygen deficiency for the fetus. In case of severe and prolonged oxygen deficiency this can lead to asphyxia. The currently used technique for detection of asphyxia, cardiotocography (CTG), suffers from a low specificity. Recent studies suggest that analysis of fetal heart rate variability (HRV) in addition to CTG can provide information on fetal distress. However, interpretation of fetal HRV during labor is difficult due to the influence of uterine contractions on fetal HRV. The aim of this study is therefore to investigate whether HRV features differ during contraction and rest periods, and whether these differences can improve the detection of asphyxia. To this end, a case-control study was performed, using 14 cases with asphyxia that were matched with 14 healthy fetuses. We did not find significant differences for individual HRV features when calculated over the fetal heart rate without separating contractions and rest periods (p  >  0.30 for all HRV features). Separating contractions from rest periods did result in a significant difference. In particular the ratio between HRV features calculated during and outside contractions can improve discrimination between fetuses with and without asphyxia (p  <  0.04 for three out of four ratio HRV features that were studied in this paper). PMID:26862891

  8. Clinical significance of determination of serum cortisol and insulin levels in neonates with asphyxia

    International Nuclear Information System (INIS)

    Objective: To investigate the clinical significance of the changes of serum cortisol and insulin levels in neonates with asphyxia. Methods: Serum cortisol levels were determined with CLIA and serum insulin levels with RIA in 38 neonates with asphyxia (mild degree 20, advanced 18) and 30 controls. Results: 1) In mild cases, serum insulin levels were significantly higher than those in controls (p<0.01) and serum cortisol levels were very significantly higher (p<0.001). 2) In advanced cases, both serum insulin and cortisol levels were very significantly higher than those in the controls (p<0.001). Conclusion: Hypoxia in the neonates with asphyxia is a very severe stress and will induce hypersecretion of cortisol and hyperglycemia which is detrimental to the patients. However hypersecretion of insulin will result in hypoglycemia, which is also very damaging. Physicians in charge should be aware of these possibilities and deal with them appropriately

  9. Perinatal risk factors for neonatal asphyxia in Vali-e-Asr hospital, Tehran-Iran

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    Fatemeh Nayeri

    2012-01-01

    Full Text Available Background: Asphyxia is a medical condition in which placental or pulmonary gas exchange is impaired or they cease all together, typically producing a combination of progressive hypoxemia and hypercapnea. Objective: In addition to regional differences in its etiology; it is important to know its risk factors. Materials and Methods: This is a case-control study, all neonates born from May 2002 to September 2005 in Vali-e-Asr Hospital were studied. 9488 newborns were born of which 6091 of the live patients were hospitalized in NICU. 546 newborns were studied as case and control group. 260 neonates (48% were female and 286 neonates (52% were male. Among the neonates who were admitted, 182 of them were diagnosed with asphyxia and twice of them (364 newborns were selected as a control group. The variables consist of; gestational age, type of delivery, birth weight, prenatal care, pregnancy and peripartum complications and neonatal disorders. Results: Our studies showed that 35 (19.2% patients had mild asphyxia, 107 (58.8% had moderate asphyxia and 40 (22% were diagnosed as severe asphyxia. Mean maternal age was 34.23±4.29yr; (range: 23-38 yr; and mean of parity was 2±1.2; (range: 1-8. Risk factors in our study included emergent Caesarian Section, preterm labor (<37w, low birth weight (<2500g, 5 minute Apgar (less than 6, need for resuscitation, nuchal cord, impaired Biophysical Profile, neonatal anemia, and maternal infertility. Conclusion: All risk factors listed above play a role in asphyxia. The majority of these factors are avoidable by means of good perinatal care

  10. Risk Factors for Birth Asphyxia in an Urban Health Facility in Cameroon

    OpenAIRE

    Chiabi, Andreas; Nguefack, Seraphin; MAH, Evelyne; NODEM, Sostenne; Mbuagbaw, Lawrence; Mbonda, Elie; TCHOKOTEU, Pierre-Fernand; Anderson DOH

    2013-01-01

    How to Cite This Article: Chiabi A, Nguefack S, Mah E, Nodem S, Mbuagbaw L, Mbonda E, Tchokoteu PF, Doh A. Risk Factors for Birth Asphyxia in an Urban Health Facility in Cameroon. Iran J Child Neurol. 2013 Summer; 7(3):46-54.ObjectiveThe World Health Organization (WHO) estimates that 4 million children are born with asphyxia every year, of which 1 million die and an equal number survive with severe neurologic sequelae. The purpose of this study was to identify the risk factors of birth asphyx...

  11. Asphyxia-related risk factors and their timing in spastic cerebral palsy

    DEFF Research Database (Denmark)

    Nielsen, Lene F.; Schendel, Diana; Grove, Jakob;

    2008-01-01

    Objective To investigate the association of asphyxia-related conditions (reducing blood flow or blood oxygen levels in the fetus) with spastic cerebral palsy (CP) considering different gestational age groups and the timing of risk. Design Population-based case-control study. Setting Danish Cerebral...... Palsy Register in eastern Denmark and Danish Medical Birth Register. Population or Sample 271 singletons with spastic CP and 217 singleton controls, frequency matched by gestational age group, born 1982-1990 in eastern Denmark. Methods Data were abstracted from medical records, and a priori asphyxia...

  12. Brain and Cognitive-Behavioural Development after Asphyxia at Term Birth

    Science.gov (United States)

    de Haan, Michelle; Wyatt, John S.; Roth, Simon; Vargha-Khadem, Faraneh; Gadian, David; Mishkin, Mortimer

    2006-01-01

    Perinatal asphyxia occurs in approximately 1-6 per 1000 live full-term births. Different patterns of brain damage can result, though the relation of these patterns to long-term cognitive-behavioural outcome remains under investigation. The hippocampus is one brain region that can be damaged (typically not in isolation), and this site of damage has…

  13. Therapeutic Hypothermia Modifies Perinatal Asphyxia-Induced Changes of the Corpus Callosum and Outcome in Neonates

    NARCIS (Netherlands)

    Alderliesten, Thomas; de Vries, Linda S.; Khalil, Yara; van Haastert, Ingrid C.; Benders, Manon J. N. L.; Koopman-Esseboom, Corine; Groenendaal, Floris

    2015-01-01

    What Is Known about this Subject? Diffusion-weighted MRI has demonstrated changes in the corpus callosum of term neonates with perinatal asphyxia. The severity of cerebral changes demonstrated using diffusion-weighted MRI is difficult to assess without measuring values of the Apparent Diffusion Coef

  14. Fatores associados à asfixia perinatal Factors associated with perinatal asphyxia

    Directory of Open Access Journals (Sweden)

    Alfredo de Almeida Cunha

    2004-12-01

    stepwise logistic regression model. RESULTS: there were 39 (14% depressed newborns which were compared to 238 (86% not depressed babies. The final analysis (multivariate showed an association between low Apgar score and previous case of stillbirth (OR=52.6, preterm labor threat (OR=33.8, low birth weight, less than 2,500 g body weight (OR=11.2 and previous cesarean section (OR=7.4. Some factors acted as a protection, including birth weight, in grams (OR=0.9, female sex of the newborn (OR=0.1, medical complications (OR=0.4 and prematurity (gestational age < 37 weeks, OR=0.1. CONCLUSION: the study may help in the identification of fetuses at great risk of asphyxia, allowing proper reference within the health system and planning of effective assistance in neonatal intensive care units.

  15. Positional Asphyxia: Death Due to Unusual Head-Down Position in a Narrow Space.

    Science.gov (United States)

    Chaudhari, Vinod Ashok; Ghodake, Dattatray G; Kharat, Rajesh D

    2016-06-01

    Death due to a head-down position with hyperflexion of the neck is a rare event. A person accidentally falling into a narrow space and remaining in an upside-down position with no timely recovery may experience positional or postural asphyxia. It is a critical condition arising out of particular body positions, leading to mechanical obstruction of respiration. The precipitating factors are intoxication due to alcohol, drugs, obesity, psychiatric illnesses, and injuries. A 30-year-old unmarried woman, weighing 82 kg and with a body mass index of 31.24, was found in a narrow space between the bed and the wall in a naked state and in a head-down position with hyperflexion of the neck. The distribution of lividity was consistent with the position of the body at the scene. Blood was oozing from the mouth and nostrils, and signs of asphyxia were present. The toxicological analyses of viscera, blood, and urine were negative for alcohol, drugs, and poisons. Glucose levels in the blood (86 mg/dL) as well as urine and vitreous humor levels (68 mg/dL) were within normal limits. On microscopic examination, there were no findings of coronary atherosclerosis, whereas the brain and lung were edematous. After meticulous examination, we ruled out sexual assault, autoerotic asphyxia, epilepsy, psychiatric illness, diabetes, toxicity, and coronary artery disease. Death was attributed to the accidental fall of the obese individual being stuck in a narrow space, resulting in positional asphyxia. It is imperative to recognize the precipitating or risk factors before labeling positional asphyxia as a cause of death. PMID:26840099

  16. The murderer is the bed: an unusual case of death by traumatic asphyxia in a hotel folding bunk bed.

    Science.gov (United States)

    Domènech, Mercè Subirana; Alcázar, Helena Martínez; Pallarès, Antoni Aguilar; Vicente, Ignasi Galtés; García, Josep Castellà; Gutiérrez, Claudina Vidal; Muñiz, Jordi Medallo

    2012-07-10

    This paper presents the first referenced case on a death by traumatic asphyxia in a folding bunk bed. A middle-aged man was found dead in a hotel room trapped into a lower folding bunk bed where he had been sleeping after a party. The autopsy showed signs of asphyxia and excluded signs of struggle and sexual intercourse. Toxicological analyses revealed alcohol intoxication. A differential diagnosis of the manner of death including a technical study of the bed which contributed to understand the circumstances of death was made. The medico-legal investigation of the case strongly supported the hypothesis of an accidental death by traumatic asphyxia. PMID:22361389

  17. Use of brain lactate levels to predict outcome after perinatal asphyxia

    DEFF Research Database (Denmark)

    Leth, H; Toft, P.B.; Peitersen, Birgit;

    1996-01-01

    Perinatal asphyxia is an important cause of neurological disability, but early prediction of outcome can be difficult. We performed proton magnetic resonance spectroscopy (MRS) and global cerebral blood flow measurements by xenon-133 clearance in 16 infants with evidence of perinatal asphyxia....... Cerebral blood flow was determined daily in the first 3 days after birth in seven cases. Proton MRS was performed in 11 infants within the first week (mean 3.7 days), the rest within the first month (mean 22.2 days), and all had a scan around 3 months of age. Four infants died neonatally, three showed...... min-1), (p = 0.02) and outcome. The diagnostic and prognostic implications of early MRS and CBF are predictive of poor outcome in severely asphyxiated infants...

  18. Copeptin concentration in cord blood in infants with early-onset sepsis, chorioamnionitis and perinatal asphyxia

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    Aebi Christoph

    2011-05-01

    Full Text Available Abstract Background Vasopressin is one of the most important physiological stress and shock hormones. Copeptin, a stable vasopressin precursor, is a promising sepsis marker in adults. In contrast, its involvement in neonatal diseases remains unknown. The aim of this study was to establish copeptin concentrations in neonates of different stress states such as sepsis, chorioamnionitis and asphyxia. Methods Copeptin cord blood concentration was determined using the BRAHMS kryptor assay. Neonates with early-onset sepsis (EOS, n = 30, chorioamnionitis (n = 33 and asphyxia (n = 25 were compared to a control group of preterm and term (n = 155 neonates. Results Median copeptin concentration in cord blood was 36 pmol/l ranging from undetectable to 5498 pmol/l (IQR 7 - 419. Copeptin cord blood concentrations were non-normally distributed and increased with gestational age (p Conclusions Copeptin concentrations were strongly related to factors associated with perinatal stress such as birth acidosis, asphyxia and vaginal delivery. In contrast, copeptin appears to be unsuitable for the diagnosis of EOS.

  19. Evaluation of utilization of antenatal services by mothers of babies with severe birth asphyxia

    Institute of Scientific and Technical Information of China (English)

    H. A. A. Ugboma; C. N. Onyearugha

    2011-01-01

    Objective:To evaluate the utilization of antenatal services by mothers of babies delivered with severe birth asphyxia at the University of Port Harcourt Teaching Hospital (UPTH) Port Harcourt, Nigeria. Methods: A case control study of the utilization of antenatal services by 97 mothers of newborns with severe birth asphyxia delivered at UPTH from 1st February to 31st October 2009 compared with mothers of newborns with normal Apgar scores was done. Relevant pregnancy, birth, family and social history was obtained by personal interviews and referral to case notes. Results:Significantly more of the mothers of babies with normal Apgar score booked early(4 months or less) and had up to 8 or more antenatal visits prior to delivery than mothers of asphyxiated babies 86 (88.6 % ) vs 68(70.2 %), P = 0. 002 ; 93 (95.7 % ) vs 68 ( 70. 2 % ), P = 0.001 respectively. Significantly more subjects 56 (57.7 % ) than the controls 45 (46.4 % ) were primiparous, P= 0. 04. Also, significantly more subjects 19 (19.5%) suffered delay prior to intervention in labour than the controls 5 (5.1 %),P= 0. 004. Conclusion: Primiparity, delayed booking, inadequate antenatal visits and late intervention in labour have been identified as significant contributors to severe birth asphyxia.

  20. Antenatal dexamethasone after asphyxia increases neural injury in preterm fetal sheep.

    Directory of Open Access Journals (Sweden)

    Miriam E Koome

    Full Text Available BACKGROUND AND PURPOSE: Maternal glucocorticoid treatment for threatened premature delivery dramatically improves neonatal survival and short-term morbidity; however, its effects on neurodevelopmental outcome are variable. We investigated the effect of maternal glucocorticoid exposure after acute asphyxia on injury in the preterm brain. METHODS: Chronically instrumented singleton fetal sheep at 0.7 of gestation received asphyxia induced by complete umbilical cord occlusion for 25 minutes. 15 minutes after release of occlusion, ewes received a 3 ml i.m. injection of either dexamethasone (12 mg, n = 10 or saline (n = 10. Sheep were killed after 7 days recovery; survival of neurons in the hippocampus and basal ganglia, and oligodendrocytes in periventricular white matter were assessed using an unbiased stereological approach. RESULTS: Maternal dexamethasone after asphyxia was associated with more severe loss of neurons in the hippocampus (CA3 regions, 290 ± 76 vs 484 ± 98 neurons/mm(2, mean ± SEM, P<0.05 and basal ganglia (putamen, 538 ± 112 vs 814 ± 34 neurons/mm(2, P<0.05 compared to asphyxia-saline, and with greater loss of both total (913 ± 77 vs 1201 ± 75/mm(2, P<0.05 and immature/mature myelinating oligodendrocytes in periventricular white matter (66 ± 8 vs 114 ± 12/mm(2, P<0.05, vs sham controls 165 ± 10/mm(2, P<0.001. This was associated with transient hyperglycemia (peak 3.5 ± 0.2 vs. 1.4 ± 0.2 mmol/L at 6 h, P<0.05 and reduced suppression of EEG power in the first 24 h after occlusion (maximum -1.5 ± 1.2 dB vs. -5.0 ± 1.4 dB in saline controls, P<0.01, but later onset and fewer overt seizures. CONCLUSIONS: In preterm fetal sheep, exposure to maternal dexamethasone during recovery from asphyxia exacerbated brain damage.

  1. ASPHYXIA, INTRACRANIAL HEMORRHAGES AND BRAIN EDEMA OF RISK CHILDREN IN THE ADVISORY INSTITUTE IN BITOLA FROM 1989-1994

    Directory of Open Access Journals (Sweden)

    M. ILIEVSKA,

    1997-09-01

    Full Text Available 3986 files have been examined in the Advisory Institute for a five year period in relation to the present risk factors in the pre, peri and postnatal period, the occurrence of asphyxia, I.H. (intracranial hemorrhages and brain edema and their outcome for the children. There were 958 or 32% risk children, out of them 206 or 22% were with asphyxia, 25 or 3% were with brain edema and 14 or 1,5% were with intracranial hemorrhages.The analysis for the risk factors shows that 119 of them were abortive , and from them 15% were born with asphyxia; 124 were SFD and 21% of them with asphyxia; 272 children weighed over 4500 gr., 7% of them with asphyxia and 0.4% with I.H., there were 68 twins, 12% of them with asphyxia. Out of the children with no risk registered, 6 were born with I.H., or 0,2%.Mothers under the age of 18 gave birth to 13% children with asphyxia; treated for sterility and anemia during pregnancy 15%; with increased blood pressure 14%; and 5% with maintained pregnancy.The highest delivery risk is present with children born with vacuum extraction (30% or every third child is with asphyxia and 3% with I.H. and with children delivered by caesarean section (14% with asphyxia.As for the position of the fetus-Citus pedalicus gave 55% children with asphyxia, and Situs pelvicus 12%.The worst damage is suffered by infants with premature amnion disruption (62% are with asphyxia; with the umbilical cord round the neck-56% with asphyxia and 6% with I.H.; and with muddled amniotic fluid and placenta pelvia-50%.The order of risk factors related to asphyxia, I.H. and brain edema is as follows: the first is premature amnion disruption, then follows the umbilical cord round the neck, the muddled amniotic fluid, and placenta previa and Citus pedalicus-which are obstetric problems. The next are the vacuum extraction and S.C. As for the gestatory period the order is as follows: first the abortive, then the twins and hypertrofic infants. The outcome of the

  2. Magnesium sulphate and cardiovascular and cerebrovascular adaptations to asphyxia in preterm fetal sheep.

    Science.gov (United States)

    Galinsky, Robert; Davidson, Joanne O; Drury, Paul P; Wassink, Guido; Lear, Christopher A; van den Heuij, Lotte G; Gunn, Alistair J; Bennet, Laura

    2016-03-01

    Magnesium sulphate is a standard therapy for eclampsia in pregnancy and is widely recommended for perinatal neuroprotection during threatened preterm labour. MgSO4 is a vasodilator and negative inotrope. Therefore the aim of this study was to investigate the effect of MgSO4 on the cardiovascular and cerebrovascular responses of the preterm fetus to asphyxia. Fetal sheep were instrumented at 98 ± 1 days of gestation (term = 147 days). At 104 days, unanaesthetised fetuses were randomly assigned to receive an intravenous infusion of MgSO4 (n = 6) or saline (n = 9). At 105 days all fetuses underwent umbilical cord occlusion for 25 min. Before occlusion, MgSO4 treatment reduced heart rate and increased femoral blood flow (FBF) and vascular conductance compared to controls. During occlusion, carotid and femoral arterial conductance and blood flows were higher in MgSO4-treated fetuses than controls. After occlusion, fetal heart rate was lower and carotid and femoral arterial conductance and blood flows were higher in MgSO4-treated fetuses than controls. Femoral arterial waveform height and width were increased during MgSO4 infusion, consistent with increased stroke volume. MgSO4 did not alter the fetal neurophysiological or nuchal electromyographic responses to asphyxia. These data demonstrate that a clinically comparable dose of MgSO4 increased FBF and stroke volume without impairing mean arterial pressure (MAP) or carotid blood flow (CaBF) during and immediately after profound asphyxia. Thus, MgSO4 may increase perfusion of peripheral vascular beds during adverse perinatal events. PMID:26077461

  3. PERINATAL ASPHYXIA AS POTENTIAL SOURCE OF CHILDREN WITH DEVELOPMENTAL PSYCHO-MOTOR DIFFICULTIES

    Directory of Open Access Journals (Sweden)

    Elizabeta ZISOVSKA

    1997-09-01

    Full Text Available Besides the great improvement of aostetrics and neanatal intensive care, certain percentage of new born children suffer from perinatal asphyxia (PA and that is one of the first reasons for hypoxic and ischemic brain damage which leads to neuro-developing handicap. In order to show how strong is the correaltion between PA and permanent sequele, an early, precise and prompt diagnosis of asphyxia and its influence on neonatal brain is neccessary.This study presents answers to the following issues.1.Which parameters define precisely the perinatal asphyxia?2.How great is the PA incidence on our material?3.What is the percentage of postasphyxic encephalopathy (PAE in the group of asphyxic new born children?4.Which of these children bear high risk for developmental psycho-motor difficulties?MaterialThe new born children delivered on time in the Clinic of Gynecology and Obstetrics.Methods1.Early diagnosis of PA according to the score consisted of high specific, sensitivity and positive and predictive value2.Consequent neurological check-ups and PAE cathegori-zation for seven days3.Ultrasound examination of CNS through big fontanelle4.Lab analysesResults5.639 successive new born children delivered on time were examined. The included scouring system covers APGAR score at the 5th minute, cardiotocographic record, base deficit in ABS, meconium around the amniotic water. According to this system, 81 child passed the PA , i.e., 14,3/ 1.000 new born children delivered on time. Out of them, 54 have signs of PAE (9,5/1000 new born children delivered on time, i.e., 66,6% of all asphyxia new born children. Classification has been made according to the PAE grade: 34 children survived the first grade (62,9%, 11 children survived the second grade (20,4% and 9 new born children survived the third grade (16,7%. According to data in literature and long year studies of this issue, the children from the group who passed the second and the third grade of PAE have the risk

  4. CT cold areas in both putamens in cases with history of perinatal asphyxia

    International Nuclear Information System (INIS)

    CT bilaterally showed a cold area in the putamen of 5 infants with cerebral palsy who had had asphyxia at birth. The etiology was discussed, and 4 of the cases were clinically studied. All four patients had convulsive tetraplegia, or convulsive bilateral paralysis with the element of athetosis. Three of them had a history of infantile epilepsy, accompanied by abnormal ocular movement. Two patients with tetraplegia showed marked hypotonia of the trunk in ventral support (Landau). Impairment of the bilateral putamens in the abnormal muscle tone was inferred. (Chiba, N.)

  5. CT cold areas in both putamens in cases with history of perinatal asphyxia

    Energy Technology Data Exchange (ETDEWEB)

    Ishizaki, Asayo; Maruyama, Hiroshi (Tokyo Women' s Medical Coll. (Japan))

    1982-12-01

    CT bilaterally showed a cold area in the putamen of 5 infants with cerebral palsy who had had asphyxia at birth. The etiology was discussed, and 4 of the cases were clinically studied. All four patients had convulsive tetraplegia, or convulsive bilateral paralysis with the element of athetosis. Three of them had a history of infantile epilepsy, accompanied by abnormal ocular movement. Two patients with tetraplegia showed marked hypotonia of the trunk in ventral support (Landau). Impairment of the bilateral putamens in the abnormal muscle tone was inferred.

  6. Novel Approaches to Neonatal Resuscitation and the Impact on Birth Asphyxia.

    Science.gov (United States)

    Te Pas, Arjan B; Sobotka, Kristina; Hooper, Stuart B

    2016-09-01

    Historically, recommendations for neonatal resuscitation were largely based on dogma, but there is renewed interest in performing resuscitation studies at birth. The emphasis for resuscitation following birth asphyxia is administering effective ventilation, as adequate lung aeration leads not only to an increase in oxygenation but also increased pulmonary blood flow and heart rate. To aerate the lung, an initial sustained inflation can increase heart rate, oxygenation, and blood pressure recovery much faster when compared with standard ventilation. Hyperoxia should be avoided, and extra oxygen given to restore cardiac function and spontaneous breathing should be titrated based on oxygen saturations. PMID:27524447

  7. Risk Factors for Birth Asphyxia in an Urban Health Facility in Cameroon

    Directory of Open Access Journals (Sweden)

    Andreas CHIABI

    2013-08-01

    Full Text Available How to Cite This Article: Chiabi A, Nguefack S, Mah E, Nodem S, Mbuagbaw L, Mbonda E, Tchokoteu PF, Doh A. Risk Factors for Birth Asphyxia in an Urban Health Facility in Cameroon. Iran J Child Neurol. 2013 Summer; 7(3:46-54.ObjectiveThe World Health Organization (WHO estimates that 4 million children are born with asphyxia every year, of which 1 million die and an equal number survive with severe neurologic sequelae. The purpose of this study was to identify the risk factors of birth asphyxia and the hospital outcome of affected neonates.Materials & MethodsThis study was a prospective case-control study on term neonates in a tertiary hospital in Yaounde, with an Apgar score of < 7 at the 5th minute as the case group, that were matched with neonates with an Apgar score of ≥ 7 at the 5th minute as control group. Statistical analysis of relevant variables of the mother and neonates was carried out to determine the significant risk factors.ResultsThe prevalence of neonatal asphyxia was 80.5 per 1000 live births. Statistically significant risk factors were the single matrimonial status, place of antenatal visits, malaria, pre-eclampsia/eclampsia, prolonged labor, arrest of labour,prolonged rupture of membranes, and non-cephalic presentation. Hospital mortality was 6.7%, that 12.2% of them had neurologic deficits and/or abnormal transfontanellar ultrasound/electroencephalogram on discharge, and 81.1% hada satisfactory outcome.ConclusionThe incidence of birth asphyxia in this study was 80.5% per1000 live birth with a mortality of 6.7%. Antepartum risk factors were: place of antenatal visit, malaria during pregnancy, and preeclampsia/eclampsia. Whereas prolonged labor, stationary labor, and term prolonged rupture of membranes were intrapartum risk faktors. Preventive measures during prenatal  visits through informing and communicating with pregnant women should be reinforced. References1. World Health Organisation. Perinatal mortality: a listingof

  8. Effect of Marine Collagen Peptides on Physiological and Neurobehavioral Development of Male Rats with Perinatal Asphyxia

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    Linlin Xu

    2015-06-01

    Full Text Available Asphyxia during delivery produces long-term deficits in brain development. We investigated the neuroprotective effects of marine collagen peptides (MCPs, isolated from Chum Salmon skin by enzymatic hydrolysis, on male rats with perinatal asphyxia (PA. PA was performed by immersing rat fetuses with uterine horns removed from ready-to-deliver rats into a water bath for 15 min. Caesarean-delivered pups were used as controls. PA rats were intragastrically administered with 0.33 g/kg, 1.0 g/kg and 3.0 g/kg body weight MCPs from postnatal day 0 (PND 0 till the age of 90-days. Behavioral tests were carried out at PND21, PND 28 and PND 90. The results indicated that MCPs facilitated early body weight gain of the PA pups, however had little effects on early physiological development. Behavioral tests revealed that MCPs facilitated long-term learning and memory of the pups with PA through reducing oxidative damage and acetylcholinesterase (AChE activity in the brain, and increasing hippocampus phosphorylated cAMP-response element binding protein (p-CREB and brain derived neurotrophic factor (BDNF expression.

  9. Perinatal asphyxia reduces dentate granule cells and exacerbates methamphetamine-induced hyperlocomotion in adulthood.

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    Tomoyasu Wakuda

    Full Text Available BACKGROUND: Obstetric complications have been regarded as a risk factor for schizophrenia later in life. One of the mechanisms underlying the association is postulated to be a hypoxic process in the brain in the offspring around the time of birth. Hippocampus is one of the brain regions implicated in the late-onset dopaminergic dysfunction associated with hypoxic obstetric complications. METHODOLOGY/PRINCIPAL FINDINGS: We used an animal model of perinatal asphyxia, in which rat pups were exposed to 15 min of intrauterine anoxia during Cesarean section birth. At 6 and 12 weeks after birth, the behavior of the pups was assessed using a methamphetamine-induced locomotion test. In addition, the histopathology of the hippocampus was examined by means of stereology. At 6 weeks, there was no change in the methamphetamine-induced locomotion. However, at 12 weeks of age, we found an elevation in methamphetamine-induced locomotor activity, which was associated with an increase of dopamine release in the nucleus accumbens. At the same age, we also found a reduction of the dentate granule cells of the hippocampus. CONCLUSIONS/SIGNIFICANCE: These results suggest that the dopaminergic dysregulation after perinatal asphyxia is associated with a reduction in hippocampal dentate granule cells, and this may partly contribute to the pathogenesis of schizophrenia.

  10. The Behaviour of Protein Carbonyls in Newborns with Birth Respiratory Distress and Asphyxia

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    Gabriela ZAHARIE

    2009-12-01

    Full Text Available Objective: A prospective study was carried out in premature newborns with respiratory distress syndrome (RDS and asphyxia at birth in order to identify and analyze the effects of RDS on proteins. Material and Methods: Protein peroxidation was studied using the Reznick spectrophotometric method. The study group included 14 premature newborns with respiratory distress and asphyxia at birth. The control group included 13 newborns that were born on term, eutrophic and healthy. The determinations were carried out using venous blood. Statistical data analyses were performed using Statistica software. The comparisons between groups (study and controls were performed by applying parametric and non-parametric tests according with the type of distribution. Results: Statistically significant correlations were found between the value of protein carbonyls (PC and the weight of premature newborns in the case group (p < 0.05, as well as between the PC value and the presence of respiratory distress due to surfactant deficiency in the study group. The average PC value in the study group was higher in the third day as compared with the first day. The PC value was significantly higher in the control group as compared with study group. Conclusion: The results of our study revealed that the respiratory distress in the premature newborn and oxygen therapy stimulate the peroxidation of proteins.

  11. Diagnostic and prognostic value of asphyxia, Sarnat's clinical classification, and CT-scan in perinatal brain damage

    Energy Technology Data Exchange (ETDEWEB)

    Kubo, Toshihide; Wakita, Yoshiharu; Kubonishi, Sakae; Yoshikawa, Seishi (Kochi Prefectural Central Hospital (Japan)); Ito, Toshiyuki; Okada, Yasusuke

    1990-11-01

    A retrospective review was made of 145 babies, excluding those with congenital heart disease or chromosome aberration, admitted for CT scanning. The study was done to determine the diagnostic and prognostic value of CT findings, as well as the presence of asphyxia and the clinical stage based on the Sarnat's classification, in perinatal brain damage. The patients had a minimum follow up of 2 years for the evaluation of neurologic manifestations, such as cerebral palsy, epilepsy and mental retardation. Among babies weighing 2,000 g or more at birth, neonatal asphyxia was significantly correlated with neurologic prognosis. In addition, both clinical stages and CT findings were significantly correlated with neurologic prognosis, irrespective of birth weight. The correlation between clinical stages and CT findings was significant, irrespective of body weight, however, a significant correlation between clinical stages and neonatal asphyxia was restricted to those weighing 2,000 g or more. These findings suggest that the presence of asphyxia, clinical stages and CT findings are complementary in the diagnosis and prognosis evaluation of perinatal brain damage. (N.K.).

  12. Interaction Pattern and Developmental Outcome of Infants with Severe Asphyxia: A Longitudinal Study of the First Years of Life.

    Science.gov (United States)

    Campbell, Philippa H.; And Others

    1989-01-01

    Seven full-term infants with severe encephalopathy following perinatal asphyxia were followed longitudinally to two years of age to determine health and developmental outcome and to investigate mother-infant interaction patterns over time. Six infants demonstrated delayed development; five were diagnosed with cerebral palsy. Mother-infant…

  13. Diagnostic and prognostic value of asphyxia, Sarnat's clinical classification, and CT-scan in perinatal brain damage

    International Nuclear Information System (INIS)

    A retrospective review was made of 145 babies, excluding those with congenital heart disease or chromosome aberration, admitted for CT scanning. The study was done to determine the diagnostic and prognostic value of CT findings, as well as the presence of asphyxia and the clinical stage based on the Sarnat's classification, in perinatal brain damage. The patients had a minimum follow up of 2 years for the evaluation of neurologic manifestations, such as cerebral palsy, epilepsy and mental retardation. Among babies weighing 2,000 g or more at birth, neonatal asphyxia was significantly correlated with neurologic prognosis. In addition, both clinical stages and CT findings were significantly correlated with neurologic prognosis, irrespective of birth weight. The correlation between clinical stages and CT findings was significant, irrespective of body weight, however, a significant correlation between clinical stages and neonatal asphyxia was restricted to those weighing 2,000 g or more. These findings suggest that the presence of asphyxia, clinical stages and CT findings are complementary in the diagnosis and prognosis evaluation of perinatal brain damage. (N.K.)

  14. Analysis of Obstetric Factors of Neonatal Asphyxia%新生儿窒息的产科因素分析

    Institute of Scientific and Technical Information of China (English)

    庞正钰; 杨妹; 孙艳萍; 林怡; 黄蓉

    2015-01-01

    目的:探讨新生儿窒息的产科危险因素,分析如何有效降低新生儿窒息发生率和病死率,提高人口素质。方法对2011~2012年间在我院住院分娩的病历、统计资料进行回顾性分析,对新生儿不同性别、产式、孕周、产妇产龄等新生儿窒息影响因素进行比较,找出新生儿窒息的主要原因。结果新生儿窒息率为5.09%;男、女新生儿窒息发生率和病死率无显著性差异;新生儿窒息的前三位原因是:早产、脐带绕颈、妊娠高血压疾病,分别占56.23%、19.15%和12.46%;早产是新生儿窒息和死亡的首位原因;阴道助产、高龄分娩都会增加新生儿窒息的风险。结论加强围产保健,积极预防早产,是降低新生儿窒息的关键。为了母婴健康,应鼓励适龄婚育,才是提高人口素质的有效措施。%Objective To explore the factors of neonatal asphyxia obstetric risk, to reduce the incidence and mortality rate of neonatal asphyxia, and to improve the quality of the population.Methods Medical records and statistical data of hospitalization and delivery from 2011 to 2012 in the hospital were retrospectively analyzed.The newborns′different genders, birth type, gestational age, maternal age and asphyxia were compared, to find out the main causes of neonatal asphyxia.Results The rate of neonatal asphyxia was 5.09%;male and female, the incidence of neonatal asphyxia and mortality had no significant difference;the first three causes of neonatal asphyxia were pre-mature birth, umbilical cord around the neck, pregnancy induced hypertension, accounting for 56.23%, 19.15%and 12.46%;premature was the first cause of neonatal asphyxia and death;vaginal instrumental delivery and advanced age delivery can increase neonatal asphyxia.Conclusion Strengthening perinatal health care and preventing premature delivery is the key to reduce neonatal asphyxia.For maternal and child health, marriage and

  15. Metabolic Changes Following Perinatal Asphyxia: Role of Astrocytes and Their Interaction with Neurons.

    Science.gov (United States)

    Logica, Tamara; Riviere, Stephanie; Holubiec, Mariana I; Castilla, Rocío; Barreto, George E; Capani, Francisco

    2016-01-01

    Perinatal Asphyxia (PA) represents an important cause of severe neurological deficits including delayed mental and motor development, epilepsy, major cognitive deficits and blindness. The interaction between neurons, astrocytes and endothelial cells plays a central role coupling energy supply with changes in neuronal activity. Traditionally, experimental research focused on neurons, whereas astrocytes have been more related to the damage mechanisms of PA. Astrocytes carry out a number of functions that are critical to normal nervous system function, including uptake of neurotransmitters, regulation of pH and ion concentrations, and metabolic support for neurons. In this work, we aim to review metabolic neuron-astrocyte interactions with the purpose of encourage further research in this area in the context of PA, which is highly complex and its mechanisms and pathways have not been fully elucidated to this day. PMID:27445788

  16. Prematurity, asphyxia and congenital malformations underrepresented among neonates in a tertiary pediatric hospital in Vietnam

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    Kruse Alexandra Y

    2012-12-01

    Full Text Available Abstract Background Estimated 17,000 neonates (≤ 28 days of age die in Vietnam annually, corresponding to more than half of the child mortality burden. However, current knowledge about these neonates is limited. Prematurity, asphyxia and congenital malformations are major causes of death in neonates worldwide. To improve survival and long term development, these vulnerable neonates need access to the specialized neonatal care existing, although limited, in lower middle-income countries like Vietnam. The aim of this study was to describe these conditions in a specialized Vietnamese hospital, compared to a Danish hospital. Methods We performed a comparative observational study of all neonates admitted to a tertiary pediatric hospital in South Vietnam in 2009–2010. The data were prospectively extracted from the central hospital registry and included basic patient characteristics and diagnoses (International Classification of Diseases, 10th revision. Prematurity, asphyxia and designated congenital malformations (oesophageal atresia, gastroschisis, omphalocoele, diaphragmatic hernia and heart disease were investigated. In a subgroup, the prematurity diagnosis was validated using a questionnaire. The hospitalization ratio of each diagnosis was compared to those obtained from a Danish tertiary hospital. The Danish data were retrieved from the neonatal department database for a ten-year period. Results The study included 5763 neonates (missing Conclusion Our findings suggest the investigated diagnoses were underrepresented in the Vietnamese study hospital. In contrast, relatively mild diagnoses were frequent. These results indicate the use of specialized care may not be optimal. Pre-hospital selection mechanisms were not investigated and additional studies are needed to optimise utilisation of specialized care and improve neonatal survival.

  17. Brain caspase-3 and intestinal FABP responses in preterm and term rats submitted to birth asphyxia

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    R.L. Figueira

    2016-01-01

    Full Text Available Neonatal asphyxia can cause irreversible injury of multiple organs resulting in hypoxic-ischemic encephalopathy and necrotizing enterocolitis (NEC. This injury is dependent on time, severity, and gestational age, once the preterm babies need ventilator support. Our aim was to assess the different brain and intestinal effects of ischemia and reperfusion in neonate rats after birth anoxia and mechanical ventilation. Preterm and term neonates were divided into 8 subgroups (n=12/group: 1 preterm control (PTC, 2 preterm ventilated (PTV, 3 preterm asphyxiated (PTA, 4 preterm asphyxiated and ventilated (PTAV, 5 term control (TC, 6 term ventilated (TV, 7 term asphyxiated (TA, and 8 term asphyxiated and ventilated (TAV. We measured body, brain, and intestine weights and respective ratios [(BW, (BrW, (IW, (BrW/BW and (IW/BW]. Histology analysis and damage grading were performed in the brain (cortex/hippocampus and intestine (jejunum/ileum tissues, as well as immunohistochemistry analysis for caspase-3 and intestinal fatty acid-binding protein (I-FABP. IW was lower in the TA than in the other terms (P<0.05, and the IW/BW ratio was lower in the TA than in the TAV (P<0.005. PTA, PTAV and TA presented high levels of brain damage. In histological intestinal analysis, PTAV and TAV had higher scores than the other groups. Caspase-3 was higher in PTAV (cortex and TA (cortex/hippocampus (P<0.005. I-FABP was higher in PTAV (P<0.005 and TA (ileum (P<0.05. I-FABP expression was increased in PTAV subgroup (P<0.0001. Brain and intestinal responses in neonatal rats caused by neonatal asphyxia, with or without mechanical ventilation, varied with gestational age, with increased expression of caspase-3 and I-FABP biomarkers.

  18. Maturation of the mitochondrial redox response to profound asphyxia in fetal sheep.

    Directory of Open Access Journals (Sweden)

    Paul P Drury

    Full Text Available UNLABELLED: Fetal susceptibility to hypoxic brain injury increases over the last third of gestation. This study examined the hypothesis that this is associated with impaired mitochondrial adaptation, as measured by more rapid oxidation of cytochrome oxidase (CytOx during profound asphyxia. METHODS: Chronically instrumented fetal sheep at 0.6, 0.7, and 0.85 gestation were subjected to either 30 min (0.6 gestational age (ga, n = 6, 25 min (0.7 ga, n = 27 or 15 min (0.85 ga, n = 17 of complete umbilical cord occlusion. Fetal EEG, cerebral impedance (to measure brain swelling and near-infrared spectroscopy-derived intra-cerebral oxygenation (ΔHb = HbO(2 - Hb, total hemoglobin (THb and CytOx redox state were monitored continuously. Occlusion was associated with profound, rapid fall in ΔHb in all groups to a plateau from 6 min, greatest at 0.85 ga compared to 0.6 and 0.7 ga (p<0.05. THb initially increased at all ages, with the greatest rise at 0.85 ga (p<0.05, followed by a progressive fall from 7 min in all groups. CytOx initially increased in all groups with the greatest rise at 0.85 ga (p<0.05, followed by a further, delayed increase in preterm fetuses, but a striking fall in the 0.85 group after 6 min of occlusion. Cerebral impedance (a measure of cytotoxic edema increased earlier and more rapidly with greater gestation. In conclusion, the more rapid rise in CytOx and cortical impedance during profound asphyxia with greater maturation is consistent with increasing dependence on oxidative metabolism leading to earlier onset of neural energy failure before the onset of systemic hypotension.

  19. Histological Changes in the Thyroid Gland in Cases of Infant and Early Childhood Asphyxia-A Preliminary Study.

    Science.gov (United States)

    Byard, Roger W; Bellis, Maria

    2016-05-01

    A retrospective blinded study of thyroid gland histology was undertaken in 50 infants and young children aged from 1 to 24 months. Deaths were due to (i) suffocation (N = 7), hanging (4), wedging (3), and chest and/or neck compression (4), and (ii) SIDS (20), noncervical trauma (7), organic disease, (4) and drug toxicity (1). In the asphyxia group (N = 18), thyroid gland congestion ranged from 0 to 3+ with 39% of cases (7/18) having moderate/marked congestion. In three cases, focal aggregates of red blood cells (blood islands) were observed within the intrafollicular colloid. These deaths involved chest compression, chest and/or neck compression, and crush asphyxia in a vehicle accident, and all had facial petechiae. Only 22% of the 32 control cases (7/32) had moderate/marked congestion with no blood islands being identified (p crushing or compression and may provide supportive evidence for this diagnosis. PMID:27122404

  20. Clinical significance of blood gas and electrolyte analysis, CK, CK-MB and HBDH changes in neonatal asphyxia

    Institute of Scientific and Technical Information of China (English)

    Bao-Hua Xu; Xin Lin; Mi-Jia Huang

    2016-01-01

    Objective:To investigate the clinical significance of blood gas and electrolyte analysis, CK, CK-MB and HBDH changes in neonatal asphyxia.Methods:A total of 100 newborns with asphyxia who visited in our hospital were collected, and divided into severe group (n=20) and mild group (n=80) according to the asphyxia degree, and 50 healthy newborns regarded as control group. The 3 groups received blood gas analysis (pH, BE and PaCO2), electrolyte (K+, Na+ and Ca2+) and 3 kinds of enzymes (CK, CK-MB and HBDH) were tested and compared.Results: Compared with control group, pH and BE of blood gas indexes decreased significantly and PaCO2 increased significantly in severe group (P0.05). Compared with mild group, pH and BE of blood gas indexes decreased significantly and PaCO2 increased significantly in severe group (P0.05). Compared with mild group, the level of Ca2+ decreased significantly in severe group (P<0.05); Compared with control group, the levels of CK, CK-MB and HBDH increased significantly in severe and mild group (P<0.05). Compared with mild group, the levels of CK, CK-MB and HBDH increased significantly in severe group (P<0.05).Conclusions:The detection of blood gas and electrolyte analysis, CK, CK-MB and HBDH can provide an objective evidence for the diagnosis of neonatal asphyxia and estimation of severity degree which was helpful in clinical treatment.

  1. Experimental modelling of the consequences of brief late gestation asphyxia on newborn lamb behaviour and brain structure.

    Directory of Open Access Journals (Sweden)

    Margie Castillo-Melendez

    Full Text Available Brief but severe asphyxia in late gestation or at the time of birth may lead to neonatal hypoxic ischemic encephalopathy and is associated with long-term neurodevelopmental impairment. We undertook this study to examine the consequences of transient in utero asphyxia in late gestation fetal sheep, on the newborn lamb after birth. Surgery was undertaken at 125 days gestation for implantation of fetal catheters and placement of a silastic cuff around the umbilical cord. At 132 days gestation (0.89 term, the cuff was inflated to induce umbilical cord occlusion (UCO, or sham (control. Fetal arterial blood samples were collected for assessment of fetal wellbeing and the pregnancy continued until birth. At birth, behavioral milestones for newborn lambs were recorded over 24 h, after which the lambs were euthanased for brain collection and histopathology assessments. After birth, UCO lambs displayed significant latencies to (i use all four legs, (ii attain a standing position, (iii find the udder, and (iv successfully suckle--compared to control lambs. Brains of UCO lambs showed widespread pathologies including cell death, white matter disruption, intra-parenchymal hemorrhage and inflammation, which were not observed in full term control brains. UCO resulted in some preterm births, but comparison with age-matched preterm non-UCO control lambs showed that prematurity per se was not responsible for the behavioral delays and brain structural abnormalities resulting from the in utero asphyxia. These results demonstrate that a single, brief fetal asphyxic episode in late gestation results in significant grey and white matter disruption in the developing brain, and causes significant behavioral delay in newborn lambs. These data are consistent with clinical observations that antenatal asphyxia is causal in the development of neonatal encephalopathy and provide an experimental model to advance our understanding of neuroprotective therapies.

  2. Asfixia perinatal e problemas cardíacos Perinatal asphyxia and heart problems

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    Gesmar Volga H. Herdy

    1998-08-01

    Full Text Available OBJETIVO: Avaliar a gravidade das complicações cardíacas na asfixia neonatal, sua evolução e correlacioná-las com o grau e duração do processo hipóxico. MÉTODOS: Foram estudados 90 bebês nos últimos 7 anos com grau de Apgar PURPOSE: To evaluate the severity of cardiac complications of neonatal asphyxia in relation to the length and degree of hipoxia. METHODS: Ninety babies with an Apgar score <6 were examined in the intensive care unit at our institution during seven years. Arterial blood for measuring pH, glucose, LDH and MB fraction of CK, together with serial electrocardiogram (ECG, echocardiogram and chest X rays was obtained. The fatal cases were studied with macro and microscopic examination. RESULTS: From a total of 90 cases, 73 were premature: 30 (41% appropriate for gestation age (AGA and 43 (59% small for gestation age (SGA. Twenty one (23% cases had arterial pH <7.2. The most common clinical conditions were: pneumonia 28 (31%, anemia 24 (26% and jaundice 12 (13%. The main cardiological findings were: systolic murmur in 46 (50%, signs of heart hypertrophy in 18 (20% and heart failure in 8 (9%. On ECG the main findings were ST and T abnormalities. The echocardiogram showed a patent ductus arteriosus (PDA in 20 (22%, tricuspid regurgitation in 6 (7%, pulmonary hypertension in 6 (7%, dyskinesia and ventricular dilatation in 4 (5%. Necropsy was performed in 23 cases and macro and microscopy obtained in 14; the most frequent findings were: myocite necrosis in 8 (54%, congestion, vacuolization and loss of striae in 4 (29%. CONCLUSION: In the majority of cases, patients had a benign course, even those presenting with severe acidemia. Many abnormal EKGs and echocardiograms became normal after a few weeks. Among those who had a fatal outcome, the severity of histological lesions was observed in babies who had suffered asphyxia for more prolonged periods.

  3. Effect of perinatal asphyxia on tuberomammillary nucleus neuronal density and object recognition memory: A possible role for histamine?

    Science.gov (United States)

    Flores-Balter, Gabriela; Cordova-Jadue, Héctor; Chiti-Morales, Alessandra; Lespay, Carolyne; Espina-Marchant, Pablo; Falcon, Romina; Grinspun, Noemi; Sanchez, Jessica; Bustamante, Diego; Morales, Paola; Herrera-Marschitz, Mario; Valdés, José L

    2016-10-15

    Perinatal asphyxia (PA) is associated with long-term neuronal damage and cognitive deficits in adulthood, such as learning and memory disabilities. After PA, specific brain regions are compromised, including neocortex, hippocampus, basal ganglia, and ascending neuromodulatory pathways, such as dopamine system, explaining some of the cognitive disabilities. We hypothesize that other neuromodulatory systems, such as histamine system from the tuberomammillary nucleus (TMN), which widely project to telencephalon, shown to be relevant for learning and memory, may be compromised by PA. We investigated here the effect of PA on (i) Density and neuronal activity of TMN neurons by double immunoreactivity for adenosine deaminase (ADA) and c-Fos, as marker for histaminergic neurons and neuronal activity respectively. (ii) Expression of the histamine-synthesizing enzyme, histidine decarboxylase (HDC) by western blot and (iii) thioperamide an H3 histamine receptor antagonist, on an object recognition memory task. Asphyxia-exposed rats showed a decrease of ADA density and c-Fos activity in TMN, and decrease of HDC expression in hypothalamus. Asphyxia-exposed rats also showed a low performance in object recognition memory compared to caesarean-delivered controls, which was reverted in a dose-dependent manner by the H3 antagonist thioperamide (5-10mg/kg, i.p.). The present results show that the histaminergic neuronal system of the TMN is involved in the long-term effects induced by PA, affecting learning and memory. PMID:27444242

  4. Serum cortisol concentrations during induced hypothermia for perinatal asphyxia are associated with neurological outcome in human infants.

    Science.gov (United States)

    Scaramuzzo, Rosa T; Giampietri, Matteo; Fiorentini, Erika; Bartalena, Laura; Fiori, Simona; Guzzetta, Andrea; Ciampi, Mariella; Boldrini, Antonio; Ghirri, Paolo

    2015-01-01

    Birth asphyxia is a cause of neonatal death or adverse neurological sequelae. Biomarkers can be useful to clinicians in order to optimize intensive care management and communication of prognosis to parents. During perinatal adverse events, increased cortisol secretion is due to hypothalamo-pituitary-adrenal axis activation. We aimed to investigate if cortisol variations during therapeutic hypothermia are associated with neurodevelopmental outcome. We compared 18 cases (neonates with birth asphyxia) with 18 controls (healthy term newborns) and confirmed increased serum cortisol concentrations following the peri-partum adverse event. Among cases, we stratified patients according to neurological outcome at 18 months (group A - good; group B - adverse) and found that after 24 h of therapeutic hypothermia serum cortisol concentration was significantly lower in group A vs group B (28.7 ng/mL vs 344 ng/mL, *p = 0.01). In group B serum, cortisol concentration decreased more gradually during therapeutic hypothermia. We conclude that monitoring serum cortisol concentration during neonatal therapeutic hypothermia can add information to clinical evaluation of neonates with birth asphyxia; cortisol values after the first 24 h of hypothermia can be a biomarker associated with neurodevelopmental outcome at 18 months of age. PMID:25394684

  5. Brain caspase-3 and intestinal FABP responses in preterm and term rats submitted to birth asphyxia

    Science.gov (United States)

    Figueira, R.L.; Gonçalves, F.L.; Simões, A.L.; Bernardino, C.A.; Lopes, L.S.; Castro e Silva, O.; Sbragia, L.

    2016-01-01

    Neonatal asphyxia can cause irreversible injury of multiple organs resulting in hypoxic-ischemic encephalopathy and necrotizing enterocolitis (NEC). This injury is dependent on time, severity, and gestational age, once the preterm babies need ventilator support. Our aim was to assess the different brain and intestinal effects of ischemia and reperfusion in neonate rats after birth anoxia and mechanical ventilation. Preterm and term neonates were divided into 8 subgroups (n=12/group): 1) preterm control (PTC), 2) preterm ventilated (PTV), 3) preterm asphyxiated (PTA), 4) preterm asphyxiated and ventilated (PTAV), 5) term control (TC), 6) term ventilated (TV), 7) term asphyxiated (TA), and 8) term asphyxiated and ventilated (TAV). We measured body, brain, and intestine weights and respective ratios [(BW), (BrW), (IW), (BrW/BW) and (IW/BW)]. Histology analysis and damage grading were performed in the brain (cortex/hippocampus) and intestine (jejunum/ileum) tissues, as well as immunohistochemistry analysis for caspase-3 and intestinal fatty acid-binding protein (I-FABP). IW was lower in the TA than in the other terms (Pmechanical ventilation, varied with gestational age, with increased expression of caspase-3 and I-FABP biomarkers. PMID:27356106

  6. Influences on the activities of tissue- type plasminogen activator of mouse brain in asphyxia%窒息对鼠脑分泌组织型纤溶酶原激活物的影响

    Institute of Scientific and Technical Information of China (English)

    徐剑文; 王玮; 康仲涵; 赵小贞; 张更

    2001-01-01

    Objective To observe the changes of the activity of tissue-type plasminogen activator(TPA) after asphyxia. Methods Asphyxia was induced in mouse pups by performing a‘ delayed cesarean section' . The experiment was designed for a control group and 4 asphyctic groups to detect the activity of TPA. Results TPA activity of brain increased after asphyxia (P<0.01). Conclusion TPA increased after asphyxia might be able to attack the basement membrane of microvessels, then opened the blood-brain barrier and induced neuronal damage.

  7. Monitoring of pain and stress in an infant with asphyxia during induced hypothermia: a case report.

    Science.gov (United States)

    Hoffman, Karin; Bromster, Therése; Hakansson, Stellan; van den Berg, Johannes

    2013-08-01

    The purpose of this article was to study an infant who suffered from asphyxia undergoing induced hypothermia with regard to (1) describe the pain and stress as measured by physiological variables skin conductance algesimeter (SCA) and pain rating scales, (2) the correlation between SCA and pain rating scales, and (3) how temperature cycles in the cooling blanket affect the response of the sympathetic nervous system as measured by the SCA and physiological variables. A single prospective case study was used for this article. Data were recorded every 15 minutes for 96 hours. Each observation was categorized according to treatment phase: cooling 0 to 72 hours, rewarming, and controlled normal temperature up to 96 hours. Structured observations were carried out and all nursing care was documented. In addition, 5 periods with no other nursing interventions were identified in which data were recorded every minute for analysis. Skin conductance algimetry showed a variable response during treatment. During cooling, 68% of the 15-minute periods, signs of stress and pain were recorded. During rewarming, the corresponding figure was 83%. During the time sequences with normal temperature, 89% of the periods were associated with stress and pain. During 80% of the nursing procedures, the SCA showed stress and pain. There was no correlation between the pain-rating scales and SCA. When the cooling blanket temperature was lower than core temperature, the infant had more stress and pain according to SCA (P heart rate and blood pressure (P < .001). In infants during induced hypothermia, SCA seem to detect pain and stress. Future evaluation of SCA for the detection of pain and stress during hypothermia treatment is necessary. Pain-rating scales do not appear reliable in this case report. PMID:23912017

  8. Reducing one million child deaths from birth asphyxia – a survey of health systems gaps and priorities

    Directory of Open Access Journals (Sweden)

    Manandhar Ananta

    2007-05-01

    Full Text Available Abstract Background Millions of child deaths and stillbirths are attributable to birth asphyxia, yet limited information is available to guide policy and practice, particularly at the community level. We surveyed selected policymakers, programme implementers and researchers to compile insights on policies, programmes, and research to reduce asphyxia-related deaths. Method A questionnaire was developed and pretested based on an extensive literature review, then sent by email (or airmail or fax, when necessary to 453 policymakers, programme implementers, and researchers active in child health, particularly at the community level. The survey was available in French and English and employed 5-point scales for respondents to rate effectiveness and feasibility of interventions and indicators. Open-ended questions permitted respondents to furnish additional details based on their experience. Significance testing was carried out using chi-square, F-test and Fisher's exact probability tests as appropriate. Results 173 individuals from 32 countries responded (44%. National newborn survival policies were reported to exist in 20 of 27 (74% developing countries represented, but respondents' answers were occasionally contradictory and revealed uncertainty about policy content, which may hinder policy implementation. Respondents emphasized confusing terminology and a lack of valid measurement indicators at community level as barriers to obtaining accurate data for decision making. Regarding interventions, birth preparedness and essential newborn care were considered both effective and feasible, while resuscitation at community level was considered less feasible. Respondents emphasized health systems strengthening for both supply and demand factors as programme priorities, particularly ensuring wide availability of skilled birth attendants, promotion of birth preparedness, and promotion of essential newborn care. Research priorities included operationalising

  9. Pressure passive cerebral blood flow and breakdown of the blood-brain barrier in experimental fetal asphyxia

    DEFF Research Database (Denmark)

    Lou, H C; Lassen, N A; Tweed, W A;

    1979-01-01

    mean arterial blood pressure in the fetuses by blood withdrawal or infusion in this state, CBF was measured at different perfusion pressures (mean arterial blood pressure (MABP) minus central venous pressure (CVP)). A passive flow/pressure relationship--loss of autoregulation--was found, with hyperemia...... reaching CBF values up to 6 times normal at normal MABP of about 60 to 70 mmHg, and severe ischemia reaching CBF values close to zero in large cortical areas at MABP of 30 mmHg. CVP remained essentially unchanged at 10--15 mmHg. The severe and prolonged asphyxia rendered the blood-brain barrier leaky to...

  10. Perinatal asphyxia results in altered expression of the hippocampal acylethanolamide/endocannabinoid signaling system associated to memory impairments in postweaned rats

    OpenAIRE

    Eduardo Blanco Calvo; Pablo Galeano

    2015-01-01

    Perinatal asphyxia (PA) is an obstetric complication that strongly affects the CNS. The endocannabinoid system (ECS) is a lipid transmitter system involved in several physiological processes including synaptic plasticity, neurogenesis, memory, and mood. Endocannabinoids, and other acylethanolamides (AEs) without endocannabinoid activity, have recently received growing attention due to their potential neuroprotective functions in neurological disorders, including cerebral ischemia. In the pres...

  11. 新生儿窒息血清微量元素观察%Analysis of the serum trace elements of newborns with asphyxia

    Institute of Scientific and Technical Information of China (English)

    李帅; 王荣刚

    2013-01-01

    目的 探讨新生儿窒息血清微量元素水平变化情况,分析不同窒息程度新生儿血清微量元素的差异.方法 选取2011年4月至2012年7月本院的53例窒息新生儿为观察组,同期的53例健康新生儿为对照组,将2组新生儿的血清锌、铁、硒、镁、钙及铜水平进行检测及比较,并将观察组中重度窒息者及轻度窒息者的上述指标进行比较.结果 观察组的血清锌、铁、硒、镁及钙水平均明显低于对照组,而血清铜水平则明显高于对照组,而观察组中重度窒息者的血清锌、铁、硒、镁及钙水平低于轻度窒息者,血清铜则高于轻度窒息者,差异有统计学意义(P<0.05).结论 窒息新生儿血清微量元素水平呈现异常状态,且重度窒息新生儿表现更为明显.%Objective To study the change state of serum trace elements of newborns with asphyxia and the differences of serum trace elements between different asphyxia degree.Methods A total of 53 newborns with asphyxia in our hospital from April 2011 to July 2012were selected as observation group,and 53 healthy newborns at the same time were selected as control group.Then the serum zinc,iron,selenium,magnesium,calcium and copper of two groups were compared,and these indexes of observation group with mild asphyxia and severe asphyxia were compared.Results The serum zinc,iron,selenium,magnesium and calcium of observation group were obviously lower than those of control group,serum copper was obvious higher than that of control group,while the serum zinc,iron,selenium,magnesium and calcium of observation group with severe asphyxia were lower than those with mild asphyxia,and serum copper was higher than those with mild asphyxia; there were significant differences (allP <0.05).Conclusion The serum trace elements of newborns with asphyxia show an abnormal state,and those of newborns with serve asphyxia were more obvious.

  12. Atrial fibrillation in rats induced by rapid transesophageal atrial pacing during brief episodes of asphyxia: A new in vivo model

    DEFF Research Database (Denmark)

    Haugan, K.; Lam, Henrik Rye; Knudsen, C. B.;

    2004-01-01

    anesthetized male Sprague-Dawley rats. AF was reproducibly induced in 81% of the rats. The presence of AF was associated with an increased heart rate, and a decreased blood pressure. Treatment with amiodarone, D,L-sotalol, flecainide, and propranolol all reduced duration of AF, whereas verapamil treatment was...... associated with a marked profibrillatory effect. Increasing gap junction intracellular communication using the antiarrhythmic peptide analogue AAP 10 did not affect AF duration. Basal plasma level of epinephrine and norepinephrine were increased 5- to 20-fold relative to values reported by others, but...... unchanged following 35 seconds of asphyxia. The results from our study demonstrate that the rat model shares several clinical key characteristics with human AF: (1) hemodynamic response to AF; (2) increased autonomic tone; (3) antiarrhythmic effects of clinically used drugs; (4) profibrillatory effect of...

  13. Iatrogenic scald injuries in Nigerian babies with perinatal asphyxia: A re-awakening call to strengthen primary health care services

    Directory of Open Access Journals (Sweden)

    Kuti Bankole Peter

    2015-01-01

    Full Text Available Birth asphyxia is a major cause of neonatal morbidity and mortality in developing countries. Majority of pregnant women in Nigeria still deliver their babies in places where there are no personnel skilled in essential obstetric care and neonatal resuscitation. Consequently newborns are poorly handled at delivery with resultant poor outcome. We report two cases of iatrogenic burns injuries from hot water formentation in an attempt to resuscitate two neonates at peripheral health care facilities in Ilesa, Nigeria. These babies needlessly sustained burns injuries coupled with hypoxic-ischaemic injuries and poor perinatal outcome. These unfortunate cases of "insults upon injuries" underscore the need to strengthen the primary health care system in Nigeria by training and retraining health workers at these facilities. Proper antenatal care, adequate screening of high risk pregnancy for delivery at adequately equipped centres and making efficient referral system available will go a long way in reducing these needless injuries and morbidities.

  14. Forensic Identification of 50 Cases of Aspiration Asphyxia Death%50例吸入性窒息死亡的法医学鉴定分析

    Institute of Scientific and Technical Information of China (English)

    刘钧; 石磊; 帅群; 雷普平; 于建云

    2013-01-01

    Objective To investigate the forensic identification points of deaths caused by aspiration asphyxia, and provide the help to daily work of forensic identification. Methods We collected 50 cases died of aspiration asphyxia in Judicial Identification of Center Kunming Medical University from 1990 to 2012, and retrospectively analyzed the gender, age, inhalation causes, choking sign, and obstructive site. Results Aspiration asphyxia was the most common in infants and young children, secondly in young adults. Newborn infants always died by amniotic fluid aspiration, babies got aspiration asphyxia based on diseases like pneumonia, encephalitis, and meningitis, and more reasons caused this in young adults. Choking signs were impacted by the factors like inhalation traits, inhaled amount, obstructive site, time of asphyxia process. Conclusion With the reference to the epidemiological characteristics above-mentioned of aspiration asphyxia death, combined with case scene, comprehensive necropsy, and toxicological examination in identification work, can make a scientific and objective appraisal conclusion.%目的 探讨吸入性窒息死亡案例的法医学鉴定要点,为其法医学鉴定工作提供帮助.方法 收集昆明医科大学司法鉴定中心1990年1月至2012年1月间吸入性窒息死亡案例50例,对吸入性窒息死亡案例的性别、年龄、吸入原因、窒息征象、堵塞部位等因素回顾性分析.结果 吸入性窒息常见于婴幼儿,其次是青壮年.新生儿多为羊水吸入,婴幼儿多在肺炎、脑炎、脑膜炎等疾病的基础上引发吸入性窒息,中青年吸入性窒息的发生原因则较多.窒息征象受吸入物性状、数量、堵塞部位、窒息过程的长短等多方面因素影响.结论 参考上述吸入性窒息死亡的流行病学特征,鉴定时结合现场、案情及全面系统的尸体检验、毒化检验,才能作出科学客观的鉴定结论.

  15. Life-long environmental enrichment counteracts spatial learning, reference and working memory deficits in middle-aged rats subjected to perinatal asphyxia

    Science.gov (United States)

    Galeano, Pablo; Blanco, Eduardo; Logica Tornatore, Tamara M. A.; Romero, Juan I.; Holubiec, Mariana I.; Rodríguez de Fonseca, Fernando; Capani, Francisco

    2015-01-01

    Continuous environmental stimulation induced by exposure to enriched environment (EE) has yielded cognitive benefits in different models of brain injury. Perinatal asphyxia results from a lack of oxygen supply to the fetus and is associated with long-lasting neurological deficits. However, the effects of EE in middle-aged rats suffering perinatal asphyxia are unknown. Therefore, the aim of the present study was to assess whether life-long exposure to EE could counteract the cognitive and behavioral alterations in middle-aged asphyctic rats. Experimental groups consisted of rats born vaginally (CTL), by cesarean section (C+), or by C+ following 19 min of asphyxia at birth (PA). At weaning, rats were assigned to standard (SE) or enriched environment (EE) for 18 months. During the last month of housing, animals were submitted to a behavioral test battery including Elevated Plus Maze, Open Field, Novel Object Recognition and Morris water maze (MWM). Results showed that middle-aged asphyctic rats, reared in SE, exhibited an impaired performance in the spatial reference and working memory versions of the MWM. EE was able to counteract these cognitive impairments. Moreover, EE improved the spatial learning performance of middle-aged CTL and C+ rats. On the other hand, all groups reared in SE did not differ in locomotor activity and anxiety levels, while EE reduced locomotion and anxiety, regardless of birth condition. Recognition memory was altered neither by birth condition nor by housing environment. These results support the importance of environmental stimulation across the lifespan to prevent cognitive deficits induced by perinatal asphyxia. PMID:25601829

  16. Life-long environmental enrichment counteracts spatial learning, reference and working memory deficits in middle-aged rats subjected to perinatal asphyxia

    Directory of Open Access Journals (Sweden)

    Pablo eGaleano

    2015-01-01

    Full Text Available Continuous environmental stimulation induced by exposure to enriched environment (EE has yielded cognitive benefits in different models of brain injury. Perinatal asphyxia results from a lack of oxygen supply to the fetus and is associated with long-lasting neurological deficits. However, the effects of EE in middle-aged rats suffering perinatal asphyxia are unknown. Therefore, the aim of the present study was to assess whether life-long exposure to EE could counteract the cognitive and behavioral alterations in middle-aged asphyctic rats. Experimental groups consisted of rats born vaginally (CTL, by cesarean section (C+, or by C+ following 19 min of asphyxia at birth (PA. At weaning, rats were assigned to standard (SE or enriched environment (EE for 18 months. During the last month of housing, animals were submitted to a behavioral test battery including Elevated Plus Maze, Open Field, Novel Object Recognition and Morris water maze (MWM. Results showed that middle-aged asphyctic rats, reared in SE, exhibited an impaired performance in the spatial reference and working memory versions of the MWM. EE was able to counteract these cognitive impairments. Moreover, EE improved the spatial learning performance of middle-aged CTL and C+ rats. On the other hand, all groups reared in SE did not differ in locomotor activity and anxiety levels, while EE reduced locomotion and anxiety, regardless of birth condition. Recognition memory was altered neither by birth condition nor by housing environment. These results support the importance of environmental stimulation across the lifespan to prevent cognitive deficits induced by perinatal asphyxia.

  17. Perinatal asphyxia as the leading cause of death and brain injury of newborns: prognosis and neuroprotection of long-term outcomes [

    Directory of Open Access Journals (Sweden)

    Herrera-Marschitz, Mario

    2007-11-01

    Full Text Available [english] Interruption of oxygen availability and re-oxygenation at birth implies a severe metabolic insult, affecting the development of the central nervous system (CNS, increasing its vulnerability to challenges occurring at adult stages. It has been reported that perinatal asphyxia produces regionally specific neuronal decrease and neurite atrophy in basal ganglia, and hippocampus. In hippocampus, a concomitant increase of neurogenesis and neurite hypertrophy has also been observed. The potential neuroprotection of nicotinamide, a non-selective inhibitor of poly (ADP-ribose polymerase (PARP-1, has been investigated, finding functional and morphological improvements when administered 24h after the insult (0.8 mmol/kg, i.p., 24, 48 and 72 h after birth.. The main effect of nicotinamide has been seen in neostriatum, preventing an asphyxia-induced decrease of the number of nNOS cells, and nNOS- and dopamine-like neurite atrophy. The present results support the idea that nicotinamide can prevent the effects elicited by a sustained energy-failure condition, as occurring during perinatal asphyxia, enlightening the enzyme PARP-1 as a novel target for neuronal protection. The support by FONDECYT, ICBM-Enlace, DAAD-CONICYT Programme-2007 grants is acknowledged.

  18. Importance of blood gas measurements in perinatal asphyxia and alternatives to restore the acid base balance status to improve the newborn performance

    Directory of Open Access Journals (Sweden)

    H. Orozco-Gregorio

    2007-01-01

    Full Text Available Prolonged or intermittent asphyxia in utero and during farrowing weakens piglets and renders them less capable of adaptation to extrauterine life. Piglets with lesser viability at birth have increased blood pCO2 and blood lactic acid concentrations and decreased blood pH. Moreover, the ability to thermoregulate during an acute cold stress is inversely related to umbilical blood lactate concentrations. Blood gas measurements and noninvasive estimations provide important information about oxygenation. The general goals of oxygen therapy in the neonate are to maintain adequate arterial PaO2 and SaO2, and to minimize cardiac work and the work of breathing. Arterial blood gas determinations of pCO2 provide the most accurate determinations of the adequacy of alveolar ventilation. Blood gases obtained in the immediate perinatal period can help assess perinatal asphyxia, but particular attention must be paid to the sampling site, the time of life, and the possible and proven diagnoses. The decision to obtain blood gases must be weighed by the individual clinician against the potential benefits. Current measures for restoring the acid base balance status in the newborn with perinatal asphyxia are discussed.

  19. Expression of intestinal trefoil factor, proliferating cell nuclear antigen and histological changes in intestine of rats after intrauterine asphyxia

    Institute of Scientific and Technical Information of China (English)

    Ling-Fen Xu; Jun Li; Mei Sun; Hong-Wei Sun

    2005-01-01

    AIM: To study the expressions of intestinal trefoil factor (ITF) and proliferating cell nuclear antigen (PCNA) and histologic changes in intestine, to investigate the relationship between ITF and intestinal damage and repair after intrauterine hypoxia so as to understand the mechanism of intestinal injury and to find a new way to prevent and treat gastrointestinal diseases.METHODS: Wistar rats, pregnant for 21 d, were used to establish animal models of intrauterine asphyxia by clamping one side of vessels supplying blood to uterus for 20 min, another side was regarded as sham operation group. Intestinal tissues were taken away at 0, 24, 48and 72 h after birth and stored in different styles. ITF mRNA was detected by RT-PCR. PCNA expression was measured by immunohistochemistry. Intestinal tissues were studied histologically by HE staining in order to observe the areas and degree of injury and to value the intestinal mucosa injury index (IMDI).RESULTS: ITF mRNA appeared in full-term rats and increased with age. After ischemia, ITF mRNA was decreased to the minimum (0.59±0.032) 24 h after birth, then began to increase higher after 72 h than it was in the control group (P<0.01). PCNA positive staining located in goblet cell nuclei. The PCNA level had a remarkable decline (53.29±1.97) 48 h after ischemia. Structure changes were obvious in 48-h group, IMDI (3.40±0.16) was significantly increased. Correlation analyses showed that IMDI had a negative correlation with ITF mRNA and PCNA (r = -0.543,P<0.05; r = -0.794, P<0.01, respectively).CONCLUSION: Intrauterine ischemia can result in an early decrease of ITF mRNA expression. ITF and PCNA may play an important role in the damage and repair of intestinal mucosa.

  20. Inter-pregnancy Weight Change and Risks of Severe Birth-Asphyxia-Related Outcomes in Singleton Infants Born at Term: A Nationwide Swedish Cohort Study

    Science.gov (United States)

    Johansson, Stefan; Cnattingius, Sven

    2016-01-01

    Background Maternal overweight and obesity are associated with increased risks of birth-asphyxia-related outcomes, but the mechanisms are unclear. If a change of exposure (i.e., maternal body mass index [BMI]) over time influences risks, this would be consistent with a causal relationship between maternal BMI and offspring risks. Our objective was to investigate associations between changes in maternal BMI between consecutive pregnancies and risks of birth-asphyxia-related outcomes in the second offspring born at term. Methods and Findings This study was a prospective population-based cohort study that included 526,435 second-born term (≥37 wk) infants of mothers with two consecutive live singleton term births in Sweden between January 1992 and December 2012. We estimated associations between the difference in maternal BMI between the first and second pregnancy and risks of low Apgar score (0–6) at 5 min, neonatal seizures, and meconium aspiration in the second-born offspring. Odds ratios (ORs) were adjusted for BMI at first pregnancy, maternal height, maternal age at second delivery, smoking, education, mother´s country of birth, inter-pregnancy interval, and year of second delivery. Analyses were also stratified by BMI (pregnancy. Risks of low Apgar score, neonatal seizures, and meconium aspiration increased with inter-pregnancy weight gain. Compared with offspring of mothers with stable weight (BMI change of −1 to pregnancy. A study limitation was the lack of data on the effects of obstetric interventions and neonatal resuscitation efforts. Conclusions Risks of birth-asphyxia-related outcomes increased with maternal weight gain between pregnancies. Preventing weight gain before and in between pregnancies may improve neonatal health. PMID:27270217

  1. 集体外伤后儿童心理健康随访研究%Mental Health of Adolescents Suffered from Traumatic Asphyxia

    Institute of Scientific and Technical Information of China (English)

    赵映敏; 陈沛文

    2001-01-01

    目的:探讨集体外伤后患儿的心理健康状况。方法:使用症状自评量表(SCL-90)、艾森克个性测量问卷(EPQ)、于外伤窒息后1周、6周、10周、16周、34周对44例外伤性窒息患儿的心理健康状况进行跟踪调查,精神创伤后应激障碍(PTSD)按CCMD-2-R标准进行诊断。结果:全部患儿外伤后均有不同程度的应激反应,1周内有19例患儿、6周时有10例患儿符合PTSD诊断,其中8例患儿于34周后恢复正常。结论:外伤性窒息治疗中应重视对患儿精神状态的观察,对有心理障碍者应及时进行适当处理。%Objective: To explore the effect of traumatic asphyxia on mental health of adolescents. Method: Forty-four adolescents were assessed with Styles Questionnaire (SCL-90), Eysenck Personality Questionnaire (EPQ) after one week, 6 weeks, 10 weeks, 16 weeks and 34 weeks of asphyxia. Post-traumatic Stress Disorder (PTSD) was diagnosed according to CCMD-2-R. Results: All 44 adolescents suffered from traumatic asphyxia had some psychiatric symptoms. Nineteen of them fulfilled the symptomatic criterta of DTSD in the first week,10 of them were diagnosed as PTSD at the 6th week,8 of the them returned to normal after 34 weeks. Conclusion: Mental health of adolescents suffered from traumatic asphyxia need our attention.

  2. The prognostic value of multivoxel magnetic resonance spectroscopy determined metabolite levels in white and grey matter brain tissue for adverse outcome in term newborns following perinatal asphyxia

    Energy Technology Data Exchange (ETDEWEB)

    Doormaal, Pieter Jan van [University Medical Center Groningen and University of Groningen, Department of Pediatrics, Division of Neonatology, Groningen (Netherlands); Meander Medical Center Amersfoort, Department of Radiology, PO Box 1502, Amersfoort (Netherlands); Meiners, Linda C.; Sijens, Paul E. [University Medical Center Groningen and University of Groningen, Department of Radiology, Groningen (Netherlands); Horst, Hendrik J. ter; Veere, Christa N. van der [University Medical Center Groningen and University of Groningen, Department of Pediatrics, Division of Neonatology, Groningen (Netherlands)

    2012-04-15

    Magnetic resonance spectroscopy can identify brain metabolic changes in perinatal asphyxia by providing ratios of metabolites, such as choline (Cho), creatine (Cr), N-acetyl aspartate (NAA) and lactate (Lact) [Cho/Cr, Lact/NAA, etc.]. The purpose of this study was to quantify the separate white and grey matter metabolites in a slab cranial to the ventricles and relate these to the outcome. A standard 2D-chemical shift imaging protocol was used for measuring a transverse volume of interest located cranial to the ventricles allowing for direct comparison of the metabolites in white and grey matter brain tissue in 24 term asphyxiated newborns aged 3 to 16 days. Cho, NAA and Lact showed significant differences between four subgroups of asphyxiated infants with more and less favourable outcomes. High levels of Cho and Lact in the grey matter differentiated non-survivors from survivors (P = 0.003 and P = 0.017, respectively). In perinatal asphyxia the levels of Cho, NAA and Lact in both white and grey matter brain tissue are affected. The levels of Cho and Lact measured in the grey matter are the most indicative of survival. It is therefore advised to include grey matter brain tissue in the region of interest examined by multivoxel MR spectroscopy. (orig.)

