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Sample records for early neonatal period

  1. Intestinal Obstruction in Early Neonatal Period: A 3-Year Review Of ...

    African Journals Online (AJOL)

    BACKGROUND: Failure to pass meconium by a full-term neonate within the first 24 hours should raise a suspicion of bowel obstruction. The objective of this study was to determine pattern of presentation, diagnosis and outcome of management of intestinal obstruction in the early neonatal period in the Neonatal Care Unit ...

  2. [Pregnancy and labor associated with encephalopathy in neonates during the early neonatal period].

    Science.gov (United States)

    Skrablin, S; Drazancić, A; Letica, N; Tadić, V

    1992-01-01

    Pregnancy complications, drugs and surgical interventions during pregnancy, fetal growth, medications and interventions during labor, labor complications as well as fetal heart activity during labor in a group of 114 term infants without malformations, but with signs of central nervous system (CNS) damage throughout early neonatal period are compared with paired group of term healthy infants born in the same presentation and mode of delivery. Among prelabor factors only maternal hypertension (found in 16.7% of encephalopathy children versus 0.8% in a control group) was significantly correlated with CNS damage. Fetal growth retardation and long term ritodrine administration were found more frequent in encephalopathy than in healthy group of infants, although statistical significance between the groups could not be demonstrated. A prolonged second stage of labor, high oxytocin dosage, too frequent uterine contractions and vacuum extractions were found significantly correlated with neonatal encephalopathy. CTG pattern during labor was normal in only 28.9% of children, with encepalopathy prepathologic in 46.4% and pathologic in 24.7%. The respective percentages for healthy newborns were: 82.5%, 16.25% and 1.2%. All differences between the groups were statistically significant. Mean duration of prepathologic CTG score in the group of infants with encephalopathy (78.8 minutes) as well as of pathologic score (51.7 minutes) was significantly longer than in healthy infants (23.7 minutes prepathologic and 7 minutes pathologic).(ABSTRACT TRUNCATED AT 250 WORDS)

  3. The Red Blood Cell Membrane of Preterm Infants in the Early Neonatal Period

    Directory of Open Access Journals (Sweden)

    S. A. Perepelitsa

    2014-01-01

    Full Text Available Objective: to study the nanostructure of red blood cell membranes and erythrocyte index in preterm neonatal infants.Subjects and methods. The trial enrolled 47 neonatal infants, including 33 preterm infants who were included in a study group and 14 fullterm infants who formed a comparative group. The gestational age of the preterm infants was 33.3±1.9 weeks and the birth weight was 2065.4±304.8 g. Red blood cell counts, hemoglobin, and erythrocyte indices were estimat ed and the red blood cells were examined using an atomicforce microscope.Results. At birth, the preterm infants showed macrocytosis, intrauterine poikylocytosis, and the impaired nanostructure of red blood cell membranes. Intrauterine hypoxia affects the red blood cell membrane nanostructures: a phospholipid bilayer and a spectrin matrix, without damaging the membrane protein component. The detected changes are reversible and directed to maintaining the functional ability of red blood cells in a critical situation. At birth, gestational age, a baby's weight, hemoglobin, and blood cholesterol and standard bicarbonate levels influence the parameters of a red blood cell component. The early neonatal period was characterized by an active process on the red blood cell membranes and a change of morphological forms, suggesting the continuing postnatal rearrangement of erythropoiesis and a preterm infant's adaptation to new environmental conditions.

  4. [Bilirubin in the early neonatal period. Is there a positive aspect of hyperbilirubinemia?--A medical hypothesis].

    Science.gov (United States)

    Bervoets, K; Schlenzig, J S; Böhles, H

    1994-05-10

    The fact that almost all neonates exhibit a "physiological" jaundice, prompts the question whether bilirubin, usually exclusively considered a potentially toxic endproduct of the metabolism of heme, might not also have a positive task in the first days of life. A recently discovered property of bilirubin under in vitro conditions is its ability to combine with free oxygen radicals such as are produced in the oxidative metabolic processes of the neonate immediately following birth. In the present article, the concept of the anti-oxidative effect of bilirubin, and its translation to the early neonatal period is presented and discussed on the basis of a number of examples.

  5. Analysis of acylcarnitine profiles in umbilical cord blood and during the early neonatal period by electrospray ionization tandem mass spectrometry

    Directory of Open Access Journals (Sweden)

    E. Vieira Neto

    2012-06-01

    Full Text Available Acylcarnitine profiling by electrospray ionization tandem mass spectrometry (ESI-MS/MS is a potent tool for the diagnosis and screening of fatty acid oxidation and organic acid disorders. Few studies have analyzed free carnitine and acylcarnitines in dried blood spots (DBS of umbilical cord blood (CB and the postnatal changes in the concentrations of these analytes. We have investigated these metabolites in healthy exclusively breastfed neonates and examined possible effects of birth weight and gestational age. DBS of CB were collected from 162 adequate for gestational age neonates. Paired DBS of heel-prick blood were collected 4-8 days after birth from 106 of these neonates, the majority exclusively breastfed. Methanol extracts of DBS with deuterium-labeled internal standards were derivatized before analysis by ESI-MS/MS. Most of the analytes were measured using a full-scan method. The levels of the major long-chain acylcarnitines, palmitoylcarnitine, stearoylcarnitine, and oleoylcarnitine, increased by 27, 12, and 109%, respectively, in the first week of life. Free carnitine and acetylcarnitine had a modest increase: 8 and 11%, respectively. Propionylcarnitine presented a different behavior, decreasing 9% during the period. The correlations between birth weight or gestational age and the concentrations of the analytes in DBS were weak (r £ 0.20 or nonsignificant. Adaptation to breast milk as the sole source of nutrients can explain the increase of these metabolites along the early neonatal period. Acylcarnitine profiling in CB should have a role in the early detection of metabolic disorders in high-risk neonates.

  6. Analysis of acylcarnitine profiles in umbilical cord blood and during the early neonatal period by electrospray ionization tandem mass spectrometry

    Energy Technology Data Exchange (ETDEWEB)

    Vieira Neto, E. [Serviço de Genética Médica, Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Laboratório Diagnósticos Laboratoriais Especializados, Rio de Janeiro, RJ (Brazil); Fonseca, A.A.; Almeida, R.F. [Laboratório Diagnósticos Laboratoriais Especializados, Rio de Janeiro, RJ (Brazil); Figueiredo, M.P.; Porto, M.A.S. [Maternidade Escola, Rio de Janeiro, RJ (Brazil); Ribeiro, M.G. [Serviço de Genética Médica, Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ (Brazil)

    2012-04-13

    Acylcarnitine profiling by electrospray ionization tandem mass spectrometry (ESI-MS/MS) is a potent tool for the diagnosis and screening of fatty acid oxidation and organic acid disorders. Few studies have analyzed free carnitine and acylcarnitines in dried blood spots (DBS) of umbilical cord blood (CB) and the postnatal changes in the concentrations of these analytes. We have investigated these metabolites in healthy exclusively breastfed neonates and examined possible effects of birth weight and gestational age. DBS of CB were collected from 162 adequate for gestational age neonates. Paired DBS of heel-prick blood were collected 4-8 days after birth from 106 of these neonates, the majority exclusively breastfed. Methanol extracts of DBS with deuterium-labeled internal standards were derivatized before analysis by ESI-MS/MS. Most of the analytes were measured using a full-scan method. The levels of the major long-chain acylcarnitines, palmitoylcarnitine, stearoylcarnitine, and oleoylcarnitine, increased by 27, 12, and 109%, respectively, in the first week of life. Free carnitine and acetylcarnitine had a modest increase: 8 and 11%, respectively. Propionylcarnitine presented a different behavior, decreasing 9% during the period. The correlations between birth weight or gestational age and the concentrations of the analytes in DBS were weak (r ≤ 0.20) or nonsignificant. Adaptation to breast milk as the sole source of nutrients can explain the increase of these metabolites along the early neonatal period. Acylcarnitine profiling in CB should have a role in the early detection of metabolic disorders in high-risk neonates.

  7. Sudden and unexpected and near death during the early neonatal period: A multicenter study

    Directory of Open Access Journals (Sweden)

    Pei-Chen Tsao

    2012-02-01

    Conclusion: More effort on promotion of autopsy to discover the underlying disease is necessary and helpful. To build up an alarm system or protocol for education and early detection is the basis to prevent this tragedy.

  8. Cardiorespiratory control and cytokine profile in response to heat stress, hypoxia, and lipopolysaccharide (LPS) exposure during early neonatal period.

    Science.gov (United States)

    McDonald, Fiona B; Chandrasekharan, Kumaran; Wilson, Richard J A; Hasan, Shabih U

    2016-02-01

    Sudden infant death syndrome (SIDS) is one of the most common causes of postneonatal infant mortality in the developed world. An insufficient cardiorespiratory response to multiple environmental stressors (such as prone sleeping positioning, overwrapping, and infection), during a critical period of development in a vulnerable infant, may result in SIDS. However, the effect of multiple risk factors on cardiorespiratory responses has rarely been tested experimentally. Therefore, this study aimed to quantify the independent and possible interactive effects of infection, hyperthermia, and hypoxia on cardiorespiratory control in rats during the neonatal period. We hypothesized that lipopolysaccharide (LPS) administration will negatively impact cardiorespiratory responses to increased ambient temperature and hypoxia in neonatal rats. Sprague-Dawley neonatal rat pups were studied at postnatal day 6-8. Rats were examined at an ambient temperature of 33°C or 38°C. Within each group, rats were allocated to control, saline, or LPS (200 μg/kg) treatments. Cardiorespiratory and thermal responses were recorded and analyzed before, during, and after a hypoxic exposure (10% O2). Serum samples were taken at the end of each experiment to measure cytokine concentrations. LPS significantly increased cytokine concentrations (such as TNFα, IL-1β, MCP-1, and IL-10) compared to control. Our results do not support a three-way interaction between experimental factors on cardiorespiratory control. However, independently, heat stress decreased minute ventilation during normoxia and increased the hypoxic ventilatory response. Furthermore, LPS decreased hypoxia-induced tachycardia. Herein, we provide an extensive serum cytokine profile under various experimental conditions and new evidence that neonatal cardiorespiratory responses are adversely affected by dual interactions of environmental stress factors. © 2016 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on

  9. MR imaging in the neonatal period

    International Nuclear Information System (INIS)

    Aida, Noriko; Inuzuka, Michiko; Odagiri, Kunio

    1994-01-01

    We reviewed 118 MR examinations in the neonatal period to define its indication, problem, and usefulness. The patients were 58 term infants under 28 days of age and 46 preterm infants under 46 week of their post conceptional age. Almost all patients were examined under sedation. We used pulse wave monitoring and respiration was monitored only by observing the chest motion. Hot water bags were used in some cases to keep the patient warm. No serious accidents or sequelae occurred, although a very few patients had a brief apnea attacks during sedation and some developed hypothermia after the examination. The MR provided many useful information such as basal ganglial lesions after perinatal asphyxia and multiplaner demonstration of the CN5 anomalies which no other modality could. The detection rate of abnormality in the study was about 65%. Although MR studies in the neonatal period have many difficulties to be overcome including sedation, maintenance of body temperature and monitoring, they can demonstrate useful information that are helpful for their early treatment and care. Thus we believe that the MR study should be performed in a more positive manner in a variety of clinical setting in the neonatal period. (author)

  10. MR imaging in the neonatal period

    Energy Technology Data Exchange (ETDEWEB)

    Aida, Noriko; Inuzuka, Michiko; Odagiri, Kunio (Kanagawa Children' s Medical Center (Japan))

    1994-01-01

    We reviewed 118 MR examinations in the neonatal period to define its indication, problem, and usefulness. The patients were 58 term infants under 28 days of age and 46 preterm infants under 46 week of their post conceptional age. Almost all patients were examined under sedation. We used pulse wave monitoring and respiration was monitored only by observing the chest motion. Hot water bags were used in some cases to keep the patient warm. No serious accidents or sequelae occurred, although a very few patients had a brief apnea attacks during sedation and some developed hypothermia after the examination. The MR provided many useful information such as basal ganglial lesions after perinatal asphyxia and multiplaner demonstration of the CN5 anomalies which no other modality could. The detection rate of abnormality in the study was about 65%. Although MR studies in the neonatal period have many difficulties to be overcome including sedation, maintenance of body temperature and monitoring, they can demonstrate useful information that are helpful for their early treatment and care. Thus we believe that the MR study should be performed in a more positive manner in a variety of clinical setting in the neonatal period. (author).

  11. A PEARL Study Analysis of National Neonatal, Early Neonatal, Late Neonatal, and Corrected Neonatal Mortality Rates in the State of Qatar during 2011: A Comparison with World Health Statistics 2011 and Qatar's Historic Data over a Period of 36 Years (1975-2011).

    Science.gov (United States)

    Rahman, Sajjad; Al Rifai, Hilal; El Ansari, Walid; Nimeri, Nuha; El Tinay, Sarrah; Salameh, Khalil; Abbas, Tariq; Jarir, Rawia A; Said, Nawal; Taha, Samer

    2012-10-01

    To prospectively ascertain Qatar's national Neonatal Mortality Rate (NMR), Early Neonatal Mortality Rate (ENMR), and Late Neonatal Mortality Rate (LNMR) during 2011, compare it with recent data from high-income countries, and analyze trends in Qatar's NMR's between 1975 and 2011 using historic data. A National prospective cohort-study. National data on live births and neonatal mortality was collected from all public and private maternity facilities in Qatar (1(st) January-December 31(st) 2011) and compared with historical neonatal mortality data (1975-2010) ascertained from the database of maternity and neonatal units of Women's Hospital and annual reports of Hamad Medical Corporation. For inter country comparison, country data of 2009 was extracted from World Health Statistics 2011 (WHO) and the European Perinatal Health report (2008). A total of 20583 live births were recorded during the study period. Qatar's national NMR during 2011 was 4.95, ENMR 2.7, LNMR 2.2, and cNMR 3.33. Between 1975 and 2011, Qatar's population increased by 10-fold, number of deliveries by 7.2 folds while relative risk of NMR decreased by 87% (RR 0.13, 95% CI 0.10-0.18, P<0.001), ENMR by 91% (RR 0.09, 95% CI 0.06-0.12, P<0.001) and LNMR by 58% (RR 0.42, 95% CI 0.23-0.74, P=0.002). The comparable ranges of neonatal mortality rates from selected high-income West European countries are: NMR: 2-5.7, ENMR 1.5-3.8, and LNMR 0.5-1.9. The neonatal survival in the State of Qatar has significantly improved between 1975 and 2011. The improvement has been more marked in ENMR than LNMR. Qatar's current neonatal mortality rates are comparable to most high-income West European countries. An in-depth research to assess the correlates and determinants of neonatal mortality in Qatar is indicated.

  12. Hypertension in the Neonatal Period: An Update.

    Science.gov (United States)

    Pillai, Anish; Sharma, Deepak; Kadam, Pratichi

    2016-01-01

    There has been a growing interest among neonatologists and paediatricians regarding identification and evaluation of hypertension in the neonatal period. Despite the emergent normative data on blood pressure values in term and preterm neonates over the last two decades, there is still controversy regarding correct definition and classification of hypertension. This article will discuss the current definitions, available normative data and etiology of neonatal hypertension. There is paucity of records in terms of efficacy of antihypertensive drugs in this specific population and management is usually experience based, causing considerable heterogeneity amongst different units. This review article will also cover the evaluation, management, outcomes and follow up of neonatal hypertension with latest advances in this field. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  13. Antiretroviral therapy during the neonatal period

    African Journals Online (AJOL)

    2015-05-04

    May 4, 2015 ... until clinical or CD4 criteria were met.1 In the landmark Children with HIV Early ... to cART regimens aimed at long-term treatment requires further investigation. ... therefore be a consideration for short-term use in neonatal ...... of memory B cells and the longevity of humoral responses in HIV-1 vertically-.

  14. Neonatal Respiratory Distress Syndrome: Early Diagnosis, Prevention, and Treatment

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    S. A. Perepelitsa

    2012-01-01

    Full Text Available to improve treatment results in premature infants with neonatal respiratory distress syndrome (NRDS, by establishing developmental mechanisms and elaborating methods for its early diagnosis, treatment, and prevention. Material and methods. The paper analyzes the results of a clinical observation and laboratory, instrumental, immunological, morphological, and radiological studies of 320 premature neonates at 26—35 weeks gestational age. The following groups of neonates were identified: 1 40 premature neonatal infants without NRDS and with the physiological course of an early neonatal period (a comparison group; 2 190 premature neonates with severe NRDS in whom the efficiency of therapy with exogenous surfactants, such as surfactant BL versus curosurf, was evaluated; 3 90 premature newborn infants who had died from NRDS at its different stages. Results. The poor maternal somatic, obstetric, and gynecological histories in the early periods of the current pregnancy create prerequisites for its termination, favor the development of severe acute gestosis, and cause abnormal placental changes. Each gestational age is marked by certain placental changes that promote impaired uterineplacentalfetal blood flow and premature birth. Alveolar and bronchial epithelial damages, including those ante and intranatally, microcircula tory disorders play a leading role in the tanatogenesis of NRDS. Intranatal hypoxia and amniotic fluid aspiration are one of the important factors contributing to alveolar epithelial damage and NRDS in premature neonates. Exogenous surfactants prevent the development of hyaline membranes and are useful in the normalization of ventilation-perfusion relationships and lung biomechanical properties. Conclusion. This study could improve the diagnosis and treatment of NRDS, which assisted in reducing the duration of mechanical ventilation from 130±7.6 to 65±11.6 hours, the number of complications (the incidence of intragastric

  15. [Heart failure as early manifestation of neonatal hyperthyroidism. Case report].

    Science.gov (United States)

    Alvarado S, Jorge Luis; Fernández V, Zhirly Andrea

    2014-04-01

    Neonatal hyperthyroidism is usually a self-limited condition frequently associated with transplacental passage of thyroid stimulating antibodies secondary to maternal autoimmune disorders. To timely detect mothers with this medical antecedents decreases the risk for fetal adverse events. To report a case of neonatal hyperthyroidism associated with intrauterine growth restriction and heart failure. A 36 week-old newborn with birth weight of 1,240 g. Symptoms were tachycardia, distal coldness, exophthalmos, hepatomegaly and tremors. Echocardiogram ruled out structural heart disorders. Due to maternal symptoms suggestive of hyperthyroidism, TSH tests were performed showing 0.01 ulU/ml, free T4 7.7 ng/dl, so the diagnosis of neonatal hyperthyroidism was confirmed. It was treated with methimazole and propanol, alleviating the symptoms and decreasing the levels of free T4. To know the maternal history helps identify and manage neonatal complications of hyperthyroidism. Heart failure and other cardiopulmonary disorders are determinants of mortality during early neonatal period. High-risk newborns should receive follow up assessments.

  16. [Association between risk factors during maternal pregnancy and the neonatal period and childhood bronchial asthma].

    Science.gov (United States)

    Zhang, Hui-Qin; Fan, Rui; Zhang, Jing-Jing; Tao, Xiao-Juan; Sun, Xin

    2017-01-01

    To study the association of the risk factors during maternal pregnancy and the neonatal period with childhood bronchial asthma. A total of 306 children with asthma (asthma group) and 250 healthy children (control group) were enrolled. Their clinical data during the neonatal period and the maternal data during pregnancy were retrospectively studied. The univariate analysis showed that there were significant differences in the rates of maternal use of antibiotics during pregnancy, use of antibiotics and probiotics during the neonatal period, preterm birth, cesarean section, low birth weight, and breast feeding (>6 months) between the asthma and control groups (Pchildhood asthma. The use of probiotics during the neonatal period (OR=0.014, 95%CI: 0.004-0.046) and breast feeding (>6 months) (OR=0.161, 95%CI: 0.103-0.253) were protective factors for childhood asthma. The early prevention of childhood asthma can be improved by reducing the use of antibiotics during pregnancy, reducing cesarean section, avoiding abuse of antibiotics during the neonatal period, trying breast feeding and taking probiotics in early stage.

  17. Serum procalcitonin as an early marker of neonatal sepsis | Ballot ...

    African Journals Online (AJOL)

    Background. It has recently been suggested that procalcitonin (PCT) is of value in the diagnosis of neonatal sepsis, with varying results. This study was to evaluate the role of PCT as a single early marker of neonatal sepsis. Setting. Neonatal Unit, Johannesburg Hospital, and Microbiology Laboratory, National Health ...

  18. Early continuous video electroencephalography in neonatal stroke.

    LENUS (Irish Health Repository)

    Walsh, Brian H

    2011-01-01

    Perinatal stroke is the second most common cause of neonatal seizures, and can result in long-term neurological impairment. Diagnosis is often delayed until after seizure onset, owing to the subtle nature of associated signs. We report the early electroencephalographic (EEG) findings in a female infant with a perinatal infarction, born at 41 weeks 2 days and weighing 3.42 kg. Before the onset of seizures, the EEG from 3 hours after delivery demonstrated occasional focal sharp waves over the affected region. After electroclinical seizures, focal sharp waves became more frequent, complex, and of higher amplitude, particularly in \\'quiet sleep\\'. In \\'active sleep\\

  19. Early continuous video electroencephalography in neonatal stroke.

    LENUS (Irish Health Repository)

    Walsh, Brian H

    2012-01-31

    Perinatal stroke is the second most common cause of neonatal seizures, and can result in long-term neurological impairment. Diagnosis is often delayed until after seizure onset, owing to the subtle nature of associated signs. We report the early electroencephalographic (EEG) findings in a female infant with a perinatal infarction, born at 41 weeks 2 days and weighing 3.42 kg. Before the onset of seizures, the EEG from 3 hours after delivery demonstrated occasional focal sharp waves over the affected region. After electroclinical seizures, focal sharp waves became more frequent, complex, and of higher amplitude, particularly in \\'quiet sleep\\'. In \\'active sleep\\

  20. Epidemiology of small-bowel obstruction beyond the neonatal period

    African Journals Online (AJOL)

    Background The aim of this study was to evaluate the etiologies causing intestinal obstruction beyond the neonatal period. Patients and methods An observational study was conducted on children between 1 month and 17 years of age who underwent surgery for small-bowel obstruction. (SBO) at this tertiary referral center ...

  1. Approach to seizures in the neonatal period: a European perspective

    DEFF Research Database (Denmark)

    Vento, M; de Vries, Lisbeth Elvira; Alberola, A

    2010-01-01

    In the neonatal period, seizures rank among the most common neurological symptoms, often indicating an underlying serious neurological condition. It is remarkable that although new tools have been incorporated into the diagnosis of neonatal seizures, there is no consensus about the therapeutic ap...... infusion is most common. Of note, clinical studies with newer drugs have been mostly performed in the United States but not in Europe....... approach among different doctors and institutions. Hence, although phenobarbital is still considered the initial drug of choice, the protocols reported in the literature show a great variability in the approach to treatment of refractory seizures. We used a questionnaire to gain information regarding...

  2. Predictors of early neonatal mortality at a neonatal intensive care ...

    African Journals Online (AJOL)

    admin

    mortality and they have been the reasons for the wide variation in mortality rates among the health facilities reporting. Objective: ... A study in Indonesia about determinants of neonatal ..... antenatal visit, frequency of visits and administration of.

  3. Breastfeeding in the neonatal transitional period at a Baby-Friendly Hospital

    Directory of Open Access Journals (Sweden)

    Jéssica Machado Teles

    2015-03-01

    Full Text Available The objective of this study was to learn the breastfeeding rates in the neonatal transition period at a child-friendly hospital. A quantitative, exploratory, cross-sectional study was developed with 342 mother-baby pairs. Data were collected by means of interviews and analysis of medical records. Low breastfeeding rates were identified in the first hour of life of the newborns or neonatal reactivity period (53.2%. In the second transition period the rate was 20.7%, and 20.5% in the third period. Encouragement to breastfeeding is not appropriate for the phases of the neonatal transition period, as the rates for the first hour of life were expected to be higher than 90%, considering low risk newborns and births that occurred in a child-friendly hospital. Our findings indicate a need for adopting care strategies that favor the early contact and training of professionals at maternity hospitals toward the adequacy of breastfeeding to the neonatal transition period.

  4. Specific features of a neonatal period in infants following intrauterine intravascular blood transfusion for fetal hemolytic disease

    Directory of Open Access Journals (Sweden)

    A. V. Ivanova

    2015-01-01

    Full Text Available The paper gives data on the characteristics of a neonatal period in infants following intrauterine blood transfusion for Rh-induced fetal hemolytic disease. It is shown that the early diagnosis and detection of the signs of fetal hemolytic disease, and intrauterine intravascular blood transfusion may prolong pregnancy, ensure the birth of a baby with normal anthropometric indicators, optimize his/her neonatal period and prognosis of severe hemolytic disease in the fetus and newborn.

  5. Failure to thrive among neonates, associated factors and early neonatal outcome

    International Nuclear Information System (INIS)

    Thomas, Erica; Manji, Karim; Mpembeni Rose

    2005-01-01

    Failure to thrive or growth failure is an important feature of problems prevalent in the neonate. It remains one of the greatest challenges for the practicing pediatrician and it is a common pathway or outcome of several different underlaying infant and maternal conditions. To determine the prevalence, possible causes and early neonatal outcome of failure to thrive among young infants admitted to the Neonatal Unit in this hospital. A cross-sectional descriptive hospital based study, was carried for 10 months from April 2001 to January 2002 at the Neonatal Unit at Muhimbili National Hospital. (author)

  6. Neutrophil CD64 in early-onset neonatal sepsis

    African Journals Online (AJOL)

    EL-HAKIM

    of 3.5 to 8 cases per 1,000 live births; and mortality rate 16 to 30%. Cytokines, produced by ... 40 weeks with a picture of early onset neonatal sepsis within 48 hours of life admitted to neonatal ..... Infect Dis J 2000;19 (9):879-87. 5. Gonzalez BE ...

  7. Predictors of neonatal outcome in early-onset placental dysfunction

    NARCIS (Netherlands)

    Baschat, Ahmet A.; Cosmi, Erich; Bilardo, Catarina M.; Wolf, Hans; Berg, Christoph; Rigano, Serena; Germer, Ute; Moyano, Dolores; Turan, Sifa; Hartung, John; Bhide, Amarnath; Müller, Thomas; Bower, Sarah; Nicolaides, Kypros H.; Thilaganathan, Baskaran; Gembruch, Ulrich; Ferrazzi, Enrico; Hecher, Kurt; Galan, Henry L.; Harman, Chris R.

    2007-01-01

    To identify specific estimates and predictors of neonatal morbidity and mortality in early onset fetal growth restriction due to placental dysfunction. Prospective multicenter study of prenatally diagnosed growth-restricted liveborn neonates of less than 33 weeks of gestational age. Relationships

  8. A neonate with intestinal volvulus without malrotation exhibiting early jaundice with a suspected fetal onset.

    Science.gov (United States)

    Hara, Kaori; Kinoshita, Mari; Kin, Takane; Arimitsu, Takeshi; Matsuzaki, Yohei; Ikeda, Kazushige; Tomita, Hiroshi; Fujino, Akihiro; Kuroda, Tatsuo

    2015-01-01

    Intestinal volvulus without malrotation is a rare disease that causes volvulus of the small intestine despite normal intestinal rotation and fixation. We encountered a neonate with this disease who developed early jaundice and was suspected to have a fetal onset. This patient was characterized by early jaundice complicating intestinal volvulus without malrotation and is considered to have exhibited reduced fetal movement and early jaundice as a result of volvulus, necrosis, and hemorrhage of the small intestine in the fetal period. If abdominal distention accompanied by early jaundice is noted in a neonate, intestinal volvulus without malrotation and associated intraabdominal hemorrhage should be suspected and promptly treated.

  9. Justification of early neurorehabilitation in neonates

    Directory of Open Access Journals (Sweden)

    L.P. Badogina

    2017-10-01

    Full Text Available Background. The problem of disabled children in Ukraine is of special significance as a result of the constant growth of their number among the peadiatric population. Currently, many premature neonates and children with inoperable malformations are nursed in the neonatal intensive care unit (NICU. At the same time, the increase of clinical cases of chronic and associated pathology of the nervous system leads to deepening the process of disability in peadiatric population. Today, the primary need is neurorehabilitation of children, but many questions are still not resolved. When should we begin rehabilitation of a child with one or another pathology? Who should conduct this process? How intensive could it be? What are the goals and objectives in this case? The purpose of the study was to highlight the need for early neurorehabilitation of newborns already in the first days of life, at the stage of the NICU. Also, to evaluate the effectiveness of a set of measures for primary neonatal rehabilitation in the nursing stage according to the Alberta Infant Motor Scale (AIMS during the first year of child’s life. Materials and methods. Neurorehabilitation according to the developed method was carried on in neonates with pathology of nervous the nervous system who received treatment in the nursing department of NICU. Rehabilitation activities were conducted with the participation of nurses, neonatologists, physical therapists with the involvement of mothers of sick children. Twenty-five patients who underwent ventricular bypass surgery were monitored. Among them — 12 children with malformations of the spinal cord (spina bifida and 13 — with posthemorrhagic hydrocephalus. The examined group included 18 patients who underwent neurorehabilitation according to the developed method. The control group consisted of 7 children treated only with massage. To evaluate the effectiveness of a set of exercises, AIMS was used during the first year of child

  10. Approach to seizures in the neonatal period: a European perspective

    DEFF Research Database (Denmark)

    Vento, M; de Vries, Lisbeth Elvira; Alberola, A

    2010-01-01

    approach among different doctors and institutions. Hence, although phenobarbital is still considered the initial drug of choice, the protocols reported in the literature show a great variability in the approach to treatment of refractory seizures. We used a questionnaire to gain information regarding...... the treatment of seizures in the neonatal period in different European institutions. Conclusion: We conclude that phenobarbital is still the initial drug of choice followed by benzodiazepines, except in preterm infants with a birth weight below 1800 g. In refractory seizures, the use of continuous lidocaine...

  11. Early onset neonatal sepsis in preterm premature rupture of membranes

    International Nuclear Information System (INIS)

    Ashraf, M.N.

    2015-01-01

    To determine the frequency of early onset neonatal sepsis in newborn with various duration of preterm premature rupture of membranes (PPROM). Study Design: Cross sectional study. Place and Duration of Study: Neonatal Intensive Care Unit Combined Military Hospital, Lahore from November 2009 to November 2010. Material and Methods: Neonates of singleton pregnancies complicated by preterm premature rupture of the membranes (PPROM) with delivery between 30 and 36 weeks gestation were included in the study. The overall frequency of neonatal sepsis was calculated on clinical and serological basis. Comparison of the frequency of sepsis among groups with varying duration of rupture of membranes was done. Results: Out of 164 babies, 84 (51.2%) were female and 80 (48.8%) were male. Mean maternal age was 23 years (range: 18-36 years). Mean gestational age was 33 weeks (range: 30-36 weeks). Sepsis was suspected in 41(25%) babies on clinical grounds. C-reactive protein was raised in 36 (22%) neonates. There was statistically insignificant difference between clinical versus serological diagnosis (p=0.515). Frequency of neonatal sepsis was significantly higher in mothers with longer duration of rupture of membrane (p < 0.001). Conclusion: Frequency of neonatal sepsis was observed to be 22%. PPROM is an important risk factor for early onset neonatal sepsis. (author)

  12. Did professional attendance at home births improve early neonatal survival in Indonesia?

    Science.gov (United States)

    Hatt, Laurel; Stanton, Cynthia; Ronsmans, Carine; Makowiecka, Krystyna; Adisasmita, Asri

    2009-07-01

    BACKGROUND Early neonatal mortality has been persistently high in developing countries. Indonesia, with its national policy of home-based, midwife-assisted birth, is an apt context for assessing the effect of home-based professional birth attendance on early neonatal survival. METHODS We pooled four Indonesian Demographic and Health Surveys and used multivariate logistic regression to analyse trends in first-day and early neonatal mortality. We measured the effect of the context of delivery, including place and type of provider, and tested for changes in trend when the 'Midwife in the Village' programme was initiated. RESULTS Reported first-day mortality did not decrease significantly between 1986 and 2002, whereas early neonatal mortality decreased by an average of 3.2% annually. The rate of the decline did not change over the time period, either in 1989 when the Midwife in the Village programme was initiated, or in any year following when uptake of professional care increased. In simple and multivariate analyses, there were no significant differences in first-day or early neonatal death rates comparing home-based births with or without a professional midwife. Early neonatal mortality was higher in public facilities, likely due to selection. Biological determinants (twin births, male sex, short birth interval, previous early neonatal loss) were important for both outcomes. CONCLUSIONS Decreasing newborn death rates in Indonesia are encouraging, but it is not clear that these decreases are associated with greater uptake of professional delivery care at home or in health facilities. This may suggest a need for improved training in immediate newborn care, strengthened emergency referral, and continued support for family planning policies.

  13. Neonatal oxytocin and vasopressin manipulation alter social behavior during the juvenile period in Mongolian gerbils.

    Science.gov (United States)

    Taylor, Jack H; Cavanaugh, Jon; French, Jeffrey A

    2017-07-01

    Oxytocin and vasopressin are important modulators of a wide variety of social behaviors, and increasing evidence is showing that these neuropeptides are important organizational effectors of later-life behavior as well. We treated day-old gerbil pups with oxytocin, vasopressin, an oxytocin receptor antagonist, a vasopressin V1a receptor antagonist, or saline control, and then measured received parental responsiveness during the early postnatal period and juvenile social behavior during weaning. Neonatal vasopressin treatment enhanced sociality in males, but not females, at both developmental time points. When pups were individually placed outside the nest, parents were more responsive to male pups treated with vasopressin compared with littermates, and vasopressin treated male pups exhibited increased play with littermates as juveniles. These results show that vasopressin during very early life can enhance social interactions throughout early development. © 2017 Wiley Periodicals, Inc.

  14. Comparison of microbial pattern in early and late onset neonatal sepsis in referral center Haji Adam Malik hospital Medan Indonesia

    Science.gov (United States)

    Hasibuan, B. S.

    2018-03-01

    Neonatal sepsis contributes a significant rate of infants mortality and morbidity. The pathogens are diverse from region to another and change time to time even in the same place. To analyze the microbial pattern in early and late onset neonatal sepsis andthe pattern of antibiotic resistance of the causative microbes at one of referral center hospital in Indonesia, Haji Adam Malik Hospital, a cross-sectional descriptive study was conducted on neonates with sepsis diagnosis proven with positive blood culture within one year period (2015-2016). Among 626 neonates admitted to perinatology unit, the total of 154 neonates was proven to have neonatal sepsis with positive blood culture with the incidence rate 24.6%. Seventy-nine (51.3%) neonates were diagnosed with early onset sepsis while 75 (48,7%) neonates had late-onset sepsis. Klebsiella pneumonia was the most commonly isolated organism in both early and late onset sepsis, encompassing 19.5% of cases. Periodic surveillance of the causative agents of neonatal sepsis is needed to implement the rational, empirical choice of antibiotic prescription while waiting for blood culture result to come out.

  15. Breastfeeding for procedural pain in infants beyond the neonatal period.

    Science.gov (United States)

    Harrison, Denise; Reszel, Jessica; Bueno, Mariana; Sampson, Margaret; Shah, Vibhuti S; Taddio, Anna; Larocque, Catherine; Turner, Lucy

    2016-10-28

    Randomised controlled trials (RCTs) show that breastfeeding newborn infants during painful procedures reduces pain. Mechanisms are considered to be multifactorial and include sucking, skin-to-skin contact, warmth, rocking, sound and smell of the mother, and possibly endogenous opiates present in the breast milk. To determine the effect of breastfeeding on procedural pain in infants beyond the neonatal period (first 28 days of life) up to one year of age compared to no intervention, placebo, parental holding, skin-to-skin contact, expressed breast milk, formula milk, bottle feeding, sweet-tasting solutions (e.g. sucrose or glucose), distraction, or other interventions. We searched the following databases to 18 February 2016: the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library), MEDLINE including In-Process & Other Non-Indexed Citations (OVID), Embase (OVID), PsycINFO (OVID), and CINAHL (EBSCO); the metaRegister of Controlled Trials (mRCT), ClinicalTrials.gov (clinicaltrials.gov), and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) (apps.who.int/trialsearch/) for ongoing trials. We included RCTs and quasi-RCTs involving infants aged 28 days postnatal to 12 months and receiving breastfeeding while undergoing a painful procedure. Comparators included, but were not limited to, oral administration of water, sweet-tasting solutions, expressed breast or formula milk, no intervention, use of pacifiers, positioning, cuddling, distraction, topical anaesthetics, and skin-to-skin care. Procedures included, but were not limited to: subcutaneous or intramuscular injection, venipuncture, intravenous line insertion, heel lance, and finger lance. We applied no language restrictions. We used standard methodological procedures expected by Cochrane. Two review authors independently considered trials for inclusion in the review, assessed risk of bias, and extracted data. The main outcome measures were behavioural

  16. Fatores de risco para mortalidade neonatal precoce Risk factors for early neonatal mortality

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    Daniela Schoeps

    2007-12-01

    assess risk factors for early neonatal mortality. METHODS: A population-based case-control study was carried out with 146 early neonatal deaths and a sample of 313 controls obtained among survivals of the neonate period in the south region of the city of São Paulo, in the period of 8/1/2000 to 1/31/2001. Information was obtained through home interviews and hospital charts. Hierarchical assessment was performed in five groups with the following characteristics 1 socioeconomic conditions of mothers and families, 2 maternal psychosocial conditions, 3 obstetrical history and biological characteristics of mothers, 4 delivery conditions, 5 conditions of newborns RESULTS: Risk factors for early neonate mortality were: Group 1: poor education of household head (OR=1.6; 95% CI: 1.1;2.6, household located in a slum area (OR=2.0; 95% CI: 1.2;3.5 with up to one room (OR=2.2; 95% CI: 1.1;4.2; Group 2: mothers in recent union (OR=2.0; 95% CI: 1.0;4.2, unmarried mothers (OR=1.8; 95% CI: 1.1;3.0, and presence of domestic violence (OR=2.7; 95% CI: 1;6.5; Group 3: presence of complications in pregnancy (OR=8.2; 95% CI: 5.0;13.5, previous low birth weight (OR=2.4; 95% CI: 1.2;4.5, absence of pre-natal care (OR=16.1; 95% CI: 4.7;55.4, and inadequate pre-natal care (block 3 (OR=2.1; 95% CI: 2.0;3.5; Group 4: presence of clinical problems during delivery (OR=2.9; 95% CI: 1.4;5.1, mothers who went to hospital in ambulances (OR=3.8; 95% CI: 1.4;10.7; Group 5: low birth weight (OR=17.3; 95% CI: 8.4;35.6 and preterm live births (OR=8.8; 95% CI: 4.3;17.8. CONCLUSIONS: Additionally to proximal factors (low birth weight, preterm gestations, labor complications and unfavorable clinical conditions in gestation, the variables expressing social exclusion and presence of psychosocial factors were also identified. This context may affect the development of gestation and hinder the access of women to health services. Adequate prenatal care could minimize the effect of these variables.

  17. Association Between Early Idiopathic Neonatal Jaundice and Urinary Tract Infections

    Science.gov (United States)

    Özcan, Murat; Sarici, S Ümit; Yurdugül, Yüksel; Akpinar, Melis; Altun, Demet; Özcan, Begüm; Serdar, Muhittin A; Sarici, Dilek

    2017-01-01

    Background and purpose: Etiologic role, incidence, demographic, and response-to-treatment characteristics of urinary tract infection (UTI) among neonates, its relationship with significant neonatal hyperbilirubinemia, and abnormalities of the urinary system were studied in a prospective investigation in early (≤10 days) idiopathic neonatal jaundice in which all other etiologic factors of neonatal hyperbilirubinemia were ruled out. Patients and methods: Urine samples for microscopic and bacteriologic examination were obtained with bladder catheterization from 155 newborns with early neonatal jaundice. Newborns with a negative urine culture and with a positive urine culture were defined as group I and group II, respectively, and the 2 groups were compared with each other. Results: The incidence of UTI in whole of the study group was 16.7%. Serum total and direct bilirubin levels were statistically significantly higher in group II when compared with group I (P = .005 and P = .001, respectively). Decrease in serum total bilirubin level at the 24th hour of phototherapy was statistically significantly higher in group I compared with group II (P = .022). Conclusions: Urinary tract infection should be investigated in the etiologic evaluation of newborns with significant hyperbilirubinemia. The possibility of UTI should be considered in jaundiced newborns who do not respond to phototherapy well or have a prolonged duration of phototherapy treatment. PMID:28469520

  18. An assessment of the interpupillary distance, the inner and outer intercanthal distances in the normal Indian population from early neonatal period upto over 70 years of age: a study of 3500 subjects.