  3. Efficacy of creatine phosphate sodium on myocardial ischemia in neonatal asphyxia%磷酸肌酸钠治疗新生儿窒息心肌缺血

    Institute of Scientific and Technical Information of China (English)

    张佳磊

    2015-01-01

    目的:探讨磷酸肌酸钠治疗新生儿窒息心肌缺血的疗效。方法选择2013年1月至2014年11月新生儿窒息致心肌缺血的早产儿53例,随机分为实验组27例和对照组26例。对照组给予维生素 C 和三磷酸腺苷的常规治疗,实验组在此基础上加用磷酸肌酸钠。比较两组疗效。结果实验组总有效率为81.5%,对照组为53.8%,实验组总有效率高于对照组,差异有统计学意义(P <0.05)。结论磷酸肌酸钠治疗新生儿窒息心肌缺血有效,值得临床应用。%Objective To investigate the efficacy of creatine phosphate sodiym on myocardial ischemia in neonatal asphyxia. Methods From Janyary 2013 to November 2014,53 patients with myocardial ischemia in neonatal asphyxia were selected,and they were randomly divided into control groyp with 26 cases and experimental groyp with 27 caces. The control groyp was given the conventional treatment of vitamin C and adenosine triphosphate,the experimental groyp based on the yse of creatine phos-phate sodiym. The effects of the two groyps were observed. Results The total effective rate of experimental groyp was 81. 5% , while that of control groyp was 53. 8% ,the difference was significant(P < 0. 05). Conclusion Creatine phosphate sodiym has positive effect on neonatal asphyxia with myocardial damage,so it is worthy of application.

  4. 新生儿窒息后肾损害的阴离子间隙分析%Analysis on Anion Gap of Neonates with Renal Injury after Asphyxia

    Institute of Scientific and Technical Information of China (English)

    任青; 张兴芳

    2014-01-01

    目的:分析窒息后肾功能损害新生儿的阴离子间隙(AG)变化及其与肾损害的关系。方法首先测定151例窒息新生儿的血尿素氮(BUN)、肌酐(Cr)、电解质、动脉血气分析;然后,从中选取肾损害新生儿60例,并同时测定30例正常足月儿的上述指标,计算AG值并分析。结果窒息后肾损害的60例新生儿,代谢性酸中毒发生率为76.7%,且以高AG代酸为主,随窒息程度的加重,BUN、Cr无明显变化。结论窒息后肾功能损害新生儿血AG值可明显异常,需及时处理,BUN、Cr不能早期反映新生儿肾损害。%Objective To analysis the changes of anion gap (AG) and discuss the relationship between AG and renal function of the neonates with renal injury after asphyxia. Methods Firstly, interval index of serum BUN, Cr, electrolytes, artery blood gas analysis was detected in 151 cases of neonatal asphyxia. Then, 60 cases of neonates with renal injury were selected from them and the same interval index of 30 cases of normal term infants was also detected. The AG value was calculated and analyzed. Results In 60 cases of neonates with renal injury after asphyxia, the incidence of metabolic acidosis was 76.7%, especially metabolic acidosis with high AG. With the severity of asphyxia, serum BUN and Cr made no obvious changes. Conclusion AG in neonates with renal injury after asphyxia changed significantly and should be treated promptly, BUN and Cr were not early indicators of neonates with renal injury.

  5. Perinatal asphyxia results in altered expression of the hippocampal acylethanolamide/endocannabinoid signaling system associated to memory impairments in postweaned rats

    Science.gov (United States)

    Blanco, Eduardo; Galeano, Pablo; Holubiec, Mariana I.; Romero, Juan I.; Logica, Tamara; Rivera, Patricia; Pavón, Francisco J.; Suarez, Juan; Capani, Francisco; Rodríguez de Fonseca, Fernando

    2015-01-01

    Perinatal asphyxia (PA) is an obstetric complication that strongly affects the CNS. The endocannabinoid system (ECS) is a lipid transmitter system involved in several physiological processes including synaptic plasticity, neurogenesis, memory, and mood. Endocannabinoids, and other acylethanolamides (AEs) without endocannabinoid activity, have recently received growing attention due to their potential neuroprotective functions in neurological disorders, including cerebral ischemia. In the present study, we aimed to analyze the changes produced by PA in the major metabolic enzymes and receptors of the ECS/AEs in the hippocampus using a rodent model of PA. To induce PA, we removed uterine horns from ready-to-deliver rats and immersed them into a water bath during 19 min. Animals delivered spontaneously or by cesarean section were employed as controls. At 1 month of age, cognitive functions were assessed and immunohistochemical procedures were carried out to determine the expression of NeuN and glial fibrillary acidic protein, enzymes responsible for synthesis (DAGLα and NAPE-PLD) and degradation (FAAH) of ECS/AEs and their receptors (CB1 and PPARα) in the hippocampus. Postweaned asphyctic rats showed impaired recognition and spatial reference memory that were accompanied by hippocampal astrogliosis and changes in the expression of enzymes and receptors. The most remarkable findings in asphyctic rats were a decrease in the expression of NAPE-PLD and PPARα in both hippocampal areas CA1 and CA3. In addition, postweaned cesarean delivery rats showed an increase in the immunolabeling for FAAH in the hippocampal CA3 area. Since, NAPE-PLD and PPARα are proteins that participate in the biochemical process of AEs, specially the neuroprotective oleoylethanolamide, these results suggest that PA dysregulates this system. These data encourage conducting future studies using AEs as potential neuroprotective compounds in animal models of PA. PMID:26578900

  6. Perinatal asphyxia results in altered expression of the hippocampal acylethanolamide/endocannabinoid signaling system associated to memory impairments in postweaned rats.

    Science.gov (United States)

    Blanco, Eduardo; Galeano, Pablo; Holubiec, Mariana I; Romero, Juan I; Logica, Tamara; Rivera, Patricia; Pavón, Francisco J; Suarez, Juan; Capani, Francisco; Rodríguez de Fonseca, Fernando

    2015-01-01

    Perinatal asphyxia (PA) is an obstetric complication that strongly affects the CNS. The endocannabinoid system (ECS) is a lipid transmitter system involved in several physiological processes including synaptic plasticity, neurogenesis, memory, and mood. Endocannabinoids, and other acylethanolamides (AEs) without endocannabinoid activity, have recently received growing attention due to their potential neuroprotective functions in neurological disorders, including cerebral ischemia. In the present study, we aimed to analyze the changes produced by PA in the major metabolic enzymes and receptors of the ECS/AEs in the hippocampus using a rodent model of PA. To induce PA, we removed uterine horns from ready-to-deliver rats and immersed them into a water bath during 19 min. Animals delivered spontaneously or by cesarean section were employed as controls. At 1 month of age, cognitive functions were assessed and immunohistochemical procedures were carried out to determine the expression of NeuN and glial fibrillary acidic protein, enzymes responsible for synthesis (DAGLα and NAPE-PLD) and degradation (FAAH) of ECS/AEs and their receptors (CB1 and PPARα) in the hippocampus. Postweaned asphyctic rats showed impaired recognition and spatial reference memory that were accompanied by hippocampal astrogliosis and changes in the expression of enzymes and receptors. The most remarkable findings in asphyctic rats were a decrease in the expression of NAPE-PLD and PPARα in both hippocampal areas CA1 and CA3. In addition, postweaned cesarean delivery rats showed an increase in the immunolabeling for FAAH in the hippocampal CA3 area. Since, NAPE-PLD and PPARα are proteins that participate in the biochemical process of AEs, specially the neuroprotective oleoylethanolamide, these results suggest that PA dysregulates this system. These data encourage conducting future studies using AEs as potential neuroprotective compounds in animal models of PA. PMID:26578900

  7. Perinatal asphyxia results in altered expression of the hippocampal acylethanolamide/endocannabinoid signaling system associated to memory impairments in postweaned rats

    Directory of Open Access Journals (Sweden)

    Eduardo Blanco Calvo

    2015-11-01

    Full Text Available Perinatal asphyxia (PA is an obstetric complication that strongly affects the CNS. The endocannabinoid system (ECS is a lipid transmitter system involved in several physiological processes including synaptic plasticity, neurogenesis, memory and mood. Endocannabinoids, and other acylethanolamides (AEs without endocannabinoid activity, have recently received growing attention as they have potential neuroprotective functions in neurological disorders, including cerebral ischemia. In the present study, we aimed to analyze the changes produced by PA in the major metabolic enzymes and receptors of the ECS/AEs in the hippocampus using a rodent model of PA. To induce PA, we removed uterine horns from ready-to-deliver rats and immersed them into a water bath during 19 min. Animals that were delivered spontaneously or by caesarean section were employed as controls. At one month of age, cognitive functions were assessed and immunohistochemical procedures were carried out to determine the expression of NeuN and GFAP, enzymes responsible for synthesis (DAGLα and NAPE-PLD and degradation (FAAH of ECS/AEs and their receptors (CB1 and PPARα in the hippocampus. Postweaned asphyctic rats showed impaired recognition and spatial reference memory that were accompanied by hippocampal astrogliosis and changes in the expression of enzymes and receptors. The most remarkable findings in asphyctic rats were a decrease in the expression of NAPE-PLD and PPARα in both hippocampal areas CA1 and CA3. In addition, postweaned cesarean delivery rats showed an increase in the immunolabeling for FAAH in the hippocampal CA3 area. Since NAPE-PLD and PPARα are proteins that participate in the biochemical process of AEs, specially the neuroprotective oleoylethanolamide, these results suggest that PA dysregulates this system. These data encourage conducting future studies using AEs as potential neuroprotective compounds in animal models of PA.

  8. 新生儿窒息多器官损害发生率、高危因素和转归的多中心研究%Incidence, risk factors and outcomes of multiple organ damage after neonatal asphyxia

    Institute of Scientific and Technical Information of China (English)

    新生儿窒息多器官损害临床诊断多中心研究协作组

    2016-01-01

    重度窒息,且合并严重代谢性酸中毒时更严重。%ObjectiveTo investigate the incidence, risk factors and outcomes of multiple organ damage (MOD) after neonatal asphyxia and formulate the diagnostic criteria of MOD, in order to strengthen the management of neonatal asphyxia and provide evidences for reduction of the mortality and disability rate of asphyxia newborns.MethodsTotally, 487 asphyxiated newborns, who were term neonates or preterm neonates with fetal age over 34 weeks and birth weight over 2 500 g and admitted to hospitals included in the collaboration group from November 2012 to February 2015 were selected. Neonatal asphyxia was diagnosed based on Apgar score, and all recruited newborns were divided into mild and severe groups, and those in severe group were devided into two subgroups (GroupⅠ and groupⅡ). GroupⅠ included those babies with severe asphyxia and serious metabolic acidosis (pH≤7 and/or base excess≤-16 mmol/L) and groupⅡ were those without serious metabolism acidosis group (7asphyxia, 371 were mild asphyxia and 116 were severe ones. Altogether, 232 out of the 487 babies (47.6%) developed multiple organ injury of asphyxia. More MOD babies were seen in the severe asphyxia group than in the mild asphyxia group [79.3% (92/116) vs 37.7% (140/371),χ2=59.58,P<0.01]. (2) Babies with MOD after asphyxia were more likely to be born by emergency cesarean delivery [14.7% (34/232) vs 5.9% (15/255)], but less likely to have regular prenatal care [57.8% (134/232) vs 89.8% (229/255)] (χ2=9.04 and 65.73, allP<0.01). (3) Incidence of MOD in group I was significantly higher than that in groupⅡ [90.7% (39/43) vs 73.0% (27/37),χ2=11.36,P<0.01];(4) The median hospital stay of MOD newborns was longer than that of non-MOD ones [11 (8-15) vs 8 (6-9) d, P<0.01], the recovery rate

  9. Management of Tetanus Neonatorum in a respiratory unit

    Directory of Open Access Journals (Sweden)

    C. Sikosana

    1979-09-01

    Full Text Available Tetanus results from infection by clostridium tetani, which is present in the faeces of animals and man therefore also in the soil. It enters the body through a wound; in the case of a neonate, this is always the raw surface of the umbilicus. The infection of this wound occurs by contamination of cord dressings by dust or soil, but in some cases mothers apply cow dung to the umbilicus. In some cases the umbilical cord is cut with an unsterile blade or even an old broken bottle. The baby is usually born at home.

  10. Effect of neonatal asphyxia on the impairment of the auditory pathway by recording auditory brainstem responses in newborn piglets: a new experimentation model to study the perinatal hypoxic-ischemic damage on the auditory system.

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    Francisco Jose Alvarez

    Full Text Available Hypoxia-ischemia (HI is a major perinatal problem that results in severe damage to the brain impairing the normal development of the auditory system. The purpose of the present study is to study the effect of perinatal asphyxia on the auditory pathway by recording auditory brain responses in a novel animal experimentation model in newborn piglets.Hypoxia-ischemia was induced to 1.3 day-old piglets by clamping 30 minutes both carotid arteries by vascular occluders and lowering the fraction of inspired oxygen. We compared the Auditory Brain Responses (ABRs of newborn piglets exposed to acute hypoxia/ischemia (n = 6 and a control group with no such exposure (n = 10. ABRs were recorded for both ears before the start of the experiment (baseline, after 30 minutes of HI injury, and every 30 minutes during 6 h after the HI injury.Auditory brain responses were altered during the hypoxic-ischemic insult but recovered 30-60 minutes later. Hypoxia/ischemia seemed to induce auditory functional damage by increasing I-V latencies and decreasing wave I, III and V amplitudes, although differences were not significant.The described experimental model of hypoxia-ischemia in newborn piglets may be useful for studying the effect of perinatal asphyxia on the impairment of the auditory pathway.

  11. 脐动脉血血气分析对新生儿窒息的预后评估价值%Gas analysis of umbilical cord artery blood on predicating the prognosis of asphyxia neonate

    Institute of Scientific and Technical Information of China (English)

    曹棨; 潘革; 莫锦丽; 何潇; 农常亮; 黄芬

    2016-01-01

    目的:探讨脐动脉血与桡动脉血血气分析在缺氧新生儿预后评估中的临床应用价值。方法选取2014年9月至2015年9月我院分娩的足月新生儿328例,根据Apgar评分分为重度窒息组11例、轻度窒息组27例、健康对照组290例,出生后取脐动脉血、桡动脉血行血气分析,计算氧合指数,定期随访窒息组新生儿行为神经评估( NBNA)结果,分析其与脐动脉血血气分析pH值之间的关系。结果重度窒息组脐动脉血的pH值、PO2、PCO2、氧合指数分别为7�11±0�25、(73�93±23�35) mmHg、(51�36±16�37) mmHg、206�23±98�12,与轻度窒息组[7�24±0�05、(86�35±12�56) mmHg、(45�89±9�21) mmHg、411�22±57�94]和健康对照组[7�28±0�08、(87�80±12�07) mmHg、(43�68±6�45) mmHg、426�23±73�30]比较,差异均有统计学意义( P均<0�05);桡动脉血 pH 值、PO2、PCO2、氧合指数分别为7�25±0�18、(74�66±24�09) mmHg、(51�42±17�83) mmHg、332�03±65�19,与轻度窒息组[7�31±0�09、(87�24±11�75) mmHg、(45�73±10�21) mmHg、405�67±82�65]和健康对照组[7�32±0�06、(87�99±11�81) mmHg、(42�84±9�32) mmHg、439�89±60�76]比较差异均有统计学意义(P均<0�05);重度窒息组NBNA为(34�09±5�02)分,低于轻度窒息组[(36�62±2�04)分],差异有统计学意义(F=21�65,P<0�05);重度窒息组脐动脉血pH值与NBNA呈正相关( r=0�877,P<0�01)。结论重度窒息组脐动脉血与桡动脉血血气分析的pH值、PO2、氧合指数下降,PCO2升高。重度窒息组NBNA与脐动脉血气分析pH值相关,脐动脉血气分析pH值有助于评估新生儿近期预后。%Objective To study the gas analysis of umbilical cord artery blood and radial artery blood on predicating the prognosis of asphyxia neonate

  12. Compensatory rebound of body movements during sleep, after asphyxia in neonatal rats Resposta compensatória dos movimentos corporais do sono após a asfixia em ratos recém-nascidos

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    Olivia Adayr Xavier Suarez

    2008-06-01

    Full Text Available PURPOSE: The usefulness of body movements that occur during sleep when assessing perinatal asphyxia and predicting its long-term consequences is contradictory. This study investigated whether neonatal rats manifest these movements in compensatory rebound after asphyxia, and if these alterations play an important role in its pathogenesis. METHODS: Eight neonatal rats (aged 6-48h were implanted with small EMG and EKG electrodes and sleep movements were recorded over a 30-minute control period. Recordings were continued during asphyxia caused by the enclosure of the animal in a polyvinyl sheet for 60 minutes, followed by a 30-minute recovery period. RESULTS: Heart rate was lowered to bradycardic level during asphyxia causing behavioral agitation and increased waking time during the initial phase (30 minutes. Sleep-related movements were also significantly reduced from 12.5 ± 0.5 (median ± SE/2min to 9.0 ± 0.44 in the final half of the period (Anova, pOBJETIVO: A utilidade dos movimentos corporais (MC que ocorrem durante o sono para diagnosticar e predizer as conseqüências, em longo prazo, da asfixia perinatal é contraditório. Este estudo investigou se ratos recém-nascidos (RN manifestam MC em resposta compensatória à asfixia, e se estas alterações podem ter alguma importância na sua patogênese. MÉTODOS: Oito ratos RN (6-48h de vida foram submetidos à implantação de pequenos eletrodos para registros da eletromiografia e eletrocardiografia. Os MC e a freqüência cardíaca (FC foram registrados durante períodos de 30 min: fase controle (F1, fases de asfixia (F2; F3 e fase de recuperação pós-asfixia (F4. A asfixia foi promovida pelo envolvimento completo do animal com uma lâmina de polivinil. RESULTADOS: A FC diminuiu progressivamente durante F2 e F3 até a bradicardia. Em F2 houve grande agitação dos animais e aumento dos períodos de vigília. Em F3 houve redução significante dos MC de 12,5 ± 0,5 (Md ± SE/2min para 9,0

  13. 血乳酸联合血糖监测在产后新生儿窒息诊断中的应用%Application of the monitoring of blood lactic acid and blood sugar levels in the diagnosis of postpartum neonatal asphyxia

    Institute of Scientific and Technical Information of China (English)

    罗孝华

    2014-01-01

    Objective:To investigate the role of the monitoring of blood lactic acid and blood sugar levels in the diagnosis of postpartum neonatal asphyxia. Methods:Eighty newborns with asphyxia in our hospital from February, 2013 to March, 2014 were selected as an observation group and meanwhile 30 cases healthy newborns as a control group. Blood lactate and blood sugar levels in two groups were compared. The relationship between postpartum neonatal asphyxia and both blood lactate and blood sugar levels and risk factors of postpartum neonatal asphyxia were analyzed. Results:Blood lactate and blood sugar levels in the observation group were (5.86±2.18) mmol/L and (5.15±2.26) mmol/L, which were signiifcantly higher than the (2.81±0.49) mmol/L and (2.74±0.62) mmol/L in the control group (P<0.05). The results of Pearson correlation analysis showed that both blood lactate and blood sugar levels were negatively correlated with postpartum neonatal asphyxia (P<0.05). The results of Logistic multivariate regression analysis showed that the risk factors resulting in postpartum newborns asphyxia were ascribed to the high levels of blood lactic acid, blood sugar and indirect bilirubin and blood pressure, etc. Conclusion:The levels of both blood lactic acid and blood sugar may be as an important predictors for postpartum neonatal asphyxia, which can be used for the auxiliary diagnosis of postpartum neonatal asphyxia.%目的:探讨血乳酸联合血糖监测在产后新生儿窒息诊断中的应用价值。方法:选取2013年2月-2014年3月在我院出生的80例发生窒息的新生儿为观察组,并选取同期健康新生儿30例作为对照组。统计分析两组血乳酸和血糖水平与新生儿窒息的关系并进行产后新生儿窒息发生的危险因素的多因素分析。结果:观察组血乳酸和血糖水平分别为(5.86±2.18)mmol/L和(5.15±2.26)mmol/L,显著高于对照组的(2.81±0.49)mmol/L和(2.74±0.62)mmol/L,

  14. Umbilical artery blood gas analysis in the diagnosis of multiple organ damage of neonatal asphyxia%新生儿脐动脉血气分析在新生儿窒息多器官损害诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    全国新生儿窒息多器官损害临床诊断多中心研究协作组

    2016-01-01

    Objective To study the relationship between umbilical arterial blood gas analysis and perinatal high risk factors, Apgar score and multiple organ damage of neonatal asphyxia. Methods Clinical data of cases of neonatal asphyxia in from the Neonatal Department and Intensive Care Unit of our research group from November 2012 to December 2014 were studied. Full term infants and premature infants ( gestational age >34 weeks, birth weight >2500 g) with neonatal asphyxia, whose umbilical artery blood gas analysis ( including pH and BE) were tested were enrolled in our study. Neonatal asphyxia was diagnosed according to the Apgar score, umbilical artery blood gas analysis, mild asphyxia group and severe asphyxia group were assigned into three groups respectively: severe metabolic acidosis group: pH≤7 and/or BE≤-16 mmol/L; non-severe metabolic acidosis group:77. 2, BE> -8 mmol/L. The diagnosis of multiple organ damage of neonatal asphyxia was made according to the history of perinatal hypoxia,clinical manifestations,laboratory examination and imaging examination.Results Therewere 111 cases in our study ( mild asphyxia: n =79 , severe asphyxia: n =32 ) . ( 1 ) The pH and BE of umbilical artery blood gas were positively related to 1 minute Apgar score ( pH: r=0. 223, P=0. 016;BE: r=0. 293, P=0. 002). (2) Multi-factor analysis of umbilical artery blood pH and BE showed that abnormal fetal heart rate was an important factor (β =0. 080 , 95℅ CI 0. 010 -0. 160 , P =0. 025 ) . (3) The incidence of multiple organ damage in severe asphyxia group was significantly higher than that in mild asphyxia group (75. 0℅ vs. 29. 1℅, Χ2 =17. 810, P34周、生后检测脐动脉血pH和BE的窒息新生儿,根据Apgar评分诊断新生儿窒息,根据脐血血气分析将轻度窒息组和重度窒息组分别分为严重代谢性酸中毒组(pH≤7和/或BE≤-16mmol/L)、非严重代谢性酸中毒组(77.2且BE>-8).根据围产期缺氧病史、临床表现、实验室检查和影

  15. Thermopharmacology of anticonvulsive treatment after perinatal asphyxia

    NARCIS (Netherlands)

    van den Broek, M.P.H.

    2013-01-01

    Therapeutic hypothermia in the immediate postnatal period has been shown to be a successful strategy for neuroprotection in encephalopathic newborns in clinical trials. Due to the effect of hypothermia on physiological functions, such as heart rate and liver enzyme metabolic capacity, as well as eff

  16. Acute kidney injury in asphyxiated neonates

    Directory of Open Access Journals (Sweden)

    Roy Amardiyanto

    2013-07-01

    Full Text Available Background Asphyxia neonatorum may result in multiorgan dysfunction including renal involvement. There is no consensus on the determination of acute kidney injury (AKI in neonates making establishment of the diagnosis and its management becomes difficult. The Acute Kidney Injury Network (AKIN recommends AKI criteria based on increased serum creatinine level and reduced urine output. Objectives To identify the prevalence of AKI in asphyxiated neonates using the AKIN criteria, to compare the difference of AKI stages, and the glomerular filtration rates (GFR between moderate and severe asphyxia. Methods This was a cross-sectional analytical study conducted between July 2012 and January 2013. Subjects were all asphyxiated neonates (Apgar score 35 weeks delivered and hospitalized in Cipto Mangunkusumo Hospital and Koja District Hospital, Jakarta, Indonesia. Glomerular filtration rate was calculated using the components of urine creatinine, serum creatinine, and urine output; while AKI stages were determined according to AKIN criteria. Urinary output was measured via urethral catheterization. Results Of 94 subjects, there were 70 neonates with moderate and 24 neonates with severe asphyxia, with the prevalence of AKI was 63%. Twenty one out of 24 neonates with severe asphyxia experienced AKI, while neonates with moderate asphyxia who experienced AKI was 38 out of 70 subjects (54%. Two third of neonates with severe asphyxia who experienced AKI had stage 3 of AKI. More severe AKI stages and lower median GFR were found in neonates with severe compared to moderate asphyxia (P<0.001. Conclusion The prevalence of AKI in neonatal asphyxia is high (63%. The more severe degree of neonatal asphyxia, the more severe AKI stage and the lower median GFR. [Paediatr Indones. 2013;53:232-8.].

  17. Icterus Neonatorum in Near-Term and Term Infants: An overview

    OpenAIRE

    Rehan Ali; Shakeel Ahmed; Maqbool Qadir; Khalil Ahmad

    2012-01-01

    Neonatal jaundice is the yellowish discoloration of the skin and/or sclerae of newborn infants caused by tissue deposition of bilirubin. Physiological jaundice is mild, unconjugated (indirect-reacting) bilirubinaemia, and affects nearly all newborns. Physiological jaundice levels typically peak at 5 to 6 mg/dL (86 to 103 μmol/L) at 72 to 96 hours of age, and do not exceed 17 to 18 mg/dL (291–308 μmol/L). Levels may not peak until seven days of age in Asian infants, or in infants born at 35 to...

  18. Asfixia perinatal associada à mortalidade neonatal precoce: estudo populacional dos óbitos evitáveis Asfixia perinatal asociada a la mortalidad neonatal temprana: estudio de población de los óbitos evitables Perinatal asphyxia associated with early neonatal mortality: populational study of avoidable deaths

    Directory of Open Access Journals (Sweden)

    Mandira Daripa

    2013-03-01

    TODOS: Cohorte de población constituida por 2.873 óbitos evitables hasta seis días de vida asociados a la asfixia perinatal ocurridos entre enero de 2001 y diciembre de 2003. Se consideró como asfixia perinatal la presencia de hipoxia intraútero, asfixia al nacer o síndrome de aspiración de meconio en cualquier línea de la Declaración de Óbito original. Variables epidemiológicas también fueron extraídas de las Declaraciones de Nacido Vivo. RESULTADOS: En el trienio, 1,71 muertes por 1.000 nacidos vivos estaban asociadas a la asfixia perinatal, correspondiendo al 22% de los óbitos neonatales tempranos. De los 2.873 óbitos evitables, 761 (27% tuvieron lugar en São Paulo, capital; 640 (22%, en la región metropolitana de la capital; y 1.472 (51% en el interior de la provincia. En las dos primeras regiones predominaron las muertes en hospitales públicos, recién nacidos con edad gestacional inferior a 37 semanas y peso inferior a 2.500g. En el interior, los óbitos fueron más frecuentes en entidades benéficas, recién nacidos a término y con peso superior a 2.500g. La mayoría de los bebés nació durante el día en el municipio de residencia materna y evolucionó a óbito en el hospital de nacimiento hasta 24 horas después del parto. El síndrome de aspiración de meconio estuvo presente en el 18% de los óbitos. CONCLUSIONES: La asfixia perinatal es un contribuyente frecuente a la muerte neonatal temprana evitable en la provincia con el más grande producto interno bruto per capita de Brasil, lo que evidencia la necesidad de intervenciones específicas con enfoque regionalizado en la asistencia al parto y al nacimiento.OBJECTIVE: To compare the epidemiological profile of avoidable early neonatal deaths associated with perinatal asphyxia according to region of death in the State of São Paulo, Brazil. METHODS: Population-based cohort study including 2,873 avoidable deaths up to six days of life associated with perinatal asphyxia from January 2001 to December

  19. Effect of Simo decoction,Clostridium butyricnm powder in treatment of neonatal asphyxia during perinatal period after feeding intolerance%四磨汤与酪酸梭菌活菌散治疗新生儿围生期窒息后喂养不耐受的观察

    Institute of Scientific and Technical Information of China (English)

    卓文娟

    2012-01-01

    [目的]观察四磨汤、酪酸梭菌活菌散治疗新生儿围生期窒息后喂养不耐受的情况. [方法]选择本院有围生期窒息后喂养不耐受的新生儿68例为实验对象,并随机分为对照组(n=36)和治疗组(n=32),羊水有胎粪污染者,两组均予洗胃,洗胃后禁食6h才开奶,对照组予枯草杆菌二联活菌颗粒治疗,治疗组予四磨汤、酪酸梭菌活菌散治疗.每天记录呕吐的次数、呕吐量、进食的奶量、大便次数、腹胀消失的日龄、恢复出生体重的日龄等. [结果]实验组呕吐次数减少、呕吐及腹胀消失时间提前、达50 kCal/(kg·d)日龄,恢复出生体重的日龄均提前,差异有统计学意义(P<0.05).[结论]四磨汤、酪酸梭菌活菌散治疗新生儿围生期窒息后喂养不耐受,能促进胃肠功能成熟,提高喂养的耐受性,而且安全.%[Objective] To observe the effect of Simo decoction,the condition of intolerant infants under Clostridium butyricum powder in treatment of neonatal asphyxia during perinatal period after feeding. [Methods] 68 infants selected as cases and were randomly divided into the control group (n=36) and treatment group (n = 32) cases with amniotic fluid meconium pollution in two groups were treated with gastric lav-age,after gastric lavage they could not open the milk until fasting for 6 hours. The control group received the treatment of Combined Bacillus Subtilis and Enterococcus Faecium Granules with Multivitamines,Live,and the treatment group was treated with the Simo decoction,Clostridium bulyricutn powder treatment,daily record of vomiting,amount of milk,stool frequency,abdominal distention disappeared days of age,the days of birth weight,such as age of recovery. [Results] The experimental group reduced frequency of vomiting ,and vomiting, abdominal distension disappeared ahead of time,up to 50 kCal/Ckg·) days in advance, to restore the birth weight of the days in advance,with statistically significant (P<0. 05

  20. Investigation on protective effect of fructose 1, 6-diphosphate used within 6 hours after birth on brain of neonates with asphyxia%窒息新生儿6h内使用1,6-二磷酸果糖对脑保护的效果研究

    Institute of Scientific and Technical Information of China (English)

    卢峥俏; 李宏; 李晓菲; 尹琦

    2011-01-01

    Objective: To explore the protective effect of fructose 1, 6 - diphosphate used within 6 hours on brain of neonates with asphyxia. Methods: 70 neonates with asphyxia were divided into fructose 1, 6 - diphosphate group (40 neonates) and control group (30 neonates), the incidence of hypoxic - ischemic encephalopathy (HIE) in neonates within 72 hours was observed, the changes of serum enzymes (LDH, AST, CK, CK-MB and HBDH), interleukin -6 (IL-6), interleukin -8 (IL-8), tumor necrosis factor-α (TNF-α)levels within 6 hours after birth, 3 days, 10 days were monitored; the neonates at 13 ~ 14 days and 27 ~28 days after birth received neonatal behavioral neurological assessment ( NBNA), psychomotor development quotient (DQ) was detected by Gesell development table at 42 days,3 months, 6 months, 9 months and 12 months after birth. Results: The incidences of HIE and moderate to severe HIE in fructose 1, 6 -diphosphate group were significantly lower than those in control group ( P < 0. 05 ); there was significant difference in the decrease levels of serum enzymes between fructose 1, 6 -diphosphate group and control group (P <0. 01 ); at three days after birth, the level of serum IL-6 in fructose 1, 6 - diphosphate group was significantly higher than that in control group (P < 0. 05 ), while the levels of serum lL - 8 and TNF - α in fructose 1, 6 - diphosphate group were significantly lower than those in control group ( P < 0. 01 ); at ten days after birth, the levels of serum IL - 8 and TNF - α in fructose 1, 6 - diphosphate group were significantly lower than those in control group ( P < 0. 01 );NBNA score and DQ in fructose 1, 6 - diphosphate group were significantly higher than those in control group ( P < 0. 05 ) . Conclusion:For the neonates with asphyxia, fructose 1, 6 -diphosphate used within 6 hours after birth can prevent and treat HIE significantly, which has a protective effect on brain of neonates.%目的:探讨研究窒息新生儿于生后6

  1. Predictive value of qualitative assessment of general movements for adverse outcomes at 24 months of age in infants with asphyxia%全身运动质量评估对窒息新生儿24月龄时不良结局的预测价值

    Institute of Scientific and Technical Information of China (English)

    陈楠; 温晓红; 黄金华; 王水云; 祝月娥

    2015-01-01

    ObjectiveTo investigate the predictive value of the qualitative assessment of general movements (GMs) for adverse outcomes at 24 months of age in full-term infants with asphyxia.MethodsA total of 114 full-term asphyxiated infants, who were admitted to the neonatal intensive care unit between 2009 and 2012 and took part in follow-ups after discharge were included in the study. All of them received the qualitative assessment of GMs within 3 months after birth. The development quotient was determined with the Bayley Scales of Infant Development at 24 months of age.ResultsThe results of the qualitative assessment of GMs within 3 months after birth showed that among 114 infants, 20 (17.5%) had poor repertoire movements and 7 (6.1%) had cramped-synchronized movements during the writhing movements period; 8 infants (7.0%) had the absence of fidgety movements during the fidgety movements period. The results of development quotient at 24 months of age showed that 7 infants (6.1%) had adverse developmental outcomes:6 cases of cerebral palsy and mental retardation and 1 case of mental retardation. There was a poor consistency between poor repertoire movements during the writhing movements period and the developmental outcomes at 24 months of age (Kappa=-0.019;P>0.05). There was a high consistency between cramped-synchronized movements during the writhing movements period and the developmental outcomes at 24 months of age (Kappa=0.848;P0.05)。痉挛性同步运动与24月龄时患儿发育结局的一致性较高(Kappa=0.848, P<0.05),其对24月龄发育结局的预测效度为98.2%,敏感度为85.7%,特异度为99.1%,阳性预测值为85.7%,阴性预测值为99.1%。不安运动阶段不安运动缺乏与24月龄时患儿发育结局的一致性较高(Kappa=0.786, P<0.05),其对24月龄发育结局的预测效度为97.4%,敏感度为85.7%,特异度为98.1%,阳性预测值为75.0%,阴性预测值为99.1%。结论 GMs评估示痉挛性同步

  2. PELAYANAN KESEHATAN PERINATAL DI DAERAH PEDESAAN UJUNG BERUNG

    Directory of Open Access Journals (Sweden)

    Anna Alisjahbana

    2012-09-01

    Full Text Available A survey on perinatal care in a rural area at Ujung Berung district, located 15—20 km outside Bandung, West Java was conducted. Three villages with a population of 40,787 were selected. Health services were provided by one health post and several family planning posts. In this study 1303 pregnant women were followed throughout the 28 weeks of pregnancy until the infant is 28 days of age. Among the 1303 pregnant women 5.7% had received tetanus toxoid immunization. Perinatal mortality rate (PMR was 43.6 per thousand and incidence of low birth weight was 14.3 percent. Only 12.8% pregnant women were using some kind of contraception before the last pregnancy. The PMR decreased in spite of the low percentage users. The main causes of death during perinatal period vece asphyxia neonatorum and infections. The incidence of tetanus neonatorum during neonatal period was 17 per thousand live births. An evaluation of health service activities showed 47.5% of these pregnant women had antenatal care. Care during delivery and early postnatal period was carried out by TBAs. No significant difference was found between the PMR of trained and untrained TBAs. Another aspect of health service activities is referral to the health centre or hospital. A total of 3.8 percent infants were referred because of neo­natal problems; among these, refusal was 12.5% due to the totalistic attitude of the parents in the village. The results showed that coverage of pregnant women and their infants by safe health care services is very low. This may be due to lack of facilities and health personnel, and probably also due to the confidence of village people for traditional health care providers. Thus, education and training as well as supervision of traditional health care providers and their integration into the formal health care structure is of extreme importance.  

  3. Conventional versus combined apgar scores in neonatal asphyxia: a prospective study

    Directory of Open Access Journals (Sweden)

    Amir Kamal Hardani

    2015-01-01

    Conclusion: In asphyxiated neonates sensitivity and specificity of combined apgar were more than conventional apgar. With respect to this study, better assessment could be achieved by combined apgar score method instead of conventional Apgar.

  4. Multiple causes of asphyxia in infants at high risk for sudden infant death.

    OpenAIRE

    Jeffery, H E; Rahilly, P; Read, D J

    1983-01-01

    A wide range of clinical findings was present in 58 near-miss sudden infant death syndrome (SIDS) infants and 6 surviving twins of SIDS siblings. Specific investigations included: studies of gastro-oesophageal reflux and aspiration (24-hour oesophageal pH recordings, barium swallow, radionuclide 'milk-scan'); polygraphic studies of breathing, reflux, and sleep state; studies of upper airways disease (lateral airways radiography and endoscopy); detection of seizure activity by electroencephalo...

  5. Long-term sequelae of perinatal asphyxia in the aging rat

    DEFF Research Database (Denmark)

    Weitzdoerfer, R; Gerstl, N; Hoeger, H; Mosgoeller, W; Dreher, W; Engidawork, E; Larsen, Jytte Overgaard; Lubec, B

    2002-01-01

    function was tested by an observational test battery and rota rod test. Cognitive functions were examined by multiple-T-maze and the Morris water maze (MWM). Increased serotonin transporter (SERT) immunoreactivity in the CA2 region of the hippocampus and a significant difference in the escape latency, when...

  6. Síndrome de Asfixia Sumersión Asphyxia Drowning Syndrome

    Directory of Open Access Journals (Sweden)

    A. Sibón Olano

    2005-07-01

    Full Text Available El hallazgo de un cadáver en el agua siempre nos plantea dudas diagnósticas: ¿Estamos ante un cadáver arrojado o caído al agua? ¿El sujeto ha fallecido por causas distintas a la sumersión, incluidas las de origen natural? ¿Se trata de una verdadera muerte por sumersión?. La utilización de exámenes complementarios en el diagnóstico de asfixia por sumersión ha sufrido diversos avatares. Las determinaciones bioquímicas han tropezado con los artefactos debidos a la putrefacción, lo que ha llevado a la aparición de determinados métodos de diagnóstico muy controvertidos. Además, los experimentos realizados en animales no siempre son extrapolables al ser humano, dado que hasta la cantidad de agua absorbida por vía aérea, parece ser mucho menor para estos últimos. El diagnóstico de muerte por sumersión se realizará, por lo tanto, estableciendo una correlación entre los hallazgos propios de la sumersión observados en la autopsia y las diferentes pruebas analíticas realizadas en el laboratorio.The finding of a corpse in water always raise doubts for a proper diagnosis: Are we before a corpse thrown or fallen into the water? Was the death due to causes different from drowning, including naturals?. It is a true death by drowning?. The use of complementary examinations in the diagnosis of drowning has undergone diverse ups and downs. The biochemical determinations have been confronted with the artefacts related to the putrefaction which has favoured the appearance of certain very controverted methods of diagnosis. In addition, the experiments made in animals not always must be applied to the human's beings, since the absorbed amount of water by air passages seems to be much smaller for the latest's. The diagnosis of death by drowning will be made, therefore, establishing a correlation between the typical findings of the submersion observed in the autopsy and the different complementary laboratory tests.

  7. Inhaled 45–50% argon augments hypothermic brain protection in a piglet model of perinatal asphyxia

    Science.gov (United States)

    Broad, Kevin D.; Fierens, Igor; Fleiss, Bobbi; Rocha-Ferreira, Eridan; Ezzati, Mojgan; Hassell, Jane; Alonso-Alconada, Daniel; Bainbridge, Alan; Kawano, Go; Ma, Daqing; Tachtsidis, Ilias; Gressens, Pierre; Golay, Xavier; Sanders, Robert D.; Robertson, Nicola J.

    2016-01-01

    Cooling to 33.5 °C in babies with neonatal encephalopathy significantly reduces death and disability, however additional therapies are needed to maximize brain protection. Following hypoxia–ischemia we assessed whether inhaled 45–50% Argon from 2–26 h augmented hypothermia neuroprotection in a neonatal piglet model, using MRS and aEEG, which predict outcome in babies with neonatal encephalopathy, and immunohistochemistry. Following cerebral hypoxia–ischemia, 20 Newborn male Large White piglets < 40 h were randomized to: (i) Cooling (33 °C) from 2–26 h (n = 10); or (ii) Cooling and inhaled 45–50% Argon (Cooling + Argon) from 2–26 h (n = 8). Whole-brain phosphorus-31 and regional proton MRS were acquired at baseline, 24 and 48 h after hypoxia–ischemia. EEG was monitored. At 48 h after hypoxia–ischemia, cell death (TUNEL) was evaluated over 7 brain regions. There were no differences in body weight, duration of hypoxia–ischemia or insult severity; throughout the study there were no differences in heart rate, arterial blood pressure, blood biochemistry and inotrope support. Two piglets in the Cooling + Argon group were excluded. Comparing Cooling + Argon with Cooling there was preservation of whole-brain MRS ATP and PCr/Pi at 48 h after hypoxia–ischemia (p < 0.001 for both) and lower 1H MRS lactate/N acetyl aspartate in white (p = 0.03 and 0.04) but not gray matter at 24 and 48 h. EEG background recovery was faster (p < 0.01) with Cooling + Argon. An overall difference between average cell-death of Cooling versus Cooling + Argon was observed (p < 0.01); estimated cells per mm2 were 23.9 points lower (95% C.I. 7.3–40.5) for the Cooling + Argon versus Cooling. Inhaled 45–50% Argon from 2–26 h augmented hypothermic protection at 48 h after hypoxia–ischemia shown by improved brain energy metabolism on MRS, faster EEG recovery and reduced cell death on TUNEL. Argon may provide a cheap and practical therapy to augment cooling for neonatal encephalopathy. PMID:26687546

  8. Carbon dioxide euthanasia in rats: Oxygen supplementation minimizes signs of agitation and asphyxia

    NARCIS (Netherlands)

    Coenen, A.M.L.; Drinkenburg, W.H.I.M.; Hoenderken, R.; Luijtelaar, E.L.J.M. van

    1995-01-01

    This paper records the effects of carbon dioxide when used for euthanasia, on behaviour, electrical brain activity and heart rate in rats. Four different methods were used. Animals were placed in a box (a) that was completely filled with carbon dioxide; (b) into which carbon dioxide was streamed at

  9. Firing probability and mean firing rates of human muscle vasoconstrictor neurones are elevated during chronic asphyxia

    DEFF Research Database (Denmark)

    Ashley, Cynthia; Burton, Danielle; Sverrisdottir, Yrsa B;

    2010-01-01

    in the obstructive sleep apnoea syndrome (OSAS) is associated with an increase in firing probability and mean firing rate, and an increase in multiple within-burst firing. Here we characterize the firing properties of muscle vasoconstrictor neurones in patients with chronic obstructive pulmonary disease (COPD), who...... are chronically asphyxic. We tested the hypothesis that this elevated chemical drive would shift the firing pattern from that seen in healthy subjects to that seen in OSAS. The mean firing probability (52%) and mean firing rate (0.92 Hz) of 17 muscle vasoconstrictor neurones recorded in COPD were comparable...

  10. Setting research priorities to reduce almost one million deaths from birth asphyxia by 2015.

    OpenAIRE

    Lawn, Joy E.; Rajiv Bahl; Staffan Bergstrom; Bhutta, Zulfiqar A; Darmstadt, Gary L; Matthew Ellis; Mike English; Kurinczuk, Jennifer J.; Anne C C Lee; Mario Merialdi; Mohamed Mohamed; David Osrin; Robert Pattinson; Vinod Paul; Siddarth Ramji

    2011-01-01

    Intrapartum-related neonatal deaths (previously called “birth asphyxia”) are the fifth most common cause of deaths among children under 5 years of age, accounting for an estimated 814,000 deaths each year, and also associated with significant morbidity, resulting in a burden of 42 million disability adjusted life years (DALYs). This paper uses a systematic process developed by the Child Health Nutrition Research Initiative (CHNRI) to define and rank research options to reduce mortality...

  11. Gastric Myoelectrical Activity of Neonatal Asphyxia%窒息后新生儿胃电活动的研究

    Institute of Scientific and Technical Information of China (English)

    毛志芹; 王伟; 李军; 孙梅; 张惠

    2001-01-01

    目的利用胃电图探讨窒息对新生儿胃电活动的影响. 方法采用瑞典CTd-synectics公司生产的便携式胃电图(EGG)记录仪对50例窒息后新生儿和20例正常新生儿进行了喂奶前、后各30 min的胃电活动的检测,利用计算机EGG Version 6.40软件分析系统分析数据. 结果 70例新生儿有39例(56%)成功记录到EGG.轻度窒息组与对照组比较,喂奶前胃动过缓(4 cpm)百分比明显增多(P<0.01).主功频率不稳定系数(DFIC)增高(P<0.01). 结论 EGG可以用来研究窒息后新生儿的胃电活动,进而研究新生儿消化道动力;围产期轻度窒息新生儿喂奶前胃动过缓增多,重度窒息新生儿喂奶前、后正常慢波百分比明显降低,胃动过速百分比明显增多,提示围产期窒息的新生儿出现拒乳、腹胀、呕吐等症状,可能与其胃电节律异常有关.

  12. Formal training in general movement assessment is required to effectively evaluate infants with perinatal asphyxia in outpatient settings

    DEFF Research Database (Denmark)

    Brown, Annemette K; Greisen, Gorm; Haugsted, Ulla;

    2016-01-01

    AIM: General movement assessment (GMA) can help to identify children with a high risk of developing neurological dysfunction, such as cerebral palsy, and certified training is provided in this specialism. The aim of this study was to investigate the feasibility and reliability of using video...... were analysed using proportional agreement and nominal kappa statistics were used to calculate 95% confidence intervals (95% CI). RESULTS: We found substantial and almost perfect inter-observer and intra-observer reliability. Intra-observer agreement was 0.85 (95% CI: 0.65-1.00; p<0.0001) and 0.85 (95...... the reliability of the GMA method in a busy multidisciplinary Danish paediatric outpatient setting, when assessors had been formally trained in the method and used it regularly. This article is protected by copyright. All rights reserved....

  13. 窒息对新生儿胃电活动的影响%The Study of Gastric Myoelectrical Activity Neonatal Asphyxia

    Institute of Scientific and Technical Information of China (English)

    李利; 陈艳敏; 范红; 李献珍; 曾明辉

    2002-01-01

    目的:研究窒息对新生儿胃电活动的影响.方法:研究对象来自我院1998年9月~2000年5月以窒息收住新生儿病房的足月新生儿32例,其中重度窒息20例,轻度窒息12例.对照组:系同期以新生儿生理性黄疸收住院的足月新生儿10例,无消化道症状,吃奶好,二便正常.采用瑞典Synectics公司生产的便携式Digitrapper双电极EGG记录仪进行胃电图检查,用计算机运行频谱分析数据.结果:窒息组与对照组比较,餐前胃动过缓显著增加,正常节律百分比、胃动过速明显降低,差别有显著意义(P<0.01和P<0.05).餐后胃动过缓也有增加,差别有显著意义(P<0.01).餐后正常节律百分比、胃动过速也有降低但差别无显著性意义.重度窒息组与轻度窒息组比较,前者餐前胃动过缓明显增加,正常节律百分比明显降低,差别有显著意义(P<0.01).两者餐前胃动过速及餐后各项指标比较均无显著差异(P>0.05).结论:(1)窒息新生儿存在明显胃电节律紊乱.临床多表现为拒奶、喂养不耐受、呕吐和腹胀等消化道症状;(2)体表胃电图与胃肌电活动的相关性较好,可用来研究窒息新生儿的胃电活动,进而研究新生儿消化道动力;(3)窒息组胃电提示异常者,曾试用普瑞博思0.2 mg/(kg@次)治疗能改善临床症状,但尚缺乏胃电图观察,有待进一步胃电图研究.

  14. Etiological Analysis of172 Cases of Mental Retardation%智力低下172例病因分析

    Institute of Scientific and Technical Information of China (English)

    李维君

    2001-01-01

    Objective: To investigate the cause of mental retardation (MR) and its preventive and therapeutic measures. Methods: One hundred and seventy-two children with mental retardation were divided into 2 groups according to age, the younger group being 4 m~3 yrs and the elder group 4~14 yrs old. And 172 healthy children were selected for matched survey from outpatients of child healthy clinic, and the cause of disease was analyzed also. Results: (1) More patients with severe MR were found in the younger group,but more patients of mild MR were found in the older group; (2) Asphyxia neonatorum, premature birth and intracranial infection were important factors causing MR; (3) The development of children's intelligence was closely related with economic condition and cultural level of urban and rural areas. Conclusion:To decrease the occurrence of MR, good service of antenatal care, during delivery and postnatal breeding should be done.%目的:了解智力低下的病因,探索其防治规律。方法:选择儿保门诊172例智力低下患儿按年龄分为4月~3岁78例和4~14岁94例二组,同时选同龄、同性别门诊正常儿172例,采用1:1配对的方法进行病因分析。结果:(1)小年龄组重度智力低下儿较大年龄组多,而大年龄组轻型智力低下者多;(2)新生儿窒息、早产儿、颅内感染是产生智力低下的重要因素;(3)儿童的智能发育状况与城乡经济状况、文化程度密切相关。结论:做好产前、产时、产后各阶段的优生优育优教工作,才能减少智力低下儿的产生。

  15. 脑电图在窒息新生儿早期诊断脑损伤的应用研究%Early evaluation of brain injury by electroencephalogram in neonates with asphyxia

    Institute of Scientific and Technical Information of China (English)

    宋雄; 廖家宣

    2008-01-01

    目的 探讨脑电图(EEC)在窒息新生儿超早期诊断脑损伤的价值.方法 对2003年9月至2005年6月收治住院的49例窒息新生儿生后6 h内进行EEG检查.结果 49例窒息新生儿中,诊断缺氧缺血性脑病(HIE)33例,EEG异常21例,异常率63.3%;单纯窒息16例,EEG仅1例异常,异常率6.3%,中重度HIE患儿EEG异常100%.EEG异常程度与HIE 临床分度基本一致,EEG表现为电静息、爆发抑制改变且2周后持续不恢复者预后差.结论 新生儿窒息早期(6 h内)即可出现EEG改变,EEG可早期反映窒息后脑损伤及程度,EEG可作为窒息新生儿超早期诊断脑损伤的重要检查方法,值得推广应用.

  16. Application effect study on nursing serving model of midwife group in perinatal care%助产士小组护理服务模式在围产期保健中的应用效果研究

    Institute of Scientific and Technical Information of China (English)

    钟萍

    2013-01-01

    目的探讨助产士小组护理服务模式在围产期保健服务中的应用价值。方法选取100例初产妇,随机分为助产士小组护理模式的观察组和常规产科护理模式的对照组,比较两组分娩方式及新生儿窒息率、不同产程时间及出血量、产妇负面情绪等。结果观察组患者自然分娩显著高于对照组(x2=11.422,P<0.01);阴道助产率(2.0%)、剖宫产率(6.0%)、新生儿窒息率(2.0%)均明显低于对照组(x2=4.891、5.316、4.891,P<0.05);第一产程、第二产程、产后出血量明显低于对照组(t=4.784、6.695、5.292,P<0.05),第三产程略低于对照组,但差异无统计学意义(t=0.688,P>0.05);焦虑评分、抑郁评分均明显低于对照组(t=8.035、9.095,P<0.05)。结论助产士小组护理服务模式可以有效提高自然分娩率,缩短产程时间,缓解负性情绪,具有积极的临床意义。%Objective To discuss the using value of nursing serving model of midwife group in perinatal care. Methods 100 primiparas were randomly divided into observation group given nursing serving model of midwife group and control group given routine obstetrics nursing serving model. The delivery mode, asphyxia rate of neonatorum, different time of labor stage, amount of bleeding and negative emotion of puerperal of two groups were compared. Results Cesarean section rate in observation group was significantly higher than that in control group(x2=11.422, P0.05). The score of anxiety and depression in observation group were significantly lower than those in control group(t=8.035,9.095, P<0.05). Conclusion Nursing serving model of midwife group may effectively improve cesarean section rate,shorten the time of labor stage, relieve negative emotion, and which has a positive clinical meaning.

  17. Integralidade e acessibilidade no cuidado à criança portadora de paralisia cerebral Integralidad y accesibilidad en el cuidado del niño portador de parálisis cerebral Integration and accessibility of care for children with brain paralysis

    Directory of Open Access Journals (Sweden)

    Viviane Marten Milbrath

    2009-12-01

    ón: La inaccesibilidad de la asistencia no se restringe al nivel de la atención básica, él mismo se extiende a todas las esferas de atención, no contemplando la referencia y contra-referencia.Objective: To determine the Brazilian Universal Health Care System (Sistema Único de Saúde [SUS] health services integration and accessibility of care for children with brain paralysis. Methods: This was an exploratory, descriptive, qualitative study. Six families with children who have brain paralysis caused by asphyxia neonatorum and who were residents in Rio Grande, RS, participated in the study. Data were collected in the participants' home through a semi-structured interview. Results: Families had difficulties with the SUS health services' integration and accessibility. There were gaps between the care the SUS proposes to provide and the care the families actually received. Conclusion: The lack of access to adequate care extends beyond primary care and not always observes reference and contra reference.

  18. 汉中市农村与城区5岁以下儿童死亡对比分析%Contrastive analysis of the death of children under 5 years old in urban and rural areas of Hanzhong

    Institute of Scientific and Technical Information of China (English)

    彭海玲; 白倩; 王琼

    2013-01-01

    Objective To analyze the death oi children under 5 years old in urban and rural areas of Hanzhong and to explore possible interventional measures. Methods Death data of 5 years old children from 2000 to 2010 in both of urban and rural areas of Hanzhong was analyzed retrospectively. Results The mortality rate of children under 5 years old in Hantai and Nanzheng was 13.65‰ and 20. 32‰, respectively. The mortality rate of newboms , infants , children of 1-4 years old and children under 5 years old in urban area ( Hantai) was much lower than that in rural area ( Nanzheng ) (χ2 value was 16. 89, 42. 69, 17. 54 and 59. 04, respectively, all P 0. 05 ). The causes of death of children under 5 years old in two areas were different. The first five causes of death in the urban were congenital malformation , asphyxia neonatomm , contretemps, premature and low birth weight, and pneumonia, while they were asphyxia neonatorum , pneumonia, contretemps, congenital malformation , and premature and low birth weight in the rural area. Conclusion In the past 11 years, the mortality rate of children under 5 years old of each age groups decreases year by year', and the death rate in the urban area is lower than that in the rural area . Infants and newboms death takes the majority of the death of children under 5 years old. The top five causes of children 's death in the urban and rural area are different , which indicates different impact of economics , culture and medical care on children in urban and rural area . Therefore, the future work in different areas should have their own focus .%目的 对汉中市农村与城区5岁以下儿童死亡进行对比分析,并探讨其干预措施.方法 将2000至2010年汉中市城市与农村5岁以下儿童死亡资料进行回顾性分析.结果 汉台区、南郑县5岁以下儿童死亡率分别为13.65‰和20.32‰;城区(汉台)的新生儿、婴儿、1~4岁、5岁以下死亡率明显低于农村(南郑)(χ2值分别为16.89、42

  19. 24 h动态血糖监测在妊娠期糖尿病患者中对妊娠结局的影响%Effect of continuous glucose monitoring system to pregnancy outcome in gestational diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    王娟; 陈学敬; 杨香菊; 陈柳华; 郭中秋; 王秀梅; 陈玉华

    2014-01-01

    Objective To investigate the influence of pregnancy outcome in GDM patients by continuous glucose moni-toring system (CGMS). Methods 60 patients with GDM in Longgang District People's Hospital of Shenzhen City from January 2011 to December 2012 were selected and divided into group A and group B with 30 cases in each group. The group A was treated with continuous glucose monitoring for 24 h, group B was treated with normal peripheral blood sugar checking without continuous glucose monitoring. The indexes were observed and compared:①the occurrence rate of perinatal complications of pregnancy induced hypertension, premature birth, intrauterine infection, polyhydramnios, premature rupture of fetal membranes, cesarean delivery in pregnant women of the two groups; ②the occurrence rate of hyperbilirubinemia, hypoglycemia, perinatal death, asphyxia neonatorum, fetal macrosomia, weight and gestational age in newborn of the two groups. Results ①The occurrence rate of pregnancy induce d hypertension, pregnancy induced hypertension, intrauterine infection, polyhydramnios, premature rupture of fetal membranes, caesarean section in group B [13.33% (4/30), 6.67% (2/30), 6.67% (2/30), 6.67% (2/30), 10.00% (3/30), 53.33% (16/30)] were all higher than those in group A [6.67% (2/30), 3.33% (1/30), 0.00%(0/30), 0.00% (0/30), 3.33% (1/30), 40.00%(12/30)], the differences were statistically significant (P< 0.05).②The hyperbilirubinemia, hypoglycemia, newborn weight, neonatal asphyxia, fetal macrosomia in group B [13.33%(4/30), 6.67%(2/30), (3345±512) g, 6.67%(2/30), 6.67%(2/30)] were all higher than those in group A [6.67% (2/30), 0.00% (0/30), (3045±460) g, 0.00% (0/30), 0.00% (0/30)], the differences were statistically significant (P< 0.05). Conclusion It is able for CGMS to provide the early dynamic blood sugar monitoring for GDM patients, it also can provide more accurate blood sugar basis for the subsequent treat-ment, it is one of the methods to reduce the maternal

  20. Impaired autoregulation of cerebral blood flow in the distressed newborn infant

    DEFF Research Database (Denmark)

    Lou, H C; Lassen, N A; Friis-Hansen, B

    1979-01-01

    Cerebral blood flow was measured, using the 133Xe clearance technique, a few hours after birth in 19 infants with varying degrees of respiratory distress syndrome. Ten of these infants had had asphyxia at birth. The least affected infants with normotension (systolic blood pressure 60 to 65 mm Hg......) had CBF values of about 40 ml/100 gm/minute. Hypotensive infants with asphyxia at birth or RDS or both had values for CBF of about 20 ml/100 gm/minute, or less. CBF was strongly correlated with the arterial blood pressure, showing a linear relationship that was identical in infants with asphyxia at...

  1. Study shows ongoing benefits of cooling therapy for neonates.

    Science.gov (United States)

    Holmström, Radhika

    2014-10-01

    OXYGEN DEPRIVATION at birth - perinatal asphyxia - is a well-known risk to children's health and development, resulting in permanent neurological damage that can include cerebral palsy and/or learning disability. PMID:25289614

  2. Woe patient is purple

    Directory of Open Access Journals (Sweden)

    Hatice Dogan

    2014-08-01

    Conclusion: Traumatic asphyxia is a clinical condition caused by blunt thoracoabdominal trauma, and with good trauma management patients can be discharged with less mortality and morbidity. [Cukurova Med J 2014; 39(4.000: 914-917

  3. Syndromes Associated with Sexually Transmitted Infections

    Directory of Open Access Journals (Sweden)

    Max Chernesky

    2005-01-01

    Full Text Available Excellent technologies have been developed to identify the specific microbial agents of chlamydia, gonorrhea, syphilis, herpes, chancroid, trichomoniasis, human papillomavirus and HIV infection. However, it is also crucial to recognize syndromes that may be caused by one or more sexually transmitted pathogens. When laboratory services are lacking or are inadequate to provide timely results to enable appropriate treatment, some patients must be managed and treated syndromically. Most Canadian laboratories should be able to provide diagnostic services to determine the etiology of syndromes such as cervicitis, urethritis, pelvic inflammatory disease, prostatitis, genital ulcers, sexually transmitted infection (STI-related enteric infections, epididymitis, hepatitis, ophthalmia neonatorum, vulvovaginitis and vaginosis.

  4. Effect of slaughter methods on the quality of Chilean jack mackerel (Trachurus murphyi) during refrigerated storage

    OpenAIRE

    Lyu, Fei; Huang, Rui-Ji; Liu, Lin; Zhou, Xuxia; Ding, Yu-Ting

    2013-01-01

    The main objective of this study was to assess the influence of slaughter methods on the quality of Chilean jack mackerel (Trachurus murphyi) during refrigerated storage on board. Fishes were slaughtered by asphyxia in air (AA), asphyxia in ice water (AI) or stunning fish heads (SH), and the rigor mortis, pH, total volatile basic nitrogen (TVB-N), trimethylamine (TMA), 2-thiobarbituric acid reactive substances (TBARS) and sensory properties for the fishes were analyzed. On day 0, Chilean jack...

  5. Correlation of Apgar Score with Asphyxial Hepatic Injury and Mortality in Newborns: A Prospective Observational Study From India

    OpenAIRE

    Sharma, Deepak; Choudhary, Mukesh; Lamba, Mamta; Shastri, Sweta

    2016-01-01

    OBJECTIVE The objective of this study is to determine the correlation of Apgar score with asphyxial hepatic injury and neonatal mortality in moderately and severely asphyxiated newborns. MATERIAL AND METHODS This is a secondary analysis of our prospective observational case-controlled study. Sixteen neonates with severe birth asphyxia (five-minute Apgar ≤3) were compared with either 54 moderate asphyxia neonates (five-minute Apgar >3) or 30 normal neonates. Liver function tests were measured ...

  6. Přednemocniční neodkladná péče u dětí s akutním dušením

    OpenAIRE

    VETÝŠKOVÁ, Petra

    2014-01-01

    Bachelor thesis is prehospital emergency care for children with acute asphyxia. It discusses the treatment of children in prehospital care, whereby it becomes specific because care of children and adults is not always identical. Acute asphyxia is a very unpleasant condition, which requires expert intervention as fast as possible. Without help the patient's life can be threatened by loss of consciousness with shortness of breath. The theoretical section of the thesis deals initially with a con...

  7. A premature infant with a bilateral thalamostriatal hemorrhage

    International Nuclear Information System (INIS)

    Hemorrhagic areas were seen on ultrasonography and computed tomography in both thalamostriatal regions in a preterm female infant with perinatal asphyxia due to abruptio placentae. At autopsy, marked perivascular bleeding in the thalamus and putamen and eosinophilic neuronal changes in the thalamus and pontine tegmentum were seen. These thalamostriatal and brain stem lesions are thought to have been caused by an acute process causing total asphyxia. (author)

  8. Crystallographic investigationsof urine at newborns with ischemic nephropathy

    Directory of Open Access Journals (Sweden)

    Loboda A.

    2012-01-01

    Full Text Available The study is devoted to the identification of structural markers of ischemic nephropathy by studying facies (dry drops of urine in newborn infants. The study involved two groups of full-term newborns with gestational age 38-41 weeks and signs of ischemic nephropathy: 1st - 75 children who suffered severe asphyxia, 2nd - 75 children with moderate asphyxia. Comparison group consisted of 20 infants without asphyxia at birth. Morphological changes were detected in dry drops by microscopy at 40-fold increase in 1-2 and 7-8 days of life. Asphyxia cause disturbance of renal filtration, tubular reabsorption and secretion that lead to increase levels of organic components and mineral salts in urine, crystallization of which forms a specific picture of facies. By urine’s facies morphology at 1-2 days of life is possible to evaluate renal function in newborns suffered from asphyxia. The number of inclusions in facies, their total area and distribution are depending on the severity of asphyxia. Structural changes in the urine of children with ischemic nephropathy remain till the end of the early neonatal period.

  9. Measurement of the Urinary Lactate/ Creatinine Ratio for Early Diagnosis of the Hypoxic Ischemic Encephalopathy in Newborns

    Directory of Open Access Journals (Sweden)

    Nahid Ghotbi

    2010-03-01

    Full Text Available Objective:Hypoxic ischemic encephalopathy (HIE is a major cause of permanent neurological disabilities. Perinatal asphyxia may induce neonatal mortality after birth or neurological impairment among survivors. There are no reliable methods for identifying infants at risk for this disorder.Methods:We measured the ratio of lactate/creatinine (L/C in urine by proton nuclear magnetic resonance spectroscopy within 6 and 24 hours after birth in 50 normal infants and 50 infants with asphyxia who developed hypoxic-ischemic encephalopathy. The study was performed from September 2006 to May 2007. For statistical analysis, the SPSS software was used. Group comparisons were performed with chi-square and t-test(1,5.Findings:L/C ratio was 3.3+ 2 among asphyxiated neonates in the first six hours after birth which was 11 folds greater than in normal neonates (0.3+ 0.08, P=0.0001. This ratio decreased to 1.5�0.55 for asphyxiated cases in the first 24 hours after birth, which was 5 folds greater than in control group (P=0.0001. Asphyxiated neonates were subdivided into Group A with mild asphyxia and L/C ratio 2.5�0.5; Group B with moderate asphyxia and L/C ratio 4.2�1.5; and Group C with severe asphyxia and L/C ratio 3.4�3.3. The severity of asphyxia correlated with the greater L/C ratio among our cases and was significant (P=0.0007. The sensitivity and specificity of L/C ratio in cut off point of 0.48, was 96.1% and 100% respectively.Conclusion:Measurement of the urinary L/C ratio soon after birth maybe a promising tool to identify asphyxiated neonates and also to predict the severity of asphyxia.

  10. The cranial MRI in severe cerebral palsy

    International Nuclear Information System (INIS)

    The magnetic resonance examination was performed in 38 patients with severe cerebral palsy (CP; 15 males and 23 females) who had both motor delay (unable to move anywhere) and mental retardation (I.Q. or D.Q. below 30). Neuroimaging findings were compared with the CP type, etiology, and grade of understanding of language. Cranial magnetic resonance imagings (MRI) in CP were divided into five types. In type 1, nine predominantly showed cyst-liked ventricles and periventricular hyperintensity on T2-weighted imaging (PVH) and only scarred basal ganglia and thalamus were visible. All suffered from neonatal asphyxia and the clinical type was rigospastic tetraplegia (RST). In type 2, eleven predominantly showed PVH and hyperintensity on T2-weighted (HT2) in basal ganglia and thalamus. All suffered from neonatal asphyxia and the clinical type was RST or rigospastic diplegia. In type 3, five showed PVH and three had cortical atrophy. All suffered from neonatal asphyxia and the clinical type was spastic diplegia. In type 4, four predominantly showed HT2 in putamen and thalamus. Three had cortical atrophy. All suffered from neonatal asphyxia. The clinical type was athetotic CP (ATH). In type 5, nine predominantly showed HT2 in globus pallidus. Four had cortical atrophy and two had hippocampal atrophy. All suffered from neonatal jaundice and the clinical type was ATH. All patients who suffered from neonatal asphyxia and spastic CP had MRI in PVH. All patients who suffered from neonatal asphyxia and ATH showed HT2 in putamen and thalamus. Almost patients who suffered from neonatal jaundice and ATH showed HT2 in globus pallidus. With athetotic CP, cases with atrophy of the cerebral cortex and/or hippocampus were lower grade of understanding of language than no atrophy of both. The results of studies of MRI are in agreement with neuropathological findings. (author)

  11. The cranial MRI in severe cerebral palsy; A comparative study with clinical data

    Energy Technology Data Exchange (ETDEWEB)

    Yamada, Kazutaka; Itoh, Masahiro; Fueki, Noboru; Hirasawa, Kyoko; Suzuki, Noriko; Kurata, Kiyoko (Metropolitan Medical Center of the Severely Handicapped, Tokyo (Japan)); Sato, Junichi; Morimatsu, Yoshio; Yagishita, Akira

    1993-09-01

    The magnetic resonance examination was performed in 38 patients with severe cerebral palsy (CP; 15 males and 23 females) who had both motor delay (unable to move anywhere) and mental retardation (I.Q. or D.Q. below 30). Neuroimaging findings were compared with the CP type, etiology, and grade of understanding of language. Cranial magnetic resonance imagings (MRI) in CP were divided into five types. In type 1, nine predominantly showed cyst-liked ventricles and periventricular hyperintensity on T[sub 2]-weighted imaging (PVH) and only scarred basal ganglia and thalamus were visible. All suffered from neonatal asphyxia and the clinical type was rigospastic tetraplegia (RST). In type 2, eleven predominantly showed PVH and hyperintensity on T[sub 2]-weighted (HT2) in basal ganglia and thalamus. All suffered from neonatal asphyxia and the clinical type was RST or rigospastic diplegia. In type 3, five showed PVH and three had cortical atrophy. All suffered from neonatal asphyxia and the clinical type was spastic diplegia. In type 4, four predominantly showed HT2 in putamen and thalamus. Three had cortical atrophy. All suffered from neonatal asphyxia. The clinical type was athetotic CP (ATH). In type 5, nine predominantly showed HT2 in globus pallidus. Four had cortical atrophy and two had hippocampal atrophy. All suffered from neonatal jaundice and the clinical type was ATH. All patients who suffered from neonatal asphyxia and spastic CP had MRI in PVH. All patients who suffered from neonatal asphyxia and ATH showed HT2 in putamen and thalamus. Almost patients who suffered from neonatal jaundice and ATH showed HT2 in globus pallidus. With athetotic CP, cases with atrophy of the cerebral cortex and/or hippocampus were lower grade of understanding of language than no atrophy of both. The results of studies of MRI are in agreement with neuropathological findings. (author).

  12. A pediatric case of life-threatening airway obstruction caused by a cervicomediastinal thymic cyst

    Energy Technology Data Exchange (ETDEWEB)

    Komura, Makoto; Kanamori, Yutaka; Sugiyama, Masahiko; Iwanaka, Tadashi [University of Tokyo Hospital, Department of Pediatric Surgery, Tokyo (Japan); Fukushima, Noriyoshi [University of Tokyo Hospital, Department of Pathology, Tokyo (Japan)

    2010-09-15

    Most patients with thymic cysts complain of a slowly enlarging, asymptomatic cervical mass. Only 6-10% suffer dysphagia, dyspnoea, stridor, cervical pain or vocal paralysis. In some rare cases sudden onset of severe dyspnoea or asphyxia is the first symptom, especially in neonates and small infants. We report a unique case of a 20-month-old child, who required emergency tracheal intubation due to asphyxia. Cervicomediastinal thymic cyst might need to be included in causes of life-threatening airway obstruction in young children. (orig.)

  13. Hypertensive peaks in the pathogenesis of intraventricular hemorrhage in the newborn. Abolition by phenobarbitone sedation

    DEFF Research Database (Denmark)

    Wimberley, P D; Lou, H C; Pedersen, H; Hejl, M; Lassen, N A; Friis-Hansen, B

    1982-01-01

    (33%), diagnosed by computered tomography (CT). IVH was more common in infants of lower gestational age, in infants delivered vaginally and in infants with perinatal asphyxia. Variable increases in MABP over the resting value occurred in all infants associated with increases in both active and passive...... motor activity. In 6 infant pairs matched for birth weight, gestational age, mode of delivery and severity of perinatal asphyxia, the infants who developed IVH had higher peak MABP valued compared to matched controls. Resting and minimum MABP values were not different in the two groups. We conclude that...

  14. [Bullous autoimmune disorders in children].

    Science.gov (United States)

    Sárdy, M; Kasperkiewicz, M

    2013-06-01

    We review the pathogenesis, clinical features, diagnosis, differential diagnosis, and therapy of autoimmune bullous skin diseases of childhood, especially of the most common linear IgA dermatosis. In autoimmune bullous diseases, autoantibodies are formed against different adhesion molecules of the skin. These are not only pathophysiologically relevant, but also serve as basis for diagnosis and follow-up of these diseases. In case an autoimmune bullous disease is suspected, histopathology and immunohistopathology (direct immunofluorescence microscopy) as well as serological tests (indirect immunofluorescence microscopy, ELISA, immunoblot) should be performed. Therapy depends on the diagnosis. In IgA-mediated pathogenesis, dapsone can be successfully used. In IgG-mediated diseases, immunosuppression with corticosteroids and steroid-sparing agents should be initiated, although only local therapy is sufficient to control a self-limiting pemphigus neonatorum. In dermatitis herpetiformis, a life-long gluten-free diet is recommended. PMID:23677541

  15. [Recommendations for the care of healthy newborn infants].

    Science.gov (United States)

    Figueras Aloy, J; García Alix, A; Alomar Ribes, A; Blanco Bravo, D; Esqué Ruiz, M T; Fernández Lorenzo, J R

    2001-08-01

    This article makes certain recommendations on the care of the healthy newborn. Firstly, we discuss the situations that should be reported to the pediatrician/neonatologist and the reasons why the presence of these specialists is required in the delivery room (urgent or elective cesarean section, preterm labor). Secondly, we discuss the most important guidelines to follow in the delivery room and after birth. Concerning care in the delivery room, we stress the importance of care of the newborn (especially of the umbilical cord), bonding between the mother and child, identification of the newborn, assessment of neonatal adaptation to extrauterine life, prevention of ophthalmia neonatorum and hypoprothrombinemia, placing the baby correctly in the crib and hepatitis B prophylaxis. Concerning the postnatal period, we recommend feeding (promotion of breast feeding), rooming-in with the mother if the newborn is hospitalized in the nursery screening for hypoacousia and metabolic diseases, and discharge with special surveillance in cases of early discharge. PMID:11472666

  16. THE ATTITUDE, KNOWLEDGE AND BEHAVIOUR OF TRADITIONAL BIRTH ATTENDANTS IN A RURAL AREA, UJUNG -BERUNG, WEST JAVA

    Directory of Open Access Journals (Sweden)

    Anna Alisjahbana

    2012-09-01

    Full Text Available Telah dilaksanakan suatu penelitian mengenai pengetahuan, sikap dan perbuatan dari para dukun bayi di desa Ujung Berung, yang letaknya kira-kira 15 km dari Bandung. Dukun yang diteliti berjumlah 45 orang dan 11 di antaranya telah mendapat latihan dari Dinas Kesehatan setempat. Metoda penelitian yang dipakai ialah wawancara, observasi langsung dan pengumpulan data morta­litas dan morbiditas. Hasil penelitian tersebut menunjukkan bahwa dukun yang terlatih mempunyai pengetahuan dan sikap yang lebih baik daripada dukun yang tidak terlatih, namun tindakannya masih banyak yang tidak berbeda dengan cara tradisional. Frekuensi tetanus neonatorum misalnya masih tinggi pada bayi yang ditolong dukun terlatih. Untuk meningkatkan efektivitas dari pekerjaan dukun terlatih diperlukan bimbingan dan pertemuan berkala yang lebih teratur dari petugas kesehatan setempat.

  17. Cutaneous lesions in new born

    Directory of Open Access Journals (Sweden)

    Sachdeva Meenakshi

    2002-11-01

    Full Text Available Five hundred unselected newborn babies delivered in the Department of Obstetrics and Gynaecology, Unit II of SGBT Hospital attached to Government Medical College, Amritsar during April 2000 to October 2000 were examined for cutaneous lesions daily for the first five days after birth. Different cutaneous lesions were seen in 474(94. 8% newborns. The physiological skin changes observed in order of frequency were Epstein pearls in 305(61%, Mongolian spot in 301(60. 2%, superficial cutaneous desquamation in 200(40%, icterus in 128(25. 6%, milia in 119(23. 8%, sebaceous gland hyperplasia in 107 (21. 4%, occipital alopecia in 94(18. 8%, lanugo in 72(14. 4%, peripheral cyanosis in 47(9. 4%, breast hypertrophy in 29(5. 8% and miniature puberty in 28(5. 6% newborns. Of the transient non-infective skin diseases, erythema toxicum neonatorum was observed most commonly in 105(21 %, followed by miliaria rubra in 103(20. 6% and acne neonatorum in 27(5. 4% newborns. The naevi and other developmental defects in the descending order were salmon patch in 69(13. 8%, congenital melanocytic noevi in 10(2%, accessory tragi in 3(0.6%, spina bifida in 2(0.4%, hydrocephalus in 1(0.2% and poliosis in 1(0.2% newborns. Cradle cap was the only dermatitis observed in 50(10% newborns. One (0.2% case each of Harlequin ichthyosis and labial cyst was seen.

  18. Diagnósticos diferenciales de la histiocitosis a células de Langerhans The differential diagnostics of Langerhans cell histiocytosis

    Directory of Open Access Journals (Sweden)

    C. N. Chirino

    2007-06-01

    Full Text Available La histiocitosis a células de Langerhans (HCL debe diferenciarse de las siguientes entidades: eritema tóxico neonatorum (ETN, dermatitis seborreica (DS, foliculitis pustulosa eosinofílica (FPE, incontinencia pigmenti (IP, mastocitosis/urticaria pigmentosa (M/UP, acrodermatitis enteropática (ADE, síndrome de Wiskott-Aldrich (WAS, acropustulosis infantil (API. Además se deben considerar la enfermedad de Rosai- Dorfman (ERD, xantomas diseminados, melanosis pustulosa neonatal (MPN, candidiasis congénita, listeriosis neonatal, herpes simple perinatal y la varicela neonatal. Debido a que los métodos auxiliares de laboratorio no siempre están disponibles o los resultados laboratoriales algunas veces son extemporáneos, y puesto que el médico práctico a menudo necesita tomar decisiones precozmente, es que la epidemiología resulta útil, pues brinda el marco adecuado para ordenar y jerarquizar las sospechas diagnósticas frente a un caso concreto, con un paciente determinado, en un momento específico.The differential diagnostics of Langerhans cell histiocytosis should include the following disorders: erythema toxicum neonatorum, seborrheic dermatitis, eosinophilic pustular folliculitis, incontinentia pigmenti, mastocytosis / urticaria pigmentosa, acrodermatitis enteropathica, Wiskott-Aldrich syndrome, infantile acropustulosis, Rosai- Dorfman disease, xanthoma disseminatum, neonatal pustular melanosis, congenital candidiasis, perinatal listeriosis, perinatal herpes simplex, neonatal varicella. Since the auxiliary methods of lab are not always available, or lab results are sometimes extemporaneous, the physicians often needs to make quick decisions. The epidemiology is useful because it offers the appropriate mark to prioritize the diagnostic in specific cases

  19. When Self-Pleasuring Becomes Self-Destruction: Autoerotic Asphyxiation.

    Science.gov (United States)

    Jenkins, Andrew P.