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    Shah K.

    2014-12-01

    Full Text Available Background and aim:\tThe normal range for anthropometric assessment of intercanthal, interpupillary and outer orbital dimensions is important and changes with age. This study was undertaken for setting a reference range for interpupillary distance, the inner and outer intercanthal distances in the normal Indian population, to observe the variation of these parameters with age, any differences in these parameters observed in male & female population and to find correlation with the refractive errors if any. Materials and Methods: This study was conducted in 3500 subjects of both sexes from birth till over 70 years of age, which presented to us in the outpatient department of M & J institute of Ophthalmology and Dr. Thakorbhai V Patel Eye Institute in the period ranging from August 2008 to January 2010. Results: A correlation with refractive errors has not been studied in previous literature. In our study, the range of IPDD in males was found to be 51.87-64.23mm & in females it was 51.16-62.23 mm, range of IPDN was 51.22 – 61.75 mm in males & 47.73-59.93 mm in females. The range of IICD was 18-36.09 mm in males & in females it was 19.38-34.89 mm. The range of OICD in males was 58- 92.8 mm & in females it was 56.63-88.56mm. Conclusion: We present the data for the neonatal children to the older age groups from the same population group. The standards based on local data reflect the potentially different patterns of craniofacial growth resulting from racial, ethnic & sexual differences. These could be relied upon in diagnosis of craniofacial syndromes and orbito-facial trauma or for planning reconstructive surgeries for the same.

  19. Early and Periodic Screening, Diagnosis and Treatment

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit provides comprehensive and preventive health care services for children under age 21 who...

  20. Early-onset preeclampsia is associated with perinatal mortality and severe neonatal morbidity

    NARCIS (Netherlands)

    Esch, J.J.A. van; Heijst, A.F. van; Haan, A.F.J. de; Heijden, O.W.H. van der

    2017-01-01

    OBJECTIVE: To evaluate neonatal outcomes of pregnancies complicated by early-onset preeclampsia (PE) and compare these outcomes to those of gestational age matched neonates born to mothers whose pregnancy was not complicated by early-onset PE. METHODS: We analyzed the outcome in 97 neonates born to

  1. Neonatal Early Warning Tools for recognising and responding to clinical deterioration in neonates cared for in the maternity setting: A retrospective case-control study.

    Science.gov (United States)

    Paliwoda, Michelle; New, Karen; Bogossian, Fiona

    2016-09-01

    All newborns are at risk of deterioration as a result of failing to make the transition to extra uterine life. Signs of deterioration can be subtle and easily missed. It has been postulated that the use of an Early Warning Tool may assist clinicians in recognising and responding to signs of deterioration earlier in neonates, thereby preventing a serious adverse event. To examine whether observations from a Standard Observation Tool, applied to three neonatal Early Warning Tools, would hypothetically trigger an escalation of care more frequently than actual escalation of care using the Standard Observation Tool. A retrospective case-control study. A maternity unit in a tertiary public hospital in Australia. Neonates born in 2013 of greater than or equal to 34(+0) weeks gestation, admitted directly to the maternity ward from their birthing location and whose subsequent deterioration required admission to the neonatal unit, were identified as cases from databases of the study hospital. Each case was matched with three controls, inborn during the same period and who did not experience deterioration and neonatal unit admission. Clinical and physiological data recorded on a Standard Observation Tool, from time of admission to the maternity ward, for cases and controls were charted onto each of three Early Warning Tools. The primary outcome was whether the tool 'triggered an escalation of care'. Descriptive statistics (n, %, Mean and SD) were employed. Cases (n=26) comprised late preterm, early term and post-term neonates and matched by gestational age group with 3 controls (n=78). Overall, the Standard Observation Tool triggered an escalation of care for 92.3% of cases compared to the Early Warning Tools; New South Wales Health 80.8%, United Kingdom Newborn Early Warning Chart 57.7% and The Australian Capital Territory Neonatal Early Warning Score 11.5%. Subgroup analysis by gestational age found differences between the tools in hypothetically triggering an escalation of

  2. Early neonatal deaths associated with perinatal asphyxia in infants ≥2500 g in Brazil,

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    Maria Fernanda Branco de Almeida

    Full Text Available Abstract Objective: To assess the annual burden of early neonatal deaths associated with perinatal asphyxia in infants weighing ≥2500 g in Brazil from 2005 to 2010. Methods: The population study enrolled all live births of infants with birth weight ≥2500 g and without malformations who died up to six days after birth with perinatal asphyxia, defined as intrauterine hypoxia, asphyxia at birth, or meconium aspiration syndrome. The cause of death was written in any field of the death certificate, according to International Classification of Diseases,10th Revision (P20.0, P21.0, and P24.0. An active search was performed in 27 Brazilian federative units. The chi-squared test for trend was applied to analyze early neonatal mortality ratios associated with perinatal asphyxia by study year. Results: A total of 10,675 infants weighing ≥2500 g without malformations died within six days after birth with perinatal asphyxia. Deaths occurred in the first 24 h after birth in 71% of the infants. Meconium aspiration syndrome was reported in 4076 (38% of these deaths. The asphyxia-specific early neonatal mortality ratio decreased from 0.81 in 2005 to 0.65 per 1000 live births in 2010 in Brazil (p < 0.001; the meconium aspiration syndrome-specific early neonatal mortality ratio remained between 0.20 and 0.29 per 1000 live births during the study period. Conclusions: Despite the decreasing rates in Brazil from 2005 to 2010, early neonatal mortality rates associated with perinatal asphyxia in infants in the better spectrum of birth weight and without congenital malformations are still high, and meconium aspiration syndrome plays a major role.

  3. Randomized trial of BCG vaccination at birth to low-birth-weight children: beneficial nonspecific effects in the neonatal period?

    Science.gov (United States)

    Aaby, Peter; Roth, Adam; Ravn, Henrik; Napirna, Bitiguida Mutna; Rodrigues, Amabelia; Lisse, Ida Maria; Stensballe, Lone; Diness, Birgitte Rode; Lausch, Karen Rokkedal; Lund, Najaaraq; Biering-Sørensen, Sofie; Whittle, Hilton; Benn, Christine Stabell

    2011-07-15

    Observational studies have suggested that BCG may have nonspecific beneficial effects on survival. Low-birth-weight (LBW) children are not given BCG at birth in Guinea-Bissau; we conducted a randomized trial of BCG at birth (early BCG) vs delayed BCG. In the period 2004-2008 we recruited 2320 LBW children in Bissau. The children were visited at home at 2, 6, and 12 months of age. With a pretrial infant mortality of 250 per 1000, we hypothesized a 25% reduction in infant mortality for LBW children. Infant mortality was only 101 per 1000 during the trial. In the primary analysis, infant mortality was reduced insignificantly by 17% (mortality rate ratio [MRR] = .83 [.63-1.08]). In secondary analyses, early BCG vaccine was safe with an MRR of .49 (.21-1.15) after 3 days and .55 (.34-.89) after 4 weeks. The reduction in neonatal mortality was mainly due to fewer cases of neonatal sepsis, respiratory infection, and fever. The impact of early BCG on infant mortality was marked for children weighing <1.5 kg (MRR = .43 [.21-.85]) who had lower coverage for diphtheria-tetanus-pertussis vaccinations. Though early BCG did not reduce infant mortality significantly, it may have a beneficial effect in the neonatal period. This could be important for public health because BCG is often delayed in low-income countries.

  4. Pentraxin 3 concentrations of the mothers with preterm premature rupture of membranes and their neonates, and early neonatal outcome.

    Science.gov (United States)

    Akin, Mustafa Ali; Gunes, Tamer; Coban, Dilek; Ozgun, Mahmut Tuncay; Akgun, Hulya; Kurtoglu, Selim

    2015-07-01

    Pentraxin 3 (PTX3) is an acute phase reactant which has been used to detect intra-amniotic infections (IAI) in pregnancy, but the prognostic value of PTX3 concentrations on neonates has not been studied. We aimed to investigate the relationship between maternal PTX3-neonatal PTX3 concentrations and early neonatal outcome. The mothers diagnosed with preterm prelabor rupture of membranes (PPROM) (n = 28) and their preterm infants (n = 28) were included in the study. PTX3 concentrations were studied in plasma in the maternal peripheral blood and umbilical/peripheral vein in the neonates. The relationship between the mPTX3-nPTX3 concentrations and neonatal outcome were investigated using non-parametric tests and binary logistic regression analysis. The mean mPTX3 concentration was 10.35 ± 7.82 μg/L. Ten (35.7%) of all mothers were within the normal range and 18 (64.3%) in high percentile (≥ 97.5 percentile). There was no relation between mPTX3 concentrations and clinical or histologic chorioamnionitis, latency of PPROM, and early neonatal outcome. Mean nPTX3 concentrations was 9.18 ± 7.83 μg/L and high nPTX3 concentrations were detected in five (17.8%) neonates. nPTX3 concentrations were inversely correlated with gestational age and correlated with rate of intraventricular hemorrhage (IVH) and mortality. Neonates with high nPTX3 concentrations also have lowered APGAR scores, increased rate of respiratory distress syndrome, clinical sepsis, IVH, necrotizing enterocolitis and prolonged NICU stay. High PTX3 concentrations of the newborns are associated with some worsened early neonatal outcome including lower gestational age at delivery, increased rate of IVH and mortality. Maternal PTX3 concentrations are not an adequate marker in defining clinical or histologic chorioamnionitis and early neonatal outcome.

  5. Profile of newborns undergoing early stimulation in a neonatal intensive care unit

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    Karla Camila Lima de Souza

    2014-09-01

    Full Text Available Objective: To describe the profile of newborns undergoing early stimulation in a neonatal intensive care unit, characterizing the study population according to their neonatal variables and risk factors indicative for the early stimulation treatment. Methods: Cross-sectional and analytical study, held in a reference hospital of Fortaleza, in the period from February to March 2011, with sample consisting of 116 medical records of newborns indicated for the early stimulation treatment. The following variables were analyzed: weight, sex, gestational age, Apgar score, diagnosis of Respiratory Distress Syndrome and Intracranial Hemorrhage, use of mechanical ventilation and continuous positive airway pressure (CPAP. The variables were analyzed using Microsoft Excel™ 2007 software to obtain mean and mode. Results: Among the studied variables, there was a prevalence of low birth weight, prematurity and male newborns. According to the Apgar score, scores of 1st and 5th minutes showed increasing values. Regarding the studied pathologies, the Respiratory Distress Syndrome stands out as the most prevalent, followed by Intracranial Hemorrhage. Concerning the use of mechanical ventilation, CPAP was the most frequently indicated modality, followed by mechanical ventilation. Conclusion: The profile of newborns investigated in this study, which underwent early stimulation in a neonatal intensive care, is represented by male, premature, low weight and high rate of Apgar score at 1st and 5th minutes, with prevalence of respiratory distressand increased use of CPAP. doi:http://dx.doi.org/10.5020/18061230.2013.p523

  6. Neonatal herpes infections in The Netherlands in the period 2006-2011.

    Science.gov (United States)

    Hemelaar, Steffannie J A L; Poeran, Jashvant; Steegers, Eric A P; van der Meijden, Willem I

    2015-05-01

    To monitor the incidence of neonatal herpes in The Netherlands between 2006 and 2011, as well as the adherence to the rather conservative Dutch prevention policy. Questionnaires were sent to all virology laboratories (n = 44), gynaecology and paediatrics departments of all hospitals in The Netherlands (n = 89). Questionnaires for the laboratories pertained to rates of proven cases of neonatal herpes; for the gynaecologists and paediatricians it pertained to rates of genital herpes during pregnancy and neonatal herpes, and their policy. For gynaecologists this concerned the risk of herpes simplex virus transmission in case of primary genital herpes during pregnancy or labour; for paediatricians it concerned the diagnostic policy in a neonate suspected of neonatal herpes. For the period 2006-2011 38 cases of neonatal herpes were reported, yielding an incidence of 4.7 per 100,000 births. The estimated annual number of pregnant women with primary or recurrent genital herpes was 278. Of the responding gynaecologists and paediatricians, only 59% and up to 39%, respectively, reported a policy in accordance with the national guideline. The incidence of neonatal herpes in The Netherlands seems to have increased in the period 2006-2011. Combined with suboptimal guideline adherence this warrants strategies to improve awareness and subsequent adherence.

  7. Caffey disease in neonatal period: the importance of the family!

    Science.gov (United States)

    Prior, Ana Rita; Moldovan, Oana; Azevedo, António; Moniz, Carlos

    2012-10-09

    A male newborn was apparently well until his second day of life, when increased irritability and a swelling in his right leg were noted. He was rooming-in with his mother since birth. On examination, a mass on the anterior surface of the right leg was noticed. The mass was firm, elongated, ill-defined, unmovable and painful at palpation. No overlying skin changes were seen. The newborn had a family history of neonatal bone swelling with resolution before the age of 2. Subsequent images showed hyperostosis in the diaphysis of the right tibia. After exclusion of other conditions such as trauma, osteomyelitis and congenital syphilis, the involvement of the tibial diaphysis, sparing the epiphyses and the benign course of the disease in family history, were indicative of Caffey disease. The genetic study confirmed this diagnosis. Caffey disease, although rare, should not be overlooked in the diagnostic approach to childhood bone swelling.

  8. Antiretroviral Therapy during the Neonatal Period | Nuttall | Southern ...

    African Journals Online (AJOL)

    Initiation of combination antiretroviral therapy (cART) at 6–9 weeks of age has been shown to reduce early infant mortality by 76% and HIV progression by 75% compared with cART deferred until clinical or CD4 criteria were met. In the landmark Children with HIV Early Antiretroviral Therapy (CHER) trial, although the ...

  9. Cardiac sarcoplasmic reticulum. Effects of an atherogenic diet during the neonatal and juvenile period

    Energy Technology Data Exchange (ETDEWEB)

    Jacobson, M S; Ambudkar, I S; Young, E P; Naseem, S M; Heald, F P; Shamoo, A E [Maryland Univ., College Park (USA). School of Medicine

    1985-04-01

    The effect on the cardiac sarcoplasmic reticulum of an atherogenic (1% cholesterol) diet fed during the neonatal vs the juvenile period of life was studied in Yorkshire swine. Male piglets were randomly assigned at birth to 1 of 4 groups: group I (control), group II (lactation feeding), group III (juvenile period feeding) and group IV (lactation and juvenile feeding). All animals were killed at 55 weeks of age and cardiac sarcoplasmic reticulum (SR) isolated for assay of calcium uptake, Ca/sup 2 +/-Mg/sup 2 +/ ATPase activity, and lipid analysis by thin-layer chromatography and gas chromatography. The amount of cholesterol/mg SR protein and the cholesterol/phospholipid ratio were higher in the animals fed during lactation (groups II and IV) and lower in those fed only during the juvenile period (group III). Phospholipid fatty acid patterns as measured by gas chromatography were unaltered in any group. Calcium uptake was markedly diminished in all experimental conditions: group II 47%, group III 65% and group IV 96%. Compared to the observed changes in calcium transport, the ATP hydrolytic activity was relatively less affected. Only in group IV a significant decrease (41%) was seen. Groups II and III show no change in ATP hydrolytic activity. The decrease in calcium uptake and altered cholesterol/phospholipid ratio without effect on ATP hydrolytic activity is consistent with an uncoupling of calcium transport related to the atherogenic diet in early life.

  10. Geographical Accessibility to Obstetric and Neonatal Care and its Effect on Early Neonatal Mortality in Colombia, 2012-2014

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    Diego Fernando Rojas Gualdrón

    2017-04-01

    Full Text Available Introduction: The distribution of health resources influences early neonatal mortality, granting access to obstetric care which is a major public health problem. However, the geographical dimension of this influence has not been studied in Colombia. Objective: To describe the geographical accessibility to obstetric and neonatal care beds and its association with early neonatal mortality in Colombia and its municipalities. Method:An ecological study at municipal level was carried out. Ordinary least squares (OLS regression and a geographically weighted regression (GWR were used to explore statistical and spatial associations. Results: The municipalities in Colombia with Higher mortality tend to have lower geographical accessibility to obstetric and neonatal beds after controlling the fertility and economic characteristics of these municipalities. This association is significant only in municipalities of the west coast. The strength of this association decreases in inner municipalities. Discussion: The centralization of obstetric and neonatal beds in major municipalities around the central region leaves municipalities with high risk of mortality underserved. The decentralization of obstetric and neonatal healthcare resources is a mandatory issue in order to reduce geographical disparities in mortality and to improve neonatal survival, and a healthy beginning of life.

  11. Management of Conjoined Twins During Neonatal Period | Ali ...

    African Journals Online (AJOL)

    Background/Purpose: Conjoined twins are rare and complex anomalies of the newborn. It is reported in 1/50.000 to 1/100.000 live births. The aim of the study was to summarize the experiences gained during separation of 5 sets of conjoined twins with presentation of literature review. Materials & Methods: During the period ...

  12. Effect of Maternal and Pregnancy Risk Factors on Early Neonatal Death in Planned Home Births Delivering at Home.

    Science.gov (United States)

    Bachilova, Sophia; Czuzoj-Shulman, Nicholas; Abenhaim, Haim Arie

    2018-05-01

    The prevalence of home birth in the United States is increasing, although its safety is undetermined. The objective of this study was to investigate the effects of obstetrical risk factors on early neonatal death in planned home births delivering at home. The authors conducted a retrospective 3-year cohort study consisting of planned home births that delivered at home in the United States between 2011 and 2013. The study excluded infants with congenital and chromosomal anomalies and infants born at ≤34 weeks' gestation. Multivariate logistic regression models were used to estimate the adjusted effects of individual obstetrical variables on early neonatal deaths within 7 days of delivery. During the study period, there were 71 704 planned and delivered home births. The overall early neonatal death rate was 1.5 deaths per 1000 planned home births. The risks of early neonatal death were significantly higher in nulliparous births (OR 2.71; 95% CI 1.71-4.31), women with a previous CS (OR 2.62, 95% CI 1.25-5.52), non-vertex presentations (OR 4.27; 95% CI 1.33-13.75), plural births (OR 9.79; 95% CI 4.25-22.57), preterm births (OR 4.68; 95% CI 2.30-9.51), and births at ≥41 weeks of gestation (OR 1.76; 95% CI 1.09-2.84). Early neonatal deaths occur more commonly in certain obstetrical contexts. Patient selection may reduce adverse neonatal outcomes among planned home births. Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

  13. Radioecological studies in early period of NIRS

    International Nuclear Information System (INIS)

    Ichikawa, Ryushi

    2004-01-01

    Japanese tuna-fishing boat Fukuryumaru No.5 was exposed to heavy radioactive fallout due to the nuclear test explosion carried out by U.S.A. at Bikini Atoll of Marshal Islands in the central part of Pacific Ocean on March 1, 1954. Following this accident, radioactivity was detected in various environmental samples including rain, marine fishes and agricultural crops. Science Council of Japan organized the new research group of many scientists in the field of fisheries, agricultural, medical and biological studies and radiation protection studies. Government of Japan established National Institute of Radiological Sciences (NIRS) in 1957. In this Institute various radioecological studies have been carried out. In this paper, some of these radioecological studies carried out in early period of NIRS are described. (author)

  14. Alloimmune neonatal neutropenia in Croatia during the 1998-2008 period.

    Science.gov (United States)

    Tomicic, Maja; Starcevic, Mirta; Ribicic, Rebeka; Golubic-Cepulic, Branka; Hundric-Haspl, Zeljka; Jukic, Irena

    2014-05-01

    The aim of this study was to estimate the incidence of the disease and to analyze laboratory data of 23 newborns undergoing serologic testing for alloimmune neonatal neutropenia (ANN) during the 1998-2008 period in Croatia. Laboratory data on 23 newborns undergoing serologic testing for ANN during the 1998-2008 period and epidemiologic data on the number of live births in Croatia were analyzed. Laboratory testing for ANN included serologic screening of maternal and neonatal sera and granulocytes (neutrophils) by immunofluorescence (IF) method. The monoclonal antibody immobilization of neutrophil antigens (MAINA) was employed to determine anti-HNA antibody specificity. Anti-HNA antibodies were detected in seven (54%) of 13 cases of serologically positive ANN. Only anti-HLA class I antibodies were demonstrated in four (31%) of 13 cases In the 2007-2008 period of prospective data collection, the number of serologically verified ANN cases was one case per 17,323 live births. Results of the prospective study conducted at Maternity Ward, Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Center yielded the ANN incidence of one case per 2843 live births. Monitoring of neutrophil count in neonatal blood and serologic testing for ANN in case of isolated neutropenia in the newborn contributed considerably to timely detection of ANN. Neonatal alloimmune neutropenia-incidence, serologic diagnosis, antineutrophil antibodies, anti-HNA, anti-HLA class I, Croatia. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Early-Onset Thrombocytopenia in Small-For-Gestational-Age Neonates: A Retrospective Cohort Study

    NARCIS (Netherlands)

    Fustolo-Gunnink, S. F.; Vlug, R. D.; Smits-Wintjens, V. E. H. J.; Heckman, E. J.; te Pas, A. B.; Fijnvandraat, K.; Lopriore, E.

    2016-01-01

    Thrombocytopenia is a common finding in small for gestational age (SGA) neonates and is thought to result from a unique pathophysiologic mechanism related to chronic intrauterine hypoxia. Our objective was to estimate the incidence and severity of early-onset thrombocytopenia in SGA neonates, and to

  16. The predictive value of early behavioural assessments in pet dogs--a longitudinal study from neonates to adults.

    Directory of Open Access Journals (Sweden)

    Stefanie Riemer

    Full Text Available Studies on behavioural development in domestic dogs are of relevance for matching puppies with the right families, identifying predispositions for behavioural problems at an early stage, and predicting suitability for service dog work, police or military service. The literature is, however, inconsistent regarding the predictive value of tests performed during the socialisation period. Additionally, some practitioners use tests with neonates to complement later assessments for selecting puppies as working dogs, but these have not been validated. We here present longitudinal data on a cohort of Border collies, followed up from neonate age until adulthood. A neonate test was conducted with 99 Border collie puppies aged 2-10 days to assess activity, vocalisations when isolated and sucking force. At the age of 40-50 days, 134 puppies (including 93 tested as neonates were tested in a puppy test at their breeders' homes. All dogs were adopted as pet dogs and 50 of them participated in a behavioural test at the age of 1.5 to 2 years with their owners. Linear mixed models found little correspondence between individuals' behaviour in the neonate, puppy and adult test. Exploratory activity was the only behaviour that was significantly correlated between the puppy and the adult test. We conclude that the predictive validity of early tests for predicting specific behavioural traits in adult pet dogs is limited.

  17. The predictive value of early behavioural assessments in pet dogs--a longitudinal study from neonates to adults.

    Science.gov (United States)

    Riemer, Stefanie; Müller, Corsin; Virányi, Zsófia; Huber, Ludwig; Range, Friederike

    2014-01-01

    Studies on behavioural development in domestic dogs are of relevance for matching puppies with the right families, identifying predispositions for behavioural problems at an early stage, and predicting suitability for service dog work, police or military service. The literature is, however, inconsistent regarding the predictive value of tests performed during the socialisation period. Additionally, some practitioners use tests with neonates to complement later assessments for selecting puppies as working dogs, but these have not been validated. We here present longitudinal data on a cohort of Border collies, followed up from neonate age until adulthood. A neonate test was conducted with 99 Border collie puppies aged 2-10 days to assess activity, vocalisations when isolated and sucking force. At the age of 40-50 days, 134 puppies (including 93 tested as neonates) were tested in a puppy test at their breeders' homes. All dogs were adopted as pet dogs and 50 of them participated in a behavioural test at the age of 1.5 to 2 years with their owners. Linear mixed models found little correspondence between individuals' behaviour in the neonate, puppy and adult test. Exploratory activity was the only behaviour that was significantly correlated between the puppy and the adult test. We conclude that the predictive validity of early tests for predicting specific behavioural traits in adult pet dogs is limited.

  18. The Predictive Value of Early Behavioural Assessments in Pet Dogs – A Longitudinal Study from Neonates to Adults

    Science.gov (United States)

    Riemer, Stefanie; Müller, Corsin; Virányi, Zsófia; Huber, Ludwig; Range, Friederike

    2014-01-01

    Studies on behavioural development in domestic dogs are of relevance for matching puppies with the right families, identifying predispositions for behavioural problems at an early stage, and predicting suitability for service dog work, police or military service. The literature is, however, inconsistent regarding the predictive value of tests performed during the socialisation period. Additionally, some practitioners use tests with neonates to complement later assessments for selecting puppies as working dogs, but these have not been validated. We here present longitudinal data on a cohort of Border collies, followed up from neonate age until adulthood. A neonate test was conducted with 99 Border collie puppies aged 2–10 days to assess activity, vocalisations when isolated and sucking force. At the age of 40–50 days, 134 puppies (including 93 tested as neonates) were tested in a puppy test at their breeders' homes. All dogs were adopted as pet dogs and 50 of them participated in a behavioural test at the age of 1.5 to 2 years with their owners. Linear mixed models found little correspondence between individuals' behaviour in the neonate, puppy and adult test. Exploratory activity was the only behaviour that was significantly correlated between the puppy and the adult test. We conclude that the predictive validity of early tests for predicting specific behavioural traits in adult pet dogs is limited. PMID:25003341

  19. Early neonatal deaths associated with perinatal asphyxia in infants ≥2500 g in Brazil

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    Maria Fernanda Branco de Almeida

    2017-11-01

    Full Text Available Objective: To assess the annual burden of early neonatal deaths associated with perinatal asphyxia in infants weighing ≥2500 g in Brazil from 2005 to 2010. Methods: The population study enrolled all live births of infants with birth weight ≥2500 g and without malformations who died up to six days after birth with perinatal asphyxia, defined as intrauterine hypoxia, asphyxia at birth, or meconium aspiration syndrome. The cause of death was written in any field of the death certificate, according to International Classification of Diseases, 10th Revision (P20.0, P21.0, and P24.0. An active search was performed in 27 Brazilian federative units. The chi-squared test for trend was applied to analyze early neonatal mortality ratios associated with perinatal asphyxia by study year. Results: A total of 10,675 infants weighing ≥2500 g without malformations died within six days after birth with perinatal asphyxia. Deaths occurred in the first 24 h after birth in 71% of the infants. Meconium aspiration syndrome was reported in 4076 (38% of these deaths. The asphyxia-specific early neonatal mortality ratio decreased from 0.81 in 2005 to 0.65 per 1000 live births in 2010 in Brazil (p < 0.001; the meconium aspiration syndrome-specific early neonatal mortality ratio remained between 0.20 and 0.29 per 1000 live births during the study period. Conclusions: Despite the decreasing rates in Brazil from 2005 to 2010, early neonatal mortality rates associated with perinatal asphyxia in infants in the better spectrum of birth weight and without congenital malformations are still high, and meconium aspiration syndrome plays a major role. Resumo: Objetivo: Avaliar a taxa anual de óbitos neonatais precoces associados à asfixia perinatal em neonatos de peso ≥2.500 g no Brasil de 2005 a 2010. Métodos: A população do estudo envolveu todos os nascidos vivos de neonatos com peso ao nascer ≥2.500 g e sem malformações que morreram até seis dias ap

  20. Schedules for home visits in the early postpartum period.

    Science.gov (United States)

    Yonemoto, Naohiro; Dowswell, Therese; Nagai, Shuko; Mori, Rintaro

    2017-08-02

    Maternal complications including psychological and mental health problems and neonatal morbidity have been commonly observed in the postpartum period. Home visits by health professionals or lay supporters in the weeks following the birth may prevent health problems from becoming chronic with long-term effects on women, their babies, and their families. To assess outcomes for women and babies of different home-visiting schedules during the early postpartum period. The review focuses on the frequency of home visits, the duration (when visits ended) and intensity, and on different types of home-visiting interventions. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (28 January 2013) and reference lists of retrieved articles. Randomised controlled trials (RCTs) (including cluster-RCTs) comparing different types of home-visiting interventions enrolling participants in the early postpartum period (up to 42 days after birth). We excluded studies in which women were enrolled and received an intervention during the antenatal period (even if the intervention continued into the postnatal period) and studies recruiting only women from specific high-risk groups. (e.g. women with alcohol or drug problems). Study eligibility was assessed by at least two review authors. Data extraction and assessment of risk of bias were carried out independently by at least two review authors. Data were entered into Review Manager software. We included data from 12 randomised trials with data for more than 11,000 women. The trials were carried out in countries across the world, and in both high- and low-resource settings. In low-resource settings women receiving usual care may have received no additional postnatal care after early hospital discharge.The interventions and control conditions varied considerably across studies with trials focusing on three broad types of comparisons: schedules involving more versus fewer postnatal home visits (five studies), schedules

  1. Risk of early-onset neonatal infection with maternal infection or colonization: a global systematic review and meta-analysis.

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    Grace J Chan

    2013-08-01

    Full Text Available Neonatal infections cause a significant proportion of deaths in the first week of life, yet little is known about risk factors and pathways of transmission for early-onset neonatal sepsis globally. We aimed to estimate the risk of neonatal infection (excluding sexually transmitted diseases [STDs] or congenital infections in the first seven days of life among newborns of mothers with bacterial infection or colonization during the intrapartum period.We searched PubMed, Embase, Scopus, Web of Science, Cochrane Library, and the World Health Organization Regional Databases for studies of maternal infection, vertical transmission, and neonatal infection published from January 1, 1960 to March 30, 2013. Studies were included that reported effect measures on the risk of neonatal infection among newborns exposed to maternal infection. Random effects meta-analyses were used to pool data and calculate the odds ratio estimates of risk of infection. Eighty-three studies met the inclusion criteria. Seven studies (8.4% were from high neonatal mortality settings. Considerable heterogeneity existed between studies given the various definitions of laboratory-confirmed and clinical signs of infection, as well as for colonization and risk factors. The odds ratio for neonatal lab-confirmed infection among newborns of mothers with lab-confirmed infection was 6.6 (95% CI 3.9-11.2. Newborns of mothers with colonization had a 9.4 (95% CI 3.1-28.5 times higher odds of lab-confirmed infection than newborns of non-colonized mothers. Newborns of mothers with risk factors for infection (defined as prelabour rupture of membranes [PROM], preterm <37 weeks PROM, and prolonged ROM had a 2.3 (95% CI 1.0-5.4 times higher odds of infection than newborns of mothers without risk factors.Neonatal infection in the first week of life is associated with maternal infection and colonization. High-quality studies, particularly from settings with high neonatal mortality, are needed to

  2. Fatores de risco para o desenvolvimento de sepse neonatal precoce em hospital da rede pública do Brasil Risk factors for early-onset neonatal sepsis in Brazilian public hospital short-title: early-onset neonatal sepsis

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    Ana Paula Goulart

    2006-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O conhecimento dos fatores de risco associados à sepse neonatal precoce em unidade de neonatologia, inserida na realidade de nosso sistema de saúde, no sentido de se detectar, prevenir e adotar medidas específicas e reduzir as taxas de mortalidade nessa faixa etária. O objetivo deste estudo foi determinar os fatores de risco associados a sepse neonatal precoce em hospital de referência em neonatologia ligado à rede pública de saúde. MÉTODO: Foi realizado um estudo observacional, prospectivo, tipo caso-controle. Foram incluídos os recém-nascidos com diagnóstico de sepse precoce e como controle, recém-nascidos sem infecção neonatal nascido na mesma data do recém-nascido considerado como caso. Foram incluídos 50 casos e três controles para cada caso, resultando em amostra total de 200 pacientes. Foi considerada estatisticamente significativa a associação quando p BACKGROUND AND OBJECTIVES: The determination of the risk factors to early-onset neonatal sepsis in our country is essential to prevent and reduce the mortality associated with this syndrome. Thus, the objective of this study was to determine the frequency and associated risk factors to early-onset neonatal sepsis in public hospital in Southern Brazil. METHODS: Observational, case-control study. Were included neonates with diagnostic of early-onset neonatal sepsis and as controls, neonates without neonatal infection. Were included 50 cases and 3 controls for each case resulting in a total sample of 200 patients. Associations were considered significant when p < 0.05. RESULTS: The sepsis frequency was 50.3 per 1000 born-alive. Risk factors associated to the development of neonatal sepsis were prematurity (OR 9.33; p < 0.001, low birth weight (OR 11.74; p < 0.001, maternal infection (OR 2.28; p = 0.009, mother with history of previous infant with neonatal sepsis (OR 6.43; p = 0.035 and rupture of the membranes more than 18 hours before delivery

  3. Neonatal autonomic function after pregnancy complications and early cardiovascular development.

    Science.gov (United States)

    Aye, Christina Y L; Lewandowski, Adam James; Oster, Julien; Upton, Ross; Davis, Esther; Kenworthy, Yvonne; Boardman, Henry; Yu, Grace Z; Siepmann, Timo; Adwani, Satish; McCormick, Kenny; Sverrisdottir, Yrsa B; Leeson, Paul

    2018-05-23

    Heart rate variability (HRV) has emerged as a predictor of later cardiac risk. This study tested whether pregnancy complications that may have long-term offspring cardiac sequelae are associated with differences in HRV at birth, and whether these HRV differences identify abnormal cardiovascular development in the postnatal period. Ninety-eight sleeping neonates had 5-min electrocardiogram recordings at birth. Standard time and frequency domain parameters were calculated and related to cardiovascular measures at birth and 3 months of age. Increasing prematurity, but not maternal hypertension or growth restriction, was associated with decreased HRV at birth, as demonstrated by a lower root mean square of the difference between adjacent NN intervals (rMSSD) and low (LF) and high-frequency power (HF), with decreasing gestational age (p < 0.001, p = 0.009 and p = 0.007, respectively). We also demonstrated a relative imbalance between sympathetic and parasympathetic tone, compared to the term infants. However, differences in autonomic function did not predict cardiovascular measures at either time point. Altered cardiac autonomic function at birth relates to prematurity rather than other pregnancy complications and does not predict cardiovascular developmental patterns during the first 3 months post birth. Long-term studies will be needed to understand the relevance to cardiovascular risk.

  4. Effects of noise exposure on neonatal auditory brainstem response thresholds in pregnant guinea pigs at different gestational periods.

    Science.gov (United States)

    Morimoto, Chihiro; Nario, Kazuhiko; Nishimura, Tadashi; Shimokura, Ryota; Hosoi, Hiroshi; Kitahara, Tadashi

    2017-01-01

    Noise exposure during pregnancy has been reported to cause fetal hearing impairment. However, little is known about the effects of noise exposure during various gestational stages on postnatal hearing. In the present study, we investigated the effects of noise exposure on auditory brainstem response (ABR) at the early, mid-, and late gestational periods in newborn guinea pigs. Pregnant guinea pigs were exposed to 4-kHz pure tone at a 120-dB sound pressure level for 4 h. We divided the animals into four groups as follows: the control, early gestational exposure, mid-gestational exposure, and late gestational exposure groups. ABR thresholds and latencies in newborns were recorded using 1-, 2-, and 4-kHz tone burst on postnatal days 1, 7, 14, and 28. Changes in ABR thresholds and latencies were measured between the 4 × 4 and 4 × 3 factorial groups mentioned above (gestational periods × postnatal days, gestational periods × frequencies). The thresholds were low in the order of control group guinea pigs. This is the first study to show that noise exposure during the early, mid-, and late gestational periods significantly elevated ABR thresholds in neonatal guinea pigs. © 2016 Japan Society of Obstetrics and Gynecology.

  5. Early Postnatal Diets Affect the Bioregional Small Intestine Microbiome and Ileal Metabolome in Neonatal Pigs.

    Science.gov (United States)

    Piccolo, Brian D; Mercer, Kelly E; Bhattacharyya, Sudeepa; Bowlin, Anne K; Saraf, Manish K; Pack, Lindsay; Chintapalli, Sree V; Shankar, Kartik; Adams, Sean H; Badger, Thomas M; Yeruva, Laxmi

    2017-08-01

    Background: Breastfeeding is known to be protective against gastrointestinal disorders and may modify gut development. Although the gut microbiome has been implicated, little is known about how early diet affects the small intestine microbiome. Objective: We hypothesized that disparate early diets would promote unique microbial profiles in the small intestines of neonatal pigs. Methods: Male and female 2-d-old White Dutch Landrace pigs were either sow fed or provided dairy (Similac Advance powder; Ross Products Abbott Laboratories) or soy (Enfamil Prosobee Lipil powder; Mead Johnson Nutritionals) infant formulas until day 21. Bacterial ecology was assessed in the contents of the small intestine through the use of 16S ribosomal RNA sequencing. α-Diversity, β-diversity, and differential abundances of operational taxonomic units were assessed by ANOVA, permutational ANOVA, and negative binomial regression, respectively. Ileum tissue metabolomics were measured by LC-mass spectrometry and assessed by weighted correlation network analysis. Results: Greater α-diversity was observed in the duodena of sow-fed compared with formula-fed neonatal pigs ( P 60% relative abundance in all of the groups. In the duodenum, 77 genera were altered by diet, followed by 48 in the jejunum and 19 in the ileum. Metabolomics analyses revealed associations between ileum tissue metabolites (e.g., acylcarnitines, 3-aminoisobutyric acid) and diet-responsive microbial genera. Conclusions: These results indicate that the neonatal diet has regional effects on the small intestine microbiome in pigs, with the most pronounced effects occurring in the duodena. Regional effects may be important factors when considering gut tissue metabolism and development in the postnatal period. © 2017 American Society for Nutrition.

  6. Early-Onset Thrombocytopenia in Small-For-Gestational-Age Neonates: A Retrospective Cohort Study.

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    S F Fustolo-Gunnink

    Full Text Available Thrombocytopenia is a common finding in small for gestational age (SGA neonates and is thought to result from a unique pathophysiologic mechanism related to chronic intrauterine hypoxia. Our objective was to estimate the incidence and severity of early-onset thrombocytopenia in SGA neonates, and to identify risk factors for thrombocytopenia. We performed a retrospective cohort study of all consecutive SGA neonates admitted to our ward and a control group of appropriate for gestational age (AGA neonates matched for gestational age at birth. Main outcome measures were incidence and severity of thrombocytopenia, hematological and clinical risk factors for thrombocytopenia, and bleeding. A total of 330 SGA and 330 AGA neonates were included, with a mean gestational age at birth of 32.9 ± 4 weeks. Thrombocytopenia (<150x109/L was found in 53% (176/329 of SGA neonates and 20% (66/330 of AGA neonates (relative risk (RR 2.7, 95% confidence interval (CI [2.1, 3.4]. Severe thrombocytopenia (21-50x109/L occurred in 25 neonates (8% in the SGA and 2 neonates (1% in the AGA group (RR 12.5, 95% CI [3.0, 52.5]. Platelet counts <20x109/L were not recorded. Within the SGA group, lower gestational age at birth (p = <0.01 and erythroblastosis (p<0.01 were independently associated with a decrease in platelet count. Platelet count was positively correlated with birth weight centiles. In conclusion, early-onset thrombocytopenia is present in over 50% of SGA neonates and occurs 2.7 times as often as in AGA neonates. Thrombocytopenia is seldom severe and is independently associated with lower gestational age at birth and erythroblastosis.