    This paper describes autoerotic asphyxia (AEA), using strangulation to enhance the pleasure of masturbation. AEA claims the lives of between 250-1,000 U.S. young men each year (though it is likely that it is underreported). Though AEA is found primarily among males, females participate, but in far smaller numbers. The most common motivation for…

  20. Effektiv behandling af hyperkalcaemi ved neonatal subkutan fedtnekrose

    DEFF Research Database (Denmark)

    Bergstein, Katrine Ryttov; Jacobsen, Ronni Bengtson; Jacobsen, Bengt Brock; Christesen, Henrik T

    2010-01-01

    This is a description of two cases of subcutaneous fat necrosis due to asphyxia in two newborns, and associated hypercalcaemia. Treatment with intravenous pamidronate 0.5 mg/kg for three days was very successful and well-tolerated. In conclusion, the treatment of hypercalcaemia was effective, but...

  1. ACE-inhibitor induced angio-oedema treated with complement C1-inhibitor concentrate

    DEFF Research Database (Denmark)

    Rasmussen, Eva Rye; Bygum, Anette

    2013-01-01

    ACE-inhibitor is an antihypertensive drug which is increasingly used to treat a wide range of medical conditions. A known adverse reaction is angio-oedema of the head and neck, which can become fatal when the upper airway is involved, causing asphyxia. We present a Caucasian man, who developed...

  2. Umbilical cord blood lactate: a valuable tool in the assessment of fetal metabolic acidosis

    DEFF Research Database (Denmark)

    Gjerris, Anne Cathrine Roslev; Staer-Jensen, Jette; Jørgensen, Jan Stener;

    2008-01-01

    The aim of the present study was (1) to evaluate the relationship between umbilical cord arterial blood lactate and pH, standard base excess (SBE), and actual base excess (ABE) at delivery and (2) to suggest a cut-off level of umbilical cord arterial blood lactate in predicting fetal asphyxia usi...

  3. Risk factors for meconium stained amniotic fluid and its implications

    Directory of Open Access Journals (Sweden)

    Ramya Sundaram

    2016-08-01

    Conclusions: Meconium stained amniotic fluid is associated with a higher incidence of operative deliveries resulting in an increased maternal morbidity. It is also associated with an increased neonatal morbidity due to birth asphyxia and respiratory depression at birth and a significant risk of neonatal mortality due to meconium aspiration syndrome. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2503-2506

  4. 高压氧治疗新生儿缺氧缺血性脑病39例%Therapy of hyperbaric oxygenation for 39 children with hypoxic and ischemic encephalopathy

    Institute of Scientific and Technical Information of China (English)

    周宝华; 裴颖; 刘俊礼

    2003-01-01

    @@ BACKGROUND: Hypoxic and ischemic encephalopathy(HIE) of new-born is thought as a severe disease with organ suf-fering anoxic and iscbemic injury caused by perinatal asphyxi-a. Now it is generally recognized that HIE serves as a main factorleading to the sequela of death and disableement of new-born.

  5. Security problems at Vivitron

    International Nuclear Information System (INIS)

    The risks of accidents and the safety actions concerning the components and the staff protection at Vivitron are analyzed. The risks induced by the utilization of SF6 is mainly asphyxia. The sealing defects on the gas storage devices and gas leaking inside Vivitron are considered. The safety actions and devices are summarized. Radiation protection problems are also discussed

  6. Myocardial infarction and arterial thrombosis in identical newborn twins with homozygosity for the PAI-1 4 G/5 G polymorphism

    OpenAIRE

    De Lucia, Vittoria; Andreassi, Maria Grazia; Sabatini, Laura; Ait-Ali, Lamia; Spadoni, Isabella; Giusti, Sandra

    2009-01-01

    Myocardial infarction in the perinatal period, in the absence of congenital heart disease or coronary artery lesions, is rare. The most common etiology described are the thromboembolism and perinatal asphyxia. We report a case of monozygotic twins who developed, after birth, acute vascular events and both had PAI-1 4G/4G homozygosity.

  7. MATERNAL AND FETAL OUTCOME IN PREGNANCIES WITH SLE - A PROSPECTIVE STUDY OF 40 CASES

    OpenAIRE

    Menon Nalini; Lakshmi

    2015-01-01

    Pregnancy and child birth in SLE patients can be complicated by disease activity, lupus nephritis, gestational diabetes, hypertensive disorders, intrauterine growth retardation, placental abruption, intrauterine and neonatal death, birth asphyxia, neonatal lupus and maternal mortality. AIMS AND OBJECTIVES : T o find out 1) T he most common complicatio...

  8. Socioeconomic Inequality in Malnutrition in Developing Countries

    NARCIS (Netherlands)

    E. Van de Poel (Ellen); A.R. Hosseinpoor (Ahmad); N. Speybroeck (Niko); T.G.M. van Ourti (Tom); J. Vega (Jeanette)

    2008-01-01

    textabstractEpidemiological evidence points to a small set of primary causes of child mortality that are the main killers of children aged less than 5 years: pneumonia, diarrhoea, low birth weight, asphyxia and, in some parts of the world, HIV and malaria. Malnutrition is the underlying cause of one

  9. Laryngotracheal stenosis and reconstruction

    NARCIS (Netherlands)

    L.M. Janssen (Luuk)

    2010-01-01

    textabstractThe patency of the larynx and the trachea is sometimes compromised acutely with a direct threat of suffocation or asphyxia. Of old this occurred quite often as a consequence of diphteria and other infectious diseases or as a result of various kinds of exogenous traumata. Infectious disea

  10. Cerebral Palsy in Pakistani Children: A Hospital Based Survey

    Directory of Open Access Journals (Sweden)

    Atif Ahmed Khan

    2014-08-01

    Conclusion:Spastic quadriplegia or spastic diplegia are the commonest presentations in Pakistani children diagnosed with CP. The frequent etiological factors in CP development are birth asphyxia, prematurity, meningoencephalitis and kernicterus. [Cukurova Med J 2014; 39(4.000: 705-711

  11. PROFILE OF ASPHYXIATED BABIES AT NEONATAL INTENSIVE CARE UNIT IN A TERTIARY CARE HOSPITAL IN NORTH EASTERN INDIA

    Directory of Open Access Journals (Sweden)

    Ananta Kumar

    2016-05-01

    Full Text Available BACKGROUND Birth asphyxia is one of the major causes of neonatal mortality as well as morbidity in India, but it studied that the causes which lead to asphyxia are usually preventable. Many metabolic as well as other sequential changes occurs in the body as a result of birth asphyxia which further lead to major long-term sequelae like cerebral palsy, mental retardation and seizure disorder. AIM To identify antepartum, intrapartum and postnatal risk factors for neonatal mortality due to birth asphyxia and to assess the clinico-biochemical status and outcome in the early neonatal period of babies who were asphyxiated at birth. DESIGN Cohort study. SETTING Neonatal Intensive Care Unit, Gauhati Medical College and Hospital. METHODS After clearance from the Hospital Ethical Committee, all severely asphyxiated babies at birth, admitted to neonatal unit from August 2009 to July 2010 were included in the study. A specially designed questionnaire was used to assess the role of maternal factors and neonatal presentation of birth asphyxia. Antenatal and intrapartum factors like maternal anaemia, Pregnancy Induced Hypertension (PIH, eclampsia, antenatal visits, Meconium Stained Amniotic Fluid (MSAF were recorded. Asphyxiated babies were observed for stages of Hypoxic Ischaemic Encephalopathy (HIE, reflexes and any end organ involvement. Investigations were done for blood counts, electrolytes, USG, etc. RESULTS Among 150 babies, we found significant association between birth asphyxia and factors like poor antenatal check-up (48%, MSAF (38.7%, maternal anaemia (78%, PIH (20.7%, eclampsia (15.3%, prolonged labour (28%, ante partum foetal distress (14.7%; 24% cases were in HIE stage I, 32% in stage II and 44% in stage III. Multiorgan involvement seen with renal (9.3%, haematological (3.3% abnormalities. During management 54.6% needed inotropes (54.6% for circulatory support, 60% cases needed anticonvulsant and mortality rate was (48%. CONCLUSION There were lots

  12. Brain Research to Ameliorate Impaired Neurodevelopment - Home-based Intervention Trial (BRAIN-HIT

    Directory of Open Access Journals (Sweden)

    Mahantshetti Niranjana S

    2010-04-01

    Full Text Available Abstract Background This randomized controlled trial aims to evaluate the effects of an early developmental intervention program on the development of young children in low- and low-middle-income countries who are at risk for neurodevelopmental disability because of birth asphyxia. A group of children without perinatal complications are evaluated in the same protocol to compare the effects of early developmental intervention in healthy infants in the same communities. Birth asphyxia is the leading specific cause of neonatal mortality in low- and low-middle-income countries and is also the main cause of neonatal and long-term morbidity including mental retardation, cerebral palsy, and other neurodevelopmental disorders. Mortality and morbidity from birth asphyxia disproportionately affect more infants in low- and low-middle-income countries, particularly those from the lowest socioeconomic groups. There is evidence that relatively inexpensive programs of early developmental intervention, delivered during home visit by parent trainers, are capable of improving neurodevelopment in infants following brain insult due to birth asphyxia. Methods/Design This trial is a block-randomized controlled trial that has enrolled 174 children with birth asphyxia and 257 without perinatal complications, comparing early developmental intervention plus health and safety counseling to the control intervention receiving health and safety counseling only, in sites in India, Pakistan, and Zambia. The interventions are delivered in home visits every two weeks by parent trainers from 2 weeks after birth until age 36 months. The primary outcome of the trial is cognitive development, and secondary outcomes include social-emotional and motor development. Child, parent, and family characteristics and number of home visits completed are evaluated as moderating factors. Discussion The trial is supervised by a trial steering committee, and an independent data monitoring

  13. SURVEI KEMATIAN NEONATAL (STUDI AUTOPSI VERBAL DI KABUPATEN CIREBON, 2004

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    Sarimawar Djaja

    2012-09-01

    Full Text Available In its attempt to realize the intervention program to saving newborn babies with asphyxia, the Ministry of Health will initiate to train midwives in the village in order to that they know how to operate resuscitation equipment to save neonatal baby with asphyxia. The intervention program his dubbed successful if the mortality proportion due if asphyxia decreased to half as targeted. The survey was conducted in the rural area of Cirebon district. The sample was 200 neonatal death babies, calculated using the hypothesis test with different proportion; p1 0.3 (30% neonatal death cause of asphyxia, according household health survey 2001, p2 0.15, α 0.05, β 0.2, (l-β 0.8. Neonatal dead cases happened within 12 months prior to the survey were identified by rural midwives out of their personal records. The death cases were followed up by interviewing the mother of the neonatal baby concerning its birth, illness or disorder histories before death. The diagnosis of the diseases were based on the International Classification of Diseases 10 and Wigglesworth classification, determined in union by NIHRD researchers and neonatologists. The neonatal mortality rate was 13 out of 1,000 live births. The major cause of early neonatal mortality was respiration disorder mainly caused by birth asphyxia (45%, of which 90 percent could be intervened by doing resuscitation (for babies weighed more than 1.000 gram. The second and third order of the mortality causes was infection (22% and congenital disorders (11% respectively. The major cause of late neonatal mortality was infection (56%, followed by low birth weight and prematurely born, as well as neonatal jaundice (14 percent each, and congenital disorder comes in the third place. The option to handle asphyxia with the early neonatal babies is the right effort to decrease the neonatal mortality rate. And to achieve the utmost result, it is necessary that the rural midwives maintain their standard performance (in

  14. Litigation related to intrapartum fetal surveillance.

    Science.gov (United States)

    Schifrin, Barry S; Soliman, Mohamed; Koos, Brian

    2016-01-01

    The role of intrapartum care including cardiotocography (CTG) monitoring in cases of perinatal neurological injury receives considerable debate in both clinical and medicolegal settings. The debate, however, has distracted attention from fundamental questions about the timing, mechanism, and preventability of perinatal injury. CTG tracings are used as a surrogate for asphyxia with the timing of intervention ("rescue") predicated on the presumed severity of asphyxia. Using CTG in this way has prevented intrapartum stillbirth, but it has not reduced the long-term injury in part, because, contrary to popular belief, the majority of intrapartum fetal injuries are unassociated with severe hypoxia or severe neonatal depression. This article describes the timing and mechanisms, including mechanical factors, of intrapartum perinatal injury and the benefit of using the CTG, not for the purpose of "rescue", but for identifying risk factors for fetal injury and keeping the fetus out of harm's way. PMID:26227999

  15. BURKING: A CASE REPORT

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    Durga Prasad

    2014-08-01

    Full Text Available Homicide means causing death of a person by another person. This homicide may be lawful or unlawful. There are many ways of committing a homicide. Burking is one of the methods. The term ‘Burking’ is derived from notorious criminal ‘Burke’, who with his accomplice ‘Hare’, killed old people by a combination of smothering and traumatic asphyxia, and sold the bodies to the medical school in Edinburgh. We here presented a case of homicide by burking. AIM: To explain the term burking and to present a real case of homicide by burking, which we encountered. MATERIALS & METHODS: Various journal articles, textbooks of Forensic Medicine, FIR copy of the case, crime scene visit, photos, inquest report, post mortem examination, crime investigation information. CONCLUSION: Burking is a type of homicide by smothering with traumatic asphyxia. Though it is rare, it is not completely unseen

  16. Cerebral atrophic and degenerative changes following various cerebral diseases, (1)

    International Nuclear Information System (INIS)

    Patients having cerebral atrophic and degenerative changes following hypoglycemia, cerebral contusion, or cerebral hypoxia including cerebrovascular disorders were reported. Description was made as to cerebral changes visualized on CT images and clinical courses of a patient who revived 10 minutes after heart stoppage during neurosurgery, a newborn with asphyxia, a patient with hypoglycemia, a patient who suffered from asphyxia by an accident 10 years before, a patient with carbon monoxide poisoning at an acute stage, a patient who had carbon monoxide poisoning 10 years before, a patient with diffuse cerebral ischemic changes, a patient with cerebral edema around metastatic tumor, a patient with respiration brain, a patient with neurological sequelae after cerebral contusion, a patient who had an operation to excise right parietal lobe artery malformation, and a patient who was shooted by a machine gun and had a lead in the brain for 34 years. (Tsunoda, M.)

  17. IMPACT OF MECONIUM STAINED AMNIOTIC FLUID ON EARLY NEONATAL OUTCOME

    Directory of Open Access Journals (Sweden)

    Uday

    2013-11-01

    Full Text Available ABSTRACT: OBJECTIVE: To find out the incidence, neonatal outcome and associated maternal antepartum & intrapartum risk factors of meconium stained amniotic fluid (MSAF. DESIGN: Prospective St udy. SETTINGS: Neonatal Unit of Hospital and PNC Ward. SUBJECTS & METHODS: Prospective Study was conducted including 100 babies born with meconium stained amniotic fluid who are admitted in NICU and with mother in PNC ward in a period of six months (April 2012 - October 2012 excluding those who born with congenital abnormalities. Detail history of babies and mother with MSAF noted with emphasis on antepartum and intrapartum risk factors and outcome in terms of morbidity and mortality. RESULTS: Incidence of M SAF in the study was 8. 98%. Out of 100, 24 babies were admitted to NICU with most common indications being birth asphyxia (16% and Meconium Aspiration Syndrome (MAS (6%. Majority babies were delivered through thin Meconium Stained Liquor (MSL (44% fo llowed by thick (35% and moderate (21%. Total number of deaths were 9 and all these babies had thick meconium with severe birth asphyxia. Ninety one babies were born at >37 weeks of gestation and 57 had birth weight over 2. 5 Kg. Nineteen percent were no n vigorous requiring tracheal suctioning and positive pressure ventilation at birth. Common mode of delivery was emergency Cesarean in 83% patients. Common maternal and fetal risk factors were fetal distress (30% followed by Oligohydramnios (30%, Pregnan cy induced hypertension (PIH (24%, anemia (14%, severe anemia (5%, Antepartum hemorrhage (4% and Antepartum eclampsia (4%. CONCLUSIONS: Oligohydramnios, PIH, anemia and fetal distress were common antenatal and intranatal factors associated with MSAF. Major morbidity and indication for NICU admission was Birth asphyxia and non vigorous babies. Mortality rate was 9% which is commonly associated with thick meconium and severe birth asphyxia.

  18. Acute Respiratory Distress Due to Methane Inhalation

    OpenAIRE

    Jo, Jun Yeon; Kwon, Yong Sik; Lee, Jin Wook; Park, Jae Seok; Rho, Byung Hak; Choi, Won-Il

    2013-01-01

    Inhalation of toxic gases can lead to pneumonitis. It has been known that methane gas intoxication causes loss of consciousness or asphyxia. There is, however, a paucity of information about acute pulmonary toxicity from methane gas inhalation. A 21-year-old man was presented with respiratory distress after an accidental exposure to methane gas for one minute. He came in with a drowsy mentality and hypoxemia. Mechanical ventilation was applied immediately. The patient's symptoms and chest rad...

  19. MRI and US findings of subcutaneous fat necrosis of the newborn

    International Nuclear Information System (INIS)

    Subcutaneous fat necrosis of the newborn (SCFN) is an uncommon, benign disorder found in full-term or post-mature neonates. It usually presents in neonates who have experienced perinatal difficulty such as asphyxia, peripheral hypoxemia, hypothermia, meconium aspiration or trauma. We present a newborn with abnormal findings on MRI and US within the axilla, neck, and abdominal walls that were pathologically proved via biopsy to be subcutaneous fat necrosis. (orig.)

  20. [The first application of therapeutic hypothermia in Poland--selective head cooling (Cool-Cap) with whole-body moderate hypothermia in a newborn with features of hypoxic ischemic encephalopathy].

    Science.gov (United States)

    Gulczyńska, Ewa; Kesiak, Marcin; Kryszczyńska, Joanna; Gadzinowski, Janusz; Oszukowski, Przemysław

    2012-05-01

    The authors present the first application of therapeutic hypothermia in a newborn in Poland. The female newborn, born with severe asphyxia, was transported to a referral perinatal center where the method of brain cooling was possible. Severe hypoxic ischemic encephalopathy was confirmed by an integrated EEG. During the cooling procedure (which lasted 72 hours), no important side effects were noticed. The neurodevelopmental outcome of the baby assessed during the first 2 years of her life is normal. PMID:22708339

  1. The Success of Cardiotocography in predicting Perinatal Outcome

    OpenAIRE

    Kaban, Alpaslan; Cengiz, Hüseyin; Kaban, Işık; Özcan, Alim; Karakaş, Sema

    2012-01-01

    Objectives: The determination of the fetal condition during labor is important to minimize fetal death due to asphyxia and the neurological sequelae of fetal hypoxia. This study evaluated the success of fetal cardiotocography in predicting perinatal consequences. Materials and methods: This study enrolled 101 full-term pregnant women admitted for delivery to Vakif Gureba Training and Research Hospital between October 2009 and February 2010. Women were included if they were aged 18-45 year...

  2. Cardiotocography in the Prognosis of Perinatal Outcome

    OpenAIRE

    Bogdanovic, Gordana; Babovic, Adnan; Rizvanovic, Mirzeta; LJUCA Dzenita; Grgic, Gordana; Djuranovic–Milicic, Jadranaka

    2014-01-01

    ABSTRACT Aim: The objective of the study was to examine whether cardiotocography can (CTG) predict asphyxia of the embryo, manifested as hypoxic-ischemic encephalopathy (HIE), and to what extent one can rely on CTG record. Material and methods: Retrospective research was carried out at the Clinic for Gynecology and Obstetrics UKC Tuzla and medical documentation from the history of mothers and newborns was used. The study group consisted of 68 pregnancies and newborns who developed HIE. The co...

  3. Modern methods in the prevention and management of complications in labor

    OpenAIRE

    Ojala, K.

    2010-01-01

    Abstract Although in Finland the incidence of maternal and neonatal mortality in labor is very low, labor carries some risks. This study focused on two major complications in labor: fetal asphyxia and maternal hemorrhage. The roles of fetal electrocardiographic ST-analysis (STAN) and pelvic artery embolization in the prevention and management of these complications were investigated. Intrapartum fetal monitoring aims at a timely detection of fetal hypoxemia. When non-selected parturie...

  4. Intrapartum fetal monitoring by ST-analysis of the fetal ECG

    OpenAIRE

    Westerhuis, M.E.M.H.

    2010-01-01

    Objective Intrapartum fetal monitoring aims to identify fetuses at risk for neonatal and long-term injury due to asphyxia. To serve this purpose, cardiotocography (CTG) combined with ST-analysis of the fetal electrocardiogram (ECG), which is a relatively new method, may be used. The main aim of this thesis was to quantify the (cost) effectiveness of intrapartum fetal monitoring by ST-analysis of the fetal ECG in women with a singleton term pregnancy in cephalic position. Methods Several studi...

  5. A Comparison between APGAR Scores and Birth Weight in Infants of Addicted and Non-Addicted Mothers

    OpenAIRE

    Rahi, Esmat; Baneshi, Mohammad Reza; Mirkamandar, Ehsan; Haji Maghsoudi, Saiedeh; Rastegari, Azam

    2011-01-01

    Background Addiction in pregnant women causes complications such as abortion, asphyxia and cerebral and physical problems. APGAR score assesses vital signs and birth weight and represents the physical and brain growth of newborns. In this study, the effects of opium addiction in mothers on birth weight and APGAR scores of neonates were discussed. Methods This study analytic, descriptive study was conducted on 49 pregnant women addicted to oral consumption of opium (0.5-0.8 grams daily) and 49...

  6. Recent Trends in Erythropoietin-mediated Neuroprotection

    OpenAIRE

    McPherson, Ronald J.; Juul, Sandra E.

    2007-01-01

    Fifteen years of evidence have established that the cytokine erythropoietin offers promise as a treatment for brain injury. In particular, neonatal brain injury may be reduced or prevented by early treatment with recombinant erythropoietin. Extreme prematurity and perinatal asphyxia are common conditions associated with poor neurodevelopmental outcomes including cerebral palsy, mental retardation, hearing or visual impairment, and attention deficit hyperactivity disorder. When high doses of e...

  7. Does Maturity Affect Cephalic Perfusion and T/QRS Ratio during Prolonged Umbilical Cord Occlusion in Fetal Sheep?

    Directory of Open Access Journals (Sweden)

    Guido Wassink

    2014-01-01

    Full Text Available T/QRS ratio monitoring is used to help identify fetal asphyxia. However, immature animals have greater capacity to maintain blood pressure during severe asphyxia, raising the possibility that they may show an attenuated T/QRS increase during asphyxia. Chronically instrumented fetal sheep at 0.6 of gestation (0.6 GA; n = 12, 0.7 GA (n = 12, and 0.8 GA (n = 8 underwent complete umbilical cord occlusion for 30 min, 25 min, or 15 min, respectively. Cord occlusion was associated with progressive metabolic acidosis and initial hypertension followed by severe hypotension, with a more rapid fall in mean arterial blood pressure (MAP and carotid blood flow (CaBF with advancing gestation. T/QRS ratio rose after occlusion more rapidly at 0.8 GA than in immature fetuses, to a similar final peak at all ages, followed by a progressive fall that was slower at 0.8 GA than in the immature fetuses. The increase in T/QRS ratio correlated with initial hypertension at 0.8 GA (P<0.05, R2 = 0.38, and conversely, its fall correlated closely with falling MAP in all gestational groups (P<0.01, R2 = 0.67. In conclusion, elevation of the T/QRS ratio is an index of onset of severe asphyxia in the last third of gestation, but not of fetal compromise.

  8. Virtual simulator for the generation of patho-physiological foetal ECGs during the prenatal period

    OpenAIRE

    Martinek, Radek; Kelnar, Michal; Vojčinák, Petr; Koudelka, Petr; Vaňuš, Jan; Bilík, Petr; Janků, Petr; Nazeran, Homer; Žídek, Jan

    2015-01-01

    The design, implementation, and verification of a signal simulator for the generation of patho-physiological records of foetal electrocardiograms (fECGs) during the prenatal period are briefly reported. The simulator enables users to model the patho-physiological changes that occur within the foetus’ myocardium under hypoxic conditions (hypoxemia, hypoxia, asphyxia, etc.) during the 20th to 42nd week of pregnancy. The simulator deploys a dynamic fECG model including an ac...

  9. Autoerotic death due to electrocution

    Directory of Open Access Journals (Sweden)

    Piotr Arkuszewski

    2014-08-01

    Full Text Available Autoerotic death is a very rare case in forensic medicine. It is usually caused by asphyxia, but other reasons are also possible. Herein we present a case of autoerotic death due to electrocution caused by a self-made electrical device. The device was constructed to increase sexual feelings through stimulation of the scrotal area.

  10. Cerebrocostomandibular syndrome in four sibs, two pairs of twins.

    OpenAIRE

    Drossou-Agakidou, V; Andreou, A.; Soubassi-Griva, V; Pandouraki, M

    1991-01-01

    We report four sibs, two pairs of twins, with cerebrocostomandibular syndrome (CCMS). The family history was negative. All four babies had the characteristic features of CCMS, including Pierre-Robin anomalad and rib dysplasia. Cerebral involvement was evident in two of the patients who had suffered perinatal asphyxia. The presence of the syndrome in all four sibs together with the negative family history in previous generations is consistent with Mendelian autosomal recessive inheritance with...

  11. Visual disorders in cerebral palsy

    OpenAIRE

    Govind Amita; Lamba P

    1988-01-01

    Seventy children with cere-bral palsy were examined for aetiological factors responsible, type of disorder and ocular abnormalities. The overall inci-dence of ocular abnormalities was 68.69%, the highest frequency being of squint (35.7%). Other anomalies detected inclu-ded refractive errors (28.5%), optic atrophy (10%) and coloboma (2.9%). Most children were spastic quadriplegics with asphyxia as the major aetiological factor. The study created an awareness ...

  12. Value of radiological and ultrasound examination in the prenatal diagnosis of the siren syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Fiegler, W.; Hunsdiek, F.W.

    1980-11-01

    A sirenomelia is described. In addition to the characteristic single lower extremity, there are also, as in all cases of sympodia, severe malformations in the urogenital system, intestine, pelvis and vertebral column. The various theories of genesis are discussed. Ultrasound can be used as a screening procedure in early detection of deformities. So it is possible to avoid an emergency section in cases, where a non-viable child is endangered by intrauterine asphyxia.

  13. The value of radiological and ultrasound examination in the prenatal diagnosis of the siren syndrome

    International Nuclear Information System (INIS)

    A sirenomelia is described. In addition to the characteristic single lower extremity, there are also, as in all cases of sympodia, severe malformations in the urogenital system, intestine, pelvis and vertebral column. The various theories of genesis are discussed. Ultrasound can be used as a screening procedure in early detection of deformities. So it is possible to avoid an emergency sectio in cases, where a non-viable child is endangered by intrauterine asphyxia. (orig.)

  14. Value of radiological and ultrasound examination in the prenatal diagnosis of the siren syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Fiegler, W.; Hunsdiek, F.W.

    1980-11-01

    A sirenomelia is described. In addition to the characteristic single lower extremity, there are also, as in all cases of sympodia, severe malformations in the urogenital system, intestine, pelvis and vertebral column. The various theories of genesis are discussed. Ultrasound can be used as a screening procedure in early detection of deformities. So it is possible to avoid an emergency sectio in cases, where a non-viable child is endangered by intrauterine asphyxia.

  15. Characterization of newborns with nonimmune hydrops fetalis admitted to a neonatal intensive care unit Caracterização dos recém-nascidos com hidropisia fetal não imune admitidos em uma unidade neonatal de terapia intensiva

    OpenAIRE

    Renata Suman Mascaretti; Mário Cícero Falcão; de Silva, Andrea M; Flávio Adolfo Costa Vaz; Cléa Rodrigues Leone

    2003-01-01

    PURPOSE: To determine the incidence and characteristics of nonimmune hydrops fetalis in the newborn population. METHOD: A retrospective study of the period between 1996 and 2000, including all newborns with a prenatal or early neonatal diagnosis of nonimmune hydrops fetalis, based on clinical history, physical examination, and laboratory evaluation. The following were analyzed: prenatal follow-up, delivery type, gender, birth weight, gestational age, presence of perinatal asphyxia, nutritiona...

  16. Capnography during cardiac resuscitation: a clue on mechanisms and a guide to interventions

    OpenAIRE

    Gazmuri, Raúl J.; Kube, Erika

    2003-01-01

    Measurement of the end-tidal partial pressure of carbon dioxide (PETCO2) during cardiac arrest has been shown to reflect the blood flow being generated by external means and to prognosticate outcome. In the present issue of Critical Care, Grmec and colleagues compared the initial and subsequent PETCO2 in patients who had cardiac arrest precipitated by either asphyxia or ventricular arrhythmia. A much higher PETCO2 was found immediately after intubation in instances of asphyxial arrest. Yet, a...

  17. Maximum opening of the mouth by mouth prop during dental procedures increases the risk of upper airway constriction

    OpenAIRE

    Yamazaki, Shinya

    2010-01-01

    Hiroshi Ito1, Hiroyoshi Kawaai1, Shinya Yamazaki1, Yosuke Suzuki21Division of Systemic Management, Department of Oral Function, 2Division of Radiology and Diagnosis, Department of Medical Sciences, Ohu University, Post Graduate School of Dentistry, Koriyama City, Fukushima Prefecture, JapanAbstract: From a retrospective evaluation of data on accidents and deaths during dental procedures, it has been shown that several patients who refused dental treatment died of asphyxia during dental proced...

  18. MRI and US findings of subcutaneous fat necrosis of the newborn

    Energy Technology Data Exchange (ETDEWEB)

    Vasireddy, Syam; Long, Scott D. [Southern Illinois University, Department of Radiology, Springfield, IL (United States); St. John' s Hospital, Department of Radiology, Springfield, IL (United States); Sacheti, Bhavna [Medical College of Wisconsin, Department of Pediatric Critical Care, Milwaukee, WI (United States); Children' s Hospital Wisconsin, Department of Critical Care, Milwaukee, WI (United States); Mayforth, Ruth D. [Southern Illinois University, Department of Surgery, Springfield, IL (United States); St. John' s Hospital, Department of Surgery, Springfield, IL (United States)

    2009-01-15

    Subcutaneous fat necrosis of the newborn (SCFN) is an uncommon, benign disorder found in full-term or post-mature neonates. It usually presents in neonates who have experienced perinatal difficulty such as asphyxia, peripheral hypoxemia, hypothermia, meconium aspiration or trauma. We present a newborn with abnormal findings on MRI and US within the axilla, neck, and abdominal walls that were pathologically proved via biopsy to be subcutaneous fat necrosis. (orig.)

  19. Intramuscular Injection of “Site Enhancement Oil”

    DEFF Research Database (Denmark)

    Petersen, Maria Louise; Colville-Ebeling, Bonnie; Jensen, Thomas Hartvig Lindkær;

    2015-01-01

    The use of intramuscular injection of foreign substances for aesthetic purposes is well known. Complications are usually local to the site of injection but can be potentially lethal. Here, we present a case of "site enhancement oil" use in a 42-year-old man who died from asphyxia due to hanging....... Macroscopic and microscopic changes as well as computed tomographic changes in injected musculature are described and the potentially lethal adverse effects after site enhancement oil use are warranted....

  20. Symmetrical thalamic lesions in infants.

    OpenAIRE

    Eicke, M.; Briner, J; Willi, U; Uehlinger, J; Boltshauser, E

    1992-01-01

    Clinical observations and findings on imaging are reported in six newborns with symmetrical thalamic lesions (STL). In three cases the diagnosis was confirmed by postmortem examination. Characteristic observations in this series and 17 previously reported cases include no evidence of perinatal asphyxia, high incidence of polyhydramnios, absent suck and swallow, absent primitive reflexes, appreciable spasticity at or within days of birth, lack of psychomotor development, and death within days ...

  1. Ellagic acid improves electrocardiogram waves and blood pressure against global cerebral ischemia rat experimental models

    OpenAIRE

    Nejad, Khojasteh Hoseiny; Dianat, Mahin; Sarkaki, Alireza; Naseri, Mohammad Kazem Gharib; Badavi, Mohammad; Farbood, Yaghoub

    2015-01-01

    Background: Global cerebral ischemia (GCIR) arises in patients that are shown a variety of clinical difficulty including cardiac arrest, asphyxia, and shock. In spite of advances in understanding of the brain, ischemia and protective effects to improve ischemic injury still remain unknown. The aim of our study was to investigate the effect of ellagic acid (EA) pretreatment in the rat models of global cerebral ischemia reperfusion. Methods: This experimental study was conducted in 2014 at the ...

  2. Sepsis neonatal precoz causada por transmisión vertical de Morganella morganii, en un embarazo de término Fatal neonatal sepsis caused by vertical transmission of Morganella morganii. Report of one case

    OpenAIRE

    Alfredo Ovalle; M Angélica Martínez; Elena Kakarieka; Mirna García; Abril Salinas

    2009-01-01

    We report a term neonate who developed early-onset sepsis due to Morganella morganii. The child was vaginally delivered after a short labor, and presented signs of perinatal asphyxia. Blood cultures taken soon after birth and from mother's lochia were positive for this microorganism. The infection was unresponsive to treatment with cefotaxime, to which the microorganism was susceptible, and the infant died at 17 days of age. M morganii is an opportunistic and uncommon pathogen, causing diseas...

  3. Translational Approaches for Studying Neurodevelopmental Disorders Utilizing in Vivo Proton (+H) Magnetic Resonance Spectroscopic Imaging in Rats

    Science.gov (United States)

    Ronca, April E.

    2014-01-01

    Intrauterine complications have been implicated in the etiology of neuripsychiatric disorders including schizophrenia, autism and ADHD. This presentation will describe new translational studies derived from in vivo magnetic resonance imaging of developing and adult brain following perinatal asphyxia (PA). Our findings reveal significant effects of PA on neurometabolic profiles at one week of age, and significant relationships between early metabolites and later life phenotypes including behavior and brain morphometry

  4. Genomic insights into the etiology and classification of the cerebral palsies

    OpenAIRE

    Moreno-De-Luca, Andres; Ledbetter, David H.; Martin, Christa L.

    2012-01-01

    Cerebral palsy (CP), the most common physical disability of childhood, is a clinical diagnosis that encompasses a highly heterogeneous group of neurodevelopmental disorders resulting in movement and posture impairments that persist throughout life. Despite being commonly attributed to a variety of environmental factors, particularly to birth asphyxia, the specific cause remains unknown in the majority of individuals. Conversely, a growing body of evidence suggests that CP is likely caused by ...

  5. Korioamnionitis sebagai Faktor Risiko Terjadinya Palsi Serebral

    OpenAIRE

    Lubis, Siska Mayasari

    2010-01-01

    Cerebral palsy affects motion, muscle strength, balance, and coordination. Despite improvements in perinatal medicine, the prevalence of cerebral palsy has increased over the last 2 decades, and the etiology of cerebral palsy remains poorly understood. Evidence suggests that 70-80% of cases are due to prenatal factors, and that birth asphyxia plays a relatively minor role. A number of studies have assessed the relationship between chorioamnionitis and cerebral palsy in infants. Multicenter co...

  6. Laryngotracheal stenosis and reconstruction

    OpenAIRE

    Janssen, Luuk

    2010-01-01

    textabstractThe patency of the larynx and the trachea is sometimes compromised acutely with a direct threat of suffocation or asphyxia. Of old this occurred quite often as a consequence of diphteria and other infectious diseases or as a result of various kinds of exogenous traumata. Infectious diseases for instance, epiglottitis are still among us but are usually handled efficiently by medication and occasionally by intubation.

  7. Non-invasive optical monitoring of the newborn piglet brain using continuous-wave and frequency-domain spectroscopy

    International Nuclear Information System (INIS)

    We have used continuous-wave (CW) and frequency-domain spectroscopy to investigate the optical properties of the newborn piglet brain in vivo and non-invasively. Three anaesthetized, intubated, ventilated and instrumented newborn piglets were placed into a stereotaxic instrument for optimal experimental stability, reproducible probe-to-scalp optical contact and 3D adjustment of the optical probe. By measuring the absolute values of the brain absorption and reduced scattering coefficients at two wavelengths (758 and 830 nm), frequency-domain spectroscopy provided absolute readings (in contrast to the relative readings of CW spectroscopy) of cerebral haemoglobin concentration and saturation during experimentally induced perturbations in cerebral haemodynamics and oxygenation. Such perturbations included a modulation of the inspired oxygen concentration, transient brain asphyxia, carotid artery occlusion and terminal brain asphyxia. The baseline cerebral haemoglobin saturation and concentration, measured with frequency-domain spectroscopy, were about 60% and 42 μM respectively. The cerebral saturation values ranged from a minimum of 17% (during transient brain asphyxia) to a maximum of 80% (during recovery from transient brain asphyxia). To analyse the CW optical data, we have (a) derived a mathematical relationship between the cerebral optical properties and the differential pathlength factor and (b) introduced a method based on the spatial dependence of the detected intensity (dc slope method). The analysis of the cerebral optical signals associated with the arterial pulse and with respiration demonstrates that motion artefacts can significantly affect the intensity recorded from a single optode pair. Motion artefacts can be strongly reduced by combining data from multiple optodes to provide relative readings in the dc slope method. We also report significant biphasic changes (initial decrease and successive increase) in the reduced scattering coefficient measured

  8. Resuscitation and auto resuscitation by airway reflexes in animals

    OpenAIRE

    Tomori, Zoltan; Donic, Viliam; Benacka, Roman; Jakus, Jan; Gresova, Sona

    2013-01-01

    Various diseases often result in decompensation requiring resuscitation. In infants moderate hypoxia evokes a compensatory augmented breath – sigh and more severe hypoxia results in a solitary gasp. Progressive asphyxia provokes gasping respiration saving the healthy infant – autoresuscitation by gasping. A neonate with sudden infant death syndrome, however, usually will not survive. Our systematic research in animals indicated that airway reflexes have similar resuscitation potential as gasp...

  9. Reversal of functional disorders by aspiration, expiration, and cough reflexes and their voluntary counterparts

    OpenAIRE

    ZoltanTomori

    2012-01-01

    Agonal gasping provoked by asphyxia can save ~15% of mammals even from untreated ventricular fibrillation (VF), but it fails to revive infants with sudden infant death syndrome (SIDS). Our systematic study of airway reflexes in cats and other animals indicated that in addition to cough, there are two distinct airway reflexes that may contribute to auto-resuscitation. Gasp- and sniff-like spasmodic inspirations (SIs) can be elicited by nasopharyngeal stimulation, strongly activating the brains...

  10. New frontiers in obstructive sleep apnoea

    OpenAIRE

    Ayas, NT; Hirsch, AAJ; Laher, I; Douglas Bradley, T; Malhotra, A; Polotsky, VY; Tasali, E

    2014-01-01

    OSA (obstructive sleep apnoea), the most common respiratory disorder of sleep, is caused by the loss of upper airway dilating muscle activity during sleep superimposed on a narrow upper airway. This results in recurrent nocturnal asphyxia. Termination of these events usually requires arousal from sleep and results in sleep fragmentation and hypoxaemia, which leads to poor quality sleep, excessive daytime sleepiness, reduced quality of life and numerous other serious health consequences. Furth...

  11. Feasibility and safety of passive cooling in a cohort of asphyxiated newborn infants

    OpenAIRE

    Daetwyler, Karin; Brotschi, Barbara; Berger, Thomas M.; Wagner, Bendicht Peter

    2013-01-01

    OBJECTIVE: Therapeutic hypothermia has become a standard neuroprotective treatment in term newborn infants following perinatal asphyxia. Active cooling with whole body surface or head cooling is complex, expensive and often associated with initial hypothermic overshoot. We speculated that passive cooling might suffice to induce and maintain hypothermia. METHODS: We analysed 18 asphyxiated term newborns treated with hypothermia in three tertiary neonatal and paediatric intensive care units....

  12. Effects of different slaughtering methods on rigor mortis development and flesh quality of tench (TInca tinca)

    OpenAIRE

    GASCO L.; F. Gai; Rotolo, L.; Parisi, G.

    2014-01-01

    The effects of different slaughtering methods on rigor mortis and flesh quality parameters were investigated. Eighty tench were divided into four groups, whereby each group was slaughtered using a different method: percussive stunning (PS), live chilling (LC), asphyxia (CO2), or electrical stunning (ES). Progression of rigor mortis (RM) was recorded (30 h) as well as pH, colour, cooking losses, texture, drip losses and free water after 24 h of storage at +2°C. The PS grou...

  13. Stress Duodenal Ulcer Presenting as Hematochezia in a Neonate

    OpenAIRE

    Shrivastava, Rimjhim; Rathore, Mukesh; Goyal, Ravinder; Thapa, BR

    2013-01-01

    Background Primary duodenal ulcers are very rare in children under 10 years of age but stress induced ulceration in the stomach occurs more often in the neonatal period due to birth asphyxia, prolonged labour, caesarean deliveries, instrumentations, respiratory distress syndrome and sepsis. These present as acute onset of gastrointestinal bleed commonly as altered gastric aspirate, hematemesis or melena. Aim Management of a neonate with stress ulcer presenting as hematochezia ...

  14. FACTORS CONTRIBUTING TO PERINATAL MORTALITY : OPTIMIZING OUTCOME

    Directory of Open Access Journals (Sweden)

    Lakshmi

    2015-03-01

    Full Text Available OBJECTIVE: To evaluate the various causes of perinatal deaths and adopt strategies to improve perinatal outcome at a referral teaching hospital in North Kerala. METHODS: A prospective observational study conducted at Institute of Maternal and Child Health, Government Medical College, Kozhikode. All perinatal deaths during the period January 2013 to December 2014 were analysed and from this factors responsible for perinatal deaths were identified. RESULTS: Out of total 30,042 deliveries , there were 966 perinatal deaths during the study period. 566 were still births and 400 early neonatal deaths. The perinatal mortality rate was 31.1 per 1000 live births. Perinatal asphyxia was the major cause of perinatal mortality. The important factors contributing to perinatal asphyxia were prematurity (39%, abruptio placenta (19% and MSAF ( 12%. Among the antenatal factors, hypertensive disorders of pregnancy leading to iatrogenic elective preterm delivery were the most important. CONCLUSION: Perinatal asphyxia due to prematurity and low birth weight emerged as the most important cause of perinatal mortality in this study and hypertensive disorders of pregnancy were the most important antenatal complication leading to prematurity

  15. In vitro research of the alteration of neurons in vagal core in medulla oblongata at asphyxic deaths.

    Science.gov (United States)

    Haliti, Naim; Islami, Hilmi; Elezi, Nevzat; Shabani, Ragip; Abdullahu, Bedri; Dragusha, Gani

    2010-08-01

    The aim of this study was to research the morphological changes of neurons in the vagus nerve nuclei in medulla oblongata in asphyxia related death cases. Morphological changes that were investigated were mainly in the dorsal motor respiratory center (DMRC), nucleus tractus solitarius (nTS) and nucleus ambigus (nA) in the medulla oblongata. In our research, the autopsy material from asphyxia related death cases was used from various etiologies: monoxide carbon (CO), liquid drowning, strangulation, electricity, clinical-pathological death, firing weapon, explosive weapon, sharp and blunt objects and death cases due to accident. The material selected for research was taken from medulla oblongata and lungs from all lobes. The material from the medulla oblongata and lungs was fixed in a 10% solution of buffered formalin. Special histochemical methods for central nervous system (CNS) were employed like: Cresyl echt violet, toluidin blue, Sevier-Munger modification and Grimelius. For stereometrical analysis of the quantitative density of the neurons the universal testing system Weibel M42 was used. The acquired results show that in sudden asphyxia related death cases, there are alterations in the nuclei of vagal nerve in form of: central chromatolysis, axonal retraction, axonal fragmentation, intranuclear vacuolization, cytoplasmic vacuolization, edema, condensation and dispersion of substance of Nissl, proliferation of oligodendrocytes, astrocytes and microglia. The altered population of vagus nerve neurons does not show an important statistical significance compared to the overall quantity of the neurons in the nuclei of the vagus nerve (p<0.05). PMID:20846134

  16. The myths and physiology surrounding intrapartum decelerations: the critical role of the peripheral chemoreflex.

    Science.gov (United States)

    Lear, Christopher A; Galinsky, Robert; Wassink, Guido; Yamaguchi, Kyohei; Davidson, Joanne O; Westgate, Jenny A; Bennet, Laura; Gunn, Alistair J

    2016-09-01

    A distinctive pattern of recurrent rapid falls in fetal heart rate, called decelerations, are commonly associated with uterine contractions during labour. These brief decelerations are mediated by vagal activation. The reflex triggering this vagal response has been variably attributed to a mechanoreceptor response to fetal head compression, to baroreflex activation following increased blood pressure during umbilical cord compression, and/or a Bezold-Jarisch reflex response to reduced venous return from the placenta. Although these complex explanations are still widespread today, there is no consistent evidence that they are common during labour. Instead, the only mechanism that has been systematically investigated, proven to be reliably active during labour and, crucially, capable of producing rapid decelerations is the peripheral chemoreflex. The peripheral chemoreflex is triggered by transient periods of asphyxia that are a normal phenomenon associated with all uterine contractions. This should not cause concern as the healthy fetus has a remarkable ability to adapt to these repeated but short periods of asphyxia. This means that the healthy fetus is typically not at risk of hypotension and injury during uncomplicated labour even during repeated brief decelerations. The physiologically incorrect theories surrounding decelerations that ignore the natural occurrence of repeated asphyxia probably gained widespread support to help explain why many babies are born healthy despite repeated decelerations during labour. We propose that a unified and physiological understanding of intrapartum decelerations that accepts the true nature of labour is critical to improve interpretation of intrapartum fetal heart rate patterns. PMID:27328617

  17. Violent Asphyxial Death: A Study in Dinajpur Medical College, Dinajpur

    Directory of Open Access Journals (Sweden)

    Md. Mizanur Rahman

    2013-07-01

    Full Text Available Background: The word asphyxia is now commonly used to describe a range of conditions for which the lack of oxygen whether it is partial (hypoxia or complete (anoxia is considered to be the cause. The cardinal signs of asphyxia are cyanosis, congestion and petechial haemorrhage.Objective: To investigate the causes and manner of asphyxial death.Materials and Methods: It was a retrospective study conducted in the department of Forensic Medicine, Dinajpur Medical College, Dinajpur during July 2004 to June 2006. A total of 96 cases were examined and recorded. These cases were brought to the morgue of Dinajpur Medical College from 13 different police stations and 1 railway GRP station of Dinajpur district. The data were collected from the autopsy reports (preserved third copy with permission of the concerned autopsy surgeons.Results: 88.55% of asphyxia deaths were due to hanging, 6.25% due to strangulation and 5.20% were due to suffocation.Conclusion: Most of the asphyxial deaths are due to hanging.

  18. Aetiology and types of neonatal seizures presenting at ayub teaching hospital abbottabad

    International Nuclear Information System (INIS)

    Background: Neonatal seizures (NS) affect approximately 1% of neonates. Clonic, tonic, myoclonic and subtle seizures are the common types. Birth asphyxia, sepsis, metabolic derangements, intracranial bleed, kernicterus, tetanus and 5th day fits are the common aetiologies. This study was planned to evaluate the types and causes of neonatal seizures. Methods: It was a descriptive case series conducted at Ayub Teaching Hospital, Abbottabad from 12th December 2006 to 25th September 2007 on neonates having seizures. Serum chemistry, blood counts, cerebrospinal fluid examination and cranial ultrasound were done in all patients. Blood culture, renal and liver function tests, computerised tomography scan, metabolic and septic screening was done in selected patients. Descriptive statistics were applied for analysis. Results: Tonic clonic seizure was the commonest type (28%) followed by multi-focal clonic, and focal tonic seizures (25% each). Birth asphyxia was found to be the main aetiology (46%). Conclusion: Tonic clonic seizure was the commonest type and birth asphyxia the main aetiology identified in the majority of neonatal seizures. (author)

  19. Patterns and causes of neonatal and postneonatal mortality in rural Bangladesh.

    Science.gov (United States)

    Bhatia, S

    1989-01-01

    Community-level research data from a Maternal-Child Health and Family Planning (MCH/FP) program and comparison areas in rural Bangladesh indicate that 60 percent of infant deaths occurred in the neonatal period in both areas. Since the inception of the MCH/FP program, mortality rates declined relative to those in the comparison area. This decline, however, was confined to the neonatal period death rates only, with mortality rates in the postneonatal period remaining similar in the two areas. Prematurity accounted for approximately 40 percent of deaths in the neonatal period. Cause-of-death data indicated that the differences in the neonatal mortality rates between the two areas was mainly due to a marked decline in tetanus neonatorum deaths in the MCH/FP program area, because of the tetanus toxoid immunization of pregnant women there. The interventions in the MCH/FP area, however, did not significantly influence mortality due to any other cause. This study provides an explanation for the limited impact on infant mortality of health interventions that focus on diarrheal diseases and immunizations of children. PMID:2734810

  20. Benign skin disease with pustules in the newborn*

    Science.gov (United States)

    Reginatto, Flávia Pereira; Villa, Damie De; Cestari, Tania Ferreira

    2016-01-01

    The neonatal period comprises the first four weeks of life. It is a period of adaptation where the skin often presents several changes: transient lesions, resulting from a physiological response, others as a consequence of transient diseases and some as markers of severe disorders. The presence of pustules in the skin of the newborn is always a reason for the family and for the assisting doctor to be worried, since the newborn is especially vulnerable to bacterial, viral or fungal infection. However, the majority of neonatal skin pustules is not infectious, comprising the benign neonatal pustulosis. Benign neonatal pustuloses are a group of clinical disease characterized by pustular eruptions in which a contagious agent is not responsible for its etiology. The most common ones are erythema toxicum neonatorum, the transient neonatal pustular melanosis and the benign cephalic pustulosis. These dermatoses are usually benign, asymptomatic and self-limited. It is important that the dermatologist and the neonatologist can identify benign and transient lesions, those caused by genodermatoses, and especially differentiate between neonates with systemic involvement from those with benign skin lesions, avoiding unnecessary diagnostic tests and worries. PMID:27192509

  1. Benign skin disease with pustules in the newborn.

    Science.gov (United States)

    Reginatto, Flávia Pereira; Villa, Damie De; Cestari, Tania Ferreira

    2016-04-01

    The neonatal period comprises the first four weeks of life. It is a period of adaptation where the skin often presents several changes: transient lesions, resulting from a physiological response, others as a consequence of transient diseases and some as markers of severe disorders. The presence of pustules in the skin of the newborn is always a reason for the family and for the assisting doctor to be worried, since the newborn is especially vulnerable to bacterial, viral or fungal infection. However, the majority of neonatal skin pustules is not infectious, comprising the benign neonatal pustulosis. Benign neonatal pustuloses are a group of clinical disease characterized by pustular eruptions in which a contagious agent is not responsible for its etiology. The most common ones are erythema toxicum neonatorum, the transient neonatal pustular melanosis and the benign cephalic pustulosis. These dermatoses are usually benign, asymptomatic and self-limited. It is important that the dermatologist and the neonatologist can identify benign and transient lesions, those caused by genodermatoses, and especially differentiate between neonates with systemic involvement from those with benign skin lesions, avoiding unnecessary diagnostic tests and worries. PMID:27192509

  2. ASSESSMENT OF UNIJECT TRAINING CURRICULUM AND DEVICE PERFORMANCE DURING STUDENT IMMUNIZATION SESSIONS IN YOGYAKARTA, INDONESIA

    Directory of Open Access Journals (Sweden)

    Muljati Prijanto

    2012-09-01

    Full Text Available Penggunaan ulang alat suntik sekali pakai rusak merupakan pilihan dalam mencapai suntikan aman. Salah satunya adalah Uniject™ berisi vaksin Hep B atau TT yang dapat disimpan pada suhu kamar selama 1-2 bulan. Penggunaannya merupakan alternatif untuk meningkatkan cakupan dan mencegah penyakit yang dapat ditularkan melalui jarum suntik, terutama di daerah terpencil. Dalam pencapaian Eliminasi Tetanus Neonatorum di Indonesia, imunisasi TT pada siswa SD dilakukan pada bulan imunisasi anak sekolah (BIAS, setiap bulan November mulai tahun 1998. Penelitian yang bertujuan untuk menilai pemahaman materi latihan dan praktek penggunaan Uniject™ pada 1788 orang siswa SD kelas 2-6 pada program BIAS, serta mengetahui penerimaan vaksinator dan siswa telah dilakukan di 3 kabupaten di Yogyakarta. Hasil penelitian menunjukkan bahwa materi pelatihan telah dapat dimengerti oleh supervisor dan vaksinator. Kemudahan mengaktivasi Uniject™ adalah 97,76% dan vaksinator yang merasa tidak mengalami kesulitan sebanyak 97,87%. Hanya 1,94% yang belum dapat menekan reservoir secara benar sehingga dosis vaksin menjadi kurang. Pembuangan alat suntik bekas 99,89% telah dilakukan dengan benar. Jumlah Uniject yang rusak saat akan digunakan sebanyak 24 buah (1,35%, sebagian besar karena jarum belum teraktivasi dengan baik sehingga timbul kebocoran atau jarum terlepas. Pada pelatihan yang perlu diperhatikan adalah: Cara menekan reservoir dengan benar agar diperoleh dosis yang tepat dan cara menyuntik dengan memperhatikan posisi Uniject™ dan kedalaman jarum. Hasil pemantauan menunjukkan tidak ditemui adanya reaksi samping akibat imunisasi TT.

  3. Fuzzy expert system in the prediction of neonatal resuscitation

    Directory of Open Access Journals (Sweden)

    Reis M.A.M.

    2004-01-01

    Full Text Available In view of the importance of anticipating the occurrence of critical situations in medicine, we propose the use of a fuzzy expert system to predict the need for advanced neonatal resuscitation efforts in the delivery room. This system relates the maternal medical, obstetric and neonatal characteristics to the clinical conditions of the newborn, providing a risk measurement of need of advanced neonatal resuscitation measures. It is structured as a fuzzy composition developed on the basis of the subjective perception of danger of nine neonatologists facing 61 antenatal and intrapartum clinical situations which provide a degree of association with the risk of occurrence of perinatal asphyxia. The resulting relational matrix describes the association between clinical factors and risk of perinatal asphyxia. Analyzing the inputs of the presence or absence of all 61 clinical factors, the system returns the rate of risk of perinatal asphyxia as output. A prospectively collected series of 304 cases of perinatal care was analyzed to ascertain system performance. The fuzzy expert system presented a sensitivity of 76.5% and specificity of 94.8% in the identification of the need for advanced neonatal resuscitation measures, considering a cut-off value of 5 on a scale ranging from 0 to 10. The area under the receiver operating characteristic curve was 0.93. The identification of risk situations plays an important role in the planning of health care. These preliminary results encourage us to develop further studies and to refine this model, which is intended to implement an auxiliary system able to help health care staff to make decisions in perinatal care.

  4. Paediatricians’ perspectives on global health priorities for newborn care in a developing country: a national survey from Nigeria

    Directory of Open Access Journals (Sweden)

    Olusanya Bolajoko O

    2012-07-01

    Full Text Available Abstract Background An understanding of the perception of paediatricians as key stakeholders in child healthcare delivery and the degree of congruence with current investment priorities is crucial in accelerating progress towards the attainment of global targets for child survival and overall health in developing countries. This study therefore elicited the views of paediatricians on current global priorities for newborn health in Nigeria as possible guide for policy makers. Methods Paediatric consultants and residents in the country were surveyed nationally between February and March 2011 using a questionnaire requiring the ranking of nine prominent and other neonatal conditions based separately on hospital admissions, mortality, morbidity and disability as well as based on all health indices in order of importance or disease burden. Responses were analysed with Friedman test and differences between subgroups of respondents with Mann-Whitney U test. Results Valid responses were received from 152 (65.8% of 231 eligible physicians. Preterm birth/low birthweight ranked highest by all measures except for birth asphyxia which ranked highest for disability. Neonatal jaundice ranked next to sepsis by all measures except for disability and above tetanus except mortality. Preterm birth/low birthweight, birth asphyxia, sepsis, jaundice and meningitis ranked highest by composite measures while jaundice had comparable rating with sepsis. Birth trauma was most frequently cited under other unspecified conditions. There were no significant differences in ranking between consultants and residents except for birth asphyxia in relation to hospital admissions and morbidity as well as sepsis and tetanus in relation to mortality. Conclusions Current global priorities for neonatal survival in Nigeria largely accord with paediatricians’ views except for neonatal jaundice which is commonly subsumed under “other“ or "miscellaneous" neonatal conditions. While the

  5. An audit of paediatric mortality patterns in a Nigerian teaching hospital

    Directory of Open Access Journals (Sweden)

    Gerald Dafe Forae

    2014-01-01

    Full Text Available Background: The 4 th millennium development goals (2002 reported that sub-Saharan Africa countries including Nigeria have a persistently high childhood mortality rates in-spite of all the preventive and interventional measures to reduce this ugly trend. Patients and Methods: Childhood mortality data was obtained from the medical records department and post-mortem records of the pathology departments over a 5-year period from January 2007 to December 2011. The selection criteria include all case notes with mortality records involving children admitted into the paediatrics department through the labour ward and the obstetrics theater, children emergency unit (CHER, paediatric out-patient clinic. Results : A total of 12,442 children were admitted during this period. Of this, 711 paediatric deaths were documented accounting for 17.5%. The male to female mortality ratio was 1.4:1. The age range was from birth to 17 years. Neonatal deaths accounted for the most common cause of death constituting 344 (48.4% of all deaths. Among the neonatal mortality patterns, severe birth asphyxia/perinatal asphyxia was the most common cause of early neonatal deaths accounting for 97 (28.2%. Septicaemia accounted for the most frequent cause of infant mortality accounting for 28 (21.8%. Among the under-5 age group, severe malaria constituted the most common cause of death accounting for 52 (36.6% cases while malignancy topped the list of 5-17 years mortality rate constituting 15 (15.4% cases. Conclusion: Perinatal and neonatal deaths constitute the vast majority of death in our environment with most of the deaths resulting from severe birth asphyxias, prematurity. Again in the post-neonatal period, infections and other preventable diseases constitute the most common cause of death in children of under age group of five years. Above 5 years childhood malignancies constitutes the highest mortality pattern.

  6. Disease profile and Outcome of Newborn admitted to Neonatology unit of BPKIHS

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    Piush Kanodia

    2015-12-01

    Full Text Available Background & Objectives: Neonatal period is a vulnerable time in which the newborn has to adapt to a totally new environment and is susceptible to many problems, which may even be life threatening. Every year, millions of neonates are born and a large proportion of them are admitted to the neonatal intensive care unit (NICU for various indications. It is found that neonatal mortality rate is decreasing in Nepal but at a slower pace than infant and child mortality. In order to improve neonatal outcome, it is crucial to identify the areas where health care can be improved. Therefore, this study was conducted to identify the clinical profile, pattern of diseases and common causes of mortality and morbidity in neonates admitted to neonatology unit.Materials & Methods: A retrospective study was conducted at neonatology unit of BPKIHS, from January 2014 to December 2014. A total of 1009 neonates (both inborn and out-born were admitted to neonatology division during the study period. Data was collected from the hospital record section. Ethical clearance was taken from the institutional ethical committee before the initiation of the study. Data was entered and descriptive analysis was done by using SPSS 20.0.Results: Total of 1009 neonates were admitted in neonatology unit. Among them, 349(34.5% cases were admitted due neonatal sepsis, 236 (23.3% due to prematurity and 233 (23.1% with birth asphyxia. Among birth asphyxia, 102(43.7% were in HIE III, 34.3% and 21.8% in HIE II and HIE I, respectively. The overall mortality was 47 (4.7% during hospital stay.Conclusion: Sepsis, prematurity and birth asphyxia were major causes for admission in NICU. All these etiologies are preventable up to some extent and, if detected earlier, can be effectively treated in order to reduce morbidity and mortalityJCMS Nepal. 2015;11(3:20-24.

  7. Angiogenesis dysregulation in term asphyxiated newborns treated with hypothermia.

    Directory of Open Access Journals (Sweden)

    Henna Shaikh

    Full Text Available Neonatal encephalopathy following birth asphyxia is a major predictor of long-term neurological impairment. Therapeutic hypothermia is currently the standard of care to prevent brain injury in asphyxiated newborns but is not protective in all cases. More robust and versatile treatment options are needed. Angiogenesis is a demonstrated therapeutic target in adult stroke. However, no systematic study examines the expression of angiogenesis-related markers following birth asphyxia in human newborns.This study aimed to evaluate the expression of angiogenesis-related protein markers in asphyxiated newborns developing and not developing brain injury compared to healthy control newborns.Twelve asphyxiated newborns treated with hypothermia were prospectively enrolled; six developed eventual brain injury and six did not. Four healthy control newborns were also included. We used Rules-Based Medicine multi-analyte profiling and protein array technologies to study the plasma concentration of 49 angiogenesis-related proteins. Mean protein concentrations were compared between each group of newborns.Compared to healthy newborns, asphyxiated newborns not developing brain injury showed up-regulation of pro-angiogenic proteins, including fatty acid binding protein-4, glucose-6-phosphate isomerase, neuropilin-1, and receptor tyrosine-protein kinase erbB-3; this up-regulation was not evident in asphyxiated newborns eventually developing brain injury. Also, asphyxiated newborns developing brain injury showed a decreased expression of anti-angiogenic proteins, including insulin-growth factor binding proteins -1, -4, and -6, compared to healthy newborns.These findings suggest that angiogenesis pathways are dysregulated following birth asphyxia and are putatively involved in brain injury pathology and recovery.

  8. Predictive Value of Nucleated Red Blood Cell Counts in Cord and Peripheral Blood of Asphyxiated Term Neonates in the First Week of Life

    Directory of Open Access Journals (Sweden)

    B Bahman Bijari

    2010-03-01

    Full Text Available Introduction: Increased numbers of nucleated red blood cells (NRBC circulating in the blood of neonates can be associated with relative hypoxia and adverse outcomes. Thus, the aim of this study was to assess the NRBC count during the first week of life in neonates diagnosed with asphyxia as compared to healthy neonates and to determine the short-term morbidity and mortality for the affected babies. Methods: The cross-sectional study compared 15 healthy neonates with 15 neonates diagnosed with asphyxia confirmed by pH of cord blood or Apgar scores. The nucleated red blood cell (NRBC counts were calculated right after birth, and on days 3 and 7, and the hematological parameters of umbilical cord blood were also evaluated. The infants were followed for mortality and associated morbidity. Statistical analysis was conducted using the Mann-Whitney U test, analysis of variance, chi-square tests, and Pearson’s correlation coefficient. A p-value < 0.05 was considered as statistically significant. Results: The initial NRBC counts were significantly higher in the asphyxiated group than in the control group and the difference remained significant through the end of first week. All of the umbilical cord blood parameters were significantly lower in the study group and were negatively correlated with the NRBC count. At birth, higher NRBC count correlated with higher mortality. conclution: Results show that NRBC count is a useful predictive factor for neonatal asphyxia through the end of the first week of life, although a larger study population and a longer follow up period seems to be necessary.

  9. Assessment of Knowledge Attitude and Practice of Trainees on Neonatal Resuscitation in the Healthcare Center Affiliated to the University of Medical Science of Mazandaran

    Directory of Open Access Journals (Sweden)

    M. Ahmady, M.Sc

    Full Text Available Background and purpose: There are more than five million neonatal death around the world of which %19 was because of Asphyxia at birth time. In our country, there has been educational program in order to decrease the mortality caused by Asphyxia and to practice a scientific method for resuscitation. This study was conducted to determine the rate of knowledge, attitude and practice for every learner of neonatal resuscitation in the governmental hospitals of Mazandaran province in 2005(1384.Materials and Methods: current study was a descriptive cross sectional done on All Trainees who had professional direct contact with birth Asphyxia. We selected exactly 137 people who had attended Neonatal Resuscitation Workshop for three days.Results: The subjects under the study were %62/8 midwife and %89/8 women. Data show that % 44.5 had good knowledge and % 11.7 had very good knowledge on neonatal Resuscitation. The highest acknowledge was %93/4 and %89/1 on chest compression and breath stimulation way respectively. Data also suggested that totally % 96.34 of the subjects had good and very good attitudes towards neonatal resuscitation. The results show that only % 38.4 of the subjects under the study had a good level practice and their attitudes in terms of age were significantly different (P<0.01. Also, their practice on job showed a significant difference (P<0.017. In the study, there was a converse relation between age and professional experience which was r = 0.25 and r = 0.26, respectively.Conclusion: Results obtained suggest that the amount of knowledge and practice for the subjects under the study was average, but their attitudes towards neonatal resuscitation was good. There fore, according to the positive attitude of the subjects,there must be a trend to promote knowledge and practice.

  10. Glucose-6-Phosphate Dehydrogenase Deficiency and Adrenal Hemorrhage in a Filipino Neonate with Hyperbilirubinemia

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    Akira Ohishi

    2013-05-01

    Full Text Available We report on a Filipino neonate with early onset and prolonged hyperbilirubinemia who was delivered by a vacuum extraction due to a prolonged labor. Subsequent studies revealed adrenal hemorrhage and glucose-6-phosphate dehydrogenase (G6PD deficiency. It is likely that asphyxia and resultant hypoxia underlie the occurrence of adrenal hemorrhage and the clinical manifestation of G6PD deficiency and that the presence of the two events explains the early onset and prolonged hyperbilirubinemia of this neonate. Our results represent the importance of examining possible underlying factors for the development of severe, early onset, or prolonged hyperbilirubinemia.

  11. Learning and Memory Recoveries in a Young Girl Treated with Growth Hormone and Neurorehabilitation

    OpenAIRE

    Jesús Devesa; Hortensia Lema; Eva Zas; Borja Munín; Pilar Taboada; Pablo Devesa

    2016-01-01

    Background—To describe the results obtained after treating a non growth hormone-deficient 10-year-old girl who suffered asphyxia during delivery, resulting in important cognitive deficits, with growth hormone (GH) and neurorehabilitation. Methods—GH was administered (mg/day) at doses of 0.5 over three months followed by 0.9, every two weeks over three months, and then alternating 1.2 three days/week and 0.3 two days/week. Neurorehabilitation consisted of daily sessions of neurostimulation, sp...

  12. TRANSIENT ABNORMAL MYELOPOIESIS IN A NEONATE

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    Ketan P

    2013-01-01

    Full Text Available ABSTRACT: Transient abnormal myelopoiesis (TAM is a unique di sorder of newborns associated intimately with Down’s syndrome, present ing with clinical and morphological features indistinguishable from acute myeloid leuka emia (AML. We report a case in a neonate, presenting with severe perinatal asphyxia and cyanosis ; complicated by metabolic acidosis. The hemogram revealed leucocytosis and thrombocytopenia. The peripheral smear showed marked left shift and 55% circulating myeloblasts. Additio nal findings included a hepatomegaly and mild dysmorphic features. The child eventually succu mbed to pulmonary hemorrhage on day one itself. TAM has to be differentiated from conge nital leukemia which portends a poor prognosis

  13. Angiotensin Converting Enzyme-induced Angioedema - A Dangerous New Epidemic

    DEFF Research Database (Denmark)

    Rasmussen, Eva Rye; Mey, Kristianna; Bygum, Anette

    2013-01-01

    Angioedema is a sudden localised and often asymmetric swelling of the skin or mucous membranes caused by transient increased endothelial permeability causing plasma extravasation. In the last decades the incidence of severe angioedema involving the upper airways and even fatal outcome due to...... asphyxia has increased. This is mainly due to pharmaceuticals such as angiotensin converting enzyme-inhibitors, which are extensively used worldwide. Some aspects of the pathophysiology have been elucidated and the vasoactive molecule bradykinin is shown to be one of the main causative agents. The...

  14. Racking the brain: Detection of cerebral edema on postmortem computed tomography compared with forensic autopsy

    International Nuclear Information System (INIS)

    Graphical abstract: -- Highlights: •Postmortem swelling of the brain is a typical finding on PMCT and occurs concomitant with potential antemortem or agonal brain edema. •Cerebral edema despite normal postmortem swelling is indicated by narrowed temporal horns and symmetrical herniation of the cerebral tonsils on PMCT. •Cases with intoxication or asphyxia demonstrated higher deviations of the attenuation between white and gray matter (>20 Hounsfield Units) and a ratio >1.58 between the gray and white matter. •The Hounsfield measurements of the white and gray matter help to determine the cause of death in cases of intoxication or asphyxia. -- Abstract: Purpose: The purpose of this study was to compare postmortem computed tomography with forensic autopsy regarding their diagnostic reliability of differentiating between pre-existing cerebral edema and physiological postmortem brain swelling. Materials and methods: The study collective included a total of 109 cases (n = 109/200, 83 male, 26 female, mean age: 53.2 years) and were retrospectively evaluated for the following parameters (as related to the distinct age groups and causes of death): tonsillar herniation, the width of the outer and inner cerebrospinal fluid spaces and the radiodensity measurements (in Hounsfield Units) of the gray and white matter. The results were compared with the findings of subsequent autopsies as the gold standard for diagnosing cerebral edema. p-Values <0.05 were considered statistically significant. Results: Cerebellar edema (despite normal postmortem swelling) can be reliably assessed using postmortem computed tomography and is indicated by narrowed temporal horns and symmetrical herniation of the cerebellar tonsils (p < 0.001). There was a significant difference (p < 0.001) between intoxication (or asphyxia) and all other causes of death; the former causes demonstrated higher deviations of the attenuation between white and gray matter (>20 Hounsfield Units), and the gray to

  15. Severe calcinosis cutis in an infant

    International Nuclear Information System (INIS)

    We report on an infant with severe asphyxia and persistent pulmonary hypertension as a newborn. The baby received prolonged intravenous calcium gluconate therapy for hypocalcemia. At 5 weeks of age, multiple firm, indurated areas (armor-like lesions) were palpable in the subcutaneous tissues of the trunk, arms, legs, and face, particularly in skin folds. Roentgenographic study showed generalized soft-tissue calcifications throughout the body, extremities, and face. Calcinosis cutis occurs through a variety of pathogenetic mechanisms. Case reports on calcinosis cutis in infants are uncommon, and the calcifications are mostly localized. In our patient, they are generalized. (orig.)

  16. Severe calcinosis cutis in an infant

    Energy Technology Data Exchange (ETDEWEB)

    Puvabanditsin, Surasak; Patel, Jigneshkumar B. [University of Medicine and Dentistry of New Jersey, Department of Pediatrics, Newark, NJ (United States); University of Medicine and Dentistry of New Jersey, Department of Surgery, Newark, NJ (United States); Garrow, Eugene; Titapiwatanakun, Ruetima; Getachew, Rahel [University of Medicine and Dentistry of New Jersey, Department of Pediatrics, Newark, NJ (United States)

    2005-05-01

    We report on an infant with severe asphyxia and persistent pulmonary hypertension as a newborn. The baby received prolonged intravenous calcium gluconate therapy for hypocalcemia. At 5 weeks of age, multiple firm, indurated areas (armor-like lesions) were palpable in the subcutaneous tissues of the trunk, arms, legs, and face, particularly in skin folds. Roentgenographic study showed generalized soft-tissue calcifications throughout the body, extremities, and face. Calcinosis cutis occurs through a variety of pathogenetic mechanisms. Case reports on calcinosis cutis in infants are uncommon, and the calcifications are mostly localized. In our patient, they are generalized. (orig.)

  17. A fatal case of Perthes syndrome

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    Jérôme Jobé

    2013-01-01

    Full Text Available Perthes syndrome, or traumatic asphyxia, is a clinical syndrome associating cervicofacial cyanosis with cutaneous petechial haemorrhages and subconjonctival bleeding resulting from severe sudden compressive chest trauma. Deep inspiration and a Valsalva maneuver just prior to rapid and severe chest compression, are responsible for the development of this syndrome. Current treatment is symptomatic: urgent relief of chest compression and cardiopulmonary resuscitation if needed. Outcome may be satisfactory depending on the duration and severity of compression. Prolonged thoracic compression may sometimes lead to cerebral anoxia, irreversible neurologic damage and death. We report a fatal case of Perthes syndrome resulting from an industrial accident.

  18. The outcomes of screening retinopathy in risky preterms Review

    OpenAIRE

    Kavuncuoğlu, Sultan; Karaçorlu, Murat; Arıdaşır, Özlem; Arası, Cengiz; Yılmaz, Çiğdem; Arslan, Gülseren; Palabıyık, Murat; Öztürk, Haydar

    2002-01-01

    As ROP causes serious complications and significiant morbidity in preterms it is mandatory to be screened In this study our aim is determining the incidence of ROP in preterms who were followed in our prematurity unit and search the relationship between risk factors and the disease All patients who were smaller than 1500 gr and 32 gestational weeks GW and prematures small for gestational age SGA who had perinatal asphyxia and received oxygen for more than 48 hours and who had a ventilation wi...