  7. NEONATAL MORBIDITY AND EARLY OUTCOME OF VERY PRETERM INFANTS

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    Heljić Suada

    2013-01-01

    Full Text Available Background: Although the mortality rate for preterm infants and the gestational age-specific mortality rate have dramatically improved over the last 3 to 4 decades, infants born preterm remain vulnerable to many complications, including respiratory distress syndrome, chronic lung disease, necrotizing enterocolitis, a compromised immune system, cardiovascular disorders, hearing and vision problems, and brain lesions.The aim is to determine mortality and morbidity rates and selected outcome variables for preterm infant’s < 30 weeks’ gestation, who were admitted to the NICU. Patients and methods: This study enrolled 102 infants with gestational age less than 30 weeks’ gestation, hospitalized in Neonatal Intensive Care Unit, Pediatric Hospital, Clinical University Center Sarajevo, from Jan. 2010 to Dec. 2010. Parameters taken at admission were: birth weight, gestational age, Apgar score, excess base and CRIB score. Early outcome is considered as a survival at discharge or common preterm morbidities presented during hospitalizationResults: The mean BW of evaluated preterm infants was 1086 ± 250 g, the mean GA27.89 ± 1.97, Apgar score 5.41 ± 1.76, excess base at admission 6.39 ± 1.74 and mean CRIB score 3.72 ± 3.16. The overall survival rate was 70.5%. Selected outcomes at discharge were: RDS with 70.5% infants treated with natural surfactant, PDA treated with NSAIDS (23.5%, brain injury ( ≥ grade 3 IVH or PVL 16.6%, NEC Bell stages II or III 9.8%, BPD 25/72 (33.3% of infants who survived to 36 weeks postmenstrual age. In 38 (37.2% infants, episodes of infections were noticed (one or more episodes in 25 infants, half of them were caused by Gram positive bacteria, most frequent coagulasa negative staphylococci. Klebsiella pneumoniae was the mostfrequent organism among Gram negative bacteria. One patient had invasive candidiasis caused by Candida albicans. In 5 infants (4.9% early onset of sepsis was documented. Conclusion: Very preterm

  8. High mortality among children with gastroschisis after the neonatal period: A long-term follow-up study.

    Science.gov (United States)

    Risby, Kirsten; Husby, Steffen; Qvist, Niels; Jakobsen, Marianne S

    2017-03-01

    During the last decades neonatal outcomes for children born with gastroschisis have improved significantly. Survival rates >90% have been reported. Early prenatal diagnosis and increased survival enforce the need for valid data for long-term outcome in the pre- and postnatal counseling of parents with a child with gastroschisis. Long-term follow-up on all newborns with gastroschisis at Odense University Hospital (OUH) from January 1 1997-December 31 2009. Follow-up included neonatal chart review for neonatal background factors, including whether a GORE ® DUALMESH was used for staged closure, electronic questionnaires, interview and laboratory investigations. Cases were divided into complex and simple cases according to the definition by Molik et al. (2001). Survival status was determined by the national personal identification number registry. Because of the consistency of the registration, survival status was obtained from all children participating in the study. A total of 71 infants (7 complex and 64 simple) were included. Overall seven out of the 71 children (9.9%, median age: 52days (25-75% percentile 0-978days) had died at the time of follow-up. Three died during the neonatal period and four died after the neonatal period. Parenteral nutrition (PN) induced liver failure and suspected adhesive small bowel obstruction were the causes of deaths after the neonatal period. Overall mortality was high in the "complex" group compared to the simple group (3/7 (42.9%) vs 4/64 (6.3%), p = 0.04). Forty (62.5%) of the surviving children consented to participate in the follow-up. A total of 12 children had had suspected adhesive small bowel obstruction. Prevalence of small bowel obstruction was not related to the number of operations needed for neonatal closure of the defect. Staged closure was done in 5/12 (41.7%) who developed small bowel obstruction vs 11/35 (31.43%) without small bowel obstruction, p=0.518. A GORE ® DUALMESH was used in 16 children (22.5%). Of these

  9. The Impact of Twin Birth on Early Neonatal Outcomes.

    Science.gov (United States)

    Fumagalli, Monica; Schiavolin, Paola; Bassi, Laura; Groppo, Michela; Uccella, Sara; De Carli, Agnese; Passera, Sofia; Sirgiovanni, Ida; Dessimone, Francesca; Consonni, Dario; Acaia, Barbara; Ramenghi, Luca Antonio; Mosca, Fabio

    2016-01-01

    This study aims to describe the impact of twin birth, chorionicity, intertwin birth weight (BW) discordance and birth order on neonatal outcomes. We performed a hospital-based retrospective study on 2,170 twins (6.4% of all live births) and 2,217 singletons inborn 2007 to 2011. Data on neonatal characteristics, morbidities, and mortality were collected and compared. Univariate and multiple (adjusted for gestational age [GA] and gender) linear random intercept regression models were used. Overall, 62.3% of twins were born premature. At multiple regression, twins were similar to singletons for neonatal morbidities, but they were more likely to have lower BW and to be born by cesarean delivery. Monochorionic twins had lower GA and BW compared with dichorionic ones and were more likely to develop respiratory distress syndrome (odds ratio [OR], 1.7), hypoglycemia (OR, 3.3), need for transfusion, (OR, 3.4) but not brain abnormalities. Moderate and severe BW discordance were associated with longer length of stay and increased risk for morbidities but not for death. Birth order had no effects. Prematurity was the most common outcome in twins and accounted for the apparently increased risk in morbidities. Monochorionicity was confirmed as risk factor for lower GA and neonatal morbidities. BW discordance may play a role in developing neonatal complications and needs to be further investigated. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  10. Impact of improved neonatal care on the profile of retinopathy of prematurity in rural neonatal centers in India over a 4-year period.

    Science.gov (United States)

    Vinekar, Anand; Jayadev, Chaitra; Kumar, Siddesh; Mangalesh, Shwetha; Dogra, Mangat Ram; Bauer, Noel J; Shetty, Bhujang

    2016-01-01

    To report the reduction in the incidence and severity of retinopathy of prematurity (ROP) in rural India over a 4-year period following the introduction of improved neonatal care practices. The Karnataka Internet Diagnosis of Retinopathy of Prematurity program (KIDROP), is a tele-medicine network that screens for ROP in different zones of Karnataka state in rural India. North Karnataka is the most underdeveloped and remote zone of this program and did not have any ROP screening programs before the intervention of the KIDROP in 2011. Six government and eleven private neonatal centers in this zone were screened weekly. Specific neonatal guidelines for ROP were developed and introduced in these centers. They included awareness about risk factors, oxygen regulation protocols, use of pulse oxymetry, monitoring postnatal weight gain, nutritional best practices, and management of sepsis. The incidence and severity of ROP were compared before the guidelines were introduced (Jan 2011 to Dec 2012) and after the guidelines were introduced (July 2013 to June 2015). During this 4-year period, 4,167 infants were screened over 11,390 imaging sessions. The number of enrolled infants increased from 1,825 to 2,342 between the two periods ( P large, unscreened burden of ROP. Improving neonatal care in these centers can positively impact the incidence and severity of ROP even in a relatively short period. A combined approach of a robust ROP screening program and improved neonatal care practices is required to address the challenge.

  11. Neonatal retinoblastoma

    Directory of Open Access Journals (Sweden)

    Tero T Kivelä

    2017-01-01

    Full Text Available From 7% to 10% of all retinoblastomas and from 44% to 71% of familial retinoblastomas in developed countries are diagnosed in the neonatal period, usually through pre- or post-natal screening prompted by a positive family history and sometimes serendipitously during screening for retinopathy of prematurity or other reasons. In developing countries, neonatal diagnosis of retinoblastoma has been less common. Neonatal retinoblastoma generally develops from a germline mutation of RB1, the retinoblastoma gene, even when the family history is negative and is thus usually hereditary. At least one-half of infants with neonatal retinoblastoma have unilateral tumors when the diagnosis is made, typically the International Intraocular Retinoblastoma Classification (Murphree Group B or higher, but most germline mutation carriers will progress to bilateral involvement, typically Group A in the fellow eye. Neonatal leukokoria usually leads to the diagnosis in children without a family history of retinoblastoma, and a Group C tumor or higher is typical in the more advanced involved eye. Almost all infants with neonatal retinoblastoma have at least one eye with a tumor in proximity to the foveola, but the macula of the fellow eye is frequently spared. Consequently, loss of reading vision from both eyes is exceptional. A primary ectopic intracranial neuroblastic tumor known as trilateral retinoblastoma is no more common after neonatal than other retinoblastoma. For many reasons, neonatal retinoblastoma may be a challenge to eradicate, and the early age at diagnosis and relatively small tumors do not guarantee the preservation of both eyes of every involved child. Oncology nurses can be instrumental in contributing to better outcomes by ensuring that hereditary retinoblastoma survivors receive genetic counseling, by referring families of survivors to early screening programs when they are planning for a baby, and by providing psychological and practical support

  12. Early neonatal special care units and their scientific achievements.

    Science.gov (United States)

    Obladen, Michael

    2012-01-01

    Treatment of sick neonates originated in maternity and foundling hospitals in the 19th century. Nosocomial infections and difficult logistics of wet-nursing prevented admission of neonates in most children's hospitals well into the 20th century. In this article, 31 hospitals are described, all located in large cities, in which preterm and sick neonates were treated before the Great Depression. Even though mostly initiated by private charity, these institutions performed research right from the start. Topics included warming and feeding preterm infants, collecting and distributing human milk, developing and storing breast milk substitutes, prevention of rickets and nosocomial infections, maternal and public education regarding infection control, pathoanatomic characterisation of diseases and malformations and epidemiologic studies of infant mortality. These pioneering hospitals, their founding dates, researchers and classic publications are presented in a table. Copyright © 2012 S. Karger AG, Basel.

  13. RISK FACTORS FOR THE EARLY NEONATAL MORTALITY IN NEWBORNS WITH VERY LOW AND EXTREMELY LOW BIRTH WEIGHT

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    О. V. Lebedeva

    2014-01-01

    Full Text Available Objective: Our aim was to assess the association of perinatal factors with the early neonatal mortality in newborns with very low (VLBW and extremely low birth weight (ELBW.Methods: The statistical data was carried out, that is analysis of 17 perinatal factors of 28 newborns with an ELBW with gestation of 23–27 weeks and 18 newborns with a VLBW with gestation of 28–32 weeks, who died in the first 7 days of life. The comparison group consisted of 25 newborns with an ELBW and 56 children with a VLBW with gestation of 25–27 and 28–32 weeks, respectively, who survived the early neonatal period. The association of risk factors with the early neonatal mortality was assessed by means of a multiple-factor logistic regression analysis. A critical p error level was set equal to 0.05. Results: In newborns with a VLBW the increased risk of the early neonatal mortality depended on a gestation term (OR 4.40, 95% CI 1.56–11.71; р = 0.002 and emergency Caesarean section (OR 7.48, 95% CI 1.28–43.74; р = 0.008. A vaginal birth increased the survival chance (OR 0.12, 95% CI 0.01–0.86; р = 0.032. Newborns with an ELBW had the following factors of the increased risk of the early neonatal mortality: gestational age (OR 2.86, 95% CI 1.06–7.73; р = 0.038, Apgar score at the 5th minute (OR 1.91, 95% CI 0.99–3.69; р = 0.050 and presence of chorioamnionitis (OR 5.45, 95% CI 1.0–29.53; p = 0.048. An elective Caesarean section increased the survival chance (OR 0.02, 95% CI 0.001–0.44; p = 0.048. Conclusion: Summarizing the obtained data, we can conclude that besides a gestational age the risk of early neonatal mortality in newborns with a VLBW may be increased due to the emergency Caesarean section, with an ELBW — due to a low Apgar score at the 5th minute and the presence of mother's chorioamnionitis. A vaginal birth in newborns with a VLBW and an elective Caesarean section in children with an ELBW increase survival chances.

  14. Inflammatory and vascular placental lesions are associated with neonatal amplitude integrated EEG recording in early premature neonates.

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    Dorit Paz-Levy

    .007.Depressed neonatal aEEG patterns are associated with placental lesions consistent with maternal under perfusion, and amniotic fluid infection of fetal type, but not with fetal thrombo-oclusive vascular disease of inflammatory type. Our findings highlight the association between the intrauterine mechanisms leading to preterm parturition and subsequent depressed neonatal cerebral function early after birth, which eventually may put premature infants at risk for abnormal neurodevelopmental outcome.

  15. A comparison of early neonatal deaths among preterm infants with ...

    African Journals Online (AJOL)

    Background: Prematurity is a common complication that contributes significantly to high neonatal mortality. In spite of many efforts by the government and other partners, non-significant decline has been achieved in the recent past. Globally, 15 million babies are born preterm (<37 weeks gestation) each year, and more than ...

  16. 7. A comparison of early neonatal deaths among preterm infants ...

    African Journals Online (AJOL)

    user

    ABSTRACT. Background: Prematurity is a common complication that contributes significantly to high neonatal mortality. In spite of many efforts by the government and other partners, non-significant decline has been achieved in the recent past. Globally, 15 million babies are born preterm (<37 weeks gestation) each year, ...

  17. Impact of improved neonatal care on the profile of retinopathy of prematurity in rural neonatal centers in India over a 4-year period

    Science.gov (United States)

    Vinekar, Anand; Jayadev, Chaitra; Kumar, Siddesh; Mangalesh, Shwetha; Dogra, Mangat Ram; Bauer, Noel J; Shetty, Bhujang

    2016-01-01

    Purpose To report the reduction in the incidence and severity of retinopathy of prematurity (ROP) in rural India over a 4-year period following the introduction of improved neonatal care practices. Methods The Karnataka Internet Diagnosis of Retinopathy of Prematurity program (KIDROP), is a tele-medicine network that screens for ROP in different zones of Karnataka state in rural India. North Karnataka is the most underdeveloped and remote zone of this program and did not have any ROP screening programs before the intervention of the KIDROP in 2011. Six government and eleven private neonatal centers in this zone were screened weekly. Specific neonatal guidelines for ROP were developed and introduced in these centers. They included awareness about risk factors, oxygen regulation protocols, use of pulse oxymetry, monitoring postnatal weight gain, nutritional best practices, and management of sepsis. The incidence and severity of ROP were compared before the guidelines were introduced (Jan 2011 to Dec 2012) and after the guidelines were introduced (July 2013 to June 2015). Results During this 4-year period, 4,167 infants were screened over 11,390 imaging sessions. The number of enrolled infants increased from 1,825 to 2,342 between the two periods (P<0.001). The overall incidence of any stage ROP reduced significantly from 26.8% to 22.4% (P<0.001). The incidence of treatment-requiring ROP reduced from 20.7% to 16% (P=0.06), and of the treated disease, aggressive posterior ROP reduced from 20.8% to 13.1% (P=0.23) following introduction of the guidelines. Discussion Rural neonatal centers in middle-income countries have a large, unscreened burden of ROP. Improving neonatal care in these centers can positively impact the incidence and severity of ROP even in a relatively short period. A combined approach of a robust ROP screening program and improved neonatal care practices is required to address the challenge. PMID:28539801

  18. Neonatal and early infancy management of prenatally detected hydronephrosis.

    Science.gov (United States)

    Swords, Kelly A; Peters, Craig A

    2015-09-01

    Hydronephrosis discovered during prenatal ultrasound will often resolve spontaneously; however, it should be evaluated in the postnatal period in a manner commensurate with its risk of renal injury. Early intervention is appropriate in cases of bladder outlet obstruction or the severely obstructed solitary kidney. In most other cases, it is both safe and reasonable to allow the possibility of spontaneous improvement with the intensity of follow-up based on the severity of the hydronephrosis. Clinical decision making should be a shared process between families and caregivers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. Efficacy, immunogenicity, and safety of two doses of a tetravalent rotavirus vaccine RRV-TV in Ghana with the first dose administered during the neonatal period.

    Science.gov (United States)

    Armah, George E; Kapikian, Albert Z; Vesikari, Timo; Cunliffe, Nigel; Jacobson, Robert M; Burlington, D Bruce; Ruiz, Leonard P

    2013-08-01

    Oral rhesus/rhesus-human reassortant rotavirus tetravalent vaccine (RRV-TV) was licensed in 1998 but withdrawn in 1999 due to a rare association with intussusception, which occurred disproportionately in infants receiving their first dose at ≥90 days of age. This study examined RRV-TV for the prevention of rotavirus gastroenteritis (RV-GE) in Ghana, West Africa, with infants receiving the first dose during the neonatal period and the second before 60 days of age. In a double-blinded, randomized, placebo-controlled trial in Navrongo, Ghana, we recruited neonates to receive 2 doses of RRV-TV or placebo and followed them to age 12 months. In the intention-to-treat population of 998 infants, we measured a vaccine efficacy of 63.1% against RV-GE of any severity associated with any of the 4 serotypes represented in the vaccine and 60.7% against RV-GE associated with any rotavirus serotype. RRV-TV in a 2-dose schedule with the first dose during the neonatal period is efficacious in preventing RV-GE in rural Ghana. Neonatal dosing results in early protection and may be the optimum schedule to avoid or significantly reduce intussusception, now reported to be associated in international settings with the 2 most widely marketed, licensed, live virus, oral rotavirus vaccines.

  20. Neonatal immune activation during early and late postnatal brain development differently influences depression-related behaviors in adolescent and adult C57BL/6 mice

    Directory of Open Access Journals (Sweden)

    Jafar Majidi-Zolbanin

    2014-06-01

    Full Text Available Aim: Immune challenge during early and late neonatal periods can induce robust alterations in physiological and behavioral functions, resulting in greater risk for the development of neuropsychiatric disorders, such as anxiety and depression, later in life. In addition, previous studies concluded that increasing age correlates with increased depression behaviors in humans and rodents. This study aimed to investigate for the first time whether immune challenge with a viral mimic, synthetic double-stranded ribonucleic acid (Poly I: C during different neonatal periods can differently affect depression-related behaviors in adolescent and adult mice. Methods: Male C57BL/6 mice were treated with either saline or Poly I:C (1 mg/kg and 4 mg/kg on postnatal days (PND 3-5 (early neonatal phase or PND 14-16 (late neonatal phase, and then subjected to behavioral tests, including tail suspension test and forced swimming test, during adolescence (PND 35 or 40 and adulthood (PND 85 or 90. Results: The results demonstrated that early neonatal immune activation increases depression-related behaviors in both adolescent and adult mice, but late neonatal immune activation only increases depression in adult mice. In other words, these findings indicated that the nature of the offspring's neuropathology can depend on the severity of the insult, the pup's age at the time of the insult, and offspring age at the time of behavioral testing. Conclusion: These findings suggest that dose and timing of neonatal insult and offspring age may be important factors for evaluating neuropsychiatric disorders in adults who experienced early life infection.

  1. Antibiotic exposure in neonates and early adverse outcomes: a systematic review and meta-analysis.

    Science.gov (United States)

    Esaiassen, Eirin; Fjalstad, Jon Widding; Juvet, Lene Kristine; van den Anker, John N; Klingenberg, Claus

    2017-07-01

    To systematically review and meta-analyse the relationship between antibiotic exposure in neonates and the following early adverse outcomes: necrotizing enterocolitis (NEC), invasive fungal infections (IFIs) and/or death. Data sources were PubMed, Embase, Medline and the Cochrane Database (to December 2016), supplemented by manual searches of reference lists. Randomized controlled trials (RCTs) and observational studies were included if they provided data on different categories of antibiotic exposures (yes versus no, long versus short duration, and/or broad- versus narrow-spectrum regimens) and the risk of developing NEC, IFI and/or death in the neonatal period. Two reviewers extracted data and evaluated the risk of bias using the Cochrane Handbook, adapted to include observational studies. When appropriate, meta-analyses were conducted using the random-effect model. We identified 9 RCTs and 38 observational studies. The quality of the majority of studies was poor to moderate. There was a significant association between prolonged antibiotic exposure and an increased risk of NEC in five observational studies (5003 participants) and/or risk of death in five observational studies (13 534 participants). Eleven of 15 studies with data on broad- versus narrow-spectrum regimens reported an increased risk of IFI after broad-spectrum antibiotic exposure, in particular with third-generation cephalosporins and carbapenems. Meta-analysis was limited by few and old RCTs, insufficient sample sizes and diversity of antibiotic exposure and outcomes reported. Prolonged antibiotic exposure in uninfected preterm infants is associated with an increased risk of NEC and/or death, and broad-spectrum antibiotic exposure is associated with an increased risk of IFI. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Magnetic resonance imaging versus transcranial ultrasound in early identification of cerebral injuries in neonatal encephalopathy

    Directory of Open Access Journals (Sweden)

    Eman A.Sh. Genedi

    2016-03-01

    Conclusion: TCUS is an effective screening tool in detecting the etiology of NE in suspected cases; it is sometimes crucial in critically sick neonates; however, early MRI is mandatory as it can detect precisely the extent of brain injury compared with TCUS alone.

  3. Early neonatal deaths associated with perinatal asphyxia in infants ≥2500 g in Brazil

    Directory of Open Access Journals (Sweden)

    Maria Fernanda Branco de Almeida

    2017-11-01

    Conclusions: Despite the decreasing rates in Brazil from 2005 to 2010, early neonatal mortality rates associated with perinatal asphyxia in infants in the better spectrum of birth weight and without congenital malformations are still high, and meconium aspiration syndrome plays a major role.

  4. "Social marketing" for early neonatal care: saving newborn lives in Pakistan.

    Science.gov (United States)

    Ejaz, Iram; Shaikh, Babar Tasneem

    2010-01-01

    According to the World Health Organization and the United Nations Children's Fund, developing countries carry a large share of neonatal mortality in the world. According to UNICEF, almost 450 newborn children die every hour, mostly from preventable causes. Restricted access to quality and hygienic delivery services and limited knowledge about handling the newborn aggravate the situation. South Asia, and Pakistan in particular, have reduced their child and infant mortality during the last decade; however, neonatal mortality still remains unacceptably high. There are multiple reasons, mainly related to practices and behaviours of communities and traditional birth attendants. Rural and poor populations suffer most in Pakistan, where three out of five deliveries still occur at home. Traditional community practices and conservative norms drastically affect neonatal health outcomes. Preventing sepsis at the umbilical cord, keeping the baby at the correct temperature after birth and early initiation of exclusive breastfeeding are three simple strategies or messages that need to be disseminated widely to prevent many neonatal mortalities and morbidities. Since inappropriate practices in handling newborns are directly linked with persistent and unremitting behaviours among health providers and the community at large, we suggest doing robust "social marketing" for saving newborn lives. The objective of the paper is to present a social-marketing strategy and a marketing mix that will help address and surmount actual barriers and promote alternative behaviours in early neonatal care.

  5. Comparison of early and late MRI in neonatal hypoxic-ischemic encephalopathy using three assessment methods

    International Nuclear Information System (INIS)

    Charon, Valerie; Proisy, Maia; Bruneau, Bertrand; Treguier, Catherine; Rozel, Celine; Ferre, Jean-Christophe; Beuchee, Alain; Chauvel, Jennifer

    2015-01-01

    There is no consensus on the optimum timing of MRI in neonates with hypoxic-ischemic encephalopathy treated with hypothermia. Reliable early imaging assessment might help managing treatment. To assess non-random differences between early and late MRI that might influence intensive-care decisions. This single-center retrospective study included all asphyxiated term neonates eligible for hypothermia treatment November 2009-July 2012. MRI scans were systematically performed at day 4 (early MRI) and day 11 of life as part of routine protocol. Two experienced pediatric radiologists reviewed both scans according to three assessment methods: a pattern classification, a scoring system and a simplified classification. Agreement between early and late imaging findings was assessed using Cohen's kappa coefficients. Thirty-three neonates were included. Interobserver agreement was excellent. Early MRI detected all severe injuries. Agreement between early and late MRI was excellent for the simplified classification (κ = 0.82), good for the pattern classification (κ = 0.64), and good to excellent for 3 scores out of 4 in the scoring system (κ = 0.70-0.89). Early MRI may provide valuable information about brain injury to help parents and neonatologists in intensive-care decisions at the end of hypothermia treatment. (orig.)

  6. Comparison of early and late MRI in neonatal hypoxic-ischemic encephalopathy using three assessment methods

    Energy Technology Data Exchange (ETDEWEB)

    Charon, Valerie; Proisy, Maia; Bruneau, Bertrand; Treguier, Catherine; Rozel, Celine [University Hospital, Department of Imaging, Hopital Sud, Rennes, Cedex 2 (France); Ferre, Jean-Christophe [University Hospital, Department of Neuroradiology, Hopital Pontchaillou, Rennes (France); Beuchee, Alain [University Hospital, Department of Neonatology, Hopital Sud, Rennes (France); Chauvel, Jennifer [Saint Brieuc Hospital, Department of Neonatology, Saint-Brieuc (France)

    2015-12-15

    There is no consensus on the optimum timing of MRI in neonates with hypoxic-ischemic encephalopathy treated with hypothermia. Reliable early imaging assessment might help managing treatment. To assess non-random differences between early and late MRI that might influence intensive-care decisions. This single-center retrospective study included all asphyxiated term neonates eligible for hypothermia treatment November 2009-July 2012. MRI scans were systematically performed at day 4 (early MRI) and day 11 of life as part of routine protocol. Two experienced pediatric radiologists reviewed both scans according to three assessment methods: a pattern classification, a scoring system and a simplified classification. Agreement between early and late imaging findings was assessed using Cohen's kappa coefficients. Thirty-three neonates were included. Interobserver agreement was excellent. Early MRI detected all severe injuries. Agreement between early and late MRI was excellent for the simplified classification (κ = 0.82), good for the pattern classification (κ = 0.64), and good to excellent for 3 scores out of 4 in the scoring system (κ = 0.70-0.89). Early MRI may provide valuable information about brain injury to help parents and neonatologists in intensive-care decisions at the end of hypothermia treatment. (orig.)

  7. Bubble CPAP versus ventilator CPAP in preterm neonates with early onset respiratory distress--a randomized controlled trial.

    Science.gov (United States)

    Tagare, Amit; Kadam, Sandeep; Vaidya, Umesh; Pandit, Anand; Patole, Sanjay

    2013-04-01

    Bubble continuous positive airway pressure (BCPAP) is a low cost nasal CPAP delivery system with potential benefits to developing nations. To compare the efficacy and safety of BCPAP with ventilator-derived CPAP (VCPAP) in preterm neonates with respiratory distress. In a randomized controlled trial, preterm neonates with Silverman-Anderson score ≥ 4 and oxygen requirement >30% within first 6 h of life were randomly allocated to BCPAP or VCPAP. Proportion of neonates with success or failure was compared. In all, 47 of 57 (82.5%) neonates from BCPAP group and 36 of 57 (63.2%) neonates from the VCPAP group completed CPAP successfully (p = 0.03). Neonates who failed CPAP had higher Silverman-Anderson score (p neonates with early onset respiratory distress, with comparable safety.

  8. Early neonatal mortality in twin pregnancy: Findings from 60 low- and middle-income countries.

    Science.gov (United States)

    Bellizzi, Saverio; Sobel, Howard; Betran, Ana Pilar; Temmerman, Marleen

    2018-06-01

    Around the world, the incidence of multiple pregnancies reaches its peak in the Central African countries and often represents an increased risk of death for women and children because of higher rates of obstetrical complications and poor management skills in those countries. We sought to assess the association between twins and early neonatal mortality compared with singleton pregnancies. We also assessed the role of skilled birth attendant and mode of delivery on early neonatal mortality in twin pregnancies. We conducted a secondary analysis of individual level data from 60 nationally-representative Demographic and Health Surveys including 521 867 singleton and 14 312 twin births. We investigated the occurrence of deaths within the first week of life in twins compared to singletons and the effect of place and attendance at birth; also, the role of caesarean sections against vaginal births was examined, globally and after countries stratification per caesarean sections rates. A multi-level logistic regression was used accounting for homogeneity within country, and homogeneity within twin pairs. Early neonatal mortality among twins was significantly higher when compared to singleton neonates (adjusted odds ratio (aOR) 7.6; 95% confidence interval (CI) = 7.0-8.3) in these 60 countries. Early neonatal mortality was also higher among twins than singletons when adjusting for birth weight in a subgroup analysis of those countries with data on birth weight (n = 20; less than 20% of missing values) (aOR = 2.8; 95% CI = 2.2-3.5). For countries with high rates (>15%) of caesarean sections (CS), twins delivered vaginally in health facility had a statistically significant (aOR = 4.8; 95% CI = 2.4-9.4) increased risk of early neonatal mortality compared to twins delivered through caesarean sections. Home twin births without SBA was associated with increased mortality compared with delivering at home with SBA (aOR = 1.3; 95% CI = 1.0-1.8) and

  9. Management of early onset neonatal sepsis differs in the north and south of Scandinavia

    DEFF Research Database (Denmark)

    Drageset, Martin; Fjalstad, Jon Widding; Mortensen, Sven

    2017-01-01

    AIM: This study compared the management and outcomes of early-onset neonatal sepsis (EONS) in two tertiary neonatal units in Denmark and Norway. METHODS: We retrospectively studied all infants diagnosed with EONS between April 2010 and March 2013 and managed at Odense University Hospital, Denmark...... blood cultures had higher C-reactive protein levels than patients with negative blood cultures and higher sepsis-attributable mortality. Lumbar punctures were performed more frequently in Denmark. CONCLUSION: There were marginal differences in the management of EONS between units in Denmark and Norway...

  10. Periodic Early Childhood Hearing Screening: The EHDI Perspective

    Science.gov (United States)

    Hoffman, Jeff; Houston, K. Todd; Munoz, Karen F.; Bradham, Tamala S.

    2011-01-01

    State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that examined 12 areas within state EHDI programs. Concerning periodic early childhood hearing screening, 47 coordinators listed 241 items and themes were identified within each SWOT…

  11. Early microvascular changes in the preterm neonate: a comparative study of the human and guinea pig.

    Science.gov (United States)

    Dyson, Rebecca M; Palliser, Hannah K; Lakkundi, Anil; de Waal, Koert; Latter, Joanna L; Clifton, Vicki L; Wright, Ian M R

    2014-09-17

    Dysfunction of the transition from fetal to neonatal circulatory systems may be a major contributor to poor outcome following preterm birth. Evidence exists in the human for both a period of low flow between 5 and 11 h and a later period of increased flow, suggesting a hypoperfusion-reperfusion cycle over the first 24 h following birth. Little is known about the regulation of peripheral blood flow during this time. The aim of this study was to conduct a comparative study between the human and guinea pig to characterize peripheral microvascular behavior during circulatory transition. Very preterm (≤28 weeks GA), preterm (29-36 weeks GA), and term (≥37 weeks GA) human neonates underwent laser Doppler analysis of skin microvascular blood flow at 6 and 24 h from birth. Guinea pig neonates were delivered prematurely (62 day GA) or at term (68-71 day GA) and laser Doppler analysis of skin microvascular blood flow was assessed every 2 h from birth. In human preterm neonates, there is a period of high microvascular flow at 24 h after birth. No period of low flow was observed at 6 h. In preterm animals, microvascular flow increased after birth, reaching a peak at 10 h postnatal age. Blood flow then steadily decreased, returning to delivery levels by 24 h. Preterm birth was associated with higher baseline microvascular flow throughout the study period in both human and guinea pig neonates. The findings do not support a hypoperfusion-reperfusion cycle in the microcirculation during circulatory transition. The guinea pig model of preterm birth will allow further investigation of the mechanisms underlying microvascular function and dysfunction during the initial extrauterine period. © 2014 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.

  12. Análisis de la mortalidad neonatal precoz en San Miguel del Padrón (La Habana Analysis of early neonatal mortality in San Miguel del Padrón municipality in Havana City

    Directory of Open Access Journals (Sweden)

    Emilio Vidal Borrás

    2009-12-01

    found that early neonatal mortality was of a decreasing trend during the study period. The year with a higher figure of live births was in 1999 with 2146 births and an infant mortality rate of 10,7 x 1 000 life births. The early neonatal mortality rate was of 3,7 x 1 000 life births in 1999 and in 2002 years with 7 deceases in neonates under 7 days of life.. From the 129 deceases, 49 corresponded to early neonatal component and the preterm delivery was of 20.1%. The leading death cause was the sepsis (48.9%. CONCLUSIONS: Leading death causes were the sepsis, asphyxia and the congenital manifestations whereas the more frequent risk factors related to pregnancy were the vaginal moniliasis and urinary infections.

  13. [Acute pyelonephritis in the neonatal period] [Article in Italian] • Pielonefrite acuta in epoca neonatale

    Directory of Open Access Journals (Sweden)

    Giovanni Ottonello

    2014-01-01

    Full Text Available Urinary tract infections (UTIs represent one of the most common pathological conditions in children. It is estimated that even in the countries with the most advanced health care programmes, such as the United States and Europe, UTIs represent the most common serious infections in pediatrics. In the earliest stages of life, UTIs represent the most common febrile illness, although the non specific clinical presentation often leads to diagnostic underestimation. Neonatal UTIs surely represent a special case among pediatric UTIs and need specific considerations and separate treatment with respect to later age: it is no coincidence that the main national and international guidelines for the diagnosis and treatment of UTIs, such as those issued by the American Academy of Pediatrics (AAP and by the Working Group of the Italian Society of Pediatric Nephrology, exclude from their indications the newborn and the infant under two months of age. Low gestational age, low birth weight, association with malformative uropathies are considered specific risk factors. Breastfeeding has a protective effect. E. coli is the major responsible of UTI in term newborns and infants, followed by K. pneumoniae, Proteus spp., E. cloacae. Finally, Candida spp. is very important in hospitalized children. Treatment includes the combination of ampicillin plus an aminoglycoside (frequently gentamicin. The article shows the main aspects of the urinary tract infections in the neonatal period and a review of the most recent literature on the subject.Articoli Selezionati del “3° Convegno Pediatrico del Medio Campidano” · Guspini · 25 Maggio 2013 Guest Editor: Roberto Antonucci

  14. Effects of early nerve repair on experimental brachial plexus injury in neonatal rats.

    Science.gov (United States)

    Bourke, Gráinne; McGrath, Aleksandra M; Wiberg, Mikael; Novikov, Lev N

    2018-03-01

    Obstetrical brachial plexus injury refers to injury observed at the time of delivery, which may lead to major functional impairment in the upper limb. In this study, the neuroprotective effect of early nerve repair following complete brachial plexus injury in neonatal rats was examined. Brachial plexus injury induced 90% loss of spinal motoneurons and 70% decrease in biceps muscle weight at 28 days after injury. Retrograde degeneration in spinal cord was associated with decreased density of dendritic branches and presynaptic boutons and increased density of astrocytes and macrophages/microglial cells. Early repair of the injured brachial plexus significantly delayed retrograde degeneration of spinal motoneurons and reduced the degree of macrophage/microglial reaction but had no effect on muscle atrophy. The results demonstrate that early nerve repair of neonatal brachial plexus injury could promote survival of injured motoneurons and attenuate neuroinflammation in spinal cord.

  15. Early weaning PCB 95 exposure alters the neonatal endocrine system: thyroid adipokine dysfunction.

    Science.gov (United States)

    Ahmed, R G

    2013-12-01

    Polychlorinated biphenyls (PCBs) are persistent environmental pollutants that can severely disrupt the endocrine system. In the present study, early-weaned male rats were administered a single dose of 2,3,6-2',5'-pentachlorinated biphenyl (PCB 95; 32 mg/kg per day, by i.p. injection) for two consecutive days (postnatal days (PNDs) 15 and 16) and killed 24 and 48 h after the administration of the last dose. Compared with the control group, administration of PCB 95 induced a reduction (Pcolloidal contents at PND 18. The dyshormonogenesis and thyroid dysgenesis may be attributed to the elevation of DNA fragmentation at PNDs 17 and 18. Furthermore, this hypothyroid state revealed higher (Pinsulin at both PNDs compared with the control group. Interestingly, the body weight of the neonates in the PCB 95 group exhibited severe decreases throughout the experimental period in relation to that of the control group. These results imply that PCB 95 may act as a disruptor of the developmental hypothalamic-pituitary-thyroid axis. Hypothyroidism caused by PCB 95 may impair the adipokine axis, fat metabolism, and in general postnatal development. Thus, further studies need to be carried out to understand this concept.

  16. Position of folic acid in fortification of nutrition in neonatal period

    Directory of Open Access Journals (Sweden)

    Tatiana Žikavská

    2013-07-01

    Full Text Available Folic acid is an essential vitamin which has been known in recent 50 years. It plays an important role in period of neurogenesis. The substitution of folic acid is one of the important parts in the complex treatment of anaemia in premature newborns. It is also a component of artificial milk formulae or breast milk following mother’s intake. Fortification of foods with folic acid for population in the world is still discussed. To determine optimal dose of folic acid in premature newborns is difficult. Daily recommended doses of folic acid in infants under the six months were identified. The needs of folic acid in newborns vary. It depends upon the gestational age, body reserves at birth or maternal status of folates during gravidity. On the other hand there is a risk of accumulation of unmetabolised folic acid in circulation of newborns after mandatory folic acid fortification in some countries, which were reported in some studies. The safe upper limits of folic acid intake in premature newborns are not known. In this review article authors inform about the clear positive effect of folic acid in prenatal and neonatal period, but excessive doses of folic acid could present risk of accumulation and possible adverse effects. To follow up these notions further studies are required.

  17. Vomiting, abdominal distention and early feeding of banana (Musa paradisiaca) in neonates.

    Science.gov (United States)

    Wiryo, Hananto; Hakimi, M; Wahab, A Samik; Soeparto, Pitono

    2003-09-01

    The objective of this cohort study was to assess the relationship between banana given as early solid food with the symptoms of intestinal obstruction (SIO) among neonates, in a rural community in West Lombok District, West Nusa Tenggara Province, Indonesia. Mothers having newborn infants were interviewed and 3,420 neonates were followed for 28 days. Compared with infants who were not given solid food, the relative risk (RR) for infants given food other than banana as early solid food was 1.87, 95% CI 0.48-8.24, p=0.4, while for infants given banana only as early solid food the RR was 9.15, 95% CI 1.96-42.58, p 0.0005. After adjustment for birthweight, colostrum, and breastfeeding, the odds ratio for infants given banana and the appearance of SIO was 2.99, 95% CI 2.65-5.14; p=0.0012. These data indicate that banana given as early solid food is an important risk factor for the appearance of SIO in neonates.

  18. Early Life Microbiota, Neonatal Immune Maturation and Hematopoiesis

    DEFF Research Database (Denmark)

    Kristensen, Matilde Bylov

    Emerging epidemiologic data supports the hypothesis that early life colonization is a key player in development of a balanced immune system. Events in early life, as birth mode and infant diet, are shown to influence development of immune related diseases, like asthma, diabetes and inflammatory...... bowl disease, later in life. The intestinal epithelium makes up a physical and biochemical barrier between the bacteria in the gut lumen and the immune cells in the submocusal tissue. This monolayer of intestinal epithelial cells (IEC) makes up an extremely large surface and is highly important...... for the synergistic coexistence between trillions of bacteria in the gastrointestinal tract and their mammalian hosts. The IEC actively communicate with the microbiota of the gut lumen and tolerance establishment in the intestine is induced as a result of a balanced and controlled communication between IEC...

  19. Early feeding and neonatal hypoglycemia in infants of diabetic mothers

    Directory of Open Access Journals (Sweden)

    Leandro Cordero

    2013-12-01

    Full Text Available Objectives: To examine the effects of early formula feeding or breast-feeding on hypoglycemia in infants born to 303 A1-A2 and 88 Class B-RF diabetics. Methods: Infants with hypoglycemia (blood glucose < 40 mg/dL were breast-fed or formula-fed, and those with recurrences were given intravenous dextrose. Results: Of 293 infants admitted to the well-baby nursery, 87 (30% had hypoglycemia, corrected by early feeding in 75 (86%, while 12 (14% required intravenous dextrose. In all, 98 infants were admitted to the newborn intensive care unit for respiratory distress (40%, prematurity (33% or prevention of hypoglycemia (27%. Although all newborn intensive care unit patients received intravenous dextrose, 22 (22% had hypoglycemia. Of 109 hypoglycemia episodes, 89 (82% were single low occurrences. At discharge, 56% of well-baby nursery and 43% of newborn intensive care unit infants initiated breast-feeding. Conclusions: Hypoglycemia among infants of diabetic mothers can be corrected by early breast-feeding or formula feeding.

  20. Early feeding and neonatal hypoglycemia in infants of diabetic mothers

    Science.gov (United States)

    Ramesh, Shilpa; Hillier, Kirsty; Giannone, Peter J; Nankervis, Craig A

    2013-01-01

    Objectives: To examine the effects of early formula feeding or breast-feeding on hypoglycemia in infants born to 303 A1-A2 and 88 Class B-RF diabetics. Methods: Infants with hypoglycemia (blood glucose < 40 mg/dL) were breast-fed or formula-fed, and those with recurrences were given intravenous dextrose. Results: Of 293 infants admitted to the well-baby nursery, 87 (30%) had hypoglycemia, corrected by early feeding in 75 (86%), while 12 (14%) required intravenous dextrose. In all, 98 infants were admitted to the newborn intensive care unit for respiratory distress (40%), prematurity (33%) or prevention of hypoglycemia (27%). Although all newborn intensive care unit patients received intravenous dextrose, 22 (22%) had hypoglycemia. Of 109 hypoglycemia episodes, 89 (82%) were single low occurrences. At discharge, 56% of well-baby nursery and 43% of newborn intensive care unit infants initiated breast-feeding. Conclusions: Hypoglycemia among infants of diabetic mothers can be corrected by early breast-feeding or formula feeding. PMID:26770697

  1. Swords and sabers during the Early Islamic Period

    Directory of Open Access Journals (Sweden)

    Alexander, David

    2001-12-01

    Full Text Available The present article offers a discussion on early swords and sabers during the Early Islamic Period, from the Topkap’ Sarayi collection to written, iconographic and archeological sources.

    El presente art’culo trata las espadas y sables utilizados en los primeros tiempos del Islam a partir de la colecció—n del Topkap’ Sarayi y de las fuentes escritas, iconogr‡ficas y arqueol—gicas.

  2. Early BCG-Denmark and Neonatal Mortality Among Infants Weighing <2500 g: A Randomized Controlled Trial

    DEFF Research Database (Denmark)

    Biering-Sørensen, Sofie; Aaby, Peter; Lund, Najaaraq

    2017-01-01

    -Denmark” (intervention group; n = 2083) or “control” (local policy for LW and no BCG-Denmark; n = 2089) at discharge from the maternity ward or at first contact with the health center. The infants were randomized (1:1) without blinding in blocks of 24. Data was analyzed in Cox hazards models providing mortality rate...... ratios (MRRs). We had prespecified an analysis censoring follow-up at oral poliovirus vaccine campaigns. Results. Early administration of BCG-Denmark was associated with a nonsignificant reduction in neonatal mortality rate (MRR, 0.70; 95% confidence interval [CI], .47–1.04) and a 34% reduction (0......Background. BCG vaccine may reduce overall mortality by increasing resistance to nontuberculosis infections. In 2 randomized trials in Guinea-Bissau of early BCG-Denmark (Statens Serum Institut) given to low-weight (LW) neonates (mortality rates, we observed...

  3. The neonatal brain : early connectome development and childhood cognition

    NARCIS (Netherlands)

    Keunen, K.

    2017-01-01

    The human brain is a vastly complex system that develops rapidly during human gestation. Its developmental pace is unprecedented in any other period of human development. By the time of normal birth the brain's layout verges on the adult human brain. All major structures have come into place,

  4. A neonate with mitral stenosis due to accessory mitral valve, ventricular septal defect, and patent ductus arteriosus: changes in echocardiographical findings during the neonatal period.

    Science.gov (United States)

    Ito, Tadahiko; Okubo, Tadashi

    2002-12-01

    A female neonate with mitral stenosis due to accessory mitral valve with ventricular septal defect and patent ductus arteriosus is described. She was referred to our hospital because of neonatal asphyxia. Asphyxia was improved by ventilator support, but rapid deterioration of respiration with pulmonary congestion and hemorrhage appeared 8 days after birth. Echocardiography revealed an accessory mitral valve attached to the anterior mitral leaflet with a perimembranous ventricular septal defect and patent ductus arteriosus. Although there were no echocardiographical findings indicating mitral stenosis on admission, the mitral stenosis blood flow patterns were detected by color and pulsed Doppler examination performed on the eighth day after admission. Transaortic resection of accessory mitral valve tissue was performed with patch closure of the ventricular septal defect and ligation of the ductus arteriosus 35 days after birth. After operation, pulmonary congestion and hemorrhage were improved. Postoperative echocardiography showed complete resection of the accessory mitral valve and no mitral insufficiency. We concluded that the combination of the accessory mitral valve and left-to-right shunt due to ventricular septal defect or patent ducturs arteriosus might have led to a critical hemodynamic condition due to relative mitral stenosis in the neonatal period with the decrease in pulmonary vascular resistance.

  5. Neonatal immune activation during early and late postnatal brain development differently influences depression-related behaviors in adolescent and adult C57BL/6 mice

    OpenAIRE

    Jafar Majidi-Zolbanin; Mohammad-Hossein Doosti; Behzad Baradaran; Mohammad Amani; Maryam Azarfarin; Ali-Akbar Salari

    2014-01-01

    Aim: Immune challenge during early and late neonatal periods can induce robust alterations in physiological and behavioral functions, resulting in greater risk for the development of neuropsychiatric disorders, such as anxiety and depression, later in life. In addition, previous studies concluded that increasing age correlates with increased depression behaviors in humans and rodents. This study aimed to investigate for the first time whether immune challenge with a viral mimic, synthetic dou...

  6. Maternal and neonatal risk factors for early-onset group B streptococcal disease: a case control study

    Directory of Open Access Journals (Sweden)

    Al-Kadri HM

    2013-10-01

    Full Text Available Hanan M Al-Kadri,1 Samira S Bamuhair,2 Sameera M Al Johani,3 Namsha A Al-Buriki,1 Hani M Tamim4 1Department of Obstetrics and Gynecology, 2Department of Basic Medical Sciences, 3Microbiology Division, 4Department of Medical Education, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia Objectives: To identify the prominent maternal and neonatal risk factors associated with early-onset group B streptococcus (EOGBS disease in neonates and to determine their importance by comparing them with a control group. Setting: Neonatal unit at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia. Patients: Cases were infants <7 days of age with invasive group B streptococcus (GBS disease diagnosed between January 1, 2000 and December 31, 2009. Controls were healthy infants born in the same hospital during the same period having the same birth weight and gestational age category. Main outcome measures: Maternal risk factors for developing EOGBS disease, feto–maternal and neonatal clinical data, their morbidities, mortalities, and length of hospital stay. Results: A total of 99 cases and 200 controls were included. The majority of cases presented in the first 72 hours of life (62/99 [63.9%], of which 87/99 (89.7% had at least one clinical risk factor for the development of EOGBS disease. Mothers of neonates with EOGBS disease were more likely to have GBS bacteriuria (odds ratio [OR] 10.76, 95% confidence interval [CI] 1.24–93.42, infection in the peripartum period (OR 8.92, CI 2.87–27.68, and temperature ≥38°C (OR 7.10, CI 2.50–20.17. GBS disease was associated with premature rupture of membranes and fetal tachycardia (P<0.01 for both. Neonates with EOGBS disease were more likely to have respiratory distress disease and convulsions, require tube feeding, and have longer hospital stays compared with the controls (P<0.01 for all. Stepwise multiple logistic

  7. The early period of the universal Fermi interaction

    International Nuclear Information System (INIS)

    Tiomno, J.

    1984-01-01

    A critical analysis of the contributions which lead, in the early period, to the discovery of the universality of Fermi-type weak interactions is made. In particular the current references to this universality as 'Puppi's triangle' are shown to be incorrect. (Author) [pt

  8. Reference ranges for hematocrit and blood hemoglobin concentration during the neonatal period: data from a multihospital health care system.

    Science.gov (United States)

    Jopling, Jeffery; Henry, Erick; Wiedmeier, Susan E; Christensen, Robert D

    2009-02-01

    "Reference ranges" are developed when it is impossible or inappropriate to establish "normal ranges" by drawing blood on healthy normal volunteers. Reference ranges for the hematocrit and the blood hemoglobin concentration of newborn infants have previously been reported from relatively small sample sizes by using measurement methods that now are considered outmoded. We sought to develop reference ranges for hematocrit and hemoglobin during the neonatal period (28 days) by using very large sample sizes and modern hematology analyzers, accounting for gestational and postnatal age and gender. Data were assembled from a multihospital health care system after exclusion of patients with a high likelihood of an abnormal value and those who were receiving blood transfusions. During the interval from 22 to 40 weeks' gestation, the hematocrit and blood hemoglobin concentration increased approximately linearly. For every week advance in gestational age, the hematocrit increased by 0.64% and the hemoglobin concentration increased by 0.21 g/dL. No difference was seen on the basis of gender. During the 4-hour interval after birth, hematocrit/hemoglobin values of late preterm and term neonates (35-42 weeks' gestation) increased by 3.6% +/- 0.5% (mean +/- SD), those of neonates of 29 to 34 weeks' gestation remained unchanged, and those of hematocrit/hemoglobin occurred. The figures presented herein describe reference ranges for hematocrit and blood hemoglobin concentration during the neonatal period, accounting for gestational and postnatal age.

  9. Reward or its denial during the neonatal period affects adult spatial memory and hippocampal phosphorylated cAMP response element-binding protein levels of both the neonatal and adult rat.

    Science.gov (United States)

    Diamantopoulou, A; Stamatakis, A; Panagiotaropoulos, T; Stylianopoulou, F

    2011-05-05

    Early life experiences, particularly mother-infant interactions, have been shown to influence adult coping and learning abilities via gene-environment interactions. We have developed a paradigm, in which mother contact is used as either a positive or a negative reinforcer in a T-maze, during postnatal days 10-13. In both neonates receiving (RER) or denied (DER) the expected reward, exposure to the memory test in the absence of the mother resulted in a remarkable increase in the number of pCREB immunopositive cells, when compared to their corresponding levels 2 h after the completion of the training process, but also to the levels of naïve animals. In the CA3 area, the pattern of pCREB immunoreactivity, when evaluated 2 h after the completion of the training on postnatal day 13 seemed to distinguish between the two different neonatal experiences in the T-maze, with the DER pups showing higher levels of pCREB immunopositive cells than the RER. Exposure to the Morris Water Maze (MWM) during adulthood revealed a memory advantage of the DER animals compared to the RER and the animals not exposed to the neonatal experience. Relevantly, in the DER animals an increased number of pCREB immunopositive cells was observed in the CA3 area even 24 h after the end of MWM training. When also measured after exposure to the probe trial, the number of pCREB immunopositive cells was again higher in the DER compared to the RER animals. In conclusion, we show that a learning experience involving discrepancy during the particularly plastic neonatal period is able to induce long-term effects, which result in enhanced adult hippocampal dependent spatial memory. Furthermore, our data document a role of plasticity molecules like pCREB in mediating hippocampal dependent learning and detection of novelty not only in adulthood, but also more importantly in the neonatal period of the rat. Copyright © 2011 IBRO. Published by Elsevier Ltd. All rights reserved.

  10. Maternal and neonatal outcome in obstetric cholestasis: a comparison of early versus late term delivery

    International Nuclear Information System (INIS)

    Anjum, N.; Babar, N.; Sheikh, S.

    2015-01-01

    To evaluate maternal and neonatal outcome in Obstetric Cholestasis (OC) in early versus late term delivery. Study Design: Retrospective cohort study. Place and Duration of Study: Aga khan hospital for women (AKHW) Karimabad, Karachi, from 1st Jan, 2011 to 31st Oct, 2012. Patient and Methods: This was a retrospective cohort study. All patients of OC with singleton pregnancy, admitted for labor induction between Jan 2011 to Oct 2012 were included in the study. At or after 37 week of gestation, patient is offered labor induction. Patients were divided in two groups as in early term delivery (Group A) and late term delivery (Group B). Early term delivery is taken from 37+o to 37+6 and late term delivery at or after 38 weeks of gestation. The demographic, laboratory and clinical data of these patients were collected from their medical record. Maternal and neonatal outcome were analyzed using SPSS version 19. Results: The study found that in obstetric cholestasis patients admitted for labor induction, the risk of caesarean delivery was higher in group A (before 38 weeks) as compared to group B (after 38 weeks). There was no difference in postpartum hemorrhage and drop in hemoglobin between two groups. Obstetric cholestasis was not associated with adverse perinatal outcome such as intrauterine death (IUD), low Apgar Scores, respiratory distress and neonatal intensive care admission in both the groups. However more cases of neonatal jaundice were observed in babies born after 38 weeks. Conclusion: OC patients who deliver after 38 weeks of gestation have a higher chance of vaginal delivery without increasing the risk of IUD. (author)

  11. Zinc in Early Life: A Key Element in the Fetus and Preterm Neonate

    Science.gov (United States)

    Terrin, Gianluca; Berni Canani, Roberto; Di Chiara, Maria; Pietravalle, Andrea; Aleandri, Vincenzo; Conte, Francesca; De Curtis, Mario

    2015-01-01

    Zinc is a key element for growth and development. In this narrative review, we focus on the role of dietary zinc in early life (including embryo, fetus and preterm neonate), analyzing consequences of zinc deficiency and adequacy of current recommendations on dietary zinc. We performed a systematic search of articles on the role of zinc in early life. We selected and analyzed 81 studies. Results of this analysis showed that preservation of zinc balance is of critical importance for the avoidance of possible consequences of low zinc levels on pre- and post-natal life. Insufficient quantities of zinc during embryogenesis may influence the final phenotype of all organs. Maternal zinc restriction during pregnancy influences fetal growth, while adequate zinc supplementation during pregnancy may result in a reduction of the risk of preterm birth. Preterm neonates are at particular risk to develop zinc deficiency due to a combination of different factors: (i) low body stores due to reduced time for placental transfer of zinc; (ii) increased endogenous losses; and (iii) marginal intake. Early diagnosis of zinc deficiency, through the measurement of serum zinc concentrations, may be essential to avoid severe prenatal and postnatal consequences in these patients. Typical clinical manifestations of zinc deficiency are growth impairment and dermatitis. Increasing data suggest that moderate zinc deficiency may have significant subclinical effects, increasing the risk of several complications typical of preterm neonates (i.e., necrotizing enterocolitis, chronic lung disease, and retinopathy), and that current recommended intakes should be revised to meet zinc requirements of extremely preterm neonates. Future studies evaluating the adequacy of current recommendations are advocated. PMID:26690476

  12. Early BCG-Denmark and Neonatal Mortality Among Infants Weighing <2500 g: A Randomized Controlled Trial

    DEFF Research Database (Denmark)

    Biering-Sørensen, Sofie; Aaby, Peter; Lund, Najaaraq

    2017-01-01

    ratios (MRRs). We had prespecified an analysis censoring follow-up at oral poliovirus vaccine campaigns. Results. Early administration of BCG-Denmark was associated with a nonsignificant reduction in neonatal mortality rate (MRR, 0.70; 95% confidence interval [CI], .47–1.04) and a 34% reduction (0.......66; .44–1.00) when censoring for oral poliovirus vaccine campaigns. There was no reduction in mortality rate for noninfectious diseases, but a 43% reduction in infectious disease mortality rate (MRR, 0.57; 95% CI, .35–.93). A meta-analysis of 3 BCG trials showed that early BCG-Denmark reduced mortality...

  13. Early release of neonatal ureteral obstruction preserves renal function

    DEFF Research Database (Denmark)

    Shi, Yimin; Pedersen, Michael; Li, Chunling

    2004-01-01

    was left in place or released after 1 or 4 wk. Renal blood flow (RBF) and kidney size were measured sequentially over 24 wk using MRI. In rats in which the obstruction was left in place, RBF of the obstructed kidney was progressively reduced to 0.92 ± 0.17 vs. 1.79 ± 0.12 ml·min−1·100 g body wt−1 (P ...The incidence of congenital hydronephrosis is ∼1% and is often associated with renal insufficiency. It is unknown whether early release is essential to prevent deterioration of renal function. Rats were subjected to partial unilateral ureteral obstruction (PUUO) on postnatal day 2. The obstruction...... downregulation of Na-K-ATPase to 62 ± 7%, aquaporin-1 to 53 ± 3%, and aquaporin-3 to 53 ± 7% of sham levels. Release after 1 wk completely prevented development of hydronephrosis, reduction in RBF and glomerular filtration rate, and downregulation of renal transport proteins, whereas release after 4 wk had...

  14. Neonatal morbidity and early outcome of very preterm infants

    Directory of Open Access Journals (Sweden)

    Heljić Suada

    2013-03-01

    Full Text Available Background: Although the mortality rate for preterm infants and the gestational age-specific mortality rate have dramatically improved over the last 3 to 4 decades, infants born preterm remain vulnerable to many complications, including respiratory distress syndrome, chronic lung disease, necrotizing enterocolitis, a compromised immune system, cardiovascular disorders, hearing and vision problems, and brain lesions. The aim is to determine mortality and morbidity rates and selected outcome variables for preterm infant’s grade 3 IVH or PVL 16.6%, NEC Bell stages II or III 9.8%, BPD 25/72 (33.3% of infants who survived to 36 weeks postmenstrual age. In 38 (37.2% infants, episodes of infections were noticed (one or more episodes in 25 infants, half of them were caused by Gram positive bacteria, most frequent coagulasa negative staphylococci. Klebsiella pneumoniae was the most frequent organism among Gram negative bacteria. One patient had invasive candidiasis caused by Candida albicans. In 5 infants (4.9% early onset of sepsis was documented. Conclusion: Very preterm infants remain very vulnerable group of population, and interventions to reduce the morbidity and mortality of preterm babies include tertiary interventions such as regionalized care, transportation in uterus, and treatment with antenatal steroids.

  15. Early biometric lag in the prediction of small for gestational age neonates and preeclampsia.

    Science.gov (United States)

    Schwartz, Nadav; Pessel, Cara; Coletta, Jaclyn; Krieger, Abba M; Timor-Tritsch, Ilan E

    2011-01-01

    An early fetal growth lag may be a marker of future complications. We sought to determine the utility of early biometric variables in predicting adverse pregnancy outcomes. In this retrospective cohort study, the crown-rump length at 11 to 14 weeks and the head circumference, biparietal diameter, abdominal circumference, femur length, humerus length, transverse cerebellar diameter, and estimated fetal weight at 18 to 24 weeks were converted to an estimated gestational age using published regression formulas. Sonographic fetal growth (difference between each biometric gestational age and the crown-rump length gestational age) minus expected fetal growth (number of days elapsed between the two scans) yielded the biometric growth lag. These lags were tested as predictors of small for gestational age (SGA) neonates (≤10th percentile) and preeclampsia. A total of 245 patients were included. Thirty-two (13.1%) delivered an SGA neonate, and 43 (17.6%) had the composite outcome. The head circumference, biparietal diameter, abdominal circumference, and estimated fetal weight lags were identified as significant predictors of SGA neonates after adjusted analyses (P biometric lag variables and the development of preeclampsia. Routinely available biometric data can be used to improve the prediction of adverse outcomes such as SGA. These biometric lags should be considered in efforts to develop screening algorithms for adverse outcomes.

  16. Gardens, knowledge and the sciences in the early modern period

    CERN Document Server

    Remmert, Volker; Wolschke-Bulmahn, Joachim

    2016-01-01

    This volume focuses on the outstanding contributions made by botany and the mathematical sciences to the genesis and development of early modern garden art and garden culture. The many facets of the mathematical sciences and botany point to the increasingly “scientific” approach that was being adopted in and applied to garden art and garden culture in the early modern period. This development was deeply embedded in the philosophical, religious, political, cultural and social contexts, running parallel to the beginning of processes of scientization so characteristic for modern European history. This volume strikingly shows how these various developments are intertwined in gardens for various purposes.

  17. Severe combined immunodeficiency (SCID) presenting with neonatal aplastic anemia.

    Science.gov (United States)

    Scott, Angela; Glover, Jason; Skoda-Smith, Suzanne; Torgerson, Troy R; Xu, Min; Burroughs, Lauri M; Woolfrey, Ann E; Fleming, Mark D; Shimamura, Akiko

    2015-11-01

    Aplastic anemia in the neonate is rare. We report a case of severe combined immunodeficiency (SCID) presenting with neonatal aplastic anemia. This report highlights the importance of considering SCID early in the evaluation of neonatal aplastic anemia prior to the development of infectious complications. © 2015 Wiley Periodicals, Inc.

  18. Prevalence of neonatal septicaemia in the University of Port ...

    African Journals Online (AJOL)

    Background : Septicaemia is a major cause of morbidity and mortality in the neonatal period. Early detection of neonatal septicaemia is often hampered by its subtle and nonspecific symptoms and signs thus a high index of suspicion is needed. Objectives: To determine the prevalence of neonatal sept ic a emia , ident i fy ...

  19. Early mortality after neonatal surgery: analysis of risk factors in an optimized health care system for the surgical newborn

    Directory of Open Access Journals (Sweden)

    Dora Catré

    2013-12-01

    Full Text Available OBJECTIVE: Anesthetic and operative interventions in neonates remain hazardous procedures, given the vulnerability of the patients in this pediatric population. The aim was to determine the preoperative and intraoperative factors associated with 30-day post-operative mortality and describe mortality outcomes following neonatal surgery under general anesthesia in our center. METHODS: Infants less than 28 days of age who underwent general anesthesia for surgery during an 11-year period (2000 - 2010 in our tertiary care pediatric center were retrospectively identified using the pediatric intensive care unit database. Multiple logistic regression was used to identify independent preoperative and intraoperative factors associated with 30-day post-operative mortality. RESULTS: Of the 437 infants in the study (median gestational age at birth 37 weeks, median birth weight 2,760 grams, 28 (6.4% patients died before hospital discharge. Of these, 22 patients died within the first post-operative month. Logistic regression analysis showed increased odds of 30-day post-operative mortality among patients who presented American Society of Anesthesiologists physical status (ASA score 3 or above (odds ratio 19.268; 95%CI 2.523 - 147.132 and surgery for necrotizing enterocolitis/gastrointestinal perforation (OR 5.291; 95%CI 1.962 - 14.266, compared to those who did not. CONCLUSION: The overall in-hospital mortality of 6.4% is within the prevalence reported for developed countries. Establishing ASA score 3 or above and necrotizing enterocolitis/gastrointestinal perforation as independent risk factors for early mortality in neonatal surgery may help clinicians to more adequately manage this high risk population.

  20. Causes of death among full term stillbirths and early neonatal deaths in the Region of Southern Denmark

    DEFF Research Database (Denmark)

    Basu, Millie; Johnsen, Iben Birgit Gade; Wehberg, Sonja

    2018-01-01

    OBJECTIVE: We examined the causes of death amongst full term stillbirths and early neonatal deaths. METHODS: Our cohort includes women in the Region of Southern Denmark, who gave birth at full term to a stillborn infant or a neonate who died within the first 7 days from 2010 through 2014. Demogra......OBJECTIVE: We examined the causes of death amongst full term stillbirths and early neonatal deaths. METHODS: Our cohort includes women in the Region of Southern Denmark, who gave birth at full term to a stillborn infant or a neonate who died within the first 7 days from 2010 through 2014....... Demographic, biometric and clinical variables were analyzed to assess the causes of death using two classification systems: causes of death and associated conditions (CODAC) and a Danish system based on initial causes of fetal death (INCODE). RESULTS: A total of 95 maternal-infant cases were included. Using...

  1. Lactate as an early predictor of psychomotor development in neonates with asphyxia receiving therapeutic hypothermia.

    Science.gov (United States)

    Polackova, Renata; Salounova, Dana; Kantor, Lumir

    2017-12-04

    This prospective study aimed to evaluate the relationship between persistently elevated lactate values in the arterial blood of newborns with grade II and III hypoxic ischemic encephalopathy (treated with therapeutic hypothermia) and psychomotor development at 24 months. 51 neonates of gestational age from 36 to 41 weeks receiving therapeutic hypothermia for moderate to severe hypoxic ischaemic encephalopathy had arterial blood lactate levels regularly analysed. At 24 months the infants' psychomotor development was evaluated and they were divided into two groups - those where the outcome was favourable (i.e. normal psychomotor development) and adverse (severe motor or sensory impairment or death). The lactate dynamics over time were retrospectively evaluated from the data collected, with the normal upper limit set at 4 mmol/L. Of the 51 affected neonates, 7 died over the course of the study. 34 of the remaining 44 infants demonstrated normal psychomotor findings at 2 years old, with adverse findings in 10 cases. Although both groups experienced significant reductions in lactate over time, there were statistically significant differences between them regarding currently measured lactate levels. Absolute lactate values and their development over time can be a used as an auxiliary factor in making early estimates of the long-term outcome for newborns with neonatal asphyxia being treated with therapeutic hypothermia.

  2. Clinical case of using discrete plasmapheresis in infant with early neonatal sepsis and hemolytic disease

    Directory of Open Access Journals (Sweden)

    S. V. Aborin

    2017-01-01

    Full Text Available Currently in the literature there are insufficient data on the use of efferent hemocorrection methods in neonatal practice. The basic principle of this method is the removal of plasma containing endotoxins and exotoxins and other pathological substances, replacing it with donor plasma, colloid and crystalloid solutions. The therapeutic effect of plasmapheresis includes detoxification, anti-inflammatory and immunomodulatory effects by removing toxins and removal of circulating immune complexes, inflammatory mediators, and activated structures of the complement system. Discrete plasmapheresis in neonatal practice may be used in any body mass of the patient. This article describes a clinical case of successful application of discrete plasmapheresis in full-term newborn baby is in critical condition. The severity was due to severe early neonatal sepsis, development of multiple organ failure and accompanying RH-conflict. After two sessions of plasmapheresis was observed a positive clinical effect in reducing intoxication, systemic inflammatory response syndrome. Reducing the level of bilirubin is allowed to avoid the operation replacement blood transfusion.

  3. Development of left ventricular longitudinal speckle tracking echocardiography in very low birth weight infants with and without bronchopulmonary dysplasia during the neonatal period.

    Directory of Open Access Journals (Sweden)

    Christoph Czernik

    Full Text Available OBJECTIVES: In preterm infants, postnatal myocardial adaptation may be complicated by bronchopulmonary dysplasia (BPD. We aimed to describe the development of left ventricular function by serial 2D, Doppler, and speckle tracking echocardiography (2D-STE in infants with and without BPD during the neonatal period and compare these to anthropometric and conventional hemodynamic parameters. STUDY DESIGN: Prospective echocardiography on day of life (DOL 1, 7, 14, and 28 in 119 preterm infants 10% were seen for the apical segment. While anthropometric parameters show rapid development during the first 4 weeks of life, the speckle tracking parameters did not differ statistically significantly during the neonatal period. Infants with and without BPD differed significantly (p<0.001 in the development of anthropometric parameters, conventional hemodynamic parameters except for heart rate, and 2D-STE parameters: global longitudinal systolic strain rate (GLSSR and longitudinal systolic strain for the mid left wall (LSSR. The largest differences were seen at DOL 1 and 7 in GLSSR (p<0.001 and in LSSR (p<0.01. CONCLUSIONS: Reproducible 2D-STE measurements are possible in preterm infants <1500 g. Cardiac deformation reveals early (DOL 1 and 7 ventricular changes (GLSSR and LSSR in very low birth weight infants who develop BPD.

  4. Renal excretion of water-soluble contrast media after enema in the neonatal period.

    Science.gov (United States)

    Kim, Hee Sun; Je, Bo-Kyung; Cha, Sang Hoon; Choi, Byung Min; Lee, Ki Yeol; Lee, Seung Hwa

    2014-08-01

    When abdominal distention occurs or bowel obstruction is suspected in the neonatal period, a water-soluble contrast enema is helpful for diagnostic and therapeutic purposes. The water-soluble contrast medium is evacuated through the anus as well as excreted via the kidneys in some babies. This study was designed to evaluate the incidence of renal excretion after enemas using water-soluble contrast media and presume the causes. Contrast enemas using diluted water-soluble contrast media were performed in 23 patients under 2 months of age. After the enema, patients were followed with simple abdominal radiographs to assess the improvement in bowel distention, and we could also detect the presence of renal excretion of contrast media on the radiographs. Reviewing the medical records and imaging studies, including enemas and consecutive abdominal radiographs, we evaluated the incidence of renal excretion of water-soluble contrast media and counted the stay duration of contrast media in urinary tract, bladder, and colon. Among 23 patients, 12 patients (52%) experienced the renal excretion of water-soluble contrast media. In these patients, stay-in-bladder durations of contrast media were 1-3 days and stay-in-colon durations of contrast media were 1-10 days, while stay-in-colon durations of contrast media were 1-3 days in the patients not showing renal excretion of contrast media. The Mann-Whitney test for stay-in-colon durations demonstrated the later evacuation of contrast media in the patients with renal excretion of contrast media (p = 0.07). The review of the medical records showed that 19 patients were finally diagnosed as intestinal diseases, including Hirschsprung's disease, meconium ileum, meconium plug syndrome, and small bowel atresia or stenosis. Fisher's exact test between the presence of urinary excretion and intestinal diseases indicated a statistically significant difference (p = 0.04). The intestinal diseases causing bowel obstruction may increase the

  5. Home-based Care Needs of Preterm Infants Discharged Early from the Neonatal Intensive Care Unit: A Descriptive Qualitative Study

    Directory of Open Access Journals (Sweden)

    Mahboobeh Namnabati

    2017-12-01

    Conclusion: The enhancement of the nurses' knowledge about the needs of the preterm neonates with early discharge would result in the improvement of their abilities in the relevant domain. Accordingly, these nurses could help the mothers to prevent the incidence of several complications in the neonates, such as readmissions to the NICU. More importantly, these measures could prevent from the consequences of failure to fulfil these needs emerging in the later stages of life.

  6. Congenital abnormalities of aortic artery. Assessment in neonates and early childhood with multislice tomography

    International Nuclear Information System (INIS)

    Haberman, D.; Gurfinkel, E.; Beresnak, A.; Martinez, A.; Emsani, R.; Toledo, R.

    2009-01-01

    In the evaluation of aortic artery congenital abnormalities, the echocardiography and the plain X ray are the traditionally used imaging methods. Multislice angiotomography appears as an important method in diagnosis of these different diseases allowing evaluate these entities in a non invasive, fast and accurate form, giving to cardiovascular surgeons very important information to delineate the surgical strategy. In this article, we review the applications of multislice angiotomography in the evaluation of most frequent congenital anomalies of aorta artery, performed in neonates and early childhood. (authors) [es

  7. Early oral-motor management on feeding performance in premature neonates

    Directory of Open Access Journals (Sweden)

    Yan-Lin Liu

    2013-03-01

    Conclusion: Abnormal brain sonography [odds ratio (OR: 2.222, p = 0.047 and necrotizing enterocolitis (NEC (OR: 2.857, p = 0.017 did affect the first trial in the study group. Early intervention of oral-motor management in very-low-birth-weight premature infants improved feeding performance and neonatal outcome in terms of shorter hospital days. Abnormal brain image and NEC could interfere with the success rate of initial challenge of transitioning from tube to oral feeding in the study group.

  8. Nutritional Transition Period in Early Larvae Clarias Gariepinus

    International Nuclear Information System (INIS)

    Ing, N.S.; Chew, H.H.

    2015-01-01

    The nutritional transition period of Clarias gariepinus were described based on the early development from hatching to 120 hours after hatching (hAH) reared at 27.5 - 28.6 degree Celsius. Newly hatched larvae had a large greenish yolk sac volume (0.99 ± 0.31 mm"3) located below a straight undeveloped digestive tract, mouth not opened, eyes unpigmented and the larvae lie on the bottom of rearing tank. During endogenous feeding period, the larval feeding system has developed rapidly with development oesophagus. Yolk sac were not completely depleted at the onset of exogenous feeding (36 hAH, 0.19 ± 0.11 mm"3), and a period of mixed nutrition was observed up to 68 hAH when yolk was completely exhausted. Yolk sac volume was significantly different by time at hatching, 6, 12 and 18 to 36 hAH (ANOVA, P<0.05). At 36 hAH, the larvae commenced feeding once morphologically developed with opened anus, functional jaw and intestine, and demonstrated horizontally swimming. The rudimentary chemoreceptors like olfactory organs and taste buds that were found on the barbels and oral cavity assisted in food detection and commenced feeding without vision. Due to the cannibalistic behaviour at early stage, feed are suggested to be provided during 36 hAH and avoided delay feeding in the larval rearing. (author)

  9. Association Between Early Caffeine Citrate Administration and Risk of Acute Kidney Injury in Preterm Neonates: Results From the AWAKEN Study.

    Science.gov (United States)

    Harer, Matthew W; Askenazi, David J; Boohaker, Louis J; Carmody, J Bryan; Griffin, Russell L; Guillet, Ronnie; Selewski, David T; Swanson, Jonathan R; Charlton, Jennifer R

    2018-04-02

    caffeine remained associated with reduced odds of developing AKI (adjusted odds ratio, 0.20; 95% CI, 0.11-0.34), indicating that for every 4.3 neonates exposed to caffeine one case of AKI was prevented. Among neonates with early AKI, those receiving caffeine were less likely to develop stage 2 or 3 AKI (adjusted odds ratio, 0.20; 95% CI, 0.12-0.34). Caffeine administration in preterm neonates is associated with reduced incidence and severity of AKI. Further studies should focus on the timing and dosage of caffeine to optimize the prevention of AKI.

  10. Epidural analgesia during labor: impact on delivery outcome, neonatal well-being, and early breastfeeding.

    Science.gov (United States)

    Gizzo, Salvatore; Di Gangi, Stefania; Saccardi, Carlo; Patrelli, Tito Silvio; Paccagnella, Gianluca; Sansone, Laura; Barbara, Favaron; D'Antona, Donato; Nardelli, Giovanni Battista

    2012-08-01

    The effect of epidural analgesia on labor and effective breastfeeding is still being debated. The aim of this study is to define its impact on the trend of labor, the newborns' well-being, and early breastfeeding. We considered first-term physiologic pregnant women who delivered by the vaginal route. We divided them into two groups: group A received epidural analgesia during labor, whereas group B received no analgesia. We recorded maternal age, gestational age, modality of delivery, length of labor, and length of active labor. All newborns received skin-to-skin contact; early breastfeeding was encouraged. We recorded data on birth weight and length, Apgar score at minutes 1 and 5, type of crying, neonatal reactivity, and time between birth and exposure to the breast. Statistical significance was considered for panalgesia, and 245 patients agreed to participate in our study. Only 128 patients met inclusion criteria. We randomized them in 64 women in group A and 64 women in group B. Data on maternal age, gestational age, type of delivery, neonatal birth weight and length, and Apgar score showed no significant differences. Total length of labor was 363.58±62.20 minutes in Group A versus 292.30±64.75 minutes in group B (pneonatal parameters we found a statistically significant difference only for length of first breastfeeding, with a mean duration of analgesia has little effect on trend of labor and duration of first breastfeed and none on neonatal outcome. A new protocol of epidural analgesia may solve these side effects.

  11. Barriers to implementing the NICE guidelines for early-onset neonatal infection: cross-sectional survey of neonatal blood culture reporting by laboratories in the UK.

    Science.gov (United States)

    Paul, S P; Caplan, E M; Morgan, H A; Turner, P C

    2018-04-01

    The National Institute for Health and Care Excellence published guidelines for managing early-onset neonatal infections in 2012. It recommended provision for reporting blood cultures (BCs) with growth detected or not detected at 36 h. To determine if this was followed, a telephone survey was conducted amongst lead biomedical scientists based at microbiology laboratories (N = 209) in the UK. Overall, 202/209 responded and 139/202 had on-site facilities for BCs. BC results with growth detected or not detected at 36 h were available out-of-hours in 36/139 (26.6%) and 66/139 (47.5%) neonatal units, respectively. Early discontinuation of antibiotics should lead to improved antibiotic stewardship. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  12. [Acute pyelonephritis in the neonatal period] [Article in Italian] • Pielonefrite acuta in epoca neonatale

    OpenAIRE

    Giovanni Ottonello; Angelica Dessì; Danila Manus; Anna Paola Pinna; Fabiana Sau; Vassilios Fanos

    2014-01-01

    Urinary tract infections (UTIs) represent one of the most common pathological conditions in children. It is estimated that even in the countries with the most advanced health care programmes, such as the United States and Europe, UTIs represent the most common serious infections in pediatrics. In the earliest stages of life, UTIs represent the most common febrile illness, although the non specific clinical presentation often leads to diagnostic underestimation. Neonatal UTIs surely represent...

  13. Early treatment with the von Rosen splint for neonatal instability of the hip is safe regarding avascular necrosis of the femoral head

    Science.gov (United States)

    Wenger, Daniel; Samuelsson, Hanna; Düppe, Henrik; Tiderius, Carl Johan

    2016-01-01

    Background and purpose — Avascular necrosis of the femoral head (AVN) is a complication in treatment of developmental dysplasia of the hip (DDH). We evaluated the risk of AVN after early treatment in the von Rosen splint and measured the diameter of the ossific nucleus at 1 year of age. Children and methods — All children born in Malmö, Sweden, undergo clinical screening for neonatal instability of the hip (NIH). We reviewed 1-year radiographs of all children treated early for NIH in our department from 2003 through 2010. The diameter of the ossific nucleus was measured, and signs of AVN were classified according to Kalamchi-MacEwen. Subsequent radiographs, taken for any reason, were reviewed and a local registry of diagnoses was used to identify subsequent AVN. Results — 229 of 586 children referred because of suspected NIH received early treatment (age ≤ 1 week) for NIH during the study period. 2 of the 229 treated children (0.9%, 95% CI: 0.1–3.1) had grade-1 AVN. Both had spontaneous resolution and were asymptomatic during the observation time (6 and 8 years). 466 children met the inclusion criteria for measurement of the ossific nucleus. Neonatally dislocated hips had significantly smaller ossific nuclei than neonatally stable hips: mean 9.4 mm (95% CI: 9.1–9.8) vs. 11.1 mm (95% CI: 10.9–11.3) at 1 year (p < 0.001). Interpretation — Early treatment with the von Rosen splint for NIH is safe regarding AVN. The ossification of the femoral head is slower in children with NIH than in untreated children with neonatally stable hips. PMID:26730503

  14. [Hospitals and other philanthropic foundations in early Byzantine period].

    Science.gov (United States)

    Yildirim, R Vedat; Ataç, Adnan

    Early Byzantine Period includes between A.D. 330 when Constantinople was established and A.D. 518 when Justinus I became emperor. In this time period, a lot of philanthropic foundations such as hospitals, hospices, orphanages, rest homes and soup kitchens are established. Many of patriarchs and religious men opened them. In some of them, it refers to there was patients' care. The oldest hospital in Constantinople was established by Hasios Marcianos, and was next to Saint Irene Church. In addition to this Empress Flacilla wife of Theodosius the Great made hospitals restored and visited patients regularly. Hospitals were not limited in the center of Empire. Hospitals and other philanthropic foundations were established in Antiochia, Alexandria, Nikea, Adrianopolis, Castoria and Jerusalem. The concept of the modern hospital (the actual care, 'hospitality' and treatment of visitors) for the civilian masses in Europe didn't come to fruition until post Constantine and the rise of Christianity. While these early Christian hospitals were grossly over their heads regarding medical capability (they essentially served as last stops for the dying or quarantine centers), the concept of providing care to the public was the actual intent. In this regard, the first civilian hospitals were developed.

  15. Impact of Early Versus Late Diuretic Exposure on Metabolic Bone Disease and Growth in Premature Neonates.

    Science.gov (United States)

    Orth, Lucas E; O'Mara, Keliana L

    2018-01-01

    This study aimed to determine whether there are differences in the incidence of metabolic bone disease (MBD) between preterm neonates first exposed to diuretics prior to 2 weeks of life versus those exposed after 2 weeks. This study was a retrospective analysis of premature neonates born at a tertiary care center between 2011 and 2015 who received either furosemide or chlorothiazide. The primary outcome was incidence of MBD. Secondary outcomes included growth, electrolyte disturbances, oxygen requirement, and length of stay. A total of 147 patients were included. Early initiation (n = 90) and late initiation (n = 57) arms were balanced with respect to birth weight and gestational age. There was no difference in incidence of MBD in the early group (76%) versus the late group (65%; p = 0.164). Stratification by cumulative dose showed incidence of 85% in patients receiving ≥8 mg/kg of furosemide, compared with 68% and 64% of those in the <4 mg/kg and 4 to 7.9 mg/kg strata, respectively (p = 0.06). The early group experienced greater reductions in length-for-age growth during diuretic therapy (-70% versus -40%; p = 0.009). Electrolyte abnormalities were more prevalent in the early group. Although there was no difference in duration of mechanical ventilation, duration of supplemental oxygen requirement was reduced in the late group (75 versus 89 days; p = 0.003). Timing of diuretic initiation did not affect incidence of MBD. Increased cumulative furosemide exposure may be associated with higher incidence. Patients first exposed to diuretics within 2 weeks of life are at higher risk for electrolyte abnormalities and reduced growth velocity.