  19. Racking the brain: Detection of cerebral edema on postmortem computed tomography compared with forensic autopsy

    Energy Technology Data Exchange (ETDEWEB)

    Berger, Nicole [Institute of Forensic Medicine, Virtopsy, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich (Switzerland); Institute of Diagnostic and Interventional Radiology, University Hospital of Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Ampanozi, Garyfalia; Schweitzer, Wolf; Ross, Steffen G.; Gascho, Dominic [Institute of Forensic Medicine, Virtopsy, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich (Switzerland); Ruder, Thomas D. [Institute of Forensic Medicine, Virtopsy, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich (Switzerland); Institute of Diagnostic, Interventional and Pediatric Radiology, University Hospital of Bern, Freiburgstrasse, 3010 Bern (Switzerland); Thali, Michael J. [Institute of Forensic Medicine, Virtopsy, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich (Switzerland); Flach, Patricia M., E-mail: patricia.flach@irm.uzh.ch [Institute of Forensic Medicine, Virtopsy, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich (Switzerland); Institute of Diagnostic and Interventional Radiology, University Hospital of Zurich, Raemistrasse 100, 8091 Zurich (Switzerland)

    2015-04-15

    Graphical abstract: -- Highlights: •Postmortem swelling of the brain is a typical finding on PMCT and occurs concomitant with potential antemortem or agonal brain edema. •Cerebral edema despite normal postmortem swelling is indicated by narrowed temporal horns and symmetrical herniation of the cerebral tonsils on PMCT. •Cases with intoxication or asphyxia demonstrated higher deviations of the attenuation between white and gray matter (>20 Hounsfield Units) and a ratio >1.58 between the gray and white matter. •The Hounsfield measurements of the white and gray matter help to determine the cause of death in cases of intoxication or asphyxia. -- Abstract: Purpose: The purpose of this study was to compare postmortem computed tomography with forensic autopsy regarding their diagnostic reliability of differentiating between pre-existing cerebral edema and physiological postmortem brain swelling. Materials and methods: The study collective included a total of 109 cases (n = 109/200, 83 male, 26 female, mean age: 53.2 years) and were retrospectively evaluated for the following parameters (as related to the distinct age groups and causes of death): tonsillar herniation, the width of the outer and inner cerebrospinal fluid spaces and the radiodensity measurements (in Hounsfield Units) of the gray and white matter. The results were compared with the findings of subsequent autopsies as the gold standard for diagnosing cerebral edema. p-Values <0.05 were considered statistically significant. Results: Cerebellar edema (despite normal postmortem swelling) can be reliably assessed using postmortem computed tomography and is indicated by narrowed temporal horns and symmetrical herniation of the cerebellar tonsils (p < 0.001). There was a significant difference (p < 0.001) between intoxication (or asphyxia) and all other causes of death; the former causes demonstrated higher deviations of the attenuation between white and gray matter (>20 Hounsfield Units), and the gray to

  20. Maximum opening of the mouth by mouth prop during dental procedures increases the risk of upper airway constriction

    Directory of Open Access Journals (Sweden)

    Hiroshi Ito

    2010-05-01

    Full Text Available Hiroshi Ito1, Hiroyoshi Kawaai1, Shinya Yamazaki1, Yosuke Suzuki21Division of Systemic Management, Department of Oral Function, 2Division of Radiology and Diagnosis, Department of Medical Sciences, Ohu University, Post Graduate School of Dentistry, Koriyama City, Fukushima Prefecture, JapanAbstract: From a retrospective evaluation of data on accidents and deaths during dental procedures, it has been shown that several patients who refused dental treatment died of asphyxia during dental procedures. We speculated that forcible maximum opening of the mouth by using a mouth prop triggers this asphyxia by affecting the upper airway. Therefore, we assessed the morphological changes of the upper airway following maximal opening of the mouth. In 13 healthy adult volunteers, the sagittal diameter of the upper airway on lateral cephalogram was measured between the two conditions; closed mouth and maximally open mouth. The dyspnea in each state was evaluated by a visual analog scale. In one subject, a computed tomograph (CT was taken to assess the three-dimensional changes in the upper airway. A significant difference was detected in the mean sagittal diameter of the upper airway following use of the prop (closed mouth: 18.5 ± 3.8 mm, maximally open mouth: 10.4 ± 3.0 mm. All subjects indicated upper airway constriction and significant dyspnea when their mouth was maximally open. Although a CT scan indicated upper airway constriction when the mouth was maximally open, muscular compensation was admitted. Our results further indicate that the maximal opening of the mouth narrows the upper airway diameter and leads to dyspnea. The use of a prop for the patient who has communication problems or poor neuromuscular function can lead to asphyxia. When the prop is used for patient refusal in dentistry, the respiratory condition should be monitored strictly, and it should be kept in mind that the “sniffing position” is effective for avoiding upper airway

  1. Ischiopagus tripus conjoined twins in a western lowland gorilla (Gorilla gorilla).

    Science.gov (United States)

    Langer, S; Jurczynski, K; Gessler, A; Kaup, F-J; Bleyer, M; Mätz-Rensing, K

    2014-05-01

    Conjoined twinning is rare in man and non-human primates. The current report describes a case of ischiopagus tripus conjoined Western Lowland gorilla (Gorilla gorilla) twins. The female twins were joined at the umbilical and pelvic region, involving the liver, xiphoid, umbilicus, body wall and skin. Computed tomography revealed two complete spines. The combined pelvic space was formed by two sacra, each connected with two iliac bones. The twins were only conjoined by a common pubis. Cause of death was attributed to cardiac and circulatory collapse resulting from a large patent foramen ovale (8 mm in diameter) of one twin and neonatal asphyxia. PMID:24529511

  2. Systemic and structural analysis of morbidity of pregnant women and newborns on the radionuclide contaminated territories

    International Nuclear Information System (INIS)

    In the work, systemic and structural analysis of causes and dynamics of the morbidity of pregnant women and newborns in the Gomel, Mogilov and Brest area during the period from 1986 to 2001 has been made. The pregnant morbidity rate of anemias, urogenital system diseases, late gestosis, as well as of newborn morbidity rate of acute viral infections, intrauterus hypoxia and asphyxia, respiratory distress-syndrome, birth traumas and inborn pneumonias was higher on the radionuclide contaminated territories. The main directions for improvement of medical care to pregnant women and the ways of their realization have been determined (authors)

  3. Cardiovascular dysfunction in infants with neonatal encephalopathy.

    LENUS (Irish Health Repository)

    Armstrong, Katey

    2012-04-01

    Severe perinatal asphyxia with hypoxic ischaemic encephalopathy occurs in approximately 1-2\\/1000 live births and is an important cause of cerebral palsy and associated neurological disabilities in children. Multiorgan dysfunction commonly occurs as part of the asphyxial episode, with cardiovascular dysfunction occurring in up to a third of infants. This narrative paper attempts to review the literature on the importance of early recognition of cardiac dysfunction using echocardiography and biomarkers such as troponin and brain type natriuretic peptide. These tools may allow accurate assessment of cardiac dysfunction and guide therapy to improve outcome.

  4. Severe visual Impairment and blindness in infants: Causes and opportunities for control

    Directory of Open Access Journals (Sweden)

    Parikshit Gogate

    2011-01-01

    Full Text Available Childhood blindness has an adverse effect on growth, development, social, and economic opportunities. Severe visual impairment (SVI and blindness in infants must be detected as early as possible to initiate immediate treatment to prevent deep amblyopia. Although difficult, measurement of visual acuity of an infant is possible. The causes of SVI and blindness may be prenatal, perinatal, and postnatal. Congenital anomalies such as anophthalmos, microphthalmos, coloboma, congenital cataract, infantile glaucoma, and neuro-ophthalmic lesions are causes of impairment present at birth. Ophthalmia neonatorum, retinopathy of prematurity, and cortical visual impairment are acquired during the perinatal period. Leukocoria or white pupillary reflex can be cause by congenital cataract, persistent hyperplastic primary vitreous, or retinoblastoma. While few medical or surgical options are available for congenital anomalies or neuro-ophthalmic disorders, many affected infants can still benefit from low vision aids and rehabilitation. Ideally, surgery for congenital cataracts should occur within the first 4 months of life. Anterior vitrectomy and primary posterior capsulotomy are required, followed by aphakic glasses with secondary intraocular lens implantation at a later date. The treatment of infantile glaucoma is surgery followed by anti-glaucoma medication. Retinopathy of prematurity is a proliferation of the retinal vasculature in response to relative hypoxia in a premature infant. Screening in the first few weeks of life can prevent blindness. Retinoblastoma can be debulked with chemotherapy; however, enucleation may still be required. Neonatologists, pediatricians, traditional birth attendants, nurses, and ophthalmologists should be sensitive to a parent′s complaints of poor vision in an infant and ensure adequate follow-up to determine the cause. If required, evaluation under anesthesia should be performed, which includes funduscopy, refraction

  5. A clinical and statistical survey of cutaneous changes in the first 120 hours of life

    Directory of Open Access Journals (Sweden)

    Dinkar J Sadana

    2014-01-01

    Full Text Available Background: The spectrum of dermatological manifestations during neonatal period varies from transient self-limiting conditions to serious dermatoses; the latter, fortunately few, are disproportionately stressful to the parents, who due to lack of specialized pediatric dermatology clinics frequently get tossed between a dermatologist and a pediatrician. Objectives: This study was formulated to record cutaneous changes over the first five postnatal days of life and to statistically correlate those changes occurring in ≥ 11 neonates with three (parity, associated illnesses, and mode of delivery maternal and three (sex, birth weight, and gestational age neonatal factors. Methods: This descriptive, cross-sectional study at a tertiary care hospital entailed recording detailed dermatological examination of 300 neonates having some (physiological and/or pathological cutaneous changes and their statistical evaluation using the Chi-square test and significance (P < 0.05 as above. Results: Superficial cutaneous desquamation (SCD, Mongolian spots (MS, and erythema toxicum neonatorum (ETN were the first three common changes among a total of 15 conditions observed overall; these three, as also milia and icterus, revealed statistical significance with both maternal as well as neonatal factors. Lanugo and napkin dermatitis (ND were statistically significant with respect to two neonatal factors and cradle cap (CC, a single maternal factor. Gestational age was of statistical significance regarding five cutaneous changes, associated maternal illness during pregnancy regarding four, birth weight as well as parity regarding three each, and sex of the neonate as well as mode of delivery regarding two each. Conclusion: Despite observing a statistically significant correlation of eight cutaneous changes with three maternal and/or three neonatal factors, more extensive studies in neonatal dermatology are required for validation of these unique statistical

  6. A clinico-etiological study of dermatoses in pediatric age group in tertiary health care center in South Gujarat region

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    Sugat A Jawade

    2015-01-01

    Full Text Available Background: Dermatologic conditions have different presentation and management in pediatric age group from that in adult; this to be studied separately for statistical and population based analysis. Objective: To study the pattern of various dermatoses in infants and children in tertiary health care center in South Gujarat region. Materials and Methods: This is a prospective study; various dermatoses were studied in pediatric patients up to 14 years of age attending the Dermatology OPD of New Civil Hospital, Surat, Gujarat over a period of 12 months from June 2009 to June 2010. All patients were divided into four different study groups: 1 to 6 years and 7 to 14 years. Results: There were 596 boys and 425 girls in total 1021 study populations. Majority of the skin conditions in neonates were erythema toxicum neonatorum (12.97%, scabies (9.92%, mongolian spot (9.16%, and seborrheic dermatitis (7.63%. In > 1 month to 14 years age group of children among infectious disorder, children were found to be affected most by scabies (24.49%, impetigo (5.96%, pyoderma (5.62%, molluscum contagiosum (5.39%, tinea capitis (4.49%, leprosy (2.02%, and viral warts (1.35% while among non-infectious disorders, they were affected by atopic dermatitis (4.27%, pityriasis alba (4.16%, seborrheic dermatitis (3.60%, pityriasis rosea (3.15%, others (3.01%, phrynoderma (2.70%, lichen planus (2.58%, contact dermatitis (1.57% and ichthyosis (1.45%. Conclusion: There is a need to emphasize on training the management of common pediatric dermatoses to dermatologists, general practitioners and pediatricians for early treatment.

  7. Myiasis in Republic of Yemen (cutaneous myiasis three cases reported and genito-urinary myiasis three cases reported

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    Mohammed Abdul Qader Al-Malmi

    2014-01-01

    Full Text Available Myiasis is a condition resulting from the invasion of living human and animal′s tissues by larval stages of flies. study the cutaneous and genito-urinary myiasis in the Republic of Yemen. Two females and one male, Yemeni patient 12-30 years old presented with urethra-genital discharge, burning, and difficulty during micturition (dysuria. They saw whitish brownish blackish like worms passed in their urine. Three males, Yemeni patients 2 months to 30 years old had solitary and multiple furuncle like skin lesions in upper left thigh (myiasis pubis, right buttock (myiasis neonatorum and in the upper trunk. It was associated with stabbing pain (caused by creeping a foreign body subcutaneously. The duration varied from 2 days to 1 week. The larvae were detected in the urine and the skin lesions. Swab from the urethral discharge was not specific. I used the forceps accidentally and gently caught the larvae and removed them from the fruncular skin lesions. The clinical data and detection of the larvae showed the two females and one male case were genito-urinary myiasis, which caused by latrine Fannia fly larvae during defecation or sleeping and ended spontaneously. The three male patients had cutaneous myiasis, and the causative agent was the larvae of the tumbu fly, Cordylobia anthropophaga species. It penetrates the patients′ normal skin and removed by forceps or squeezing the skin lesion by the patient himself thinking that is abscess to remove the pus. Cutaneous and genito-urinary myiasis was not rare in the Republic of Yemen. Health education, hygiene, and control the flies restrict the incidence of this disease.

  8. [Gamete donation in an in vitro fertilization program].

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    Zhang, L Z

    1993-12-01

    Two cases of gamete donation in an IVF program were reported in this paper. In the first case the wife with recurrent abortions was found to have chromosomal abnormality, her karyotype was 45,XX,-14,-14 + rob (14 Q 14 Q). She became pregnant after IVF-ET with donated ova, and was delivered of a normal male baby on June 12, 1992. The baby's karyotype was normal. The blood group of both the husband and wife was O, while that of the baby was B. The baby suffered from icterus neonatorum as a result of ABO incompatibility but recovered quickly after treatment. Further DNA finger print analysis of the husband, wife and baby, combined with the history of egg donation IVF, proved the relationship of the parents with the baby. In the second case the husband's karyotype was 46,XY, t(4; 9) (4Q+; 9Q-). The wife had also history of recurrent abortions. Since 1989, the wife received sperm donation IUI 5 times in another hospital without success. IVF-ET with donated sperms was performed in November 1991 resulting in clinical pregnancy. She was delivered of a pair of twins, one male and one female on July 20, 1992. The possibilities of different types of gamete formation during meiosis in carriers of chromosomal balanced translocation were briefly discussed. Donation of oocytes could be realized only in an IVF program, which is also the only way to propagate for the family. However, IVF with donated sperms is indicated in women with blocked tubes besides the male factor or after repeated failures of other assisted reproductive technologies. PMID:8137642

  9. Evaluation of 80 Term Neonates with Hypoxic Ischemic Encephalopathy

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    Selahattin Katar

    2007-01-01

    Full Text Available This study aimed to review the etiology, clinical - laboratory features and mortality rate of term 80 neonates with perinatal asphyxia admitted to our neonatal unit between January 2005-April 2006. The sex distribution was 24 (%30 female and 56 (% 70 male. The mean gestational age was 38.6±1.3 weeks and weight 3156±561 gram. Of the patients % 46.25 were delivered with a cesarean section and % 53.75 with spontaneous vaginal delivery. The etiologic factors for hypoxic ischemic encephalopathy were % 31.25 force delivery, meconium aspiration, and % 66.25 preeclampsia, eclampsia and diabetic mother’s infant. The distribution of patients according to HIE statging system (Sarnat&Sarnat were as follows: 33 patients (% 41.25 in stage 1, 20 (% 25 in stage 2 and 27 (% 33.75 in stage 3. Seizures were observed in % 33.75 of patients. The mean duration of hospital stay was 10.6±7.7 days for the surviving patients and 4.2±3.4 days for patients who died. Except from central nervous system, liver and kidney were the most involved organs.Perinatal asphyxia remains to be leading cause of neonatal mortality. Hypoxic ischemic encephalopathy is a common newborn problem and cause important mortality and morbidity where low-social –cultural –education conditions with in regions.

  10. Adverse perinatal outcomes for advanced maternal age: a cross-sectional study of Brazilian births

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    Núbia Karla O. Almeida

    2015-10-01

    Full Text Available ABSTRACT OBJECTIVES: To investigate the risk of adverse perinatal outcomes in women aged ≥41 years relatively to those aged 21-34. METHODS: Approximately 8.5 million records of singleton births in Brazilian hospitals in the period 2004-2009 were investigated. Odds ratios were estimated for preterm and post-term births, for low Apgar scores at 1 min and at 5 min, for asphyxia, for low birth weight, and for macrosomia. RESULTS: For pregnant women ≥41, increased risks were identified for preterm births, for post-term births (except for primiparous women with schooling ≥12 years, and for low birth weight. When comparing older vs. younger women, higher educational levels ensure similar risks of low Apgar score at 1 min (for primiparous mothers and term births, of low Apgar score at 5 min (for term births, of macrosomia (for non-primiparous women, and of asphyxia. CONCLUSION: As a rule, older mothers are at higher risk of adverse perinatal outcomes, which, however, may be mitigated or eliminated, depending on gestational age, parity, and, especially, on the education level of the pregnant woman.

  11. Tracheobronchial foreign bodies in children – a retrospective study of 2,000 cases in Northwestern China

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    Liang, Jianmin; Hu, Juan; Chang, Huimin; Gao, Ying; Luo, Huanan; Wang, Zhenghui; Zheng, Guoxi; Chen, Fang; Wang, Ting; Yang, Yeye; Kou, Xiaohui; Xu, Min

    2015-01-01

    The aim of this study is to report our experience in the diagnosis and treatment of tracheobronchial foreign bodies (TFBs). We retrospectively reviewed medical records of 2,000 TFB patients (1,260 males and 740 females) who were treated between January 2010 and December 2013. Chest radiography and computed tomography were performed to diagnose TFBs. The location and type of foreign bodies (FBs), anesthesia methods, and treatment outcomes and complications were analyzed. Overall, 72.5% of our patients with TFB were aged between 1 years and 3 years. Plant-based FBs are the most common FB type, accounting for 91.5%. Almost 52.1% of the FBs were encountered in the right bronchus. The coincidence rate for computed tomography-based three-dimensional reconstruction was significantly greater than that for chest X-ray examination (98.7% vs 82.0%, P<0.01). Under general anesthesia, the FBs were removed by rigid bronchoscopy. Neither anesthesia complication nor intraoperative hypoxemia occurred. There were seven deaths from acute obstructive asphyxia and eight from residual FB-induced chronic asphyxia and respiration-circulation failure. In conclusion, early diagnosis and prompt treatment of TFBs with rigid bronchoscopy under general anesthesia is effective in reducing complications and mortality in affected children. PMID:26357477

  12. Tracheobronchial foreign bodies in children - a retrospective study of 2,000 cases in Northwestern China.

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    Liang, Jianmin; Hu, Juan; Chang, Huimin; Gao, Ying; Luo, Huanan; Wang, Zhenghui; Zheng, Guoxi; Chen, Fang; Wang, Ting; Yang, Yeye; Kou, Xiaohui; Xu, Min

    2015-01-01

    The aim of this study is to report our experience in the diagnosis and treatment of tracheobronchial foreign bodies (TFBs). We retrospectively reviewed medical records of 2,000 TFB patients (1,260 males and 740 females) who were treated between January 2010 and December 2013. Chest radiography and computed tomography were performed to diagnose TFBs. The location and type of foreign bodies (FBs), anesthesia methods, and treatment outcomes and complications were analyzed. Overall, 72.5% of our patients with TFB were aged between 1 years and 3 years. Plant-based FBs are the most common FB type, accounting for 91.5%. Almost 52.1% of the FBs were encountered in the right bronchus. The coincidence rate for computed tomography-based three-dimensional reconstruction was significantly greater than that for chest X-ray examination (98.7% vs 82.0%, P<0.01). Under general anesthesia, the FBs were removed by rigid bronchoscopy. Neither anesthesia complication nor intraoperative hypoxemia occurred. There were seven deaths from acute obstructive asphyxia and eight from residual FB-induced chronic asphyxia and respiration-circulation failure. In conclusion, early diagnosis and prompt treatment of TFBs with rigid bronchoscopy under general anesthesia is effective in reducing complications and mortality in affected children. PMID:26357477

  13. Micro computed tomography features of laryngeal fractures in a case of fatal manual strangulation.

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    Fais, Paolo; Giraudo, Chiara; Viero, Alessia; Miotto, Diego; Bortolotti, Federica; Tagliaro, Franco; Montisci, Massimo; Cecchetto, Giovanni

    2016-01-01

    Cases of subtle fatal neck compression are often complicated by the lack of specificity of the post-mortem signs of asphyxia and by the lack of clear signs of neck compression. Herein we present a forensic case of a 45-year-old schizophrenic patient found on the floor of the bedroom of a psychiatric ward in cardiopulmonary arrest and who died after two days in a vegetative state. The deposition of the roommate of the deceased, who claimed responsibility for the killing of the victim by neck compression, was considered unreliable by the prosecutor. Autopsy, toxicological analyses, and multi-slice computed tomography (MSCT), micro computed tomography (micro-CT) and histology of the larynx complex were performed. Particularly, micro-CT analysis of the thyroid cartilage revealed the bilateral presence of ossified triticeous cartilages and the complete fragmentation of the right superior horn of the thyroid, but it additionally demonstrated a fracture on the contralateral superior horns, which was not clearly diagnosable at MSCT. On the basis of the evidence of intracartilaginous laryngeal hemorrhages and bilateral microfracture at the base of the superior horns of the larynx, the death was classified as a case of asphyxia due to manual strangulation. Micro-CT was confirmed as a useful tool in cases of subtle fatal neck compression, for the detection of minute laryngeal cartilage fractures, especially in complex cases with equivocal findings on MSCT. PMID:26832384

  14. Cardiotocography (CTG as the screening method of fetal condition assessment

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    V. Zulčić-Nakić

    2007-02-01

    Full Text Available A basic function of fetal monitoring is an analysis of fetal cardiac action. Cardiotocography (CTG cannot provide all necessary information for assessment of the fetal condition as it is not sufficiently reliable and gives a large number of false positive results that increase the number of cesarean sections. An objective of this work was to establish CTG reliability as a method for assessment of intrapartal fetal condition. Based on CTG parameters (baseline fetal heart rate, fetal heart rate variability, oscillations and decelerations 100 pathological CTG records, collected at Obstetrics and Gynecology Department of the Tuzla University Clinic Hospital from 01.12.2004 to 05.08.2005 were identified. Using binomial distribution they were classified as non-pathological (indicating absence of asphyxia and pathological (indicating possible presence of asphyxia. After the delivery the condition of newborns was assessed according to the Apgar score. Based on comparison between certain pathological parametres of CTG records and newborns’ conditions at birth the results indicated high positive predictive values whereas sensitivity and accuracy were low. Apgar score 1. from 7 upwards was given to 96 (96% newborns whereas Apgar score 2 from 7 upwards was given to all the newborns with previous pathological CTG records. Results have confirmed that CTG can be used only as a screening method for assessment of intrapartal fetal condition.

  15. Support-vector-machines-based multidimensional signal classification for fetal activity characterization

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    Ribes, S.; Voicu, I.; Girault, J. M.; Fournier, M.; Perrotin, F.; Tranquart, F.; Kouamé, D.

    2011-03-01

    Electronic fetal monitoring may be required during the whole pregnancy to closely monitor specific fetal and maternal disorders. Currently used methods suffer from many limitations and are not sufficient to evaluate fetal asphyxia. Fetal activity parameters such as movements, heart rate and associated parameters are essential indicators of the fetus well being, and no current device gives a simultaneous and sufficient estimation of all these parameters to evaluate the fetus well-being. We built for this purpose, a multi-transducer-multi-gate Doppler system and developed dedicated signal processing techniques for fetal activity parameter extraction in order to investigate fetus's asphyxia or well-being through fetal activity parameters. To reach this goal, this paper shows preliminary feasibility of separating normal and compromised fetuses using our system. To do so, data set consisting of two groups of fetal signals (normal and compromised) has been established and provided by physicians. From estimated parameters an instantaneous Manning-like score, referred to as ultrasonic score was introduced and was used together with movements, heart rate and associated parameters in a classification process using Support Vector Machines (SVM) method. The influence of the fetal activity parameters and the performance of the SVM were evaluated using the computation of sensibility, specificity, percentage of support vectors and total classification accuracy. We showed our ability to separate the data into two sets : normal fetuses and compromised fetuses and obtained an excellent matching with the clinical classification performed by physician.

  16. Chemical shift imaging and localised magnetic resonance spectroscopy in full-term asphyxiated neonates

    International Nuclear Information System (INIS)

    Diagnosis of brain lesions after birth anoxia-ischemia is essential for appropriate management. Clinical evaluation is not sufficient. MRI has been proven to provide useful information. To compare abnormalities observed with MRI, including diffusion-weighted imaging (DWI), localised magnetic resonance spectroscopy (MRS) and chemical shift imaging (CSI) and correlate these findings with the clinical outcome. Fourteen full-term neonates with birth asphyxia were studied. MRI, MRS and CSI were performed within the first 4 days of life. Lesions observed with DWI were correlated with outcome, but the apparent diffusion coefficient (ADC) did improve diagnostic confidence. The mean value of Lac/Cr for the neonates with a favourable outcome was statically lower than for those who died (0.22 vs 1.04; P = 0.01). The same results were observed for the Lac/NAA ratio (0.21 vs 1.23; P = 0.01). Data obtained with localised MRS and CSI were correlated for the ratio N-acetyl-aspartate/choline, but not for the other metabolites. No correlation was found between the ADC values and the metabolite ratios. Combination of these techniques could be helpful in our understanding of the physiopathological events occurring in neonates with asphyxia. (orig.)

  17. Semi-automated analysis of EEG spikes in the preterm fetal sheep using wavelet analysis

    International Nuclear Information System (INIS)

    Full text: Presentation Preference Oral Presentation Perinatal hypoxia plays a key role in the cause of brain injury in premature infants. Cerebral hypothermia commenced in the latent phase of evolving injury (first 6-8 h post hypoxic-ischemic insult) is the lead candidate for treatment however currently there is no means to identify which infants can benefit from treatment. Recent studies suggest that epileptiform transients in latent phase are predictive of neural outcome. To quantify this, an automated means of EEG analysis is required as EEG monitoring produces vast amounts of data which is timely to analyse manually. We have developed a semi-automated EEG spike detection method which employs a discretized version of the continuous wavelet transform (CWT). EEG data was obtained from a fetal sheep at approximately 0.7 of gestation. Fetal asphyxia was maintained for 25 min and the EEG recorded for 8 h before and after asphyxia. The CWT was calculated followed by the power of the wavelet transform coefficients. Areas of high power corresponded to spike waves so thresholding was employed to identify the spikes. The performance of the method was found have a good sensitivity and selectivity, thus demonstrating that this method is a simple, robust and potentially effective spike detection algorithm.

  18. Association between maternal HBsAg carrier status and neonatal adverse outcomes: meta-analysis.

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    Luo, Lili; Wu, Jinlin; Qu, Yi; Li, Jiao; Pan, Lingli; Li, Deyuan; Wang, Huiqing; Mu, Dezhi

    2014-09-18

    Abstract Objective: We conducted a meta-analysis to evaluate whether maternal hepatitis B virus (HBV) carrier status increases the risk of neonatal complications. Methods: Publications addressing the association between maternal HBV carrier status and neonatal outcomes were selected from the PubMed, EMBASE, Web of Science, Cochrane Library and China National Knowledge Infrastructure. Publication bias and heterogeneity across studies were evaluated and summary odds ratios, weighted mean difference or standardized mean difference and 95% confidence intervals were calculated and compared between groups. Results: Eighteen studies and 7600 pregnant HBV carriers were selected for analyses. A statistically association with maternal HBV carrier status was demonstrated for premature birth and asphyxia, with no difference found among perinatal mortality, gestational age, small for gestational age, large for gestational age, birth weight, low birth weight, macrosomia, Apgar sore at 1 min, jaundice and congenital anomaly. Heterogeneity across studies was found, and no publication bias was detected. Conclusion: Our analysis suggests that maternal hepatitis B carrier status is significantly associated with premature birth and asphyxia. Large-scale prospective studies are still warranted. PMID:25231370

  19. A study of early neonatal morbidity profile in a district teaching hospital, Mysore, India

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    Vadiraja Nagarajarao

    2014-10-01

    Full Text Available Introduction: Early neonates are more prone towards infections and deaths. As a result we are interested in finding out the health behavior of inborn early neonates in a district hospital of Mysore. Materials and Methods: A total of 24,578 live births were monitored for their morbidity status from September 2011 to June 2013. The number of morbidity causes was detected for every 100 early neonates, monthly wise. The non-conformities behavior was observed through Poisson u-chart with variable control limits. 20% vital few contributors that contributes to variations in morbidity and mortality aspects of early neonates were detected through checklists and super imposed Pareto charts. Results: The number of causes per inspection unit for sample number 9 is out of control. Values corresponding to samples 1 and 2 are within the warning region. It appears that hypoxic ischemic encephalopathy (HIE/moderate-severe birth asphyxia is the major contributing factor for both morbidity and mortality based on the occurrences. However, in the process of detecting the impact of morbidity factor on their corresponding mortality, it is found that the major nonconformity factor is major congenital malformation (MCM and not HIE/Moderate-severe birth asphyxia as MCM has 0.217 chance of causing mortality, whereas HIE has 0.19 chance standing at the fourth position. Conclusion: We conclude that the hospital management needs to develop appropriate preventive and management strategies for the major causes viz., MCM, sepsis/pneumonia/meningitis and respiratory distress syndrome.

  20. Ligature strangulation deaths in the province of Konya (Turkey).

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    Demirci, Serafettin; Dogan, Kamil Hakan; Erkol, Zerrin; Gunaydin, Gursel

    2009-07-01

    In the present study, deaths by ligature strangulation in the province of Konya (Turkey) were evaluated from the medicolegal point of view between 2001 and 2006. In total 2850 medicolegal death cases, 161 (5.65%) were resulted from asphyxia and 20 (12.4%) of the deaths due to asphyxia were cases of ligature strangulation. Male:female ratio of the victims was 1:1 with ages ranging from 1.5 to 70 years and a mean age of 37.22+/-19.28 years. 17 cases (85%) were of homicidal and 3 cases (15%) of suicidal origin. The most widely used ligature material was clothesline in 6 cases (30%). On the examination of neck structures, thyroid cartilage fracture was present in 7 (35%) cases, fracture of the hyoid bone in 3 cases (15%), fracture both of the thyroid cartilage and hyoid bone in 1 case (5%), only ecchymosis in soft tissues in 7 cases (35%). In the paper, the findings determined in our cases are discussed in the light of the literature on the subject. PMID:19481705

  1. [An experimental study of the effects of ketamine on the central sympathetic system, respiration and circulation (author's transl)].

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    Pfeifer, G; Tauberger, G; Schulte am Esch, J

    1981-06-01

    Cats were given basal anaesthesia (nitrous oxide-oxygen) with artificial ventilation. They were then injected intravenously with 5 mg/kilogram bodyweight of ketamine. The injection was followed by a marked ketamine. The injection was followed by a marked reduction in both the tone of the central sympathetic system and the activity of the phrenic nerve which lasted for 10 minutes and 30 minutes respectively. Doses of 10 mg/kilogram bodyweight caused a longer lasting and more pronounced lowering of sympathetic activity while phrenic activity was approximately the same as with the smaller dosage. Injection of 2.5 mg/kilogram bodyweight reduced the sympathetic tone only if it was accompanied by asphyxia (central stimulation). Administration of 5 mg and of 10 mg/kilogram bodyweight was followed by a fall in blood pressure by 15-45 per cent up to 2 minutes after the injection. The heart rate at rest was unaffected but in the presence of asphyxia there was a dose-dependent reduction in the expected bradycardia. Ketamine also induced definite central inhibition thereby preventing the circulatory activation which occurs when the drug is used for anaesthetic purposes. The observation that the bradycardic effect arising from central stimulation was weakened suggests a reduction of central vagal activity. PMID:7258572

  2. Immunohistochemical detection of early myocardial damage in two sudden deaths due to intentional butane inhalation. Two case reports with review of literature.

    Science.gov (United States)

    Novosel, Irena; Kovačić, Zdravko; Gusić, Stjepan; Batelja, Lovorka; Nestić, Marina; Seiwerth, Sven; Skavić, Josip

    2011-04-01

    The abuse of household and other commercially available products containing volatile organic solvents is underrecognized. Not infrequently intentional butane inhalation results in high morbidity and mortality. A fatal outcome of butane abuse can be caused by asphyxia, cardiac arrhythmia or trauma. The reported number of cases in which death was the consequence of pure butane inhalation is limited, and in most cases a mixture of propellants was involved. This report covers two cases of sudden death due to the sniffing of a cigarette lighter refill containing butane. Autopsy was followed by toxicological, pathohistological and immunohistochemical analysis. Butane gas was confirmed in samples of blood, urine, brain and lungs by the gas chromatography method - "headspace" technique. Histology showed almost identical changes in the lungs and heart in both cases. The morphology of heart damage on standard H/E stains was of special interest because it displayed all the characteristics of chronic and acute myocardial hypoxia found in the absence of atherosclerotic heart disease. In order to confirm early cardiac death caused by asphyxia due to butane inhalation a panel of immunohistochemical agents was used: Myoglobin, Desmin, Fibronectin, Fibrinogen and CC9. PMID:21420651

  3. NEONATAL SEIZURES: ETIOLOGY AND FREQUENCY

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    F. Eghbalian

    2008-11-01

    Full Text Available ObjectiveThe aim of the present study was to evaluate the etiology and frequency of neonatal seizure in hospitalized neonates.Materials and MethodsIn this descriptive, cross-sectional study, we evaluated 1295 neonates with seizures admitted to neonatal and NICU wards in our center. Data was collected on age, sex, birth weight, serum levels of calcium, glucose, and sodium, CT scan findings, history of maternal opium abuse, blood and cerebrospinal fluid culture, and analyzed using SPSS 13.ResultsOf a total of 1295 patients, 34 (2.62% had seizure. Mean age was 14.03 ± 10.05 days (range, 1 to 29 days; twenty-five (73.5% neonates were boys and 9 (26.5% were girls. Of 34 neonates with neonatal seizures, 12 (35.3%, 11 (32.4%, 9 (26.5%, 7 (20.6%, and 3 (8.8% had hypocalcemia, asphyxia, hypoglycemia, intracranial hemorrhage, and hypernatremia, respectively.Maternal addiction, meningitis, and sepsis were found in 3 (8.8%, 1 (2.9% and 1 (2.9% of neonates, respectively.ConclusionThe incidence rate of neonatal seizure in the neonates in our NICU and neonatal ward was 2.62%. Common causes of seizure in this study included hypocalcemia, asphyxia, hypoglycemia, intracranial hemorrhage, and hypernatremia. Maternal ddiction, meningitis and sepsis had the lowest prevalence.Keywords:Neonate, Seizure, Etiologies.

  4. A retrospective study of the outcome of cesarean section for women with severe pre-eclampsia in a third world setting

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    Obinna V Ajuzieogu

    2011-01-01

    Full Text Available Objective: To compare the outcome of subarachnoid block (spinal anesthesia and general anesthesia in Cesarean delivery for women with severe pre-eclampsia. Methods: A retrospective study of women with severe pre-eclampsia requiring Cesarean section from January 2005 to June 2009 was carried out. Maternal age, parity, gestational age at delivery, booking status, Apgar scores, maternal and perinatal mortality of the sub-arachnoid block group were compared with those of general anesthesia group using c2 , Student t-test and Fischer exact test. Results: There were no significant difference between the two groups in overall maternal mortality (5.4% vs. 11.9%, P=0.5 and perinatal mortality (2.7% vs. 11.9%, P=0.15. The general anesthesia group had significantly more birth asphyxia than the spinal group (55.9% vs. 27.0%, P=0.0006. Conclusion: There was no significant difference in the maternal and perinatal mortality outcome of cesarean delivery between women with severe pre-eclampsia who had regional anesthesia and those that had general anesthesia. There was significantly higher proportion of birth asphyxia in babies of women who received general anesthesia.

  5. Dexmedetomidine Postconditioning Reduces Brain Injury after Brain Hypoxia-Ischemia in Neonatal Rats.

    Science.gov (United States)

    Ren, Xiaoyan; Ma, Hong; Zuo, Zhiyi

    2016-06-01

    Perinatal asphyxia can lead to death and severe disability. Brain hypoxia-ischemia (HI) injury is the major pathophysiology contributing to death and severe disability after perinatal asphyxia. Here, seven-day old Sprague-Dawley rats were subjected to left brain HI. Dexmedetomidine was given intraperitoneally after the brain HI. Yohimbine or atipamezole, two α2 adrenergic receptor antagonists, were given 10 min before the dexmedetomidine injection. Neurological outcome was evaluated 7 or 28 days after the brain HI. Frontal cerebral cortex was harvested 6 h after the brain HI. Left brain HI reduced the left cerebral hemisphere weight assessed 7 days after the brain HI. This brain tissue loss was dose-dependently attenuated by dexmedetomidine. Dexmedetomidine applied within 1 h after the brain HI produced this effect. Dexmedetomidine attenuated the brain HI-induced brain tissue and cell loss as well as neurological and cognitive dysfunction assessed from 28 days after the brain HI. Dexmedetomidine postconditioning-induced neuroprotection was abolished by yohimbine or atipamezole. Brain HI increased tumor necrosis factor α and interleukin 1β in the brain tissues. This increase was attenuated by dexmedetomidine. Atipamezole inhibited this dexmedetomidine effect. Our results suggest that dexmedetomidine postconditioning reduces HI-induced brain injury in the neonatal rats. This effect may be mediated by α2 adrenergic receptor activation that inhibits inflammation in the ischemic brain tissues. PMID:26932203

  6. Spectrum and immediate outcome of seizures in neonates

    International Nuclear Information System (INIS)

    To determine the frequency, etiology, the clinical types, and outcome of seizures in neonates during the course of stay in the neonatal unit. All neonates (1-28 days) presented with seizures during that period were included in the study. Their detailed history, physical examination, and appropriate investigations were recorded on a study proforma. Out of a total 680 patients, 100 patients presented with the seizures; this comprises the frequency of 14.7%. Male to female ratio was 2.1:1. Regarding gestational age, 65% were full-term, 31% were pre-term, and 4% were post-term. Regarding etiology, 40% patients had birth asphyxia; 14% had hypoglycemia; 12% were due to hypocalcaemia, 5% were due to intracranial hemorrhage (ICH), 4% had malformation, 10 % had infection /neonatal sepsis, and in 12%, the etiology was kernicterus. Among the patients with seizures, 45% were completely recovered and discharged and 15% patients had neurological deficit at the time of discharge. From the hospitalized 100 patients, 22% expired. The critical factors for the outcome were etiology, gestational age, birth weight, APGAR score, and clinical characteristics. Generally, birth asphyxia had poor, while metabolic causes had good prognosis. (author)

  7. Clinical profile of patients with infantile spasms

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    Wael hayel khreisat

    2011-04-01

    Full Text Available Objective: The present study was done in order to obtain a baseline profile of infantile spasms and associated neurological disorders Patient and methods:. The study included 50 patients with infantile spasm in Queen Rania Hospital for children in Jordan. The following data were obtained: sex, age of onset and presentation, details of seizure , family history of epilepsy, significant pre-/peri/post-natal insults, neuro imaging evaluation , detailed neurological and neuro developmental ,assessment were done by. Broad categories of possible etiologies were used the results were recorded for further study. Results: Age of onset of infantile spasm ranged from 1month to 1 year and 6 months , (mean 4.8 months. The mean time of presentation was 9.4 months . A male preponderance was noted (74 %. flexor spasms (52% were the commonest. Other types of seizures also accompanied infantile spasm in 44% children. (84% were born of normal delivery, History of birth asphyxia was obtained in 48%, 3 (6% had positive family history Developmental delay was recognized prior to onset of spasms in 52% . microcephaly was the commonest associated problem , Imaging studies of the brain revealed abnormality in 18 patients. 78% patients symptomatic and 22 % as cryptogenic.. Conclusion: The pattern of infantile spasm in our country do not differ from that of developed countries, further researches is required to prevent both chronic epilepsy and psychomotor retardation and .preventive measurement to prevent birth asphyxia is recommended

  8. Different extent in decline of infant mortality by region and cause in Shenyang, China.

    Science.gov (United States)

    Huang, Yan-Hong; Wu, Qi-Jun; Li, Li-Li; Li, Da; Li, Jing; Zhou, Chen; Wu, Lang; Zhu, Jingjing; Gong, Ting-Ting

    2016-01-01

    To compare the pattern of cause of death of infant mortality rates by urban/rural areas as well as to generate knowledge for potential strategies to decrease this mortality, we carried out a study by analyzing the infant mortality data from the Shenyang Women and Children Health Care Centre. From 1997 to 2014, 970,583 live births and 6510 infant deaths were registered. Infant mortality rates, percent change, and annual percent change (APC) were calculated. The infant mortality significantly decreased by 5.92%, 7.41%, and 3.92% per year in overall, urban, and rural areas, respectively. Among the categories of causes of infant death, congenital anomalies (APC = -7.87%), asphyxia-related conditions (APC = -9.43), immaturity-related conditions (APC = -3.44%), diseases of the nervous system and sense organs (APC = -6.01%), and diseases of the respiratory system (APC = -6.29%) decreased significantly in the observational periods. Additionally, among selective causes of infant death, pneumonia, congenital heart disease, neural tube defects, preterm birth and low birth weight, birth asphyxia, and intracranial hemorrhage of the newborn significantly decreased by 5.45%, 5.45%, 16.47%, 2.18%, 10.95%, and 10.33% per year, respectively. In conclusion, infant mortality has been continuously decreased in Shenyang from 1997 to 2014, although further efforts are still needed to decrease the infant mortality in rural areas. PMID:27075740

  9. 护理干预对产妇自然分娩及产后出血的影响

    Institute of Scientific and Technical Information of China (English)

    周菊芳; 阳娟娟

    2013-01-01

    Purpose Explore the nursing intervention on natural childbirth and postpartum hemorrhage maternal effects .Method Select a hospital in May 2009---2010 in August obstetric primipara 200 cases were randomly divided into observation group and control group 100 cases.Implementation of routine obstetric care control group,the observation group was given on the basis of relatively systematic nursing intervention.Two groups of maternal mode of delivery,the total labor time,2h postpar-tum hemorrhage and neonatal asphyxia comparing.Result Natural childbirth maternal observation group rate,the total labor time,neonatal asphyxia and postpartum hem-orrhage compared with the control group were significantly different,P<0.05.Conclusion System at the beginning of maternity nursing intervention plays a positive role in promoting the process,you can improve natural childbirth rate,reduce postpartum hemorrhage and neonatal asphyxia,improve delivery quality.%目的:探讨护理干预对产妇自然分娩及产后出血的影响。方法选取我院2009年5月---2010年8月产科的初产妇200例,随机分为观察组和对照组各100例。对照组施行产科常规护理,观察组在对照组的基础上给予相对较系统的护理干预。比较2组产妇的分娩方式、总产程时间、产后2h出血量和新生儿窒息率。结果观察组产妇的自然分娩率、总产程时间、新生儿窒息率以及产后出血量与对照组比较有统计学差异,P<0.05。结论系统的护理干预在初产妇分娩过程起积极的促进作用,可以提高自然分娩率,减少产后出血和新生儿窒息,提高分娩质量。

  10. Correlation of Apgar Score with Asphyxial Hepatic Injury and Mortality in Newborns: A Prospective Observational Study From India

    Science.gov (United States)

    Sharma, Deepak; Choudhary, Mukesh; Lamba, Mamta; Shastri, Sweta

    2016-01-01

    OBJECTIVE The objective of this study is to determine the correlation of Apgar score with asphyxial hepatic injury and neonatal mortality in moderately and severely asphyxiated newborns. MATERIAL AND METHODS This is a secondary analysis of our prospective observational case-controlled study. Sixteen neonates with severe birth asphyxia (five-minute Apgar ≤3) were compared with either 54 moderate asphyxia neonates (five-minute Apgar >3) or 30 normal neonates. Liver function tests were measured on postnatal days 1, 3, and 10 in the study and control groups. Neonatal mortality was observed in the study and control population. RESULTS Correlation of Apgar score in severely asphyxiated neonates compared with normal Apgar score neonates and moderately asphyxiated neonates for deranged hepatic function showed significant correlation (odds ratio [OR] 4.88, 95% CI 3.26–5.84, P = 0.01 and OR 2.46, 95% CI 1.94–3.32, P = 0.02, respectively). There was a significant increase in serum lactate dehydrogenase (LDH) and total bilirubin on day 1 and serum LDH at age of 10th postnatal life in severely asphyxiated neonates when compared to moderately asphyxiated neonates, whereas there was a significant decrease in total bilirubin and serum albumin on day 3 in severely asphyxiated neonates. There was a significant increase in serum alanine transaminase, serum LDH, and total bilirubin on day 1, serum aspartate transaminase, serum LDH, and total bilirubin on day 3, and International Normalized Ratio on day 10 of postnatal life when severely asphyxiated neonates were compared with normal neonates. There was a significant reduction in total protein and serum albumin on day 1 and direct bilirubin on day 3 in severely asphyxiated neonates when compared with normal neonates. There was a significant increase in neonatal mortality in severely asphyxiated neonates when compared to the other two groups. Correlation of Apgar score in severely asphyxiated neonates compared with normal Apgar

  11. Observation on the Effect of Humanized Nursing Applied to the Delivery in Primiparas%人性化护理在初产妇分娩中的效果观察

    Institute of Scientific and Technical Information of China (English)

    张淑兰

    2015-01-01

    Objective To observe the effect of humanistic nursing on primiparas undergoing delivery. Methods 260 primiparas un-derwent delivery in our hospital from March 2014 to October 2014 were selected and randomly divided into the observation group (124 cases) and the control group(136 cases). The observation group was given humanistic nursing, and the control group was given general obstetrical nursing. And the natural birth rate, neonatal asphyxia rate and incidence of postpartum hemorrhage were com-pared between the two groups. Results Compared with the control group, the observation group had much higher natural birth rate (87.9%vs 51.5%), obviously lower neonatal asphyxia rate(2.4%vs 12.5%) and incidence of postpartum hemorrhage(1.8%vs 4.4%) with statistically significant difference. Conclusion For primiparas undergoing delivery, humanistic nursing is of great significance in improving the natural birth rate and reducing the neonatal asphyxia rate and incidence of postpartum hemorrhage.%目的:探讨和分析人性化护理在初产妇分娩中的作用。方法整群选取该院2014年3-10月收治分娩的260例初产妇中,随机分为观察组124人,对照组136人,观察组实施人性化护理,对照组给予分娩期的一般护理常规。比较两组的自然分娩率、新生儿窒息率和产后出血率的情况。结果观察组自然分娩率为87.9%,远高于对照组的51.5%;且观察组的新生儿窒息率和产后出血率为2.4%和1.8%,也低于对照组的12.5%和4.4%,差异有统计学意义。结论在初产妇分娩期实施人性化护理对提高自然分娩率、降低新生儿窒息率和产后出血率有重要意义。

  12. To Explore the Effects on Birth Outcomes Take Unprotected Perineum Midwives Technical of Natural Birth%探讨在自然分娩过程中采取无保护会阴接生技术对分娩结局的影响

    Institute of Scientific and Technical Information of China (English)

    张建芹

    2015-01-01

    Objective To explore the effects on birth outcomes take unprotected perineum midwives technical of natural birth and analyze. Methods Selected 102 cases of full-term birth of obstetrics and gynecology from 2013 September to 2014 October in our hospital. Compared the two groups of maternal episiotomy rates and neonatal asphyxiaResults Experimental group maternal and neonatal asphyxia rate of episiotomy rate was signiifcantly lower than the control group, and the difference was statistically signiifcant (P<0.05).Conclusion In natural childbirth, mothers take their unprotected perineum delivery techniques reduce the rate of maternal and neonatal asphyxia episiotomy rate effectively, it possible to the maximum ensure the safety of the mother and child.%目的:探讨在自然分娩过程中采取无保护会阴接生技术对分娩结局的影响,并进行分析,以供参考。方法选取2013年9月~2014年10月我院妇产科收治的足月产妇,共102例作为研究对象。比较2组产妇的会阴侧切率及其新生儿窒息率,并进行分析。结果实验组产妇的会阴侧切率及其新生儿窒息率均要低于对照组,P<0.05,差异具有统计学意义。结论在自然分娩过程中,对其产妇采取无保护会阴接生技术,可以有效降低产妇的会阴侧切率及其新生儿窒息率,在最大程度上保证了母婴安全。

  13. 拉玛泽呼吸法在产程中的观察分析%A observation and analysis on Lamaze breathing during the process of labor

    Institute of Scientific and Technical Information of China (English)

    罗冰贤; 何华聪; 黎紫玲

    2013-01-01

    目的 观察拉玛泽呼吸法在产程中的应用效果.方法 选择2010年2月至2013年2月我院阴道试产产妇240例为研究对象,对照组采用常规护理,实验组给予拉玛泽呼吸法,观察比较两组疼痛程度、剖宫产率、产后出血和新生儿窒息.结果 实验组疼痛程度(3.63±1.02)降低,产妇剖宫产率(15.00%)降低,其产后出血率(3.33%)降低,新生儿窒息率(7.50%)降低,与对照组患者比较,P< 0.05,差异有统计学意义.结论 使用拉玛泽呼吸法可以减轻产妇的疼痛,减少产后出血和新生儿窒息,降低剖宫产率,具有较高的优势.%Objective To observe the effect of Lamaze breathing during the process of labor.Methods 240 puerperas who gave vaginal delivery in our hospital during the period of February 2010 to February 2013 were enrolled as study subjects.The control group received routine care,while the study group received Lamaze breathing.The pain level,rate of Cesarean section,postpartum hemorrhage,and neonatal asphyxia.Results The pain level (3.63 + 1.02),and rates of Cesarean section (15.00%),postpartum hemorrhage (3.33%),and neonatal asphyxia (7.50%)were reduced in the study group,with significant differences as compared with the control group (P<0.05).Conclusions Lamaze breathing can relieve pain level in puerperas and reduce rates of postpartum hemorrhage,neonatal asphyxia,and Cesarean section.

  14. Treatable newborn and infant seizures due to inborn errors of metabolism.

    Science.gov (United States)

    Campistol, Jaume; Plecko, Barbara

    2015-09-01

    About 25% of seizures in the neonatal period have causes other than asphyxia, ischaemia or intracranial bleeding. Among these are primary genetic epileptic encephalopathies with sometimes poor prognosis and high mortality. In addition, some forms of neonatal infant seizures are due to inborn errors of metabolism that do not respond to common AEDs, but are amenable to specific treatment. In this situation, early recognition can allow seizure control and will prevent neurological deterioration and long-term sequelae. We review the group of inborn errors of metabolism that lead to newborn/infant seizures and epilepsy, of which the treatment with cofactors is very different to that used in typical epilepsy management. PMID:26234933

  15. [Renal ultrasound in fat necrosis].

    Science.gov (United States)

    Tizki, S; Lasry, F; Elftoiki, F Z; Hadj Khalifa, H; Itri, M; Khadir, K; Benchikhi, H

    2013-07-01

    Subcutaneous fat necrosis is an uncommon disease that may be complicated with potentially fatal hypercalcemia or with nephrocalcinosis. We report on the case of a patient with a history of significant perinatal asphyxia, hospitalized for a urinary tract infection. Lesions of subcutaneous fat necrosis were noted, with asymptomatic hypercalcemia at 3.9mmol/L. A renal ultrasound was performed and showed echogenic medullary pyramids bilaterally, consistent with nephrocalcinosis and left nephrolithiasis. The treatment of hypercalcemia included hyperhydration, a diuretic and corticosteroids. Progression was characterized by the total regression of skin lesions and normalization of serum calcium. Hypercalcemia is a rare complication of subcutaneous fat necrosis. It develops within days to weeks after the appearance of skin lesions. Nephrocalcinosis appears after several weeks or months. Hypercalcemia must be treated in due time to avoid the impact on the kidney. PMID:23726682

  16. RESPONSES OF SHEEP TO ZYGADENUS GRAMINEUS, "DEATH CAMAS".

    Science.gov (United States)

    McLaughlin, A R

    1931-01-30

    An extract of Zygadenus gramineus, "death camas," from which most of the resins had been removed was given intravenously to sheep prepared for recording blood-pressure and respiratory movements. Following the intravenous injection of this extract there occurred a respiratory inhibition which in the case of the injection of larger amounts of the extract was followed by asphyxia-like rises of blood-pressure. The graphic record of this asphyxial condition was practically duplicated by closing the tracheal cannula for a short time following the recovery of the animal from the effects of the plant extract. Although, from a field standpoint, no satisfactory antidote has been found, it has been demonstrated that caffein sodio-benzoate possesses marked powers of stimulation for the respiratory center affected by the depressive substances found in Zygadenus gramineus. PMID:17802372

  17. [Interpair differences in the characteristics of the ontogeny, premorbid personality and severity of schizophrenia in twins].

    Science.gov (United States)

    Moskalenko, V D

    1980-01-01

    In each of the studied 124 pairs, a twin A was distinguished (the patient with manifest symptoms in the discordant pairs, or more seriously affected twin in concordant pairs) and twin B--its partner. It was demonstrated that the order of birth, differences in the weight at birth, periodization of development do not correlate with the differences in the clinical expression of schizophrenia. Such unfavourable factors as asphyxia, complications during delivery, severe somatic illnesses had a certain tendency to accumulate in twin A. The most distinct correlation was found between the traits of a premorbid personality and the eventual intrapair differences in the severeity of schizophrenia. Twin A in the majority of the cases was more excitable in childhood, had more fears, slept worse, and had a poor appetite. The twin A by its premorbid traits was generally characterized by prevalent asthenic features, withdrawal signs and a more dysharmonic type of personality. PMID:7188820

  18. Severe Life Threatening Maxillofacial Infection in Pregnancy Presented as Ludwig's Angina

    Directory of Open Access Journals (Sweden)

    M. Franklin Dolwick

    2006-08-01

    Full Text Available Background. Ludwig's angina is a rapidly spreading cellulitis that may produce upper airway obstruction often leading to death. There is very little published information regarding this condition in the pregnant patient. Case. A 24-year old black female was admitted at 26 weeks gestation with tooth pain, submandibular swelling, severe trismus, and dysphagea, consistent with Ludwig's angina. Her treatment included emergent tracheostomy, incision and drainage of associated spaces, teeth extraction, and antibiotic therapy. Conclusions. During a life threatening infectious situation such as the one described, risks of maternal and fetal morbidity include both septicemia and asphyxia. Furthermore, the healthcare provider must consider the risks that the condition and the possible treatments may cause the mother and her unborn child.

  19. [Acute airway obstruction during chemotherapy-induced agranulocytosis with fever].

    Science.gov (United States)

    Vandenbos, F; Deswardt, Ph; Hyvernat, H; Burel-Vandenbos, F; Bernardin, G

    2006-02-01

    Acute airway obstruction caused by mucoid impaction can cause sometimes life-threatening respiratory distress. Bronchial plugging is usually observed in subjects with chronic diseases such as asthma, allergic bronchopulmonary aspergillosis, or cystic fibrosis. In children, it can be related to heart failure. Acute airway obstruction in a patient without a chronic respiratory disease is exceptional. We report the case of a patient who developed bronchial plugs obstructing the bronchi during a period of agranulocytosis induced by chemotherapy. The patient experienced acute respiratory distress with asphyxia. The plugs were composed of fibrin and required several fibroscopic procedures for clearance. To our knowledge, this is the first case report of acute airway obstruction by plugging during a period of agranulocytosis. PMID:16604039

  20. 极低出生体质量新生儿DIC高危因素分析%HIGH RISK FACTORS OF DISSEMINATED INTRAVASCULAR COAGULATION IN VERY LOW BIRTH-WEIGHT INFANTS

    Institute of Scientific and Technical Information of China (English)

    邵长荣; 姜红; 王启红

    2012-01-01

    Objective To investigate and analyse high risk factors of disseminated intravascular coagulation (DIC) in very low birth-weight infants (VLBWIs), so as to offer an early intervention. Methods Clinical data of 78 VLBWIs treated in the neonatal intensive care unit CNICU) between November 2010 and October 2011 were reviewed retrospectively for the incidence of DIC the information of those in DIC and non-DIC groups was analyzed for their perinatal periodi complicationsi and outcome, Logistic regression analysis was employed for the correlated risk factors. Results Twenty-six of the 78 VLBWIs were diagnosed with DIC, 74(94. 9%) survived. The differences between DIC and non-DIC group were significant in terms of gestational agef birth weight, intrauterine growth retardation (IUGR). asphyxia, septicemia, hypothermia, pulmonary hemorrhage, anemia, respiratory failure, and alimentary tract hemorrhage (t=2, 095,3. 100;X2 = 4. 524 - 18. 567,P<0, 05). Logistic regression analysis showed that IUGR, asphyxia., septicemia, hypothermia, pulmonary hemorrhage, anemia, and respiratory failure were the high-risk factors for DIC (X2 =4. 325-17. 175,P<0. 05). Conclusion VLBWI is the high-risk group of DIC, which is associated with gestational age, birth weight, IUGR, asphyxia, septicemia, anemia, pulmonary hemorrhage, anemia, respiratory failure, and alimentary tract hemorrhage in which, IUGR, asphyxia, septicemia, hypothermia, anemia and respiratory failure are risk factors for DIC. For those with younger gestational age and lighter birth weight, more DIC will be involved.%目的 调查分析极低出生体质量新生儿(VLBWI)弥散性血管内凝血(DIC)高危因素,以便早期干预.方法 回顾性分析2010年11月-2011年10月我院NICU住院治疗VLBWI 78例DIC发生情况,分析DIC组与非DIC组基本资料、围生期情况、并发症及治疗方面的差异,并对相关危险因素行Logistic回归分析.结果 78例VLBWI发生DIC 26例,存活74例(94.9%).DIC组与

  1. Proton magnetic resonance spectroscopy of the brain in pediatric patients

    International Nuclear Information System (INIS)

    H1-MRS is a non-invasive technique which provides different levels of information on brain tissue: the N-acetyl aspartate (NAA) is an indicator of neuronal development, the choline containing compound peak (Cho) provides information on myelination and on cell membrane turnover and gliosis, inositol (Ins) is considered a marker of neuronal degeneration. Lactate may be detected in presence of defective energy metabolism. In the perineonatal period, the brain is apt to be insulted by a variety of events including asphyxia, hypoxemia, hemorrhage, which may subsequently cause delay in development. It is clinically important to assess the degree of brain damage and to obtain the prognostic information in the neonatal and early infantile period. MRS has become available for clinical examinations of the brain during development and these techniques can be used to document improvement or the progression towards irreversible damage

  2. MR imaging of the neonatal brain: Pathologic features

    International Nuclear Information System (INIS)

    Seventy-three neonates, aged 29-43 weeks since conception, were studied. US and/or CT correlations were obtained in most infants with pathology. In the first 4-5 days after hemorrhage, US and CT were superior to MR imaging, but after that time MR imaging was the single best modality for imaging blood. In early premature infants with very watery white matter, US detected infarction and brain edema that were poorly seen on both MR imaging and CT. However, in late premature and full-term infants, MR imaging was better than CT in distinguishing between normal white matter and infarction. Only MR imaging disclosed delayed myelination in 13 term infants with hydrocephalus and severe asphyxia. MR imaging with play an important role in imaging neonates once MR imaging-compatible monitors and neonatal head coils become widely available

  3. THE EFFECT OF PHOTOTHERAPY ON SERUM IONIZED CALCIUM LEVELS IN NEONATES WITH UNCONJUGATED HYPER BILIRUBINEMIA

    Directory of Open Access Journals (Sweden)

    Durga

    2015-04-01

    Full Text Available AIM : T o study the occurance of hypocalcemia in neonates with hyperbilirubinemia after 48 hours of continuous phototherapy and to compare the results between term and preterm neonates. METHODS : T his study was performed on 100 neonates with unconjugated hyper bilirubinemia , 55 term and 45 preterm , who were given photo phototherapy in neonatal intensive care unit . serum ionized calcium levels were checked and after 48 hours of phototherapy . The prevalence of hypo calcemia after 48 hrs. of phototherapy was observed and compared between full term and preterm neonates. Neonates who had hyperbilirubinemia , asphyxia , respiratory distress , haemolytic anaemia sepsis were excluded from the study . RESULTS: 46/100 NEONATES, THAT IS 46 % developed hypocalcemia. 22/55 full term neonates , that is 40% and 24/45 preterm neonates that is 53% developed hypocalcemia after 48 hrs. of phototherapy. CONCLUSION: significant decline in serum calcium level is observed in neonates receiving phototherapy for hyperbilirubinemia

  4. The Value of Brainstem Auditory Evoked Potentials in High Risk Children

    Directory of Open Access Journals (Sweden)

    M Malekzadeh

    1999-09-01

    Full Text Available In this retrospective study 100 out of 2000 brain stem auditory evoked potentials (BAEPs recording, chosen randomly from BAEPs file of takhti children's hospital in Tehran (March 1993-March 1996, are reviewed. Indications for BAEPs recording were: Neonatal hyperbilirubinemia leading to blood exchange transfusion and/or very low birth weight (<1500 g, CNS infections, ataxia, history of asphyxia, head and neck anomalies, coma, psychomotor or language delay, and suspicious hearing loss. Infants with very low birth weight associated with hyperbilirubinemia had the highest frequency of abnormal BAEPs. The second group consisted of children with neonatal hyperbilirubinemia. BAEPs recording is suggested to be used as a screening test in high-risk pediatric patients for early detection of hearing loss.

  5. SUCCESSFUL TREATMENT OF ONE CASE OF SEVERE CEREBRAL PALSY DURING EARLY STAGE WITH FILIFORM SHALLOW NEEDLING COMBINED WITH ACUPOINT-INJECTION OF PIRACETUM

    Institute of Scientific and Technical Information of China (English)

    Wang Junying

    2001-01-01

    @@ He, a baby of aged 94 days, was administered to our hospital on January 11, 2000 due to inability to hold up the head. His mother told me that she gave birth to her baby by cesarean section (term birth). During delivery, owing to twining of the neck by umbilical cord, her baby experienced asphyxia for 30 min. After emergency treatment, the baby recovered autonomous respiration and had a weak cry voice, with the Apgar score being 2 points. Thereafter, this baby frequently had convulsion. CT examination showed encephalatrophy and outer hydrocephalus. It was diagnosed as cerebral palsy, and he was hospitalized for 45 days and treated with Cerebrolysin, hyperbaric oxygen, home training, etc.

  6. Reducing stillbirths in low-income countries.

    Science.gov (United States)

    Goldenberg, Robert L; Saleem, Sarah; Pasha, Omrana; Harrison, Margo S; Mcclure, Elizabeth M

    2016-02-01

    Worldwide, 98% of stillbirths occur in low-income countries (LIC), where stillbirth rates are ten-fold higher than in high-income countries (HIC). Although most HIC stillbirths occur prenatally, in LIC most stillbirths occur at term and during labor/delivery. Conditions causing stillbirths include those of maternal origin (obstructed labor, trauma, antepartum hemorrhage, preeclampsia/eclampsia, infection, diabetes, other maternal diseases), and fetal origin (fetal growth restriction, fetal distress, cord prolapse, multiples, malpresentations, congenital anomalies). In LIC, aside from infectious origins, most stillbirths are caused by fetal asphyxia. Stillbirth prevention requires recognition of maternal conditions, and care in a facility where fetal monitoring and expeditious delivery are possible, usually by cesarean section (CS). Of major causes, only syphilis and malaria can be managed prenatally. Targeting single conditions or interventions is unlikely to substantially reduce stillbirth. To reduce stillbirth rates, LIC must implement effective modern antepartum and intrapartum care, including fetal monitoring and CS. PMID:26577070

  7. Histological appearance of postmortem pink teeth: Report of two cases

    Directory of Open Access Journals (Sweden)

    B K Charan Gowda

    2015-01-01

    Full Text Available This article presents images and histological changes in the dentin of two cases involving posmortem pink teeth. Postmortem pink teeth were noted among two deceased male individuals. Pink teeth were noted during autopsy examination after twelve days in one corpse, and eight days following death in the second case. During the examination decomposition and putrefaction of the body was noted. Cause of death was drowning in one case and haemorrhages and shock in another. A central incisor tooth was obtained from each body. Both teeth exhibited a pink appearance and the intensity was more pronounced in the cervical region. Although pink teeth can be noted in death due to asphyxia, carbon monoxide poisoning and so on, it is necessary to study the exact role behind the appearance of pink teeth and try to incorporate the finding medico legally.

  8. A breath of fresh air for cryogenics training

    CERN Multimedia

    HSE Unit

    2014-01-01

    Whether you work full-time in a cryogenic installation or are required to handle cryogenic substances temporarily, you need to have followed the appropriate safety training.   Photo: Christoph Balle. Two new training courses are now available in English and French at CERN: “Cryogenic Safety – Fundamentals” (at the Prévessin Training Centre) and “Cryogenic Safety – Helium Transfer” (at the Cryolab). The first covers the content of levels 1 and 2 of the old “Cryogenic Safety” course. The second is a completely new course for CERN: it covers specific aspects of the transfer of liquid helium, such as the evaporation process of helium and the associated risks to human health (asphyxia due to displacement of oxygen), the colour code for gas bottles, etc. These training modules have been rewritten in response to the increase in the number of projects involving cryogenics and following various related incident...

  9. CT findings in neonatal hypothermia

    Energy Technology Data Exchange (ETDEWEB)

    Schulman, H.; Laufer, L.; Berginer, J.; Hertzanu, Y. [Department of Radiology, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, P. O. Box 151, Beer-Sheva 84101 (Israel); Hershkowitz, E.; Berenstein, T.; Sofer, S. [Pediatric Intensive Care Unit, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva (Israel); Maor, E. [Department of Pathology, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva (Israel)

    1998-06-01

    Background. Newborn infants are particularly prone to hypothermia, a condition with a high mortality. Objective. To study the CT brain patterns in infants with hypothermia and neurological symptoms. Materials and methods. We reviewed the brain CT of nine infants with neonatal hypothermia, multiple organ failure, seizures and coma. Results. Two infants had normal CT scans, acutely and at follow-up, and were clinically normal at follow-up. In seven infants, CT showed diffuse cerebral oedema, with reversal of the normal density relationship between grey and white matter and a relative increased density of the thalami, brainstem and cerebellum - the `reversal sign`. In six surviving infants with severe developmental delay, follow-up CT revealed cerebral atrophy with multicystic encephalomalacia. Conclusions. The `reversal sign` has been described in the abused child, birth asphyxia and anoxia due to drowning. Neonatal hypothermia is offered as a further cause. (orig.) With 6 figs., 1 tab., 13 refs.

  10. Premature closure of the upper esophageal sphincter as a cause of severe deglutition disorder in infancy

    DEFF Research Database (Denmark)

    Nielsen, Rasmus; Husby, Steffen; Kruse-Andersen, Søren

    2005-01-01

    Deglutition disorders in infancy are often associated with birth asphyxia or structural abnormalities in the hypopharynx, the trachea, or the esophagus. Manometry can be crucial for clarifying the dynamics of the swallowing disorder in the infant with deglutition problems and without signs of these...... causes. An 8-week-old infant was referred because of suspicion of cricopharyngeal achalasia causing persistent swallowing problems and failure to thrive. Manometry results showed normal resting tone and relaxation but premature closure of the upper esophageal sphincter. The infant was treated with...... balloon dilatation of the upper esophageal sphincter and expectance. A maturation process of the swallowing sequence was noted over time and documented by repeated manometric procedures....

  11. Curved reformat of the paediatric brain MRI into a 'flat-earth map' - standardised method for demonstrating cortical surface atrophy resulting from hypoxic-ischaemic encephalopathy.

    Science.gov (United States)

    Simpson, Ewan; Andronikou, Savvas; Vedajallam, Schadie; Chacko, Anith; Thai, Ngoc Jade

    2016-09-01

    Hypoxic-ischaemic encephalopathy is optimally imaged with brain MRI in the neonatal period. However neuroimaging is often also performed later in childhood (e.g., when parents seek compensation in cases of alleged birth asphyxia). We describe a standardised technique for creating two curved reconstructions of the cortical surface to show the characteristic surface changes of hypoxic-ischaemic encephalopathy in children imaged after the neonatal period. The technique was applied for 10 cases of hypoxic-ischaemic encephalopathy and also for age-matched healthy children to assess the visibility of characteristic features of hypoxic-ischaemic encephalopathy. In the abnormal brains, fissural or sulcal widening was seen in all cases and ulegyria was identifiable in 7/10. These images could be used as a visual aid for communicating MRI findings to clinicians and other interested parties. PMID:27337989

  12. Double fatal outcome after ruptured vasa previa in monochorionic twins: case report and review of the literature.

    Science.gov (United States)

    van Steenis, A; Zhao, D P; Steggerda, S J; Kist, W J; Haak, M C; Oepkes, D; Lopriore, Enrico

    2016-08-01

    Vasa previa is a condition in which one or more fetal blood vessels run through the amniotic membranes and cross or run near the external orifice of the uterus. Rupture of membranes can lead to tearing of these vessels and cause acute fetal exsanguination. In monochorionic twin (MC) pregnancies, acute exsanguination in one twin can lead to severe complications in the co-twin due to the presence of inter-twin placental vascular connections. We report a MC pair with severe perinatal asphyxia due to acute exsanguination after prenatally undetected ruptured vasa previa. This resulted in severe hemorrhagic shock in both twins with double fatal outcome. Antenatal detection of vasa previa is of paramount importance to prevent severe morbidity and mortality, especially in MCs. A review of the literature is presented. PMID:26366672

  13. Fentanyl-droperidol supplementation of rapid sequence induction in the presence of severe pregnancy-induced and pregnancy-aggravated hypertension.

    Science.gov (United States)

    Lawes, E G; Downing, J W; Duncan, P W; Bland, B; Lavies, N; Gane, G A

    1987-11-01

    Twenty-six patients manifesting severe pregnancy-induced (PIH) or pregnancy-aggravated (PAH) hypertension who presented for emergency Caesarean section under general anaesthesia were studied. All patients came from a previously identified high risk group--namely greater than 25 yr, multiparous and with diastolic arterial pressures sustained at greater than 120 mm Hg. Our standard accelerated induction technique for the management of severely hypertensive mothers was modified to include the use of fentanyl and droperidol before induction. This modification of the induction sequence produced a clinically significant amelioration of the reflex sympathetic hypertensive response to laryngoscopy and intubation in most mothers receiving antihypertensive therapy, without apparent deleterious effect in the immediate postoperative period to those neonates unaffected by intrauterine asphyxia. PMID:3689612

  14. Relationship between serum heat-stable alkaline phosphatase level and pregnancy

    International Nuclear Information System (INIS)

    Serum heat-stable alkaline phosphatase (HSAP) level in 649 cases of normal pregnancy and 164 cases of high-risk pregnancy is measured by radioimmunoassay (RIA). The results indicate that the HSAP level in normal pregnancy increased proportionally with gestation weeks (r = 0.9843). In 33 cases of pregnancy induced hypertension and 21 cases of intrauterine fetal growth retardation, the HSAP level is significantly low. In 7 cases of neonatal asphyxia and 26 cases of fetal distress, the HSAP level in the mother's serum is also low. In 53 cases of intrahepatic cholestasis of pregnancy, the HSAP level is similar to those of normal pregnancy. This study illustrates that HSAP RIA can play an important role in the evaluation of placental function and fetal prognosis for cases of high-risk pregnancy

  15. CT findings in neonatal hypothermia

    International Nuclear Information System (INIS)

    Background. Newborn infants are particularly prone to hypothermia, a condition with a high mortality. Objective. To study the CT brain patterns in infants with hypothermia and neurological symptoms. Materials and methods. We reviewed the brain CT of nine infants with neonatal hypothermia, multiple organ failure, seizures and coma. Results. Two infants had normal CT scans, acutely and at follow-up, and were clinically normal at follow-up. In seven infants, CT showed diffuse cerebral oedema, with reversal of the normal density relationship between grey and white matter and a relative increased density of the thalami, brainstem and cerebellum - the 'reversal sign'. In six surviving infants with severe developmental delay, follow-up CT revealed cerebral atrophy with multicystic encephalomalacia. Conclusions. The 'reversal sign' has been described in the abused child, birth asphyxia and anoxia due to drowning. Neonatal hypothermia is offered as a further cause. (orig.)

  16. Imaging findings of avalanche victims

    Energy Technology Data Exchange (ETDEWEB)

    Grosse, Alexandra B.; Grosse, Claudia A.; Anderson, Suzanne [University Hospital of Berne, Inselspital, Department of Diagnostic, Pediatric and Interventional Radiology, Berne (Switzerland); Steinbach, Lynne S. [University of California San Francisco, Department of Radiology, San Francisco, CA (United States); Zimmermann, Heinz [University Hospital of Berne, Inselspital, Department of Trauma and Emergency Medicine, Berne (Switzerland)

    2007-06-15

    Skiing and hiking outside the boundaries remains an attractive wilderness activity despite the danger of avalanches. Avalanches occur on a relatively frequent basis and may be devastating. Musculoskeletal radiologists should be acquainted with these injuries. Fourteen avalanche victims (11 men and 3 women; age range 17-59 years, mean age 37.4 years) were air transported to a high-grade trauma centre over a period of 2 years. Radiographs, CT and MR images were prospectively evaluated by two observers in consensus. Musculoskeletal findings (61%) were more frequent than extraskeletal findings (39%). Fractures were most commonly seen (36.6%), involving the spine (14.6%) more frequently than the extremities (9.8%). Blunt abdominal and thoracic trauma were the most frequent extraskeletal findings. A wide spectrum of injuries can be found in avalanche victims, ranging from extremity fractures to massive polytrauma. Asphyxia remains the main cause of death along with hypoxic brain injury and hypothermia. (orig.)

  17. Setting health research priorities using the CHNRI method: I. Involving funders

    Directory of Open Access Journals (Sweden)

    Igor Rudan

    2016-06-01

    Full Text Available In 2007 and 2008, the World Health Organization's Department for Child and Adolescent Health and Development commissioned five large research priority setting exercises using the CHNRI (Child Health and Nutrition Research Initiative method. The aim was to define research priorities related to the five major causes of child deaths for the period up to the year 2015. The selected causes were childhood pneumonia, diarrhoea, birth asphyxia, neonatal infections and preterm birth/low birth weight. The criteria used for prioritization in all five exercises were the “standard” CHNRI criteria: answerability, effectiveness, deliverability, potential for mortality burden reduction and the effect on equity. Having completed the exercises, the WHO officers were left with another question: how “fundable” were the identified priorities, i.e. how attractive were they to research funders?

  18. Oxidative stress in relation to surgery: is there a role for the antioxidant melatonin?

    DEFF Research Database (Denmark)

    Kücükakin, Bülent; Gögenur, Ismail; Reiter, Russel J;

    2009-01-01

    preliminary studies in newborns with asphyxia, sepsis, or respiratory distress syndrome, melatonin has proven to be a highly potent antioxidant. This review summarizes the results of animal and human studies wherein melatonin was shown to modulate oxidative stress; this discussion emphasizes the stress......During and after surgical procedures, there is a well defined physiological stress response that involves activation of inflammatory, endocrine, metabolic, and immunological mediators. Oxidative stress, which is defined to be a situation where the production of reactive oxygen/nitrogen species...... exceeds the mechanisms required to detoxify them, is believed to be an integrated part of the surgical stress response. Oxidative stress per se may be associated with complications such as myocardial injury, sepsis, pulmonary edema, kidney and liver failure, and increased mortality. Melatonin is a potent...

  19. Does Resuscitation Training Reduce Neonatal Deaths in Low-Resource Communities? A Systematic Review of the Literature.

    Science.gov (United States)

    Sousa, Sarah; Mielke, John G

    2015-10-01

    Every year, nearly 1 million babies succumb to birth asphyxia (BA) within the Asia-Pacific region. The present study sought to determine whether educational interventions containing some element of resuscitation training would decrease the relative risk (RR) of neonatal mortality attributable to BA in low-resource communities. We systematically reviewed 3 electronic databases and identified 14 relevant reports. For community deliveries, providing traditional birth attendants (TBAs) with neonatal resuscitation training modestly reduced the RR in 3 of 4 studies. For institutional deliveries, training a range of clinical staff clearly reduced the RR within 2 of 8 studies. When resuscitation-specific training was directed to community and institutional health care workers, a slight benefit was observed in 1 of 2 studies. Specific training in neonatal resuscitation appears most effective when provided to TBAs (specifically, those presented with ongoing opportunities to review and update their skills), but this particular intervention alone may not appreciably reduce mortality. PMID:26378066

  20. Brain magnetic resonance imaging of infants exposed prenatally to buprenorphine

    International Nuclear Information System (INIS)

    Purpose: To evaluate the brains of newborns exposed to buprenorphine prenatally. Material and Methods: Seven neonates followed up antenatally in connection with their mothers' buprenorphine replacement therapy underwent 1.5T magnetic resonance imaging (MRI) of the brain before the age of 2 months. The infants were born to heavy drug abusers. Four mothers were hepatitis C positive, and all were HIV negative. All mothers smoked tobacco and used benzodiazepines. All pregnancies were full term, and no perinatal asphyxia occurred. All but one neonate had abstinence syndrome and needed morphine replacement therapy. Results: Neither structural abnormalities nor abnormalities in signal intensity were recorded. Conclusion: Buprenorphine replacement therapy does not seem to cause any major structural abnormalities of the brain, and it may prevent known hypoxic-ischemic brain changes resulting from uncontrolled drug abuse. Longitudinal studies are needed to assess possible abnormalities in the brain maturation process

  1. The cerebral effects of ascent to high altitudes.

    Science.gov (United States)

    Wilson, Mark H; Newman, Stanton; Imray, Chris H

    2009-02-01

    Cellular hypoxia is the common final pathway of brain injury that occurs not just after asphyxia, but also when cerebral perfusion is impaired directly (eg, embolic stroke) or indirectly (eg, raised intracranial pressure after head injury). We Review recent advances in the understanding of neurological clinical syndromes that occur on exposure to high altitudes, including high altitude headache (HAH), acute mountain sickness (AMS), and high altitude cerebral oedema (HACE), and the genetics, molecular mechanisms, and physiology that underpin them. We also present the vasogenic and cytotoxic bases for HACE and explore venous hypertension as a possible contributory factor. Although the factors that control susceptibility to HACE are poorly understood, the effects of exposure to altitude (and thus hypobaric hypoxia) might provide a reproducible model for the study of cerebral cellular hypoxia in healthy individuals. The effects of hypobaric hypoxia might also provide new insights into the understanding of hypoxia in the clinical setting. PMID:19161909

  2. Irish neonatal mortality statistics for 2004 and over the past 17 years: how do we compare internationally?

    LENUS (Irish Health Repository)

    Fleming, P

    2012-02-01

    In the past 17 years neonatal mortality survey has provided important data on the trends in deaths of all live born infants born in Southern Ireland who are greater than 500 g birth weight and who die within the first 28 days of life. The aims of this study were to report neonatal mortality data for Southern Ireland for 2004, to examine trends in neonatal mortality over the past 17 years and compare Irish Neonatal Mortality rates to other countries around the world. The neonatal mortality rate for 2004 was 2.9\\/1000 with a corrected NMR of 1.9\\/1000. The response rate to the survey was 100%. Prematurity is now the leading cause of neonatal mortality representing a change from previous years. Deaths related to asphyxia have remained largely unchanged. When compared to international figures Ireland compares favourably to other countries around the world.