  16. Evaluation of serum chemokine RANTES concentration as a biomarker in the diagnosis of early-onset severe infections in neonates

    Directory of Open Access Journals (Sweden)

    Małgorzata Stojewska

    2016-04-01

    Full Text Available Objective: Only a few studies on improving the early diagnosis of severe neonatal infections have focused on the role of serum RANTES concentration (sRC. The aim of the study was to establish sRC in neonates with early-onset infections, according to their gestational age, sex, birth asphyxia, mode of delivery and value of some biochemical and hematological parameters.Material/Methods: The analysis comprised 129 neonates, including 89 infected (52 preterm, 37 full-term; 43 with sepsis, 39 with congenital pneumonia, 7 with severe urinary tract infection and 40 healthy (control group, 25 full-term, 15 preterm. The sRC in peripheral vein blood was measured by the ELISA method using Quantikine Set (R & D systems, USA.Results: The sRC in infected neonates ranged from 10.83 to 122.55 μg/ml, in full-term neonates from 18.28 to 122.55 μg/ml, and in preterm from 10.83 to 118.24 μg/ml. The mean sRCs in full-term septic neonates (73.95±25.99 μg/ml and with organ infections (58.43±29.24 μg/ml were significantly higher than healthy ones (28.25±14.06 μg/ml. The mean sRCs in septic preterm neonates (59.17±28.29 μg/ml and those with organ infections (50.86±28.16 were significantly higher than in healthy preterm neonates (25.61±8.29 μg/ml. Positive correlations between sRC and CRP value (r=0.3014, p=0.004 and between sRC and band cell count (r=0.2489, p=0.019 were found in all infected neonates. Conclusion. The significant increase of serum RANTES concentration in early-onset infections in neonates, regardless of their gestational age, sex and birth asphyxia, not only proves the presence of an active immunological process but also may be a useful biomarker for diagnosis of severe neonatal infections.

  17. Repeated touch and needle-prick stimulation in the neonatal period increases the baseline mechanical sensitivity and postinjury hypersensitivity of adult spinal sensory neurons.

    Science.gov (United States)

    van den Hoogen, Nynke J; Patijn, Jacob; Tibboel, Dick; Joosten, Bert A; Fitzgerald, Maria; Kwok, Charlie H T

    2018-03-08

    Noxious stimulation at critical stages of development has long-term consequences on somatosensory processing in later life, but it is not known whether this developmental plasticity is restricted to nociceptive pathways. Here, we investigate the effect of repeated neonatal noxious or innocuous hind paw stimulation on adult spinal dorsal horn cutaneous mechanical sensitivity. Neonatal Sprague-Dawley rats of both sexes received 4 unilateral left hind paw needle pricks (NPs, n = 13) or 4 tactile (cotton swab touch) stimuli, per day (TC, n = 11) for the first 7 days of life. Control pups were left undisturbed (n = 17). When adult (6-8 weeks), lumbar wide-dynamic-range neuron activity in laminae III-V was recorded using in vivo extracellular single-unit electrophysiology. Spike activity evoked by cutaneous dynamic tactile (brush), pinch and punctate (von Frey hair) stimulation, and plantar receptive field areas were recorded, at baseline and 2 and 5 days after left plantar hind paw incision. Baseline brush receptive fields, von Frey hair, and pinch sensitivity were significantly enhanced in adult NP and TC animals compared with undisturbed controls, although effects were greatest in NP rats. After incision, injury sensitivity of adult wide-dynamic-range neurons to both noxious and dynamic tactile hypersensitivity was significantly greater in NP animals compared with TC and undisturbed controls. We conclude that both repeated touch and needle-prick stimulation in the neonatal period can alter adult spinal sensory neuron sensitivity to both innocuous and noxious mechanical stimulation. Thus, spinal sensory circuits underlying touch and pain processing are shaped by a range of early-life somatosensory experiences.This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  18. They Are What You Eat: Can Nutritional Factors during Gestation and Early Infancy Modulate the Neonatal Immune Response?

    Directory of Open Access Journals (Sweden)

    Sarah Prentice

    2017-11-01

    Full Text Available The ontogeny of the human immune system is sensitive to nutrition even in the very early embryo, with both deficiency and excess of macro- and micronutrients being potentially detrimental. Neonates are particularly vulnerable to infectious disease due to the immaturity of the immune system and modulation of nutritional immunity may play a role in this sensitivity. This review examines whether nutrition around the time of conception, throughout pregnancy, and in early neonatal life may impact on the developing infant immune system.

  19. Automatic segmentation of the hippocampus for preterm neonates from early-in-life to term-equivalent age

    Directory of Open Access Journals (Sweden)

    Ting Guo

    2015-01-01

    Conclusions: MAGeT-Brain is capable of segmenting hippocampi accurately in preterm neonates, even at early-in-life. Hippocampal asymmetry with a larger right side is demonstrated on early-in-life images, suggesting that this phenomenon has its onset in the 3rd trimester of gestation. Hippocampal volume assessed at the time of early-in-life and term-equivalent age is linearly associated with GA at birth, whereby smaller volumes are associated with earlier birth.

  20. Proliferation during early phases of bronchiolar repair in neonatal rabbits following lung injury by 4-ipomeanol

    International Nuclear Information System (INIS)

    Smiley-Jewell, Suzette M.; Plopper, Charles G.

    2003-01-01

    Nonciliated bronchiolar (Clara cells) are progenitor cells during development. During differentiation, they are more susceptible to injury by environmental toxicants metabolized by the cytochrome P450 monooxygenase system, and injury results in altered bronchiolar repair and development. Squamous cells and abnormal cuboidal epithelium persist into early adulthood. The hypothesis tested in this study was that the failure of bronchiolar epithelium to repair normally in neonates following injury is due to an inhibition of proliferation. A model of differential repair in rabbit kits was used. Proliferation was followed for 1 week post injury in rabbit kits treated with a single dose of the P450-mediated cytotoxicant 4-ipomeanol (IPO) at 7 days old (repair abnormal) and compared to rabbits treated with a single dose of IPO at 21 days old (repair normal). Proliferation was measured by the nuclear incorporation of 5-chloro-2'-deoxyuridine (CldU) within epithelium at the target site (terminal bronchiole). The repair pattern between the two age groups was histologically defined. There was no difference in the CdlU labeling index during the week of repair between the two age groups, even though the bronchiolar epithelium did not return to normal in the animals treated at 7 days old. In summary, proliferation (through S-phase) is not inhibited during repair in neonatal rabbits treated with IPO at 7 days old compared to animals treated at 21 days old, and we conclude that other factors may be responsible for the altered repair in the young neonates injured by a P450-mediated cytotoxicant

  1. Reliability of Early Magnetic Resonance Imaging (MRI) and Necessity of Repeating MRI in Noncooled and Cooled Infants With Neonatal Encephalopathy.

    Science.gov (United States)

    Chakkarapani, Elavazhagan; Poskitt, Kenneth J; Miller, Steven P; Zwicker, Jill G; Xu, Qi; Wong, Darren S T; Roland, Elke H; Hill, Alan; Chau, Vann

    2016-04-01

    In cooled newborns with encephalopathy, although late magnetic resonance imaging (MRI) scan (10-14 days of age) is reliable in predicting long-term outcome, it is unknown whether early scan (3-6 days of life) is. We compared the predominant pattern and extent of lesion between early and late MRI in 89 term neonates with neonatal encephalopathy. Forty-three neonates (48%) were cooled. The predominant pattern of lesions and the extent of lesion in the watershed region agreed near perfectly in noncooled (kappa = 0.94; k = 0.88) and cooled (k = 0.89; k = 0.87) infants respectively. There was perfect agreement in the extent of lesion in the basal nuclei in noncooled infants (k = 0.83) and excellent agreement in cooled infants (k = 0.67). Changes in extent of lesions on late MRI occurred in 19 of 89 infants, with higher risk in infants with hypoglycemia and moderate-severe lesions in basal nuclei. In most term neonates with neonatal encephalopathy, early MRI (relative to late scan) robustly predicts the predominant pattern and extent of injury. © The Author(s) 2015.

  2. Early and total neonatal mortality in relation to birth setting in the United States, 2006-2009.

    Science.gov (United States)

    Grünebaum, Amos; McCullough, Laurence B; Sapra, Katherine J; Brent, Robert L; Levene, Malcolm I; Arabin, Birgit; Chervenak, Frank A

    2014-10-01

    We examined neonatal mortality in relation to birth settings and birth attendants in the United States from 2006 through 2009. Data from the Centers for Disease Control and Prevention-linked birth and infant death dataset in the United States from 2006 through 2009 were used to assess early and total neonatal mortality for singleton, vertex, and term births without congenital malformations delivered by midwives and physicians in the hospital and midwives and others out of the hospital. Deliveries by hospital midwives served as the reference. Midwife home births had a significantly higher total neonatal mortality risk than deliveries by hospital midwives (1.26 per 1000 births; relative risk [RR], 3.87 vs 0.32 per 1000; P home births of 41 weeks or longer (1.84 per 1000; RR, 6.76 vs 0.27 per 1000; P home births of women with a first birth (2.19 per 1000; RR, 6.74 vs 0.33 per 1000; P home births, neonatal mortality for first births was twice that of subsequent births (2.19 vs 0.96 per 1000; P home births compared with midwife hospital births was 9.32 per 10,000 births, and the excess early neonatal mortality was 7.89 per 10,000 births. Our study shows a significantly increased total and early neonatal mortality for home births and even higher risks for women of 41 weeks or longer and women having a first birth. These significantly increased risks of neonatal mortality in home births must be disclosed by all obstetric practitioners to all pregnant women who express an interest in such births. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Early hybrid approach and enteral feeding algorithm could reduce the incidence of necrotising enterocolitis in neonates with ductus-dependent systemic circulation.

    Science.gov (United States)

    Manuri, Lucia; Morelli, Stefano; Agati, Salvatore; Saitta, Michele B; Oreto, Lilia; Mandraffino, Giuseppe; Iannace, Enrico; Iorio, Fiore S; Guccione, Paolo

    2017-01-01

    The reported incidence of necrotising enterocolitis in neonates with complex CHD with ductus-dependent systemic circulation ranges from 6.8 to 13% despite surgical treatment; the overall mortality is between 25 and 97%. The incidence of gastrointestinal complications after hybrid palliation for neonates with ductus-dependent systemic circulation still has to be defined, but seems comparable with that following the Norwood procedure. We reviewed the incidence of gastrointestinal complications in a series of 42 consecutive neonates with ductus-dependent systemic circulation, who received early hybrid palliation associated with a standardised feeding protocol. The median age and birth weight at the time of surgery were 3 days (with a range from 1 to 10 days) and 3.07 kg (with a range from 1.5 to 4.5 kg), respectively. The median ICU length of stay was 7 days (1-70 days), and the median hospital length of stay was 16 days (6-70 days). The median duration of mechanical ventilation was 3 days. Hospital mortality was 16% (7/42). In the postoperative period, 26% of patients were subjected to early extubation, and all of them received treatment with systemic vasodilatory agents. Feeding was started 6 hours after extubation according to a dedicated feeding protocol. After treatment, none of our patients experienced any grade of necrotising enterocolitis or major gastrointestinal adverse events. Our experience indicates that the combination of an "early hybrid approach", systemic vasodilator therapy, and dedicated feeding protocol adherence could reduce the incidence of gastrointestinal complications in this group of neonates. Fast weaning from ventilatory support, which represents a part of our treatment strategy, could be associated with low incidence of necrotising enterocolitis.

  4. Total and Differential Phylloquinone (Vitamin K1 Intakes of Preterm Infants from All Sources during the Neonatal Period

    Directory of Open Access Journals (Sweden)

    Paul Clarke

    2015-09-01

    Full Text Available All newborns require phylloquinone after birth to prevent vitamin K deficiency bleeding. Babies born prematurely may be at particular risk of deficiency without adequate supplementation during infancy. The main sources of phylloquinone in preterm babies during the neonatal period are the prophylactic dose of phylloquinone given at birth, and that derived from parenteral and/or enteral feeding. This observational study formed part of a prospective, multicentre, randomised, controlled trial that examined the vitamin K status of preterm infants after random allocation to one of three phylloquinone prophylactic regimens at birth (0.5 or 0.2 mg intramuscularly or 0.2 mg intravenously. In this nutritional sub-study we quantified the proportional and total phylloquinone intakes of preterm infants within the neonatal period from all sources. Almost all infants had average daily phylloquinone intakes that were in excess of the currently recommended amounts. In infants who did not receive parenteral nutrition, the bolus dose of phylloquinone given at birth was the major source of phylloquinone intake, whereas in infants who received parenteral nutrition, the intake from the parenteral preparation exceeded that from the bolus dose by a ratio of approximately 3:1. Our study supports the concern of others that preterm infants who receive current parenteral nutrition formulations may be receiving excessive vitamin K.

  5. Neonatal Bacterial Colonization Predispose to Lower Respiratory Infections in Early Childhood

    DEFF Research Database (Denmark)

    Vissing, Nadja Hawwa

    2014-01-01

    , and high sensitivity to respiratory, infectious and skin related illness. In particular, sensitivity on LRI was 96%. There was no evidence of bias from concurrent asthmatic disease or socioeconomic status. In conclusion, the study confirmed that COPSAC data is a valid source for investigating childhood......Lower respiratory infections (LRI) in childhood are common and account for considerable morbidity and health care utilization. The frequency of LRI varies significantly between otherwise healthy children, but extrinsic and intrinsic triggers of such variation are poorly understood. Traditionally...... neonatal airway colonization and risk of the LRI in a validated study cohort, and whether a possible association could be reflected in the early immune response to airway pathogens. In study I we aimed to ascertain the quality of information on child’s health, including asthma, allergy, eczema, respiratory...

  6. Cardiovascular oscillations at the bedside: early diagnosis of neonatal sepsis using heart rate characteristics monitoring

    International Nuclear Information System (INIS)

    Moorman, J Randall; Lake, Douglas E; Delos, John B; Flower, Abigail A; Cao, Hanqing; Kovatchev, Boris P; Richman, Joshua S

    2011-01-01

    We have applied principles of statistical signal processing and nonlinear dynamics to analyze heart rate time series from premature newborn infants in order to assist in the early diagnosis of sepsis, a common and potentially deadly bacterial infection of the bloodstream. We began with the observation of reduced variability and transient decelerations in heart rate interval time series for hours up to days prior to clinical signs of illness. We find that measurements of standard deviation, sample asymmetry and sample entropy are highly related to imminent clinical illness. We developed multivariable statistical predictive models, and an interface to display the real-time results to clinicians. Using this approach, we have observed numerous cases in which incipient neonatal sepsis was diagnosed and treated without any clinical illness at all. This review focuses on the mathematical and statistical time series approaches used to detect these abnormal heart rate characteristics and present predictive monitoring information to the clinician

  7. Features of the Early Adaptation Period of Newborns with Hypoxic-Ischemic Encephalopathy Depending on Birth Weight

    Directory of Open Access Journals (Sweden)

    Ye.P. Ortemenka

    2015-04-01

    Full Text Available In the department of neonatal pathology of Chernivtsi regional children’s clinical hospital, 41 full-term newborns with hypoxic-ischemic encephalopathy have been exa­mined in order to study the features of early period of their adaptation depending on birth weight. It was found that the early adaptation period of full-term newborns with hypoxi­­c-ischemic encephalopathy and body weight adequate in terms of gestational age was characterized by: pathological deli­very in one third (32.1 % of cases and the birth of one fourth (25 % of infants with tight nuchal cord that three times more often (22.2 % of neonates led to severe asphyxia, associated with the development of the multiple organ failure (14.3 % of cases and seizures (17.9 % of observations. Full-term children with hypoxic-ischemic encephalopathy and body weight low in terms of gestational age are characterized by: lower gestational age (37–39 weeks at birth (84.6 % of children, which has been associated with young (under 20 years age of mothers in 15.4 % of cases, and twice as likely (61.5 % of children led to respiratory disorders at birth, requiring artificial lung ventilation.

  8. Neonatal stress-induced affective changes in adolescent Wistar rats: early signs of schizophrenia-like behavior

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Neves Girardi

    2014-09-01

    Full Text Available Psychiatric disorders are multifactorial diseases with etiology that may involve genetic factors, early life environment and stressful life events. The neurodevelopmental hypothesis of schizophrenia is based on a wealth of data on increased vulnerability in individuals exposed to insults during the perinatal period. Maternal deprivation disinhibits the adrenocortical response to stress in neonatal rats and has been used as an animal model of schizophrenia. To test if long-term affective consequences of early life stress were influenced by maternal presence, we submitted 10-day old rats, either deprived (for 22 h or not from their dams, to a stress challenge (i.p. saline injection. Corticosterone plasma levels were measured 2 h after the challenge, whereas another subgroup was assessed for behavior in the open field, elevated plus maze, social investigation and the negative contrast sucrose consumption test in adolescence (postnatal day 45. Maternally deprived rats exhibited increased plasma corticosterone levels which were higher in maternally deprived and stress challenged pups. Social investigation was impaired in maternally deprived rats only, while saline injection, independently of maternal deprivation, was associated with increased anxiety-like behavior in the elevated plus maze and an impaired intake decrement in the negative sucrose contrast. In the open field, center exploration was reduced in all maternally-deprived adolescents and in control rats challenged with saline injection. The most striking finding was that exposure to a stressful stimulus per se, regardless of maternal deprivation, was linked to differential emotional consequences. We therefore propose that besides being a well-known and validated model of schizophrenia in adult rats, the maternal deprivation paradigm could be extended to model early signs of psychiatric dysfunction, and would particularly be a useful tool to detect early signs that resemble schizophrenia.

  9. A qualitative descriptive exploration of the educational and career plans of early career neonatal nurses and midwives: An Irish perspective.

    Science.gov (United States)

    Coughlan, Linda Martina; Patton, Declan

    2018-01-01

    The scarcity of appropriately qualified nurses and midwives is a major obstacle in achieving an effective health system. Neonatal nurses and midwives require a high level of skill and education to fulfil their role. It is also an area that sees high staff turnover rates. For this study a descriptive qualitative approach was used to ascertain early career neonatal nurses' and midwives' experiences of further education, their future career plans, and their perceived facilitators and barriers to further education and career progression. After receiving ethical approval, twelve nurses and midwives were recruited across three tertiary level neonatal units in Ireland. Semi structured interviews were carried out and interview transcripts were subsequently analysed using Attride-Stirling's (2001) Thematic Networks to deduce themes from the data. Support and involvement, mentoring, and career progression and retention were the three main themes identified upon analysis of the data. The majority of participants identified definitive career plans but some felt their goals were unachievable in their current workplace. Consequently a large number of participants have plans to leave their employment in neonates and pursue a career in other areas of nursing. Staff appraisals and succession planning programmes may assist early career nurses and midwives in focusing on their individual career goals, leading to a greater uptake of further specialised education and improved retention of neonatal nurses and midwives. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. [Genital bacterial carriage during the last trimester of pregnancy and early-onset neonatal sepsis].

    Science.gov (United States)

    Balaka, B; Agbèrè, A; Dagnra, A; Baeta, S; Kessie, K; Assimadi, K

    2005-05-01

    Bacterial infections remain a major cause of morbidity and mortality in newborn infants. To determine the bacterial ecology and pathological status of the genital organs during the last trimester of pregnancy and the germs of the following early-onset neonatal sepsis, in order to evaluate the risk of materno-foetal infections and to find out a drug prophylaxis. Vaginal and endocervical samples, usually taken during the first trimester of pregnancy were delayed and taken during the last trimester of pregnancy. A macroscopic examination described the aspect of the vagina, the cervix uteri, leukorrhea and of possible inflammatory lesions or ulcerations. A microscopic examination searched for parasites, epithelial cells, clue cells and leukocytes. The appropriate bacteriological cultures were performed after reading the Gram stain and scoring the vaginal flora. The clinical and cytobacteriological aspects were used to identify the bacterial ecology and the pathological genital states. An exploration was carried out in every newborn suspected of infection. Genital samples were collected from 306 pregnant women. Among them, 118 were at 29-32 weeks of gestation, 104 at 33-36, and 84 at 37-40. The most frequent germs were C. albicans (33,5%), Enterbacteriaceae (20.3%) including E. coli (10.9%), S. aureus (15.4%), Gardnerella (13.6%), and Trichomonas (10.6%), in monomicrobian (79.2%) and polymicrobian carriage (20.8%). Lower genital tract pathological states such as vaginitis (29.4%), bacterial vaginosis (21.5%) or endocervicitis (10.4%), asymptomatic bacterial carriage (23.5%) and normal genital flora (15%) were identified. These pregnancies led to 334 live births with 27 cases of early-onset neonatal sepsis to which endocervicitis (25%) and vaginosis (19,7%) were most often linked. Genital samples at the last trimester of pregnancy could evaluate the risk of maternofoetal infections and allow to adapt a drug prophylaxis of Enterobacteriaceae, the most frequent germ of

  11. Maternal and Neonatal Outcomes With Early Compared With Delayed Pushing Among Nulliparous Women.

    Science.gov (United States)

    Yee, Lynn M; Sandoval, Grecio; Bailit, Jennifer; Reddy, Uma M; Wapner, Ronald J; Varner, Michael W; Caritis, Steve N; Prasad, Mona; Tita, Alan T N; Saade, George; Sorokin, Yoram; Rouse, Dwight J; Blackwell, Sean C; Tolosa, Jorge E

    2016-11-01

    To describe factors associated with delayed pushing and evaluate the relationship between delayed pushing and perinatal outcomes in nulliparous women with singleton term gestations. This was a secondary analysis of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Assessment of Perinatal Excellence cohort of 115,502 women and their neonates born in 25 U.S. hospitals from 2008 to 2011. Nulliparous women with singleton, cephalic, nonanomalous term births who achieved 10-cm cervical dilation were included. Women in whom pushing was delayed by 60 minutes or greater (delayed group) were compared with those who initiated pushing within 30 minutes (early group). Multivariable regression analyses were used to assess the independent association of delayed pushing with mode of delivery, length of the second stage, and other maternal and perinatal outcomes (significance defined as Ppushing was delayed in 18.4% (n=3,870). Women who were older, privately insured, or non-Hispanic white as well as those who had induction or augmentation of labor, diabetes, or epidural analgesia were more likely to have delayed pushing. Delayed pushing was more common when the second stage began during daytime hours or in hospitals with dedicated 24-hour obstetric anesthesia, although differences were small. After adjusting for differences in baseline and labor characteristics including center, women in the delayed group had longer mean durations of the second stage (191 compared with 84 minutes, Ppushing (86 compared with 76 minutes, Ppushing was associated with greater rates of cesarean delivery (11.2% compared with 5.1%; adjusted odds ratio [OR] 1.86, 95% confidence interval [CI] 1.63-2.12), operative vaginal delivery (adjusted OR 1.26, 95% CI 1.14-1.40), postpartum hemorrhage (adjusted OR 1.43, 95% CI 1.05-1.95), and blood transfusion (adjusted OR 1.51, 95% CI 1.04-2.17). Delayed pushing was not associated with increased odds of adverse neonatal outcomes

  12. Neonatal hypocalcemia, neonatal seizures, and intellectual disability in 22q11.2 deletion syndrome

    Science.gov (United States)

    Cheung, Evelyn Ning Man; George, Susan R.; Andrade, Danielle M.; Chow, Eva W. C.; Silversides, Candice K.; Bassett, Anne S.

    2015-01-01

    Purpose Hypocalcemia is a common endocrinological condition in 22q11.2 deletion syndrome. Neonatal hypocalcemia may affect neurodevelopment. We hypothesized that neonatal hypocalcemia would be associated with rare, more severe forms of intellectual disability in 22q11.2 deletion syndrome. Methods We used a logistic regression model to investigate potential predictors of intellectual disability severity, including neonatal hypocalcemia, neonatal seizures, and complex congenital heart disease, e.g., interrupted aortic arch, in 149 adults with 22q11.2 deletion syndrome. Ten subjects had moderate-to-severe intellectual disability. Results The model was highly significant (P < 0.0001), showing neonatal seizures (P = 0.0018) and neonatal hypocalcemia (P = 0.047) to be significant predictors of a more severe level of intellectual disability. Neonatal seizures were significantly associated with neonatal hypocalcemia in the entire sample (P < 0.0001), regardless of intellectual level. There was no evidence for the association of moderate- to-severe intellectual disability with other factors such as major structural brain malformations in this sample. Conclusion The results suggest that neonatal seizures may increase the risk for more severe intellectual deficits in 22q11.2 deletion syndrome, likely mediated by neonatal hypocalcemia. Neonatal hypocalcemia often remains unrecognized until the postseizure period, when damage to neurons may already have occurred. These findings support the importance of early recognition and treatment of neonatal hypocalcemia and potentially neonatal screening for 22q11.2 deletions. PMID:23765047

  13. [Intrauterine devices in the immediate, early and late postabortion period].

    Science.gov (United States)

    Nun, S

    1971-01-01

    2146 cases of IUD insertions after hospitalization for abortion at a hospital in Chile were studied. In 1514 cases the IUDs were inserted immediately after abortion, in 430 cases between 1-5 days after the operation, and in 202 cases between 5-40 days after. It is concluded that immediate or early insertion results in a somewhat lower retention rate, but offers the advantage of making it possible to treat a greater number of patients, many of whom would not return later to have the IUD inserted. The incidence of removal for medical causes was very low and immediate insertion was found to be harmless. The medical causes of removal were the usual ones of bleeding, pain, and infection; the most frequent cause of interruption of use was expulsion, which tends to occur during the 1st few months of use and among younger women. The probability of failure due to pregnancy was somewhat higher than in the case of insertion during the intermenstrual period. Cases of voluntary removal tend to increase after prolonged use, and a study to analyze the actual reasons for this fact is necessary.

  14. Early versus Late Parenteral Nutrition in Very Low Birthweight Neonates; A retrospective study from Oman

    Directory of Open Access Journals (Sweden)

    Amitha R Aroor

    2012-02-01

    Full Text Available Objectives: The aim of this study was to compare the biochemical parameters, weight gain, osteopenia and phosphate supplementation in very low birth weight (VLBW neonates receiving early versus late parenteral nutrition (EPN versus LPN. Methods: A retrospective study was undertaken in the level III Neonatal Intensive Care Unit at Sultan Qaboos University Hospital, Oman: from January 2007 to October 2008 (LPN group, n = 47 and from January 2009 to June 2010 (EPN group, n = 44. Demographic data, anthropometric and laboratory parameters were extracted from the electronic record system. Results: The mean age of PN initiation was LPN = 47.3 hours versus EPN = 14.3 hours. Biochemical parameters analysed during the first week of life revealed a reduction in hypernatraemia (12.7% versus 6.8% and non-oliguric hyperkalemia (12.7% versus 6.8% in EPN, with no significant differences in acidosis and urea levels between the two groups. Hyperglycemia >12 mmol/L in <1000g was higher in EPN. Nutritional parameters in 81 babies who survived/stayed in the unit up to a corrected gestational age (CGA of 34 weeks (40 in LPN and 41 in EPN, revealed a reduction in metabolic bone disease (osteopenia of prematurity [OOP], 17.5% versus 7.3% and the need for phosphate supplementation (22.5% versus 7.3% in the EPN group. There was no increase in acidosis or cholestasis. No difference was noted in albumin levels, time to full feeds, time to regain birthweight and mean weight gain per day till 34 weeks corrected CGA. Conclusion: EPN in VLBW newborns is well tolerated and reduces hypernatraemia, non-oliguric hyperkalemia, OOP and the need for phosphate supplementation.

  15. The prevention of early-onset neonatal group B streptococcal disease.

    Science.gov (United States)

    Money, Deborah; Allen, Victoria M

    2013-10-01

    To review the evidence in the literature and to provide recommendations on the management of pregnant women in labour for the prevention of early-onset neonatal group B streptococcal disease. The key revisions in this updated guideline include changed recommendations for regimens for antibiotic prophylaxis, susceptibility testing, and management of women with pre-labour rupture of membranes. Maternal outcomes evaluated included exposure to antibiotics in pregnancy and labour and complications related to antibiotic use. Neonatal outcomes of rates of early-onset group B streptococcal infections are evaluated. Published literature was retrieved through searches of MEDLINE, CINAHL, and The Cochrane Library from January 1980 to July 2012 using appropriate controlled vocabulary and key words (group B streptococcus, antibiotic therapy, infection, prevention). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no date or language restrictions. Searches were updated on a regular basis and incorporated in the guideline to May 2013. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1). The recommendations in this guideline are designed to help clinicians identify and manage pregnancies at risk for neonatal group B streptococcal disease to optimize maternal and perinatal outcomes. No cost-benefit analysis is provided. There is good evidence based on randomized control trial data that in women with pre-labour rupture of membranes at term who are colonized with group B streptococcus, rates of neonatal infection are

  16. Relationship of neonatal cerebral blood flow velocity asymmetry with early motor, cognitive and language development in term infants.

    Science.gov (United States)

    Wu, Ying-Chin; Hsieh, Wu-Shiun; Hsu, Chyong-Hsin; Chiu, Nan-Chang; Chou, Hung-Chieh; Chen, Chien-Yi; Peng, Shinn-Forng; Hung, Han-Yang; Chang, Jui-Hsing; Chen, Wei J; Jeng, Suh-Fang

    2013-05-01

    The objective of this study was to examine the relationships of Doppler cerebral blood flow velocity (CBFV) asymmetry measures with developmental outcomes in term infants. Doppler CBFV parameters (peak systolic velocity [PSV] and mean velocity [MV]) of the bilateral middle cerebral arteries of 52 healthy term infants were prospectively examined on postnatal days 1-5, and then their motor, cognitive and language development was evaluated with the Bayley Scales of Infant and Toddler Development, Third Edition, at 6, 12, 18 and 24 months of age. The left CBFV asymmetry measure (PSV or MV) was calculated by subtracting the right-side value from the left-side value. Left CBFV asymmetry measures were significantly positively related to motor scores at 6 (r = 0.3-0.32, p cognitive or language outcome. Thus, the leftward hemodynamic status of the middle cerebral arteries, as measured by cranial Doppler ultrasound in the neonatal period, predicts early motor outcome in term infants. Copyright © 2013 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  17. The Effects of Exposure to Repeated Minor Pain During the Neonatal Period on Formalin Pain Behavior and Thermal Withdrawal Latencies

    Directory of Open Access Journals (Sweden)

    C Celeste Johnston

    2003-01-01

    Full Text Available Preterm infants undergoing untreated, repeated painful procedures as part of their early experience are more likely to behave differently to pain as they mature than infants who were born at term and did not experience excessive exogenous pain. The neonatal rat model was used to investigate the short- and long-term effects of repeated pain in infancy on later development of pain responses. Newborn rat pups were randomly assigned by litter to be left unhandled (UH, handled by being removed from the dam for 15 min four times daily (H, and being handled and receiving pain from a paw prick with a 26G needle four times daily (Pon postnatal days (PD 2 through 8 (PD2-PD8. Maternal behaviour and grooming of pups on their return to the nest were recorded at PD6 for H and P pups. At PD15, PD36 and PD65, animals were first tested for latency to thermal stimulation threshold using the Hargreaves test and then for inflammatory pain using the formalin test. Pups in the HP group received significantly more grooming from their mothers (359 s than pups in the H group (295 s, P<0.0001. When accounting for differences in maternal grooming, a decreased thermal threshold in the P group compared with the H group (6.04 s versus 5.3 s, P<0.05 was found, although the correlations were not significant between maternal grooming and thermal thresholds. No group differences were seen with the formalin test. Interestingly, age was a significant factor in both tests, with younger animals showing fewer pain behaviours regardless of group or maternal grooming of the pup. Sex was significant at one age only in latency to thermal stimulation testing. The results suggest that changes in maternal care may be an important factor mediating the long-term effects of repeated neonatal experiences of pain.

  18. Neonatal pain and reduced maternal care: Early-life stressors interacting to impact brain and behavioral development.

    Science.gov (United States)

    Mooney-Leber, Sean M; Brummelte, Susanne

    2017-02-07

    Advances in neonatal intensive care units (NICUs) have drastically increased the survival chances of preterm infants. However, preterm infants are still exposed to a wide range of stressors during their stay in the NICU, which include painful procedures and reduced maternal contact. The activation of the hypothalamic-pituitary-adrenal (HPA) axis, in response to these stressors during this critical period of brain development, has been associated with many acute and long-term adverse biobehavioral outcomes. Recent research has shown that Kangaroo care, a non-pharmacological analgesic based on increased skin-to-skin contact between the neonate and the mother, negates the adverse outcomes associated with neonatal pain and reduced maternal care, however the biological mechanism remains widely unknown. This review summarizes findings from both human and rodent literature investigating neonatal pain and reduced maternal care independently, primarily focusing on the role of the HPA axis and biobehavioral outcomes. The physiological and positive outcomes of Kangaroo care will also be discussed in terms of how dampening of the HPA axis response to neonatal pain and increased maternal care may account for positive outcomes associated with Kangaroo care. Copyright © 2016 IBRO. Published by Elsevier Ltd. All rights reserved.

  19. A Study On Neonatal Mortality In Jamnagar District Of Gujarat

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    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.

  20. Early magnetic resonance detection of cortical necrosis and acute network injury associated with neonatal and infantile cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Okabe, Tetsuhiko; Aida, Noriko; Nozawa, Kumiko [Kanagawa Children' s Medical Center, Department of Radiology, Yokohama (Japan); Niwa, Tetsu [Kanagawa Children' s Medical Center, Department of Radiology, Yokohama (Japan); Tokai University School of Medicine, Department of Radiology, Isehara (Japan); Shibasaki, Jun [Kanagawa Children' s Medical Center, Department of Neonatology, Yokohama (Japan); Osaka, Hitoshi [Kanagawa Children' s Medical Center, Department of Neurology, Yokohama (Japan)

    2014-05-15

    Knowledge of MRI findings in pediatric cerebral infarction is limited. To determine whether cortical necrosis and network injury appear in the acute phase in post-stroke children and to identify anatomical location of acute network injury and the ages at which these phenomena are seen. Images from 12 children (age range: 0-9 years; neonates [<1 month], n=5; infants [1 month-12 months], n=3; others [≥1 year], n=4) with acute middle cerebral artery (MCA) cortical infarction were retrospectively analyzed. Cortical necrosis was defined as hyperintense cortical lesions on T1-weighted imaging that lacked evidence of hemorrhage. Acute network injury was defined as hyperintense lesions on diffusion-weighted imaging that were not in the MCA territory and had fiber connections with the affected cerebral cortex. MRI was performed within the first week after disease onset. Cortical necrosis was only found in three neonates. Acute network injury was seen in the corticospinal tract (CST), thalamus and corpus callosum. Acute network injury along the CST was found in five neonates and one 7-month-old infant. Acute network injury was evident in the thalamus of four neonates and two infants (ages 4 and 7 months) and in the corpus callosum of five neonates and two infants (ages 4 and 7 months). The entire thalamus was involved in three children when infarction of MCA was complete. In acute MCA cortical infarction, MRI findings indicating cortical necrosis or acute network injury was frequently found in neonates and early infants. Response to injury in a developing brain may be faster than that in a mature one. (orig.)

  1. Early magnetic resonance detection of cortical necrosis and acute network injury associated with neonatal and infantile cerebral infarction

    International Nuclear Information System (INIS)

    Okabe, Tetsuhiko; Aida, Noriko; Nozawa, Kumiko; Niwa, Tetsu; Shibasaki, Jun; Osaka, Hitoshi

    2014-01-01

    Knowledge of MRI findings in pediatric cerebral infarction is limited. To determine whether cortical necrosis and network injury appear in the acute phase in post-stroke children and to identify anatomical location of acute network injury and the ages at which these phenomena are seen. Images from 12 children (age range: 0-9 years; neonates [<1 month], n=5; infants [1 month-12 months], n=3; others [≥1 year], n=4) with acute middle cerebral artery (MCA) cortical infarction were retrospectively analyzed. Cortical necrosis was defined as hyperintense cortical lesions on T1-weighted imaging that lacked evidence of hemorrhage. Acute network injury was defined as hyperintense lesions on diffusion-weighted imaging that were not in the MCA territory and had fiber connections with the affected cerebral cortex. MRI was performed within the first week after disease onset. Cortical necrosis was only found in three neonates. Acute network injury was seen in the corticospinal tract (CST), thalamus and corpus callosum. Acute network injury along the CST was found in five neonates and one 7-month-old infant. Acute network injury was evident in the thalamus of four neonates and two infants (ages 4 and 7 months) and in the corpus callosum of five neonates and two infants (ages 4 and 7 months). The entire thalamus was involved in three children when infarction of MCA was complete. In acute MCA cortical infarction, MRI findings indicating cortical necrosis or acute network injury was frequently found in neonates and early infants. Response to injury in a developing brain may be faster than that in a mature one. (orig.)

  2. Early magnetic resonance detection of cortical necrosis and acute network injury associated with neonatal and infantile cerebral infarction.

    Science.gov (United States)

    Okabe, Tetsuhiko; Aida, Noriko; Niwa, Tetsu; Nozawa, Kumiko; Shibasaki, Jun; Osaka, Hitoshi

    2014-05-01

    Knowledge of MRI findings in pediatric cerebral infarction is limited. To determine whether cortical necrosis and network injury appear in the acute phase in post-stroke children and to identify anatomical location of acute network injury and the ages at which these phenomena are seen. Images from 12 children (age range: 0-9 years; neonates [acute middle cerebral artery (MCA) cortical infarction were retrospectively analyzed. Cortical necrosis was defined as hyperintense cortical lesions on T1-weighted imaging that lacked evidence of hemorrhage. Acute network injury was defined as hyperintense lesions on diffusion-weighted imaging that were not in the MCA territory and had fiber connections with the affected cerebral cortex. MRI was performed within the first week after disease onset. Cortical necrosis was only found in three neonates. Acute network injury was seen in the corticospinal tract (CST), thalamus and corpus callosum. Acute network injury along the CST was found in five neonates and one 7-month-old infant. Acute network injury was evident in the thalamus of four neonates and two infants (ages 4 and 7 months) and in the corpus callosum of five neonates and two infants (ages 4 and 7 months). The entire thalamus was involved in three children when infarction of MCA was complete. In acute MCA cortical infarction, MRI findings indicating cortical necrosis or acute network injury was frequently found in neonates and early infants. Response to injury in a developing brain may be faster than that in a mature one.

  3. Copper to Zinc Ratio as Disease Biomarker in Neonates with Early-Onset Congenital Infections

    Science.gov (United States)

    Wisniewska, Monika; Cremer, Malte; Wiehe, Lennart; Becker, Niels-Peter; Rijntjes, Eddy; Martitz, Janine; Renko, Kostja; Bührer, Christoph; Schomburg, Lutz

    2017-01-01

    Copper (Cu) and zinc (Zn) are essential trace elements for regular development. Acute infections alter their metabolism, while deficiencies increase infection risks. A prospective observational case-control study was conducted with infected (n = 21) and control (n = 23) term and preterm newborns. We analyzed trace element concentrations by X-ray fluorescence, and ceruloplasmin (CP) by Western blot. Median concentration of Cu at birth (day 1) was 522.8 [387.1–679.7] μg/L, and Zn was 1642.4 ± 438.1 μg/L. Cu and Zn correlated positively with gestational age in control newborns. Cu increased in infected newborns from day 1 to day 3. CP correlated positively to Cu levels at birth in both groups and on day 3 in the group of infected neonates. The Cu/Zn ratio was relatively high in infected newborns. Interleukin (IL)-6 concentrations on day 1 were unrelated to Cu, Zn, or the Cu/Zn ratio, whereas C-reactive protein (CRP) levels on day 3 correlated positively to the Cu/Zn -ratio at both day 1 and day 3. We conclude that infections affect the trace element homeostasis in newborns: serum Zn is reduced, while Cu and CP are increased. The Cu/Zn ratio combines both alterations, independent of gestational age. It may, thus, constitute a meaningful diagnostic biomarker for early-onset infections. PMID:28358335

  4. [Predictive value of interleukin 6 from the umbilical cord blood in early neonatal infection].

    Science.gov (United States)

    Cosićkić, Almira; Skokić, Fahrija

    2009-01-01

    We have analyzed diagnostic value of interleukin 6 (IL-6) from the umbilical cord blood in recognition of early neonatal infection (ENI) of newborns whose mothers have obstetrical risks. The study included 120 newborns with birth weight ENI), group B (clinical signs and hematological parameters of ENI) and group C (newborns without ENI). Median of IL-6 value in group A was 48.5 pg/ml with sensitivity, specificity and diagnostic value in recognition of ENI 78%, 81% and 80%. In group B median of IL-6 was 49 pg/ml with sensitivity, specificity and diagnostic value 65%, 80% and 77%. In group C median of IL-6 was 9.7 pg/ml. We noticed significant connection between value of IL-6 and mother's urinary tract infection; group A (p=0.023), group B (p = 0.007). Also there was a remarkable relationship between mother's colpitis and level of IL-6 in newborn with ENI in group A (p=0.011) and group B (p = 0.012). High levels of IL-6 in umbilical cord blood can help us in recognition of newborns that are endangered by infection and they are clearly connected with some of mother's obstetrical risks.

  5. Early nasal continuous positive airway pressure versus INSURE in VLBW neonates

    Directory of Open Access Journals (Sweden)

    Ana Saianda

    2010-09-01

    Full Text Available Background: Evidence suggests the INSURE strategy (INtubate-SURfactant administration and Extubate to nasal continuous positive airway pressure [nCPAP] is superior to mechanical ventilation (MV with rescue surfactant for the management of respiratory distress syndrome (RDS in very low birth weight (VLBW neonates. There is limited data, however, to assess whether INSURE is superior to nCPAP alone. We aimed to compare these two strategies regarding early and late outcomes. Methods: Retrospective cohort study from Jan/2002 to Aug/2008. We included VLBW neonateswith gestational age (GA ≤ 30 weeks registered in the Vermont Oxford Network that used either nCPAP alone (nCPAP group, N = 40, or with INSURE (INSURE group, N = 56. We assessed early (RDS, need for rescue surfactant, and CPAP failure with MV and late outcomes (chronic lung disease of prematurity (CLD, mortality, and composite outcome of mortality and/or CLD. Results: Neonates in the INSURE group had lower mean GA, while other baseline variables were comparable. The proportion of RDS was significantly superior in the nCPAP group (53% vs. 30%; adjusted OR [95% CI] – 0.2 [0.1-0.6]. Therapeutic surfactant was administered to all cases with RDS in the nCPAP group, but to none from the INSURE group. MV was more frequently required in the nCPAP group (11/ 40, 28% vs. 9/ 56, 12%; p = 0.04. No statistically significant differences were found in either of the late outcomes. Conclusion: The use of nCPAP alone in VLBW neonates with GA ≤ 30 weeks may be associated with slightly poorer early outcomes than the INSURE strategy, but there were no significant differences in CLD or mortality. Resumo: Introdução: Pretende-se determinar se a utilização do método INSURE em recém-nascidos de muito baixo peso, com idade gestacional (IG ≤ 30 semanas se associa a menor morbilidade e mortalidade quando comparado com uso de nCPAP isolado. Métodos: Estudo de

  6. Laboratory contamination in the early period of radiation research

    International Nuclear Information System (INIS)

    Rona, E.

    1979-01-01

    Meagre records exist of the levels of contamination and human exposure encountered by those who took part in the early research on radioactive materials. In order to throw some light on the nature and extent of the problem the author presents some recollections of the conditions of the laboratories in which she worked from 1924-1940. These include the Kaiser Wilhelm Institute, the Radium Institute of Vienna and the Curie Institute. The health, radiation injuries and causes of death of some early workers are discussed. Although the effects of acute exposure were recognised early on, there was less awareness of the possible effects of chronic exposure, and lack of prompt clinical signs of injury encouraged complacency. Laboratory contamination was often seen more as a problem affecting experimental results than as a health hazard. (author)

  7. Early neonatal mortality and neurological outcomes of neonatal resuscitation in a resource-limited setting on the Thailand-Myanmar border: A descriptive study.

    Directory of Open Access Journals (Sweden)

    Sophie Janet

    Full Text Available Of the 4 million neonatal deaths worldwide yearly, 98% occur in low and middle-income countries. Effective resuscitation reduces mortality and morbidity but long-term outcomes in resource-limited settings are poorly described. This study reports on newborn neurological outcomes following resuscitation at birth in a resource-limited setting where intensive newborn care including intubation is unavailable.Retrospective analysis of births records from 2008 to 2015 at Shoklo Malaria Research Unit (SMRU on the Thailand-Myanmar border.From 21,225 newbonrs delivered, 15,073 (71% met the inclusion criteria (liveborn, singleton, ≥28 weeks' gestation, delivered in SMRU. Neonatal resuscitation was performed in 460 (3%; 422 basic, 38 advanced cases. Overall early neonatal mortality was 6.6 deaths per 1000 live births (95% CI 5.40-8.06. Newborns receiving basic and advanced resuscitation presented an adjusted rate for death of 1.30 (95%CI 0.66-2.55; p = 0.442, and 6.32 (95%CI 3.01-13.26; p<0.001 respectively, compared to newborns given routine care. Main factors related to increased need for resuscitation were breech delivery, meconium, and fetal distress (p<0.001. Neurodevelopmental follow-up to one year was performed in 1,608 (10.5% of the 15,073 newborns; median neurodevelopmental scores of non-resuscitated newborns and those receiving basic resuscitation were similar (64 (n = 1565 versus 63 (n = 41; p = 0.732, while advanced resuscitation scores were significantly lower (56 (n = 5; p = 0.017.Newborns requiring basic resuscitation at birth have normal neuro-developmental outcomes at one year of age compared to low-risk newborns. Identification of risk factors (e.g., breech delivery associated with increased need for neonatal resuscitation may facilitate allocation of staff to high-risk deliveries. This work endorses the use of basic resuscitation in low-resource settings, and supports on-going staff training to maintain bag-and-mask ventilation skills.

  8. Periodization of the early postnatal development in the rat with particular attention to the weaning period

    Czech Academy of Sciences Publication Activity Database

    Ošťádalová, Ivana; Babický, A.

    2012-01-01

    Roč. 61, Suppl.1 (2012), S1-S7 ISSN 0862-8408 R&D Projects: GA MŠk(CZ) 1M0510; GA ČR(CZ) GAP303/12/1162 Institutional research plan: CEZ:AV0Z50110509 Keywords : rat * ontogenic development * presuckling period * suckling period * weaning period Subject RIV: ED - Physiology Impact factor: 1.531, year: 2012

  9. Early primary repair of tetralogy of fallot in neonates and infants less than four months of age.

    Science.gov (United States)

    Tamesberger, Melanie I; Lechner, Evelyn; Mair, Rudolf; Hofer, Anna; Sames-Dolzer, Eva; Tulzer, Gerald

    2008-12-01

    The ideal age for correction of tetralogy of Fallot is still under discussion. The aim of this study was to analyze morbidity and mortality in patients who underwent early primary repair of tetralogy of Fallot at the age of less than 4 months and to assess whether neonates, who needed early repair within the first 4 weeks of life, faced an increased risk. From 1995 to 2006, 90 consecutive patients with tetralogy of Fallot and pulmonary stenosis underwent early primary repair. Patient charts were analyzed retrospectively for two groups: group A, 25 neonates younger than 28 days who needed early operation owing to duct-dependent pulmonary circulation or severe hypoxemia; and group B, 65 infants younger than 4 months of age who underwent elective early repair. There was no 30-day mortality; late mortality was 2% after a median follow-up time of 4.7 years. Seven of 88 patients (8%) needed reoperation and twelve of 88 patients (14%) needed reintervention. Groups A and B did not differ significantly in terms of intensive care unit stay, days of mechanical ventilation, overall hospital stay, major or minor complications, or reoperation. Significant differences were found in a more frequent use of a transannular patch (p = 0.045) and more reinterventions (p = 0.046) in group A. Early primary repair of tetralogy of Fallot can be performed safely and effectively in infants younger than 4 months of age and even in neonates younger than 28 days with duct-dependent pulmonary circulation or severe hypoxemia.

  10. Correlation between risk factors during the neonatal period and appearance of retinopathy of prematurity in preterm infants in neonatal intensive care units in Alexandria, Egypt

    Directory of Open Access Journals (Sweden)

    Abdel Hadi AM

    2013-05-01

    Full Text Available Ahmed Mahmoud Abdel Hadi, Islam Shereen HamdyDepartment of Ophthalmology, Alexandria University Hospital, Alexandria, EgyptBackground: This study aimed to identify the main risk factors for development of retinopathy of prematurity (ROP in neonatal intensive care units in Alexandria, Egypt, from January 2010 to January 2012.Methods: A prospective cohort study was undertaken in infants weighing < 1250 g and maternal postmenstrual age < 32 weeks if there was concern about prolonged exposure to oxygen. The main clinical outcomes were occurrence of any stage of ROP and in particular severe ROP. Perinatal variables considered were: birth weight, gestational age, gender, method of ventilation (nasal continuous airway pressure or intermittent mechanical ventilation, packed red blood cell and/or plasma transfusion, occurrence of sepsis, neonatal indirect hyperbilirubinemia, intraventricular hemorrhage, and patent ductus arteriosus. After obtaining informed consent from the parents, infants at risk were examined for ROP using indirect ophthalmoscopy, ie, RetCam II fundus photography.Results: The study included 152 infants of mean gestational age 31.02 weeks and mean birth weight 1.229 kg. Seventy-two cases (47.5% were male and 80 cases (52.5% were female. Of the cases screened, 100 (65.6% had no ROP, 52 had ROP of any stage (34.4%, and 27 (18% had stage 1, five (3.3% had stage 2, 17 (11.5% had stage 3, and three (1.6% had stage 4 disease. No infants had stage 5 ROP. Of all our cases with ROP, 15 (28.6% had prethreshold disease type 1 that required treatment, comprising 9.8% of all cases screened for ROP. Using stepwise logistic regression analysis, all risk factors studied were found to be significantly associated with the development of ROP, except for neonatal indirect hyperbilirubinemia. Severity of ROP was inversely proportional to birth weight and gestational age.Conclusion: ROP occurred in 34.4% of all infants screened in the neonatal intensive

  11. Spondyloepiphyseal dysplasia congenita. A cause of lethal neonatal dwarfism

    Energy Technology Data Exchange (ETDEWEB)

    Macpherson, R.I.; Wood, B.P.

    1980-07-01

    Spondyloepiphyseal dysplasia congenita is a form of primarily short trunk dwarfism, that is manifest at birth but generally has not been regarded as a cause of lethal neonatal dwarfism. Seven neonates with severe dwarfism are presented. The first survived the newborn period, but the other six were early neonatal deaths. All displayed the clinical and radiologic features of spondyloepiphyseal dysplasia congenita. The striking similarities between spondyloepiphyseal dysplasia congenita and achondrogenesis type 2 are discussed.

  12. Causes of death among full term stillbirths and early neonatal deaths in the Region of Southern Denmark.

    Science.gov (United States)

    Basu, Millie Nguyen; Johnsen, Iben Birgit Gade; Wehberg, Sonja; Sørensen, Rikke Guldberg; Barington, Torben; Nørgård, Bente Mertz

    2018-02-23

    We examined the causes of death amongst full term stillbirths and early neonatal deaths. Our cohort includes women in the Region of Southern Denmark, who gave birth at full term to a stillborn infant or a neonate who died within the first 7 days from 2010 through 2014. Demographic, biometric and clinical variables were analyzed to assess the causes of death using two classification systems: causes of death and associated conditions (CODAC) and a Danish system based on initial causes of fetal death (INCODE). A total of 95 maternal-infant cases were included. Using the CODAC and INCODE classification systems, we found that the causes of death were unknown in 59/95 (62.1%). The second most common cause of death in CODAC was congenital anomalies in 10/95 (10.5%), similar to INCODE with fetal, genetic, structural and karyotypic anomalies in 11/95 (11.6%). The majority of the mothers were healthy, primiparous, non-smokers, aged 20-34 years and with a normal body mass index (BMI). Based on an unselected cohort from an entire region in Denmark, the cause of stillbirth and early neonatal deaths among full term infants remained unknown for the vast majority.

  13. Neonatal Morbidity at Term, Early Child Development, and School Performance: A Population Study.

    Science.gov (United States)

    Bentley, Jason P; Schneuer, Francisco J; Lain, Samantha J; Martin, Andrew J; Gordon, Adrienne; Nassar, Natasha

    2018-02-01

    Investigate the association between severe neonatal morbidity (SNM) and child development and school performance among term infants. The study population included term infants without major congenital conditions born between 2000 and 2007 in New South Wales, Australia, with a linked record of developmental assessment at ages 4 to 6 years in 2009 or 2012 ( n = 144 535) or school performance at ages 7 to 9 years from 2009 to 2014 ( n = 253 447). Developmental outcomes included special needs or being vulnerable and/or at risk in 1 of 5 developmental domains. School performance outcomes were test exemption, or performing <-1 SD on reading or numeracy tests. Binary generalized estimating equations were used to estimate associations between SNM and outcomes, adjusting for sociodemographic, perinatal, and assessment and/or test characteristics. Overall, 2.1% of infants experienced SNM. The adjusted odds ratio (95% confidence interval) for SNM and physical health was 1.18 (1.08-1.29), 1.14 (1.02-1.26) for language and cognitive skills, and 1.14 (1.06-1.24) and 1.13 (1.05-1.21) for scoring <-1 SD in reading and numeracy, respectively. SNM was most strongly associated with special needs 1.34 (1.15-1.55) and test exemption 1.50 (1.25-1.81). SNM infants born at 37 to 38 weeks' gestation and who were small for gestational age had the greatest likelihood of poorer outcomes. Term infants with SNM have greater odds of poor neurodevelopment in childhood. These findings provide population-based information for families and can inform clinical counseling and guidelines for follow-up and early intervention. Copyright © 2018 by the American Academy of Pediatrics.

  14. Early changes in brain structure correlate with language outcomes in children with neonatal encephalopathy.

    Science.gov (United States)

    Shapiro, Kevin A; Kim, Hosung; Mandelli, Maria Luisa; Rogers, Elizabeth E; Gano, Dawn; Ferriero, Donna M; Barkovich, A James; Gorno-Tempini, Maria Luisa; Glass, Hannah C; Xu, Duan

    2017-01-01

    Global patterns of brain injury correlate with motor, cognitive, and language outcomes in survivors of neonatal encephalopathy (NE). However, it is still unclear whether local changes in brain structure predict specific deficits. We therefore examined whether differences in brain structure at 6 months of age are associated with neurodevelopmental outcomes in this population. We enrolled 32 children with NE, performed structural brain MR imaging at 6 months, and assessed neurodevelopmental outcomes at 30 months. All subjects underwent T1-weighted imaging at 3 T using a 3D IR-SPGR sequence. Images were normalized in intensity and nonlinearly registered to a template constructed specifically for this population, creating a deformation field map. We then used deformation based morphometry (DBM) to correlate variation in the local volume of gray and white matter with composite scores on the Bayley Scales of Infant and Toddler Development (Bayley-III) at 30 months. Our general linear model included gestational age, sex, birth weight, and treatment with hypothermia as covariates. Regional brain volume was significantly associated with language scores, particularly in perisylvian cortical regions including the left supramarginal gyrus, posterior superior and middle temporal gyri, and right insula, as well as inferior frontoparietal subcortical white matter. We did not find significant correlations between regional brain volume and motor or cognitive scale scores. We conclude that, in children with a history of NE, local changes in the volume of perisylvian gray and white matter at 6 months are correlated with language outcome at 30 months. Quantitative measures of brain volume on early MRI may help identify infants at risk for poor language outcomes.

  15. Early changes in brain structure correlate with language outcomes in children with neonatal encephalopathy

    Directory of Open Access Journals (Sweden)

    Kevin A. Shapiro

    2017-01-01

    Full Text Available Global patterns of brain injury correlate with motor, cognitive, and language outcomes in survivors of neonatal encephalopathy (NE. However, it is still unclear whether local changes in brain structure predict specific deficits. We therefore examined whether differences in brain structure at 6 months of age are associated with neurodevelopmental outcomes in this population. We enrolled 32 children with NE, performed structural brain MR imaging at 6 months, and assessed neurodevelopmental outcomes at 30 months. All subjects underwent T1-weighted imaging at 3 T using a 3D IR-SPGR sequence. Images were normalized in intensity and nonlinearly registered to a template constructed specifically for this population, creating a deformation field map. We then used deformation based morphometry (DBM to correlate variation in the local volume of gray and white matter with composite scores on the Bayley Scales of Infant and Toddler Development (Bayley-III at 30 months. Our general linear model included gestational age, sex, birth weight, and treatment with hypothermia as covariates. Regional brain volume was significantly associated with language scores, particularly in perisylvian cortical regions including the left supramarginal gyrus, posterior superior and middle temporal gyri, and right insula, as well as inferior frontoparietal subcortical white matter. We did not find significant correlations between regional brain volume and motor or cognitive scale scores. We conclude that, in children with a history of NE, local changes in the volume of perisylvian gray and white matter at 6 months are correlated with language outcome at 30 months. Quantitative measures of brain volume on early MRI may help identify infants at risk for poor language outcomes.

  16. Is 1H NMR metabolomics becoming the promising early biomarker for neonatal sepsis and for monitoring the antibiotic toxicity?

    Science.gov (United States)

    Noto, Antonio; Mussap, Michele; Fanos, Vassilios

    2014-06-01

    Metabolomics, the latest of omics disciplines, has been successfully used in various fields of basic research such as pharmacology and toxicology. Recently, this new science has gained an important role in the translational research of diagnostics. In this regard, the challenge for neonatologists and medical laboratories is to diagnose neonatal sepsis, a disease with high mortality and morbidity due to the difficulty in diagnosing it. Metabolomics, through its ability to identify perturbations caused by this condition, aims at recognizing metabolites that characterize neonatal sepsis with high specificity and sensitivity. The purpose of this review is to highlight the ability of metabolomics to find early biomarkers for this condition, as well as to predict the toxic effects caused by antibiotics.

  17. Neonatal stroke causes poor midline motor behaviors and poor fine and gross motor skills during early infancy.

    Science.gov (United States)

    Chen, Chao-Ying; Lo, Warren D; Heathcock, Jill C

    2013-03-01

    Upper extremity movements, midline behaviors, fine, and gross motor skills are frequently impaired in hemiparesis and cerebral palsy. We investigated midline toy exploration and fine and gross motor skills in infants at risk for hemiplegic cerebral palsy. Eight infants with neonatal stroke (NS) and thirteen infants with typical development (TD) were assessed from 2 to 7 months of age. The following variables were analyzed: percentage of time in midline and fine and gross motor scores on the Bayley Scales of Infant Development (BSID-III). Infants with neonatal stroke demonstrated poor performance in midline behaviors and fine and gross motor scores on the BSID-III. These results suggest that infants with NS have poor midline behaviors and motor skill development early in infancy. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. The early period of the calculus of variations

    CERN Document Server

    Freguglia, Paolo

    2016-01-01

    This monograph explores the early development of the calculus of variations in continental Europe during the Eighteenth Century by illustrating the mathematics of its founders. Closely following the original papers and correspondences of Euler, Lagrange, the Bernoullis, and others, the reader is immersed in the challenge of theory building. We see what the founders were doing, the difficulties they faced, the mistakes they made, and their triumphs. The authors guide the reader through these works with instructive commentaries and complements to the original proofs, as well as offering a modern perspective where useful. The authors begin in 1697 with Johann Bernoulli’s work on the brachystochrone problem and the events leading up to it, marking the dawn of the calculus of variations. From there, they cover key advances in the theory up to the development of Lagrange’s δ-calculus, including: • The isoperimetrical problems • Shortest lines and geodesics • Euler’s Methodus Inveniendi and the two Addi...

  19. Ibuprofen exposure in early neonatal life does not affect renal function in young adolescence.

    Science.gov (United States)

    Raaijmakers, Anke; Zhang, Zhen-Yu; Levtchenko, Elena; Simons, Sinno Hp; Cauwenberghs, Nicholas; Heuvel, Lambertus P van den; Jacobs, Lotte; Staessen, Jan A; Allegaert, Karel

    2018-03-01

    Ibuprofen exposure results in acute transient renal dysfunction in preterm neonates, but we are unaware of data on long-term renal safety. In a previously studied cohort of extreme low birth weight (ELBW, ibuprofen. In this post hoc analysis, we linked markers of renal function in young adolescence in ELBW cases with their perinatal (prenatal maternal, setting at birth, treatment modalities including drug prescription during neonatal stay, neonatal creatinine values, postdischarge growth) characteristics, including but not limited to ibuprofen exposure during neonatal stay. Ibuprofen exposure was not associated with significant differences in renal length or eGFR cysC . Moreover, we were unable to identify any other risk factor (perinatal characteristics, postnatal creatinine trends, postdischarge growth) on renal outcome in this cohort. Neonatal exposure to ibuprofen did not affect renal function. Larger studies are needed to explore the confounders of variability in renal function in former ELBW cases. This matters since ELBW relates to risk for hypertension, cardiovascular events and renal disease in later life and identification of risk factors holds the promise of secondary prevention. NCT02147457. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. [Sensorineural hearing loss due to neonatal hyperbilirubinemia].

    Science.gov (United States)

    Clarós, P; Turcanu, D; Caballero, M; Costa, C; Clavería, M A; Clarós, A; Clarós, A

    2003-01-01

    In this article, the sensorineural hearing loss is presented as a possible sequelae of neonatal hyperbilirubinemia. In our program of early hipoacusia detection, 241 babies were examined from January 1996 until November 1999; 7 cases had a history of hyperbilirubinemia in the neonatal period and 2 of them were diagnosed of sensorineural hearing loss. We discuss how the bilirubin or any other associated factor might have been the cause and this could explain the selective affectation of some children.

  1. Through the client's eyes: using narratives to explore experiences of care transfers during pregnancy, childbirth, and the neonatal period.

    Science.gov (United States)

    van Stenus, Cherelle M V; Gotink, Mark; Boere-Boonekamp, Magda M; Sools, Anneke; Need, Ariana

    2017-06-12

    The client experience is an important outcome in the evaluation and development of perinatal healthcare. But because clients meet different professionals, measuring such experiences poses a challenge. This is especially the case in the Netherlands, where pregnant women are often transferred between professionals due to the nation's approach to risk selection. This paper explores questions around how clients experience transfers of care during pregnancy, childbirth, and the neonatal period, as well as how these experiences compare to the established quality of care aspects the Dutch Patient Federation developed. Narratives from 17 Dutch women who had given birth about their experiences with transfers were collected in the Netherlands. The narratives, for which informed consent was obtained, were collected on paper and online. Storyline analysis was used to identify story types. Story types portray patterns that indicate how clients experience transfers between healthcare providers. A comparative analysis was performed to identify differences and similarities between existing quality criteria and those clients mentioned. Four story types were identified: 1) Disconnected transfers of care lead to uncertainties; 2) Seamless transfers of care due to proper collaboration lead to positive experiences; 3) Transfers of care lead to disruption of patient-provider connectedness; 4) Transfer of care is initiated by the client to make pregnancy and childbirth dreams come true. Most of the quality aspects derived from these story types were identified as being similar or complementary to the Dutch Patient Federation list. A 'new' aspect identified in the clients' stories was the influencing role of prior experiences with transfers of care on current expectations, fears, and wishes. Transfers of care affect clients greatly and influence their experiences. Good communication, seamless transfers, and maintaining autonomy contribute to more positive experiences. The stories also

  2. Macrosomic Neonates Carry Increased Risk of Dental Caries in Early Childhood: Findings from a Cohort Study, the Okinawa Child Health Study, Japan.

    Directory of Open Access Journals (Sweden)

    Hiroshi Yokomichi

    Full Text Available Although many studies have discussed health risks in neonates with a low birth weight, few studies have focused on the risks in neonates with a high birth weight. The objective of this study was to determine whether differences in the incidence of dental caries in early childhood are associated with birth weight status.A total of 117,175 children born in Okinawa Prefecture, Japan from 1997 to 2007 were included in this study. Medical professionals collected information about birth records, growth and development, parental child-rearing practices and dental health at 3 months, 18 months and 3 years of age. The risk of dental caries among neonates with macrosomia (birth weight ≥4000 g was compared with that among neonates with normal weight (2500-3999 g. Sensitivity analyses included 'large for gestational age' (LGA, birth weight above the 90th percentile for gestational age, which was relative to 'appropriate for gestational age' (birth weight between 10th and 90th percentiles. Relative risks and relative risk increases were estimated by multivariate Poisson regression.At 3 years of age, the relative risk increases for dental caries after adjusting for confounding factors were 19% [95% confidence interval (CI, 11%-28%, P < 0.001] for macrosomic neonates and 12% (95% CI, 9%-16%, P < 0.001 for LGA neonates.Macrosomia and LGA were associated with an increased risk of dental caries in early childhood. Particular attention should be paid to abnormally large neonates.

  3. Early hospital discharge of the healthy term neonate: the Italian perspective.

    Science.gov (United States)

    Petrone, E; Mansi, G; Tosco, A; Capasso, L; Migliaro, F; Umbaldo, A; Romano, A; Paludetto, R; Raimondi, F

    2008-06-01

    An appropriate timing of hospital discharge of the healthy, term neonate represents a balance between birth medicalization and surveillance of immediate health hazards. In the absence of European recommendations, the authors have conducted a broad national survey on the current policies of neonatal discharge. A 13-item questionnaire was sent to 136 Italian birth centers. Quantitative variables were expressed as mean+/-range. Qualitative variables were expressed as frequencies. chi squared test was used for variables comparison. Mean age at discharge for a vaginally delivered neonate was 72 hours. Twelve percent of centres would not schedule a follow-up appointment. Neonates born after a cesarean section were discharged at a mean age of 97 hours. Almost all centres (95/98) would discharge an healthy infant without risk factors for hyperbilirubinemia with a total serum bilirubin (TSB) of 13 mg/dL at 72 hours but 14.7% of these centers would not recheck TSB. The same healthy neonate would be discharged at the age of 45 hours with a TSB=10 mg/dL in 67/98 centers and in 11.9% of cases would not be rechecked. Most Italian hospitals discharge healthy, term neonates born after spontaneous vaginal delivery (SVD) at over 72 hours of age. This policy should protect from missed diagnoses of clinical importance (e.g. hyperbilirubinemia). On the other hand, a prolonged hospitalization tends to increase maternal discomfort and medical costs. Implementing a protocol of home visits/clinic follow-up appointments after an earlier discharge may minimize health hazards and medical costs and optimizing the patient's feedback.

  4. Síndromes genéticos reconocibles en el período neonatal Genetic syndromes recognizable in the neonatal period

    Directory of Open Access Journals (Sweden)

    Víctor L. Ruggieri

    2009-01-01

    Full Text Available La presencia de un cuadro neurológico neonatal asociado o no a dismorfias o a un fenotipo particular puede responder a diversas causas a Prenatales: infecciosas (Grupo TORCH, agentes tóxicos o teratogénicos (alcohol, cocaína, antiepilépticos, inhalantes como el tolueno, etc., defectos vasculares o anomalías genéticas b Perinatales: cuadros hipóxico isquémicos, infecciones o trastornos metabólicos, entre otros. En este trabajo analizaremos aquellas entidades de origen genético reconocibles en el período neonatal por su fenotipo, las cuales deben incluirse entre los diagnósticos diferenciales frente a un niño con compromiso neurológico. Con el objeto de facilitar el reconocimiento de estas entidades las dividiremos de acuerdo al fenotipo más destacado u orientador, presente en el momento del nacimiento dividiéndolas en 2 grandes grupos: 1 Génicas, en las que incluimos: Síndromes con facies características y malformaciones en los miembros; Síndromes de sobrecrecimiento; Síndromes con déficit del crecimiento prenatal; Síndromes neuro-ectodérmicos; Síndromes con facies características con compromiso ocular y Síndromes con facies características (incluyendo, en las que lo tienen, su número del MIM y 2 Cromosómicas (anomalías en los autosomas: de número; en mosaico; deleciones y anomalías en los cromosomas sexuales. El reconocimiento a través del fenotipo de encefalopatías congénitas de origen genético es de gran importancia ya que su identificación permitirá: Orientar estudios diagnósticos específicos; evitar prácticas cruentas y/o costosas, inútiles si el diagnóstico clínico es por sí orientador; proveer el adecuado asesoramiento genético familiar y controlar evolutivamente las posibles complicaciones.The presence of a neonatal neurological lesion associated or not with dysmorphism or with a particular phenotype can be caused by a prenatal infections (Group TORCH toxic or teratotoxic agents (alcohol

  5. Proteomics Mapping of Cord Blood Identifies Haptoglobin ?Switch-On? Pattern as Biomarker of Early-Onset Neonatal Sepsis in Preterm Newborns

    OpenAIRE

    Buhimschi, Catalin S.; Bhandari, Vineet; Dulay, Antonette T.; Nayeri, Unzila A.; Abdel-Razeq, Sonya S.; Pettker, Christian M.; Thung, Stephen; Zhao, Guomao; Han, Yiping W.; Bizzarro, Matthew; Buhimschi, Irina A.

    2011-01-01

    Background Intra-amniotic infection and/or inflammation (IAI) are important causes of preterm birth and early-onset neonatal sepsis (EONS). A prompt and accurate diagnosis of EONS is critical for improved neonatal outcomes. We sought to explore the cord blood proteome and identify biomarkers and functional protein networks characterizing EONS in preterm newborns. Methodology/Principal Findings We studied a prospective cohort of 180 premature newborns delivered May 2004-September 2009. A prote...

  6. Perfis de mortalidade neonatal precoce: um estudo para uma Maternidade Pública de Belo Horizonte (MG, 2001-2006 Profiles of early neonatal deaths: a study for a Public Maternity Hospital of Belo Horizonte (MG, 2001 - 2006

    Directory of Open Access Journals (Sweden)

    Heloísa Maria de Assis

    2008-12-01

    Full Text Available Trata-se de estudo seccional, com base em dados secundários, com o objetivo de traçar o perfil dos óbitos neonatais precoces ocorridos em uma Maternidade Pública de referência no Estado de Minas Gerais (Maternidade Odete Valadares, Belo Horizonte, no período de 2001 a 2006. Foram utilizadas variáveis relacionadas ao recém-nascido (período de ocorrência do óbito, idade ao óbito, sexo, idade gestacional e peso ao nascer, à mãe (tipo de gravidez, tipo de parto, idade, parturição e número de nascidos mortos, bem como causas múltiplas de mortalidade categorizadas. Obtiveram-se três perfis de óbitos neonatais precoces por meio do método Grade of Membership, que possibilitou também encontrar a prevalência destes perfis. O Perfil 1 foi caracterizado por óbitos de difícil redução e teve prevalência de 41,4%; o Perfil 2, pelos óbitos passíveis de redução (prevalência de 28,3%; e o Perfil 3, pelos óbitos redutíveis (prevalência de 30,4%. Estes perfis possibilitaram a compreensão da mortalidade neonatal precoce na Maternidade Odete Valadares e a análise da sua relação com a história reprodutiva e obstétrica materna, bem como com as condições do recém-nascido. Chama a atenção a elevada prevalência de óbitos evitáveis, realidade que deve ser enfrentada pelos profissionais e pela rede pública de saúde.This is a cross-sectional study with the aim of describing the early neonatal deaths that took place at a Public Maternity Hospital, Maternidade Odete Valadares in Belo Horizonte, Minas Gerais, Brazil, from 2001 to 2006. It used variables related to the newborn (period the death took place, age at death, gender, gestational age, and birth weight, to the mother (type of pregnancy, type of delivery, age, parity, and number of stillborn children, and to the multiple causes of death. Three profiles of early neonatal death were obtained through the Grade of Membership method (GoM, which also made it possible to find

  7. Change in body weight of mothers and neonates and in milk composition during denning period in captive Japanese black bears (Ursus thibetanus japonicus).

    Science.gov (United States)

    Iibuchi, Ruriko; Nakano, Noriko; Nakamura, Tadashi; Urashima, Tadasu; Shimozuru, Michito; Murase, Tetsuma; Tsubota, Toshio

    2009-05-01

    Japanese black bears, Ursus thibetanus japonicus, have been classified as a vulnerable species so that data on reproduction are needed to maintain and/or extend their population. They are known to have a peculiar style of reproduction, giving birth to their neonates and raising them during denning, a period of complete fasting. In this study, we investigated the metabolic rate and milk composition of mother bears raising neonates, and the changes in body weight of the neonates under captive conditions. Seven female bears kept in dens were weighed once a month, and the amount of energy they used was calculated. From birth, cubs were also weighed and their growth rate was determined. In addition, the milk composition was analyzed to investigate its characteristics. As a result, it was found that mother bears used 34% more energy than did solitary females. There was no significant difference in the energy used for nursing whether they had single or twin cubs. On the other hand, the body weight gain of single cubs was significantly higher than that of twin cubs, suggesting that the growth of the cubs was highly affected by the suppression of mother's energy consumption during the fasting period. The milk had high fat and low sugar concentrations. This indicates that mother bears used the fat accumulated prior to denning for their main energy source when raising cubs. Considering all results together, Japanese black bears showed remarkable efficiency in the use of energy for reproduction during the fasting period.

  8. Early evolution and recovery from excitotoxic injury in the neonatal rat brain

    NARCIS (Netherlands)

    Lookeren Campagne, van M.; Verheul, H.B.; Nicolaij, K.; Balázs, R.E.

    1994-01-01

    We explored the therapeutic potentials of two N-methyl-D-aspartate (NMDA) receptor antagonists in vivo using different techniques. NMDA injected into the striatum of neonatal rats (20 nmol/0.5 microliters) induced a rapid increase in the diffusion-weighted (DW) image intensity, spreading over a

  9. Successful early neonatal repair of cleft lip within first 8 days of life

    Czech Academy of Sciences Publication Activity Database

    Borský, J.; Velemínská, J.; Jurovčík, M.; Kozák, J.; Hechtová, D.; Tvrdek, M.; Černý, M.; Kabelka, Z.; Fajstavr, J.; Janota, J.; Zach, J.; Peterková, Renata; Peterka, Miroslav

    2012-01-01

    Roč. 76, č. 11 (2012), s. 1616-1626 ISSN 0165-5876 Grant - others:MZd(CZ) NS10012 Institutional research plan: CEZ:AV0Z50390512 Keywords : total cleft lip and palate * neonate * malformation Subject RIV: FP - Other Medical Disciplines Impact factor: 1.350, year: 2012

  10. Neonatal Procalcitonin Intervention Study (NeoPInS): Effect of Procalcitonin-guided decision making on Duration of antibiotic Therapy in suspected neonatal early-onset Sepsis: A multi-centre randomized superiority and non-inferiority Intervention Study

    NARCIS (Netherlands)

    M. Stocker (Martin); W.C.J. Hop (Wim); A.M.C. van Rossum (Annemarie)

    2010-01-01

    textabstractBackground: Early diagnosis and treatment of the newborn infant with suspected sepsis are essential to prevent severe and life threatening complications. Diagnosis of neonatal sepsis is difficult because of the variable and nonspecific clinical presentation. Therefore, many newborns with

  11. Neonatal Amygdala Functional Connectivity at Rest in Healthy and Preterm Infants and Early Internalizing Symptoms.

    Science.gov (United States)

    Rogers, Cynthia E; Sylvester, Chad M; Mintz, Carrie; Kenley, Jeanette K; Shimony, Joshua S; Barch, Deanna M; Smyser, Christopher D

    2017-02-01

    Alterations in the normal developmental trajectory of amygdala resting state functional connectivity (rs-FC) have been associated with atypical emotional processes and psychopathology. Little is known, however, regarding amygdala rs-FC at birth or its relevance to outcomes. This study examined amygdala rs-FC in healthy, full-term (FT) infants and in very preterm (VPT) infants, and tested whether variability of neonatal amygdala rs-FC predicted internalizing symptoms at age 2 years. Resting state fMRI data were obtained shortly after birth from 65 FT infants (gestational age [GA] ≥36 weeks) and 57 VPT infants (GA amygdala regions of interest. Total internalizing symptoms and the behavioral inhibition, depression/withdrawal, general anxiety, and separation distress subdomains were assessed in a subset (n = 44) at age 2 years using the Infant Toddler Social Emotional Assessment. In FT and VPT infants, the amygdala demonstrated positive correlations with subcortical and limbic structures and negative correlations with cortical regions, although magnitudes were decreased in VPT infants. Neonatal amygdala rs-FC predicted internalizing symptoms at age 2 years with regional specificity consistent with known pathophysiology in older populations: connectivity with the anterior insula related to depressive symptoms, with the dorsal anterior cingulate related to generalized anxiety, and with the medial prefrontal cortex related to behavioral inhibition. Amygdala rs-FC is well established in neonates. Variability in regional neonatal amygdala rs-FC predicted internalizing symptoms at 2 years, suggesting that risk for internalizing symptoms may be established in neonatal amygdala functional connectivity patterns. Copyright © 2016 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  12. Cannabis Use During the Perinatal Period in a State With Legalized Recreational and Medical Marijuana: The Association Between Maternal Characteristics, Breastfeeding Patterns, and Neonatal Outcomes.

    Science.gov (United States)

    Crume, Tessa L; Juhl, Ashley L; Brooks-Russell, Ashley; Hall, Katelyn E; Wymore, Erica; Borgelt, Laura M

    2018-03-28

    To evaluate state-level prevalence estimates of prenatal and early postnatal cannabis use in a state with legalized medical and recreational marijuana and the association with adverse neonatal outcomes. We conducted a cross-sectional study on 3,207 respondents from the 2014-2015 Colorado Pregnancy Risk Assessment Monitoring System with state-developed questions on cannabis use. Differences in perinatal cannabis use were evaluated according to maternal characteristics, breastfeeding patterns, and pregnancy intendedness. Multiple logistic regression models evaluated the relationship between prenatal cannabis use and adverse neonatal outcomes including low birth weight, small for gestational age, preterm birth, and admission to the neonatal intensive care unit. The self-reported prevalence of cannabis use at any time during pregnancy was 5.7 ± 0.5% and the prevalence of early postnatal cannabis use among women who breastfed was 5.0% (95% CI, 4.1%-6.2%). Prenatal cannabis use was associated with a 50% increased likelihood of low birth weight, independent of maternal age, race/ethnicity, level of education, and tobacco use during pregnancy (OR, 1.5; 95% CI, 1.1-2.1; P = .02). Small for gestational age, preterm birth, and neonatal intensive care unit admission were not associated with prenatal cannabis use, independent of prenatal tobacco use. Our findings underscore the importance of screening for cannabis use during prenatal care and the need for provider counselling about the adverse health consequences of continued use during pregnancy and lactation. Copyright © 2018 Elsevier Inc. All rights reserved.

  13. Reference ranges for blood concentrations of eosinophils and monocytes during the neonatal period defined from over 63 000 records in a multihospital health-care system.

    Science.gov (United States)

    Christensen, R D; Jensen, J; Maheshwari, A; Henry, E

    2010-08-01

    Blood concentrations of eosinophils and monocytes are part of the complete blood count. Reference ranges for these concentrations during the neonatal period, established by very large sample sizes and modern methods, are needed for identifying abnormally low or high values. We constructed reference ranges for eosinophils per microl and monocytes per microl among neonates of 22 to 42 weeks of gestation, on the day of birth, and also during 28 days after birth. Data were obtained from archived electronic records over an eight and one-half-year period in a multihospital health-care system. In keeping with the reference range concept, values were excluded from neonates with a diagnosis of infection or necrotizing enterocolitis (NEC). Eosinophils and monocytes per microl of blood were electronically retrieved from 96 162 records, of which 63 371 that lacked a diagnosis of infection or NEC were included in this reference range report. The mean value for eosinophils per microl on the day of birth increased linearly between 22 and 42 weeks of gestation, as did the 5 and 95% values. The reference range at 40 weeks was 140 to 1300 microl(-1) (mean 550 microl(-1)). Similarly, the mean value for monocytes increased linearly over this interval, with a reference range at 40 weeks of 300 to 3300 microl(-1) (mean 1400 microl(-1)). Over the first 4 weeks after birth, no appreciable change was observed in 5% limit and mean eosinophil count, with a slight increase in the 95% limit in week 4. A slight increase in monocyte count was observed during the first 2 weeks after birth. The results of this analysis describe reference ranges for blood concentrations of eosinophils and monocytes during the neonatal period. Additional study is needed for determining the relevance of values falling outside the reference range.