  3. Anaesthetic management of a patient with hereditary angioedema

    Directory of Open Access Journals (Sweden)

    Nergis Ataol

    2015-12-01

    Full Text Available Hereditary angioedema is a rare autosomal dominant disorder caused by reduced activity of the C1 esterase inhibitor. Patients with hereditary angioedema are clinically characterized by recurrent episodes of swelling of the extremities, face, trunk, airways and abdominal organs. Attacks may occur either spontaneously or following trauma, stress, surgery, infections and hormonal fluctuations. The most common cause of death is asphyxia related to laryngeal edema. Giving C1 esterase inhibitor is the most effective method of treatment. Also fresh frozen plasma, androgen steroids, quinine pathway inhibitors, antifibrinolytics and bradykinin receptor antagonists can be used as treatment. In this paper, the anesthetic management of a patient with hereditary angioedema undergoing inguinal hernia repair surgery is reported.

  4. Icatibant in hereditary angioedema: news and challenges.

    Science.gov (United States)

    Bouillet, Laurence

    2011-05-01

    Hereditary angioedema (HAE) is a rare condition. Its prognosis depends on whether there is laryngeal involvement with a risk of asphyxia, which is present in 25% of such cases. Improved understanding of the pathophysiology of this disease has resulted in the development of targeted therapies including icatibant, which acts as an antagonist at bradykinin B2 receptors. This agent has been shown to be effective in the treatment of attacks of HAE in three Phase III randomized double-blind published studies. Efficacy data have been collected in all types of attack: cutaneous, abdominal and laryngeal. Safety data are also encouraging. Icatibant is administered subcutaneously, with the potential for patients to self-administer. In the future, this therapy may offer increased independence for HAE patients. PMID:21595592

  5. Outcome at school-age after neonatal mechanical ventilation.

    Science.gov (United States)

    Gunn, T R; Lepore, E; Outerbridge, E W

    1983-06-01

    103 school-age children (5 to 12 years) who survived mechanical ventilation for neonatal respiratory failure were evaluated for growth, neurological, intellectual, psychological and school function in order to determine those children most at risk for handicap. A major handicap occurred in seven children, preventing attendance at normal school or normal classes. Neurological sequelae were significantly associated with perinatal asphyxia and with birthweights of 1500g or less, and neurological sequelae and socio-economic factors were the major determinants of ability. The effects of the Neonatal Intensive Care Unit (NICU) experience on parents and subsequent parent-child relationships were also investigated: 67 per cent of the mothers were very upset by the experience and many continue to worry excessively about the health of their child. Parents who visited their child in the NICU frequently were significantly more anxious and overprotective, restricting many activities even when the child was of school age. PMID:6873492

  6. Primary health care of the newborn baby.

    Science.gov (United States)

    Bhakoo, O N; Kumar, R

    1990-01-01

    More than 50% of infant deaths in India occur during the neonatal period. High priority therefore needs to be given to improving the survival of newborns. A large number of neonatal deaths have their origin in the perinatal period and are mainly determined by the health and nutritional status of the mother, the quality of care during pregnancy and delivery, and the immediate care of the newborn at birth. Main causes of neonatal mortality are birth asphyxia, respiratory problems, and infections, especially tetanus. Most such deaths occur among low birthweight babies. Hypothermia, undernutrition, and mismanaged breast feeding may also indirectly contribute to neonatal mortality. Community-based studies have, however, demonstrated that most neonatal mortality can be affordably prevented through primary health care. Efforts are underway to expand the health care infrastructure, but the outreach of maternal and child health care remains unsatisfactory especially in rural areas. PMID:12319228

  7. Luxatio erecta humeri: Report of a swimming injury with analysis of the mechanism of the injury and associated injuries in literature

    Directory of Open Access Journals (Sweden)

    Kemal Gökkus

    2015-01-01

    Full Text Available Inferior shoulder dislocation also referred to as luxatio erecta is an unusual and rare type of shoulder dislocation. Its incidence is about 0.5% among all shoulder dislocations. After an exhaustive search of all the available literature we were unable to find a swimming accident case that did not have other associated injuries and an uneventful reduction. The mechanism of the injury was mostly related to direct axial loading and indirect hyperabduction lever arm. We would like to emphasize the importance of this being a swimming accident, a type of accident that requires awareness of the possibility of dangerous asphyxia injuries caused by panic in the water (swimming pool, river, lake, sea, etc.. We described the nature of the injury and review the literature concerning the mechanism of the injury and associated neurovascular impairment at admission time. We also presented a supplemental video to contribute to the education of young residents and orthopedic surgeons.

  8. Child homicide or natural death? A case report of unexpected death of unusual asymptomatic acute laryngotracheobronchitis.

    Science.gov (United States)

    Zhuo, Luo; Liu, Liang; Ren, Liang; Liu, Qian

    2016-07-01

    Cases involving the unexpected deaths of children are always a concern for the police and medical examiners alike. In particular, unexpected deaths due to asphyxia without obvious injuries sometimes make decisions regarding the manner of death more difficult. In the present case, a 2-year-old boy was found dead at home, and his mother was initially believed to have killed him. A complete autopsy and forensic investigation were performed, and no injuries were found on the body; however, marked laryngeal edema was observed. Histology showed extensive inflammatory infiltration of the mucosa and submucosa of the larynx, trachea, and bronchi. The cause of death was given as respiratory failure due to acute laryngotracheobronchitis; thus, the manner of death was natural. This case helps to remind the forensic community to keep an open mind and consider a broad differential diagnosis when approaching a case rather than jumping to a conclusion based solely on a preliminary investigation. PMID:26101441

  9. A case of AML with preceding hypoplastic stage after oophoro-hysterectomy and 60Co-irradiation

    International Nuclear Information System (INIS)

    A case of AML (preceded by a hypoplastic stage) which developed after oophoro-hysterectomy and 60Co-irradiation is presented, and related literature concerning irradiation-induced leukemia and the early diagnosis of leukemia and/or preleukemia are discussed. The patient, a 47 year old female had had surgery and irradiation with a subsequent normachromic anemia necessitating transfusions 11 years prior to her presenting herself at our hospital because of anemia. Her pancytopenic peripheral blood picture combined with a relatively hypererythroid marron led to a diagnosis of atypical hypoplastic anemia. Two years after this she suddenly developed a high fever, general fatigue and a severe anemia. Hematological studies revealed acute myeloblastic leukemia. A combination therapy consisting of DM, 6MP, prednisolon and blood transfusions was given with no effect and 3 months after the onset, the patient died of asphyxia resulting from gross hemoptysis. Autopsy revealed pulmonary hemorrhage secondary to the leukemia. (J. Evans)

  10. Computed tomographic (CT) scans in cerebral palsy (CP)

    International Nuclear Information System (INIS)

    The CT findings in 120 cerebral palsied children are analysed. The 72.5% positive findings are correlated with the clinical types, as well as the aetiological basis for the cerebral palsy. The spastic type, 83.3% of the total number of children, had the highest positive findings. The yield was increased in children with seizures (91.3%) and those in the postnatal group (90%), as well as those with birth trauma and neonatal asphyxia (94%). The findings were those of atrophy in 30.8%, hydrocephalus, in 10%, infarct in 11.6%, porencephaly in 8.3% and others. The atropic changes and their patterns are explained. Treatable lesions, such as tumour, hydrocephalus, subdural haematoma, porencephaly and hygroma were identified in 22.5% of cases. It is concluded that CT scan is definitely efficacious in the management of cerebral palsied children. (orig.)

  11. Focal perinatal acquired brain injury - a sonographic study of the course

    International Nuclear Information System (INIS)

    A case of a perinatal acquired focal brain lesion is reported, and the process of resorption and healing demonstrated by ultrasound. Within four weeks a cortical area of increased echogenicity was resorbed. After two months, the resulting porencephalic cyst had been transformed into glial tissue of very high echogenicity. The neurologic development of two children with such glial focus was good. These cases demonstrate that porencephalic cysts are not always the final state after resorption of a focal brain lesion. They are no reliable prognostic indicator of poor neurological outcome. Traumatic and complicated delivery, asphyxia and coagulopathy are conditions which have been found several times in connection with a focal brain lesion. In contrast to periventricular injury, prematurity does not seem to be a factor of higher risk. (orig.)

  12. Computed tomographic (CT) scans in cerebral palsy (CP)

    Energy Technology Data Exchange (ETDEWEB)

    Kolawole, T.M.; Patel, P.J. (King Saud Univ., Riyadh (Saudi Arabia). Dept. of Radiology); Mahdi, A.H. (King Saud Univ., Riyadh (Saudi Arabia). Dept. of Paediatrics)

    1989-11-01

    The CT findings in 120 cerebral palsied children are analysed. The 72.5% positive findings are correlated with the clinical types, as well as the aetiological basis for the cerebral palsy. The spastic type, 83.3% of the total number of children, had the highest positive findings. The yield was increased in children with seizures (91.3%) and those in the postnatal group (90%), as well as those with birth trauma and neonatal asphyxia (94%). The findings were those of atrophy in 30.8%, hydrocephalus, in 10%, infarct in 11.6%, porencephaly in 8.3% and others. The atropic changes and their patterns are explained. Treatable lesions, such as tumour, hydrocephalus, subdural haematoma, porencephaly and hygroma were identified in 22.5% of cases. It is concluded that CT scan is definitely efficacious in the management of cerebral palsied children. (orig.).

  13. Assessment of the Relationship between Recurrent High-risk Pregnancy and Mothers’ Previous Experience of Having an Infant Admitted to a Neonatal Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Sedigheh Hantoosh Zadeh

    2015-01-01

    Full Text Available Background & aim:  High-risk pregnancies increase the risk of Intensive Care Unit (ICU and Neonatal Intensive Care Unit (NICU admission in mothers and their newborns. In this study, we aimed to identify the association between the recurrence of high-risk pregnancy and mothers’ previous experience of having an infant admitted to NICU. Methods:We performed a cohort, retrospective study to compare subsequent pregnancy outcomes among 232 control subjects and 200 female cases with a previous experience of having a newborn requiring NICU admission due to intrauterine growth retardation, preeclampsia, preterm birth, premature rupture of membranes, and asphyxia. The information about the prevalence of subsequent high-risk pregnancies was gathered via phone calls. Results: As the results indicated, heparin, progesterone, and aspirin were more frequently administered in the case group during subsequent pregnancies, compared to the control group (P

  14. Neonatal management of pregnancy complicated by diabetes.

    Science.gov (United States)

    Mohsin, Fauzia; Khan, Shareen; Baki, Md Abdul; Zabeen, Bedowra; Azad, Kiswhar

    2016-09-01

    Women with diabetes in pregnancy, either pre-gestational Diabetes Mellitus (Type 1 & Type 2) or Gestational Diabetes, are at increased risk for adverse pregnancy outcomes, including preterm labour and increased foetal mortality rate. Adequate glycaemic control before and during pregnancy is crucial for improving foetal and perinatal outcomes in these babies. Perinatal and neonatal morbidities and mortality rates have declined since the development of specialized maternal, foetal, and neonatal care for women with diabetes and their offspring. However, infants of diabetic mothers are at risk for developing complications as macrosomia, hypoglycaemia, perinatal asphyxia, cardiac and respiratory problems, birth injuries and congenital malformations. In this review article we describe the neonatal management of the offspring of diabetic mothers. PMID:27582162

  15. New operational technology of intrauterine ventilation the fetus lungs by breathing gas

    Science.gov (United States)

    Urakov, A. L.; Nikityuk, D. B.; Urakova, N. A.; Kasankin, A. A.; Chernova, L. V.; Dementiev, V. B.

    2015-11-01

    New operational technology for elimination intrauterine hypoxia and asphyxia of the fetus using endoscopic artificial ventilation lungs by respiratory gas was developed. For intrauterine ventilation of fetal lung it is proposed to enter into the uterus a special breathing mask and wear it on the head of the fetus using the original endoscopic technology. The breathing mask, developed by us is connected with external breathing apparatus with a hose. The device is called "intrauterine aqualung". Intrauterine aqualung includes a ventilator and breathing circuit with a special fold-out breathing mask that is put on inside the uterus on the head of fetus like a mesh hat. Controlled by ultrasound the technology of the introduction of the mask inside of the uterus through the natural opening in the cervix and technology of putting on the respiratory mask on the head of the fetus with its head previa were developed. The technology intrauterine ventilation of the fetus lungs by respiratory gas was developed.

  16. Supraglottic airway devices in children

    Science.gov (United States)

    Ramesh, S; Jayanthi, R

    2011-01-01

    Modern anaesthesia practice in children was made possible by the invention of the endotracheal tube (ET), which made lengthy and complex surgical procedures feasible without the disastrous complications of airway obstruction, aspiration of gastric contents or asphyxia. For decades, endotracheal intubation or bag-and-mask ventilation were the mainstays of airway management. In 1983, this changed with the invention of the laryngeal mask airway (LMA), the first supraglottic airway device that blended features of the facemask with those of the ET, providing ease of placement and hands-free maintenance along with a relatively secure airway. The invention and development of the LMA by Dr. Archie Brain has had a significant impact on the practice of anaesthesia, management of the difficult airway and cardiopulmonary resuscitation in children and neonates. This review article will be a brief about the clinical applications of supraglottic airways in children. PMID:22174464

  17. Joubert syndrome presenting as unilateral dysplastic kidney, hypotonia, and respiratory problem

    Directory of Open Access Journals (Sweden)

    Majid Malaki

    2012-01-01

    Full Text Available An 8-month-old girl with a history of asphyxia and respiratory distress immediately after birth was hospitalized at her fourth month of age with the diagnosis of kidney infection and it was revealed that she had a unilateral multicystic dysplastic kidney. In recent admission, she presented to emergency room with fever, hyperpnea, and apnea. In appearance, she was a hypotonic girl with broad forehead, hypertelorism, depressed nasal bridge and bitemporal regions, rapid vertical and horizontal nystagmus, and open mouth with salivation. In spite of normal physical growth, she had delayed developmental milestones. Blood gas O 2 saturation dropped after she received phenobarbital. Her urinary and blood tests were normal; however, her cranial magnetic resonance imaging (MRI revealed vermis agenesis and molar tooth sign. These physical and para-clinical findings suggested Joubert syndrome.

  18. Diagnosis and therapy of lacrimal system diseases by micro lacrimal endoscope

    Institute of Scientific and Technical Information of China (English)

    Nan XIANG; Weikun HU; Jing YUAN; Guigang LI; Haixia LIU

    2009-01-01

    The lacrimal endoscope is applied to the diagnosis and therapy of the disorders of the lacrimal system in combination with laser or micro drills under orthophoria. The changes of mucous membranes, the characteristics of pathological changes and the predilection sites of lacrimal system diseases were initially approached. One hundred and forty six pairs of eyes of 128 patients with lacrimal system disease were observed by the lacrimal endoscope in the Ophthalmology Department of Tongji Hospital from June 2006 to March 2007. The dynamic changes in mucous membranes, lesion sites, secreted substances and formation of membrane could be observed under orthophoria. Combined with laser or micro drill, the endoscope was applied to the therapy of lacrimal system disorders and the difference before and after the treatment was observed. Results are as follows: (1) The examination and therapy using the lacrimal endoscope were completed under topical anesthesia in 122 patients, and 6 patients of neonatorum dacryocystitis were examined and treated under general anaesthesia. All patients reported painless. (2) Sharp images of the lacrimal system were obtained by the endoscope. Normal lacrimal mucosal membrane was smooth and light pink, expanded and unobstructed during irrigation. In chronic dacryocystitis patients, the inhomo-geneous colour ofmucosal membranes was red and white, with different degrees of fibrotic membranes at the superior, middle and inferior parts of the nasolacrimal canals and secreted substances at sac could be observed. The lacrimal ducts could not be expanded and obstructed during irrigation. The patients with lacrimal system obstruction had different extents of membrane formation, and stenosis or complete obstruction of the lacrimal duct could be observed, and the corresponding mucosal membrane was not smooth which could not be expanded and obstructed during irrigation. (3) After the treatment by the endoscope combined with laser or micro drill, the major

  19. 新生儿低血糖症50例临床分析%Clinical treatment and anatysis of 50 neonates with hypoglycemia

    Institute of Scientific and Technical Information of China (English)

    陆蓓; 杨蕾; 朱慧; 陈娟

    2011-01-01

    目的 对50例新生儿低血糖症发病相关因素分析,探讨引起新生儿低血糖症的病因、临床特点,为临床诊治提供一定的参考依据.方法 对我院住院新生儿780例进行常规血糖监测.结果 ①低血糖症的发生与胎龄有关(x2=7.78,P<0.01);②低血糖症的发生与出生体重有关(x2=20.36,P<0.005).③常见病因为窒息14例(28%),硬肿症9例(18%),喂养困难6例(12%),感染5例(10%),母亲患糖尿病5例(10%),开奶延迟4例(12%),出血症4例(8%),先天性心脏病3例(6%).结论 对于有低血糖高危因素的新生儿要监测血糖,及时发现并及时纠正低血糖,以免引起新生儿中枢神经系统损伤,遗留神经系统后遗症.%Objective To study the elements of pathogeny and clinical features of neonates with hypoglycemia, and to offer evidences for clinical treatment. Methods Blood sugar of 780 neonates who were admittied to hospital. Results ①The incidence of hypoglycemia was also associated with birth weight ( x2 = 7. 78 . P < 0. 01 ) ; ②The incidence of hypoglycemia was associated with gestational age ( x2 = 20. 36 , P < 0. 005 ) ; The common clinical findings were suffocation in 14 cases ( 28% ) , sclerema neonatorum in 9 ( 18% ) , feeding dificulty in 6 cases ( 12% ) , infection in 5 cases ( 10% ) , mother sufering from diabetes mellitus in Scases ( 10% ) . hemorrhagic disease in 4 cases ( 8% ) , feeding dalay in 4 cases( 8% ) , congenital heart disease in3 ( 6% ) . Conclusion For the neonates who are likely to suffer from hypoglycemia, blood sugar level needs to monitor frequently. Early detection and corrective measures could avoid damages to the central nervous system of neonates caused hy hypoglycemia.

  20. Aquaporin 3 and skin%水通道蛋白-3与皮肤研究进展

    Institute of Scientific and Technical Information of China (English)

    朱定仙; 方红

    2010-01-01

    水通道蛋白是细胞膜上参与跨膜水转运的一组通道蛋白.水通道蛋白3是人类皮肤中表达量最丰富的水通道蛋白亚型,除对水分子通透外还对甘油等溶质具有通透性.动物研究显示,水通道蛋白3基因敲除后皮肤保湿功能和弹性降低,创伤愈合延缓;水通道蛋白3还与细胞增殖及迁移有关,可能参与皮肤肿瘤的发生、发展和转移.水通道蛋白3与炎症性皮肤病如新生儿中毒性红斑、特应性皮炎等的病理机制相关.维A酸、肿瘤坏死因子-α等多种物质可调节水通道蛋白3的表达,对其表达进行调控将为治疗相关皮肤病带来新的手段.%Aquaporins (AQPs) are a group of membrane transport proteins involved in the transport ofwater across cell membranes. AQP3, the most abundant aquaporin subset in human skin, is permeable notonly to water but also to small solutes such as glycerol. It has been reported that AQP3-knockout mice havereduced stratum corneum water content, elasticity and impaired wound healing. AQP3 has been revealed to berelated to cell proliferation and migration, and involved in the initiation, progression and metastasis of tumors.In addition, AQP3 expression is associated with the pathogenesis of inflammatory cutaneous diseases such asatopic dermatitis and erythema toxicum neonatorum. AQP3 expression can be modulated by multiple factorssuch as retinoic acid and tumor necrosis factor α, and this modulation may provide a new clue for the therapyof related skin diseases.

  1. Tracheobronchial foreign bodies in children – a retrospective study of 2,000 cases in Northwestern China

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    Liang JM

    2015-08-01

    Full Text Available Jianmin Liang,1 Juan Hu,1 Huimin Chang,2 Ying Gao,1 Huanan Luo,1 Zhenghui Wang,1 Guoxi Zheng,1 Fang Chen,1 Ting Wang,1 Yeye Yang,1 Xiaohui Kou,1 Min Xu1 1Department of Otolaryngology-Head and Neck Surgery, The Second Hospital, Xi’an Jiaotong University, 2Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of Xi’an Medical University, Xi’an, People’s Republic of China Abstract: The aim of this study is to report our experience in the diagnosis and treatment of tracheobronchial foreign bodies (TFBs. We retrospectively reviewed medical records of 2,000 TFB patients (1,260 males and 740 females who were treated between January 2010 and December 2013. Chest radiography and computed tomography were performed to diagnose TFBs. The location and type of foreign bodies (FBs, anesthesia methods, and treatment outcomes and complications were analyzed. Overall, 72.5% of our patients with TFB were aged between 1 years and 3 years. Plant-based FBs are the most common FB type, accounting for 91.5%. Almost 52.1% of the FBs were encountered in the right bronchus. The coincidence rate for computed tomography-based three-dimensional reconstruction was significantly greater than that for chest X-ray examination (98.7% vs 82.0%, P<0.01. Under general anesthesia, the FBs were removed by rigid bronchoscopy. Neither anesthesia complication nor intraoperative hypoxemia occurred. There were seven deaths from acute obstructive asphyxia and eight from residual FB-induced chronic asphyxia and respiration-circulation failure. In conclusion, early diagnosis and prompt treatment of TFBs with rigid bronchoscopy under general anesthesia is effective in reducing complications and mortality in affected children. Keywords: respiratory tract foreign body, children, diagnosis, treatment

  2. The success of cardiotocography in predicting perinatal outcome

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    Alpaslan Kaban

    2012-06-01

    Full Text Available Objectives: The determination of the fetal condition duringlabor is important to minimize fetal death due to asphyxiaand the neurological sequelae of fetal hypoxia.This study evaluated the success of fetal cardiotocographyin predicting perinatal consequences.Materials and methods: This study enrolled 101 full-termpregnant women admitted for delivery to Vakif GurebaTraining and Research Hospital between October 2009and February 2010. Women were included if they wereaged 18-45 years and within 36-41 weeks of gestation.During a 20-min period of fetal monitoring, a change inFHR (fetal heart rate lasting for 15 s or two elevated runsof 15 beats was evaluated as a reactive NST (non-stresstest. The umbilical artery pH was used as the “gold standard”for assessing fetal asphyxia.Results: The mean age of the women included in thestudy was 27.82 ± 5.29 years, the average parity was1.09± 0.96. The pH was normal in 85 neonates, while 13 hadfetal asphyxia. No significant difference in umbilical cordblood pH, pO2, or pCO2 was observed between these twogroups (p = 0.497, p = 0.722, and p = 0.053, respectively.No significant difference in maternal age, parity, or birthweight was found between the group with fetal distressbased on CTG (cardiotocography and the normal group.Conclusion: Cardiotocography is an important test duringlabor for labor management, it is insufficient for predictingthe perinatal outcome. Therefore, labor should beevaluated on an individualized basis. J Clin Exp Invest2012; 3(2: 168-171

  3. Neonatal outcomes at a subdistrict hospital in north India.

    Science.gov (United States)

    Kumar, M; Paul, V K; Kapoor, S K; Anand, K; Deoraria, A K

    2002-02-01

    Subdistrict hospitals form the first referral level facilities for essential newborn care services. However, there is a paucity of information on the pattern of neonatal admission and outcomes at this level. The objective of this study was to describe the spectrum of neonatal mortality at a subdistrict hospital. The study was conducted at a 50-bed hospital at Ballabgarh in northern India. The data of the neonates born in this hospital (inborns) and those admitted with sickness after being delivered at home (outborns) were separately analysed for the period 1994-1999. The main outcomes of interests were incidence, distribution, and primary causes of neonatal mortality. Of 6746 inborns and 385 outborns admitted (total 7,137) there were 56 deaths (0.8 per cent) and 38 (0.6 per cent) referrals among inborn and 70 deaths (18.2 per cent) and 37 (9.6 per cent) referrals among outborns. The deaths or referral rates among inborn for different weight groups were 27.7 per cent for 500 g, 7.2 per cent for 1500-1999 g, 1.2 per cent for 2,000-2,499 g, and 0.6 per cent for weight > or = 2,500 g. Most deaths under 7 days of age were related to prematurity [41 per cent (28/69)] and birth asphyxia [38 per cent (26/68)], while those aged between 7 and 27 days were mostly due to sepsis [91 per cent (42/46)]. The results of this study indicate that babies with a birthweight above 1,500 g have a good outcome at this level. Deaths under 7 days of age were mostly due to birth asphyxia and prematurity, while those after 7 days were almost entirely due to sepsis. Referral is an important outcome at this level of service. PMID:11866336

  4. Early cerebral hemodynamic, metabolic and histological changes in hypoxic-ischemic fetal lambs during postnatal life

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    Carmen eRey-Santano

    2011-09-01

    Full Text Available The hemodynamic, metabolic and biochemical changes produce during transition from fetal to neonatal life could be aggravated if asphyctic event occur during fetal life. The aim of the study was to examine the regional cerebral blood flow (RCBF, histological changes, and cerebral brain metabolism in preterm lambs, and to analyze the role of oxidative stress for the first hours of postnatal life following severe fetal asphyxia. 18 chronically instrumented fetal lambs were assigned to: hypoxic-ischemic group, following fetal asphyxia animals were delivered and maintained on intermittent-positive-pressure-ventilation for 3 hours, and non-injured animals that were managed similarly to the previous group and used as control group. During hypoxic-ischemic insult, injured group developed acidosis, hypoxia, hypercapnia, latacidaemia and tachycardia in comparison to control group, without hypotension. Intermittent-positive-pressure-ventilation transiently improved gas exchange and cardiovascular parameters. After HI injury and during ventilation-support, the increased RCBF in inner zones was maintained for hypoxic-ischemic group, but cortical flow did not exhibit differences compared to the control group. Also, the increase of TUNEL positive cells (apoptosis and antioxidant enzymes, and decrease of ATP reserves was significantly higher in the brain regions where the RCBF were not increased.In conclusion, early metabolic, histological and hemodynamic changes involved in brain damage have been intensively investigated and reported in premature asphyctic lambs for the first 3 hours of postnatal life. Those changes have been described in human neonates, so our model could be useful to test the security and the effectiveness of different neuroprotective or ventilatory strategies when are applied in the first hours after fetal hypoxic-ischemic injury.

  5. Elevated expression of KiSS-1 in placenta of Chinese women with early-onset preeclampsia.

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    Chong Qiao

    Full Text Available Preeclampsia (PE is a heterogeneous syndrome affecting 2% to 8% of all pregnancies and is the world's leading cause of fetal and maternal morbidity and mortality. In many cases of PE, shallow trophoblast invasion results in inappropriate maternal spiral artery remodeling and impaired placental function. Multiple genes have been implicated in trophoblast invasion, among which are KiSS-1 and GPR54. The gene product of KiSS-1 is metastin, which is a ligand for the receptor GPR54. Both metastin and GPR54 are expressed in the placenta of normal pregnancy and have been implicated in modulating trophoblast invasion through inhibiting migration of trophoblast cells. We have previously reported that the expression level of KiSS-1 was higher in trophoblasts from women with preeclampsia as compared to normal controls. Here, using quantitative RT-PCR, Western blot analysis and immunohistochemistry, we extend our analysis to demonstrate that elevated KiSS-1 expression occurs only in early-onset preeclampsia (ePE and not late-onset preeclampsia (lPE. However, no difference in the expression levels of GPR54 is observed between ePE, lPE, and normal controls. Further, we show that KiSS-1 expression is also increased in placenta of intrauterine death and birth asphyxia in comparison to normal newborns of ePE and lPE. Our findings suggest that aberrant upregulation of KiSS-1 expression may contribute to the underlying mechanism of ePE as well as birth asphyxia.

  6. Umbilical cord blood gases in newborns with or without nuchal cord: a comparative study

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    Shabani Zanjani M

    2011-08-01

    Full Text Available "nBackground: Entanglement of the umbilical cord around fetal neck has been reported to be associated with birth asphyxia. On the other hand, current evidence suggests that umbilical arterial pH analysis provides the most sensitive reflection of birth asphyxia. In this study we aimed to evaluate and compare the umbilical arterial hydrogen-ion concentration (pH and to analyze the blood gases of neonates with or without nuchal cord."n "nMethods: In this cohort study, 92 newborns with and 95 without nuchal cords were enrolled at Shahid Akbar Abadi Hospital in Tehran, Iran between the years 2009 and 2010. From each newborn an umbilical arterial blood sample was collected to measure pH, base excess and blood gases."n "nResults: There were no statistically significant differences between newborns with or without nuchal cord regarding maternal age, gestational age, and history of pregnancy. The mean pH in the newborns with nuchal cord (7.21±0.1 was significantly less than the value in the newborns without the cord (7.28±0.1, (P<0.001. In contrast, the mean base excess in the newborns with nuchal cord was more than the ones without the cord (P<0.001. Seven newborns (7.9% in the group with nuchal cord passed meconium during labor while only one (1% newborn did so in the other group."n "nConclusion: Our finding showed that nuchal cord had a significant relationship with acidosis in newborns with nuchal cord. However, this finding needs further investigation to reach a common conclusion. "n 

  7. Doppler imaging of hypoxic-ischemic encephalopathy in term neonates on the first day of life

    International Nuclear Information System (INIS)

    Hypoxic-ischaemic encephalopathy (HIE) is the most important neurological cause of mortality and poor neurodevelopmental outcome in neonates and infants. The aim of the study was to perform routine transfontanellar US brain scanning together with doppler evaluation of blood flow in anterior cerebral artery in the group of neonates with perinatal asphyxia studied at the first day of their life. The study group consisted of asphyxiated neonates (n=11), birth weight 3576,0 ± 426,0 g, gestational age 39,4 ± 1,1 weeks, pH of cord arterial blood 6,89 ± 0,45, 1st minute Apgar score 2 points. The control group were healthy neonates (n=20), , birth weight 3354,0 ± 378,0 g, gestational age 38,9 ± 1,8 weeks, pH of cord arterial blood 7,28 ± 0,41, 1st minute Apgar score 8 points. As compared to healthy children asphyxiated neonates had significantly decreased RI value (right cerebral artery 0,53 ± 0,02 vs. 0,72 ± 0,02; left cerebral artery 0,55 ± 0,02 vs. 0,73 ± 0,02), despite not all of them had obvious HIE features in routine US examination. None of these neonates lived longer than 10 days. Doppler examination of cerebral blood flow in term neonates born with perinatal asphyxia could be valuable complementary method of US imaging, especially in those patients with very discreet or absent HIE features in routine US scan. Results of doppler imaging could serve as prognostic factor for clinical outcome. (author)

  8. Evaluation of a cluster-randomized controlled trial of a package of community-based maternal and newborn interventions in Mirzapur, Bangladesh.

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    Gary L Darmstadt

    Full Text Available BACKGROUND: To evaluate a delivery strategy for newborn interventions in rural Bangladesh. METHODS: A cluster-randomized controlled trial was conducted in Mirzapur, Bangladesh. Twelve unions were randomized to intervention or comparison arm. All women of reproductive age were eligible to participate. In the intervention arm, community health workers identified pregnant women; made two antenatal home visits to promote birth and newborn care preparedness; made four postnatal home visits to negotiate preventive care practices and to assess newborns for illness; and referred sick neonates to a hospital and facilitated compliance. Primary outcome measures were antenatal and immediate newborn care behaviours, knowledge of danger signs, care seeking for neonatal complications, and neonatal mortality. FINDINGS: A total of 4616 and 5241 live births were recorded from 9987 and 11153 participants in the intervention and comparison arm, respectively. High coverage of antenatal (91% visited twice and postnatal (69% visited on days 0 or 1 home visitations was achieved. Indicators of care practices and knowledge of maternal and neonatal danger signs improved. Adjusted mortality hazard ratio in the intervention arm, compared to the comparison arm, was 1.02 (95% CI: 0.80-1.30 at baseline and 0.87 (95% CI: 0.68-1.12 at endline. Primary causes of death were birth asphyxia (49% and prematurity (26%. No adverse events associated with interventions were reported. CONCLUSION: Lack of evidence for mortality impact despite high program coverage and quality assurance of implementation, and improvements in targeted newborn care practices suggests the intervention did not adequately address risk factors for mortality. The level and cause-structure of neonatal mortality in the local population must be considered in developing interventions. Programs must ensure skilled care during childbirth, including management of birth asphyxia and prematurity, and curative postnatal

  9. Acute renal failure: Nephrosonographic findings in asphyxiated neonates

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    Mohd. Ashraf

    2011-01-01

    Full Text Available To determine the incidence of acute renal failure (ARF and nephrosonographic findings among asphyxiated neonates, and to correlate this with uric acid levels and the severity of hypoxic encephalopathy, we studied 80 full-term appropriate-for-date singleton neonates with perinatal asphyxia, and 30 healthy full-term neonates as controls from March 2006 to February 2007. A detailed history, thorough clinical examination along with investigations, including urine examination, 24-h urine collection, ultrasonography of abdomen and cranium, serum electrolytes, blood urea nitrogen, serum creatinine, and serum uric acid were obtained. ARF developed in 45% (36/80 of the asphyxiated neonates. Forty-eight (60% neonates showed significant elevation of blood urea and 41 (51.3% neonates had significant elevation of serum creatinine than the control group (P < 0.001. Sixty-two (77.5% neonates developed significant elevation of serum uric acid levels, and nephrosonography revealed hyperechogenicity in all of them, while only two among the healthy neonates showed the raised uric acid levels (P < 0.001. Nonoliguric renal failure was seen 28/36 (77.8% of the neonates with ARF, whereas eight (22.2% neonates had oliguric renal failure. Eight (27.8% patients among ARF patients maintained abnormal biochemical parameters after 2 weeks, and of whom four patients died after variable lengths of time with a mortality rate of 11.11%. Kidneys are the most common organs involved in perinatal asphyxia, and uric acid might be a causative factor for failure in addition to hypoxic insult. Routine use of kidney function test, along with abdominal ultrasonography form an important screening tool to detect any additional morbidity in these patients.

  10. POLA PENYAKIT PENYEBAB KEMATIAN BAYI DI PEDESAAN DAN PERKOTAAN, KONDISI SOSIO EKONOMI PADA KEJADIAN KEMATIAN BAYI DI INDONESIA HASIL RISKE5DAS 2007

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    Tety Rachmawati

    2012-11-01

    Full Text Available Background: Infant health was an important health indicator because of its relationship with various factors, maternal health, the quality of access to health services, socioeconomic conditions and public health services. Many factors influenced the Infant Mortality Rate but it is difficult to determine dominant factors and less dominant factors. The availability of various facilities or access and health services from skilled health workers, and also changing of public mind set from traditional to modern norms in health services are factors that influence the Infant Mortality Rate. This study aimed to asses the pattern infant death cause at urban and rural, socioeconomic conditions and its relations to infant death. Methods: The study design is descriptive. Data were taken from Riskesdas 2007, conducted in all provinces 33 Provinces in Indonesia. The Unit of analysis was infant death (0-11 month in household, during 1 July 2006-February 2008. Results: Results showed that infant mortality the majority patterns of infant death cause in Urban were is Low Birth Weight; followed by digestive infection,Asphyxia/aspiration and meningitis. Meanwhile pattern of Infant death cause in rural the majority were digestive infection, Pneumonia, Asphyxia/aspiration and Low Birth Weight. There was differences in access to health services between urban and rural areas. In rural areas access to health services was more difficult compared to urban. Infant deaths were more common in rural. Suggests to enhance access to health services especially in rural areas such as by enhance Desa SiagaStrategy to shorthen the health services to community like Poskesdes, enhance pre hospital care of obstetric and neonatal emergency at Polindes and puskesmas, socialization of ASI exclusive program, socialization of "PHBS" program. Key words: Infant Death - Pattern of death Cause - access - socioeconomic- Riskesdas 2007

  11. MATERNAL AND FETAL OUTCOME IN PREGNANCIES WITH SLE - A PROSPECTIVE STUDY OF 40 CASES

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    Menon Nalini

    2015-03-01

    Full Text Available Pregnancy and child birth in SLE patients can be complicated by disease activity, lupus nephritis, gestational diabetes, hypertensive disorders, intrauterine growth retardation, placental abruption, intrauterine and neonatal death, birth asphyxia, neonatal lupus and maternal mortality. AIMS AND OBJECTIVES : T o find out 1 T he most common complications and their incidence . 2 M aternal and fetal outcome in SLE patients during pregnancies. Study design; Prospective observational study. MATERIALS AND METHODS : Patients are enrolled for the study from pregnant mothers with known as well as newly diagnosed SLE who are attending outpatient department of obstetrics and gynecology department of Institute of maternal and child health, Calicut Government Medical college from 2011 February to 2012 June (18 months . Data collected from available past medical records, interview, physical examination, progress records and laboratory investigations of patients using predesigned profo r ma. RESULTS : Of the total 40 patients enrolled in the study, 45% were in the age group 26 - 30. 25% had one abortion in the past and 2 patients had 3 abortions. 65% had the disease for more than 6 years. Prior to the present pregnancy, 95% patients were in remission. During the present pregnancy 25 % patients had active lupus nephritis and 20% had flare. 25% and 75% patients had gestational diabetes mellitus and hypertensive disorders respectively. The incidence of intra uterine growth retardation was 45%. Placental abruption occurred in 10% pregnancies. The incidence of intrau terine death (25% was higher than that of neonatal deaths (10%. 20% babies had birth asphyxia and the incidence of low birth weight was very high (60%. 10% mothers had flare and 10% babies neonatal lupus. Maternal mortality was 5%. CONCLUSION : The study highlights the increased incidence of complications associated with pregnancies in SLE and thus the need for high quality care for better maternal and

  12. Clinical profile, predisposing factors, and associated co-morbidities of children with cerebral palsy in South India

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    Vykuntaraju K Gowda

    2015-01-01

    Full Text Available Introduction: Cerebral palsy (CP is the most common physical disorder of children. Causes like jaundice and birth injury though are decreasing; complications resulting from the survival of low birth weight babies are replacing some of the older etiologies. Hence, this study was planned. Objectives: The objective was to study the clinical patterns, predisposing factors, and co-morbidities in children with CP. Materials and Methods: The present study is a hospital based prospective study conducted from January 2012 to January 2013 in children presenting to neurodevelopmental clinic at a tertiary care teaching hospital in India. Hundred cases with clinical features suggestive of CP were included in the study. Cases were evaluated by history, clinical examination, and necessary investigations. Results: Results of the study showed 81% of spastic, 12% of hypotonic, 5% of dystonic, and 2% of mixed CP cases. The mean age of presentation was 2 year, 2 month, and male to female ratio of 1:2. Pregnancy-induced hypertension (PIH was the most common antenatal complication observed in 6%. Four percent had neonatal sepsis and 19% were born premature. Associated co-morbidities were mental retardation (55%, seizure disorder (46%, visual problems (26%, hearing problems (19%, and failure to thrive (47%. Discussion: Sex distribution observed in our study was male to female ratio of 1.2, which was comparable with a multicenter study in Europe. PIH was observed in 6% of cases, which was comparable with prior studies. Birth asphyxia was observed in 43% of cases. Eighty-one percent of the cases constituted a spastic variety of CP which was comparable to other studies. Conclusion: Perinatal asphyxia was the important etiological factor. We found preventable intranatal causes (60% and antenatal causes (20% forming a significant proportion. Co-morbidities were significantly observed in our study.

  13. Novel myopathy in a newborn with Shwachman-Diamond syndrome and review of neonatal presentation.

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    Topa, Alexandra; Tulinius, Mar; Oldfors, Anders; Hedberg-Oldfors, Carola

    2016-05-01

    Shwachman-Diamond-Bodian syndrome (SDS) is a pleiotropic disorder in which the main features are bone marrow dysfunction and pancreatic insufficiency. Skeletal changes can occur, and in rare cases manifest as severe congenital thoracic dystrophy. We report a newborn boy with asphyxia, narrow thorax, and severe hypotonia initially suggesting a neuromuscular disease. The muscle biopsy showed myopathic changes with prominent variability in muscle fiber size and abnormal expression of developmental isoforms of myosin. The myofibrils showed focal loss and disorganization of myofilaments, and thickening of the Z-discs including some abortive nemaline rods. The boy became permanently dependent on assisted ventilation. Pancreatic insufficiency was subsequently diagnosed, explaining the malabsorption and failure to thrive. Except transitory thrombocytopenia and leukopenia, no major hematological abnormalities were noted. He had bilateral nephrocalcinosis with preserved renal function. Transitory liver dysfunction with elevated transaminase levels and parenchymal changes on ultrasound were registered. The clinical diagnosis was confirmed by detection of compound heterozygous mutations in SBDS using whole-exome sequencing: a recurrent intronic mutation causing aberrant splicing (c.258+2T>C) and a novel missense variant in a highly conserved codon (c.41A>G, p.Asn14Ser), considered to be damaging for the protein structure by in silico prediction programs. The carrier status of the parents has been confirmed. This case illustrates the challenges in differential diagnosis of pronounced neonatal hypotonia with asphyxia and highlights the muscular involvement in SDS. To our knowledge, this is the first report of myopathy evidenced in a patient with clinically and molecularly confirmed SDS. © 2016 Wiley Periodicals, Inc. PMID:26866830

  14. Influence of prenatal fever on delivery and nursing care%产前发热对产妇分娩的影响及护理

    Institute of Scientific and Technical Information of China (English)

    张慧珠; 郭芳; 何超; 钟俊敏

    2011-01-01

    目的:探讨产前发热对产妇分娩的影响及相应护理方法.方法:将204例分娩前发热产妇作为观察组,进行回顾性病例分析;同时随机抽取同期产前无发热产妇200例作为对照组.分析、比较两组分娩、新生儿窒息及产后出血等情况,并制定出系统护理措施.结果:观察组羊水污染、剖宫产、新生儿窒息发生率明显高于对照组(P<0.01).结论:产妇产前发热对分娩有不良影响,采取针对性的护理方法具有重要临床意义.%Objective:To discuss the influence of prenatal fever on delivery and proper nursing methods. Methods: 204 pregnant women with prenatal fever before delivery were taken as observation group and the clinical history of them was retrospectively analyzed; another 200 randomly selected pregnant women without prenatal fever at the same time were taken as control group. The delivery, neonatal asphyxia and postpartum hemorrhage of those puerperant were compared between the two groups and the systematic nursing measures were implemented. Results: The incidence of amniotic fluid pollution , cesarean section and neonatal asphyxia was significantly higher in the observation group than those in the control group ( P <0. 01 ). Conclusion: The influences of prenatal fever on delivery are obvious and taking appropriate nursing methods has the important clinical significance.

  15. The role of Omi/HtrA2 protease in neonatal postasphyxial serum-induced apoptosis in human kidney proximal tubule cells

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    Zhang Yong

    2012-01-01

    Full Text Available Omi/HtrA2, a proapoptotic mitochondrial serine protease, is involved in both caspase-dependent and caspaseindependent apoptosis. A growing body of evidence indicates that Omi/HtrA2 plays an important role in the pathogenesis of a variety of ischemia-reperfusion (I/R injuries. However, the role of Omi/HtrA2 in renal injuries that occur in neonates with asphyxia remains unknown. The present study was designed to investigate whether Omi/HtrA2 plays an important role in the types of renal injuries that are induced by neonatal postasphyxial serum. Human renal proximal tubular cell line (HK-2 cells were used as targets. A 20% serum taken from neonates one day after asphyxia was applied to target cells as an attacking factor. We initially included control and postasphyxial serum-attacked groups and later included a ucf-101 group in the study. In the postasphyxial serum-treated group, cytosolic Omi/HtrA2 and caspase-3 expression in HK-2 cells was significantly higher than in the control group. Moreover, the concentration of cytosolic caspase-3 was found to be markedly decreased in HK-2 cells in the ucf-101 group. Our results suggest both that postasphyxial serum has a potent apoptosis-inducing effect on HK-2 cells and that this effect can be partially blocked by ucf-101. Taken together, our results demonstrate for the first time that postasphyxial serum from neonates results in Omi/HtrA2 translocation from the mitochondria to the cytosol, where it promotes HK-2 cell apoptosis via a protease activity-dependent, caspase-mediated pathway.

  16. Prophylaxis of neonatal respiratory distress syndrome by intra-amniotic administration of pulmonary surfactant

    Institute of Scientific and Technical Information of China (English)

    张建平; 王英兰; 王蕴慧; 张睿; 陈环; 苏浩彬

    2004-01-01

    Background Neonatal respiratory distress syndrome (NRDS) is caused by a deficiency in pulmonary surfactant (PS) and is one of the main reasons of neonatal mortality. This study was conducted to evaluate the efficacy and safety of intra-amniotic administration of pulmonary surfactant for prophylaxis of NRDS.Methods Forty-five pregnant women who were due for preterm delivery and whose fetuses' lungs proved immature were divided into two groups. Fifteen women (study group) were administered one dose of pulmonary surfactant injected into the amniotic cavity and delivered within several hours. Nothing was injected into the amniotic cavity of 30 women of the control group. The proportion of neonatal asphyxia, NRDS, mortality and the time in hospital were analyzed to determine if there was any difference between the two groups. Results There was no significant difference between the two groups for neonatal asphyxia. Foam tests showed that higher proportion of neonates in the study group than in the control group (56.3% vs 13.3%, P<0.05) had lung maturity. A greater number of control neonates (11/30, 32.3%) had NRDS, compared with the neonates given PS via the amniotic cavity before delivery (1/16, 6.3%, P<0.05). The neonates in the study group spent nearly 10 days less in hospital than the control group [(32.4±7.6) days vs (42.0±15.7) days, P<0.05], but the difference in mortality between the two groups was not statistically significant. Conclusions Intra-amniotic administration of pulmonary surfactant can significantly reduce the proportion of NRDS and the time in hospital of preterm neonates. Whether this method can reduce the mortality of preterm neonates needs to be evaluated further. Intra-amniotic administration of pulmonary surfactant provides an additional effectual means for NRDS prophylaxis.

  17. The effect of non-infectious diseases on serum procalcitonin concentrations in premature neonates%非感染因素对早产新生儿血清降钙素原浓度的影响

    Institute of Scientific and Technical Information of China (English)

    吴志新; 郭婕; 许靖; 武荣; 花少栋; 封志纯

    2015-01-01

    Objective To study the effect of non-infectious factors on serum procalcitonin(PCT) in preterm neonates.MethodThe premature infants of neonatal intensive care unit(NICU) in our hospital were chosen from gestational age ranged from 33 to 36 weeks, birth time less than 12 hours without premature rupture and hospitalization period from January 2012 to December 2012. All of the premature infants were drawn blood immediately admitted to hospital and C-reactive protein (CRP), blood cultures and procalcitonin were tested. The types of premature infants non-infectious diseases included intracranial hemorrhage (ICH), neonatal respiratory distress syndrome (NRDS), neonatal asphyxia and the control group (preterm infants) without disease. The blood routine , C-reactive protein, blood culture, procalcitonin and other infections indicators in each group were monitored dynamicly in order to study the impact of these non-infectious diseases on serum procalcitonin concentrations by statistical analysis.Results ① Compared with the current literature recommended serum procalcitonin concentrations (<0.5ng / ml), procalcitonin concentrations in preterm neonates singniifcantly increase (1.07± 0.76) ng / ml.②Compared with control group (1.07±0.76) ng/ml,the procalcitonin levels in intracranial hemorrhage group (2.12± 0.99) ng/ml, neonatal respiratory distress syndrome group (2.28±1.09) ng/ml and asphyxia group (3.64± 3.17) ng / ml signiifcantly increased (F= 10.462,P <0.05).There were no signiifcant differences (F= 0.173,P= 0.950) among the different levels of intracranial hemorrhage group; Compared with the ifrst grade NRDS , the procalcitonin leves in second grade and third grade NRDS groups were significantly increased (F=5.475,P= 0.010); The procalciton level in severe asphyxia group was signiifcantly higher than in mild asphyxia group (t= 5.245,P= 0.003). Conclusions The procalcitonin concentration physiologically increased after preterm neonates were born. Many factors

  18. Frequency of Hypoxic-Ischemic Encephalopathy Among Hospitalized Neonates in West Iran

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    Fatemeh Eghbalian

    2010-06-01

    Full Text Available Hypoxic-ischemic encephalopathy (HIE is brain damage from a shortage of oxygen or blood flow to the tissues[1,2] and is characterized by clinical and laboratory evidence of acute or subacute brain injury due to asphyxia[1-6]. It is a major contributor to neonatal death and morbidity[4-6]. 15%-20% of HIE cases die during the neonatal period and 30% of those who survive suffer from neurodevelopmental disorders[1,3,6].An estimated 23% of the 4 million neonatal deaths and 8% of all deaths at <5 years of age throughout the world each year are associated with signs of asphyxia at birth[1,4]. Even at referral centers in developed countries, death or moderate to severe disability occurs for 53% to 61% of infants diagnosed as having moderate to severe HIE[1,4,6]. Children with moderate/severe neonatal encephalopathy are at risk for reduced school performance, whereas those with mild encephalopathy have school performance scores similar to those of their peers[1,6]. HIE is one of the most common causes of cerebral palsy and other severe neurologic deficits in children occurring in two to nine of every 1000 live births [1-6]. The incidence of HIE reported in different studies varies widely[2-6], which may be explained by the selection criteria for studies of HIE during the neonatal period[3,4].The aim of the present study was to evaluate the frequency of hypoxic-ischemic encephalo-pathy in hospitalized neonates with seizure in Hamedan (west Iran in a two year period.This is a retrospective cross sectional study on 34 neonates from 2004 to 2006.Inclusion criteria were: all neonates with seizures due to HIE asphyxia having pH below 7, 5th minute Apgar score between 0 and 3, decreased muscle tone and consciousness, cortical atrophy in brain CT scan and multiple organ involvement (eg, kidney, lungs, liver, heart, intestines. Neonates with jitteriness were excluded from the study.The study was based on the recorded files of the patients. CT scan findings, blood

  19. 自然分娩中限制会阴切开的应用%Restrictive use of episiotomy during spontaneous vaginal delivery

    Institute of Scientific and Technical Information of China (English)

    李玉玲; 郭培奋; 孔欣; 彭翠霞

    2012-01-01

    Objective To compare the maternal and neonatal outcomes of restrictive use of episiotomy (only if tearing becomes apparent) versus routine episiotomy (in all cases) . Methods 314 nulliparous women at ≥37 weeks of gestation with live singleton cephalic pregnancies and no contraindication to vaginal birth, who were recruited from November 2010 to March 2011 in this department, received restrictive use of episiotomy while 739 nulliparous women from January to November in 2010 underwent episiotomy as control group. In both groups, we strengthened cardiotocograph mornitoring and intrapartum care and improved the management of the perineum ( hand on or hand off) . Total duration of labor including the first and the second stages of labour, and blood loss in 2 hours postpartum were recorded as a continuous variable. Apgar scores and anal sphincter (third or fourth degree) tears were also recorded. Results No significant difference was observed in each stage of labour between the two groups (P > 0. 05) . Restrictive use of episiotomy resulted in more blood loss than in the control group (P <0. 01) . Since the cases with severe perineum tear and neonatal asphyxia in both groups were rare, they were excused from Fisher' s exact test. However, the rate of neonatal asphyxia was a little higher in restrictive use group. Conclusions According to this clinical observation, the rate of episiotomy should and could be properly reduced, as the routine and restritive use of episiotomy results in no significant difference in labor duration, anal sphincter tear or neonatal asphyxia.%目的 探索头位初胎自然分娩中实施"限制会阴切开"对产程、严重会阴裂伤、新生儿出生评分的影响.方法 自然分娩头位足月初产妇314例作为限制会阴切开组,加强产程观察、产时对胎儿胎心率监测及改进接产手法,对具有明确会阴侧切适应证者实施会阴切开助产,对于无必要者则严格限制会阴切开;以常规会阴切开

  20. 2000~2010年哈尔滨市婴儿死亡趋势分析%Trend analysis on infantile death in Harbin city from 2000 to 2010

    Institute of Scientific and Technical Information of China (English)

    刘丽; 王春华; 吴晶; 李佳; 武丽杰

    2013-01-01

    Objective: To grasp the characteristics, rank order, and change trend of infantile death in Harbin city, and reduce infantile mortality. Methods: The data were collected and arranged according to Death Monitoring Proposal of Children below Five Year Old in China; the diagnosis and classification of infantile death were conducted according to ICD - 10. Results: The infantile mortality from 2001 to 2010 showed a decreasing trend in the whole (P <0. 05) ; from 2000 to 2010, early neonatal death accounted for 82. 95% of neonatal death, neonatal death accounted for 77. 73% of infantile death, infantile death accounted for 85. 10% of children death under five years old, the proportions didnt change obviously from 2000 to 2010; preterm low birth weight was the top cause of infantile death. The top five causes of infantile death included preterm low birth weight, congenital heart disease, neonatal asphyxia, congenital abnormalities, and pneumonia. From 2000 to 2010, the proportion of neonatal asphyxia decreased from 14. 88% to 9. 24%. Conclusion: The infantile mortality showed a decreasing trend in the whole, preterm low birth weight was still the first cause of infantile death, congenital heart disease was the second cause from 2006 to 2010. Neonatal asphyxia was the third cause of infantile death from 2000 to 2010, but the proportion showed a significant decreasing trend. Reducing neonatal mortality especially early neonatal mortality is the key point to reduce infantile mortality.%目的:掌握哈尔滨市婴儿死亡特点、死因顺位及变化趋势,降低婴儿死亡率.方法:按照《中国5岁以下儿童死亡监测方案》的要求进行资料的收集和整理.死亡诊断和分类依据国际疾病分类标准(ICD-10)进行分类和评价.结果:①2001~2010年婴儿死亡率变化趋势:婴儿死亡率总体呈下降趋势(P<0.05);②2000~2010年11年间早期新生儿占新生儿死亡82.95%,新生儿占婴儿死亡77.73%,婴儿死亡占5

  1. Death analysis and mortality prediction in children under 5 from 2006 to 2012 in Zhabei District, Shanghai%上海市闸北区2006-2012年5岁以下儿童死亡分析及死亡率预测

    Institute of Scientific and Technical Information of China (English)

    张国慧; 万秋萍; 权力

    2014-01-01

    [目的]在分析上海市闸北区2006-2012年5岁以下儿童死因的基础上,运用灰色模型GM(1,1)预测闸北区5岁以下儿童死亡率的变化趋势。[方法]对近5年的监测资料进行死因分析,并使用灰色模型( GM )进行拟合、预测死亡率。[结果]闸北区2006-2012年5岁以下儿童死亡以婴儿死亡为主,婴儿死亡以新生儿死亡为主。5年间5岁以下儿童死亡率为3.30‰~4.98‰,2010年略有上升。2006-2012年,新生儿期主要死亡原因为出生窒息,占31.82%。婴儿期主要死亡原因为其他先天异常,占30.43%,出生窒息为第2位,占20.29%。 GM拟合效果好,2013年预测死亡率为3.88‰。[结论]先天异常、出生窒息和意外死亡严重威胁闸北区5岁以下儿童的生命,必须加大新生儿筛查力度,普及新生儿意外死亡的宣教,从而有效降低5岁以下儿童死亡率。灰色模型GM(1,1)对5岁以下儿童死亡率的拟合效果好,可以应用于预测。%Objective] By the use of GM(1,1) model to predict mortality trends of children un-der 5 years, on the basis of the analysis of cause of death in children under 5 from 2006 to 2012 in Zhabei District of Shanghai City . [ Methods] Nearly 5 years of monitoring data were used for analysis of the cause of death , and the grey model ( GM) was used to fit and predict mortality . [ Results] The death of children under 5 was mainly infant death and the infant death was mainly newborns death from 2006 to 2012 in Zhabei District.During this five-year period, children mortality under 5 fluctuated from 3.30‰ to 4 .98‰and was slightly increased in 2010 .The main cause of death in the neonatal period was birth as-phyxia ,accounting for 31 .82%.For infant period , The first cause was congenital anomaly , accounting for 30.43% and the second cause was birth asphyxia ,accounting for 20.29%.The fitting effect of GM was fine and the predicted

  2. 加强助产护理对高龄产妇分娩的影响分析%Analysis of Effect of Strengthening Midwifery Care for Older Maternal Childbirth

    Institute of Scientific and Technical Information of China (English)

    黄雪霞

    2015-01-01

    Objective:To study and observe the effect of midwifery care in older maternal childbirth. Method:105 cases of advanced maternal age were collected, according to the odd and even numbers of maternal admission date number 52 cases for control group and 53 patients for the observation group, the control group received routine nursing care, the observation group added midwifery on the basis of the routine nursing care, the natural yield of two groups of puerperas, natural birth average amount of bleeding, neonatal asphyxia occurred rate and forceps delivery rate, time of the first labor, the second stage of labor time, the producing process, total labor time, splits the palace production causes were observed and compared.Result:Maternal natural yield of the observation group was significantly higher than that of the control group;maternal natural average amount of bleeding,maternal neonatal asphyxia incidence and aternal forceps delivery rate of the observation group were significantly lower than those of the control group;maternal labor time, time of the second stage of labor, the labor, the total labor time of the observation group were significantly shorter than those of the control group, maternal cesarean section rate of the observation group was significantly lower than that of the control group,and the difference was statistically significant (P<0.05).Conclusion:In the delivery process of advanced maternal age,strengthen nursing and midwifery can effectively reduce production when the amount of bleeding and improve the efficiency of natural childbirth, reduce the rate of cesarean section,reduce the rate of neonatal asphyxia, is conducive to maternal and child health,and is worthy of popularization and application.%目的:研究和观察在高龄产妇的分娩过程中使用助产护理的效果.方法:收集高龄产妇共105例,根据产妇入院日期的单双号数分为对照组52例和观察组53例,对照组产妇接受常规护理,观察组在此基础

  3. Analysis on the effect of glycemic control of pregnant women with gestational diabetes mellitus on pregnancy outcome%妊娠期糖尿病孕妇血糖控制对妊娠结局的影响分析

    Institute of Scientific and Technical Information of China (English)

    王丽丽

    2012-01-01

    目的:探讨控制妊娠期糖尿病(GDM)孕妇血糖对妊娠结局的影响.方法:将104例GDM孕妇根据治疗后血糖情况分为血糖控制满意组84例,血糖控制不满意组20例,并设健康孕妇87例为对照组,对各组妊娠期高血压、胎膜早破、羊水过多、产后出血、巨大儿以及新生儿窒息等指标进行比较.结果:血糖控制满意组的妊娠期高血压、胎膜早破、羊水过多、产后出血、巨大儿以及新生儿窒息等发生率与对照组比较差异均无统计学意义(P>0.05).血糖控制不满意组的妊娠期高血压、胎膜早破、羊水过多、产后出血、巨大儿以及新生儿窒息等发生率均高于对照组,差异有统计学意义(P<0.05).结论:有效控制GDM孕妇的血糖对妊娠有较大影响,应及时进行筛查与治疗.%Objective; To explore the effect of blood glucose in pregnant women with gestational diabetes mellitus (GDM) on pregnancy outcome. Methods; A total of 104 pregnant women with GDM were divided into well - controlled blood glucose group (84 pregnant women ) and bad - controlled blood glucose group ( 20 pregnant women) according the levels of blood glucose after treatment, and 87 healthy pregnant women were selected as control group; the incidences of GDM, premature rupture of membrane, polyhydramnios, postpartum hemorrhage , macrosomia, and neonatal asphyxia were compared among the three groups. Results; There was no statistically significant difference in the incidences of GDM, premature rupture of membrane, polyhydramnios, postpartum hemorrhage, macrosomia, and neonatal asphyxia between well - controlled blood glucose group and control group (P > 0. 05 ) , the incidences of GDM, premature rupture of membrane, polyhydramnios , postpartum hemorrhage, macrosomia, and neonatal asphyxia in bad - controlled blood glucose group were statistically significantly higher than those in control group (P < 0. 05) . Conclusion: Controlling blood glucose

  4. CLINICAL STUDY OF GESTATIONAL IMPAIRED GLUCOSE TOLERANCE IN 140 CASES%妊娠糖耐量受损140例临床研究

    Institute of Scientific and Technical Information of China (English)

    张英玲

    2012-01-01

    [Objective] To investigate the effect on the outcome of pregnancy women and fatus in gestational impaired glucose tolerance (GIGT). [Methods] Pregnancy women 2515 cases oral 50g glucose senitiv lest (GST) , glucose challenge test is abnomai, fasting again 75g oraglucose toerance test (OGTT) dignoses gestational Diabetes mellitus (GDM) and gesta-tional impaired glucose.and be compaired on the outcome pregnancy and fetus in GIGT group. in GDM group and normal group. [Results] Complication during the pregnancy and delivery, the dysklocia rate and the incidence in perint newbom.in the normal group, GIGT group, GDM group of hypertensive disorder complicating pregnancy, premature delivery, polyhydramnios, neonatal asphyxia, neonatal hypoglycemia, cesarean section, fetal macrosomia difference was statistically significant (P 0.05) ; hypertensive disorder complicating pregnancy、neonatal asphyxia, neonatal glucopenia, cesarean section, fatal raacrosomia of GDM and GIGT group were higher significantly than normal group (P 0.05 > 0.017) ; GIGT group with GDM between neonatal asphyxia complications significantly higher than GIGT group (P 0.05 > 0.017). [Conclusion] To trent-ment of GIGT in time. Prognosis of pregnant women and fetus Inprove in gestational glucose metabolic disorder%[目的]探讨妊娠糖耐量受损(GIGT)对母儿结局的影响.[方法]对2 515例孕妇进行口服50g葡萄糖筛查试验,对异常者,再空腹口服75 9葡萄糖进行糖耐量试验(OGTT)以确诊妊娠期糖尿病(GDM)及妊娠糖耐量受损.并分正常组、GIGT组及GDM组进行比较母儿结局.[结果]孕期及分娩过程中的合并症,难产率及围产儿患病率中,在正常组、GIGT组、GDM组的妊娠期高血压疾病、早产、胎膜早破、羊水过多、新生儿窒息、新生儿低血糖、剖宫产、巨大儿差异有统计学意义(P< 0.01).而胎膜早破的并发症差异无统计学意义(P>0.05);在GDM组与GIGT组中,妊娠期高血压疾病、新

  5. Analysis on death of children under five years and interventional measures in Guyuan city from 2006 to 2009%固原市2006~2009年度5岁以下儿童死亡分析及干预措施

    Institute of Scientific and Technical Information of China (English)

    惠芳; 海霞

    2012-01-01

    Objective: To explore the causes, current situation, change trend and regularity of related factors of death of children under five years in Guyuan city, provide a theoretical basis for making health policies to reduce the mortality of children under five years and infantile mortality. Methods; The monitoring data of the children under five years in Guyuan city from 2006 to 2009 were summarized and analyzed. Results; Among the dead children, the proportion of infantile death, especially neonatal death was higher. Among 1 967 dead children, the proportion of neonatal death was 66. 4% ( 1 307 neonates) . The main causes of death included premature delivery, low birth weight, and birth asphyxia. Conclusion; To reduce the mortality of children under five years and infantile mortality, perinatal health care should be enhanced, the quality of systematical and standard management of maternal and child health care works should be improved. Congenital heart disease and other congenital abnormalities become the risk factors affecting the survival and development of the children under five years. Pregestational and gestational health education should be strengthened, various factors inducing congenital abnormalities should be intervened and prevented timely to reduce birth defects. Premature delivery and asphyxia should be prevented, the construction of obstetrical department should be enhanred, the quality of obstetrical department should be improved, the intrapartum monitoring should be normalized, and the occurrence of neonatal asphyxia should be prevented. Perfecting systematical management of children and preventing, controlling the occurrence of corresponding diseases and death may achieve the goal of reducing the mortality of children.%目的:探究固原市5岁以下儿童的死亡原因、现状、相关因素变化的趋势与规律,为制定降低5岁以下儿童死亡率和婴儿死亡率的卫生政策提供理论依据.方法:对2006~2009年固原市连续4

  6. Aplicação do escore CRIB como preditor de óbito em unidade de terapia intensiva neonatal: uma abordagem ampliada The use of CRIB score as mortality predictor at neonatal intensive care unit: an extended approach

    Directory of Open Access Journals (Sweden)

    Luiz Fernando C. Nascimento

    2004-06-01

    Full Text Available OBJETIVOS: avaliar o uso do escore CRIB (Clinical Risk Index for Babies em todos os recém-nascidos internados em Unidade de Terapia Intensiva Neonatal (UTIN e comparar seus resultados com peso ao nascer e idade gestacional. MÉTODOS: estudo observacional, envolvendo todos os recém-nascidos internados na UTIN do Hospital Universitário de Taubaté. As variáveis foram escore CRIB, peso ao nascer, idade gestacional, uso de surfactante, cateterização umbilical, asfixia neonatal e óbito. Foram comparadas as médias do escore CRIB, peso ao nascer e idade gestacional segundo óbito. Foram estimados os valores da sensibilidade, especificidade, valores preditivos positivo e negativo e risco relativo e criadas curvas Receiver Operating Characteristic (ROC para CRIB, peso ao nascer e idade gestacional. Utilizou-se da técnica t de Student e qui-quadrado de tendência linear. A significância estatística foi alfa = 5%. RESULTADOS: óbito esteve associado a maiores valores do CRIB; houve tendência de mais casos com asfixia, uso de surfactante, cateterização umbilical e óbitos com as classes maiores do CRIB. A curva ROC relativa ao CRIB foi maior que as relativas ao peso ao nascer e idade gestacional. CONCLUSÕES: o escore CRIB foi bom preditor do óbito quando aplicado em todos os RN.OBJECTIVES: to evaluate the CRIB (Clinical Risk Index for Babies score as mortality predictor in all newborn at Neonatal Intensive Care Unit (NICU and to compare with birthweight and gestational age. METHODS: observational study with newborn admitted at NICU of University Hospital of Taubaté. The variables were CRIB score, birth weight, gestational age, use of surfactant, umbilical catheter, neonatal asphyxia and death. The association between CRIB score and other variables was estimated. The values of sensitivity, specificity, predictive and negative values and relative risk and 95% confidence interval of were estimated and created ROC (Receiver Operating

  7. Analysis of Inlfuence Factors of Neonatal Hyperbilirubinemia%新生儿高胆红素血症的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    曲岩杰

    2015-01-01

    目的:研究新生儿发生高胆红素血症的危险因素。方法入选2010年1月~2014年1月在我院出生的240例足月新生儿,出生后7天内测量胆红素水平,达到国家推荐的光疗干预标准的110例为黄胆组,同期未达标准的130例为对照组,分别对两组出生体重、性别、生产方式等15项潜在危险进行统计并分析。结果黄胆组与对照组相比,窒息率、胎头吸引助产率、禁食率,G-6-PD缺陷明显增高(P<0.05)。窒息率、禁食率、G-6-PD是发生高胆红素血症的危险因素(P<0.05)。结论产后禁食、窒息、G-6-PD是发生高胆红素血症的独立危险因素,分娩方式可能与黄疸的发生相关。%Objective To investigate the risk factors of neonatal hyperbilirubinemia. Methods 240 cases of full-term infants born in our hospital from measuring bilirubin level, within 7 days after birth, to achieve national standards recommend phototherapy intervention of 110 cases of jaundice group over the same period, not up to standard 130 cases as control group, two groups respectively on birth weight, sex, mode of production and other 15 potential risk statistics and analysis. Results Compared with jaundice group and control group, asphyxia, fetal head suction delivery rate, fast rate of defects, G-6-PD increased signiifcantly, but the difference was not statistically signiifcant (P<0.05). Conclusion Fasting, postpartum asphyxia, G-6-PD is an independent risk factor for the occurrence of hyperbilirubinemia, related to mode of delivery may be associated with jaundice.

  8. 产前护理干预对分娩方式的影响%Influence of prenatal nursing intervention on delivery way

    Institute of Scientific and Technical Information of China (English)

    郑婉文; 邱益娟; 林燕芬; 林丽霞

    2015-01-01

    目的:探讨产前护理干预对分娩方式的影响。方法回顾性分析1350例产妇的临床资料。将所有产妇随机分为对照组(623例)和干预组(727例),对照组接受常规检查和护理,干预组接受产前护理干预。比较两组产妇分娩方式、产后出血、新生儿窒息等发生情况。结果干预组剖宫产率为17.33%,明显低于对照组的54.74%,差异具有统计学意义(P<0.05);干预组的产后出血率为2.06%,新生儿窒息率为2.20%,明显低于对照组的5.94%、6.26%,差异具有统计学意义(P<0.05)。结论产前护理干预有助于提高产科质量,保证母婴安全,降低剖宫产率,值得临床推广应用。%Objective To investigate influence of prenatal nursing intervention on delivery ways. Methods Clinical data of 1350 puerpera were retrospectively analyzed. All puerpera were randomly divided into control group (623 cases) and intervention group (727 cases). The control group received conventional examination and nursing, and the intervention group received prenatal nursing intervention. Delivery ways, and status of postpartum hemorrhage and neonatal asphyxia were compared between the two groups. Results The intervention group had much lower cesarean section rate as 17.33% than 54.74% of the control group, and their difference had statistical significance (P<0.05). The intervention group also had obviously lower postpartum hemorrhage rate as 2.06% and lower neonatal asphyxia rate as 2.20% than 5.94% and 6.26% of the control group. The difference had statistical significance (P<0.05). Conclusion Prenatal nursing intervention is helpful for improving obstetric quality, ensuring maternal and child safety, and reducing cesarean section rate. It is worthy of clinical promotion and application.

  9. Analysis on blood glucose metabolic disorders in critically ill neonates%危重新生儿血糖代谢紊乱相关因素分析

    Institute of Scientific and Technical Information of China (English)

    李艳秋; 赵军

    2012-01-01

    目的:对危重新生儿血糖代谢紊乱的相关因素进行调查分析,为临床治疗提供参考依据.方法:分析2007年6月~2011年6月168例危重新生儿血糖代谢紊乱的形成原因.结果:168例血糖代谢紊乱患者中,低血糖症者97例,高血糖症者42例,二者兼有者29例.血糖代谢紊乱与胎龄和出生体重呈负相关,而且在轻度窒息的情形下低血糖症状较多,重度窒息的情况下高血糖症状较多.结论:对危重新生儿血糖代谢紊乱相关因素的分析,可以及时发现和治疗病症,减少患儿日后的痛苦.%Objective; To investigate and analyze the related factors of blood glucose metabolic disorders in critically ill neonates, provide reference for clinical treatment. Methods; The causes of blood glucose metabolic disorders in 168 critically ill neonates who were treated in the hospital from June 2007 to June 2011 were analyzed. Results; Among 168 neonates with blood glucose metabolic disorders, 97 neonates were found with hypoglycemia, 42 neonates were found with hyperglycemia, and 29 neonates were found with both of the above -mentioned diseases. There was a negative correlation between blood glucose metabolic disorders and birth weight, hypoglycemia was commonly found under the circumstance of mild asphyxia, and hyperglycemia was commonly found under the circumstance of severe asphyxia. Conclusion; Blood glucose metabolic disorders can be diagnosed and cured timely through analyzing the related factors of blood glucose metabolic disorders in critically ill neonates to reduce future pains of the neonates.

  10. Evaluation of effect of continuous care provided by midwife groups to pregnant women%助产士组人员为孕妇提供连续性护理的效果评价

    Institute of Scientific and Technical Information of China (English)

    徐名妨; 涂晋梅; 吴素红; 刘瑶; 梁小勤; 郑彩霞; 吴双珍

    2011-01-01

    目的 探讨助产士组人员为孕妇提供连续性护理的效果.方法 将筛选的100例孕妇随机分为研究组和对照组各50例,研究组按照助产士组人员提供连续性护理的要求服务;对照组按照传统护理模式服务,比较不同护理措施对母婴的效果.结果 研究组孕产妇对产前认知行为的依从性高,自然分娩率高,母乳喂养率升高,孕产妇满意度提高,新生儿窒息率降低,产后抑郁症的发生率低,与对照组相比差异显著.结论 助产士组人员提供连续性护理能提高孕妇对产前认知、自然分娩率、母乳喂养率、产妇满意度、护理人员的综合素质,降低新生儿窒息率,减少产后抑郁症发生,提高了围生期保健质量.%Objective To investigate the effect of continuous care provided by midwife group personnel to pregnant women.Methods 100 cases of pregnant women were screened out and divided into the study group and the control group with 50 patients in each group randomly.The study group received continuous care provided by midwife group personnel,the control group received traditional nursing.Effect of different nursing measures on mothers and neonates were compared.Results Antenatal cognition and rate of natural delivery of the study group were higher than the control group.The rate of neonatal asphyxia and postpartum depression occurred in the study group were lower than the control group,Maternal and family sarisfaction and rates of breasffeeding of the study group were higher than the control group.Conclusions Continuoas care provided by midwife group personnel can increase antenatal cognition and rate of natural delivery,maternal and family satisfaction.breast feeding rates and the overall quality of nursing staff,reduce rate of neonatal asphyxia with few postpartum depression,then improve the quality of perinatal care.

  11. 绍兴市2006~2008年5岁以下儿童死亡监测结果分析%Analysis on monitoring result of death of children under 5 years in Shaoxing city from 2006 to 2008

    Institute of Scientific and Technical Information of China (English)

    刘丹; 余红

    2011-01-01

    Objective: To understand the death of children under 5 years in monitoring points of Shaoxing city, put forward corresponding interventional measures, in order to reduce children mortality. Methods: The mortality, causes of death and health service before death of children under 5 years were analyzed in monitoring points of Shaoxing city from 2006 to 2008. Results: The mortality of children under 5 years in Shaoxing from 2006 to 2008 decreased year by year, the top five causes of death were congenital heart disease, premature delivery and low birth weight, drowning, unexpected asphyxia, birth asphyxia and other congenital abnormalities. The treatment before death was mainly in hospital, accounting for 52. 22% , but 21. 85% of the children didn't go to hospital before death. Conclusion: Maternal and child health, training medical staff in basic - level medical organizations should be enhanced, the technical levels of obstetricians and pediatricians should be improved, the consciousness of safety protection should be strengthened among the parents, unexpected death of children should be prevented and reduced, rural cooperative medical system and ability of rural community service should be enhanced to reduce the mortality of children under 5 years.%目的:了解绍兴市监测点5岁以下儿童死亡情况,提出相应干预措施,以有效降低儿童死亡率.方法:对绍兴市2006~2008年监测点5岁以下儿童死亡率、死亡原因、死前保健服务进行分析.结果:2006~ 2008年绍兴市5岁以下儿童死亡率逐年下降,死因前5位依次为先天性心脏病、早产和低出生体重、溺水、意外窒息、出生窒息和其他先天异常.死前治疗以医院为主,占52.22%,但未就医占21.85%.结论:应该加强妇幼保健工作,加强基层培训,提高产科、儿科医生技术水平,提高家长安全防范意识,预防和减少儿童意外死亡,加强农村合作医疗和农村社区服务能力,从而降低5岁以下儿童死亡率.

  12. 胎盘早剥48例临床分析%Clinical Analysis of 48 Patients with Placental Abruption

    Institute of Scientific and Technical Information of China (English)

    刘玉昆; 王振花; 黄佩贤; 刘梅兰; 张建平

    2012-01-01

      Objective: To improve the early diagnosis and treatment of placenta abruption and decrease the maternal and fetal complications.Methods:The clinical data of 48 patients with placental abruption were retrospectively analyzed from Jan.2006 to Jun.2011. Results: Premature membrane rupture, pregnancy complicated hypertension, fetal growth restriction were the main risk factors. The main clinical presentations included abdominal pain, uterine hypertonus, vaginal bleeding, uterine tenders, abnormal fetal heart, fetal intrauterine death, bloody amniotic fluid and so on. 30 cases were delivered by cesarean section. 18 cases were delivered by vagina. Maternal complications included 9 cases of post partum hemorrhage,2 cases of DIC and 1 case of subtotal hysterectomy.11 newborns had mild asphyxia. 5 newborns had severe asphyxia. 3 cases complicated with fetal intrauterine death. Conclusions: The clinical presentation of placenta abruption varies widely. Early diagnosis and timely treatment are the keys to improve maternal and neonatal outcomes.%  目的:提高胎盘早剥的早期诊断和及时治疗,降低母儿并发症。方法:回顾性分析我院2006年1月~2011年6月诊治的48例胎盘早剥的临床资料。结果:胎膜早破、妊娠期高血压疾病、胎儿生长受限为胎盘早剥的重要高危因素。主要临床表现为腹痛、子宫张力大、阴道流血、子宫压痛、胎心异常、死胎、血性羊水等。剖宫产30例,阴道产18例,产妇发生产后出血9例,DIC 2例,行次全子宫切除术1例,无孕产妇死亡。新生儿轻度窒息11例,重度窒息5例,死胎3例。结论:胎盘早剥病因多,临床表现个体差异大,及早识别和处理是降低风险,提高母婴结局的关键。

  13. 预防性护理干预对产妇分娩的影响%Impact of preventive nursing intervention on delivery

    Institute of Scientific and Technical Information of China (English)

    王栋芝

    2013-01-01

    Objective: To discuss the impact of preventive nursing intervention on delivery mode, birth process and postpartum hemorrhage. Methods: 120 parturient with single intrauterine pregnancy in cephalic presentation were randomly divided into the observation group and the control group( 60 cases in each group ) according to the order in labor. The methods of wet compress of uterine neck with lidocaine hydrochloride cotton ball combined with massaging uterine neck with hand were used in the two groups. The preventive nursing intervention was adopted in the observation group and routine nursing care was taken in the control group. Results:The natural birth rate and effective rate of analgesia was higher in the observation group than the control group( P < 0.05 ); the birth process was obviously shorter in the observation group than the control group( P <0. 05 ) ;the rate of postpartum hemorrhage of puerperant and asphyxia of newborn was lower in the observation group than the control group( P < 0. 05 ). Conclusion: The preventive nursing intervention can obviously shorten birth process, reduce maternal pain, promote parturient confidence in natural delivery, reduce the rate of postpartum hemorrhage and neonatal asphyxia and improve safety of mother and newborn as well.%目的:探讨预防性护理干预对产妇分娩方式、产程时间及产后出血等情况的影响.方法:将我院120例单胎头位产妇按临产先后顺序随机分为观察组和对照组各60例,两组均采用盐酸利多卡因棉球湿敷宫颈协同手推宫颈法,观察组采取预防性护理干预,对照组采取常规护理.结果:观察组自然分娩率高于对照组,产程时间比对照组明显缩短,产妇产后出血率及新生儿窒息率低于对照组,镇痛有效率高于对照组,两组比较差异均有统计学意义(P<0.05).结论:预防性护理干预可明显缩短产程,减轻产妇疼痛,提升产妇自然分娩的信心,降低产后出血率及新生儿窒息率,提高母婴安全.

  14. The influence of maternal islet beta-cell autoantibodies in conjunction with gestational hyperglycemia on neonatal outcomes.

    Directory of Open Access Journals (Sweden)

    Zhe Li

    Full Text Available To determine the predictive value of the presence of maternal islet beta-cell autoantibodies with respect to neonatal outcomes.A total of 311 pregnant women with abnormal 75 g oral glucose tolerance test (OGTT results were enrolled in this study. Maternal glutamic acid decarboxylase autoantibodies (GADA, islet cell autoantibodies (ICA and insulin autoantibodies (IAA were tested in fasting blood both on the day following the routine OGTT and before delivery. The birth weight, Apgar score, blood glucose and outcomes of each neonate were later evaluated and recorded.1. In this study, 33.9% of the pregnant women with gestational hyperglycemia had detectable levels of one or more types of anti-islet cell antibodies in the third trimester. The proportion of women who produced GADA and/or ICA was significantly higher in the group of women with gestational hyperglycemia than in the control group (P<0.05. The groups similarly differed in the proportion of women who tested positive for any anti-islet cell antibody (P<0.05. 2. Of the patients in our study, those who produced GADA exhibited an increase in uterine and umbilical arterial pulsatility indexes (PIs during the third trimesters compared with the control group (P˂0.05. Additionally, an increased frequency of fetal growth restriction (FGR was observed in the infants of women who produced IAA during pregnancy compared with those without autoantibodies (P˂0.05. 3. The rate of newborn admission to the neonatal intensive care unit (NICU was significantly associated with the presence of maternal ICA during the third trimester (OR, 6.36; 95% CI, 1.22-33.26. 4. The incidence of neonatal asphyxia was associated with the presence of maternal GADA in both the second (OR, 10.44; 95% CI, 1.46-74.92 and the third (OR, 8.33; 95% CI, 1.45-47.82 trimesters.Approximately one-third of the women with gestational hyperglycemia produced anti-islet cell antibodies. The incidence of FGR was higher in women with

  15. Clinical observation of unprotected perineum delivery technology%无保护会阴接生技术的临床应用观察

    Institute of Scientific and Technical Information of China (English)

    李迎春

    2015-01-01

    Objective To investigate the clinical effect of unprotected perineum delivery technology.Methods Normal vaginal delivery in 300 cases Were randomly divided into two groups,study group and control group,each group of 150 cases, The control group uses the conventional protection of perineum method. The study group using new unprotected perineum delivery technology. Results The study group of 150 cases of maternal vaginal delivery, Perineal resection in 16 cases,50 cases of perineal laceration degree II,60 cases of perineallaceration of perineum type,complete in 24 cases,neonatal asphyxia 0 cases. The control group of 150 cases of maternal vaginal delivery, Perineal resection in 31 cases,the second degree perineal laceration in 84 cases,27 cases ofperineal laceration of perineum type,complete in 8 cases,neonatal asphyxia 0 cases. Conclusion Unprotected perineum delivery technology,to reduce the rate of lateral episiotomy and perineal laceration of perineum II rate,improve the first degree laceration rate and integrity rate,is superior to the traditional protection of perineum method.%目的:探讨无保护会阴接生技术的临床效果。方法正常阴道分娩产妇300例,随机分为研究组和对照组,每组150例,研究组采用新的无保护会阴接生技术进行接生,对照组采用旧的常规保护会阴法进行接生。结果研究组150例产妇正常阴道分娩,会阴侧切16例,会阴Ⅱ度裂伤50例,会阴Ⅰ度裂伤60例,会阴完整24例,新生儿窒息0例;对照组150例产妇正常阴道分娩,会阴侧切31例,会阴Ⅱ度裂伤84例,会阴Ⅰ度裂伤27例,会阴完整8例,新生儿窒息0例。结论无保护会阴接生技术在降低会阴侧切率、会阴Ⅱ度裂伤率,提高会阴完整率方面明显优于常规保护会阴法接生。

  16. 高龄孕妇早发型重度先兆子痫对新生儿及围生结局影响分析%THE EFFECT OF EARLY ONSET SEVERE PRE- ECLAMPSIA OF ADVANCED AGE PREGNANT WOMEN ON NEONATAL AND PERINATAL OUTCOMES

    Institute of Scientific and Technical Information of China (English)

    胡水珍; 叶春波

    2011-01-01

    目的 分析高龄孕妇早发型重度先兆子痫对新生儿及围生结局的影响.方法 回顾性分析1997年1月-2010年1月早发型重度先兆子痫孕妇86例,其中年龄>35岁40例,设为研究组,年龄0.05).终止妊娠时间及孕妇严重并发症,差异有统计学意义(P<0.01).研究组围生儿病死率及颅内出血,新生儿窒息明显高于对照组(P<0.01).研究组新生儿出生体质量及新生儿Apgar评分明显小于对照组(P<0.01).结论 年龄>35岁孕妇发生早发性重度子痫,更易导致孕妇及围生儿预后不良.%Objective To analyze the effect of early onset severe pre - eclampsia( EOSP ) of advanced age pregnant women on neonatal and perinatal outcomes. Methods Eighty - six pregnant women with EOSP from Jan 1997 to Jan 2010 were chosen and analysed. According to the maternal age, 86 pregnant women with EOSP were classified into two groups, research group( the maternal age was up to 35 years and 40 patients were involved ) and control group( the maternal age was under 35 years and 46 patients were involved ). The parity, gestational age on admission, systolic pressure( SP ) and diastolic pressure( DP ) were recorded. And the pregnant outcomes of gravidas ( such as placental abruption, pneumonedema, heart failure ) and complications of perineal infants( such as perinatal mortality ratio, low birth weight, intracranial hemorrhage, neonatal asphyxia, Apgar score ) were recorded and compared between two groups. Results The parity, gestational age on admission, SP and DP had no different between two groups( P > 0.05 ). The duration of pregnancy termination and severe complication were different between two groups (P < 0. 01 ). Compared to control group, the perinatal mortality ratio, intracranial hemorrhage and neonatal asphyxia in research group were higher ( P < 0.01 ), and the birth weight, Apgar score in research group were lower ( P < 0.01 ). Conclusion The EOSP of advanced age pregnant women could

  17. Reduced miR-659-3p Levels Correlate with Progranulin Increase in Hypoxic Conditions: Implications for Frontotemporal Dementia.

    Science.gov (United States)

    Piscopo, Paola; Grasso, Margherita; Fontana, Francesca; Crestini, Alessio; Puopolo, Maria; Del Vescovo, Valerio; Venerosi, Aldina; Calamandrei, Gemma; Vencken, Sebastian F; Greene, Catherine M; Confaloni, Annamaria; Denti, Michela A

    2016-01-01

    Progranulin (PGRN) is a secreted protein expressed ubiquitously throughout the body, including the brain, where it localizes in neurons and is activated microglia. Loss-of-function mutations in the GRN gene are an important cause of familial frontotemporal lobar degeneration (FTLD). PGRN has a neurotrophic and anti-inflammatory activity, and it is neuroprotective in several injury conditions, such as oxygen or glucose deprivation, oxidative injury, and hypoxic stress. Indeed, we have previously demonstrated that hypoxia induces the up-regulation of GRN transcripts. Several studies have shown microRNAs (miRNAs) involvement in hypoxia. Moreover, in FTLD patients with a genetic variant of GRN (rs5848), the reinforcement of miR-659-3p binding site has been suggested to be a risk factor. Here, we report that miR-659-3p interacts directly with GRN 3'UTR as shown by luciferase assay in HeLa cells and ELISA and Western Blot analysis in HeLa and Kelly cells. Moreover, we demonstrate the physical binding between GRN mRNA and miR-659-3p employing a miRNA capture-affinity technology in SK-N-BE and Kelly cells. In order to study miRNAs involvement in hypoxia-mediated up-regulation of GRN, we evaluated miR-659-3p levels in SK-N-BE cells after 24 h of hypoxic treatment, finding them inversely correlated to GRN transcripts. Furthermore, we analyzed an animal model of asphyxia, finding that GRN mRNA levels increased at post-natal day (pnd) 1 and pnd 4 in rat cortices subjected to asphyxia in comparison to control rats and miR-659-3p decreased at pnd 4 just when GRN reached the highest levels. Our results demonstrate the interaction between miR-659-3p and GRN transcript and the involvement of miR-659-3p in GRN up-regulation mediated by hypoxic/ischemic insults. PMID:27199656

  18. Observation on Effect of Drug Intervention on Gestational Hypertension%高血压孕妇妊娠期实施药物干预的效果观察

    Institute of Scientific and Technical Information of China (English)

    梁惠萍

    2012-01-01

    目的观察高血压孕妇在妊娠期实施早期药物干预的临床治疗效果.方法 选取2007年1月至2012年1月在深圳市龙岗区平湖人民医院就诊的妊娠期高血压患者300例作为研究对象,其中2007年1月至2008年5月就诊的125例患者作为在妊娠期未进行药物干预的对照组,2008年6月至2012年1月就诊的175例患者作为在妊娠期进行早期药物干预的观察组,对比分析两组患者在产后出血、剖宫产、早产、胎儿窘迫及新生儿窒息方面的疗效情况.结果 观察组患者的产后出血、剖宫产、早产、胎儿窘迫及新生儿窒息发生率与对照组相比明显降低,差异有统计学意义(P<0.05).结论 在临床实践中,对妊娠期高血压患者进行早期药物干预,能降低不良妊娠结局的发生率,从而改善妊娠结局,值得临床推广使用.%Objective To observe the curative effert of drug intervention on gestations! hypertension. Methods From Jan. 2007 to Jan. 2012 ,300 gestational hypertension patients had been treated in Pinghu Hospital of Longgang District. Among these patients, 125 rases treated with drug intervention were enrolled into this study as control group( from Jan. 2007 to May 2008 ), while the other 175 cases treated with drug intervention were enrolled as observation group( from Jun. 2008 to Jan. 2012 ). The following parameters were compared and analyzed: postpaitum hemorrhage, cesarean section, premature labor, fetal distress and neonatal asphyxia. Results Compared with the control group, the rates of postpaitum hemorrhage, cesarean section, premature labor , fetal distress and neonatal asphyxia were significantly lower in observation group, the differences were statistically significant P<0.05 ). Conclusion For patients with gestational hypertension, drug intervention is effective to reduce the rates of adverse pregnancy outcomes and worthy of clinically application.

  19. Intracranial hemorrhage in full-term newborns: a hospital-based cohort study

    Energy Technology Data Exchange (ETDEWEB)

    Brouwer, Annemieke J.; Groenendaal, Floris; Koopman, Corine; Vries, Linda S. de [University Medical Center Utrecht, Department of Neonatology, Wilhelmina Children' s Hospital, PO Box 85090, Utrecht (Netherlands); Nievelstein, Rutger-Jan A. [University Medical Center Utrecht, Department of Radiology, Wilhelmina Children' s Hospital, Utrecht (Netherlands); Han, Sen K. [University Medical Center Utrecht, Department of Neurosurgery, Wilhelmina Children' s Hospital, Utrecht (Netherlands)

    2010-06-15

    In recent years, intracranial hemorrhage (ICH) with parenchymal involvement has been diagnosed more often in full-term neonates due to improved neuroimaging techniques. The aim of this study is to describe clinical and neuroimaging data in the neonatal period and relate imaging findings to outcome in a hospital-based population admitted to a level 3 neonatal intensive care unit (NICU). From our neuroimaging database, we retrospectively retrieved records and images of 53 term infants (1991-2008) in whom an imaging diagnosis of ICH with parenchymal involvement was made. Clinical data, including mode of delivery, clinical manifestations, neurological symptoms, extent and site of hemorrhage, neurosurgical intervention, and neurodevelopmental outcomes, were recorded. Seventeen of the 53 term infants had infratentorial ICH, 20 had supratentorial ICH, and 16 had a combination of the two. Seizures were the most common presenting symptom (71.7%), another ten infants (18.9%) presented with apneic seizures, and five infants had no clinical signs but were admitted to our NICU because of perinatal asphyxia (n = 2), respiratory distress (n = 2), and development of posthemorrhagic ventricular dilatation (n = 1). Continuous amplitude-integrated electroencephalography recordings were performed in all infants. Clinical or subclinical seizures were seen in 48/53 (90.6%) infants; all received anti-epileptic drugs. Thirteen of all 53 (24.5%) infants died. The lowest mortality rate was seen in infants with supratentorial ICH (10%). Three infants with a midline shift required craniotomy, six infants needed a subcutaneous reservoir due to outflow obstruction, and three subsequently required a ventriculoperitoneal shunt. The group with poor outcome (death or developmental quotient (DQ) <85) had a significantly lower 5-min Apgar score (p =.006). Follow-up data were available for 37/40 survivors aged at least 15 months. Patients were assessed with the Griffiths Mental Developmental Scales

  20. Electroencephalogram and brainstem auditory evoked potential in 539 patients with central coordination disorder

    Institute of Scientific and Technical Information of China (English)

    Huijia Zhang; Hua Yan; Paoqiu Wang; Jihong Hu; Hongtao Zhou; Rong Qin

    2008-01-01

    BACKGROUND: Electroencephalogram (EEG) and brainstem auditory evoked potential (BAEP) are objective non-invasive means of measuring brain electrophysiology.OBJECTIVE: To analyze the value of EEG and BAEP in early diagnosis, treatment and prognostic evaluation of central coordination disorder.DESIGN, TIME AND SETTING: This case analysis study was performed at the Rehabilitation Center of Hunan Children's Hospital from January 2002 to January 2006.PARTICIPANTS: A total of 593 patients with severe central coordination disorder, comprising 455 boys and 138 girls, aged 1--6 months were enrolled for this study.METHODS: EEG was monitored using electroencephalography. BAEP was recorded using a Keypoint electromyogram device. Intelligence was tested by professionals using the Gesell scale.MAIN OUTCOME MEASURES: (1) The rate of abnormal EEG and BAEP, (2) correlation of abnormalities of EEG and BAEP with associated injuries, (3) correlation of abnormalities of EEG and BAEP with high risk factors.RESULTS: The rate of abnormal EEG was 68.6% (407/593 patients), and was increased in patients who also had mental retardation (P < 0.05). The rate of abnormal BAEP was 21.4% (127/593 patients). These 127 patients included 67 patients (52.8%) with peripheral auditory damage and 60 patients (47.2%) with central and mixed auditory damage. The rate of abnormal BAEP was significantly increased in patients who also had mental retardation (P < 0.01). Logistic regression analysis showed that asphyxia (P < 0.05), jaundice,preterm delivery, low birth weight and the umbilical cord around the neck were closely correlated with abnormal EEG in patients with central coordination disorder. Intracranial hemorrhage, jaundice (P < 0.05),low birth weight and intrauterine infection (P < 0.05) were closely correlated with abnormal BAEP in patients with central coordination disorder.CONCLUSION: Central coordination disorder is often associated with abnormal EEG and BAEP. The rate of EEG or BAEP abnormality

  1. Safety and efficacy of topiramate in neonates with hypoxic ischemic encephalopathy treated with hypothermia (NeoNATI

    Directory of Open Access Journals (Sweden)

    Filippi Luca

    2012-09-01

    Full Text Available Abstract Background Despite progresses in neonatal care, the mortality and the incidence of neuro-motor disability after perinatal asphyxia have failed to show substantial improvements. In countries with a high level of perinatal care, the incidence of asphyxia responsible for moderate or severe encephalopathy is still 2–3 per 1000 term newborns. Recent trials have demonstrated that moderate hypothermia, started within 6 hours after birth and protracted for 72 hours, can significantly improve survival and reduce neurologic impairment in neonates with hypoxic-ischemic encephalopathy. It is not currently known whether neuroprotective drugs can further improve the beneficial effects of hypothermia. Topiramate has been proven to reduce brain injury in animal models of neonatal hypoxic ischemic encephalopathy. However, the association of mild hypothermia and topiramate treatment has never been studied in human newborns. The objective of this research project is to evaluate, through a multicenter randomized controlled trial, whether the efficacy of moderate hypothermia can be increased by concomitant topiramate treatment. Methods/Design Term newborns (gestational age ≥ 36 weeks and birth weight ≥ 1800 g with precocious metabolic, clinical and electroencephalographic (EEG signs of hypoxic-ischemic encephalopathy will be randomized, according to their EEG pattern, to receive topiramate added to standard treatment with moderate hypothermia or standard treatment alone. Topiramate will be administered at 10 mg/kg once a day for the first 3 days of life. Topiramate concentrations will be measured on serial dried blood spots. 64 participants will be recruited in the study. To evaluate the safety of topiramate administration, cardiac and respiratory parameters will be continuously monitored. Blood samplings will be performed to check renal, liver and metabolic balance. To evaluate the efficacy of topiramate, the neurologic outcome of enrolled newborns

  2. 拉玛泽呼吸法配合自由体位对产妇分娩的影响%Influence of Ramah ze breathing method combined with free position on maternity

    Institute of Scientific and Technical Information of China (English)

    李利; 涂素华; 何利萍

    2012-01-01

    [目的]探讨拉玛泽呼吸法配合自由体位对产妇分娩的影响.[方法]观察组120例产妇产程中应用拉玛泽呼吸法配合自由体位协助分娩;对照组120例产妇采取常规体位分娩,产程中未使用呼吸技巧,比较两组产妇产程及分娩结局.[结果]两组剧痛、总产程、活跃期的加速期、第二产程时间、胎儿宫内窘迫、新生儿窒息以及剖宫产率比较,差异有统计学意义(P<0.05或P<0.01).[结论]拉玛泽呼吸法配合自由体位能稳定产妇情绪,有效减轻产时疼痛,缩短产程,增加胎儿氧的供给量,降低胎儿宫内窘迫及新生儿窒息的发生,减少剖宫产率,促进自然分娩.%objective: To probe into the influence of Ramah ze breathing method combined with free position on maternity. Methods: 120 cases of maternal in observation group used Ramah ze breathing method combined with free position for assisting childbirth during labor; 120 cases of maternal in control group took conventional position for childbirth, breathing skills were not used during the labor, then the labor and birth outcomes were compared between the two groups. Results: There was statistically significant difference(P<0. 05 or P<0. 0l)in the sharp pain,the total labor, the accelerated phase of active phase,the time of the second stage of labor,fetal distress, neonatal asphyxia, and cesarean section rate between both groups. Conclusion: The Ramah ze breathing method combined with free position can make the maternal's mood stable,effectively alleviate labor pain,shorten labor,increase fetal oxygen supply,so as to reduce the incidence of fetal distress and neonatal asphyxia,reduce the rate of cesarean section and promote natural childbirth.

  3. Intracranial hemorrhage in full-term newborns: a hospital-based cohort study

    International Nuclear Information System (INIS)

    In recent years, intracranial hemorrhage (ICH) with parenchymal involvement has been diagnosed more often in full-term neonates due to improved neuroimaging techniques. The aim of this study is to describe clinical and neuroimaging data in the neonatal period and relate imaging findings to outcome in a hospital-based population admitted to a level 3 neonatal intensive care unit (NICU). From our neuroimaging database, we retrospectively retrieved records and images of 53 term infants (1991-2008) in whom an imaging diagnosis of ICH with parenchymal involvement was made. Clinical data, including mode of delivery, clinical manifestations, neurological symptoms, extent and site of hemorrhage, neurosurgical intervention, and neurodevelopmental outcomes, were recorded. Seventeen of the 53 term infants had infratentorial ICH, 20 had supratentorial ICH, and 16 had a combination of the two. Seizures were the most common presenting symptom (71.7%), another ten infants (18.9%) presented with apneic seizures, and five infants had no clinical signs but were admitted to our NICU because of perinatal asphyxia (n = 2), respiratory distress (n = 2), and development of posthemorrhagic ventricular dilatation (n = 1). Continuous amplitude-integrated electroencephalography recordings were performed in all infants. Clinical or subclinical seizures were seen in 48/53 (90.6%) infants; all received anti-epileptic drugs. Thirteen of all 53 (24.5%) infants died. The lowest mortality rate was seen in infants with supratentorial ICH (10%). Three infants with a midline shift required craniotomy, six infants needed a subcutaneous reservoir due to outflow obstruction, and three subsequently required a ventriculoperitoneal shunt. The group with poor outcome (death or developmental quotient (DQ) <85) had a significantly lower 5-min Apgar score (p =.006). Follow-up data were available for 37/40 survivors aged at least 15 months. Patients were assessed with the Griffiths Mental Developmental Scales

  4. Sexually transmitted diseases in Africa

    Directory of Open Access Journals (Sweden)

    A. De Schryver

    1990-01-01

    countries. An estimated 8-16% of women with untreated endocervical gonococcal or chlamydial infections will develop acute salpingitis following an ascending spread of these pathogens. After one episode of acute salpingitis approximately 10% of women may become infertile due to complete tubal occlusion. Similarly, the risk for women to develop an ectopic pregnancy after salpingitis is 6-10 times greater than in controls. Ectopic pregnancies in areas with insufficient health services carry a high mortality risk. Maternal infections with STD may not only have adverse effects on pregnancy outcome but may cause serious morbidity and mortality in the newborn (e.g. congenital syphilis, ophthalmia neonatorum, herpes simplex virus infection of the neonate, chlamydial pneumonia, congenital HIV infection. AIDS is an example "par excellence" of a sexually transmitted disease of public health importance requiring extensive clinical services and posing enormous financial and social problems for the individual and the society at large. AIDS and the other viral STD have greatly increased the interest in primary prevention strategies such as health education and behavioral modification, for the control of sexually transmitted diseases.

  5. Hereditary angioedema: classification, pathogenesis, and diagnosis.

    Science.gov (United States)

    Banerji, Aleena

    2011-01-01

    Hereditary angioedema (HAE) is a rare autosomal dominant genetic disorder associated with a deficiency in C1 inhibitor. More than 200 mutations in this gene, located on chromosome 11, have been identified. Although HAE is often inherited, 20-25% of cases are from new spontaneous mutations and they have no family history of swelling. Decreased C1 inhibitor activity leads to inappropriate activation of multiple pathways, including the complement and contact systems and the fibrinolysis and coagulation systems. Reduced C1 inhibitor activity results in increased activation of plasma kallikrein-kinin system proteases and increased bradykinin levels. Bradykinin is felt to be the main mediator of symptoms in HAE. Patients with HAE have recurrent episodes of swelling of the extremities, abdomen, face, and upper airway. Angioedema involving the gastrointestinal tract can lead to intestinal wall edema, which results in abdominal pain, nausea, vomiting, and diarrhea. Laryngeal swelling is life-threatening and may lead to asphyxia. Common triggers of an attack include trauma, stress, infection, menstruation, oral contraceptives, hormone replacement therapy, and angiotensin-converting enzyme inhibitors. Laboratory testing including C4, C1 inhibitor level, and function is needed to confirm or rule out the diagnosis of HAE. The treatment of HAE has improved significantly in recent years with the availability of several safe and effective therapies. Several consensus guidelines have been created to further assist in the management of HAE patients. This review will provide an update on the classification, pathophysiology, clinical presentation, and diagnosis of HAE. PMID:22221432

  6. Automatic classification of background EEG activity in healthy and sick neonates

    Science.gov (United States)

    Löfhede, Johan; Thordstein, Magnus; Löfgren, Nils; Flisberg, Anders; Rosa-Zurera, Manuel; Kjellmer, Ingemar; Lindecrantz, Kaj

    2010-02-01

    The overall aim of our research is to develop methods for a monitoring system to be used at neonatal intensive care units. When monitoring a baby, a range of different types of background activity needs to be considered. In this work, we have developed a scheme for automatic classification of background EEG activity in newborn babies. EEG from six full-term babies who were displaying a burst suppression pattern while suffering from the after-effects of asphyxia during birth was included along with EEG from 20 full-term healthy newborn babies. The signals from the healthy babies were divided into four behavioural states: active awake, quiet awake, active sleep and quiet sleep. By using a number of features extracted from the EEG together with Fisher's linear discriminant classifier we have managed to achieve 100% correct classification when separating burst suppression EEG from all four healthy EEG types and 93% true positive classification when separating quiet sleep from the other types. The other three sleep stages could not be classified. When the pathological burst suppression pattern was detected, the analysis was taken one step further and the signal was segmented into burst and suppression, allowing clinically relevant parameters such as suppression length and burst suppression ratio to be calculated. The segmentation of the burst suppression EEG works well, with a probability of error around 4%.

  7. A clinically relevant model of perinatal global ischemic brain damage in rats.

    Science.gov (United States)

    Yang, Ting; Zhuang, Lei; Terrando, Niccolò; Wu, Xinmin; Jonhson, Mark R; Maze, Mervyn; Ma, Daqing

    2011-04-01

    We have designed a clinically relevant model of perinatal asphyxia providing intrapartum hypoxia in rats. On gestation day 22 SD rats were anesthetized and the uterine horns were exteriorized and placed in a water bath at 37°C for up to 20min. After this, pups were delivered from the uterus and manually stimulated to initiate breathing in an incubator at 37°C for 1 h in air. Brains were harvested and stained with cresyl violet, caspase-3, and TUNEL to detect morphological and apoptotic changes on postnatal days (PND) 1, 3, and 7. Separate cohorts were maintained until PND 50 and tested for learning and memory using Morris water maze (WM). Survival rate was decreased with longer hypoxic time, and 100% mortality was noted when hypoxia time was beyond 18min. Apoptosis was increased with the duration of hypoxia with neuronal loss and cell shrinkage in the CA1 of hippocampus. The time taken for the juveniles to locate the hidden platform during WM was increased in animals subjected to hypoxia. These data demonstrate that perinatal ischemic injury leads to neuronal death in the hippocampus and long-lasting cognitive dysfunction. This model mimics hypoxic ischemic encephalopathy in humans and may be appropriate for investigating therapeutic interventions. PMID:21281606

  8. Final report on the Controlled Cold Helium Spill Test in the LHC tunnel at CERN

    CERN Document Server

    Dufay-Chanat, L; Casas-Cubillos, J; Chorowski, M; Grabowski, M; Jedrusyna, A; Lindell, G; Nonis, M; Koettig, T; Vauthier, N; van Weelderen, R; Winkler, T

    2015-01-01

    The 27 km circumference LHC underground tunnel is a space in which the helium cooled LHC magnets are installed. The vacuum enclosures of the superconducting magnets are protected by over-pressure safety relief devices that open whenever cold helium escapes either from the magnet cold enclosure or from the helium supply headers, into this vacuum enclosure. A 3-m long no stay zone around these devices is defined based on scale model studies, protecting the personnel against cold burns or asphyxia caused by such a helium release event. Recently, several simulation studies have been carried out modelling the propagation of the helium/air mixture, resulting from the opening of such a safety device, along the tunnel. The released helium flows vary in the range between 1 kg/s and 0.1 kg/s. To validate these different simulation studies, real life mock-up tests have been performed inside the LHC tunnel, releasing helium flow rates of 1 kg/s, 0.3 kg/s and 0.1 kg/s. For each test, up to 1000 liters of liquid helium wer...

  9. The etiology of neonatal sepsis and patterns of antibiotic resistance

    International Nuclear Information System (INIS)

    Objective: To study the patterns of causative bacteria and antibiotic resistance in neonatal sepsis. Results: Among 228 cases included in the study, the male to female ratio was 2.1 to 1. The gestational age was less than 36 weeks in 68 (30%) cases and low birth weight babies were 143 (62.6%). History of birth asphyxia was present in 103 (45%) cases. There were 142 (62.3%) cases of early onset (7 days). Out of 233 positive blood cultures Escherichia coli was found to be commonest (47.8%, n =111, p<0.05) both in early onset (47.8%, n=68, p <0.05) and late onset sepsis (47.3%,n=43, p<0.05). Staphylococcus aureus was the most common among gram positive organism. Resistance to cefotaxime, ceftazidime and amikacin was 34% to 80% and to ciprofloxacin 13% to 72%. A total of 64 cases (28%) died. Mortality was four times higher in early onset sespis. Conclusion: Gram negative bacteria are the commenst cause of neonatal sepsis. The resistance to the commonly used antibiotics is alarmingly high. Mortality is four times higher in early one set sepsis. (author)

  10. Airtraq喉镜的临床应用与研究进展%The clinical application and research progress of airtraq laryngoscope

    Institute of Scientific and Technical Information of China (English)

    杨广遂

    2013-01-01

    Airtraq喉镜是一次性使用气管插管工具,无需口、咽、气管三轴线的重合即能提供高质量的声门图像.Airtraq在常规或困难气道方面优于传统的Macintosh喉镜.成功应用于大量的困难气道病例,包括病态肥胖、创伤后窒息.此外,该喉镜也成功应用于普通或困难气道的经鼻气管插管及清醒插管.%The Airtraq laryngoscope (Prodol Meditec S.A.,Vizcaya,Spain) is a disposable tracheal intubation device.It was designed to provide a high quality view of the glottis without the need to align the oral,pharyngeal and tracheal axes.A number of reports suggested that use of the Airtraq laryngoscope may be superior to the Macintosh laryngoscope in patients in routine airway management and/or increased risk for difficult intubation.The Airtraq was used successfully in a number of cases with difficult airway management,including morbid obesity,posttraumatic asphyxia.In addition,this device has been used successfully for nasotracheal intubation (NTI) in an uncomplicated or difficult airway,as well as awake tracheal intubation.

  11. Foetal scalp blood sampling during labour for pH and lactate measurements.

    Science.gov (United States)

    Carbonne, Bruno; Pons, Kelly; Maisonneuve, Emeline

    2016-01-01

    Second-line methods of foetal monitoring have been developed in an attempt to reduce unnecessary interventions due to continuous cardiotocography (CTG), and to better identify foetuses that are at risk of intrapartum asphyxia. Very few studies directly compared CTG with foetal scalp blood (FBS) and CTG only. Only one randomised controlled trial (RCT) was published in the 1970s and had limited power to assess neonatal outcome. Direct and indirect comparisons conclude that FBS could reduce the number of caesarean deliveries associated with the use of continuous CTG. The main drawbacks of FBS are its invasive and discontinuous nature and the need for a sufficient volume of foetal blood for analysis, especially for pH measurement, resulting in failure rates reaching 10%. FBS for lactate measurement became popular with the design of test-strip devices, requiring <0.5 mL of foetal blood. RCTs showed similar outcomes with the use of FBS for lactates compared with pH in terms of obstetrical interventions and neonatal outcomes. In conclusion, there is some evidence that FBS reduces the need for operative deliveries. However, the evidence is limited with regard to actual standards, and large RCTs, directly comparing CTG only with CTG with FBS, are still needed. PMID:26253238

  12. [Case of intrauterine retardation and fetal death during labor].

    Science.gov (United States)

    Frundeva, B; Dimitrova, V; Museva, A; Dimitrov, A; Zlatkov, V

    2014-01-01

    The case concerns to a 37 years old pregnant woman with a history of three miscarriages. Ultrasound biometry in early pregnancy corresponds to the term calculated according the last menstrual period (LMP). At 37 week of gestation was determined retardation of 5 weeks. Doppler velocimetry and quantity of amniotic fluid were in normal ranges and the pregnant refused hospitalization. She was admitted to the hospital three days after the appointed term without uterine contractions. The fetal ultrasound biometry meets 33 weeks and the Doppler examination of a. umbilicalis found resistance index (RI) of the upper limit of normal. The cardiotocography record shows: baseline fetal heart rate--143 beats/min, good variability and reactivity. There was one deceleration for 3 minutes, and then the recording returns to normal. Re-monitoring after 30 minutes establishes of a periodic decelerations and a tendency to bradycardia with reserved variability. At the start of the emergency Cesarean Section fetal heart beats are single. The delivered babe was with Apgar O. The reanimation was not successful and the fetus died. From the autopsy signs of severe asphyxia. In conclusion, it can be assumed that in strongly retarded fetuses, cardiotocography recording and Doppler velosimetry are not sufficiently reliable methods for continued monitoring. In late-onset and severe intrauterine growth retardation (IUGR) desirable delivery time is after reaching biological maturity at 36-37 week. PMID:25558672

  13. [A careful course of action in a conflict regarding useful treatment of a newborn infant with severe brain damage].

    Science.gov (United States)

    van Beek, R H T; Buiting, H P J; de Haan, F H; van Goudoever, J B

    2005-11-26

    In a newborn female infant, it was concluded that severe perinatal asphyxia had caused such extensive cerebral damage that further medical treatment was useless. Based on their religious beliefs, the parents disagreed, despite the fact that the requested second opinions supported the conclusion of the medical staff. Since the parents persisted, a period of inurement was agreed upon during which reanimation would be performed if necessary. After several months, there was no change in the attitude of the parents towards the policy not to reanimate, even though it was clear that there was no improvement whatsoever in the patient's neurological status, while everyone agreed that she showed signs of increased suffering. The decision regarding the determination of a situation in which further medical treatment was useless was re-evaluated carefully. In a legal procedure started by the parents, the judge supported the decision of the attending physicians. In order to prevent the parents from taking their child home, in which case a situation could arise in which she would be deprived of adequate sedation or analgesia, which the attending physicians were obliged to provide, the Dutch Child Protection Council was consulted and the parents were deprived of their parental authority. Ultimately, the patient died suddenly due to respiratory and circulatory arrest without another situation in which reanimation might have been indicated. PMID:16358621

  14. Gill infection of Leporinus macrocephalus Garavello & Britski, 1988 (Osteichthyes: Anostomidae by Henneguya leporinicola n. sp. (Myxozoa: Myxobolidae. Description, histopathology and treatment

    Directory of Open Access Journals (Sweden)

    MARTINS M. L.

    1999-01-01

    Full Text Available Piauçus (Leporinus macrocephalus, were raised in 300 m² ponds (density of 10 fish/m² presenting asphyxia signals and daily mortality of 27 fishes. Specimens with 8-cm total body length, were collected for necropsy. Mucus of body surface and pieces of organs were collected and examined microscopically, in wet mounts, stained or in histological sections. The smears examination showed the presence of several spores in the secondary lamellae of the gill filaments, identified as Henneguya leporinicola n.sp (Myxozoa: Myxobolidae. Histopatological study showed epithelial hyperplasia and fulfilling of the spaces between the secondary lamellae, congestion and teleangiectasia sinusoidal. It was also observed hyperplasia of the goblet cells and several cysts of parasite with 70.3mum diameter. Such cysts were situated among the secondary lamellae, covered or not by the hyperplasic epithelium. With this diagnostic, three applications of formalin solution 10 ml/m³ were carried out. Fifteen days after that, fish were examined again to ascertain whether the treatment was efficient on disease caused by the protozoa. The tissue alterations present in the gills after the treatment were just a moderate sinusoidal congestion and a slight epithelial hyperplasia on the base of the secondary lamellae.

  15. The relationships between neonatal encephalopathy and cerebral palsy: a cohort study.

    Science.gov (United States)

    Evans, K; Rigby, A S; Hamilton, P; Titchiner, N; Hall, D M

    2001-03-01

    There is a high risk of cerebral palsy (CP) following neonatal encephalopathy (NE) with fits, often attributed to intrapartum asphyxia. The evidence for the association is inconclusive and antepartum factors offer an alternative explanation. A cohort study was carried out to assess the evidence for and against hypoxic ischaemic injury as the cause of NE-associated CP in term infants. A total of 57 159 consecutive births were enrolled. There were 150 cases with NE, of whom 92 had at least one fit and 58 had no fits. The incidence of all NE was 2.62 per 1000 births and of NE with fits was 1.61 per 1000 births. Infants with NE were followed-up to identify those with cerebral palsy. There were 13 cases of four-limb cerebral palsy and three with hemiplegia among the survivors. In 12 of the 13 cases of four-limb CP, a combination of low Apgar scores, an early onset acute evolving encephalopathy, acidosis, renal dysfunction and the absence of antepartum factors suggested an acute intrapartum event as the immediate cause of the NE. An obstetric event likely to cause acute hypoxic injury was identified in four of the 12 cases. The clinical picture was similar in the four with and the eight without a specific obstetric event. The pathway leading to NE-associated CP remains unexplained, but intrapartum events appear to play a major role in most cases. PMID:12521875

  16. Treatment of one case of cerebral palsy combined with posterior visual pathway injury using autologous bone marrow mesenchymal stem cells

    Directory of Open Access Journals (Sweden)

    Li Min

    2012-05-01

    Full Text Available Abstract Background Cerebral palsy is currently one of the major diseases that cause severe paralysis of the nervous system in children; approximately 9–30% of cerebral palsy patients are also visually impaired, for which no effective treatment is available. Bone marrow mesenchymal stem cells (BMSCs have very strong self-renewal, proliferation, and pluripotent differentiation potentials. Therefore, autologous BMSC transplantation has become a novel method for treating cerebral palsy. Methods An 11-year-old boy had a clear history of dystocia and asphyxia after birth; at the age of 6 months, the family members observed that his gaze roamed and noted that he displayed a lack of attention. A brain MRI examination at the age of 7 years showed that the child had cerebral palsy with visual impairment (i.e., posterior visual pathway injury. The patient was hospitalized for 20 days and was given four infusions of intravenous autologous BMSCs. Before transplantation and 1, 6, and 12 months after transplantation, a visual evoked potential test, an electrocardiogram, routine blood tests, and liver and kidney function tests were performed. Results The patient did not have any adverse reactions during hospitalization or postoperative follow-up. After discharge, the patient could walk more smoothly than he could before transplantation; furthermore, his vision significantly improved 6 months after transplantation, which was also supported by the electrophysiological examinations. Conclusions The clinical application of BMSCs is effective for improving vision in a patient with cerebral palsy combined with visual impairment.

  17. Learning and Memory Recoveries in a Young Girl Treated with Growth Hormone and Neurorehabilitation.

    Science.gov (United States)

    Devesa, Jesús; Lema, Hortensia; Zas, Eva; Munín, Borja; Taboada, Pilar; Devesa, Pablo

    2016-01-01

    Background-To describe the results obtained after treating a non growth hormone-deficient 10-year-old girl who suffered asphyxia during delivery, resulting in important cognitive deficits, with growth hormone (GH) and neurorehabilitation. Methods-GH was administered (mg/day) at doses of 0.5 over three months followed by 0.9, every two weeks over three months, and then alternating 1.2 three days/week and 0.3 two days/week. Neurorehabilitation consisted of daily sessions of neurostimulation, speech therapy, occupational therapy and auditive stimulation. Treatment lasted nine months. Results-Scores obtained in all the areas treated showed that, at discharge, the patient clearly increased her cognitive abilities, memory and language competence index; her intelligence quotient score increased from 51 to 80, and the index of functional independence measure reached a value of 120 over 126 (maximal value). Conclusions-This case suggests that GH administration may play a role in improving cognitive deficits during neurorehabilitation in children with brain damage suffered during delivery. This agrees with the known effects of GH on cognition. PMID:26821051

  18. The oral motor capacity and feeding performance of preterm newborns at the time of transition to oral feeding

    Directory of Open Access Journals (Sweden)

    M.A. Bauer

    2008-10-01

    Full Text Available The objective of the present study was to determine the oral motor capacity and the feeding performance of preterm newborn infants when they were permitted to start oral feeding. This was an observational and prospective study conducted on 43 preterm newborns admitted to the Neonatal Intensive Care Unit of UFSM, RS, Brazil. Exclusion criteria were the presence of head and neck malformations, genetic disease, neonatal asphyxia, intracranial hemorrhage, and kernicterus. When the infants were permitted to start oral feeding, non-nutritive sucking was evaluated by a speech therapist regarding force (strong vs weak, rhythm (rapid vs slow, presence of adaptive oral reflexes (searching, sucking and swallowing and coordination between sucking, swallowing and respiration. Feeding performance was evaluated on the basis of competence (defined by rate of milk intake, mL/min and overall transfer (percent ingested volume/total volume ordered. The speech therapist's evaluation showed that 33% of the newborns presented weak sucking, 23% slow rhythm, 30% absence of at least one adaptive oral reflex, and 14% with no coordination between sucking, swallowing and respiration. Mean feeding competence was greater in infants with strong sucking fast rhythm. The presence of sucking-swallowing-respiration coordination decreased the days for an overall transfer of 100%. Evaluation by a speech therapist proved to be a useful tool for the safe indication of the beginning of oral feeding for premature infants.

  19. Clinical Uses of Melatonin in Pediatrics

    Directory of Open Access Journals (Sweden)

    Emilio J. Sánchez-Barceló

    2011-01-01

    Full Text Available This study analyzes the results of clinical trials of treatments with melatonin conducted in children, mostly focused on sleep disorders of different origin. Melatonin is beneficial not only in the treatment of dyssomnias, especially delayed sleep phase syndrome, but also on sleep disorders present in children with attention-deficit hyperactivity, autism spectrum disorders, and, in general, in all sleep disturbances associated with mental, neurologic, or other medical disorders. Sedative properties of melatonin have been used in diagnostic situations requiring sedation or as a premedicant in children undergoing anesthetic procedures. Epilepsy and febrile seizures are also susceptible to treatment with melatonin, alone or associated with conventional antiepileptic drugs. Melatonin has been also used to prevent the progression in some cases of adolescent idiopathic scoliosis. In newborns, and particularly those delivered preterm, melatonin has been used to reduce oxidative stress associated with sepsis, asphyxia, respiratory distress, or surgical stress. Finally, the administration of melatonin, melatonin analogues, or melatonin precursors to the infants through the breast-feeding, or by milk formula adapted for day and night, improves their nocturnal sleep. Side effects of melatonin treatments in children have not been reported. Although the above-described results are promising, specific studies to resolve the problem of dosage, formulations, and length of treatment are necessary.

  20. Determining Optimal Strategies to Reduce Maternal and Child Mortality in Rural Areas in Western China: an Assessment Using the Lives Saved Tool.

    Science.gov (United States)

    Jiang, Zhen; Guo, Su Fang; Scherpbier, Robert W; Wen, Chun Mei; Xu, Xiao Chao; Guo, Yan

    2015-08-01

    China, as a whole, is about to meet the Millennium Development Goals for reducing the maternal mortality ratio (MMR) and infant mortality rate (IMR), but the disparities between rural area and urban area still exists. This study estimated the potential effectiveness of expanding coverage with high impact interventions using the Lives Saved Tool (LiST). It was found that gestational hypertension, antepartum and postpartum hemorrhage, preterm birth, neonatal asphyxia, and neonatal childhood pneumonia and diarrhea are still the major killers of mothers and children in rural area in China. It was estimated that 30% of deaths among 0-59 month old children and 25% of maternal deaths in 2008 could be prevented in 2015 if primary health care intervention coverage expanded to a feasible level. The LiST death cause framework, compared to data from the Maternal and Child Mortality Surveillance System, represents 60%-80% of neonatal deaths, 40%-50% of deaths in 1-59 month old children and 40%-60% of maternal deaths in rural areas of western China. PMID:26383598

  1. Discussion of the Diversified Nursing Intervention in the Application of Pregnancy-induced Hypertension Disease%多元化护理干预在妊娠高血压疾病中的应用探讨

    Institute of Scientific and Technical Information of China (English)

    金莉

    2014-01-01

    目的:探讨多元化护理干预对妊娠高血压疾病患者的影响,总结其方法。方法将68例妊高症患者随机分为对照组和干预组各34例,对照组给予常规护理,干预组给予多元化护理措施,比较两组产妇的妊娠结局和新生儿情况。结果干预组孕产妇早产、产后出血、胎盘早剥发生率明显低于对照组(P0.05);干预组新生儿体重及Apgar评分显著高于对照组( P0. 05 ) . While the birth weight and Apgar score of intervention group was significantly higher than the control group (P<0. 01), the incidence of fetal distress and neonatal asphyxia of the intervention group was lower than the control group (P<0. 05), and the difference was statistically significant. Conclusion By implementing diversified nursing intervention in patients with pregnancy-induced hypertension, the pregnancy outcomes can be changed, the incidence of maternal and infant complications can be reduced, and the quality of maternal and child survival rate can be improved, with great clinical application value.

  2. Essential basic and emergency obstetric and newborn care: from education and training to service delivery and quality of care.

    Science.gov (United States)

    Otolorin, Emmanuel; Gomez, Patricia; Currie, Sheena; Thapa, Kusum; Dao, Blami

    2015-06-01

    Approximately 15% of expected births worldwide will result in life-threatening complications during pregnancy, delivery, or the postpartum period. Providers skilled in emergency obstetric and newborn care (EmONC) services are essential, particularly in countries with a high burden of maternal and newborn mortality. Jhpiego and its consortia partners have implemented three global programs to build provider capacity to provide comprehensive EmONC services to women and newborns in these resource-poor settings. Providers have been educated to deliver high-impact maternal and newborn health interventions, such as prevention and treatment of postpartum hemorrhage and pre-eclampsia/eclampsia and management of birth asphyxia, within the broader context of quality health services. This article describes Jhpiego's programming efforts within the framework of the basic and expanded signal functions that serve as indicators of high-quality basic and emergency care services. Lessons learned include the importance of health facility strengthening, competency-based provider education, global leadership, and strong government ownership and coordination as essential precursors to scale-up of high impact evidence-based maternal and newborn interventions in low-resource settings. PMID:26115858

  3. Ocular problems in children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Esra Ayhan Tuzcu

    2012-09-01

    Full Text Available The aim of this study is to evaluate eye problemsin children with cerebral palsy in our region.Materials and Methods: 90 patients which was diagnosedas cerebral palsy, treated and followed up in PediatricNeurology Department of Mustafa Kemal University,were included to this study. The history was taken, anda physical examination was performed to determine theetiology of the disease and type of SP. All of the patientswere underwent a detailed ophthalmological examinationincluding visual acuity, refractive error, amblyopia, strabismus,nystagmus and fundus examination.Results: Totally 90 patients, 51 male and 39 female,were included to the study. When the etiologic factorswere evaluated, the asphyxia was seen in 33.3% of thepatients. The most common type of cerebral palsy wasspastic quadriplegia at the rate of 43.3%. Eye problemswere detected in 60% of our cases. Of this, 54.4% wererefractive errors, 35.6% were strabismus, and 22.2%were optic nerve pathologies. Amblyopia was found in11.1% of cases. Although strabismus is more common inspastic diplegia type of cerebral palsy, there was no statisticallysignificant differenceConclusions: In conclusion, eye problems are commonin children with cerebral palsy. Therefore, we recommendroutine eye examination in these patients due to be beneficialin reducing the detection and communication difficulties.Key words: Cerebral palsy, refractive error, strabismus,optic atrophy

  4. Advances in pediatrics in 2014: current practices and challenges in allergy, gastroenterology, infectious diseases, neonatology, nutrition, oncology and respiratory tract illnesses.

    Science.gov (United States)

    Caffarelli, Carlo; Santamaria, Francesca; Cesari, Silvia; Sciorio, Elisa; Povesi-Dascola, Carlotta; Bernasconi, Sergio

    2015-01-01

    Major advances in the conduct of pediatric practice have been reported in the Italian Journal of Pediatrics in 2014. This review highlights developments in allergy, gastroenterology, infectious diseases, neonatology, nutrition, oncology and respiratory tract illnesses. Investigations endorse a need to better educate guardians and improve nutritional management in food allergy. Management of hyperbilirubinemia in neonates and of bronchiolitis have been improved by position statements of scientific societies. Novel treatments for infant colic and inflammatory bowel diseases have emerged. Studies suggest the diagnostic utility of ultrasonography in diagnosing community-acquired pneumonia. Progress in infectious diseases should include the universal varicella vaccination of children. Recommendations on asphyxia and respiratory distress syndrome have been highlighted in neonatology. Studies have evidenced that malnutrition remains a common underestimated problem in developing countries, while exposure to cancer risk factors in children is not negligible in Western countries. Advances in our understanding of less common diseases such as cystic fibrosis, plastic bronchitis, idiopathic pulmonary hemosiderosis facilitate diagnosis and management. Researches have led to new therapeutic approaches in patent ductus arteriosus and pediatric malignancies. PMID:26518317

  5. Structural and Perfusion Abnormalities of Brain on MRI and Technetium-99m-ECD SPECT in Children With Cerebral Palsy: A Comparative Study.

    Science.gov (United States)

    Rana, Kamer Singh; Narwal, Varun; Chauhan, Lokesh; Singh, Giriraj; Sharma, Monica; Chauhan, Suneel

    2016-04-01

    Cerebral palsy has traditionally been associated with hypoxic ischemic brain damage. This study was undertaken to demonstrate structural and perfusion brain abnormalities. Fifty-six children diagnosed clinically as having cerebral palsy were studied between 1 to 14 years of age and were subjected to 3 Tesla magnetic resonance imaging (MRI). Brain and Technetium-99m-ECD brain single-photon emission computed tomography (SPECT) scan. Male to female ratio was 1.8:1 with a mean age of 4.16 ± 2.274 years. Spastic cerebral palsy was the most common type, observed in 91%. Birth asphyxia was the most common etiology (69.6%). White matter changes (73.2%) such as periventricular leukomalacia and corpus callosal thinning were the most common findings on MRI. On SPECT all cases except one revealed perfusion impairments in different regions of brain. MRI is more sensitive in detecting white matter changes, whereas SPECT is better in detecting cortical and subcortical gray matter abnormalities of perfusion. PMID:26353878

  6. VON RECKLINGHAUSEN’S DISEASE ASSOCIATED WITH PAPILARY THYROID CARCINOMA AND MALIGNANT MELANOMA WITH MULTIPLE METASTASIS – CASE REPORT

    Directory of Open Access Journals (Sweden)

    D. Niculescu

    2006-04-01

    Full Text Available We present the case of a 56 years old, women, known with Recklinghausen’s Disease (RD since 15 years old. She was in the evidence of Iasi Endocrynology Clinic with nodulary goitre since ’97, being treated with Euthyrox until 2005. Due to symptomatology worsening (asphyxia feeling, agitation, palpitations, insomnia, irritability, dizziness and to thyroid increase the surgical procedure was recommended. A right lobeisthmectomy was performed in 2005, but the Histopathology Exam revealed an occult Papillary Thyroid Carcinoma (PTC pT1NxMxG1 (sclerous infiltrative 3 mm node on joint nodular goitre with metaplasia, hemorrhage, sclero hyalinisation and lymphomatous thyroiditis aspects. She was treated with L Thyroxin, chemotherapy (Cisplatinum, Dacarbazin and radioactive iodine therapy. After oncological evaluation she was addressed to the First Surgery Clinic for thyroidectomy totalisation and the treatment of an umbilical tumour occurred after the fourth cure (June-July 2005. The patient was evaluated by physical exam, ultrasonography and computed tomography (cervical and abdominal which revealed tumours in the cervical region and in the liver. Thyroidectomy totalisation with limphadenectomy and an abdominal laparoscopy and biopsy were performed. The pathologic exam diagnosed multiple metastasis of malignant melanoma (MM localized in the cervical region, in the liver, great omentum and cervical limphatic nodes. The postoperative follow-up revealed multiple bone mestastasis from the malignanat melanoma. The case particularities were: association of RD with 2 primitive malignant tumours (occult PTC and MM, both diagnosed histopathologically and the multiple bone metastasis developed in a short time.

  7. The influence of the perinatal environment on the heart: morphological, electrocardiographic, and multimodality imaging features

    Directory of Open Access Journals (Sweden)

    Giuseppe Mercuro

    2015-10-01

    Full Text Available The purpose of this paper is to review the studies performed to evaluate the influence of perinatal environment on neonatal heart, detected by electrocardiography, echocardiography, and other imaging techniques. Prenatal conditions (such as intrauterine growth retardation and prematurity at birth and some post-natal events (such as perinatal asphyxia and corticosteroids administration, may have early and late detrimental effects on the heart may predispose to a number of future cardiovascular adverse events. For example, subjects born preterm may be at potentially higher risk of developing malignant ventricular arrhythmias as well. Moreover, in individuals born with an extremely low birthweight atrial septal aneurysms are present in about one third of the subjects in the study. Thus, a long-life follow up is suggested in these subjects.Proceedings of the 11th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy · October 26th-31st, 2015 · From the womb to the adultGuest Editors: Vassilios Fanos (Cagliari, Italy, Michele Mussap (Genoa, Italy, Antonio Del Vecchio (Bari, Italy, Bo Sun (Shanghai, China, Dorret I. Boomsma (Amsterdam, the Netherlands, Gavino Faa (Cagliari, Italy, Antonio Giordano (Philadelphia, USA

  8. Challenges in the management of early versus late presenting congenital diaphragmatic hernia in a poor resource setting

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    Abubakar Auwal

    2011-01-01

    Full Text Available Background: Despite the advances in management, congenital diaphragmatic hernia (CDH has continued to pose a significant challenge to paediatric surgeons. This is amplified in a setting like ours where there is a dearth of facilities to cope with the problem of CDH. This study was undertaken to highlight the peculiarities of the management of CDH in a poor resource setting. Methods: All confirmed cases of CDH were prospectively documented from 2003 till date. Results: Seven children were treated from 2003 till date. The diaphragmatic defect was on the left side in six (83.8% and on the right side in one (17.7%. All the patients had primary closure of the defect without patch via an abdominal approach. The three patients presenting at birth died while the remaining four patients survived. Conclusion: With inadequate neonatal intensive care facilities, the severe early presenting CDH has a dismal prognosis. In contrast, the late presenting CDH poses more diagnostic challenges; but once identified and appropriate treatment instituted, it has an excellent prognosis. We recommend that physicians should include CDH in the differential diagnosis of patients with birth asphyxia and in patients with chronic respiratory symptoms with failure to thrive.

  9. Utilidad de la determinación de la fracción I de la Troponina cardíaca (cTnI, en el diagnóstico de la muerte súbita de origen cardíaco en autopsias forenses Usefulness of cardiac troponin I (cTnI in the diagnosis of sudden cardiac death in forensic autopsies

    Directory of Open Access Journals (Sweden)

    E. Navarro

    2007-07-01

    Full Text Available Objetives: To evaluate practical usefulness of cardiac Troponin analysis (cTnI in peripheral blood levels, in order to improve diagnosis of sudden cardiac death in routine forensic cases. Comparing these levels with Myoglobin and MB-CK blood levels in the same type of samples. Material and methods: We have studied 97 medico legal autopsies performed in the Pathology Service of the Institute of Legal Medicine (Alicante. In every case we analyzed sample of serum from peripheral blood (femoral, by Microparticle Enzyme Immunoassay (MEIA Axsym system (Abbott Diagnostics. Causes of death were classified into 6 groups according: 1 Death of cardiac origin (n=42; 2 Traumatic deaths (n=19; 3 Death by asphyxia (n=12; 4 Natural deaths of non-cardiac origin (n=8; 5 Miscellaneous group (n=6, and 6 Traumatic death with Thoracic trauma (n=10. Data was analysed by means of SPSS 14.0 statistical software program (SPSS Inc, 2005. Results: cTnI levels were significantly high in cases of sudden cardiac death, but it were also high in the group of thoracic trauma, which could raise diagnosis problems between these groups, as was shown previously in the literature. Conclusions: The determination of cTnI is more efficient than CKMB and Myoglobine in the diagnosis of sudden cardiac death. However, the elevation of mean levels of this marker in cases of severe thoracic traumatism limits its diagnostic usefulness in these situations.

  10. Learning and Memory Recoveries in a Young Girl Treated with Growth Hormone and Neurorehabilitation

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    Jesús Devesa

    2016-01-01

    Full Text Available Background—To describe the results obtained after treating a non growth hormone-deficient 10-year-old girl who suffered asphyxia during delivery, resulting in important cognitive deficits, with growth hormone (GH and neurorehabilitation. Methods—GH was administered (mg/day at doses of 0.5 over three months followed by 0.9, every two weeks over three months, and then alternating 1.2 three days/week and 0.3 two days/week. Neurorehabilitation consisted of daily sessions of neurostimulation, speech therapy, occupational therapy and auditive stimulation. Treatment lasted nine months. Results—Scores obtained in all the areas treated showed that, at discharge, the patient clearly increased her cognitive abilities, memory and language competence index; her intelligence quotient score increased from 51 to 80, and the index of functional independence measure reached a value of 120 over 126 (maximal value. Conclusions—This case suggests that GH administration may play a role in improving cognitive deficits during neurorehabilitation in children with brain damage suffered during delivery. This agrees with the known effects of GH on cognition.

  11. Umbilical artery doppler velocimetry: a valuable tool for antenatal fetal surveillance

    International Nuclear Information System (INIS)

    To determine umbilical artery Doppler velocity parameter systolic: diastolic ratio (S/D ratio) relation with fetal well being and outcome. Setting: Department of Obstetrics and Gynecology, Lady Willingdon Hospital, Lahore Duration of study: Six months from 27-02-2008 to 26-08-2008. Subjects and methods: Sixty patients fulfilling the inclusion criteria were included in this study. They were subdivided into two groups. Group 'A' included 30 normal pregnant women with no medical or obstetrical risk factors and group 'B' included 30 pregnant women having risk factors like, hypertension, diabetes, Rhesus incompatibility, discordant twins, intrauterine growth restriction and non immunehydropsfetalis. Results: In comparison of S/D ratio with risk factors it was observed that S/D ratio 3 was present in 19 patients (31.6%) in pregnancy with hypertension/preeclampsia, 3 patients (5%) with diabetes mellitus, 11 patients (18.3%) with intrauterine growth restriction, 15 patients (25.0%) with oligohydramnios and only 1 patient (1.6%) with twin pregnancy. It was observed that women with S/D ratio 3 S/D ratio delivered 10 neonates (16.6%) with <4 Apgar score at 1 minute, 23 (38.3%) with <6 score at 5 minutes and 23 neonates (38.3%) needed resuscitation, 21 (35.0%) were admitted to neonatal unit for asphyxia. Conclusion: Umbilical artery Doppler studies is an integral tool while evaluating health of high risk pregnancies. However, it is not appropriate as a screening tool for low risk pregnancies. (author)

  12. Blood brain barrier is impermeable to solutes and permeable to water after experimental pediatric cardiac arrest.

    Science.gov (United States)

    Tress, Erika E; Clark, Robert S B; Foley, Lesley M; Alexander, Henry; Hickey, Robert W; Drabek, Tomas; Kochanek, Patrick M; Manole, Mioara D

    2014-08-22

    Pediatric asphyxial cardiac arrest (CA) results in unfavorable neurological outcome in most survivors. Development of neuroprotective therapies is contingent upon understanding the permeability of intravenously delivered medications through the blood brain barrier (BBB). In a model of pediatric CA we sought to characterize BBB permeability to small and large molecular weight substances. Additionally, we measured the percent brain water after CA. Asphyxia of 9 min was induced in 16-18 day-old rats. The rats were resuscitated and the BBB permeability to small (sodium fluorescein and gadoteridol) and large (immunoglobulin G, IgG) molecules was assessed at 1, 4, and 24 h after asphyxial CA or sham surgery. Percent brain water was measured post-CA and in shams using wet-to-dry brain weight. Fluorescence, gadoteridol uptake, or IgG staining at 1, 4h and over the entire 24 h post-CA did not differ from shams, suggesting absence of BBB permeability to these solutes. Cerebral water content was increased at 3h post-CA vs. sham. In conclusion, after 9 min of asphyxial CA there is no BBB permeability over 24h to conventional small or large molecule tracers despite the fact that cerebral water content is increased early post-CA indicating the development of brain edema. Evaluation of novel therapies targeting neuronal death after pediatric CA should include their capacity to cross the BBB. PMID:24937271

  13. Neonatal intracranial hemorrhages (perinatal onset)

    International Nuclear Information System (INIS)

    1. We have reviewed 34 cases of neonatal intracranial hemorrhages (perinatal onset, 23 mature and 11 premature infants) experienced in 10-year period from 1971 to 1980, with special reference to gestational age, birth weight, type of delivery, presence or absence of asphyxia, symptoms and cause of death. 2. Regarding 9 autopsied cases and 7 cases diagnosed by CT-scan, 10 mature infants composed of 3 subarachnoid hemorrhages, 2 intraventricular hemorrhages, 2 subdural hematomas, 2 intracerebral and 1 subependymal hemorrhage; 6 premature infants consisted of 4 subependymal hemorrhages with ventricular rupture and 2 subarachnoid hemorrhages. Most of them presented with respiratory distress, vomiting and convulsive seizures which developed within 5 days after birth. 3. Poor outcome including death amounted 49% of mature and 63% of premature infants. Along with degree of intracranial hematoma, prematurity and pulmonary complication were felt to be important prognostic factors. 4. Introduction of CT-scan led to prompt diagnosis and treatment, thus lowering mortality rate of neonatal intracranial hemorrhages. (author)

  14. Preeclampsia complicated by advanced maternal age: a registry-based study on primiparous women in Finland 1997–2008

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    Lamminpää Reeta

    2012-06-01

    Full Text Available Abstract Background Preeclampsia is a frequent syndrome and its cause has been linked to multiple factors, making prevention of the syndrome a continuous challenge. One of the suggested risk factors for preeclampsia is advanced maternal age. In the Western countries, maternal age at first delivery has been steadily increasing, yet few studies have examined women of advanced maternal age with preeclampsia. The purpose of this registry-based study was to compare the obstetric outcomes in primiparous and preeclamptic women younger and older than 35 years. Methods The registry-based study used data from three Finnish health registries: Finnish Medical Birth Register, Finnish Hospital Discharge Register and Register of Congenital Malformations. The sample contained women under 35 years of age (N = 15,437 compared with those 35 and over (N = 2,387 who were diagnosed with preeclampsia and had their first singleton birth in Finland between 1997 and 2008. In multivariate modeling, the main outcome measures were Preterm delivery (before 34 and 37 weeks, low Apgar score (5 min., small-for-gestational-age, fetal death, asphyxia, Cesarean delivery, induction, blood transfusion and admission to a Neonatal Intensive Care Unit. Results Women of advanced maternal age (AMA exhibited more preeclampsia (9.4% than younger women (6.4%. They had more prior terminations (25 ( Conclusions Preeclampsia is more common in women with advanced maternal age. Advanced maternal age is an independent risk factor for adverse outcomes in first-time mothers with preeclampsia.

  15. Brain MRI and single photon emission computed tomography in severe athetotic cerebral palsy. A comparative study with mental and motor disorders

    Energy Technology Data Exchange (ETDEWEB)

    Yamada, Kazutaka; Tsuzura, Shigenobu [Metropolitan Medical Center of the Severely Handicapped, Fuchu, Tokyo (Japan); Matsuda, Hiroshi

    1995-07-01

    Single photon emission computed tomography (SPECT) using N-isopropyl-p-[{sup 123}I]-iodoamphetamine ({sup 123}I-IMP) was performed in twelve patients with severe athetotic cerebral palsy (Ath; 5 males and 7 females) who had both motor delay (unable to move) and mental retardation (I.Q, or D.Q, below 30). The neuroimaging findings of those patients were compared with those of patients mental and motor disorders. In five caes suffering from neonatal asphyxia, SPECT demonstrated a decreased regional cerebral blood flow (rCBF) in corpus striatum, thalamus, orbitofrontal areas, pericentral gyrus areas, prefrontal areas and medial temporal areas. In seven cases suffering from neonatal jaundice, SPECT demonstrated a decreased rCBF in orbito-frontal areas, prefrontal areas and medial temporal areas. SPECT showed hypoperfusion of peri-central gyrus areas in cases with complications of spastic palsy. The decreased rCBF in medial temporal areas mostly corresponded to an alteration in hippocampal formation as assessed by magnetic resonance imaging (MRI). Cases with hypoperfusion of bilateral medial temporal areas showed a lower score of language understanding than those with the unilateral damage. In cases with hypofusion of bilateral prefrontal areas and bilateral medial temporal areas, the grade of understanding of language was almost below 12 months. In cases with hypoperfusion of orbitofrontal areas, psychomotor hypersensitivity had been observed. Those results suggest that IMP-SPECT and MRI of the brain is useful tool for neurological assessment in handicapped patients with athetotic cerebral palsy. (author).

  16. CT findings of cerebral palsy and behaviour development

    Energy Technology Data Exchange (ETDEWEB)

    Sakamoto, Zenji

    1987-06-01

    It is well recognized that CT scan is very useful in the early diagnosis of cerebral palsy. The author has studied this time the CT scan findings of cerebral palsy children in their relations to the type of palsy, cause of palsy, complications in the central nervous system, and prognosis of behaviour development, in order to predict the prognosis of behaviour development. Dilatation of the contralateral cerebral ventricle was found in 82 % of hemiplegic type. Abnormal EEG was found in 73 %, but their behaviour development was satisfactory, with good development of speech regardless to the side of palsy. This might be helped by compensational function of the brain due to plasticity. Diplegia presented bilateral moderate dilatation of ventricles with favorable prognosis. Tetraplegia was caused mostly by asphyxia or congenital anomaly and revealed marked dilatation of ventricles or severe cortical atrophy. Some cases presented diffuse cortical low-density, often associated with abnormal EEG, and their prognosis was worst. Athetosis had normal CT finding or mild ventricular dilatation, but all cases of ataxia presented normal CT findings. Hypotonia had mild ventricular dilatation. Two of three mixed type cases had normal CT findings and another had mild ventricular dilatation. No correlation was found between ventricular dilatation and behaviour development, but statistically significant difference was found in the cases with 30 % or more Evans' ratio (P < 0.05). Prognosis of severe ventricular dilatation cases was poor.

  17. Giant fibrovascular polyp of the esophagus: report of a case.

    Science.gov (United States)

    Goenka, Ajit Harishkumar; Sharma, Sanjay; Ramachandran, Vijay; Chattopadhyay, Tushar K; Ray, Ruma

    2011-01-01

    A fibrovascular polyp is a peculiar nonepithelial tumor of the esophagus that invariably arises in the cervical esophagus at the level of the thoracic inlet and grows distally into a massive elongated, pedunculated, intraluminal lesion. Although it is a benign lesion that is eminently resectable, it is a dramatic entity owing to its tendency to cause bizarre complications such as asphyxia and sudden death when it regurgitates into the pharynx and causes laryngeal impaction. This report describes the multimodality imaging appearance of an archetypal case of a giant fibrovascular polyp in a patient with a seemingly innocuous presentation for the size of the lesion. The essential role of cross-sectional imaging in establishing a prompt diagnosis, defining the tissue elements of the mass, and delineation of the exact extent of the lesion in guiding the treatment approach is highlighted. The appearance of fibrovascular polyp in a single patient with a combination of barium swallow, multidetector computed tomography, and high-resolution contrast-enhanced magnetic resonance imaging has not been reported previously. PMID:21191703

  18. Mechanisms of bilirubin toxicity: clinical implications.

    Science.gov (United States)

    Hansen, Thor Willy Ruud

    2002-12-01

    The basic mechanism of kernicterus and bilirubin encephalopathy has not been unequivocally determined. Much knowledge has been gained about phenomena that contribute to bilirubin neurotoxicity, and this knowledge has implications for clinical practice. Conditions that impact on blood-brain barrier function, increase brain blood flow, or impact on bilirubin metabolism, including its transport in serum, should be avoided, if possible. Such conditions include drugs and drug stabilizers that compete with bilirubin binding to albumin, or that inhibit P-glycoprotein in the blood-brain barrier, prematurity/immaturity, and clinically significant illness in the infant that involves hemolysis, respiratory and metabolic acidosis, infection, asphyxia, hypoxia and (perhaps) hyperoxia, and hyperosmolality. If these conditions are not avoidable then there should be a more aggressive approach to the treatment of hyperbilirubinemia. The limits of tolerance for hyperbilirubinemia varies among neonates and there are no tools to determine with certainty when a particular infant is approaching the danger zone. Neurological symptoms in a jaundiced infant require extreme vigilance, and, in most cases, immediate intervention. PMID:12516745

  19. Management of upper airway edema caused by hereditary angioedema

    Directory of Open Access Journals (Sweden)

    Farkas Henriette

    2010-07-01

    Full Text Available Abstract Hereditary angioedema is a rare disorder with a genetic background involving mutations in the genes encoding C1-INH and of factor XII. Its etiology is unknown in a proportion of cases. Recurrent edema formation may involve the subcutis and the submucosa - the latter can produce obstruction in the upper airways and thereby lead to life-threatening asphyxia. This is the reason for the high, 30-to 50-per-cent mortality of undiagnosed or improperly managed cases. Airway obstruction can be prevented through early diagnosis, meaningful patient information, timely recognition of initial symptoms, state-of-the-art emergency therapy, and close monitoring of the patient. Prophylaxis can substantially mitigate the risk of upper airway edema and also improve the patients' quality of life. Notwithstanding the foregoing, any form of upper airway edema should be regarded as a potentially life-threatening condition. None of the currently available prophylactic modalities is capable of preventing UAE with absolute certainty.

  20. Reversible analgesia, atonia, and loss of consciousness on bilateral intracerebral microinjection of pentobarbital.

    Science.gov (United States)

    Devor, M; Zalkind, V

    2001-10-01

    Concussion, asphyxia, and systemically administered general anesthetics all induce reversible depression of the organism's response to noxious stimuli as one of the elements of loss of consciousness. This is so even for barbiturate anesthetics, which have only modest analgesic efficacy at subanesthetic doses. Little is known about the neural circuits involved in this form of antinociception, although for anesthetic agents, at least, it is usually presumed that the drugs act in widely distributed regions of the nervous system. We now report the discovery of a focal zone in the brainstem mesopontine tegmentum in rats at which microinjection of minute quantities of pentobarbital induces a transient, reversible anesthetic-like state with non-responsiveness to noxious stimuli, flaccid atonia, and absence of the righting reflex. The behavioral suppression is accompanied by slow-wave EEG and, presumably, loss of consciousness. This zone, which we refer to as the mesopontine tegmental anesthesia locus (MPTA), apparently contains a barbiturate-sensitive 'switch' for both cortical and spinal activity. The very existence of the MPTA locus has implications for an understanding of the neural circuits that control motor functions and pain sensation, and for the cerebral representation of consciousness. PMID:11576749

  1. The mechanisms and treatment of asphyxial encephalopathy

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    Guido eWassink

    2014-02-01

    Full Text Available Acute post-asphyxial encephalopathy occurring around the time of birth remains a major cause of death and disability. The recent seminal insight that allows active neuroprotective treatment is that even after profound asphyxia (the primary phase, many brain cells show initial recovery from the insult during a short latent phase, typically lasting approximately 6 h, only to die hours to days later after a secondary deterioration characterized by seizures, cytotoxic edema, and progressive failure of cerebral oxidative metabolism. Although many of these secondary processes are potentially injurious, they appear to be primarily epiphenomena of the ‘execution’ phase of cell death. Animal and human studies designed around this conceptual framework have shown that moderate cerebral hypothermia initiated as early as possible but before the onset of secondary deterioration, and continued for a sufficient duration to allow the secondary deterioration to resolve, has been associated with potent, long-lasting neuroprotection. Recent clinical trials show that while therapeutic hypothermia significantly reduces morbidity and mortality, many babies still die or survive with disabilities. The challenge for the future is to find ways of improving the effectiveness of treatment. In this review, we will dissect the known mechanisms of hypoxic-ischemic brain injury in relation to the known effects of hypothermic neuroprotection.

  2. Tau 的病理性修饰与新生儿缺氧缺血性脑损伤%Abnormally modified tau and hypoxic-ischemic brain damage

    Institute of Scientific and Technical Information of China (English)

    肖婕; 李凡

    2015-01-01

    Tau is the most abundant microtubule-associated protein in the brain .If tau protein lost the normal function, the toxic effect should be showed and plays an important role in various central nervous system lesions .Hypoxic-ischemic encephalopathy ( HIE) is an important cause of mortality in the neonatal period and it is mainly characterized by neurological deficits such as cognitive limitations .However , the mechanism still needs further study , and the underlying re-lationship between tau protein and HIE lacks direct evidence .Some recent clinical study reported that tau protein expres-sion elevated in the serum of asphyxia children and had a high correlation with behavior deficient .In this review , we focus on 3 key points to provide new insights to understand the tau protein-related pathogenesis of HIE as followed:(1) tau pro-tein and its phosphorylation change during central nervous system development ;(2) comparison of tau protein expression in developing brain and adult brain under some neurological disorders;(3) potential pathological change of tau in HIE related pathological conditions , such as dysmyelination , inflammation response and glutamate metabolism .