  14. Planned home compared with planned hospital births in the Netherlands: intrapartum and early neonatal death in low-risk pregnancies.

    Science.gov (United States)

    van der Kooy, Jacoba; Poeran, Jashvant; de Graaf, Johanna P; Birnie, Erwin; Denktasş, Semiha; Steegers, Eric A P; Bonsel, Gouke J

    2011-11-01

    The purpose of our study was to compare the intrapartum and early neonatal mortality rate of planned home birth with planned hospital birth in community midwife-led deliveries after case mix adjustment. The perinatal outcome of 679,952 low-risk women was obtained from the Netherlands Perinatal Registry (2000-2007). This group represents all women who had a choice between home and hospital birth. Two different analyses were performed: natural prospective approach (intention-to-treat-like analysis) and perfect guideline approach (per-protocol-like analysis). Unadjusted and adjusted odds ratios (ORs) were calculated. Case mix was based on the presence of at least one of the following: congenital abnormalities, small for gestational age, preterm birth, or low Apgar score. We also investigated the potential risk role of intended place of birth. Multivariate stepwise logistic regression was used to investigate the potential risk role of intended place of birth. Intrapartum and neonatal death at 0-7 days was observed in 0.15% of planned home compared with 0.18% in planned hospital births (crude relative risk 0.80, 95% confidence interval [CI] 0.71-0.91). After case mix adjustment, the relation is reversed, showing nonsignificant increased mortality risk of home birth (OR 1.05, 95% CI 0.91-1.21). In certain subgroups, additional mortality may arise at home if risk conditions emerge at birth (up to 20% increase). Home birth, under routine conditions, is generally not associated with increased intrapartum and early neonatal death, yet in subgroups, additional risk cannot be excluded.

  15. Neonatal encephalopathic cerebral injury in South India assessed by perinatal magnetic resonance biomarkers and early childhood neurodevelopmental outcome.

    Directory of Open Access Journals (Sweden)

    Peter J Lally

    Full Text Available Although brain injury after neonatal encephalopathy has been characterised well in high-income countries, little is known about such injury in low- and middle-income countries. Such injury accounts for an estimated 1 million neonatal deaths per year. We used magnetic resonance (MR biomarkers to characterise perinatal brain injury, and examined early childhood outcomes in South India.We recruited consecutive term or near term infants with evidence of perinatal asphyxia and a Thompson encephalopathy score ≥6 within 6 h of birth, over 6 months. We performed conventional MR imaging, diffusion tensor MR imaging and thalamic proton MR spectroscopy within 3 weeks of birth. We computed group-wise differences in white matter fractional anisotropy (FA using tract based spatial statistics. We allocated Sarnat encephalopathy stage aged 3 days, and evaluated neurodevelopmental outcomes aged 3½ years using Bayley III.Of the 54 neonates recruited, Sarnat staging was mild in 30 (56%; moderate in 15 (28% and severe in 6 (11%, with no encephalopathy in 3 (6%. Six infants died. Of the 48 survivors, 44 had images available for analysis. In these infants, imaging indicated perinatal rather than established antenatal origins to injury. Abnormalities were frequently observed in white matter (n = 40, 91% and cortex (n = 31, 70% while only 12 (27% had abnormal basal ganglia/thalami. Reduced white matter FA was associated with Sarnat stage, deep grey nuclear injury, and MR spectroscopy N-acetylaspartate/choline, but not early Thompson scores. Outcome data were obtained in 44 infants (81% with 38 (79% survivors examined aged 3½ years; of these, 16 (42% had adverse neurodevelopmental outcomes.No infants had evidence for established brain lesions, suggesting potentially treatable perinatal origins. White matter injury was more common than deep brain nuclei injury. Our results support the need for rigorous evaluation of the efficacy of rescue hypothermic

  16. PREVENTION OF NIPPLE CRACKS OF THE MAMMARY GLAND IN THE EARLY POSTNATAL PERIOD

    Directory of Open Access Journals (Sweden)

    Marina L. Travina

    2017-01-01

    Full Text Available Preservation and prolongation of the lactation period is not only a guarantee of the child's full physical and mental development but also one of the most important methods for reducing the risk of developing breast cancer. Problems with the mammary gland nipple in a woman in the early postnatal period lead to a refusal of lactation. We carried out a retrospective analysis (period from 2010 to 2016 of the causes of traumatizing mammary gland nipples in the early postnatal period in 172 women (mean age 29.1 ± 4.3 years. Methods of prevention and treatment of nipple injuries in the early postnatal period have been offered for the lactation period prolongation.

  17. Predictors of successful early extubation following congenital cardiac surgery in neonates and infants.

    Science.gov (United States)

    Winch, Peter D; Nicholson, Lisa; Isaacs, Janet; Spanos, Steven; Olshove, Vincent; Naguib, Aymen

    2009-08-01

    There is a paucity of literature discussing the predictive likelihood of successfully extubating neonates and infants in the operating room immediately following congenital cardiac surgery. Given the unknown consequences of anaesthetics on neurodevelopmental outcomes, minimising the exposure of this population to such agents may have long-term benefits. Retrospective chart review of 391 patients less than 1 year of age. The probability of successfully extubating these patients was based on quantifiable, objective criteria. The relevant variables include age, weight, bypass time, lactate level and specific congenital anomaly. The practice of immediate extubation of infants and neonates is achievable, safe and predicted based on specific patient variables. This practice will minimise the anaesthetic exposure of these especially young patients who may be at risk for long-term consequences related to anaesthetic exposure.

  18. CLINICAL AND IMMUNOPATHOLOGIC CHARACTERISTICS OF EARLY NEONATAL SEPSIS IN INFANTS OF DIFFERENT GESTATIONAL AGE AND CLINICAL AND ECONOMICAL EVALUATION OF IMMUNOSUPPORTIVE THERAPY EFFICACY

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    I.G. Soldatova

    2011-01-01

    Full Text Available Study objective — to study clinical and immunopathologic characteristics of early neonatal sepsis in infants of different gestational age and to perform clinical and economical evaluation of immunosupportive therapy with Pentaglobin efficacy in complex treatment of this disease. 79 infants diagnosed with neonatal sepsis were included into prospective study. These patients were divided into 3 subgroups in order to evaluate clinical and economical efficacy of immunosupportive therapy: subgroup A (n = 38 — patients receiving. Pentaglobin as part of basic complex treatment from 3–6 days of life; subgroup B (n = 27 — from 7–10 days of life; subgroup C  (n = 27 — patients treated without Pentaglobin. Proven high clinical and economical efficacy of immunoglobulin preparations as a part of complex treatment of neonatal sepsis allows to recommend this type of therapy for a wide application in neonatology as a part of neonatal sepsis treatment.Key words: early neonatal sepsis, prematurity, extremely low body mass, immunosupportive therapy, intravenous immunoglobines, clinical and economical analysis, neonatal sepsis. (Voprosy sovremennoi pediatrii — Current Pediatrics. — 2011; 10 (6: 52–61

  19. Epileptic manifestations induced by midazolam in the neonatal period Manifestações epilépticas induzidas por midazolam no período neonatal

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    Maria Augusta Montenegro

    2001-06-01

    Full Text Available Antiepileptic drugs may cause worsening of epilepsy by aggravating pre-existing seizures or by triggering new seizure types. There are several reports of adverse effects related to midazolam, but only a few authors reported epileptic manifestations. We report four newborns seen at the Neonatal Intensive Care Unit of our University Hospital, who developed seizures a few seconds after the administration of midazolam. It is difficult to identify the patients at risk, but it is important to be aware and recognize this situation.Drogas antiepilépticas podem piorar o controle da epilepsia por agravar crises epilépticas pre-existentes ou por desencadear novos tipos de crises. Existem vários relatos de eventos adversos relacionados ao midazolam; entretanto, poucos autores referem manifestações epilépticas. Neste estudo relatamos a ocorrência de crises epilépticas poucos segundos após a administração de midazolam, em quatro neonatos atendidos na Unidade de Terapia Intensiva do nosso hospital universitário. É difícil determinar quais pacientes estão em risco, mas é importante estar atento e reconhecer esta situação.

  20. Early postnatal gentamicin and ceftazidime treatment in normal and food restricted neonatal wistar rats: Implications for kidney development.

    Science.gov (United States)

    Bueters, Ruud R G; Jeronimus-Klaasen, Annelies; Brüggemann, Roger J M; van den Heuvel, Lambertus P; Schreuder, Michiel F

    2017-09-01

    Up to two-thirds of premature born neonates are treated for infections with aminoglycosides such as gentamicin. Although acute toxicities are well described, there is uncertainty on developmental changes after treatment of premature born neonates. We studied the effect of gentamicin and ceftazidime on kidney development in the rat. Additionally, we evaluated the modulating effect of extrauterine growth restriction. On postnatal day (PND) 2, Wistar rats were cross-fostered into normal sized litters (12 pups) or large litters (20 pups) to create normal food (NF) or food restricted (FR) litters to simulate growth restriction and dosed daily intraperitoneally with placebo, 4 mg/kg of gentamicin or 50 mg/kg ceftazidime until PND 8. Gentamicin pharmacokinetics were studied in a separate group of animals. Kidneys were weighed. Renal expression of 18 developmental genes was evaluated by quantitative PCR on PND 8. On PND 35, glomerular number was assessed by stereology and glomerular generations were counted. Food restricted litters showed 22% less body weight compared with controls by day 35 (p kidney development, ceftazidime can affect Renin expression, and extrauterine growth restriction impairs kidney development, but did not modulate potential drug toxicity. Birth Defects Research 109:1228-1235, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  1. Hypothyroidism during neonatal and perinatal period induced by thyroidectomy of the mother causes depressive-like behavior in prepubertal rats

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    Marisol Pineda-Reynoso

    2010-04-01

    Full Text Available Marisol Pineda-Reynoso, Edgar Cano-Europa, Vanessa Blas-Valdivia, Adelaida Hernandez-Garcia, Margarita Franco-Colin, Rocio Ortiz-ButronDepartamento de Fisiología ‘Mauricio Russek Berman,’ Escuela Nacional de Ciencias Biológicas, IPN, Carpio y Plan de Ayala, MéxicoAbstract: The objective of this study was to see if neonatal and perinatal hypothyroidism caused anxiety and depressive-like behaviors. Twenty female Wistar rats were randomly divided into two groups: 1 thyroidectomy caused hypothyroidism, in which the thyroid gland had been removed and the parathyroid reimplanted; and 2 false thyroidectomy. The thyroidectomy was made on rats anesthetized with ketamine-xylazine. The rats were mated and one day after giving birth, eight pups were assigned to each group randomly and they were distributed into two groups: a hypothyroid group containing male pups of a hypothyroid mother with a hypothyroid wet nurse; and a euthyroid group of male pups of a euthyroid mother with a euthyroid wet nurse. We analyzed the behavioral test at a prepubertal age. The neonatal and perinatal hypothyroidism caused by the mother’s thyroidectomy caused a decrease in body weight and length. We found that the neonatal and perinatal hypothyroidism enhanced the total exploratory activity without affecting social contact and the time spent in the open and closed arms in an elevated plus-maze. The hypothyroidism caused immobility without altering the lower climbing duration in the swimming test. This study shows a novel model to cause neonatal and perinatal hypothyroidism without using pharmacological drugs. We demonstrated that hypothyroid animals had a reduction in body weight and length, a retardation of neurodevelopment, and they had depressive-like behavior.Keywords: perinatal hypothyroidism, thyroidectomy, thyroid hormone, behavior, metabolism

  2. Sevoflurane exposure during the neonatal period induces long-term memory impairment but not autism-like behaviors.

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    Chung, Woosuk; Park, Saegeun; Hong, Jiso; Park, Sangil; Lee, Soomin; Heo, Junyoung; Kim, Daesoo; Ko, Youngkwon

    2015-10-01

    To examine whether neonatal exposure to sevoflurane induces autism-like behaviors in mice. There are continuing reports regarding the potential negative effects of anesthesia on the developing brain. Recently, several studies suggest that neurotoxicity caused by anesthesia may lead to neurodevelopmental impairments. However, unlike reports focusing on learning and memory, there are only a few animal studies focusing on neurodevelopmental disorders after general anesthesia. Therefore, we have focused on autism, a representative neurodevelopmental disorder. Neonatal mice (P6-7) were exposed to a titrated dose of sevoflurane for 6 h. Apoptosis was evaluated by assessing the expression level of cleaved (activated) caspase-3. Autism-like behaviors, general activity, anxiety level, and long-term memory were evaluated with multiple behavioral assays. Western blotting confirmed that neonatal exposure to sevoflurane increased the expression level of activated caspase-3, indicative of apoptosis. Mice exposed to sevoflurane also showed impaired long-term memory in fear tests. However, sevoflurane-exposed mice did not exhibit autism-like features in all of the following assays: social interaction (three-chamber test, caged social interaction), social communication (ultrasonic vocalization test), or repetitive behavior (self-grooming test, digging). There were also no differences in general activity (open field test, home cage activity) and anxiety (open field test, light-dark box) after sevoflurane exposure. Our results confirm previous studies that neonatal sevoflurane exposure causes neurodegeneration and long-term memory impairment in mice. However, sevoflurane did not induce autism-like features. Our study suggests that mice are more vulnerable to long-term memory deficits than autism-like behaviors after exposure to sevoflurane. © 2015 John Wiley & Sons Ltd.

  3. Adenylyl cylases 1 and 8 mediate select striatal-dependent behaviors and sensitivity to ethanol stimulation in the adolescent period following acute neonatal ethanol exposure.

    Science.gov (United States)

    Susick, Laura L; Lowing, Jennifer L; Bosse, Kelly E; Hildebrandt, Clara C; Chrumka, Alexandria C; Conti, Alana C

    2014-08-01

    maturational parameters examined in the current study may not be sensitive enough to detect effects of a single ethanol exposure during the brain growth spurt period. Genetic deletion of AC1/8 reveals a role for these cylases in attenuating ethanol-induced behavioral effects in the neonatally-exposed adolescent. Published by Elsevier B.V.

  4. Predicting early epidurals: association of maternal, labor, and neonatal characteristics with epidural analgesia initiation at a cervical dilation of 3 cm or less.

    Science.gov (United States)

    Moore, Albert R; Shan, William Li Pi; Hatzakorzian, Roupen

    2013-01-01

    Retrospective studies have associated early epidural analgesia with cesarean delivery, but prospective studies do not demonstrate a causal relationship. This suggests that there are other variables associated with early epidural analgesia that increase the risk of cesarean delivery. This study was undertaken to determine the characteristics associated with early epidural analgesia initiation. Information about women delivering at 37 weeks or greater gestation with epidural analgesia, who were not scheduled for cesarean delivery, was extracted from the McGill Obstetric and Neonatal Database. Patients were grouped into those who received epidural analgesia at a cervical dilation of ≤3 cm and >3 cm. Univariable and multivariable logistic regression was used to determine the maternal, neonatal, and labor characteristics that increased the risk of inclusion in the early epidural group. Of the 13,119 patients analyzed, multivariable regression demonstrated odds ratios (OR) of 2.568, 5.915 and 10.410 for oxytocin augmentation, induction, and dinoprostone induction of labor (P analgesia (OR 0.780, P analgesia (P neonatal weight (OR 0.943, P analgesia. Labor augmentation and induction, nulliparity, rupture of membranes spontaneously and before labor starts, increasing maternal weight, and decreasing neonatal weight are associated with early epidural analgesia. Many of these variables are also associated with cesarean delivery.

  5. Early Detection of Hearing Impairment Among High Risk Neonates in a Tertiary Care Hospital

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    Gurudutt Joshi

    2014-07-01

    Full Text Available Background: Hearing impairment has a devastating, detrimental and an invariably adverse impact on the development of the newborns and the psychological well-being of their families. It also adversely affects development of the central auditory nervous system, and can affect speech perception that interferes with growth in social, emotional, behavioural and cognitive spheres, academic achievement, vocational options, employment opportunities and economic selfsufficiency. Objectives: To find out incidence of hearing impairment in high risk neonates in Neonatal Intensive Care Unit (NICU, prevalence of hearing impairment with and without high risk factors in newborns and to correlate the risk factors with hearing impairment. Material and Methods: A cohort study was carried out at a tertiary care hospital of Surat, Gujarat, India consisting of 190 normal newborns and 163 newborns with high risk factors. These newborns underwent a systematized Transient Otoacoustic Emissions Examination (TOAE and Brain Stem Evoked Audiometry (BERA examination according to designed protocol and were followed up with repeated ear examinations. Data were recorded and analyzed statistically. Results: The incidence of hearing impairment in NICU, newborns were 3.6% and the prevalence of hearing impairment was 13%. Hearing impairment was statistically significant in newborns with high risk factors such as low birth weight, preterms 5 days when compared to normal newborns. Conclusion: Presence of risk factors in newborns predisposes them to hearing impairment more as compared to normal newborns and the more the number of risk factors they are exposed to, the more will be the chances of hearing impairment.

  6. Serum thyroid stimulating hormone, total and free T4 during the neonatal period: Establishing regional reference intervals

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    Sara Sheikhbahaei

    2014-01-01

    Full Text Available Context: Congenital hypothyroidism (CH, the most common etiology of preventable mental retardation in children, is estimated to be more prevalent among Asian population. Aims: Since thyroid function tests (TFTs varied among different ages and geographical regions, in this study, the neonatal thyroid reference intervals in a healthy neonatal population is determined for the first time in Iran. Settings and Design: A cross-sectional study performed on 246 healthy term newborns aged between 2 days and 1 month. Materials and Methods: Blood samples were obtained by venipuncture from all subjects. The median, 2.5 th , 5 th , 95 th , and 97.5 th percentile of serum thyroid-stimulating hormone (TSH, as well as the total and free T4 were assessed among different age groups. Statistical Analysis Used: Predictive Analytics Software (PASW Statistics 18 was used for the analysis. Results: Serum TSH, total and free T4 concentration peaked in 5 th to 7 th days of life, continued over 2 weeks, then decreased and started reaching to adult reference range. A significant negative correlation between age and serum concentration of TSH (P = 0.02, total T4 (P = 0.01 and free T4 (P = 0.01 was found. Conclusion: This study yielded fairly different values for TFTs compared compared values found in other countries and also different from values reported for laboratory kits we used. These differences were assumed to be due to variations in ethnicity, age, and laboratory methods used. Due to the lack of international standardization, conducting multicenter studies helps in making a more precise evaluation of thyroid status in neonates.

  7. Maternal early pregnancy vitamin D status in relation to fetal and neonatal growth: results of the multi-ethnic Amsterdam Born Children and their Development cohort

    NARCIS (Netherlands)

    Leffelaar, Evelien R.; Vrijkotte, Tanja G. M.; van Eijsden, Manon

    2010-01-01

    Low vitamin D levels during pregnancy may account for reduced fetal growth and for altered neonatal development. The present study explored the association between maternal vitamin D status measured early in pregnancy and birth weight, prevalence of small-for-gestational-age (SGA) infants and

  8. Long term prognosis of patients with cystic fibrosis in relation to early detection by neonatal screening and treatment in a cystic fibrosis centre

    NARCIS (Netherlands)

    Dankert-Roelse, J E; te Meerman, G J

    BACKGROUND: A study was undertaken to evaluate whether an early diagnosis by neonatal screening may improve the long term prognosis of patients with cystic fibrosis and to assess the influence of expert management started immediately after the diagnosis. METHODS: Comparative clinical follow up in

  9. Early Detection with Pulse Oximetry of Hypoxemic Neonatal Conditions. Development of the IX Clinical Consensus Statement of the Ibero-American Society of Neonatology (SIBEN

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    Augusto Sola

    2018-03-01

    Full Text Available This article reviews the development of the Ninth Clinical Consensus Statement by SIBEN (the Ibero-American of Neonatology on “Early Detection with Pulse Oximetry (SpO2 of Hypoxemic Neonatal Conditions”. It describes the process of the consensus, and the conclusions and recommendations for screening newborns with pulse oximetry.

  10. Predictors of positive blood culture and deaths among neonates with suspected neonatal sepsis in a tertiary hospital, Mwanza- Tanzania

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    Jeremiah Seni

    2010-06-01

    Full Text Available Abstract Background Neonatal sepsis is a significant cause of morbidity and mortality in neonates. Appropriate clinical diagnosis and empirical treatment in a given setting is crucial as pathogens of bacterial sepsis and antibiotic sensitivity pattern can considerably vary in different settings. This study was conducted at Bugando Medical Centre (BMC, Tanzania to determine the prevalence of neonatal sepsis, predictors of positive blood culture, deaths and antimicrobial susceptibility, thus providing essential information to formulate a policy for management of neonatal sepsis. Methods This was a prospective cross sectional study involving 300 neonates admitted at BMC neonatal unit between March and November 2009. Standard data collection form was used to collect all demographic data and clinical characteristics of neonates. Blood culture was done on Brain Heart Infusion broth followed by identification of isolates using conventional methods and testing for their susceptibility to antimicrobial agents using the disc diffusion method. Results Among 770 neonates admitted during the study period; 300 (38.9% neonates were diagnosed to have neonatal sepsis by WHO criteria. Of 300 neonates with clinical neonatal sepsis 121(40% and 179(60% had early and late onset sepsis respectively. Positive blood culture was found in 57 (47.1% and 92 (51.4% among neonates with early and late onset neonatal sepsis respectively (p = 0.466. Predictors of positive blood culture in both early and late onset neonatal sepsis were inability to feed, lethargy, cyanosis, meconium stained liquor, premature rupture of the membrane and convulsion. About 49% of gram negatives isolates were resistant to third generation cephalosporins and 28% of Staphylococcus aureus were found to be Methicillin resistant Staphylococcus aureus (MRSA. Deaths occurred in 57 (19% of neonates. Factors that predicted deaths were positive blood culture (p = 0.0001, gram negative sepsis (p = 0.0001 and

  11. Pilot study in neonates using low-level laser therapy in the immediate postoperative period of myelomeningocele

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    Nathali Cordeiro Pinto

    2010-03-01

    Full Text Available Objective: To analyze the tissue repair behavior after corrective surgical incision in neonates submitted to low-level laser therapy, in an attempt to diminish the incidence of postoperative dehiscence following the surgery for myelomeningocele performed immediately after birth. Methods: It is a prospective pilot study with 13 myelomeningocele patients submitted to surgery at birth who received adjuvant treatment with low-level laser therapy (Group A. Diode laser C.W., λ = 685t nm, p = 21 mW, E = 0.19 J was punctually applied along the surgical incision, summing up 4 to 10 J energy delivered per patient, according to the surgical wound area and, then, compared with the previous results, which were obtained from 23 patients undergoing surgery without laser therapy (Group B. Results: This pilot study showed a significant decline in dehiscence of surgical wounds in neonates submitted to low-level laser therapy as compared to controls (7.69 versus 17.39%, respectively, demonstrating this is an effective, safe and noninvasive treatment method. Conclusion: This new adjuvant therapeutic proposal with low-level laser therapy aided healing of surgical wounds, preventing morbidities, as well as decreasing hospital stay, which implies cost of reduction for patients and for the institution.

  12. Neonatal Death

    Science.gov (United States)

    ... Home > Complications & Loss > Loss & grief > Neonatal death Neonatal death E-mail to a friend Please fill in ... cope with your baby’s death. What is neonatal death? Neonatal death is when a baby dies in ...

  13. Telomere Length in Preterm Infants: A Promising Biomarker of Early Adversity and Care in the Neonatal Intensive Care Unit?

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    Livio Provenzi

    2017-10-01

    Full Text Available Preterm infants present an immature neurobehavioral profile at birth, even in absence of severe brain injuries and perinatal complications. As such, they require a long-lasting hospitalization in the Neonatal Intensive Care Unit (NICU, which is thought to grant at-risk newborns’ survival, but still entails a number of physical, painful, and socio-emotional stressors. Hence, preterm birth and NICU stay represent an early adverse experience, which has been linked to detrimental consequences for neurological, neuro-endocrinal, behavioral, and socio-emotional development, as well as to disease later in life. Recent advances in the behavioral epigenetic field are helping us to unveil the potential mechanisms through which early NICU-related stress may lead to negative developmental outcomes. From this perspective, telomere regulation might be a key programming mechanism. Telomeres are the terminal portion of chromosomes and are known to get shorter with age. Moreover, telomere length (TL is affected by the exposure to stress during early development. As such, TL might be an innovative biomarker of early adverse exposures in young infants and children. Unfortunately, there is paucity of studies investigating TL in populations of preterm infants and its association with known NICU-related stressors remains unexplored. In the present paper, the potential relevance of TL for research and clinical work with preterm infants will be underlined in the light of recent contributions linking progressive telomere shortening and early exposure to adverse experiences and stressful environments in humans. Finally, insights will be provided to guide clinically relevant translational research on TL in the field of VPT birth and NICU stay.

  14. The Effects of Acoustic White Noise on the Rat Central Auditory System During the Fetal and Critical Neonatal Periods: A Stereological Study.

    Science.gov (United States)

    Salehi, Mohammad Saied; Namavar, Mohammad Reza; Tamadon, Amin; Bahmani, Raziyeh; Jafarzadeh Shirazi, Mohammad Reza; Khazali, Homayoun; Dargahi, Leila; Pandamooz, Sareh; Mohammad-Rezazadeh, Farzad; Rashidi, Fatemeh Sadat

    2017-01-01

    To evaluate the effects of long-term, moderate level noise exposure during crucial periods of rat infants on stereological parameters of medial geniculate body (MGB) and auditory cortex. Twenty-four male offspring of 12 pregnant rats were divided into four groups: fetal-to-critical period group, which were exposed to noise from the last 10 days of fetal life till postnatal day (PND) 29; fetal period group that exposed to noise during the last 10 days of fetal life; critical period group, exposed to noise from PND 15 till PND 29, and control group. White noise at 90 dB for 2 h per day was used. Variance for variables was performed using Proc GLM followed by mean comparison by Duncan's multiple range test. Numerical density of neurons in MGB of fetal-to-critical period group was lower than control group. Similar results were seen in numerical density of neurons in layers IV and VI of auditory cortex. Furthermore, no significant difference was observed in the volume of auditory cortex among groups, and only MGB volume in fetal-to-critical period group was higher than other groups. Estimated total number of neurons in MGB was not significantly different among groups. It seems necessary to prevent long-term moderate level noise exposure during fetal-to-critical neonatal period.

  15. Early amplitude‐integrated electroencephalography for monitoring neonates at high risk for brain injury

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    Gabriel Fernando Todeschi Variane

    2017-09-01

    Conclusion: This study supports previous results and demonstrates the utility of amplitude‐integrated electroencephalography for monitoring brain function and predicting early outcome in the studied groups of infants at high risk for brain injury.

  16. Association of BPD and IVH with early neutrophil and white counts in VLBW neonates with gestational age <32 weeks

    Science.gov (United States)

    Palta, Mari; Sadek-Badawi, Mona; Carlton, David P

    2008-01-01

    Objectives To investigate associations between early low neutrophil count from routine blood samples, white blood count (WBC), pregnancy complications and neonatal outcomes for very low birth weight infants (VLBW ≤1500g) with gestational age <32 weeks. Patients and Methods Information was abstracted on all infants admitted to level III NICUs in Wisconsin 2003-2004. 1002 (78%) had differential and corrected total white counts within 2 ½ hours of birth. Data analyses included frequency tables, binary logistic, ordinal logistc and ordinary regression. Results Low neutrophil count (<1000/μL) was strongly associated with low WBC, pregnancy complications and antenatal steroids. Low neutrophil count predicted bronchopulmonary dysplasia severity level (BPD) (OR: 1.7, 95% CI: 1.1-2.7) and intraventricular hemorrhage (IVH) grade (OR: 2.2, 95% CI: 1.3-3.8). Conclusions Early neutrophil counts may have multiple causes interfering with their routine use as an inflammatory marker. Nonetheless, low neutrophil count has consistent independent associations with outcomes. PMID:18563166

  17. Routine culture-based screening versus risk-based management for the prevention of early-onset group B streptococcus disease in the neonate: a systematic review.

    Science.gov (United States)

    Kurz, Ella; Davis, Deborah

    2015-04-17

    Early-onset group B streptococcus disease, recognized as the most common cause of early onset neonatal sepsis in developed countries, is transmitted vertically from the group B streptococcus carrier mother to the neonate in the peripartum. Accordingly, early-onset group B streptococcus disease is prevented by halting the transmission of the microorganism from the mother to the infant. Two main methods, routine culture-based screening and risk-based management, may be used in the identification of mothers requiring intrapartum antibiotic prophylaxis in labor. While there are advantages and disadvantages to each, there is limited high level evidence available as to which method is superior. To identify the effectiveness of risk-based management versus routine culture-based screening in the prevention of early-onset group B streptococcus disease in the neonate. This review considered studies which treated pregnant women with intrapartum antibiotic prophylaxis following risk- and culture-based protocols for the prevention of early-onset group B streptococcus disease in the neonate. Types of intervention: This review considered studies that evaluated risk-based management against routine culture-based screening for the prevention of early-onset group B streptococcus disease in the neonate. Types of studies: This review looked for highest evidence available which in this case consisted of one quasi experimental study and eight comparative cohort studies with historical or concurrent control groups. Types of outcomes: Incidence of early-onset group B streptococcus disease in neonates as measured by positive group B streptococcus culture from an otherwise sterile site. Secondary outcomes include neonatal death due to group B streptococcus sepsis and percentage of women who received intrapartum antibiotic prophylaxis. A multi-step search strategy was used to find studies which were limited to the English language and published between January 2000 and June 2013. The quality

  18. Serum zinc status of neonates with seizure

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    Olia Sharmeen

    2016-08-01

    Full Text Available Background: Seizure is a common neurological disorder in neonatal age group!. Primary metabolic derangement is one of the important reason behind this convulsion during this period. Among primary metabolic derangement hypoglycemia, is most common followed by bypocalcaemia, hypomagnesaemia, low zinc status etc. As causes of many cases of convul­sion remain unknown in neonate. Objectives: To see the zinc status in the sera of neonate with convulsion. So that if needed early intervention can be taken up and thereby prevent complications. Method: A total of 50 neonates (1-28 days who had convulsion with no apparent reasons of convulsion were enrolled as cases and 50 healthy age and sex matched neonates were enrolled as controls. After a quick clinical evaluation serum zinc status was estimated from venous blood by atomic absorption method in Chemistry Division, Atomic Energy Centre. Low zinc was considered if serum value was <0.7mg/L. Results: Among a total of 50 cases 6% had low zinc value & 2% of controls also had low zinc level. The mean serwu zinc level of cases and controls were 1.57±0.95 and 2.37±1.06 mmol/1 respectively (p<0.01. Conclusion: From the study it is seen that low zinc value is an important cause of neonatal seizure due to primary metabolic abnormalities. So early recognition and treatment could save these babies from long term neurological sequelies.

  19. [Congenital megacolon in neonates and infants: impact of early, one-stage repair on morbidity and surgical complications].

    Science.gov (United States)

    Calisti, A; Molle, P H; Vallasciani, S

    2004-01-01

    Hirschsprung's disease (HD) is a major cause of congenital bowel obstruction in children. Classical management includes stoma creation, a pull-through procedure, and restoration of bowel continuity. Colostomy may be also pulled through directly at second operation. Since the first report of a single stage (SS) primary pull-through without colostomy for HD, in 1980, several patients have been treated according to this procedure, even in neonatal period. All of them had a favourable outcome with better compliance of families and less hospital stay. The Authors reviewed the clinical records of 22 patients selected among 36 treated for HD between 1992 and 2000; in all, disease extended to rectum-sigma-descendent; all cases of "total aganglionosis" or "ultra short" cases were excluded. Fifteen patients underwent SS repair: 11 neonates were operated at mean age of 69 days (range 14-172). In four infants diagnosis was made later (mean age 15 +/- 9 months) and SS repair was performed 8 days after (range 4-14). Seven patients underwent multiple stage (MS) repairs for clinical reasons: pull-through of the previous colostomy was performed at mean age of 171 days (range 47-330). A Duhamel procedure with an Endo-GIA linear stapler was performed in all No differences in gestational age or birth weight were found in both groups. Complications were observed only in the MS group (2 related to colostomy, 1 to postoperative adhesions). The Authors conclude that primary SS treatment of HD is safe and effective even in newborn patient, reduce familiar stress and hospital stay. The lower morbidity and complication rates could be explained by the limited bowel manipulation. Accurate histological-hystochemical diagnosis and meticulous preoperative bowel management should be part of the management.

  20. Systemic Candidiasis in Extremely Low Birthweight (ELBW) Neonates Despite the Routine Use of Topical Miconazole Prophylaxis: Trends, Risk Factors and Outcomes over an 11-Year Period.

    Science.gov (United States)

    Sriram, Bhavani; Agarwal, Pratibha K; Tee, Nancy W S; Rajadurai, Victor S

    2014-05-01

    This study aims to determine the incidence, trends of systemic candidiasis and meningitis in extremely low birthweight (ELBW) neonates (candidiasis and meningitis over an 11-year period (1997 to 2007). Matched case control analyses were performed to determine the risk factors and comorbidities which were severe intraventricular haemorrhage (IVH), severe retinopathy of prematurity (ROP), patent ductus arteriosus (PDA) requiring treatment, necrotising enterocolitis (NEC), chronic lung disease (CLD) and cholestatic jaundice. Mortality and end organ involvement secondary to systemic candidiasis were identified as adverse outcomes. Of the 757 ELBW neonates, 51 (6.7%) had evidence of systemic candidiasis with a significant 3-fold increase in trend noted in 2007 as compared against 1997 (12.1% vs 3.8%) (RR 1.2, 95% CI, 1.06 to 1.36, P candidiasis (0% in 1997 vs 7.1% in 2007, RR 1.40, 95% CI, 1.04 to 1.25, P = 0.005). On logistic regression analysis, decreasing gestational age was an independent risk factor for systemic candidiasis (OR 2.0, 95% CI, 1.52 to 2.63, P candidiasis despite routine use of topical miconazole prophylaxis is of concern and future studies comparing the use of systemic fl uconazole versus oral nystatin may need to be considered.

  1. Does the Length of Fielding Period Matter? Examining Response Scores of Early Versus Late Responders

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    Sigman Richard

    2014-12-01

    Full Text Available This article discusses the potential effects of a shortened fielding period on an employee survey’s item and index scores and respondent demographics. Using data from the U.S. Office of Personnel Management’s 2011 Federal Employee Viewpoint Survey, we investigate whether early responding employees differ from later responding employees. Specifically, we examine differences in item and index scores related to employee engagement and global satisfaction. Our findings show that early responders tend to be less positive, even after adjusting their weights for nonresponse. Agencies vary in their prevalence of late responders, and score differences become magnified as this proportion increases. We also examine the extent to which early versus late responders differ on demographic characteristics such as grade level, supervisory status, gender, tenure with agency, and intention to leave, noting that nonminorities and females are the two demographic characteristics most associated with responding early.

  2. Effects of repeated anesthesia by thiopental in neonatal period on PTZ-induced convulsions and pain responses during maturation in rats

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    Fatemeh Faghih Majidi

    2012-06-01

    Full Text Available Introduction: General anesthetics during critical periods of brain development may cause some seriousmalformations or side effects. Anesthetic drugs can involve in the brain development and synaptogenesis atthe critical period of development. There are some controversy with regards the effects of(neurodegenerative or neuroprotective barbiturates on brain. The aim of the present study was toinvestigate the possible relation between repeated induced thiopental (a GABAA agonist anesthesia at thepostnatal period and pentylentetrazol-induced convulsions and pain responses in adult in the Wistar rats.Materials and methods: 40 male neonate rats were divided into experimental and sham groups. Theexperimental group (n=20 was deeply anesthetized with thiopental (30 mg/kg daily during 10 to 20-daysof post- natal period and physiologic serum was used for sham animals. After maturation of male rats, thePTZ-induced seizures were induced by daily interapritoneally injection of PTZ (45 mg/kg, and thelatency of the appearance of generalized epileptiform behaviors was recorded. Pain responses were alsoevaluated using tail-flick and formalin tests.Results: No significant differences were found in the lantency of the appearance of behaviouralconvulsions and pain sensitivity between experimental and sham groups.Conclusion: Our findings indicate that prior exposure to thiopental during nenonatal stage has no effectson PTZ-induced seizures and also pain responses after maturation. Developmental compensatorymechanisms may protect the brian against the possible damage that induced by repeated thipopental duringneonatal period.

  3. Neonatal bartter syndrome in an extremely low birth weight baby

    Directory of Open Access Journals (Sweden)

    Deeparaj Hegde

    2017-01-01

    Full Text Available Early diagnosis of Bartter syndrome (BS in the neonatal period is a clinical challenge, more so in an extremely low birth weight (ELBW baby because of the inherent renal immaturity and the associated difficulty in fluid management. However, once a diagnosis is made, the disorder is known to respond well to fluid and electrolyte management, prostaglandin inhibitors, and potassium-sparing diuretics. Herein, we report a case of neonatal BS in a very premature ELBW infant.

  4. Early postnatal diets affect the bioregional small intestine microbiome and ileal metabolome in neonatal piglets

    Science.gov (United States)

    Exclusive breastfeeding is known to be protective against gastrointestinal disorders and may modify gut development. Although the gut microbiome has been implicated, little is known about how early diet impacts the small intestinal microbiome, and how microbial shifts impact gut metabolic physiology...

  5. Early increased levels of matrix metalloproteinase-9 in neonates recovering from respiratory distress syndrome

    NARCIS (Netherlands)

    Dik, Willem A.; van Kaam, Anton H. L. C.; Dekker, Tamara; Naber, Brigitta A. E.; Janssen, Daphne J.; Kroon, A. A.; Zimmermann, Luc J. I.; Versnel, Marjan A.; Lutter, René

    2006-01-01

    Aim: Matrix metalloproteinases (MMPs) play an eminent role in airway injury and remodelling. We explored the hypothesis that pulmonary MMP levels would differ early after birth (2-4 days) between infants with resolving respiratory distress syndrome (RDS) and infants developing chronic lung disease

  6. Determination of human platelet antigen typing by molecular methods: Importance in diagnosis and early treatment of neonatal alloimmune thrombocytopenia.

    Science.gov (United States)

    Arinsburg, Suzanne A; Shaz, Beth H; Westhoff, Connie; Cushing, Melissa M

    2012-05-01

    Neonatal alloimmune thrombocytopenia (NAIT) is the most common cause of severe thrombocytopenia and intracranial hemorrhage in the perinatal period. While the gold standard for making a diagnosis of NAIT is detection of a human platelet antigen (HPA)-specific antibody in maternal serum, together with identifying an incompatibility between the parents for the cognate HPA antigen, platelet genotyping is the gold standard method for HPA typing. Platelet genotyping is critical in screening at-risk fetuses for the presence ofthe HPA corresponding to the maternal antibody. In addition, platelet genotyping may play a role in population screening to identify women at risk for sensitization, and thus, fetuses at risk for NAIT. The most commonly used methods of platelet genotyping are sequence-specific primer-polymerase chain reaction (PCR-SSP), restriction fragment length polymorphism-PCR (PCR-RFLP), and TaqMan real-time PCR. PCR-SSP and PCR-RFLP are relatively inexpensive and technically simple methods, but they are not easily automated and require expertise for reliable interpretation of results. Newer methods that allow for multiplexing, automation, and easily interpretable results, such as bead arrays, are currently in development and available for research purposes. Copyright © 2012 Wiley Periodicals, Inc.