  3. SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment.

    Science.gov (United States)

    Moon, Rachel Y

    2011-11-01

    Despite a major decrease in the incidence of sudden infant death syndrome (SIDS) since the American Academy of Pediatrics (AAP) released its recommendation in 1992 that infants be placed for sleep in a nonprone position, this decline has plateaued in recent years. Concurrently, other causes of sudden unexpected infant death that occur during sleep (sleep-related deaths), including suffocation, asphyxia, and entrapment, and ill-defined or unspecified causes of death have increased in incidence, particularly since the AAP published its last statement on SIDS in 2005. It has become increasingly important to address these other causes of sleep-related infant death. Many of the modifiable and nonmodifiable risk factors for SIDS and suffocation are strikingly similar. The AAP, therefore, is expanding its recommendations from focusing only on SIDS to focusing on a safe sleep environment that can reduce the risk of all sleep-related infant deaths, including SIDS. The recommendations described in this policy statement include supine positioning, use of a firm sleep surface, breastfeeding, room-sharing without bed-sharing, routine immunizations, consideration of using a pacifier, and avoidance of soft bedding, overheating, and exposure to tobacco smoke, alcohol, and illicit drugs. The rationale for these recommendations is discussed in detail in the accompanying "Technical Report--SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment," which is included in this issue of Pediatrics (www.pediatrics.org/cgi/content/full/128/5/e1341). PMID:22007004

  4. Suicidal asphyxiation with helium: report of three cases.

    Science.gov (United States)

    Grassberger, Martin; Krauskopf, Astrid

    2007-01-01

    Helium is an inert gas that among other things is used medically to alleviate the symptoms of airway obstruction, as part of a diving mix in deep-sea diving or as balloon gas. In recent years the so-called right-to-die literature has suggested suffocation with inhaled helium as an effective and peaceful means of self-deliverance for terminally ill patients. Helium displaces oxygen and carbon dioxide and can thus lead to asphyxia. We report three cases of suicidal asphyxiation with helium gas that were examined at the Department of Forensic Medicine Vienna within three months in 2006. In all three cases, autopsy was unrewarding from the point of view of gross pathology. Special autopsy techniques and devices are required for collection of the gas from the lungs. Gas-chromatography is used to examine the gas for helium; however, this requires replacement of the carrier gas, which is itself usually helium. The fact that three people in Vienna committed suicide using this method within a short period of time, together with the abundance of detailed how-to literature on the Internet, suggests a possible future increase in the number of deaths associated with the inhalation of inert gases, particularly helium. Because of the diagnostic obstacles involved, it is necessary to rely on good death-scene investigation for situational evidence when the body is discovered. PMID:17571238

  5. Relationship between PLAP and high-risk pregnancy

    International Nuclear Information System (INIS)

    PLAP was isolated and purified from human placenta and the antiserum was obtained by immunizing the rabbits. A radioimmunoassay of PLAP (PLAP RIA) was established by labelling the antigen using the chloramine-T method. Its sensitivity was 1.54 μg/L, the recovery rate was between 96.7% and 105.2%, the intra- and inter-assay CV were 8.94% and 9.43%, respectively, the antiserum provided a linear response from 2 to 1000 μg/L. The assay has no cross-reactivity with liver AP. Serum level of PLAP were measured by PLAP RIA in 649 cases of normal pregnancy and 164 cases of high-risk pregnancy. The results indicated that the PLAP level increased proportionally with the advance of gestational age (r = 0.9843). In 33 cases of pregnancy induced hypertension and 21 cases of intrauterine fetal growth retardation, the PLAP were at significantly low level. In 7 cases of neonatal asphyxia and 26 cases of fetal distress, the PLAP level in the mother's serum were also low. In 53 cases of intrahepatic cholestasis of pregnancy, the PLAP level were similar to those of normal pregnancy. This study illustrated that PLAP RIA can play an important role in evaluation of placental function and fetal prognosis for cases of high-risk pregnancy

  6. Radiological findings of meconium aspiration of the newborn

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Young Seok; Lee, Sung Sik; Lee, Hong Kyu; Kim, Kye Tae; Lee, Soon Il [Sohwa Children' s Hospital, Seoul (Korea, Republic of); Yeon, Kyung Mo [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1985-02-15

    Authors reviewed 264 cases of meconium aspiration pneumonia of the newborn at Sohwa Children's Hospital from July 1981 to June 1984. The radiological findings were retrospectively analysed with particular attention to the degree of pulmonic infiltrations. The results were as follows: 1. The male to female ratio was 1.8 : 1 and clinical condition which commonly associated were post-term infants (41.3%), placental dysfunction syndrome (33%) and perinatal asphyxia (11.4%). 2. There were improved (76.9%) and expired cases (12.1%) as clinical course. 3. Radiologic findings were noticed as pulmonic infiltration (68.2%), hyperinflation (35.2%), pneumo-mediastinum (18.6%), pleural effusion (14.4%), pneumothorax (13.3%) and suggestive interstitial emphysema (6.8%). The more the degree of pulmonary infiltration was been severe, the more the incidence of other pulmonary lesions was increased. 4. Pulmonary infiltrations were commonly occurred in both lungs but pneumothorax, pleural effusion and hyperinflation in right. 5. Radiologic findings of 32 expired cases were noticed as pulmonic infiltrations (93.8%), hyperinflation (53.1%), pneumomediastinum (37.5%), pneumothorax (18.8%), suggestive interstitial emphysema (18.8%) and pleural effusion (18.8%)

  7. Pregnancy and delivery complications and treatment approach in attention deficit hyperactivity disorder.

    Science.gov (United States)

    Aktepe, Evrim; Ozkorumak, Evrim; Tanriöver-Kandil, Sema

    2009-01-01

    Pregnancy, delivery complications and treatment approach were evaluated in 153 cases diagnosed with attention deficit hyperactivity disorder in the State Hospital of Antalya in the Child and Adolescent Psychiatry Polyclinic. Most of the cases had been delivered vaginally (74.5%). The most frequent delivery complication was asphyxia/hypoxia (15.6%). The agent most frequently preferred in the treatment regimen was methylphenidate (82.4%), which is a psychostimulant. The other drugs used were risperidone (29.4%), selective serotonin reuptake inhibitors (16.4%) and imipramine (4.6%). The most frequent side effect resulting from methylphenidate use was a decrease in appetite (34.9%). Attention deficit hyperactivity disorder often presents with comorbid disorders; in these cases, nonstimulant agents had to be added to methylphenidate for better treatment outcomes. Use of selective serotonin reuptake inhibitors in combined treatment and in cases with comorbidities is in agreement with the literature. Further studies of combined treatment regimens in attention deficit hyperactivity disorder are needed. PMID:20112604

  8. Prevalence and Pathology of egg bound syndrome in commercial white leghorn chicken

    Directory of Open Access Journals (Sweden)

    Palani Srinivasan

    2014-06-01

    Full Text Available Prevalence of egg bound syndrome in commercial white leghorn layer chicken in Namakkal region of India was studied over a period of two years from June 2009 to May 2011. Out of 24,158 carcasses examined, the egg bound syndrome was noticed in 663 cases with a overall mortality of 0.5 %. The study revealed that heat stress (28.66%, asphyxia (23.23%, hypocalcemia (17.35%, salpingitis (7.54%, large size egg (6.18%, dehydration (5.73%, vent trauma (5.28%, obesity (3.62%, abnormal ovulation (1.81% and oviduct neoplasm (0.60% were the various causes of egg bound syndrome in commercial layer chicken. Microbial analysis of the samples revealed the presence of Escherichia coli from cases associated with salpingitis. The syndrome was recorded with highest occurrence in 21-30 wk and 61-70 wk age laying chicken and with a higher incidence in summer season (44.95%.

  9. Radiologic evaluation of adenoids and tonsils in children with obstructive sleep apnea: Plain films and fluoroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Kreplick Fernbach, S.; Brouillette, T.; Riggs, T.W.; Hunt, C.E.

    1983-07-01

    Twenty-six children with obstructive sleep apnea were evaluated by lateral neck radiographs during wakefulness, and by polygraphic monitoring and upper airway fluoreoscopy during natural sleep. Children with craniofacial abnormalities, palatal surgery, and central nervous system disease were excluded from the study. Moderate or marked enlargement of tonsils and adenoids was noted on lateral neck radiographs of 18 of 26 patients. An objective measure of adenoidal enlargement, the adenoidal-nasopharyngeal ratio, correlated well with subjective judgment of adenoidal size but was not generally more useful than subjective estimation. Upper airway fluroescopy demonstrated the site and mechanism of obstruction in all patients. Because all children with moderate to marked adenotonsillar enlargement demonstrated obstruction at the adenoidal or tonsillar level on fluoroscopy, we now screen children with suspected sleep apnea with lateral airway radiographs and polysomnography. Fluoroscopy is reserved for children with mild adenotosillar enlargement, craniofacial dysplasia, prior cleft palate repair, or neuromuscular disorders. These results suggest that the pathogenesis of obstuctive sleep apnea in children involve anatomic factors which narrow the upper airway, sleep-related hypotonia of pharyngeal dilator musculature, and compensatory mechanisms to prevent or alleviate asphyxia.

  10. 窒息新生儿225例血糖分析%Analysis of the blood sugar in asphyxial neonates

    Institute of Scientific and Technical Information of China (English)

    吴起武

    2009-01-01

    目的 探讨窒息新生儿血糖的变化.方法 对225例窒息新生儿和43例对照组新生儿进行血糖检测和分析.结果 窒息组和对照组血糖水平比较差异无统计学意义[(3.85±2.01)与(4.37±1.01),P>0.05],重度窒息组血糖水平和高血糖发生率均显著高于轻度窒息组(均P 0.05]. The quantity of blood sugar and the incidence rate of hyperglycosemia in seriously asphyxial group were more greater than slightly asphyxial group(P <0.01). The quantity of blood sugar in slighdy asphyxial group was less than the control group (P < 0.05). The quantiy of blood sugar in asphyxial premature infants was significantly less than asphyxial full-term infants(P < 0.05). Conclusions The blood sugar level in asphyxial neonates is relative to the degree of asphyxia and gestational age. The blood sugar in highly asphyxial neonates rise whereas in slightly as-phyxial neonates and asphyxial premature infants reduce.

  11. Study of Congenital Malformations in Central Nervous System AND Gastro- Intestinal Tract

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    Saiyad SS

    2012-04-01

    Full Text Available Introduction: Congenital malformations comprise 8% of the perinatal mortality in India. They rank fifth as a cause of perinatal mortality, after asphyxia, respiratory problems, infections and cerebral trauma. However, the pattern is changing rapidly with improvement in health care and living standards. Material & Method: In the present study, authors have tried to study the cases of congenital malformations specially related to Central nervous system and Gastro-intestinal system. 5240 cases of newborn babies were studied and results were analyzed and classified in to various categories. Findings: The results show that malformations are more common in still birth, more in female babies and more in central nervous system In live born babies the percentage of malformation is0.63 % whereas in still born baby it is6.53 %. Conclusions: Chances of having malformations increases as the age advances. Parity of mother also influences the incidence. Exposure to radiation & drugs also influences malformations. Incidence of congenital malformation is highest in central nervous system. [National J of Med Res 2012; 2(2.000: 121-123

  12. Influence of pre-pregnant and pregnant body mass index of women with gestational diabetes mellitus on delivery methods and maternal and neonatal outcomes%GDM孕妇孕前体质量指数及孕期体质量指数增加对分娩方式和母婴结局的影响

    Institute of Scientific and Technical Information of China (English)

    于彩娥

    2016-01-01

    Objective To investigate Influence of pre-pregnant and pregnant body mass index (BMI) of women with gestational diabetes mellitus (GDM) on delivery methods and maternal and neonatal outcomes.Methods 264 women with GDM were selected and were divided into a low BMI group (BMI<18.5 kg/m2), a normal BMI group (18.5 kg/m2 ≤ BMI< 25 kg/m2), and an obesity group (BMI ≥ 25 kg/m2) according to the BMI before pregnancy and into an insufficient weight gain group, a normal weight gain group, and an excessive weight gain group according to pregnancy weight gain standard of IOM.The incidences of cesarean section, fetal distress, neonatal asphyxia, postpartum infection, and fetal macrosomia were compared between each two group.Results The cesarean section rate of the low BMI group were significantly higher than that of the normal BMI group but lower than that of the obesity group and the incidences of fetal distress, neonatal asphyxia, and puerperal infection of the low BMI group were significantly lower than those of the obesity group (P < 0.05).The incidences of cesarean section, fetal distress, fetal macrosomia, and neonatal asphyxia were significantly lower in the normal BMI group than in the obesity group (P < 0.05) and were significantly higher in the insufficient weight gain group than in the normal weight gain group and the excessive weight gain group (P < 0.05).Conclusions Perinatal health care, measuring Pre-pregnant height and weight and calculating BMI, screening obesity women before pregnancy, managing women with GDM as high risk pregnancy, taking intervention measures to control BMI less than 25 kg/m2 before pregnancy, reasonably controlling weight gain during pregnancy are helpful for lowering cesarean section rate and the incidences of fetal macrosomia, fetal distress, and neonatal asphyxia and ensuring the health of mothers and infants.%目的 探讨GDM孕妇孕前体质量指数及孕期体质量指数增加对分娩方式

  13. Successful Treatment of Both Mother and Infant in Pregnancy-Associated Group A Streptococcal Toxic Shock Syndrome

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    Takayuki Tanaka

    2007-01-01

    Full Text Available All perinatal cases of group A streptococcal toxic shock syndrome (STSS previously documented in English literature have been fatal for the mother, the fetus or both. We present the first report of successful treatment of a mother-infant pair with perinatal STSS. A pregnant woman developed STSS at 34 weeks’ gestation 3 h after delivery, following a 25-h history of fever and sore throat. The patient received intravenous penicillin, clindamycin and immnoglobulins and continuous hemodialysis, along with numerous supportive agents during early clinical course. The newborn infant was born with mild asphyxia and developed transient tachypnea. Both mother and infant survived without any sequelae. Streptococcus pyogenes was isolated from the patient’s blood, nasopharynx of the infant and throat of two family members. These strains were identically type T1M1 (emm1 and produced streptococcal pyrogenic exotoxins A (SPEA and B. SPEA was remarkably elevated in the maternal blood, but not in the infant’s blood. Extremely low serum anti-SPEA antibody levels might have predisposed the mother to severe invasive infection. This case highlights the importance of early recognition, prompt and intensive multimodal therapy and rapid delivery before a transfer of pathogen and its toxin to the fetus.

  14. CT image and clinical analysis of the term neonatal hypoxic-ischemic encephalopathy

    International Nuclear Information System (INIS)

    Objective: This is a retrospective investigation of 87 cases of perinatal HIE diagnosed in Junan hospital with literature review, made to improve the diagnosis of HIE, and provide objective information as well as the principle for clinical management and prognosis. Methods: In total 87 patients with HIE, including 52 males and 25 females, aged from 38 weeks to 42 weeks, underwent examination in 1 hour to 16 days after the delivery. There was natural labor in 39 cases, vacuum labor in 11 cases, forceps delivery in 9 cases, abdominal delivery in 6 cases. All the neonatal infants had a history of asphyxia on different levels. Results: CT scan showed diffuse or asymmetrical hypodense shadows with poorly-defined border, where the CT value measured between 10-18 HU, accompanying with the displacement or even absence of lateral ventricle. Subarachnoid hemorrhage (SAH) were found in 34 cases (39.5%), parenchyma hemorrhage in 24 cases (27.6%), intraventricular hemorrhage (IVH) in 15 cases (17.2%), and subdural hemorrhage in 5 cases (5.7%). Additionally, scalp turgidity was seen in 11 cases, and skull fracture in 4 cases as well. Conclusion: The CT scan shows the anoxicasphyxial lesions in the brain resulting from asphyxiation in neonatal, and the severity is rated with CT manifestation and brain edema, which provide objective guidance of the prognosis and the clinical management of HIE. (authors)

  15. Predicting performance in competitive apnea diving. Part III: deep diving.

    Science.gov (United States)

    Schagatay, Erika

    2011-12-01

    The first of these reviews described the physiological factors defining the limits of static apnea, while the second examined performance in apneic distance swimming. This paper reviews the factors determining performance in depth disciplines, where hydrostatic pressure is added to the stressors associated with apnea duration and physical work. Apneic duration is essential for performance in all disciplines, and is prolonged by any means that increases gas storage or tolerance to asphyxia or reduces metabolic rate. For underwater distance swimming, the main challenge is to restrict metabolism despite the work of swimming, and to redirect blood flow to allow the most vital functions. Here, work economy, local tissue energy and oxygen stores, anaerobic capacity of the muscles, and possibly technical improvements will be essential for further development. In the depth disciplines, direct pressure effects causing barotrauma, the narcotic effects of gases, decompression sickness (DCS) and possibly air embolism during ascent need to be taken into account, as does the risk of hypoxia when the dive cannot be rapidly interrupted before the surface is reached again. While in most deep divers apneic duration is not the main limitation thus far, greater depths may call for exceptionally long apneas and slower ascents to avoid DCS. Narcotic effects may also affect the ultimate depth limit, which the divers currently performing 'constant weight with fins' dives predict to be around 156 metres' sea water. To reach these depths, serious physiological challenges have to be met, technical developments needed and safety procedures developed concomitantly. PMID:22183699

  16. Perinatal and background risk factors for childhood autism in central China.

    Science.gov (United States)

    Duan, Guiqin; Yao, Meiling; Ma, Yating; Zhang, Wenjing

    2014-12-15

    Perinatal and background risk factors for autism were identified in a cohort of autistic children in Zhengzhou, China, to formulate preventative and treatment strategies for high-risk families. In this case-control study, children were screened for suspected autism using the Autism Behavior Checklist (ABC) and diagnosed according to DSM-IV and the Childhood Autism Rating Scale (CARS). We collected perinatal histories and clinical data of 286 confirmed autistic children treated at the Third Affiliated Hospital Children׳s Psychological Clinic of Zhengzhou University from 2011 to 2013. The control group consisted of 286 healthy children from area kindergartens. Maternal age>30 years, parental introversion as measured by the Eysenck Personality Questionnaire, low level of parental education, smoking, abortion threat, pregnancy complications, maternal illness during pregnancy, maternal mental health, family history of mental illness, neonatal jaundice, birth asphyxia, premature rupture of the fetal membrane, and gestational ageparental introversion, family history of mental illness, abortion threat, premature delivery, and smoking were identified as independent risk factors by multivariate logistic regression. PMID:25085792

  17. Design of a Functional Training Prototype for Neonatal Resuscitation

    Directory of Open Access Journals (Sweden)

    Sivaramakrishnan Rajaraman

    2014-11-01

    Full Text Available Birth Asphyxia is considered to be one of the leading causes of neonatal mortality around the world. Asphyxiated neonates require skilled resuscitation to survive the neonatal period. The project aims to train health professionals in a basic newborn care using a prototype with an ultimate objective to have one person at every delivery trained in neonatal resuscitation. This prototype will be a user-friendly device with which one can get trained in performing neonatal resuscitation in resource-limited settings. The prototype consists of a Force Sensing Resistor (FSR that measures the pressure applied and is interfaced with Arduino® which controls the Liquid Crystal Display (LCD and Light Emitting Diode (LED indication for pressure and compression counts. With the increase in population and absence of proper medical care, the need for neonatal resuscitation program is not well addressed. The proposed work aims at offering a promising solution for training health care individuals on resuscitating newborn babies under low resource settings.

  18. Brazilian guidelines for the diagnosis and treatment of hereditary angioedema

    Directory of Open Access Journals (Sweden)

    Pedro Giavina-Bianchi

    2011-01-01

    Full Text Available Hereditary angioedema is an autosomal dominant disease characterized by edema attacks with multiple organ involvement. It is caused by a quantitative or functional deficiency of the C1 inhibitor, which is a member of the serine protease inhibitor family. Hereditary angioedema is unknown to many health professionals and is therefore an underdiagnosed disease. The causes of death from hereditary angioedema include laryngeal edema with asphyxia. The estimated mortality rate in patients in whom the disease goes undetected and who are therefore incorrectly treated is 25-40%. In addition to edema of the glottis, hereditary angioedema often results in edema of the gastrointestinal tract, which can be incapacitating. Patients with hereditary angioedema may undergo unnecessary surgical interventions because the digestive tract can be the primary or only organ system involved, thus mimicking acute surgical abdomen. It is estimated that patients with hereditary angioedema experience some degree of disability 20-100 days per year. The Experts in Clinical Immunology and Allergy of the "Associação Brasileira de Alergia e Imunopatologia -ASBAI" developed these guidelines for the diagnosis, therapy, and management of hereditary angioedema.

  19. A new imaging technique on strength and phase of pulsatile tissue-motion in brightness-mode ultrasonogram

    Science.gov (United States)

    Fukuzawa, Masayuki; Yamada, Masayoshi; Nakamori, Nobuyuki; Kitsunezuka, Yoshiki

    2007-03-01

    A new imaging technique has been developed for observing both strength and phase of pulsatile tissue-motion in a movie of brightness-mode ultrasonogram. The pulsatile tissue-motion is determined by evaluating the heartbeat-frequency component in Fourier transform of a series of pixel value as a function of time at each pixel in a movie of ultrasonogram (640x480pixels/frame, 8bit/pixel, 33ms/frame) taken by a conventional ultrasonograph apparatus (ATL HDI5000). In order to visualize both the strength and the phase of the pulsatile tissue-motion, we propose a pulsatile-phase image that is obtained by superimposition of color gradation proportional to the motion phase on the original ultrasonogram only at which the motion strength exceeds a proper threshold. The pulsatile-phase image obtained from a cranial ultrasonogram of normal neonate clearly reveals that the motion region gives good agreement with the anatomical shape and position of the middle cerebral artery and the corpus callosum. The motion phase is fluctuated with the shape of arteries revealing local obstruction of blood flow. The pulsatile-phase images in the neonates with asphyxia at birth reveal decreases of the motion region and increases of the phase fluctuation due to the weakness and local disturbance of blood flow, which is useful for pediatric diagnosis.

  20. Factors associated with and causes of perinatal mortality in northeastern Tanzania

    DEFF Research Database (Denmark)

    Schmiegelow, Christentze; Minja, Daniel; Oesterholt, Mayke; Pehrson, Caroline; Suhrs, Hannah Elena; Boström, Stéphanie; Lemnge, Martha; Magistrado, Pamela; Rasch, Vibeke; Lusingu, John; Theander, Thor G.; Nielsen, Birgitte Bruun

    2012-01-01

    , including preeclampsia, small-for-gestational age, preterm delivery, anemia, and health-seeking behavior. Fetal growth was monitored using ultrasound. Finally, the specific causes of the perinatal deaths were evaluated. Main outcome measure. Perinatal mortality. Results. Forty-six deaths occurred. Key...... factors associated with perinatal mortality were preterm delivery (adjusted odds ratio (OR) 14.47, 95% confidence interval (CI) 3.23-64.86, p < 0.001), small-for-gestational age (adjusted OR 3.54, 95%CI 1.18-10.61, p = 0.02), and maternal anemia (adjusted OR 10.34, 95%CI 1.89-56.52, p = 0.007). Adherence...... to the antenatal care program (adjusted OR 0.027, 95%CI 0.003-0.26, p = 0.002) protected against perinatal mortality. The cause of death in 43% of cases was attributed to complications related to labor and specifically to intrapartum asphyxia (30%) and neonatal infection (13%). Among the remaining...

  1. GDM孕妇孕前体质量指数及孕期体质量指数增加对分娩方式和母婴结局的影响%Influence of pre-pregnant and pregnant body mass index of women with gestational diabetes mellitus on delivery methods and maternal and neonatal outcomes

    Institute of Scientific and Technical Information of China (English)

    于彩娥

    2016-01-01

    Objective To investigate Influence of pre-pregnant and pregnant body mass index (BMI) of women with gestational diabetes mellitus (GDM) on delivery methods and maternal and neonatal outcomes.Methods 264 women with GDM were selected and were divided into a low BMI group (BMI<18.5 kg/m2), a normal BMI group (18.5 kg/m2 ≤ BMI< 25 kg/m2), and an obesity group (BMI ≥ 25 kg/m2) according to the BMI before pregnancy and into an insufficient weight gain group, a normal weight gain group, and an excessive weight gain group according to pregnancy weight gain standard of IOM.The incidences of cesarean section, fetal distress, neonatal asphyxia, postpartum infection, and fetal macrosomia were compared between each two group.Results The cesarean section rate of the low BMI group were significantly higher than that of the normal BMI group but lower than that of the obesity group and the incidences of fetal distress, neonatal asphyxia, and puerperal infection of the low BMI group were significantly lower than those of the obesity group (P < 0.05).The incidences of cesarean section, fetal distress, fetal macrosomia, and neonatal asphyxia were significantly lower in the normal BMI group than in the obesity group (P < 0.05) and were significantly higher in the insufficient weight gain group than in the normal weight gain group and the excessive weight gain group (P < 0.05).Conclusions Perinatal health care, measuring Pre-pregnant height and weight and calculating BMI, screening obesity women before pregnancy, managing women with GDM as high risk pregnancy, taking intervention measures to control BMI less than 25 kg/m2 before pregnancy, reasonably controlling weight gain during pregnancy are helpful for lowering cesarean section rate and the incidences of fetal macrosomia, fetal distress, and neonatal asphyxia and ensuring the health of mothers and infants.%目的 探讨GDM孕妇孕前体质量指数及孕期体质量指数增加对分娩方式

  2. The Amnioscope Strikes Back as a Useful Device for Pinhole Amniotomy in the Management of Polyhydramnios

    Directory of Open Access Journals (Sweden)

    Shinsuke Koyama

    2011-12-01

    Full Text Available Polyhydramnios is associated with many serious maternal complications such as placental abruption or cord prolapse at rupture of membranes, uterine dysfunction at delivery, and postpartum hemorrhage. When considering uterine dysfunction caused by overstretched uterine muscles, active artificial amniotomy for more efficient labor seems to be a preferred obstetric management, but the potential adverse complications make obstetricians hesitate to perform this procedure. In such a challenging situation, a new strategy is required. We recently performed pinhole artificial amniotomy using an amnioscope in four women with polyhydramnios, not only to accelerate of labor but also to more slowly and safely reduce amniotic fluid volume. We had no complications using this procedure, and all women were able to have a vaginal delivery without postpartum hemorrhage and neonatal asphyxia. Pinhole artificial amniotomy using an amnioscope may be more convenient and safer than conventional artificial amniotomy. The significance of the amnioscope has been practically nil in modern obstetric management. In this pilot clinical study, we identified a new value for the amnioscope as a promising device for safer amniotomy in women with polyhydramnios.

  3. [A case of X-linked myotubular myopathy with chylothorax].

    Science.gov (United States)

    Oishi, Taku; Sato, Tetsuya; Matsushita, Kenshi; Takechi, Tomoki; Murakami, Nobuyuki; Fujieda, Mikiya

    2016-01-01

    We report a case of X-linked myotubular myopathy with chylothorax. A male infant weighing 2,114 g was born to a mother whose pregnancy was complicated with polyhydramnios from gestational week 32. At gestational week 37, emergent caesarian section was performed due to membrane rupture followed by fetal bradycardia. Ventilatory support was necessary because the neonate showed severe birth asphyxia accompanied by hypotonia and dyspnea. He also showed a respiratory complication of chylothorax at 10 days old; therefore, thoracic drainage was performed. Congenital chylothorax associated with congenital myotonic dystrophy (CMD) has been described in a number of past reports. Specific findings of congenital myotubular myopathy and partial CMD, such as peripheral halo of muscle fibers, were demonstrated in biopsied muscle, and mutation of the myotubularin (MTM1) gene was identified. Tracheostomy was performed at 5 months old because of prolonged ventilatory support and severe dysphagia. The infant was able to be discharged at 17 months old. Congenital chylothorax might be associated with congenital myotubular myopathies such as CMD. PMID:27012108

  4. Evaluation of the child with delayed speech or language.

    Science.gov (United States)

    Coplan, J

    1985-03-01

    Because of the relative frequency of speech/language delay, all infants and preschool children should undergo routine language screening as part of health care maintenance. Diagnostic evaluation of the child with speech or language delay should answer the following questions: What is the child's descriptive diagnosis (eg, hearing impaired, mentally retarded, DLD, etc.)? What is the child's etiologic diagnosis (eg, congenital viral infection, single gene disorder, birth asphyxia, etc.)? What is the appropriate intervention strategy (amplification, orally based speech therapy, total communication, "infant stimulation" program, etc.)? What is this child's long-term prognosis, to the extent that this is knowable? All children with speech or language delay should undergo formal audiologic testing, regardless of how well the child seems to hear in an office setting, and regardless of whether other disabilities are present which might independently explain the speech/language delay. Evaluation by a psychologist, a speech/language pathologist, or both should follow, with referral to an appropriate intervention program based upon the results of formal developmental testing. Additional medical evaluation (eg, CAT scan, EEG, karyotype), and genetic counseling must be determined on a case-by-case basis. Long-term follow-up should include an awareness that speech or language delay during the preschool years often signifies long-term developmental difficulties, warranting close follow-up of such children as they advance through the school age years. PMID:4000735

  5. Cryptosporidium parvum: From foal to veterinary students.

    Science.gov (United States)

    Galuppi, R; Piva, S; Castagnetti, C; Sarli, G; Iacono, E; Fioravanti, M L; Caffara, M

    2016-03-30

    This paper describes the transmission of a zoonotic subtype of Cryptosporidium parvum between two foals hospitalized in an Equine Perinatology Unit (EPU) linked to an outbreak of cryptosporidiosis in veterinary students. Fecal specimens of 36 mares (105 samples) and 28 foals (122 samples) were subjected to Ziehl-Neelsen staining, nested PCR of 18S rDNA. Two foals tested positive for Cryptosporidium; PCR restriction fragment length polymorphism (PCR-RFLP) analysis and subtyping by nested PCR of the 60kDa glycoprotein (gp60) gene revealed C. parvum subtype IIdA23G1. The introduction of Cryptosporidium into the EPU is suspected to be in a foal showing no initial clinical signs that tested positive for C. parvum during an asymptomatic phase. A second foal, hospitalized afterwards for perinatal asphyxia syndrome complicated with failure of passive transfer and sepsis, showed severe watery diarrhea after 4 days of hospitalization and was positive for the same subtype. During this period, six students attending the EPU complained of abdominal pain and diarrhea and were positive for the same subtype of C. parvum. To the authors' knowledge, this is the first description of this subtype in foals and the first report of evidence of zoonotic transmission of cryptosporidiosis from foals to human. PMID:26921039

  6. Sudden death due to rupture of the right internal carotid artery in neurofibromatosis type 1: A case report.

    Science.gov (United States)

    Liang, Yue; Tong, Fang; Zhang, Lin; Li, Wenhe; Zhou, Yiwu

    2016-07-01

    Vascular involvement is a well-recognized manifestation of neurofibromatosis type 1 (NF1) which has the potential to be fatal when disrupted. We here present a case of sudden death due to the fatal arterial rupture resulted from infiltration of the neurofibromas. A 42-year-old man who suffered from NF1 presented a 1-h history of sudden onset of pain in his right cervical region. His condition worsened and became unconscious on his way to the emergency room. Despite resuscitation efforts, he died 30min later without regaining consciousness. Autopsy examination showed that a neurofibroma located around the right internal carotid artery, confirmed immunohistochemically with S-100, vimentin and CD34. Furthermore, proliferation of spindle cells positive for S-100 was seen in the wall of right internal carotid artery, which was disrupted and resulted in a hemorrhage. These findings suggest that the artery was disrupted by neurofibromas in the vascular wall, which led to fragility of the vessel. On the basis of these findings, we concluded that the cause of death was asphyxia resulting from airway obstruction compressed by the hematoma due to the arterial rupture. As the locality of the neurofibroma and hemorrhage were closed to the carotid baroreflex, we considered another possible mechanism of his sudden death, which could be cardiac inhibition induced by vagal stimulation. We hope this case will increase recognition of NF-1 vasculopathy when encountering any sudden death in NF1 patients. PMID:27497331

  7. Radiologic evaluation of adenoids and tonsils in children with obstructive sleep apnea: Plain films and fluoroscopy

    International Nuclear Information System (INIS)

    Twenty-six children with obstructive sleep apnea were evaluated by lateral neck radiographs during wakefulness, and by polygraphic monitoring and upper airway fluoreoscopy during natural sleep. Children with craniofacial abnormalities, palatal surgery, and central nervous system disease were excluded from the study. Moderate or marked enlargement of tonsils and adenoids was noted on lateral neck radiographs of 18 of 26 patients. An objective measure of adenoidal enlargement, the adenoidal-nasopharyngeal ratio, correlated well with subjective judgment of adenoidal size but was not generally more useful than subjective estimation. Upper airway fluroescopy demonstrated the site and mechanism of obstruction in all patients. Because all children with moderate to marked adenotonsillar enlargement demonstrated obstruction at the adenoidal or tonsillar level on fluoroscopy, we now screen children with suspected sleep apnea with lateral airway radiographs and polysomnography. Fluoroscopy is reserved for children with mild adenotosillar enlargement, craniofacial dysplasia, prior cleft palate repair, or neuromuscular disorders. These results suggest that the pathogenesis of obstuctive sleep apnea in children involve anatomic factors which narrow the upper airway, sleep-related hypotonia of pharyngeal dilator musculature, and compensatory mechanisms to prevent or alleviate asphyxia. (orig.)

  8. Idiopathic Gastrointestinal Perforation in Neonates%新生儿特发性胃肠道穿孔

    Institute of Scientific and Technical Information of China (English)

    徐卯升; 宋家其; 董其刚; 沈玉成

    1990-01-01

    From 1978 to 1988,65 newborns of gastrointestinal perforation were admitted.we named the perforation of 5 cases whose cause was unrelated to mechanicalintestinal obstruction or NEC as idiopathic gastrointestinal perforation.The situs of perforations were in the stomahc (1),small intestine(2),and colon(2)prematurity and perinatal asphyxia were common in these series.The etiology,clinical manifastations,diagnosis,treatmeat and prognosis of the entity are discussed.%作者报道1978~1988年该院收治并经手术或尸检证实的新生儿胃肠道穿孔65例,将其中5例无胃肠道器质性病变,无机械性肠梗阻征象,X线摄片及术中未发现NEC表现者,归纳为新生儿特发性胃肠道穿孔,并对其病因、临床特点、诊断、治疗和预后作了探讨.

  9. A community based study of Infant Mortality in rural Aligarh

    Directory of Open Access Journals (Sweden)

    Shah MS

    2011-01-01

    Full Text Available BackgroundInfant mortality rate is regarded as an important andsensitive indicator of the health status of a community. Italso reflects the living standard of the people and theeffectiveness of interventions for improving maternal andchild health. Multiple factors related to social and economicconditions, health care and environment have a significantrole to play on childhood mortality and improving childhoodmortality is a national priority. The present study wasplanned to 1 determine the mortality rate among neonatesand infants. 2 identification of pattern of various factors inrelation to infant mortality and 3 to identify the causes ofdeath in this age group.MethodAll the deaths in children under 12 months during July 2005to June 2006 in Jawan block of district Aligarh, India wererecorded. The cause of death was ascertained using thestandard verbal autopsy procedure.ResultsIn the study period, 446 live births and 37 deaths in childrenunder one year of age were reported. The neonatal andinfant mortality rates were 49.4 and 83.0 per thousand livebirths respectively. The main causes of infant deaths werebirth asphyxia, diarrhoea, pneumonia, prematurity(including Low birth weight and malnutrition.ConclusionMost of the death among infants are preventable, thoughpromotion of institutional deliveries, strengthening of referralsystem, early recognition of danger signs and periodicretraining of health workers.

  10. A Study On Neonatal Mortality In Jamnagar District Of Gujarat

    Directory of Open Access Journals (Sweden)

    Yadav Sudha

    1998-01-01

    Full Text Available Research question: Which are the maternal, socio-demographic and neonatal attributes responsible for neonatal mortality in rural areas of Gujarat? Objectives: (i To know various maternal, socio-demographic and neonatal factors responsible for neonatal mortality in rural areas of Gujarat (ii To estimate neonatal mortality rate in the area. Setting: Rural areas of six Primary Health Centers of Jamnagar district of Gujarat State. Study design: Community based cohort study. Sample size: Population of 40512 Participants: Members of the family in which neonatal deaths occurred. Outcome variable: Neonatal mortality Analysis: Sample proportions. Results: Neonatal mortality rate on the basis of follow-up of births during one year was found to be 47.27 per thousand live births. The major maternal and socio-demographic factors responsible for neonatal mortality were; maternal age, illiteracy, lack of antenatal care, closely spaced pregnancies, delivery conducted at home, delivery conducted untrained personnel and delayed initiation of breast feeding. The major neonatal factors responsible for mortality in neonates were; low birth weight, prematurity, first order of birth, early phase of neonatal period, male gender of the child. The leading causes of neonatal mortality were found to be prematurity, birth asphyxia, neonatal infections and congenital anomalies.

  11. Analysis of Effectiveness and Safety of Assisted Delivery

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    Kozlova T.U.

    2014-06-01

    Full Text Available Aim: to study the outcomes of labour after the application of «KIWI» vacuum-system. Materials and Methods. Retrospective analysis of labour records with vacuum-extraction of fetus (main group: n=35 and with emergency cesarean section (comparison group: n=18on indications similar to those in the main group, has been undertaken. Results. High rate of extragenital pathology in groups (70,7% and 72,3% as well as aggravated obstetric-gynecologic anamnesis (36,9% and 55,6% has been revealed. Pregnancies of 50,7% women of the main group have been complicated by placentofetal insufficiency and chronic fetal hypoxia; in the comparison group 27,7% threatened miscarriage has been observed accordingly in 20% and 33,3%. Conditions for vacuum extraction have been the following: fetus asphyxia (52,3%, labour pains weakness (47,7%. Having evaluated the state of health of the new-born children of the main groupstraight complications (cephalohematomas, cervical injury, subaponeurotic hemorrhage, Duchen-Erb paresis, intraventricularhemorrage have been observed in 53,8% of children. In the comparison group direct complications have been marked in 22,3% of cases. Conclusions. Comparatively high rate of labour traumatism in the main group may be explained by violations in conditions and techniques of vacuum-extractions as well as by non-observance of indications and contra-indications for the application of this operational method during the labour of pregnant women of high risk groups.

  12. What neonatal complications should the pediatrician be aware of in case of maternal gestational diabetes?

    Science.gov (United States)

    Mitanchez, Delphine; Yzydorczyk, Catherine; Simeoni, Umberto

    2015-06-10

    In the epidemiologic context of maternal obesity and type 2 diabetes (T2D), the incidence of gestational diabetes has significantly increased in the last decades. Infants of diabetic mothers are prone to various neonatal adverse outcomes, including metabolic and hematologic disorders, respiratory distress, cardiac disorders and neurologic impairment due to perinatal asphyxia and birth traumas, among others. Macrosomia is the most constant consequence of diabetes and its severity is mainly influenced by maternal blood glucose level. Neonatal hypoglycemia is the main metabolic disorder that should be prevented as soon as possible after birth. The severity of macrosomia and the maternal health condition have a strong impact on the frequency and the severity of adverse neonatal outcomes. Pregestational T2D and maternal obesity significantly increase the risk of perinatal death and birth defects. The high incidence of maternal hyperglycemia in developing countries, associated with the scarcity of maternal and neonatal care, seriously increase the burden of neonatal complications in these countries. PMID:26069722

  13. The evidential value of intra-alveolar haemosiderin-macrophages in cases of sudden infant death syndrome (SIDS).

    Science.gov (United States)

    Kernbach-Wighton, G; Albalooshi, Y; Madea, B

    2012-10-10

    Intra-alveolar deposits of haemosiderin have repeatedly been brought into connection with some diagnostic value, such as markers for previous imposed suffocation, smothering due to Munchausen syndrome by proxy or sudden infant death syndrome (SIDS). This study is based on 104 SIDS cases and 14 controls (causes of death, e.g. inflammatory changes, internal haemorrhages, asphyxia, blunt force trauma or acute toxicity). The SIDS group comprised 44 females (aged 7 days to 12 months) and 60 males (aged 12 days to 16 months 8 days) with the ages of the controls ranging from 2 months 3 days to 47 months. Routine histology samples from the lungs were stained with Prussian blue and haemosiderin foci were counted in 20 hpf for each lung lobe by a pathologist blinded to the cause of death. Results were assigned to one of five categories for haemosiderin positivity. Data were analysed by the Levene-test revealing identical variances in both groups and with a two-sample t-test showing the mean values for haemosiderin counts not being significantly different between SIDS and control groups. Although the sizes of both samples differed considerably it is our opinion that the haemosiderin counts did not show sufficient diagnostic value. This outcome supports the latest results of other comparable investigations. Furthermore, it highlights the necessity to assess carefully positive haemosiderin findings to avoid false suspicion. PMID:22704554

  14. One Hundred and One Cases of Plastic Bag Suffocation in the Milan Area Between 1993 and 2013-Correlations, Circumstances, Pathological and Forensic Evidences and Literature Review.

    Science.gov (United States)

    Crudele, Graziano Domenico Luigi; Di Candia, Domenico; Gentile, Guendalina; Marchesi, Matteo; Rancati, Alessandra; Zoja, Riccardo

    2016-03-01

    Plastic Bag Suffocation is a rare cause of death in developed countries and almost unknown in the rest of the world. This study aims to retrospectively evaluate cases of PBS _asphyxia in Milan's Department of Legal Medicine from 1993 to 2013. Cases were selected from the database of 21,472 autopsies performed in the considered timeframe. One hundred and one cases were considered to be cases of Plastic Bag Suffocation, comprised of 100 suicides, no accidental events and 1 homicide. The most relevant elements pertaining to this type of death were evaluated for both the corpses and the crime scenes. From this study the typical PBS victim is an adult male, aged 52.3 years on average, depressed or afflicted by chronic or terminal diseases, and found at home. In 42.6% of cases, the victims were found with the plastic bag still positioned over their head, fastened by tying. Also common among these cases are drugs, alcohol and chemical abuses. According to the collected data, it is impossible to outline a pathognomonic detrimental background that leads to this cause of death. Crime scene investigation is, therefore, the one and only technical resource for evaluating these cases. PMID:27404609

  15. Animal experimentation in forensic sciences: How far have we come?

    Science.gov (United States)

    Cattaneo, C; Maderna, E; Rendinelli, A; Gibelli, D

    2015-09-01

    In the third millennium where ethical, ethological and cultural evolution seem to be leading more and more towards an inter-species society, the issue of animal experimentation is a moral dilemma. Speaking from a self-interested human perspective, avoiding all animal testing where human disease and therapy are concerned may be very difficult or even impossible; such testing may not be so easily justifiable when suffering-or killing-of non human animals is inflicted for forensic research. In order to verify how forensic scientists are evolving in this ethical issue, we undertook a systematic review of the current literature. We investigated the frequency of animal experimentation in forensic studies in the past 15 years and trends in publication in the main forensic science journals. Types of species, lesions inflicted, manner of sedation or anesthesia and euthanasia were examined in a total of 404 articles reviewed, among which 279 (69.1%) concerned studies involving animals sacrificed exclusively for the sake of the experiment. Killing still frequently includes painful methods such as blunt trauma, electrocution, mechanical asphyxia, hypothermia, and even exsanguination; of all these animals, apparently only 60.8% were anesthetized. The most recent call for a severe reduction if not a total halt to the use of animals in forensic sciences was made by Bernard Knight in 1992. In fact the principle of reduction and replacement, frequently respected in clinical research, must be considered the basis for forensic science research needing animals. PMID:26216717

  16. [Intracardial fungal multiplication of order Mucor in an almost totally carbonised part of a male body found after ten days missing].

    Science.gov (United States)

    Iannaccone, Silvia Farkašová; Klán, Jaroslav; Lamps, Laura W; Farkaš, Daniel; Švajdler Ml, Marián; Szabo, Miroslav

    2016-01-01

    Determination of time of death belongs to the most difficult and also the most important issues for the medical examiners, especially those who deal with violent death. Besides the most frequently evaluated postmortal changes it is sometimes possible to perform the evaluation on the basis of less frequently observed findings. One of such findings is for example the fungal multiplication on the body or in the very close vicinity. Knowledge of moulds as well as information about their speed of growth should contribute to confirmation or negation of some information gained during police investigation. In this case report authors describe the macroscopically visible fungal intracardiac multiplication in heart chambers and aorta in an almost totally carbonised body which was missing for only ten days. Based on the molecular examination it was detected that the body belonged to the 64-year-old man who was repeatedly hospitalised in psychiatry for depression with suicidal tendencies. The last hospitalisation was six weeks before death and there was no organic disability. The cause of fire was a naked flame. The cause of death was burn injury or asphyxia. The almost total carbonisation did not allow to perform toxicological investigation. By histological investigation we found the presence of wide long non-septate moulds growing in the heart muscle, which belonged to the order Mucor. Since there was no obvious inflammatory response, we suppose their growth started on the congealed blood after death. PMID:27526266

  17. The fetal circulation, pathophysiology of hypoxemic respiratory failure and pulmonary hypertension in neonates, and the role of oxygen therapy.

    Science.gov (United States)

    Lakshminrusimha, S; Saugstad, O D

    2016-06-01

    Neonatal hypoxemic respiratory failure (HRF), a deficiency of oxygenation associated with insufficient ventilation, can occur due to a variety of etiologies. HRF can result when pulmonary vascular resistance (PVR) fails to decrease at birth, leading to persistent pulmonary hypertension of newborn (PPHN), or as a result of various lung disorders including congenital abnormalities such as diaphragmatic hernia, and disorders of transition such as respiratory distress syndrome, transient tachypnea of newborn and perinatal asphyxia. PVR changes throughout fetal life, evident by the dynamic changes in pulmonary blood flow at different gestational ages. Pulmonary vascular transition at birth requires an interplay between multiple vasoactive mediators such as nitric oxide, which can be potentially inactivated by superoxide anions. Superoxide anions have a key role in the pathophysiology of HRF. Oxygen (O2) therapy, used in newborns long before our knowledge of the complex nature of HRF and PPHN, has continued to evolve. Over time has come the discovery that too much O2 can be toxic. Recommendations on the optimal inspired O2 levels to initiate resuscitation in term newborns have ranged from 100% (pre 1998) to the currently recommended use of room air (21%). Questions remain about the most effective levels, particularly in preterm and low birth weight newborns. Attaining the appropriate balance between hypoxemia and hyperoxemia, and targeting treatments to the pathophysiology of HRF in each individual newborn are critical factors in the development of improved therapies to optimize outcomes. PMID:27225963

  18. Progress in the animal model of cerebral palsy%脑性瘫痪动物模型的研究进展

    Institute of Scientific and Technical Information of China (English)

    黄会芝

    2011-01-01

    Cerebral palsy is a major cause of severe chronic disability in children. Experimental models aim to replicate one or more features of cerebral palsy in developing animals. These models are as heterogeneous as the disorder itself, such as timing.and mechanism of injury (stroke, infection, congenital malformation or asphyxia),target of injury (white matter or neurons) or function outcome. This review is to summarize different experimental models in cerebral palsy.%脑性瘫痪(脑瘫)是导致儿童严重慢性残疾的重要原因。应用动物模型的目的是在动物身上复制一种或更多的脑瘫特征来进行研究,而这些模型和疾患本身一样是具有异质性的,如损伤发作的时间和机制(中风、感染、先天畸形或窒息)、损伤的靶点(白质或神经元)或功能结果等。该文对不同的脑瘫动物模型作一综述。

  19. Brain MRI and single photon emission computed tomography in severe athetotic cerebral palsy. A comparative study with mental and motor disorders

    International Nuclear Information System (INIS)

    Single photon emission computed tomography (SPECT) using N-isopropyl-p-[123I]-iodoamphetamine (123I-IMP) was performed in twelve patients with severe athetotic cerebral palsy (Ath; 5 males and 7 females) who had both motor delay (unable to move) and mental retardation (I.Q, or D.Q, below 30). The neuroimaging findings of those patients were compared with those of patients mental and motor disorders. In five caes suffering from neonatal asphyxia, SPECT demonstrated a decreased regional cerebral blood flow (rCBF) in corpus striatum, thalamus, orbitofrontal areas, pericentral gyrus areas, prefrontal areas and medial temporal areas. In seven cases suffering from neonatal jaundice, SPECT demonstrated a decreased rCBF in orbito-frontal areas, prefrontal areas and medial temporal areas. SPECT showed hypoperfusion of peri-central gyrus areas in cases with complications of spastic palsy. The decreased rCBF in medial temporal areas mostly corresponded to an alteration in hippocampal formation as assessed by magnetic resonance imaging (MRI). Cases with hypoperfusion of bilateral medial temporal areas showed a lower score of language understanding than those with the unilateral damage. In cases with hypofusion of bilateral prefrontal areas and bilateral medial temporal areas, the grade of understanding of language was almost below 12 months. In cases with hypoperfusion of orbitofrontal areas, psychomotor hypersensitivity had been observed. Those results suggest that IMP-SPECT and MRI of the brain is useful tool for neurological assessment in handicapped patients with athetotic cerebral palsy. (author)

  20. CT findings of cerebral palsy and behaviour development

    International Nuclear Information System (INIS)

    It is well recognized that CT scan is very useful in the early diagnosis of cerebral palsy. The author has studied this time the CT scan findings of cerebral palsy children in their relations to the type of palsy, cause of palsy, complications in the central nervous system, and prognosis of behaviour development, in order to predict the prognosis of behaviour development. Dilatation of the contralateral cerebral ventricle was found in 82 % of hemiplegic type. Abnormal EEG was found in 73 %, but their behaviour development was satisfactory, with good development of speech regardless to the side of palsy. This might be helped by compensational function of the brain due to plasticity. Diplegia presented bilateral moderate dilatation of ventricles with favorable prognosis. Tetraplegia was caused mostly by asphyxia or congenital anomaly and revealed marked dilatation of ventricles or severe cortical atrophy. Some cases presented diffuse cortical low-density, often associated with abnormal EEG, and their prognosis was worst. Athetosis had normal CT finding or mild ventricular dilatation, but all cases of ataxia presented normal CT findings. Hypotonia had mild ventricular dilatation. Two of three mixed type cases had normal CT findings and another had mild ventricular dilatation. No correlation was found between ventricular dilatation and behaviour development, but statistically significant difference was found in the cases with 30 % or more Evans' ratio (P < 0.05). Prognosis of severe ventricular dilatation cases was poor. (author)

  1. Deaths from abuse of volatile substances: a national epidemiological study.

    Science.gov (United States)

    Anderson, H R; Macnair, R S; Ramsey, J D

    1985-01-26

    A survey of the United Kingdom detected 282 deaths from abuse of volatile substances during 1971-83. Deaths appeared to have increased in the most recent years, reaching 80 in 1983. Age at death ranged from 11 to 76 years but most deaths (72%) occurred under 20 years. Ninety five per cent of the subjects were male, and in 1983 deaths from volatile substance abuse accounted for 2% of all deaths in males aged 10-19. All areas of the United Kingdom were affected, the rates being highest in Scotland and urban areas. All social classes were affected, though rates were highest in social class V and the armed forces. The volatile substances abused were gas fuels (24%), mainly butane; aerosol sprays (17%); solvents in glues (27%); and other volatile substances, such as cleaning agents (31%). In 51% of cases death was attributed to the direct toxic effects of the substance abused, in 21% to plastic bag asphyxia, in 18% to inhalation of stomach contents, and in 11% to trauma. Deaths associated with the abuse of glues were more likely to be traumatic, but all substances appeared capable of killing directly by their toxic effects, probably by a cardiac mechanism. Only a small proportion of deaths (6%) were due to the abuse of glues among children under 16; hence current attempts to limit access of children to glues will probably have little impact on overall mortality. PMID:3917795

  2. Severe anemia and hydrops in a neonate with parvovirus B19 infection: a case report

    Directory of Open Access Journals (Sweden)

    Negar Sajjadian

    2013-12-01

    Full Text Available Background: Anemia at the time of birth may cause some problem like asphyxia, heart failure shock or even death in a neonate. Different etiologies can be considered for this problem. Parvovirus B19, as a viral organism, can cause hydrops fetalis and neonatal anemia and consequent complications. We present here a case of newborn infant with severe anemia who had human parvovirus B19 infection.Case Presentation: A male newborn with gestational age of 36 week was born from a mother with poor prenatal care and history of contact with domestic animal. The neonate was very pale with Apgar score 2 at 1 min and received resuscitation, mechanical ventilation and repeated blood transfusion The hemoglobin level was significantly low. Analysis was made based on the clinical presentations. According to the case history, physical and laboratory findings, neonatal severe anemia induced by parvovirus B19 infection was suggested and Laboratory work up documented his infection with parovirus B19.Conclusion: Parvovirus B19 (B19 virus is the smallest single strand linear DNA virus in animal viruses, which is the only strain of parvovirus that is pathogenic in humans. Human parvovirus B19 may cross the placenta and result in fetal infection, morbidity and death. Parvovirus is an uncommon cause of neonatal anemia and hydrops fetalis so this etiology must be considered in differential diagnosis of anemia at birth.

  3. Pulmonary thromboembolism in children

    Energy Technology Data Exchange (ETDEWEB)

    Babyn, Paul S.; Gahunia, Harpal K. [Hospital for Sick Children, Department of Pediatric Diagnostic Imaging, Toronto, ON (Canada); Massicotte, Patricia [Stollery Children' s Hospital and University of Alberta, Departments of Pediatric Hematology and Cardiology, Edmonton, AB (Canada)

    2005-03-01

    Pulmonary thromboembolism (PTE) is uncommonly diagnosed in the pediatric patient, and indeed often only discovered on autopsy. The incidence of pediatric PTE depends upon the associated underlying disease, diagnostic tests used, and index of suspicion. Multiple risk factors can be found including: peripartum asphyxia, dyspnea, haemoptysis, chest pain, dehydration, septicemia, central venous lines (CVLs), trauma, surgery, ongoing hemolysis, vascular lesions, malignancy, renal disease, foreign bodies or, uncommonly, intracranial venous sinus thrombosis, burns, or nonbacterial thrombotic endocarditis. Other types of embolism can occur uncommonly in childhood and need to be recognized, as the required treatment will vary. These include pulmonary cytolytic thrombi, foreign bodies, tumor and septic emboli, and post-traumatic fat emboli. No single noninvasive test for pulmonary embolism is both sensitive and specific. A combination of diagnostic procedures must be used to identify suspect or confirmed cases of PTE. This article reviews the risk factors, clinical presentation and treatment of pulmonary embolism in children. It also highlights the current diagnostic tools and protocols used to evaluate pulmonary embolism in pediatric patients. (orig.)

  4. Medical effects of volcanic eruptions

    Science.gov (United States)

    Baxter, Peter J.

    1990-09-01

    Excluding famine and tsunamis, most deaths in volcanic eruptions have been from pyroclastic flows and surges (nuées ardentes) and wet debris flows (lahars). Information on the causes of death and injury in eruptions is sparse but the available literature is summarised for the benefit of volcanologists and emergency planners. In nuées, thermal injury may be at least as important as asphyxia in causing immediate deaths. The high temperature of the gases and entrained particles readily causes severe burns to the skin and the air passages and the presence of both types of injury in an individual may combine to increase the delayed mortality risk from respiratory complications or from infection of burns. Trauma from missiles or body displacement is also common, but the role of asphyxiant or irritant gases, and steam, remains unclear. The ratio of dead: injured is much higher than in other natural disasters. At the periphery of a nuée being protected inside buildings which remain intact appears to greatly increase the chances of survival. In lahars, infected wounds and crush injury are the main delayed causes of death, and the scope for preventive measures, other than evacuation, is small. The evidence from Mount St. Helens, 1980, and other major eruptions indicates that, although mortality is high within the main zone of devastation and in the open, emergency planning should concentrate on the periphery of a nuée where preventive measures are feasible and could save many lives in densely populated areas.

  5. Successful intrauterine treatment and good long-term outcome in an extremely severe case of fetal hemolytic disease.

    Science.gov (United States)

    Dębska, Marzena; Kretowicz, Piotr; Tarasiuk, Anna; Dangel, Joanna; Dębski, Romuald

    2014-06-01

    A 34-year-old multiparous woman presented with anti-Rh-D antibodies (1: 512) and fetal hydrops at the 21(st) week of gestation. Ultrasound revealed massive fetal skin edema, ascites, hepatomegaly, placentomegaly, and anhydramnios. No fetal movements were observed. Fetal heart was enlarged, with reportedly decreased contractibility. The Doppler parameters were abnormal: the peak systolic velocity in median cerebral artery (MCA PSV) was increased (84 cm/s, 3 MoM), and absent end diastolic flow (AEDF) was reported in the umbilical artery. Ultrasound examination indicated severe fetal anemia and heart failure. Umbilical vein puncture was performed and the fetal blood count was determined (RBC 0.01 × 10(6)/µl, Ht 0.1%, PLT 67 × 10(3)/µl, WBC 2.1 × 10(3)/µl, indeterminable hemoglobin level). Packed red blood cells (0 Rh-, 30 ml) were immediately transfused to the fetus. Altogether, seven intrauterine transfusions were performed. Fetal hydrops disappeared gradually during the next few weeks. The male neonate (1860 g, 45 cm, Apgar score 3-4) was delivered after the last transfusion at 34(th) week of gestation due of intrauterine asphyxia. The infant was discharged after 21 days, in good condition, on breastfeeding. There was one 10 mm focus of periventricular leukomalacia in the brain, diagnosed based on trans-fontanel ultrasound, without any signs of damage to other organs. At the age of 5 years, the child is healthy, with no abnormalities in his neurodevelopmental parameters. PMID:26673879

  6. [Full-term pregnancy following failed induced abortion].

    Science.gov (United States)

    Pirhonen, J; Hulkko, S

    1986-01-01

    This study introduces a case of an 18 year old student who developed a full-term pregnancy following failed induced abortion. The abortion was performed during the 7th week of pregnancy by dilating the cervix and suctioning with the tip of a number 8 aspirator. A regular amount of pregnancy material was obtained, and the uterus was checked with a normal curette. After 3 months, when the patient's period did not recommence, a diagnosis of normal pregnancy was made. Delivery was performed by section after 2 inductions because of weak contractions, maternal exhaustion and threatening fetal asphyxia. The baby was normal and satisfactorily developed on follow-up. In conclusion, it is rare for pregnancy to continue after an abortion by aspiration. In a previous study by Fielding (1978), only 3 cases similar to this were followed. 2 of them miscarried and 1 delivered a defective baby. Among the causes of failed abortion are severely retrograded uterus, growth and developmental problems of the uterus and defective cervix. The risks are greater in the earlier weeks of pregnancy. Inexperience and technical difficulties are also reported as factors in failed abortion, as well as aspiration on only 1 fetus in cases of twin pregnancy. The authors recommend consideration of the mentioned risk factors, using sonography in suspicious cases, examining the amount of pregnancy material an always performing a follow-up examination. PMID:3757838

  7. Exploring soil water budget of a pristine oak wood in peri-urban Rome, central Italy

    Directory of Open Access Journals (Sweden)

    Valerio Moretti

    2014-06-01

    Full Text Available 72 544x376 Normal 0 14 false false false IT X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabella normale"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Calibri","sans-serif";} Exploring soil water budget of a pristine oak wood in peri-urban Rome, central Italy. The water budget in bounded and fenced areas was assessed by analyzing pedo-climatic conditions and the soil moisture content. Water content in the soil was measured using a Theta Probe Soil Moisture sensor (ML2x by Delta-T-Devices with a direct read-out device that provides soil moisture estimates as percent volume. The correlation between the experimental values obtained by the gravimetricmethod and thevalues directly measured by Theta Probe was found significant. Soil moisture at 100 cm depth indicates soil water as permanently available for plants through the year except during exceptionally dry summer periods. Therefore, oaks experienced no water deficiency with normal rainfall rates, possibly suffering root asphyxia during rainy years. Results are collected in fenced areas, sheltered by the action of the local fauna.

  8. Surgical Treatment of Neonatal Necrotic Enterocolitis: An Analysis of 17 Cases%新生儿坏死性小肠结肠炎的外科处理(附17例报告)

    Institute of Scientific and Technical Information of China (English)

    陈永田; 谷兴琳

    1983-01-01

    @@ 新生儿坏死性小肠结肠炎(简写NNE)是新生儿严重的消化道疾病.虽然近年来外科处理有很大进展,但手术死亡率仍高达39~68(1~5)%.%Neonatal necrotic enterocolitis, a lethal disease in premature infancy, is common in newborns. This report details surgical treatment of 17 infants (13 males and 4 females) in the past 10 years.Asphyxia -was noted only in 2 cases. All the patients had abdominal distension. Other physical findings include: vomiting (6 cases), diarrhea (2), lower abdomen mass (1), blood in stool (6)and fiery swelling in the abdominal wall (8).In 16 cases, the X-rays demonstrated intestinal distension with fluid levels resulting from:pneumoperitoneum (12 cases), pneu-motosis (4), portal vein gas (2) and ascites (2).Surgical interventions were indicated to 11 patients with pneumoperitoneum, 2 with clinical deterioration and 1 with positive paracentesis findings.Procedures applied in this series consist of: simple repairing of restricted perforation (4), simple explorative laparotomy or colonic resection followed by primary anastomosis or enterostomy. But in one case, the necrosis was not clearly bordered, so only the completely necrotic segment of the intestine was resected while the less affected part left untouched. Then, an anastomosis. Yet, short-bowel syndrome developed afterwards.Mortality was recorded as 30%.

  9. Massive Myocardial Infarction in a Full-Term Newborn: A Case Report

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    Emilio Caselli

    2010-01-01

    Full Text Available A full-term female newborn with neonatal asphyxia and severe anemia (Hb 2.5 g/dL with normal heart developed a massive myocardial infarction. No examinations were performed during pregnancy for parental nomadism. The baby had immediate external cardiac massage, ventilatory assistance, and blood transfusion. Cardiomegaly was evident at chest X-ray and marked signs of ischemia-lesion at ECG. Echocardiography showed dilated, hypertrophic, and hypocontractile left ventricle (LV, mitral and tricuspid regurgitation, and moderate pericardial effusion. Rh isoimmunization and infective agents were excluded at laboratory tests. Despite the treatment with inotropes, hydrocortisone, and furosemide, the baby worsened and died at 45 hours of life. Postmortem examination showed diffuse subendocardial infarction of LV and diffuse parenchymal hemorrhages and myocardial hypertrophy, increase of eosinophilia, and polymorphonucleated cells at histology. Our patient suffered apparently from longstanding fetal anemia of unknown etiology that led to perinatal distress, severe hypoxia, and massive myocardial infarction, unresponsive to the therapy.

  10. Cranial computed tomography and real-time sonography in full-term neonates and infants

    International Nuclear Information System (INIS)

    The results of cranial ultrasonography (US) and computed tomography (CT) were compared in 52 full-term neonates and young infants. The chief indications for examination included: increasing head size, dysmorphic features, myelomeningocele, inflammatory disease, and asphyxia. Disorders detected included hydrocephalus, parenchymal abnormalities, intracranial hemorrhage, extraparenchymal fluid collections, and vascular and other developmental malformations. CT and US essentially were equivalent in detecting hydrocephalus, moderate to large intraventricular hemorrhages or subdural collections, and large focal parenchymal lesions, although CT was somewhat better in determining the level and cause of obstruction in patients with hydrocephalus and characterizing parenchymal abnormalities. CT was more sensitive than ultrasound in detecting subarachnoid hemorrhage (100% vs. 0%), diffuse parenchymal abnormality (100% vs. 33%), and small intraventricular hemorrhages (100% vs. 0%) but these lesions often were not clinically significant. The results suggest that US should be used as the primary neuroradiological examination in term infants; CT probably should be reserved for further investigation after US in those patients with a history of hypoxia and progressive clinical deterioration

  11. The effectiveness analysis on systematic first aid skills training to enhance the overall level of hospital rescue%系统急救技能培训对提高基层医院整体抢救水平的效果分析

    Institute of Scientific and Technical Information of China (English)

    舒信显; 孙香玲

    2013-01-01

    and senior obstetric life support) were dispatched as faculty reserves and responsible for retraining in the hospital.Emergency simulation exercises matching with obstetrics and gynecology characteristics were carry out.Medical staff were assessed before and after training and exercises.Incidence of neonatal asphyxia and neonatal severe asphyxia and the success rate hospital critically ill patients before training (in 2010) and after training (in 2012) were compared to evaluate actual effect through training.Results Basic first aid theory,basic first aid operation skills and first aid simulation exercise scores of the medical staff participating in the training were better than before training(P<0.01).Compared with pre-training's,the incidence of neonatal asphyxia (including severe asphyxia) was significantly lower (P < 0.01) and the success rate of the hospital critically ill patients improved significantly (P<0.01).Conclusions First aid simulation exercise matching with basic first aid theory and basic first aid operation skills training was effective method to improve individual and overall hospital emergency comprehensive ability and a viable mode of system first aid training.

  12. Premature infants' health at multiple induced pregnancy.

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    Chernenkov Yu.V.

    2015-09-01

    Full Text Available Objective: to define the risk factors adversely influencing prenatal development at premature birth at use of methods of assisted reproductive technology (ART; to estimate premature' infants health from multiple induced pregnancy according to Perinatal Center of Saratov for last 3 years. Material and Methods. Under supervision there were 139 pregnant women with application ART. 202 children (51 twins were born and 5 triplet babies, from them 83 premature infants born from multiple induced pregnancy have been analyzed. Results. The newborns examined by method ART, were distributed as follows: 22-28 weeks — 19 children; 29-32 weeks — 23; 33-36 weeks — 41. Asphyxia at birth was marked at all premature infants. Respiratory insufficiency at birth is revealed in 87,3% of cases. The most frequent pathologies in premature infants are revealed: neurologic infringements and bronchopulmonary pathology occured at all children, developmental anomaly — 33, 8%, retinopathies in premature infants — 26,5%. The mortality causes include: extreme immaturity, cerebral leukomalacia, IVN 3 degrees. Conclusion. The risk factors, premature birth at application of methods ART are revealed: aged primiparas, pharmacological influence, absence of physiological conditions of prenatal development; multifetation. The high percent of birth of children with ELBW and ULBW is revealed. RDCN with further BPD development, retinopathies in premature infants and CNS defeat is more often occured.

  13. Clinical value of periventricular low-intensity areas detected by fluid attenuated inversion recovery (FLAIR). Relationships between perinatal vital parameter and neonatal MRI

    International Nuclear Information System (INIS)

    A follow-up study was performed to assess the correlation among the incidence of periventricular low intensities (PVLI) on MRI (magnetic resonance imaging) FLAIR (fluid attenuated inversion recovery) imaging, clinical evidence of perinatal insults that may cause white matter damage, and the outcome of the infants. We evaluated periventricular white matter lesions of 329 neonates whose MRI were obtained before two months corrected age. The detective rate of periventricular abnormalities on FLAIR imaging was significantly higher than that of T1-T2 weighted imaging. The most typical lesion detected on FLAIR imaging was periventricular low intensities (PVLI), frequently observed in the neonates with a history of preterm labour, very low birth weight, birth asphyxia and severe respiratory failure. Although we could not characterize the risk factors of PVLI, the incidence of PVLI had a strong correlation with the scores of motor and developmental tests at 12 and 36-months corrected age. In conclusion, FLAIR imaging, detecting the border zone damage of white matter, would be a strong tool to pick out neonates at high risk of neurological disturbances from those without clinical evidence of neurological insults in the neonatal period. (author)

  14. Multicenter clinical study on umbilical cord arterial blood gas parameters for diagnosis of neonatal asphysia%脐动脉血气指标诊断新生儿窒息的多中心临床研究

    Institute of Scientific and Technical Information of China (English)

    新生儿脐动脉血气指标研究协作组

    2010-01-01

    Objective To obtain the normal range of statistics of umbilical artery blood gas parameters of the newborns for diagnosis of neonatal asphyxia.Methods From March 2008 through September 2009,17 978 singleton term appropriate for gestationa age(AGA)or larger than gestational age(LGA)newborns in six hospitals of five provinces/autonomous regions were consecutively enrolled in this prospective study.The normal ranges of umbilical artery blood gas parameters were obtained from 17 645newborns with 1 min Apgar score ≥ 8.The correlations between umbilical artery blood pH,BE and prenatal high-risk factors,Apgar scores,and organ damage were analyzed.The diagnostic criteria for asphyxia included the following:(1)Having high-risk factors that might cause asphyxia;(2)1 min Apgar score ≤7(the respiratory depression must be present);(3)At least one organ showed evidence of hypoxic damage;(4)Other causes of low Apgar score were excluded.The study focused on the distributive characteristics of umbilical artery blood pH(clinically corrected by Eisenberg formula)and BE values of the asphyxiated and non-asphyxiated cases in low Apgar score group,as well as the sensitivity and specificity of different selected pH and BE threshold spots within their distributing ranges.Results Among the 17 978 singleton term AGA or LGA newborns,the statistically normal range of umbilical artery blood pH,BE for the 17 645 cases with 1 min Apgar scores ≥ 8 were 7.20 ±0.20((-x)±1.96 s)and -7.64±10.02((-x)± 1.96 s),respectively.The pH well correlated positively with BE(r = 0.734,P <0.01).The umbilical artery blood pH and BE values correlated positively with the Apgar scores.The umbilical artery blood pH and BE values correlated negatively with organ damage(r = 1 ,the P values =0.000 for both).Among the 333 low Apgar score cases,the umbilical artery blood pH corrected values and BE values of the asphyxiated group(163cases)were7.011 ±0.09((-x)±s)and -14.98 ±2.99((-x)±s),being lower than 7.18 ±0

  15. 100例卖淫女被杀案的法医学检验分析%The forensic analysis of 100 prostitute murders

    Institute of Scientific and Technical Information of China (English)

    吕途; 欧桂生; 成建定; 骞润宇; 金洪年; 成明; 马雁兵

    2011-01-01

    Objective Analyze the characteristics of prostitute murders in order to provide references for forensic examination and investigation. Methods The crime scene and autopsy data of 100 cases occurring between 2005 - 2010 were studied retrospectively with epidemiologic description. Results Prostitute murders mainly took place at 9:00pm-3:00am in the city . Peak months of occurrence were April and July . Indoor crime scenes occupied 85.0% of all cases . The age of 95.0% cases ranged from 16 to 40 years old.Hemorrhagic shock and mechanical asphyxia were main causes of deaths, occupied 59.0% and 38. 1%respectively. With or without uterine congestion was associated with the degree of mechanical asphyxia. Indoor crime scenes with weapons, counterreconnaissance behaviors and without used condoms expressed the information of acquaintance violence. Percentage correct of the logistic equation was 80.5%. Conclusion The time, place and victim' s characteristics of prostitute murders are concentrative. Detailed autopsy of uterus is important for the analysis of victim's identity and cause of death. The result of logistic regression is referenced for crime scene analysis.%目的 分析卖淫女被杀案件的规律特点,为此类案件检验侦查提供参考.方法 采用描述性研究方法,对2005至2010年的100例卖淫女被杀案件进行回顾性分析.结果 此类案件66.7%发生于21时至3时之间,88.0%发生于城市.4、7两月发案最多.85.0%的案件发生于室内.95.0%的死者年龄在16~40岁.38.1%的死因为机械性窒息,59.0%的死因为失血性休克.子宫淤血与机械性窒息有关.现场是否遗留使用过的避孕套、作案工具及有无反侦察行为是判断熟人作案的3个重要因素,logistic回归方程分析的总判对率为80.5%.结论 卖淫女被杀案的发案时间集中,发案场所类型固定,被害人特征突出,子宫检验对确定被害人身份及死因有重要价值,logistic回归分析在室内

  16. 产前焦虑抑郁情绪对产科并发症和妊娠结局的影响%The influence of obstetric complications and pregnancy outcome because of prenatal anxiety and depression

    Institute of Scientific and Technical Information of China (English)

    丁海燕; 安晨凤; 孙超

    2015-01-01

    目的 探讨产前焦虑抑郁情绪对产科并发症和妊娠结局的影响.方法 选择100例孕妇为研究对象,采用焦虑自评量表(SAS)和抑郁自评量表(SDS)对孕妇的情绪进行评估,SAS标准分≥50分或SDS标准分≥53分者为观察组,SAS标准分<50分且SDS标准分<53分者为对照组,比较两组孕妇分娩方式、先兆子痫、妊娠剧吐、妊娠期糖尿病、围产期感染、羊水过多、羊水过少、胎膜早破、产后出血、胎儿宫内窘迫、早产、低体质量、新生儿窒息发生情况.结果 对照组初产妇剖宫产率明显低于观察组(4.00%比22.00%,x2 =7.161,P<0.05),观察组产科并发症发生率明显高于对照组(32.00%比2.00%,x2=15.946,P<0.05),对照组围生儿结局显著优于观察组(4.00%比20.00%,x2=6.061,P<0.05).结论 产前焦虑抑郁情绪明显增加孕妇产科并发症,增加围生儿胎儿宫内窘迫、早产、低出生体质量、新生儿窒息的发生概率.%Objective To investigate the influence of obstetric complications and pregnancy outcome because of prenatal anxiety and depression.Me~ods One hundred primipara were selected as the research objects,their emotions were evaluated by Self-Rating Anxiety Scale(SAS),Self-Rating depression Scale(SDS).The patients' scores of SAS ≥50points or SDS ≥ 53points were selected as the observation group,the patients'scores of SAS ≥ 50points and SDS≥53points were selected as the control group.The pregnant women childbirth way,preeclampsia,hyperemesis gravidarum,gestational diabetes,perinatal infection,hydramnios,oligohydramnios,premature rupture of membranes,postpartum hemorrhage,fetal distress,premature birth,low birth quality,neonatal asphyxia of two groups were compared.ResultsThe primipara cesarean delivery rate of the control group was lower than that of the observation group(4.00% vs 22.00%,x2 =7.161,P <0.05),the obstetric complications incidence of the observation group was higher

  17. 渭南市2006至2010年5岁以下儿童死因分析%Analysis of death cause of children under age 5 from 2006 to 2010 in Weinan

    Institute of Scientific and Technical Information of China (English)

    赵丽萍; 曹敏辉

    2013-01-01

    Objective To master the death status of children under 5 from 2006 to 2010 in Weinan City so as to explore effective intervention measures. Methods All death report cards from 2006 to 2010 were subjected to statistical analysis of death of children under 5. Results Neonatal mortality, infant mortality, mortality of children under 5 was 10. 79%c, 13. 13 %c and 14. 77 %c, respectively. The constituent ratio of neonatal death, infant death and death of children aged 1-4 in death of children aged 1-5 was 68. 16% , 88. 94% and 11.06% , respectively. The death analysis of children under 5 in Weinan from 2006 to 2008 showed that χ2tuend was 38. 18 ( P = 0. 0001 < 0.01 ), and the mortality decreased year after year. The first death cause of children under 5 was asphyxia, followed by premature and low birth weight, pneumonia, other congenital anomalies and congenital heart disease in turn. Conclusion Reducing neonatal mortality and infant mortality is the key to reduce the mortality of children under 5. Preventing preterm birth and low birth weight, birth defects and birth asphyxia is the necessary tideway of the situation.%目的 掌握渭南市2006至2010年5岁以下儿童死亡状况,探讨有效的干预措施.方法 对2006至2010年渭南市5岁以下儿童死亡报告卡进行整理统计分析.结果 新生儿死亡率、婴儿死亡率、5岁以下儿童死亡率分别为10.79‰、13.13‰、14.77‰.新生儿死亡、婴儿死亡、1~4岁儿童死亡占5岁以下儿童死亡构成比的68.16%、88.94%和11.06%.2006至2008年渭南市5岁以下儿童死亡率经分析,χ2趋势=38.18,P=0.0001<0.01,具有逐年下降趋势.5岁以下儿童死因顺位依次为出生窒息、早产低出生体重、肺炎、其他先天异常、先天性心脏病.结论 预防早产、低出生体重、出生缺陷和出生窒息,降低新生儿、婴儿死亡率是降低5岁以下儿童死亡的关键.

  18. The Death Monitoring and Analysis of Children Under 5 Years Old in Huaihua From 2010 To 2014%2010~2014年度怀化市5岁以下儿童死亡监测分析及干预措施

    Institute of Scientific and Technical Information of China (English)

    张爱平; 黄志

    2015-01-01

    目的:通过分析近5年怀化市0~4岁儿童死亡监测中儿童死亡率的变化趋势及主要死因构成,为政府制定进一步降低5岁以下儿童死亡率措施提供科学依据。结果:5年来,监测地区5岁以下儿童死亡率呈逐年下降趋势。主要死亡原因按顺位依次为早产和低出生体重、肺炎、先天性心脏病、出生窒息、其他先天异常、意外窒息、交通意外和溺水等8种因素。新生儿死亡前5位死因依次为早产和低出生体重、出生窒息、肺炎、先天性心脏病和其他先天异常等。死前接受住院治疗的儿童呈现明显上升趋势。结论:采取多种措施,减少新生儿死亡是降低怀化市5岁以下儿童死亡率的关键。另外,加大儿童疾病综合管理技术在基层医疗机构的推广应用;减少出生缺陷;加强宣传教育,降低意外的发生;均可有效的减少5岁以下儿童死亡。%Objective changes through the analysis of child mortality surveillance of death of children aged 0~4 in Huaihua city in recent 5 years and the leading cause of death, provide scientific basis to further reduce the mortality of children under 5 years old measures for the government. Results for 5 years, and the mortality of children under 5 years of age the monitor-ing area decreased year by year. The main causes of death according to the sequence in 8 factors of preterm birth and low birth weight, congenital heart disease, pneumonia, birth asphyxia, other congenital anomalies, accidental suffocation, traffic accident and drowning. Neonatal death 5 major causes of death were premature and low birth weight, birth asphyxia, pneumonia, con-genital heart disease and other congenital disorders. Before the death of hospitalized obvious upward trend therapy in children. Conclusion adopt a variety of measures, reduce the neonatal death is the key to reduce the mortality of children under 5 years old in Huaihua city. In addition

  19. Monitoring And Analysis of Accidental Death in Children under 5 Years Old in Fujian Province%福建省5岁以下儿童意外死亡5年监测分析

    Institute of Scientific and Technical Information of China (English)

    陈曦; 陈鲁闽; 池小希; 欧阳莹; 杨式薇

    2001-01-01

    Objective To investigate the dynamic alteration and trend of the accidental death in children under 5 years old in Fujian Province.Methods We analyzed the data of the accidental death in children under 5 years old from 1995 to 1999(5 years) in the monitoring areas in our province.Results The accidental death in children under 5 years old increased 51.3% in 5 years in the monitoring areas.The ratio of accidental death to total death in children under 5 years old increased 7.26% with a more significant increase in the children aged 1~4 years;compared to city,the ratio tended to decrease in otskirt and increase in the rural area.The main causes of death in children aged less than one year were asphyxia(86.1%),aged more than one years were drown and traffic accident.Asphyxia predominantly happened in winter and spring,and drown mainly in summer and autumn.Conclusions The accidental death increased significantly in children under 5 years old;the different measures pointed toward the different ages,seasons and causes have to be developed soon in order to control the accidental children death;intervention should be centered in rural area,and healthcard is the foundmental measure.%目的 了解5岁以下儿童意外死亡的动态变化规律和趋势。方法 对我省5岁以下儿童生命监测区1995年/1999年5a监测资料进行分析。结果 监测区5岁以下儿童意外死亡率5a上升51.2%。5岁以下儿童意外死亡占总死亡比5a上升7.26%。城乡比较城市呈下降趋势,农村呈逐年上升趋势。年龄分组表现1岁~4岁组上升比其他组高,在主要死因分布上,0岁组意外窒息死亡占86.1%,1岁~4岁儿童主要死于溺水、交通意外。季节分布上,意外窒息多发生于冬春季,溺水多发生于夏秋季。结论 5岁以下儿童意外死亡率上升速度快,严重威胁儿童生存和健康,应尽快制定控制措施,针对不同年龄,不同季节,不同死因应有不

  20. Analysis of Death Cause of Children Under the Age of Five in a District from 2006 to 2010%城东区2006年-2010年5岁以下儿童死因分析

    Institute of Scientific and Technical Information of China (English)

    徐灵

    2011-01-01

    目的 了解城东区2006年-2010年5岁以下儿童死亡情况及主要死亡原因,为制定降低儿童死亡率的干预措施提供科学依据.方法 按照,对2006年-2010年城东区171例0岁~5岁儿童死亡情况、死因构成及相关因素,根据及进行回顾性分析.结果 2006年-2010年城东区活产数为6731例,要儿死亡151例,新生儿死亡131例,5岁以下儿童死亡171例,死亡率分别22.43‰、19.46‰、25.40‰.城东区5岁以下儿童死亡率逐年降低,5岁以下儿童死因顺位前三位依次是新生儿窒息、肺炎、早产(低出生体重).结论 加强三级保健网络建设,做好围生保健,提高产儿科技术水平和服务质量,重点做好新生儿窒息的抢救,加大健康教育力度,提高住院分娩率.%Objective To understand situation and the m ain cause of death of children under the age of five during 2006 and 2010 in E ast D istrict.T o provide the scientific basis for the intervening m easure of reducing m ortality.M ethods D eath situation,death structure and related factors of 171 children under the age of five during 2006 and 2010 in E ast D istrict w ere retrospectively analyzed according to the “C hinese children under 5 years death m onitoring program ”,“m aternaland child health annual report” and “children under 5 years death report cards ”.R esults T he num ber of live births is 6731,the infant deaths is 151,the neonatal deaths is 131,and the m ortality rates w ere 22.43‰,19.46‰,25.40‰. T he m ortality rate w ere reduced year by year.T he top three causes of death is asphyxia,pneum onia,prem ature birth (low birth w eight).C onclusion Som e m easures should be taken to reduce the m ortality rate such as strengthening the construction of three health netw orks,doing perinatalcare,im proving the technologicallevel and service quality of obstetrics,m aking the rescue of neonatal asphyxia,increasing health education efforts and im proving the rate of hospital

  1. 2011年浙江省绍兴市5岁以下流动儿童死亡监测结果分析%Death surveillance in migrant children aged < 5 years in Shaoxing,2011

    Institute of Scientific and Technical Information of China (English)

    余红; 刘丹

    2012-01-01

    目的 了解浙江省绍兴市流动人口5岁以下儿童死亡情况,为制定流动人口儿童卫生保健政策提供参考依据.方法 收集整理绍兴市201 1年5岁以下儿童死亡监测资料,统计分析流动人口5岁以下儿童死亡率、死亡原因、死前保健服务情况,并与本地户籍死亡儿童进行比较.结果 2011年绍兴市流动人口新生儿死亡率、婴儿死亡率、5岁以下儿童死亡率分别为5.40‰、7.69‰、9.85‰,均高于本地户籍儿童,差异有统计学意义(均P<0.01);流动人口儿童死亡原因主要为出生窒息、早产和低出生体重、溺水、意外窒息和肺炎,感染性疾病死亡、伤害死亡和死亡未治疗比率明显高于户籍儿童,差异有统计学意义(均P<0.01).结论 要降低流动儿童死亡率,应大力开展健康教育,提高流动孕产妇及儿童接受保健检查的意识,提高疾病识别和对伤害防范的能力.%Objective To understand the death causes in migrant children aged <5 years in Shaoxing, and provide evidence for their health care. Methods The statistical analysis was conducted on the death surveillance data in children aged <5 years in Shaoxing and the comparison of related data between local children and migrant children was made. Results In migrant children, the death rate was 5.4O%o in the new born, 7. 69% in infants and 9. 85%o in children aged 5 years, which were significantly higher than those in local children (P<0.01). The leading death causes in migrant children were birth asphyxia, premature birth and low birth weight, drowning, accidental asphyxia and pneumonia. The rates of infectious disease death, injury death and untreated death were significantly higher than those in local children^ <0.01). Conclusion It is necessary to strengthen the health education to improve the awareness of receiving health care service in pregnant women and children's parents in floating population to reduce the death in migrant children

  2. 2007至2012年秦淮区5岁以下儿童死亡情况分析%Death analysis of children under 5 years of age in Qinhuai District from 2007 to 2012

    Institute of Scientific and Technical Information of China (English)

    顾灵惠; 侯润馨

    2014-01-01

    目的:掌握秦淮区2007年1月至2012年1月5岁以下儿童死亡状况,探索有效的干预措施。方法对2007年1月至2012年1月秦淮区5岁以下儿童死亡报告卡进行整理、统计。结果新生儿死亡率、婴儿死亡率、5岁以下儿童死亡率分别为3.06‰、3.94‰、4.69‰。新生儿死亡、婴儿死亡、1~4岁儿童死亡占5岁以下儿童死亡的构成比分别为65.33%、84.00%、16.00%,5岁以下儿童死亡人数中新生儿占比重最大,差异具有统计学意义(χ2=9.50,P<0.05)。5岁以下儿童死因顺位依次为早产与低出生体重(16.00%)、其他新生儿病(8.00%)、肺炎(6.67%)、先天性心脏病(6.67%)、出生窒息(6.67%)、其他先天异常(4.00%)。结论降低新生儿、婴儿死亡率是降低5岁以下儿童死亡的关键;预防早产和低出生体重、肺炎、先天性心脏病和出生窒息刻不容缓。%Objective To grasp the death of children under 5 years old in Qinhuai District during the period of January 2007 to January 2012 and explore effective interventions .Methods The report cards of death of children under 5 years old were analyzed from January 2007 to January 2012.Results The neonatal mortality , infant mortality and mortality of children under 5 years of age were 3.06‰, 3.94‰and 4.69‰, respectively.Neonatal mortality, infant mortality, 1-4 years old children death accounted for 65.33%, 84.00%and 16.00%of children below 5 years age.Neonatal mortality occupied most of the death of children under 5 years of age, and the difference was significant (χ2 =9.50,P<0.05).The rank order of death causes of children under 5 was preterm birth and low birth weight (16.00%), other neonatal disease (8.00%), neonatal pneumonia (6.67%), congenital heart disease (6.67%), birth asphyxia (6.67%), and other congenital anomalies (4.00%).Conclusion Reducing neonatal and infant mortality rate

  3. Cost-effective therapeutic hypothermia treatment device for hypoxic ischemic encephalopathy

    Directory of Open Access Journals (Sweden)

    Allen RH

    2013-01-01

    Full Text Available John J Kim,1,2 Nathan Buchbinder,1,† Simon Ammanuel,1,4,5,† Robert Kim,1,† Erika Moore,1 Neil O'Donnell,1 Jennifer K Lee,3 Ewa Kulikowicz,3 Soumyadipta Acharya,1 Robert H Allen,1,9 Ryan W Lee,6,7 Michael V Johnston4–81Department of Biomedical Engineering, Whiting School of Engineering, The Johns Hopkins University, 2The James Buchanan Brady Urological Institute, Department of Urology, The Johns Hopkins University School of Medicine, 3Department of Anesthesia and Critical Care Medicine, Johns Hopkins University, 4Kennedy Krieger Institute, 5Hugo W Moser Research Institute, 6Department of Neurology, 7Department of Pediatrics, 8Department of Physical Medicine and Rehabilitation Johns Hopkins University School of Medicine, Baltimore, MD; 9Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA†These authors contributed equally to this workAbstract: Despite recent advances in neonatal care and monitoring, asphyxia globally accounts for 23% of the 4 million annual deaths of newborns, and leads to hypoxic-ischemic encephalopathy (HIE. Occurring in five of 1000 live-born infants globally and even more in developing countries, HIE is a serious problem that causes death in 25%–50% of affected neonates and neurological disability to at least 25% of survivors. In order to prevent the damage caused by HIE, our invention provides an effective whole-body cooling of the neonates by utilizing evaporation and an endothermic reaction. Our device is composed of basic electronics, clay pots, sand, and urea-based instant cold pack powder. A larger clay pot, lined with nearly 5 cm of sand, contains a smaller pot, where the neonate will be placed for therapeutic treatment. When the sand is mixed with instant cold pack urea powder and wetted with water, the device can extract heat from inside to outside and maintain the inner pot at 17°C for more than 24 hours with monitoring by LED lights and thermistors

  4. LEEP刀锥切术对宫颈癌患者生育能力和妊娠结局的影响%Impact on the fertility and pregnancy of patients with cervical cancer of LEEP knife conization

    Institute of Scientific and Technical Information of China (English)

    张海云; 边红霞; 冯艳霞

    2014-01-01

    To investigate the impact on the fertility and pregnancy of patients with cervical cancer by cervical LEEP knife conization.Methods:50 patients with early cervical cancer and 50 outpatients with-out cervical conization history and planned for pregnancy in our hospital from February 2009 to February 201 1 were chosen as the study objects.Female fertility and pregnancy outcome of the 2 groups were compared.Results:There were 49 pregnancy women (pregnancy rate of 96%)in the experimental group and 42 pregnancy women (pregnancy rate of 84%)in the control group,with significant difference (P<0.05 ).There were 8 cases of infertility in the experimental group (infertility rate of 16%)and 1 case of infertility in the control group (infertility rate of 2%), with significant difference (P<0.05 ).The rate of cesarean section in the experimental group was significantly higher than that in control group,which was of significant difference (P<0.05).Premature rupture of fetal mem-branes,premature delivery,neonatal asphyxia and neonatal low birth weight of experimental group were significantly higher than those in control group,which was significant difference (P<0.05 ).Conclusion:Cervical CINI-III pregnancy rate after cervical LEEP knife conization is lower than the normal population,but it also increases the in-cidence of premature rupture of fetal membranes,premature birth,neonatal asphyxia and low birth weight.%目的:探究宫颈LEEP刀锥切术对宫颈CINI-III患者生育能力和妊娠结局的影响。方法:选择我院妇科2009年2月至2011年2月收治的50例早期宫颈癌患者和同期孕前门诊就诊的50例无宫颈锥切术史的计划妊娠妇女为研究对象。比较两组女性生育能力和母婴结局。结果:实验组50例患者有49例(96%)妊娠,对照组50例患者有42例(84%),差异有显著性(P<0.05);实验组50例患者有8例(16%)不孕,对照组50例患者有1例(2%)不

  5. Risk factors associated with neonatal respiratory distress syndrome%足月新生儿呼吸窘迫综合征发病的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    彭宇波; 叶志其

    2014-01-01

    Objective:To study on risk factors of neonatal respiratory distress syndrome pathogenesis .Methods:Choose the research condition of 98 cases of children with respiratory distress syndrome as the observation group , 98 cases of hospitalized with the same period of children with respiratory distress syndrome as the control group , the clinical data of two groups of children were retrospectively ana-lyzed.Results:Observation group is higher than the control group , the incidence of male children on average birth weight is lower than the control group, the difference had statistical significance (P 0.05);Observation group's mother gestational diabetes, cutting palace delivery, intrauterine distress, the in-cidence of birth asphyxia is higher than the control group , the difference was statistically significant (P 0.05).Multiariable Logistic regression analy-sis showed that sex, birth weight of newborn babies, mother gestational diabetes, delivery, intrauterine distress, cutting palace labor suf-focation six factors are closely associated with the onset of NRDS .Conclusion: Gender, birth weight of newborn babies , cutting palace birth, birth asphyxia , intrauterine distress are term NRDS related risk factors of the disease .%目的:探讨足月新生儿呼吸窘迫综合征( NRDS)发病的相关危险因素。方法:选择符合研究条件的98例呼吸窘迫综合征患儿定为观察组,同期住院治疗的98例非呼吸窘迫综合征患儿定为对照组,对2组患儿的临床资料进行回顾性分析。结果:观察组男性患儿的发病率高于对照组、平均出生体重低于对照组,差异均有统计学意义(P<0.05)),但2组胎龄差异无统计学意义(P>0.05);观察组的母亲妊娠期糖尿病、剖宫分娩、宫内窘迫、分娩窒息的发生率高于对照组,差异有统计学意义(P<0.05),但2组的胎数、脐带绕颈等资料无统计学差异(P>0.05)。多因素Logistic回

  6. Application of perineum unprotected delivering technology in normal delivery of low-risk pregnant women%会阴无保护接生技术在低危孕妇正常分娩中的应用

    Institute of Scientific and Technical Information of China (English)

    陈丽

    2015-01-01

    ,the incidence of postpartum hemorrhage and neonatal asphyxia rate were significantly lower than that of the control group, the differences were statistically significant between the two groups(P<0.05).Conclusions:Perineum unprotected delivering technology applied in normal childbirth of low-risk pregnant women could reduce the episiotomy rate,improve the labor comfort and reduce the rate of postpartum hemorrhage and neonatal asphyxia rate,worthy of clinical popularization and application.

  7. CLINICAL RESEARCH ON THE EFFECT OF UNPROTECTED-PERINEUM DELIVERY AND PERINEAL BLOCK ANESTHESIA ON NATURAL DELIVERY%无保护会阴接生联合会阴阻滞麻醉用于自然分娩的临床研究

    Institute of Scientific and Technical Information of China (English)

    高丽丽; 李炳星

    2014-01-01

    Objective To explore the effect of unprotected‐perineum delivery and perineal block anesthe‐sia on stage of labor and new borns .Methods 200 cases of full‐term and normal‐dead‐position‐fetus unipara delivery were evenly divided into two groups .The experimental group underwent cesarean section ,bilater‐al perineal block anesthesia was given when fetal head began to emerge and unprotected‐perineum delivery was conducted with the midwife’s instruction on breathing .The contrast group received protected‐perine‐um delivery .Results No significant dneonatal asphyxiaifferences were found in time ,postnatal amount of bleeding and the rate of neonatal asphyxia at the first stage of labor .When compared with the contrast group at the second stage of labor ,the experiment group used less time in labor ( t =7 .167 ,P =0 .00) , showed lower rate of lateral episiotomy (χ2 =12 .21 ,P =0 .00) and higher intact rate of perineum (χ2 =9 . 89 ,P =0 .00) and had more first‐degree lacerations(χ2 =4 .08 ,P =0 .043) and less perineal discomfort‐ableness (χ2 =22 .86 ,P=0 .000) .Conclusion T he method of combined use of unprotected‐perineum deliv‐ery and perineal block anesthesia can reduce the rate of lateral episiotomy and perineal injury ,relieve peri‐neal discomfortableness and reduce the rate of neonatal asphyxia .%目的:探讨无保护会阴接生联合会阴阻滞麻醉对产程和新生儿的影响。方法将200例足月头位正常分娩初产妇分为两组各100例,实验组在产妇宫口开全后,等胎头刚拨露时行双侧会阴阻滞麻醉,助产士指导产妇呼吸哈气,在无保护会阴状态下分娩;对照组采用传统保护会阴的接生方法进行接产。结果两组第一产程时间及产后出血量、新生儿窒息发生率无差异;实验组第二产程时间短于对照组( t=7.167,P=0.00),会阴侧切率低(χ2=12.21,P=0.00),会阴完整率高(χ2=9.89, P =0

  8. Delivery Process Management in the Role of Promoting Natural Delivery%助产流程管理在促进自然分娩中的作用

    Institute of Scientific and Technical Information of China (English)

    吴仕元; 袁劲进; 肖锦艳

    2015-01-01

    ObjectiveTo discuss the effect of implementing the delivery process management to improve the quality of Midwifery and to promote natural labor.Method 1261 cases of vaginal delivery in our hospital From July 1, 2014 to December 31, 2014 were selected as the research group. And 1011 cases of vaginal delivery in our hospital from January 1, 2014 to June 30, 2014 were selected as the control group. The control group did not implement the delivery process management while the research group did. We compare the natural labor rate, the cesarean section rate, the postpartum hemorrhage rate, the rate of perineum side cut, the rate of perineum injury, and the rate of neonatal asphyxia in the two groups.Result The natural labor rate in the study group was significantly higher than that in the control group(P<0.05). The cesarean section rate, the postpartum hemorrhage rate, the rate of perineum side cut, the rate of perineum injury, and the rate of neonatal asphyxia in the study group was significantly lower than that in the control group(P<0.05).Conclusion Since the delivery process management can not only effectively improve the quality of midwifery, but also reduce the cesarean section rate and promote natural delivery, it is worthy of promotion.%目的:探讨助产流程管理对提高助产质量、促进自然分娩中的效果。方法选择本院2014年7月1日至2014年12月31日实行助产流程管理后住院阴道分娩的产妇1261例(研究组),同时选取2014年1月1日至2014年6月30日在本院未实行助产流程管理住院阴道分娩的产妇1011例(对照组),比较两组的自然分娩率、剖宫产率、产后出血率、会阴侧切率、会阴损伤率、新生儿窒息发生率等。结果研究组自然分娩率明显高于对照组(P<0.05),剖宫产率、会阴侧切率、会阴损伤率、产后出血及新生儿窒息发生率等明显低于对照组(P<0.05)。结论助产流程管理能有效地提

  9. 高龄双胎妊娠的围产结局分析%Perinatal outcomes in women aged 35 and over with twin pregnancy

    Institute of Scientific and Technical Information of China (English)

    陈敏玲; 王子莲; 凌家炜; 韩振艳

    2010-01-01

    目的 探讨高龄双胎妊娠的围产结局.方法 回顾性分析我院69例高龄双胎病例,随机对照176例非高龄双胎的临床资料,比较两组在妊娠并发症、妊娠合并症、和胎儿预后等方面的差异.结果 ①高龄组接受辅助生育技术受孕比例显著高于非高龄对照组(P<0.05);②高龄组<32孕周早产发生率明显高于对照组(P<0.05),而其他并发症及合并症两组间未见显著性差异;③高龄组以极低出生体重儿(<1500 g)比例显著高于对照组(P<0.05).高龄组新生儿窒息率及胎儿窘迫发生率明显增高(P<0.05).结论 高龄双胎妊娠不良妊娠结局主要与<32孕周的严重早产、极低体重儿、新生儿窒息及胎儿窘迫密切相关,应针对性加强高龄双胎的围生期监护,警惕严重早产的发生.%Objective The aim of this study is to present perinataloutcomes of twin gestations in older women. Methods We conducted a retrospective cohort study of 69 cases of twin pregnancies maternal age 35 years and older( study group)in our department, compared with 176 twin pregnancies cases of maternal age less than 35 years( control group). Results ①Conceptions after assisted reproductive technology were significantly higher in study group(P<0.05 ). ②The rate of preterm labour lower than 32 gestational weeks was significantly higher in the study group(P<0.05). The other complications rate did not differ singnificantly from the control groups. (3) The very low birth weight ( VLBW < 1,500 g) rate was significantly higher in the study group ( P<0.05 ), the rate of neonatal asphyxia and fetal distress were statistically significant higher in study group (P<0.05). Conclusion Advanced maternal age was related with higher incidence of the severe preterm labour(<32 gestational weeks) ,the very low birth weight(<1,500 g) ,fetal distress,neonatal asphyxia. It is important to close monitoring during perinatal period in women aged 35 and

  10. 妊娠合并系统性红斑狼疮孕妇的妊娠时机及对妊娠结局的影响(附25例临床资料分析)%Pregnancy Time and Affect of Pregnancy Outcome in Pregnancy Women with Systemic Lupus Erythematosus:A Clinical Analysis on 25 Cases

    Institute of Scientific and Technical Information of China (English)

    荣琴英; 马锦琪; 高涛

    2014-01-01

    Objective To investigate the correlative factors that affect the outcome of pregnancy complicated with SLE and try to provide the best chance for conception and pregnant monitoring, to prevent the deterioration of SLE and improve the perinatal quality. Methods Retrospective analysis of 25 cases of pregnancy complicated with SLE. Results In 25 cases pregnancy complicated with SLE, 14 cases were in remission and well-controlled stage, 1 case premature labor, neonatal asphyxia 0 case, lupus nephritis 1 case, preeclampsia 0 case, 11 cases unstable, premature labor 4 cases, neonatal asphyxia 2 cases, lupus nephritis 3 cases, low serum platelet 3 cases, preeclampsia 2 cases. Conclusion The results show that first of all, the activity of SLE should be controlled and patients should get conception under the guidance of the obstetricians and physicians, Prednisone is one of the safe drugs for prevent women to control the activation of SLE and to prevent deterioration. Intensive monitors should be offered to prevent women complicated with SLE to acquire a better pregnancy outcome.%目的:探讨影响妊娠合并系统性红斑狼疮(SLE)妊娠结局的相关因素,提出SLE患者最佳受孕时机和孕期的治疗监护,预防妊娠合并SLE的恶化及SLE对妊娠的不良影响,以提高围产质量。方法回顾性分析25例妊娠合并SLE的临床资料。结果25例妊娠合并SLE患者,14例病情处于缓解期或控制期的患者,仅1例双胎妊娠发生早产,新生儿窒息0例,1例孕妇狼疮性肾炎加重,子痫前期0例;11例病情未控制或有SLE活动者,发生早产4例,新生儿窒息2例,孕期发生狼疮性肾炎3例,血小板减少3例,子痫前期2例。结论SLE患者应首先控制疾病的活动,在产科医师及风湿免疫科医师的指导下受孕,妊娠期加强胎儿监护及SLE疾病的监测、治疗。泼尼松是目前安全可靠的妊娠期治疗及预防SLE恶化、控制SLE活动的首

  11. 围生期新生儿贫血的高危因素分析%Analysis on the high risk factors of neonatal anemia during perinatal period

    Institute of Scientific and Technical Information of China (English)

    张芹

    2014-01-01

    Objective To analyze the present situation and high risk factors of neonatal anemia during peri-natal period in order to provide clinical evidence for the control and prevention of neonatal anemia. Methods Totally 265 newborns from the hospital, between February 2014 and March 2014, were selected as research subjects. The ane-mia rate of newborns in different perinatal period was compared, then the relationship between the perinatal period fac-tors and neonatal anemia were analyzed by Logistic regression analysis. Results Of the 265 subjects, there were 24 with anemia and the incidence rate was 9.06%. The incidence rates for prematures, low-birth weight infants, asphyxia infants, fetal intrauterine distress, placental abnormality and umbilical cord abnormality were all higher than those of other newborns. And the above factors all had close relationship to neonatal anemia according to the Logistic analysis (all P<0.05). Conclusion The rate of neonatal anemia is relatively high. Prematures, low-birth weight infants, as-phyxia infants, fetal intrauterine distress, placental abnormality and umbilical cord abnormality are all the high risk fac-tors, therefore more interventions of the above factors should be given to the newborns.%目的:分析新生儿贫血的现状及其高危因素,为新生儿贫血的防控提供临床依据。方法选取2014年2~3月本院收治的265例新生儿为研究对象,比较不同围生期新生儿的贫血发生率,同时以Logistic回归分析处理围生期因素与新生儿贫血的关系。结果265例新生儿中共有贫血患儿24例,发生率为9.06%,其中早产儿、低体重儿、窒息儿、宫内窘迫、胎盘异常及脐带异常者的发生率均高于其他新生儿,经Logistic回归分析显示,上述因素均与新生儿贫血有密切的关系(P<0.05)。结论新生儿贫血的发生率较高,早产儿、低体重儿、窒息儿、宫内窘迫、胎盘异常及脐带异

  12. Pregnancy Outcome of Iron-deficiency Anemia in Third Trimester%妊娠晚期缺铁性贫血对妊娠结局的影响

    Institute of Scientific and Technical Information of China (English)

    范晓东; 王如; 常闻艳

    2014-01-01

    目的:探讨妊娠晚期缺铁性贫血对产妇和新生儿的影响,提出相应预防措施。方法:按照2013年《妇产科学》第8版对妊娠期缺铁性贫血诊断的最新分类,回顾性分析421例妊娠晚期缺铁性贫血患者(其中轻度贫血组368例,重度贫血组53例)和同期入院的正常产妇(对照组500例)。对比分析3组研究对象的产后出血率、剖宫产率、产钳助产率、羊水过少发生率、羊水污染率、胎儿窘迫率、新生儿窒息率、低体质量儿出生率。结果:重度贫血组产后出血率、剖宫产率、羊水污染率、胎儿窘迫率、新生儿窒息发生率,低体质量儿出生率高于轻度贫血组和对照组(均P<0.05)。轻度贫血组羊水污染发生率,胎儿窘迫率,低体质量儿出生率高于对照组(均P<0.05)。3组患者产钳助产率和羊水过少发生率差异无统计学意义(均P>0.05)。结论:妊娠期缺铁性贫血对产科妊娠结局有不良影响,应加强妊娠期贫血的防治。%Objective:To study the influence on pregnant women with iron deficiency anemia (IDA) and infants,and put forward the corresponding preventive measures. Methods:According to the diagnosis of anemia in the eighth edition of Obstetrics and Gynecology, retrospective analysis of 421 patients with iron deficiency anemia in late pregnancy [368 patients with moderate iron-deficiency anemia (IDA) and 53 patients with severe IDA] and 500 patients without IDA (control group). Analysis of three groups of rate of postpartum hemorrhage and cesarean section and obstetrical forceps delivery ,incidence of oligohydramnios and amniotic fluid pollution ,rate of fetal distress and neonatal asphyxia , low neonatal birth weight. Results:The rates of postpartum hemorrhage,cesarean section,amniotic fluid pollution,fetal distress,neonatal asphyxia and low neonatal birth weight in severe IDA group are higher than the rates in moderate IDA

  13. 农村孕产妇妊娠肥胖与妊娠并发症的关系研究%Relationship of pregnancy obesity and pregnancy complications among rural pregnant women

    Institute of Scientific and Technical Information of China (English)

    肖琼英

    2013-01-01

    目的:了解农村孕产妇妊娠肥胖与妊娠并发症的关系。方法:采用回顾性研究的方法,对658例足月单胎初产妇身高,体重计孕期体重增长情况进行整理,计算体重指数,将妊娠前BM I≥25以及妊娠期体质量增加≥15kg 的纳入观察组,其余纳入对照组,同时整理两组研究对象的妊娠并发症,分娩方式,产程以及产后出血,新生儿窒息,巨大儿的发生情况。结果:1)观察组孕妇妊娠期糖尿病,妊娠高血压疾病,产褥感染发生率明显高于对照组,差异有统计学意义。而产后出血及会阴裂伤,则两组差异无统计学意义;2)观察组总产程,产程异常以及阴道助产发生率明显高于对照组,而剖宫产发生率两组差异无统计学意义;3)两组新生儿体重,巨大儿,死胎及新生儿窒息发生率差异有统计学意义,观察组明显高于对照组。结论:孕期肥胖对孕妇和胎儿的影响都很大,增加孕期并发症及新生儿难产的发生率。应该在加强对肥胖孕产妇的围生期监护及产后随访的同时,积极预防妊娠肥胖的发生。%objective :To explore the relationship of pregnancy obesity and pregnancy complications among rural pregnant women .Meth-ods :The related variables of 658 eligible participants were calculated and sorted ,which included Body Mass Index (BMI) ,complications ,de-livery mode ,birth process ,postpartum hemorrhage ,neonatal asphyxia and macrosomia by retrospective study .Results :The prevalence of gestational diabetes mellitus (GDM ) ,hypertension ,puerperal infection ,abnormal birth process ,assisted labor ,macrosomia ,stillborn fetus and neonatal asphyxia in observation group was significantly higher than that in control group .Conclusions :The significant impact of pregnancy obesity was found .Not only to strengthen prenatal care and postpartum follow -up ,but also to prevent pregnancy obesity to occur .

  14. Effects of diet control combined with exercise therapy on pregnancy outcome of pregnant women%饮食控制结合运动对孕产妇妊娠结局的影响

    Institute of Scientific and Technical Information of China (English)

    董海玲

    2015-01-01

    目的::观察饮食控制结合运动对孕产妇妊娠结局的影响。方法:选择孕产妇98例,所有孕产妇均进行糖耐量试验,并分为对照组和干预组,每组各49例。对照组孕产妇采用常规的饮食指导;干预组孕产妇在对照组基础上根据具体情况调整饮食方案。比较两组孕产妇干预前、干预2个疗程后的空腹血糖、餐后2 h血糖和糖化血红蛋白( HbAlc)。同时比较两组孕产妇的妊娠高血压病、羊水过多、胎膜早破、剖宫产、新生儿窒息、巨大儿、产后出血及早产儿等的发生情况。结果:两组孕产妇妊娠高血压病、羊水过多、胎膜早破、早产儿和新生儿窒息发生率无明显差异;干预组孕产妇剖宫产率、尿路感染发生率和巨大儿发生率均明显低于对照组(P<0.05);干预组孕产妇空腹血糖、餐后2 h血糖、HbAlc明显低于对照组(P<0.05)。结论:饮食控制结合适度的运动对控制孕产妇血糖和降低母婴并发症的效果优于单纯常规的饮食指导效果。%Objective:To investigate effects of diet control combined with exercise therapy on pregnancy outcome of pregnant women. Methods:98 pregnant women were selected. All of them accepted oral glucose tolerance test (OGTT), and then were divided into control group and intervention group, 49 cases in each group. control group received conventional dietary guidance, while interven-tion group's diet plan was adjusted according to patients' specific conditions based on that of control group. The fasting blood glucose, postprandial 2 hours blood glucose, glycosylated hemoglobin ( HbAlc) before and after two courses of the treatment of the two groups were compared. At the same time, the occurrences of hypertensive disease of pregnancy, polyhydramnios, premature rupture of mem-branes, cesarean delivery, neonatal asphyxia, fetal macrosomia, postpartum hemorrhage, and premature infant were compared between the two

  15. 新生儿惊厥148例临床分析%Neonatal Shock Clinical Analysis of 148 Cases of Break Off

    Institute of Scientific and Technical Information of China (English)

    劳庆禄

    2012-01-01

      目的探讨新生儿惊厥病因、临床特点及急救方法,减少惊厥及后遗症的发生.方法回顾性分析我院2005年01月-2011年12月共收治的148例惊厥新生儿的临床资料.结果痊愈121例,有症状出院的19例,死亡5例,自动出院3例,20例遗留有不同程度神经系统后遗症.围产期窒息是引起惊厥的首要原因,其次是感染性疾病、糖及电解质紊乱、各类先天性遗传代谢病.发作类型以微小性发作为多见,其次为阵挛性发作.治疗重点在于止痉,首选苯巴比妥,14.9%的患儿足量用药不能控制.结论围产期窒息是导致新生儿惊厥的主要病因;苯巴比妥仍是抗惊厥的首选药物,少数患儿须加用二线药物;发作形式以微小性发作最为多见;EEG 背景波是判断预后的一个良好的指示.%  Objective Investigate the cause of neonatal convulsions、clinical characteristics and first-aid methods,reduce the incidence of seizures and the sequelae.Methods Retrospective analysis of our hospital from Janu-ary 2005 to December 2011 in the total of 148 cases of eclampsia admitted to the clinical data of newborn.Results 121 cases of ful recovery,discharged from hospital with symptoms of 19 cases,the death of five cases, three cases of automatic discharge, there are 20 cases left over from the nervous system sequelae of varying degrees.Caused by perinatal asphyxia is the primary cause of febrile seizures, folowed by infectious diseases, sugar and electrolyte disorders, various types of congenital genetic metabolic diseases. Type of attack made little as often, folowed by clonic seizures. To stop focusing on the reatment of seizures, Phenobarbital prefered ,14.9% of children with a sufficient quantiy of medicines stil con not control.Conclusions Perinatal asphyxia is a major cause of neonatal convulsions;Phenobarbital is stil the first choice anticonvulsant drug, a smal number of children with second-line drugs should be added; The

  16. An analysis of risk factors for cerebral patsy in newborns with periventricular leukomalacia%新生儿脑室周围白质软化发生脑性瘫痪的危险因素分析

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    战美丽; 王长芹; 李书芹; 王会芹; 张秀卿; 徐桂霞; 李洪双

    2008-01-01

    Objective To investigate the risk factors of cerebral palsy in newborns with periventricular leukomalacia(PVL).Methods Sixty-one infants with sequela of cerebral palsy among 806 neonates born at the Second People'S Hospital of Liaocheng,Shandong,China,during December 2000 to November 2005 were studied for its etiology.Diagnosis of cerebral palsy in 26 of the 61 infants was established by type B ultrasonic scanning or magnetic resonance imaging(MRI)for the head at least twice and excluded of other diseases.Thirty-five infants without PVL hospitalized at the same hospital were enrolled as control group during the same period.Logistic regression analysis was performed for the risk factors of PVL. Results Twenty-six infants were diagnosed as PVL.accounting for 42.6%of those with cerebral palsy.Main high-risk factors of PVL included severe asphyxia(x3),low gestational age(x1),intraventricular hemorrhage(x14)and low blood pressure(x8),with odds ratios of 2.843,3.575,3.268 and 1.947,respectively,and a fitted regression model as logistic(P)=β0+0.7952 x3-1.428x1-1.328 x14+0.8256x8.Pregnant hypertension,neonate respiratory distress syndrome(NRDS),and intrauterine infection could also affect occurrence of PVL,all with statistical significance(P<0.05).Conclusion PVL is one of main causes of cerebral palsy,with severe asphyxia,low gestational age,intraventricular hemorrhage and low blood pressure as main high-risk factors.%目的 探讨新生儿脑室周围白质软化(PVL)发生脑性瘫痪(脑瘫)的危险因素.方法 对2000年12月至2005年11月我院806例新生儿中遗留脑瘫后遗症的患儿61例进行病因研究.经至少2次头颅B超或MRI确诊、并已排除其他疾病的26例PVL患儿为PVL组,取同期住院的35例非PVL所致的脑瘫患儿为非PVL组,并对PVL的高危因素进行回归分析.结果 PVL 26例,占脑瘫病因的42.6%.重度窒息(x3)、低孕周(x1)、颅内出血(x14)、低血压(x8)是PVL发生的高危因素,其OR值分别为2

  17. The application of 5% Sodium Bicarbonate co-infusion of oxytocin in the delivery%5%碳酸氢钠联合缩宫素静脉滴注在分娩中的应用

    Institute of Scientific and Technical Information of China (English)

    于合珍; 完颜亚丽

    2012-01-01

    目的 探讨5%碳酸氢钠静脉滴注在产妇分娩过程中宫缩乏力伴极度疲劳应用的疗效.方法 将2009年7月~2010年3月在我院经阴道分娩出现宫缩乏力伴极度疲劳的初产妇300例,随机分为观察组和对照组,各150例.观察组在静滴缩宫素后,在第一产程中测定产妇血二氧化碳结合力(CO2CP)并给予5%碳酸氢钠200 mL快速静滴;对照组仅给予缩宫素静脉滴注,观察两组宫缩情况、血CO2CP值、产程进展、产后出血及新生儿窒息率.结果观察组显效率及总有效率明显优于对照组(P < 0.05);观察组产妇血CO2CP明显高于对照组,产程时间、产后出血率及新生儿窒息率均低于对照组(P < 0.05),且有效提高阴道分娩率.结论 在产妇极度疲劳伴宫缩乏力情况下应用碳酸氢钠联合缩宫素,能有效改善产妇酸中毒情况并加速产程进展,减少产后出血.%Objective To explore the effect of 5% Sodium Bicarbonate infusion during delivery in maternal uterine inertia associated with the application of extreme fatigue. Methods 300 primipara patients appeared vaginal delivery with uterine inertia and extreme fatigue from July 2009 to March 2010 in our hospital were randomly divided into two groups, observation group and control group, each had 150 cases. In the observation group, patients were given 5% Sodium Bicarbonate 200 Ml by rapid intravenous infusion after intravenous infusion of oxytocin in the first stage to determine maternal blood CO2CP; the control group were given intravenous infusion of oxytocin, the contraction, the blood CO2CP value, the progress of labor, postpartum hemorrhage and neonatal asphyxia were observed. Results The efficiency rate and total efficiency rate in the observation group were better than those of the control group (P < 0.05); in observation group, the maternal blood CO2CP was higher than that of the control group, the time, labor, postpartum hemorrhage and neonatal asphyxia were lower

  18. Analysis of factors affecting changes in cerebral blood flow of preterm infants%影响早产儿脑血流动力学变化因素分析

    Institute of Scientific and Technical Information of China (English)

    安晶慧; 杨永艳

    2013-01-01

    Objective To analyze factors affecting changes of hemodynamics in preterm infants,assess their value in the prevention of brain injury in preterm children.Methods American Philips Doppler was used to diagnose dynamic cerebral blood flow parameters of the premature children.Results Pathological factors (hypoglycemia,polycythemia disease,asphyxia,hyperbilirubinemia,intracranial hemorrhage,the application of mechanical ventilation) affected cerebral hemodynamics preterm children.Polycythemia disease,asphyxia and hyperbilirubinemia could lead to peak systolic blood flow velocity (Vs),diastolic velocity (Vd) reduce,Vd reduce more apparent elevated Vs and Vd ratio (S/D),and the difference was statistically significant (P < 0.05).Resistance index (RI) and pulsatility index (PI) value increased,and the difference was statistically significant (P < 0.05).Hypoglycemia,mechanical ventilation,intracranial hemorrhage,Vs,Vd increased RI and PI values decrease,and the difference were statistically significant (P < 0.05).Conclusion Color Doppler ultrasound dynamically detect changes in cerebral hemodynamics in preterm children,which has a certain diagnostic clinical value of brain damage on the prevention of premature children.%目的 应用多普勒超声仪检测早产儿脑血流变化,分析影响早产儿脑血流动力学变化的因素并评估其在预防早产儿脑损伤的应用价值.方法 采用美国飞利浦多普勒彩色超声诊断仪动态测定早产儿的脑血流参数.结果 病理因素(低血糖、红细胞增多症、窒息、高胆红素血症、颅内出血、应用机械通气)对早产儿脑血流有直接影响;红细胞增多症、窒息、高胆红素血症均可导致收缩期血流速度峰值(Vs)、舒张末期血流速度(Vd)降低,Vd降低更加明显,Vs与Vd的比值(S/D)升高,差异有统计学意义(P<0.05);阻力指数(RI)及搏动指数(PI)值增高,差异有统计学意义(P<0.05);低血糖、应用机械通气

  19. Neuroimaging in Cerebral Palsy – Report from North India

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    Anju AGGARWAL

    2013-11-01

    Full Text Available How to Cite This Article: Aggarwal A, Mittal H, Debnath SKR, Rai A. Neuroimaging in Cerebral Palsy–Report from North India. Iran J Child Neurol. 2013 Autumn; 7(3:41- 46. ObjectiveOnly few Indian reports exist on neuroimaging abnormalities in children with cerebral palsy (CP from India. Materials & MethodsWe studied the clinico-radiological profile of 98 children diagnosed as CP at a tertiary centre in North India. Relevant investigations were carried out to determine the etiology. ResultsAmong the 98 children studied, 80.5% were males and 22.2% were premature. History of birth asphyxia was present in 41.9%. Quadriplegic CP was seen in 77.5%, hemiplegic in 11.5%, and diplegic in 10.5%. Other abnormalities were microcephaly (60.5%, epilepsy (42%, visual abnormality (37%, and hearing abnormality (20%. Neuroimaging was abnormal in 94/98 (95.91%.Abnormalities were periventricular white matter abnormalities (34%, deep grey matter abnormalities (47.8%, malformations (11.7%, and miscellaneous lesions (6.4%. Neuroimaging findings did not relate to the presence of birth asphyxia, sex, epilepsy, gestation, type of CP, or microcephaly. ConclusionsNeuroimaging is helpful for etiological diagnosis, especially malformations.  ReferencesSinghi PD, Ray M, Suri G. Clinical spectrum of cerebral palsy in north India-an analysis of 1000 cases. J Trop Pediatr 2002 48(3; 162-6.Sharma P, Sharma U, Kabra A. Cerebral Palsy-Clinical Profile and Predisposing Factors. Indian Pediatr 1999;36(10:1038-42.Nelson KB, Ellenberg JH. Antecedents of cerebral palsy. Multivariate analysis of risk. N Engl J Med 1986 315(2:81-6.Krägeloh-Mann I, Horber V. The role of magnetic resonance imaging in elucidating the pathogenesis of cerebral palsy: a systematic review. Dev Med Child Neurol 2007; 49(2:144-51.Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl 2007

  20. Clinical Analysis of 32 Late Preterm and Mature Infants with Respiratory Distress Syndrome%32例晚期早产儿和足月儿呼吸窘迫综合征临床分析

    Institute of Scientific and Technical Information of China (English)

    高明

    2012-01-01

    Objective To investigate the clinical characteristics of respiratory distress syndrome (RDS) in mature and late-preterm infants. Methods The RDS neonates from January 2004 to September 2011 in our hospital were collected. 32 mature and late- preterm infants with the gestational age more than 34 weeks were included in the experimental group, while 36 premature infants with the gestational age less than 34 weeks were attributed to the control group. The cause of disease, clinical manifestation , therapeutic measures and complications were analyzed and compared between the two groups. Results (DThe main causes of disease were the premature delivery in the control group,but were the selective caesarean section,perinatal asphyxia and meco-nium aspiration in the experimental group. ㏕he application of mechanical ventilation ( MV ) was later in the experimental group, and the 01 was higher 24 h after using the convention dosage of exogenous pulmonary surfactant (P < 0.05 ). Conclusion The main cause of RDS in mature and late- preterm infants were the selective caesarean section and perinatal asphyxia,the need for the mechanical ventilation is later,and the curative effect of exogenous pulmonary surfactant is not as good as the premature infants. The persistent pulmonary hypertension of the newbora(PPHN) , pneumothorax and multiple organ dysfunction syndrome are the common complications.%目的 了解晚期早产儿和足月儿呼吸窘迫综合征(respiratory distress syndrome,RDS)的临床特征,提高对该病的认识.方法 将皖北煤电集团总医院新生儿病房2004年1月-2011年9月收治的32例胎龄≥34周的晚期早产儿或足月儿RDS为研究对象,即晚期早产儿-足月儿组;同期收治的胎龄<34周早产儿RDS 36例为对照组,即早产儿组.对两组患儿的病因、临床表现、治疗措施和并发症等资料进行对比分析.结果 ①两组发生RDS的病因不同:早产儿以早产为主要病因,晚期早产儿或足月

  1. NEONATAL MORTALITY AND MORBIDITY IN PREGNANCY INDUCED HYPERTENSION: A PROSPECTIVE OBSERVATIONAL STUDY

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    George

    2014-05-01

    Full Text Available BACKGROUND: Pregnancy induced Hypertension (PIH is one of the common complications which contributes to significant maternal and perinatal morbidity and mortality. Effective management improves outcome of both mother and the baby OBJECTIVES: To study the morbidity and mortality in babies born to mothers with pregnancy induced hypertension, assess the reasons for the outcome of the baby and monitor the growth and development till the age of 6 months. METHODS: This study was conducted at Niloufer Institute of Child Health, Hyderabad a teaching institution which caters to high risk obstetric patients and also has a tertiary level NICU care. Study was conducted over a period of 9 months and 100 cases of PIH were included over a period of 3 months and the babies were followed up till the age of 6 months. A structured proforma was designed and analyzed using Epi info for window statistical software. RESULTS: Out of 1461 deliveries, we enrolled 100 PIH cases as per inclusion criteria and studied during 3 months period. Of the study group, 48% were with mild PIH (n=48 and 52% were with severe PIH (n=52. When compared to mild PIH, severe PIH was associated with higher rates of preterm deliveries and it was statistically significant (P 2. In NICU admissions Meconium aspiration syndrome (MAS, Hyaline membrane disease (HMD, Birth asphyxia (BA and sepsis were observed. All the complications were more in severe PIH than mild PIH. After discharge infants were fallowed up till the age of 6 months. Out of 75 babies discharged, 24 cases were lost to follow up and in the remaining 51 babies, 33 were born to mild PIH mothers, 18 were born to severe PIH mothers. CONCLUSION: PIH is one of the major causes of morbidity and mortality in the fetus and newborn. The more severe the PIH, the more adverse is the outcome. Our goal is early detection and prompts Management

  2. Factors associated with morbidities among infants in three sub centre areas of belgaum district of south India: A longitudinal study

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    Nitin Joseph

    2013-01-01

    Full Text Available Background: Health status of infants is a sensitive indicator of development and factors influencing it need to be better understood. Objectives: This study was conducted to search for factors associated with morbidity among infants and to find out their influence on weight gain during infancy. Materials and Methods: This longitudinal study was undertaken in south India from November 2004 till April 2006. A birth cohort of all children born during first 6 months of the study period were assessed at enrollment and followed up monthly till they attained 1 year of age. Results: Incidence of morbidity among infants was found to be least among those exclusively breast fed (EBF for 6 months and most when EBF for less than 6 months (P = 0.045. It was also more when infants were weaned with a combination of animal milk, formula milk, semi-solids and solid diet and least when weaned only with semi-solids and solids (P = 0.018. Diarrheal episodes were more in infants who were bottle-fed (P < 0.001. Weight gain between 6 th and 12 th month of infancy was found to be significantly affected by various morbidities (P = 0.001. Incidence of morbidities was less among preterm babies and more among partially immunized (P < 0.001 babies with birth order ≥ 3 (P = 0.012, babies of mothers with low socio-economic and educational status. Delayed milestones during infancy was seen more in babies with history of birth asphyxia (P = 0.018. Conclusion: Several factors influenced incidence of morbidities and these morbidities had a negative effect on weight gain. Hence these factors need to be addressed to promote better child health.

  3. Ketamine modulates fetal hemodynamic and endocrine responses to umbilical cord occlusion.

    Science.gov (United States)

    Zarate, Miguel A; Chang, Eileen I; Antolic, Andrew; Wood, Charles E

    2016-09-01

    Umbilical cord occlusion (UCO) is a hypoxic insult that has been used to model birth asphyxia and umbilical cord compression in utero. UCO triggers vigorous neural and endocrine responses that include increased plasma ACTH and cortisol concentrations, increased blood pressure (BP), and decreased heart rate (HR). We have previously reported that ketamine, a noncompetitive N-methyl-D-aspartate receptor antagonist, can modify the fetal hemodynamic and ACTH responses to ventilatory hypoxia and cerebral ischemia-reperfusion. We performed the present experiments to test the hypothesis that ketamine has similar effects on the neuroendocrine and cardiovascular responses to UCO Fetal sheep were chronically catheterized at gestational day 125. Ketamine (3 mg/kg) was administered intravenously to the fetus 10 min prior to the insult. UCO was induced for 30 min by reducing the umbilical vein blood flow until fetal PaO2 levels were reduced from 17 ± 1 to 11 ± 1 mm Hg. UCO produced an initial increase on fetal BP in both control and ketamine groups (P = 0.018 time), followed by a decrease in the control group, but values remained higher with ketamine. HR decreased after UCO (P = 0.041 stimulus*time) in both groups, but the reduction was greater initially in control compared to ketamine groups. Fetal PaCO2 levels increased after UCO (P ketamine groups. UCO significantly decreased fetal pH values (P ketamine group. Ketamine delayed the cortisol responses to UCO (P ketamine augmented the cardiovascular response to UCO, but did not alter the ACTH response to UCO. PMID:27597770

  4. Etiological Analyses of Marked Neonatal Hyperbilirubinemia in A Single Institution in Taiwan

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    Shao-Wen Cheng

    2012-04-01

    Full Text Available Background: Hyperbilirubinemia is a common disorder during the neonatal period. Severeneonatal hyperbilirubinemia (NH carries a potential for permanent neurological impairment. The current study analyzed possible etiologies leading toNH.Methods: A retrospective cohort of neonates with total serum bilirubin (TSB ≥ 20mg/dL was surveyed from 1995 to 2007. Subjects with gestational ages < 34weeks were excluded, leaving a total of 413 enrolled neonates.Results: The most common etiology in relation to marked NH was breast milk feeding (38.5%, followed by glucose-6-phospahate dehydrogenase (G6PD deficiency (24.0%, ABO incompatibility (21.8%, extravascular hemorrhage(6.5%, Rh incompatibility (2.9%, bacterial infection (2.2%, hereditaryspherocytosis (1.2%, dehydration (1.2%, diabetic mother (1.0%, polycythemia (0.7%, and gastrointestinal obstruction (0.7%. Other rare etiologies included Down syndrome, Chinese herb intake, asphyxia, galactosemiaand congenital hypothyroidism. We did not identify any known cause in 63neonates (15.3%. Neonates with more than one etiology tended to havehigher TSB than subjects without a known etiology (p < 0.05. Anemia wasmore common in those with G6PD deficiency, blood group incompatibility,hereditary spherocytosis, and gastrointestinal obstruction. Neonates fedbreast milk tended to have prolonged NH.Conclusion: This study depicts the clinical features of marked NH. Breast milk feeding,G6PD de f i c i ency and ABO incompa t ibi l i ty a r e common e t iologi e s inTaiwan. Prolonged NH is more common in neonates fed breast milk thanthose who were given formula.

  5. Bacteriological profile and antibiotic sensitivity pattern of neonatal septicaemia in a rural tertiary care hospital in North India

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    S Thakur

    2016-01-01

    Full Text Available Background: There is not much published literature on neonatal septicemia available for the Sub-Himalayan region of North India. Hence, we undertook this study to find out the bacteriological profile and antibiotic sensitivity pattern of neonatal septicemia in the neonatal Intensive Care Unit. Material and Methods: Blood cultures were performed for all clinically suspected neonatal septicemia cases for 1-year. Identification of all pathogenic isolates was followed by antibiotic sensitivity testing. Results: We did blood cultures for 450 neonates and 42% were culture positive. Early onset sepsis were 92 (49% and 96 (51% were late onset sepsis. Gram-positive isolates were 60% and 40% were Gram-negative. Staphylococcus aureus (40%, coagulase negative Staphylococcus species (16%, non-fermenter group of organisms (NFGOs (15%, and Klebsiella pneumoniae (10% were the main isolates. Nasal cannula 101 (54%, birth asphyxia 91 (48%, and prematurity 73 (38% were the prominent risk factors associated with septicemia. Gram-positive organisms were highly resistant to penicillin (87% whereas Gram-negative isolates showed high resistance to third generation cephalosporins (53–89% and aminoglycosides (50–67%. The S. aureus isolates were methicillin-resistant in 41% whereas extended spectrum beta lactamase production was seen in 48% Gram-negative isolates.Conclusion: Our study highlights the recent emergence of Gram-positive organisms as predominant cause of neonatal septicemia in this part of Sub-Himalayan region, along with the review of literature which shows similar results from North India and rest of the world too. Though Gram-negative bacteria still remain the main cause of mortality in neonatal septicemia, we want to dispel the common notion among practitioners that they are the predominant isolates in neonatal septicemia.

  6. Relationship between Sleep Disorders, Pain and Quality of Life in Patients with Rheumatoid Arthritis

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    Majid Purabdollah

    2015-09-01

    Full Text Available Introduction: Rheumatoid arthritis as one of the most common autoimmune diseases is known to be one of the leading causes of disability. Sleep disorders have direct influence on patient’s life. According to studies, sleep problems are known to have negative impact on well-being and functioning, but the exact nature of relationship between sleep disorders and Rheumatoid arthritis is not completely understood. This study aimed to investigate the relationship between sleep disorders, pain and quality of life in patients with rheumatoid arthritis patients. Methods: In a descriptive -correlative study, 210 patients with rheumatoid arthritis referred to Tabriz medical university clinics selected by convenience sampling and were assessed by Sleep Disorders Questionnaire (SDQ, Epworth Sleepiness Scale (ESS, SF-36 Quality of Life Questionnaire and Visual Analog Scale (VAS. Data were analyzed using SPSS-13 by descriptive statistics such as frequency, mean (SD and inferential statistics including Spearman correlation analysis, linear regression, x2, t- test and ANOVA. Results: The mean age of participants was 48.41(12.92 years in which most of them (74% were female. The mean (SD quality of life was 40.51(22.94, sleepiness 13.14 (5.6 and pain 6.09 (2.14. There was significant negative relationship between some sleep disorders such as (naps, apnea, asphyxia, ... and pain with quality of life but pain severity had more effect on QOL compared to sleep problems. Furthermore, participants had low quality of life with more restriction in physical (mean=34.71 and general health (mean=34.42.Conclusion: Sleep problems and pain were associated with poor quality of life in Rheumatoid Arthritis patients.

  7. A novel LabVIEW-based multi-channel non-invasive abdominal maternal-fetal electrocardiogram signal generator.

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    Martinek, Radek; Kelnar, Michal; Koudelka, Petr; Vanus, Jan; Bilik, Petr; Janku, Petr; Nazeran, Homer; Zidek, Jan

    2016-02-01

    This paper describes the design, construction, and testing of a multi-channel fetal electrocardiogram (fECG) signal generator based on LabVIEW. Special attention is paid to the fetal heart development in relation to the fetus' anatomy, physiology, and pathology. The non-invasive signal generator enables many parameters to be set, including fetal heart rate (FHR), maternal heart rate (MHR), gestational age (GA), fECG interferences (biological and technical artifacts), as well as other fECG signal characteristics. Furthermore, based on the change in the FHR and in the T wave-to-QRS complex ratio (T/QRS), the generator enables manifestations of hypoxic states (hypoxemia, hypoxia, and asphyxia) to be monitored while complying with clinical recommendations for classifications in cardiotocography (CTG) and fECG ST segment analysis (STAN). The generator can also produce synthetic signals with defined properties for 6 input leads (4 abdominal and 2 thoracic). Such signals are well suited to the testing of new and existing methods of fECG processing and are effective in suppressing maternal ECG while non-invasively monitoring abdominal fECG. They may also contribute to the development of a new diagnostic method, which may be referred to as non-invasive trans-abdominal CTG +  STAN. The functional prototype is based on virtual instrumentation using the LabVIEW developmental environment and its associated data acquisition measurement cards (DAQmx). The generator also makes it possible to create synthetic signals and measure actual fetal and maternal ECGs by means of bioelectrodes. PMID:26799770

  8. A apostasia comunista: a subjetividade como política

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    Fernando Kolleritz

    1999-01-01

    Full Text Available Edgard Morin (Auto-critique, Annie Kriegel (Ce que j'ai cru comprendre e Claude Roy (Moi, je percorrem passo a passo, desde a infância, as trilhas que o levaram ao PCF; os três participaram da resistência anti-nazista ao lado da União Soviética, ocasião da entrada em comunismo. Seguem-se as descrições de uma lenta asfixia moral em que os depoimentos fazem perceber como a rede das necessidades internas à subjetividade. Este artigo, analisando as autobiografias de três intelectuais franceses no momento em que dão criticamente conta de seu passado comunista procura apreender a figura histórica toda negativa da relação a si nas assim chamadas "contra-sociedades comunistas" durante o período stalinista.Edgard Morin (Auto-critique, Annie Kriegel (Ce que j'ai cru comprendre and Claude Roy (Moi, je go over step by step, since childhood, the tracks that took them to the PCF; the three of them have participated in the anti-nazism resistance, on the Soviet Union's side, occasion of their entrance in communism. Descriptions of a slow moral asphyxia are given, in which the statements show how the net of internal needs of political ideology ends up echoing in the net of the internal needs of subjectivity. This article, analyzing the autobiographies of three French writers in the moment when they give a critical account of their communist past, tries to apprehend the entirely negative historical figure of the relation to oneself in the so-called "communist counter-societies" during the stalinist period.

  9. Risk Management of the Delivery Room in Obstetrics%产房风险管理探讨

    Institute of Scientific and Technical Information of China (English)

    杨艳贞; 郑剑兰; 付景丽; 孙小花; 洪阿双

    2011-01-01

    Objective To study on the importance and efficiency of the risk management in the delivery room.Methods The risk factors were analyzed, and the specific measures were summarized of the risk management of delivery room during the past three years in the hospital.Results After the implementation of risk management,the high - risk pregnancies, the cesarean section rate, the episiotomy rate, the postpartum hemorrhage rate, the rate of neonatal asphyxia, the prenatal mortality rate, the perineal wound infection rate were reduced,while the delivery room job satisfaction was increased.And these differences were statistically significant.Conclusions The risk management of delivery room can enhance the awareness of risk prevention and service level, reduce the cesarean section rate, improve the obstetric quality, ensure the safe of motherhood and neonate, and reduce the medical disputes.%目的研究风险管理在产房工作中的重要性及有效性.方法分析产房的各种风险因素,归纳总结近3年来医院产房工作中风险管理的具体措施.结果 实施风险管理后,医院高危妊娠、剖宫产率、会阴侧切率、产后出血率、新生儿窒息率、围产儿死亡率、会阴切口感染率、产房工作满意度均有明显改善.结论 产房的风险管理可以提高医护人员的风险防范意识及医疗护理水平,降低剖宫产率,提高产科质量,确保母婴安全,减少医疗纠纷.

  10. The Effect of Human Recombinant Erythropoietin on Prevention of Anemia of Prematurity

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    K Hajian

    2007-06-01

    Full Text Available Objective: Premature infants often develop significant anemia that requires blood transfusion, this carries significant risks. This study was carried out to determine the effect of recombinant human erythropoietin (r-HuEPO on prevention of anemia of prematurity. Material & Methods: From April 2001 to March 2002, 24 neonates in  newborn services at Amirkola childrens hospital randomly were assigned to erythropoietin group and control (no treatment group. Inclusion criteria were birth weight of ≤1750 grams and gestational age ≤34 weeks. Exclusion criteria were problems of hemolytic anemia, congenital infections, congenital malformations, severe asphyxia, intraventricular hemorrhage (grade III and IV, need for exchange transfusion and death during the first week of life. Erythropoietin group received r-HuEPO400 unit/kg/dose subcutaneously three times a week plus 4 mg/kg/day iron orally. White blood cell, hemoglobin (Hgb, hematocrit (Hct, platelet and reticulocyte count were obtained every 2 weeks until the 42nd day of life. Anemia was defined as Hgb≤8gr/dl and Hct≤24%. Student t test and Fisher exact were used to evaluate differences between the two groups.Findings: Hemoglobin and hematocrit values were significantly higher in erythropoietin group than the control group after the 14th day of the study (P<0.04 and this difference was getting higher until the end of the trial (P<0.001. Five neonates developed anemia; all of them were from control group. One of these neonates required transfusion. None of the erythropoietin group newborns developed anemia.Conclusion: The results of this study confirm the efficacy of recombinant human erythropoietin in the prevention of anemia of prematurity.

  11. EVALUATION OF ANTI-CHOLINERGIC AND ANTI-ANAPHYLACTIC ACTIVITY OF SHIRISHADI POLYHERBAL COMPOUND

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    Kajaria Divya

    2012-02-01

    Full Text Available Asthma is a chronic inflammatory disease of airways with widespread narrowing of air passage which may be relieved spontaneously or as a result of therapy and, clinically it is characterized by paroxysms of dyspnea, cough and wheezing. Inflammation and broncho-constriction are the two major hallmarks in the pathology of Asthma. Shirishadi is a polyherbal drug used in the management of bronchial asthma by Ayurvedic practitioners from decades. Shirisha (Albezzia lebbeck, Nagarmotha (Cyprus rotandus and Kantakari (Solanum xanthocarpum are the ingredient herbs of this compound. Hence, the present investigation was undertaken to evaluate the bronchodilator and anti-anaphylactic activity of Shirishadi Polyherbal compound. Experimental models studied were egg albumin induced anaphylaxis in guinea pigs and Anti-Cholinergic activity was studied on Isolated Frog Heart and Frog Rectus Muscle. The extract produced 30+ 0.23% inhibition in maximum contraction produced by Acetylcholine which is much less than that produced by standard drug (99.9%, moreover the dose of extract that produced the visible effect is much higher than that used for therapeutic purpose suggesting that antiasthmatic effect of drug is not due to Acetylcholine antagonism activity. Neither Acetylcholine efficacy nor its potency decreases significantly with increasing dose of drug. Drug increased the cardiac tone and stimulate the cardiac contractility but unable to prevail over complete inhibition of heart rate produced by Acetylcholine. The drug produced significant protection against egg albumin induced anaphylactic shock characterized by decrease in intensity and delay in the development of symptoms of dyspnoea, asphyxia and collapse. All these findings reveal the bronchodilator and anti-anaphylactic activity of Shirishadi compound indicating its beneficial use in asthma.

  12. A dual role for AMP-activated protein kinase (AMPK) during neonatal hypoxic-ischaemic brain injury in mice.

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    Rousset, Catherine I; Leiper, Fiona C; Kichev, Anton; Gressens, Pierre; Carling, David; Hagberg, Henrik; Thornton, Claire

    2015-04-01

    Perinatal hypoxic-ischaemic encephalopathy (HIE) occurs in 1-2 in every 1000 term infants and the devastating consequences range from cerebral palsy, epilepsy and neurological deficit to death. Cellular damage post insult occurs after a delay and is mediated by a secondary neural energy failure. AMP-activated protein kinase (AMPK) is a sensor of cellular stress resulting from ATP depletion and/or calcium dysregulation, hallmarks of the neuronal cell death observed after HIE. AMPK activation has been implicated in the models of adult ischaemic injury but, as yet, there have been no studies defining its role in neonatal asphyxia. Here, we find that in an in vivo model of neonatal hypoxia-ischaemic and in oxygen/glucose deprivation in neurons, there is pathological activation of the calcium/calmodulin-dependent protein kinase kinase β (CaMKKβ)-AMPKα1 signalling pathway. Pharmacological inhibition of AMPK during the insult promotes neuronal survival but, conversely, inhibiting AMPK activity prior to the insult sensitizes neurons, exacerbating cell death. Our data have pathological relevance for neonatal HIE as prior sensitization such as exposure to bacterial infection (reported to reduce AMPK activity) produces a significant increase in injury. We show that in an in vivo model of neonatal hypoxia-ischaemic and in oxygen/glucose deprivation in neurons, there is a pathological activation of the CaMKKβ-AMPKα1 signalling pathway. Inhibiting AMPK during OGD promotes neuronal survival; conversely, inhibiting AMPK prior to OGD exacerbates cell death. Our data have clinical relevance as prior sensitization (e.g. exposure to bacterial infection reducing AMPK activity) increases injury. AMPK, AMP-activated protein kinase; HI, hypoxia-ischaemia; OGD, oxygen-glucose deprivation. PMID:25598140

  13. Homicidal deaths in the Western suburbs of Paris: a 15-year-study.

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    Cros, Jérôme; Alvarez, Jean-Claude; Sbidian, Emilie; Charlier, Philippe; Lorin de la Grandmaison, Geoffroy

    2012-12-01

    The aim of our study was to analyze the homicide pattern in the Western suburbs of Paris and its evolution between 1994 and 2008. All autopsy reports regarding homicides from the period January 1, 1994, to December 31, 2008, were retrospectively reviewed. Five hundred eleven homicide cases were selected of 4842 autopsy cases. The following data were recorded: assailants and victims characteristics, crime scene location, homicide motive, cause of death, and victim's postmortem toxicological results. Homicide rate steadily declined over the period at the exception of the number of homicide-suicide per year, which remained constant. Homicide victims remained unidentified after medicolegal investigations in 2% of the cases. Child and elder homicide cases represented, respectively, 10.7% and 8.2% of the cases. Offenders were male in 88% of the cases. Male and female assailants showed distinct homicide patterns: females were involved more frequently in familial quarrel and child abuse. They never killed a stranger and committed homicide exclusively in a private place with a predominance of sharp weapons. Males, in contrast, assaulted almost equally a stranger or an acquaintance, often in a public place with a predominance of firearm. Victim knew the assailant(s) in 57% of the cases. Homicides mostly took place at the residence of the assailant or the victim. Homicide motive was clearly determined in 71% of the cases. Argument was the most common motive in 44% of the cases. Sexual assault was rarely found (10 cases). Gunshot wounds were the most common cause of death (37%), followed by stab wounds (27%), blunt trauma (19%), and asphyxia (13%). A decrease of gunshot wounds as a cause of death was found over the studied period. Alcohol was the most common toxic detected in blood of the victim, in 48.5% of the cases when toxicological results were available. Blood alcohol concentration ranged from 1 to 500 mg/dL with a mean value of 150 mg/dL. PMID:22922553

  14. A STUDY TO ASSESS THE ASSOCIATION OF SET - UP BEING PROVIDED AND BENEFICIARY ASSESSMENT OF SPECIAL CARE NEWBORN UNITS (SCNUS OF INDORE AND UJJAIN DIVISIONS OF M. P. AT DIFFERENT LEVELS

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    Rajendra Kumar

    2015-02-01

    Full Text Available INTRODUCTION: The neonatal mortality rate in India is high and stagnant. Special Care Newborn Units (SCNUs have been set up at different levels Health Care Delivery System to provide quality newborn - care services in several hospitals to meet this challenge. Many units are located in the districts where the burden of neonatal deaths is high, and access to special newborn care is poor. MATERIALS AND METHODS: The study was conducted to assess the functioning of SCNUs in six centers of India. The evaluation was based on an analysis of secondary data from the six units that had been functioning for at least three year. A cross - sectional survey was conducted to assess the availability of infrastructure, equipment’s and human resources and assessment of the beneficiaries. Desc riptive statistics were used for analyzing the inputs (R esources and outcomes ( A ssessment of the beneficiaries. Correlation coefficients were estimated to understand the possible association of satisfaction rate of beneficiaries with factors, such as bed : doctor ratio, bed: nurse ratio, average duration of stay, and bed occupancy rate. RESULTS: The major reasons for admission and the major causes of deaths were birth asphyxia, sepsis, and LBW/prematurity. Likart’s Analysis is used to analyze Beneficiaries Assessment. Beneficiaries were not found at Level I NBSUs at the time of evaluation. The units had a varying nurse: bed ratio (1:1 - 1:2.14. The bed occupancy rate ranged from 83% to 121% (median 115%, and the average duration of stay ranged from three da ys to 8 days (median 5 days. Repair and maintenance of equipment were a major concern. CONCLUSION: It is possible to set up and manage quality SCNUs and improve the survival of newborns with LBW and sepsis in developing countries, although several challen ges relating to infrastructure, human resources and maintenance of equipment remain.

  15. Antenatal and delivery risk factors and prevalence of cerebral palsy in Duzce (Turkey).

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    Oztürk, A; Demirci, F; Yavuz, T; Yildiz, S; Değirmenci, Y; Döşoğlu, M; Avşar, Y

    2007-01-01

    This cross-sectional study aimed at investigating the prevalence and the etiological factors of cerebral palsy (CP) and comparing them with normal population within the rural and urban areas of Duzce province. Of the 102 children with cerebral palsy, 98 were associated with antenatal and delivery risk factors. The mean crude prevalence of cerebral palsy was 1.1 per 1000 live births. The children with CP were compared with 530 control subjects. The mothers of the children with cerebral palsy were significantly younger than the mothers of children in control group, and they had less parity and abortion. Preeclampsia, premature rupture of membranes, home births, prolonged labor, and twin pregnancies were significantly more common in the mothers of children with cerebral palsy, where no significant differences were found between the groups in terms of breech delivery, rate of cesarean births, gestational diabetes, and hemorrhage in late pregnancy. Birth asphyxia, liqueur with meconium stained, prolonged jaundice and neonatal seizure were also significantly more common in the group with cerebral palsy. Of the children with cerebral palsy, 78% were born at term, 20% were born with gestational ages of 32-36 weeks, 2% were born with gestational ages of 30-31 weeks. Nine percent of those children had a birth weight of >or= 3000 g, 12.2% had a birth weight of 2500-2999 g, 33.7% had a birth weight of 1500-2499 g, and 5.1% had a birth weight of

  16. Torture and Long-Term Health Effects Among Lebanese Female Political Prisoners.

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    Ghaddar, Ali; Elsouri, Ghadier; Abboud, Zeinab

    2016-02-01

    Lebanese prisoners during the Israeli occupation of Lebanon (1981-1999) were subject to regular torture. We examined the association between torture events and post-traumatic stress and cardiovascular diseases (CVDs) among former women political prisoners. We conducted a retrospective survey and performed health check-ups among 108 former women prisoners. Post-traumatic stress disorder (PTSD) was measured through the Clinician-Administered PTSD Scale (CAPS), and CVDs were assessed by physicians' diagnoses. The study was conducted between September 2008 and March 2010. All 67 participants in the study reported having been subjected to a variety of torture events. The prevalence of PTSD was 28.4% and that of CVD was 16.42%, respectively. PTSD and CVD were more likely to occur among women who had had longer imprisonment periods, and PTSD specifically was associated with exposure to torture (beating: OR = 1.49; 95% CI [0.48, 4.27] and threatening by rape: OR = 1.43; 95% CI [0.82, 9.30]). CVD was associated with asphyxia with water (OR = 3.86; 95% CI [0.03, 2.28]). Devoutness decreased the risk of PTSD (OR = 0.24; 95% CI [0.08, 1.41]). Torture had adverse long-term effects on prisoners' physiological and psychological health; devoutness played a significant protective role. This study highlights the importance of documenting torture events and identifying the indicators of associated morbidity among surviving political prisoners for the provision of additional resources to care. PMID:25381274

  17. Mortality and morbidity analysis in neonates supported by invasive mechanical ventilation

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    Azer Kılıç Başkan

    2012-12-01

    Full Text Available Objectives: To evaluate mortality, morbidity, and invasivemechanical ventilation complications in mechanicallyventilated neonates in a tertiary care hospital, Istanbul,Turkey.Materials and methods: The neonates followed on invasivemechanical ventilation from January 2008 to December2009 were included in the study. A chart is formed foreach patient to record patient delivery room and clinicaldata prospectively.Results: The study population consisted of 236 neonates.Eighty-five percent were born at ≤37 completed weeks ofgestation (n=201. Fifty-two percent (n=123 were males.The mean gestational age was 31.9±5 weeks. The meanbirthweight was 1870.8±921.8 g. Antenatal steroid ratewas 13.3% (n=20 in 150 cases born at ≤34 weeks of gestation.Respiratory distress syndrome (n=100, 42,3%,perinatal depression and asphyxia (n=51, 21,6%, andsepsis (n=47, 19.9% were the commonest indications.Mechanical ventilation related complications (nosocomialinfection (n=57, pulmonary hemorrhage (n=30,pneumonia (n=10, pneumothorax (n=9, and atelectasis(n=4 developed in 33.5% of neonates (n=79. Bronchopulmonarydysplasia was 9.3%, intracranial hemorrhage(≥grade 3 8.47%, periventricular leukomalacia 5.93%,necrotizing enterocolitis (>stage 2 0.42%, and retinopathyof prematurity (>stage 2 2.96%. Mortality rate was30.17%. Neonates born at 1000 gram (p<0.05, p<0.05,respectively.Conclusions: Low birthweight and low gestational ageare important risk factors for neonatal mortality and morbidity.Low frequency of antenatal steroid use may be acontributing factor to increase neonatal mortality and morbidity.J Clin Exp Invest 2012; 3(4: 483-492Key words: Neonate, invasive mechanical ventilation,mortality, morbidity

  18. 大石桥市2006至2010年5岁以下儿童死亡原因分析报告%Report for death cause analysis of children under the age of five in Dashiqiao from 2006 to 2010

    Institute of Scientific and Technical Information of China (English)

    李广义

    2014-01-01

    Objective: To understand the mortality and death causes, characteristics and trend of children under ifve years old in dashiqiao to provide evidence for intervention measures.Methods retrospective survey method was used to analyze the data of children death under the age of ifve from 2006 to 2010.Results The mortality rate of children under ifve years old in dashiqiao declined year by year, and the death was mainly because of congenital heart disease and birth asphyxia, preterm delivery and low birth weight, other congenital anomalies and pneumonia.Conclusion the key to reduce the mortality rate of children under five years old was to reduce neonatal mortality, consolidate the maternal health care, enhance child care, strengthen personnel training and quality management and pay more attention to health education.%目的:了解大石桥市5岁以下儿童死亡率及死亡原因、特点与趋势,为制定干预措施提供依据。方法回顾性调查方法,对2006年至2010年5岁以下儿童死亡监测资料进行回顾性分析。结果大石桥市5岁以下儿童死亡率呈逐年下降趋势,主要死因为先天性以及心脏病出生窒息、早产和低出生体重、其他先天异常、肺炎。结论降低5岁以下儿童死亡率关键在于降低新生儿死亡率,巩固孕产妇保健和儿童保健工作,加强人员培训和质量管理,重视健康教育。

  19. Childhood deaths from external causes in Estonia, 2001–2005

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    Soonets Ruth

    2007-07-01

    Full Text Available Abstract Background In 2000, the overall rate of injury deaths in children aged 0–14 was 28.7 per 100000 in Estonia, which is more than 5 times higher than the corresponding rate in neighbouring Finland. This paper describes childhood injury mortality in Estonia by cause and age groups, and validates registration of these deaths in the Statistical Office of Estonia against the autopsy data. Methods The data on causes of all child deaths in Estonia in 2001–2005 were abstracted from the autopsy protocols at the Estonian Bureau of Forensic Medicine. Average annual mortality rates per 100,000 were calculated. Coverage (proportion of the reported injury deaths from the total number of injury deaths and accuracy (proportion of correctly classified injury deaths of the registration of causes of death in Statistical Office of Estonia were assessed by comparing the Statistical Office of Estonia data with the data from Estonian Bureau of Forensic Medicine. Results Average annual mortality from external causes in 0–14 years-old children in Estonia was 19.1 per 100,000. Asphyxia and transport accidents were the major killers followed by poisoning and suicides. Relative contribution of these causes varied greatly between age groups. Intent of death was unknown for more than 10% of injury deaths. Coverage and accuracy of registration of injury deaths by Statistical Office of Estonia were 91.5% and 95.3%, respectively. Conclusion Childhood mortality from injuries in Estonia is among the highest in the EU. The number of injury deaths in Statistical Office of Estonia is slightly underestimated mostly due to misclassification for deaths from diseases. Accuracy of the Statistical Office of Estonia data was high with some underestimation of intentional deaths. Moreover, high proportion of death with unknown intent suggests underestimation of intentional deaths. Reduction of injury deaths should be given a high priority in Estonia. More information on

  20. [Clinical study of Jiawei Bazhen decoction combined with oxytocin for cervical ripening of qi and blood deficiency type of pregnant women].

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    Ke, Xiao-yan; Chen, Bao-yan; Xu, Hui-fang; Li, Dao-cheng; Li, Yan-fang; Sun, Xue

    2015-05-01

    To study preliminarily the effect of Jiawei Bazhen decoction combined with oxytocin in promoting cervical ripening of full-term pregnancy women who were in the deficiency of qi and blood type through the syndrome differentiation of traditional Chinese medicine (TCM). 180 patients that met the inclusion criteria of the study were randomly divided into three groups: the control group(oxytocin group), the treatment group (Jiawei Bazhen decoction combined with oxytocin group), the blank control group (expected and observation group). Cervical maturity score (Bishop score), vaginal and cervical secretions fetal fibronectin (FFN), the result of induced labor, the result of mother and baby were observed in each group before and after treatment. The result comes out that the cervical Bishop score of pregnant women for treatment group were significantly higher than the control group and blank control group after treatment (P < 0.05). The FFN of pregnant women for the treatment group were significantly different from the control group and blank control group after treatment (P < 0.05). The pregnancy outcome of the three groups: the labor rate and rate of vaginal delivery of the treatment group were higher than the other two groups, and the difference was statistically significant (P < 0.05). The cesarean section rate of the treatment group was significantly lower than the other two groups, the difference was also statistically significant (P < 0.05). The three groups did not appear the phenomenon of neonatal asphyxia. Jiawei Bazhen decoction combined with oxytocin is effective in producing cervical ripening and induce labor. It is convenient, safe and reliable, for it is no obvious adverse effects on mother and fetus, but effective in reducing the rate of cesarean section, and playing a positive role in promoting natural delivery. PMID:26323156