  7. [Neonatal cholestasis

    Science.gov (United States)

    Roquete, M L

    2000-07-01

    OBJECTIVE: To warn pediatricians about the early recognition of cholestasis in newborns and infants. METHODS: A bibliographic research about cholestasis was performed using Medline, and emphasizing the most relevant publications of the last 30 years. RESULTS: The concept of cholestasis and the causes of cholestatic tendency in newborns and infants are described. Several causes of intra and extrahepatic cholestasis are reported as well. In this review, only the diseases with diagnostic, therapeutic or prognostic peculiarities are commented, including extrahepatic biliary atresia, idiopathic neonatal hepatitis, galactosemia, and Alagille s syndrome. Furthermore, several resources are discussed for the diagnosis of cholestasis. CONCLUSIONS: The establishment of the diagnosis of cholestasis through the detection of hyperbilirubinemia in newborns who present jaundice after 14 days of life is a goal that could change the prognosis of several diseases responsible for neonatal cholestasis.

  8. Changes in food processing and occlusal dental wear during the early agricultural period in northwest Mexico.

    Science.gov (United States)

    Watson, James T

    2008-01-01

    Crown dimensions and occlusal surface wear rate and wear plane were evaluated using paired first and second mandibular molars from a sample of 84 Early Agricultural period (1600 B.C.-A.D. 200) skeletons from northwest Mexico. Although this period represents a major shift in subsistence strategies in the Sonoran Desert, from food-foraging to agriculture, archaeological and dental pathology studies have identified this period as one of relative dietary stability. It was therefore predicted that very little variation in occlusal wear would have occurred between the early phase (San Pedro: 1600-800 B.C.) and late phase (Cienega: 800 B.C.-A.D. 200). Comparison of crown diameters identified some phenotypic differences between sexes but not between archaeological phases. Molar occlusal surfaces were then divided into four quadrants, and wear scores recorded for each quadrant. Principle axis analysis was performed between total wear scores of paired, adjacent first and second mandibular molars to assess rate and occlusal wear plane over time. The analysis demonstrated that both wear rate and wear plane increased from the early to the late phase of the Early Agricultural period. These results indicate that although diet may have indeed remained stable during this period in the Sonoran Desert increases in the rate of wear and wear plane may reflect changes in food-processing techniques. It is suggested that more intensive processing of agricultural products during the Cienega phase simultaneously softened the diet to create more tooth-contact wear and introduced more grit to cause faster and more angled wear on the molar occlusal surfaces. (c) 2007 Wiley-Liss, Inc.

  9. Hand disinfection in a neonatal intensive care unit: continuous electronic monitoring over a one-year period.

    Science.gov (United States)

    Helder, Onno K; van Goudoever, Johannes B; Hop, Wim C J; Brug, Johannes; Kornelisse, René F

    2012-10-08

    Good hand hygiene compliance is essential to prevent nosocomial infections in healthcare settings. Direct observation of hand hygiene compliance is the gold standard but is time consuming. An electronic dispenser with built-in wireless recording equipment allows continuous monitoring of its usage. The purpose of this study was to monitor the use of alcohol-based hand rub dispensers with a built-in electronic counter in a neonatal intensive care unit (NICU) setting and to determine compliance with hand hygiene protocols by direct observation. A one-year observational study was conducted at a 27 bed level III NICU at a university hospital. All healthcare workers employed at the NICU participated in the study. The use of bedside dispensers was continuously monitored and compliance with hand hygiene was determined by random direct observations. A total of 258,436 hand disinfection events were recorded; i.e. a median (interquartile range) of 697 (559-840) per day. The median (interquartile range) number of hand disinfection events performed per healthcare worker during the day, evening, and night shifts was 13.5 (10.8 - 16.7), 19.8 (16.3 - 24.1), and 16.6 (14.2 - 19.3), respectively. In 65.8% of the 1,168 observations of patient contacts requiring hand hygiene, healthcare workers fully complied with the protocol. We conclude that the electronic devices provide useful information on frequency, time, and location of its use, and also reveal trends in hand disinfection events over time. Direct observations offer essential data on compliance with the hand hygiene protocol. In future research, data generated by the electronic devices can be supplementary used to evaluate the effectiveness of hand hygiene promotion campaigns.

  10. Heart rate variability during sleep in healthy term newborns in the early postnatal period

    International Nuclear Information System (INIS)

    Doyle, O M; Korotchikova, I; Boylan, G B; Lightbody, G; Marnane, W; Kerins, D

    2009-01-01

    Normative time- and frequency-domain heart rate variability (HRV) measures were extracted during quiet sleep (QS) and active sleep (AS) periods in 30 healthy babies. All newborn infants studied were less than 12 h old and the sleep state was classified using multi-channel video EEG. Three bands were extracted from the heart rate (HR) spectrum: very low frequency (VLF), 0.01–0.04 Hz; low frequency (LF), 0.04–0.2 Hz, and high frequency (HF), >0.2 Hz. All metrics were averaged across all patients and per sleep state to produce a table of normative values. A noticeable peak corresponding to activity in the RSA band was found in 80% patients during QS and 0% of patients during AS, although some broadband activity was observed. The majority of HRV metrics showed a statistically significant separation between QS and AS. It can be concluded that (i) activity in the RSA band is present during QS in the healthy newborn, in the first 12 h of life, (ii) HRV measures are affected by sleep state and (iii) the averaged HRV metrics reported here could assist the interpretation of HRV data from newborns with neonatal illnesses

  11. Variation in lumbar punctures for early onset neonatal sepsis: a nationally representative serial cross-sectional analysis, 2003-2009

    Directory of Open Access Journals (Sweden)

    Patrick Stephen W

    2012-08-01

    Full Text Available Abstract Background Whether lumbar punctures (LPs should be performed routinely for term newborns suspected of having early onset neonatal sepsis (EONS is subject to debate. It is unclear whether variations in performance of LPs for EONS may be associated with patient, hospital, insurance or regional factors. Our objective was to identify characteristics associated with the practice of performing LPs for suspected EONS in a nationally representative sample. Methods Utilizing data from the 2003, 2006 and 2009 Kids’ Inpatient Database (KID compiled by the Agency for Healthcare Research and Quality, we examined the frequency and characteristics of term, normal-birth weight newborns receiving an LP for EONS. Survey-weighting was applied for national estimates and used in chi squared and multivariable regression analysis. Results In 2009, there were 13,694 discharges for term newborns that underwent LPs for apparent EONS. Newborns having LPs performed were more likely to be covered by Medicaid vs. private insurance (51.9 vs. 45.1 percent; p Conclusions We found pronounced variation in LPs performed for EONS, even when adjusting for clinical conditions that would prompt LPs. These findings indicate practice variations in newborn care that merit further examination and explanation.

  12. Early Outcomes of Endoscopic Vein Harvesting during the Initial Learning Period

    Directory of Open Access Journals (Sweden)

    Do Yeon Kim

    2015-06-01

    Full Text Available Background: The endoscopic vein harvesting (EVH method has been used in coronary artery bypass surgery in many countries. We started using the EVH method recently, and investigated the results during the early learning period. Methods: Between March 2012 and June 2014, 75 patients (31 patients in the EVH method group, and 44 patients in the open method group who underwent isolated first-time coronary artery bypass grafting using vein grafts were retrospectively analyzed with respect to the early outcomes including graft patency and risk factors for leg wound complications. For assessing the patency of vein graft, we performed coronary computed tomography angiography during the immediate postoperative period and 6 months later. Results: Mean harvesting time of endoscopic method was about 15 minutes. Patency rate during the immediate operative period and the 6-month patency rate were similar between the two groups (postoperative period: EVH 100% vs. open method 94.4%, p=0.493; at 6 months: EVH 93.3% vs. open method 90.9%, p=0.791. Leg wound complications occurred more frequently in the open method group (EVH 3.2% vs. open method 13.6%, p=0.127. According to the analysis, age was an independent risk factor for leg wound complications. Conclusion: EVH is a feasible method even for beginners and can be performed satisfactorily during their learning period.

  13. "These are not good things for other people to know": how rural Tanzanian women's experiences of pregnancy loss and early neonatal death may impact survey data quality.

    Science.gov (United States)

    Haws, Rachel A; Mashasi, Irene; Mrisho, Mwifadhi; Schellenberg, Joanna Armstrong; Darmstadt, Gary L; Winch, Peter J

    2010-11-01

    Little research in low-income countries has compared the social and cultural ramifications of loss in childbearing, yet the social experience of pregnancy loss and early neonatal death may affect demographers' ability to measure their incidence. Ninety-five qualitative reproductive narratives were collected from 50 women in rural southern Tanzania who had recently suffered infertility, miscarriage, stillbirth or early neonatal death. An additional 31 interviews with new mothers and female elders were used to assess childbearing norms and social consequences of loss in childbearing. We found that like pregnancy, stillbirth and early neonatal death are hidden because they heighten women's vulnerability to social and physical harm, and women's discourse and behaviors are under strong social control. To protect themselves from sorcery, spiritual interference, and gossip--as well as stigma should a spontaneous loss be viewed as an induced abortion--women conceal pregnancies and are advised not to mourn or grieve for "immature" (late-term) losses. Twelve of 30 respondents with pregnancy losses had been accused of inducing an abortion; 3 of these had been subsequently divorced. Incommensurability between Western biomedical and local categories of reproductive loss also complicates measurement of losses. Similar gender inequalities and understandings of pregnancy and reproductive loss in other low-resource settings likely result in underreporting of these losses elsewhere. Cultural, terminological, and methodological factors that contribute to inaccurate measurement of stillbirth and early neonatal death must be considered in designing surveys and other research methods to measure pregnancy, stillbirth, and other sensitive reproductive events. Copyright © 2010 Elsevier Ltd. All rights reserved.

  14. The association between maternal cervicovaginal proinflammatory cytokines concentrations during pregnancy and subsequent early-onset neonatal infection.

    Science.gov (United States)

    Kalinka, Jarosław; Krajewski, Paweł; Sobala, Wojciech; Wasiela, Małgorzata; Brzezińska-Błaszczyk, Ewa

    2006-01-01

    The aim of this study was to investigate the relationship between the concentration of selected proinflammatory cytokines (IL-1alpha, IL-1beta, IL-6 and IL-8) in cervicovaginal fluid, as measured in midgestation, and the risk of early-onset neonatal infection (EONI). Cervicovaginal fluids were obtained from a cohort of 114 pregnant women at 22 to 34 weeks' gestation. The samples were analyzed for the concentrations of selected proinflammatory cytokines using standard enzyme-linked immunosorbent assay technique (ELISA). Lower genital tract microbiology was diagnosed using Gram stain method according to Spiegel's criteria and by culture. Mean gestational age at the time of sampling was 29.0 weeks. Mean time between sampling and delivery was 9.3 (SD 4.7) weeks. Bacterial vaginosis (BV) was diagnosed in 27.2% of subjects and M. hominis and U. urealyticum in 22.8% and 26.3%, respectively. Out of 114 women examined, 20 (17.5%) delivered newborns with EONI. Median cervicovaginal concentrations of IL-1alpha, IL-1beta, IL-6 and IL-8 did not differ between women who delivered newborns with EONI as compared to women who delivered newborns without EONI. Women with pathological lower genital tract microflora and low IL-8 concentration (below 25(th) percentile) during pregnancy presented a significant risk of delivering newborns with EONI (OR=4.9; 95% CI, 1.1-22.8). Subjects with pathological lower genital tract microflora and a low concentration of more than one cytokine had the highest risk of delivering a newborn with EONI, OR=16.2, 95% CI, 1.1-234.0. Cytokine measurement in cervicovaginal fluid in early gestation could be useful for predicting subsequent EONI only among pregnant women with lower genital tract infection. Maternal genital tract immune hyporesponsiveness as represented by low concentrations of proinflammatory cytokines may create a permissive environment for ascending infection and may lead to subsequent EONI.

  15. Ruptured Sinus of Valsalva Aneurysm and Coarctation of Aorta in a Woman at Early Postpartum Period

    Directory of Open Access Journals (Sweden)

    Erol Sener

    2014-01-01

    Full Text Available Coarctation of aorta and sinus of Valsalva aneurysm are frequently missed congenital cardiac defects that their diagnosis might be delayed. To our knowledge, coincidence of these cardiac defects is unusual and has not been reported in the literature before. Here, we present a patient with coarctation of aorta and ruptured noncoronary sinus of Valsalva aneurysm leading to aorto-right atrial fistula in the early postpartum period and our management of this unusual case.

  16. Progressive changes in arch width from primary to early mixed dentition period: A longitudinal study

    OpenAIRE

    S Sangwan; H S Chawla; A Goyal; K Gauba; U Mohanty

    2011-01-01

    Objective: The present study was conducted to evaluate, on a longitudinal basis, the changes in intercanine and intermolar widths form the primary to the early mixed dentition periods. Materials and Methods: A total of 38 children aged 4-5 years, with normal occlusion without any proximal caries or any dental anomalies, were selected. The impressions were recorded and casts were prepared. Intercanine and intermolar widths were measured on these dental casts with the help of a digital vernier ...

  17. Effects of denial of reward through maternal contact in the neonatal period on adult hypothalamic-pituitary-adrenal axis function in the rat.

    Science.gov (United States)

    Diamantopoulou, Anastasia; Raftogianni, Androniki; Stamatakis, Antonios; Oitzl, Melly S; Stylianopoulou, Fotini

    2013-06-01

    Emotional behavioral traits associated with stress response are well documented to be affected by early life events. In the present work, we used a novel paradigm of neonatal experience, in which pups were trained in a T-maze and either received (RER rats) or were denied (DER) the reward of maternal contact, during postnatal days 10-13. We then evaluated stress coping and key factors controlling the function of the hypothalamic-pituitary-adrenal axis in adulthood. Adult male DER rats exposed to a single session of forced swim stress (FSS) showed increased immobility, while RER rats exhibited increased escape attempts. The corticosterone response following this stressor was higher although not prolonged in the DER rats. Their CRH mRNA levels in the PVN were increased up to 2h after the forced swim. However, basal levels of these hormones did not differ among groups. In addition, the DER neonatal experience induced an increase in hippocampal GR but a decrease in CRH-R1 immunopositive cells in the CA1 area of the hippocampus and the central amygdala. Overall, these data show a distinct stress response profile in the DER male rats, characterized by passive coping during the forced swim, increased hormonal response following stress, increased inhibitory control through GR and an indirect contribution of CRH-R1, the latter two factors resulting in a modified regulation of the response termination. It thus appears that DER rats have an enhanced potential for appropriate reactivity upon an incoming challenge, while maintaining in parallel an adequate control of the duration of their stress responses. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Randomized Controlled Trial on Effect of Intermittent Early Versus Late Kangaroo Mother Care on Human Milk Feeding in Low-Birth-Weight Neonates.

    Science.gov (United States)

    Jayaraman, Dhaarani; Mukhopadhyay, Kanya; Bhalla, Anil Kumar; Dhaliwal, Lakhbir Kaur

    2017-08-01

    Breastfeeding at discharge among sick low-birth-weight (LBW) infants is low despite counseling and intervention like kangaroo mother care (KMC). Research aim: The aim was to study the effects of early initiation of KMC on exclusive human milk feeding, growth, mortality, and morbidities in LBW neonates compared with late initiation of KMC during the hospital stay and postdischarge. A randomized controlled trial was conducted in level 2 and 3 areas of a tertiary care neonatal unit over 15 months. Inborn neonates weighing 1 to 1.8 kg and hemodynamically stable were randomized to receive either early KMC, initiated within the first 4 days of life, or late KMC (off respiratory support and intravenous fluids). Follow-up was until 1 month postdischarge. Outcomes were proportion of infants achieving exclusive human milk feeding and direct breastfeeding, growth, mortality and morbidities during hospital stay, and postdischarge feeding and KMC practices until 1 month. The early KMC group ( n = 80) achieved significantly higher exclusive human milk feeding (86% vs. 45%, p milk feeding (73% vs. 36%, p milk feeding and direct breastfeeding in LBW infants.

  19. Factors in Dry Period Associated with Intramammary Infection and Subsequent Clinical Mastitis in Early Postpartum Cows

    Directory of Open Access Journals (Sweden)

    Kansuda Leelahapongsathon

    2016-04-01

    Full Text Available The objective of this study was to determine cow characteristics and farm management factors during the dry period associated with early postparturient intramammary infection (IMI and subsequent clinical mastitis (CM. Data were collected three times: before drying off (P1, during the dry period (P2, and 5 to 14 days after calving (P3, using questionnaires and farm investigation. Milk samples were aseptically collected for bacterial identification at P1 and P3. Factors associated with IMI and CM were analyzed using multiple logistic regression models. The final model showed that IMI in early postpartum was significantly associated with full insertion of dry cow antibiotic, dry cows in barns with a combination of tie and free stalls, body condition score (BCS in dry period and after calving, and milk yield before drying off. For IMI cows, factors significantly associated with clinical expression of mastitis were having daily barn cleaning, teat disinfected with alcohol before administration of dry cow therapy, BCS before drying off, milk yield before drying off, and days in milk at drying off. In conclusion, both cow and farm management factors are associated with the IMI rate and subsequent expression of clinical signs of mastitis in early postpartum cows.

  20. Chronology of the early period of the Ananyino cultural and historical area

    Directory of Open Access Journals (Sweden)

    Kuzminykh Sergei V.

    2014-09-01

    Full Text Available Problems related to the chronology of the early period in the Ananyino cultural and historical area development are discussed in the article. The chronology is based upon the objects imported from the Black Sea region, Northern Caucasus and Transcaucasia and their Ananyino replicas or imitations. Radiocarbon dates have also been taken into account. The period under consideration is divided into two stages (I-1 and I-2. They are characterized by differing technological facilities that had determined the appearance of a differing set of material culture objects. The first stage, the transition from the Bronze Age to the Early Iron Age, is dated within the 9th to mid-8th century BC. The second phase (mid-8th to first quarter/first half of the 7th century BC is associated with the spread of Caucasian imports in the Volga-Kama area and mostly in the post-Maklasheevka culture sites. On the basis of these imports it is possible to claim that the Ananyino area was included into the international trade and exchange system of Eastern Europe, the Caucasus and Transcaucasia. Monuments of the early period of the Ananyino cultural and historical area are primarily synchronized with the pre-Scythian funeral monuments of the steppe zone of Eastern Europe and the Caucasus.

  1. Term infants born at home in Peru are less likely to be hospitalised in the neonatal period than those born in hospital.

    Science.gov (United States)

    Lavin, Tina; Preen, David B

    2017-08-01

    More than 50% of women worldwide give birth at home, but little is known about home birth and subsequent neonatal hospitalisation. The objective of the study was to investigate home birth and neonatal hospitalisation of term neonates in Peru. The relationship between birth setting [home - with or without skilled birth attendant (SBA), health centre, hospital] and neonatal hospitalisation (n = 1656) and incubator care (n = 1651) was investigated using data from the 2002 Young Lives Study. Infants were sampled from 20 sentinel sites across Peru. At each sentinel site 100 households with children aged 6-18 months were randomly sampled (therefore the sample only captured children surviving to 6 months of age). Multivariate regression modelling was used with models adjusted for a range of demographic and clinical factors. After adjustment, the odds of hospitalisation were lower in neonates born at home (with SBA OR 0.20, 95% CI 0.0-0.8, p = 0.021; without SBA OR = 0.4, 95% CI 0.2-0.7, p = 0.002) than in those born in hospital. Socio-demographic factors such as ethnicity, rural living, education, socio-economic status and access to transport did not influence neonatal hospitalisation, time in hospital, incubator care or time under incubator care. Neonates born at home were less likely to be hospitalised after birth owing to neonatal morbidity than neonates born in hospital. It is unclear whether this finding reflects poorer accessibility to hospital care for neonates born at home, or if neonates born at home required hospitalisation less frequently than neonates born in hospital owing to lower neonatal morbidity or other factors such as lower rates of medical intervention for home births. Further research is needed to explore the underlying mechanisms of these findings.

  2. Transient neonatal diabetes or neonatal hyperglycaemia: A case ...

    African Journals Online (AJOL)

    Transient neonatal diabetes and neonatal hyperglycaemia both present in the neonatal period with features of hyperglycaemia, dehydration and weight loss. Differentiating these conditions clinically is difficult. We describe the case of a 13 day old female whom we managed recently who could have had either condition.

  3. Early blood glucose profile and neurodevelopmental outcome at two years in neonatal hypoxic-ischaemic encephalopathy.

    LENUS (Irish Health Repository)

    Nadeem, Montasser

    2012-01-31

    BACKGROUND: To examine the blood glucose profile and the relationship between blood glucose levels and neurodevelopmental outcome in term infants with hypoxic-ischaemic encephalopathy. METHODS: Blood glucose values within 72 hours of birth were collected from 52 term infants with hypoxic-ischaemic encephalopathy. Hypoglycaemia [< 46.8 mg\\/dL (2.6 mmol\\/L)] and hyperglycaemia [> 150 mg\\/dL (8.3 mmol\\/L)] were correlated to neurodevelopmental outcome at 24 months of age. RESULTS: Four fifths of the 468 blood samples were in the normoglycaemic range (392\\/468:83.8%). Of the remaining 76 samples, 51.3% were in the hypoglycaemic range and (48.7%) were hyperglycaemic. A quarter of the hypoglycaemic samples (28.2%:11\\/39) and a third of the hyperglycaemic samples (32.4%:12\\/37) were recorded within the first 30 minutes of life. Mean (SD) blood glucose values did not differ between infants with normal and abnormal outcomes [4.89(2.28) mmol\\/L and 5.02(2.35) mmol\\/L, p value = 0.15] respectively. In term infants with hypoxic-ischaemic encephalopathy, early hypoglycaemia (between 0-6 hours of life) was associated with adverse outcome at 24 months of age [OR = 5.8, CI = 1.04-32)]. On multivariate analysis to adjust for grade of HIE this association was not statistically significant. Late hypoglycaemia (6-72 hours of life) was not associated with abnormal outcome [OR = 0.22, CI (0.04-1.14)]. The occurrence of hyperglycaemia was not associated with adverse outcome. CONCLUSION: During the first 72 hours of life, blood glucose profile in infants with hypoxic-ischaemic encephalopathy varies widely despite a management protocol. Early hypoglycaemia (0-6 hours of life) was associated with severe HIE, and thereby; adverse outcome.

  4. Early blood glucose profile and neurodevelopmental outcome at two years in neonatal hypoxic-ischaemic encephalopathy

    LENUS (Irish Health Repository)

    Nadeem, Montasser

    2011-02-04

    Abstract Background To examine the blood glucose profile and the relationship between blood glucose levels and neurodevelopmental outcome in term infants with hypoxic-ischaemic encephalopathy. Methods Blood glucose values within 72 hours of birth were collected from 52 term infants with hypoxic-ischaemic encephalopathy. Hypoglycaemia [< 46.8 mg\\/dL (2.6 mmol\\/L)] and hyperglycaemia [> 150 mg\\/dL (8.3 mmol\\/L)] were correlated to neurodevelopmental outcome at 24 months of age. Results Four fifths of the 468 blood samples were in the normoglycaemic range (392\\/468:83.8%). Of the remaining 76 samples, 51.3% were in the hypoglycaemic range and (48.7%) were hyperglycaemic. A quarter of the hypoglycaemic samples (28.2%:11\\/39) and a third of the hyperglycaemic samples (32.4%:12\\/37) were recorded within the first 30 minutes of life. Mean (SD) blood glucose values did not differ between infants with normal and abnormal outcomes [4.89(2.28) mmol\\/L and 5.02(2.35) mmol\\/L, p value = 0.15] respectively. In term infants with hypoxic-ischaemic encephalopathy, early hypoglycaemia (between 0-6 hours of life) was associated with adverse outcome at 24 months of age [OR = 5.8, CI = 1.04-32)]. On multivariate analysis to adjust for grade of HIE this association was not statistically significant. Late hypoglycaemia (6-72 hours of life) was not associated with abnormal outcome [OR = 0.22, CI (0.04-1.14)]. The occurrence of hyperglycaemia was not associated with adverse outcome. Conclusion During the first 72 hours of life, blood glucose profile in infants with hypoxic-ischaemic encephalopathy varies widely despite a management protocol. Early hypoglycaemia (0-6 hours of life) was associated with severe HIE, and thereby; adverse outcome.

  5. Neonatal Listeriosis

    Directory of Open Access Journals (Sweden)

    Shih-Yu Chen

    2007-01-01

    Full Text Available In Western developed countries, Listeria monocytogenes is not an uncommon pathogen in neonates. However, neonatal listeriosis has rarely been reported in Taiwan. We describe two cases collected from a single medical institute between 1990 and 2005. Case 1 was a male premature baby weighing 1558 g with a gestational age of 31 weeks whose mother had fever with chills 3 days prior to delivery. Generalized maculopapular rash was found after delivery and subtle seizure developed. Both blood and cerebrospinal fluid culture collected on the 1st day yielded L. monocytogenes. In addition, he had ventriculitis complicated with hydrocephalus. Neurologic development was normal over 1 year of follow-up after ventriculoperitoneal shunt operation. Case 2 was a 28-weeks' gestation male premature baby weighing 1180 g. Endotracheal intubation and ventilator support were provided after delivery due to respiratory distress. Blood culture yielded L. monocyto-genes. Cerebrospinal fluid showed pleocytosis but the culture was negative. Brain ultrasonography showed ventriculitis. Sudden deterioration with cyanosis and bradycardia developed on the 8th day and he died on the same day. Neonatal listeriosis is uncommon in Taiwan, but has significant mortality and morbidity. Early diagnosis of perinatal infection relies on high index of suspicion in perinatal health care professionals. [J Formos Med Assoc 2007;106(2:161-164

  6. Cause of neonatal deaths in Northern Ethiopia: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Hayelom Gebrekirstos Mengesha

    2017-01-01

    Full Text Available Abstract Background Despite the significant reduction in childhood mortality, neonatal mortality has shown little or no concomitant decline worldwide. The dilemma arises in that the lack of documentation of cause of death in developing countries, where registration of vital events is virtually nonexistent. Understanding of the causes of death in neonates is important to guide public health interventions. The present study identifies the common causes of neonatal death in Ethiopia. Methods A prospective cohort study was conducted among neonates born between April 2014 and July 2014 in seven hospitals, in Tigray region, Ethiopia. Mothers were interviewed by midwifes respecting risk factors and infant survival. For neonates who died in hospital, causes of death were extracted from medical records, whereas a verbal autopsy method provided presumptive assignment of cause of death for those infants who died at home. Results Of the1152 live births, there were 68 deaths (63 per 1000 live births. Two thirds of deaths were attributable to prematurity 23 (34% or asphyxia 21 (31%. Slight variance was seen between the morality patterns in early and late neonatal periods. In the early neonatal period, 37% were due to prematurity, while asphyxia (35% was more common in the late neonatal period. All infection-related deaths occurred in neonate-mother dyads from rural areas. Conclusion Prematurity, asphyxia, and infections were the leading causes of neonatal deaths in Tigray region during the study period. Causes of deaths identified during early and late neonatal mortality differed, which clearly indicates the need for responsive and evidence-based interventions and policies.

  7. Investigation of Maternal-Infant Attachment In The Early Postpartum Period With Evidence Based Practice

    Directory of Open Access Journals (Sweden)

    Asli Gulesen

    2013-04-01

    Full Text Available Healthy attachment is a key concept in creating a positive environment for the development of the infant after birth. The earlier and the healthier the mother creates a communication and interaction with her baby, a stronger maternal-infant attachment will be developed. The time period immediately after birth is the most convenient time for the initiation of positive mother-infant relationship as it is the most intense period of attachment. The aim of this article was to define mother-infant attachment and to examine the evidence-based practices for midwives and nurses who play a role in the development of this attachment in the early postpartum period. [TAF Prev Med Bull 2013; 12(2.000: 177-182

  8. Factors associated with early neonatal attendance to a paediatric emergency department.

    Science.gov (United States)

    Flanagan, C F; Stewart, M

    2014-03-01

    To examine the demographic and perinatal factors involved in the presentation of newborn babies to a paediatric emergency department (PED) and outcome following attendance. Term babies who attended the PED of the Royal Belfast Hospital for Sick Children (RBHSC) in the first 2 weeks of life, during two separate 3-month periods in summer and winter 2010-2011 were identified retrospectively from the PED electronic database. Perinatal and demographic data were also obtained on all babies born in the Royal Jubilee Maternity Hospital (RJMH) during the same time period. A total of 223 attendances to the PED involving 208 babies were identified with almost equal distribution during summer and winter months. Almost two thirds (n=139, 62%) of babies presented out-of-hours. Over half of babies were self-referred by parent/carer. The most common presentation was feeding difficulty, vomiting or faltering growth, accounting for 36%. Significant factors associated with attendance to PED included birth weight working day. Overall, a third of babies admitted stayed less than 24 h (34%). Large numbers of babies attend the PED in the first 2 weeks of life, commonly out of hours, from deprived areas and with feeding difficulties. A quarter of babies attending are admitted to hospital, with one-third discharged following an overnight stay. Services should be reevaluated, particularly in this current financial climate, in an attempt to find new models of care for these young babies.

  9. Early Period of Modern Architecture in Turkey - A Case Study of Eskisehir

    Science.gov (United States)

    Karasozen, Rana

    2017-10-01

    Modern architecture in the Western World bore fruit at the beginning of the 20th Century in consequence of the process of modernity and seeking of the proper architecture for it. It was formed firstly towards the end of the 1920s. The main reason of this nonsynchronous development was the inadequacy of enlightenment and industrial revolution during the Ottoman Empire and the lack of formation of an intellectual infrastructure which provides the basis of modernity. However, the Ottoman Westernization occurring in the 19th century constituted the foundations of the Republic modernity founded in 1923. The earliest modern architectural designs in Turkey were first practised by European architects after the foundation of the Republic and internalised and practised extensively by the native architects afterwards. The early modern architecture of Turkey, named as “1930s Modernism”, continued until the beginning of the World War II. This period was formed in between the periods of first and second nationalist architecture movements. The early modern architecture period of Turkey was a period which high-quality designs were made. It was practised and internalised not only in big cities such as Ankara and in Istanbul, but also in the medium and small cities of the country. This situation was not just about a formal exception but about the internalisation of modernity by the society. Eskisehir is one of the most important pioneering cities of the Republic period in terms of industrial and educational developments. The earliest modern buildings were built as the public buildings by the state and non-citizen architects in the inadequate conditions of the country in terms of economy and professional people. The earliest modern houses of the city designed by these architects were the prototypes for the later practices which offered the citizens a new lifestyle. The modern houses were the symbols of prestige and status for the owners and the dwellers. The features of early

  10. Risk factors for hearing loss in neonates

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    Ni Luh Putu Maharani

    2016-11-01

    Full Text Available Background An estimated 6 of 1,000 children with live births suffer from permanent hearing loss at birth or the neonatal period. At least 90% of cases occur in developing countries. Hearing loss should be diagnosed as early as possible so that intervention can be done before the age of 6 months. Objective To determine risk factors for hearing loss in neonates. Methods We performed a case-control study involving 100 neonates with and without hearing loss who were born at Sanglah Hospital, Denpasar from November 2012 to February 2013. Subjects were consisted of 2 groups, those with hearing loss (case group of 50 subjects and without hearing loss (control group of 50 subjects. The groups were matched for gender and birth weight. We assessed the following risk factors for hearing loss: severe neonatal asphyxia, hyperbilirubinemia, meningitis, history of aminoglycoside therapy, and mechanical ventilation by Chi-square analysis. The results were presented as odds ratio and its corresponding 95% confidence intervals. Results Seventy percent of neonates with hearing loss had history of aminoglycoside therapy. Multivariable analysis revealed that aminoglycoside therapy of 14 days or more was a significant risk factor for hearing loss (OR 2.7; 95%CI 1.1 to 6.8; P=0.040. There were no statistically significant associations between hearing loss and severe asphyxia, hyperbilirubinemia, meningitis, or mechanical ventilation. Conclusion Aminoglycoside therapy for >=14 days was identified as a risk factor for hearing loss in neonates.

  11. A less invasive approach to screening for early onset neonatal GBS.

    LENUS (Irish Health Repository)

    Glackin, S

    2015-03-01

    Recent recommendations for the management of an asymptomatic term infant with one septic risk factor for Group B Streptococcal (GBS) invasive disease have advised a clinical approach. Following a previous audit in our unit which showed that high numbers of asymptomatic infants were receiving antibiotics, a new protocol was introduced which emphasised the importance of clinical examination. This study assessed the safety and efficacy of this new protocol through chart review of 1855 eligible infants. We found a statistically significant decrease (P < 0.0001) from 444 (19%) to 121 (6.5%) in the total number of term infants who underwent septic evaluations and received antibiotics. 241 asymptomatic infants with one septic risk factor were managed conservatively. No eligible infants had GBS invasive disease during the three month study period. The new protocol is a safe and effective tool for evaluating infants at risk of GBS invasive disease.

  12. Dynamic spatio-temporal imaging of early reflow in a neonatal rat stroke model.

    Science.gov (United States)

    Leger, Pierre-Louis; Bonnin, Philippe; Lacombe, Pierre; Couture-Lepetit, Elisabeth; Fau, Sebastien; Renolleau, Sylvain; Gharib, Abdallah; Baud, Olivier; Charriaut-Marlangue, Christiane

    2013-01-01

    The aim of the study was to better understand blood-flow changes in large arteries and microvessels during the first 15 minutes of reflow in a P7 rat model of arterial occlusion. Blood-flow changes were monitored by using ultrasound imaging with sequential Doppler recordings in internal carotid arteries (ICAs) and basilar trunk. Relative cerebral blood flow (rCBF) changes were obtained by using laser speckle Doppler monitoring. Tissue perfusion was measured with [(14)C]-iodoantipyrine autoradiography. Cerebral energy metabolism was evaluated by mitochondrial oxygen consumption. Gradual increase in mean blood-flow velocities illustrated a gradual perfusion during early reflow in both ICAs. On ischemia, the middle cerebral artery (MCA) territory presented a residual perfusion, whereas the caudal territory remained normally perfused. On reflow, speckle images showed a caudorostral propagation of reperfusion through anastomotic connections, and a reduced perfusion in the MCA territory. Autoradiography highlighted the caudorostral gradient, and persistent perfusion in ventral and medial regions. These blood-flow changes were accompanied by mitochondrial respiration impairment in the ipsilateral cortex. Collectively, these data indicate the presence of a primary collateral pathway through the circle of Willis, providing an immediate diversion of blood flow toward ischemic regions, and secondary efficient cortical anastomoses in the immature rat brain.

  13. Paracetamol/acetaminophen (single administration) for perineal pain in the early postpartum period.

    Science.gov (United States)

    Chou, Doris; Abalos, Edgardo; Gyte, Gillian M L; Gülmezoglu, A Metin

    2013-01-31

    Perineal pain is a common but poorly studied adverse outcome following childbirth. Pain may result from perineal trauma due to bruising, spontaneous tears, surgical incisions (episiotomies), or in association with operative births (ventouse or forceps assisted births). To determine the efficacy of a single administration of paracetamol (acetaminophen) systemic drugs used in the relief of acute postpartum perineal pain We updated the search of the Cochrane Pregnancy and Childbirth Group's Trials Register on 6 November 2012. Randomised controlled trials (RCTs) assessing paracetamol (acetaminophen) in a single dose compared with placebo for women with early postpartum perineal pain. We excluded quasi-RCTs and cross-over studies. Two review authors assessed each paper for inclusion and extracted data. One review author reviewed the decisions and confirmed calculations for pain relief scores. We did not identify any new trials from the updated search so the results remain unchanged as follows.We have included 10 studies describing two dosages of paracetamol. Of these, five studies (526 women) assessed 500 mg to 650 mg and six studies (841 women) assessed 1000 mg of paracetamol. We chose to use random-effects meta-analyses because of the heterogeneity in dosage used. Studies were from the 1970s to the early 1990s, and there was insufficient information to assess the risk of bias adequately, hence the findings need to be interpreted within this context.More women experienced pain relief with paracetamol compared with placebo (average risk ratio (RR) 2.14, 95% confidence interval (CI) 1.59 to 2.89, 10 studies, 1279 women). In addition, there were significantly fewer women having additional pain relief with paracetamol compared with placebo (RR 0.34, 95% CI 0.21 to 0.55, eight studies, 1132 women). Both the 500 mg to 650 mg and 1000 mg doses were effective in providing more pain relief than placebo.Maternal and neonatal potential adverse drug effects were not assessed in

  14. Urine Biochemistry in the Early Postoperative Period after Cardiac Surgery: Role in Acute Kidney Injury Monitoring

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    Alexandre Toledo Maciel

    2013-01-01

    Full Text Available We have recently suggested that sequential urine electrolyte measurement in critically ill patients may be useful in monitoring kidney function. Cardiac surgery is one of the leading causes of acute kidney injury (AKI in the intensive care unit (ICU. In this paper, we describe the sequential behavior of urine electrolytes in three patients in the early (first 60 hours postoperative period after cardiac surgery according to AKI status: no AKI, transient AKI, and persistent AKI. We have found that the patient with no AKI had stable and high concentrations of sodium (NaU and chloride (ClU in sequential spot samples of urine. AKI development was characterized in the other two patients by decreases in NaU and ClU, which have started early after ICU admission. Transient AKI was marked by also transient and less severe decreases in NaU and ClU. Persistent AKI was marked by the less favorable clinical course with abrupt and prolonged declines in NaU and ClU values. These electrolytes in urine had a behavior like a “mirror image” in comparison with that of serum creatinine. We suggest that sequential urine electrolytes are useful in monitoring acute kidney injury development in the early postoperative period after cardiac surgery.

  15. Prediction of leakage current of non-ceramic insulators in early aging period

    Energy Technology Data Exchange (ETDEWEB)

    El-Hag, Ayman H. [Electrical Engineering Department, American University of Sharjah, Sharjah (United Arab Emirates); Jahromi, Ali Naderian [Kinectrics Inc., Transmission and Distribution Technologies, Toronto (Canada); Sanaye-Pasand, Majid [Electrical and Computer Engineering Department, University of Tehran (Iran)

    2008-10-15

    The paper presents a neural network based prediction technique for the leakage current (LC) of non-ceramic insulators during salt-fog test. Nearly 50 distribution class silicone rubber (SIR) insulators with three different voltage classes have been tested in a salt-fog chamber, where the LC has been continuously recorded for at least 100 h. A boundary for early aging period is defined by the rate of change of the LC instead of a fixed threshold value. Consequently, the Gaussian radial basis network has been adopted to predict the level of LC at the early stage of aging of the SIR insulators and is compared with a classical network. The initial values of LC and its rate of change at 10 min intervals for the first 5 h are selected as the input to the network, and the final value of LC of the early aging period is considered as the output of the network. It is found that Gaussian radial basis function network with a random optimizing training method is an appropriate network to predict the LC with a 3.5-5.3% accuracy, if the training data and the testing data are selected from the same type of SIR insulators. (author)

  16. Maternal Alcohol Consumption During the Perinatal and Early Parenting Period: A Longitudinal Analysis.

    Science.gov (United States)

    Liu, Weiwei; Mumford, Elizabeth A; Petras, Hanno

    2016-02-01

    Despite potential health risks for women and children, one in five women report alcohol use during pregnancy and a significant proportion of those who quit during pregnancy return to drinking post-delivery. This study seeks to understand the longitudinal patterns of alcohol consumption before, during pregnancy and post-delivery, and the role of maternal characteristics for purposes of informing prevention design. General growth mixture models were used to describe the average developmental patterns of maternal weekly drinking quantity at six time points, from preconception through child entering kindergarten, as well as heterogeneity in these patterns among 9100 mothers from the Early Childhood Longitudinal Study representing the 2001 US national birth cohort. Four distinct classes of mothers were defined by their longitudinal alcohol consumption patterns: Low Probability Drinkers (50.3 %), Escalating Risk Drinkers (12.0 %), Escalating Low Risk Drinkers (27.4 %), and Early Parenting Quitters (10.2 %). Heterogeneous covariate associations were observed. For example, mothers who gave birth after age 36 were twice as likely to be Escalating Risk Drinkers and Escalating Low Risk Drinkers (vs Low Probability Drinkers), but not more likely to be Early Parenting Quitters, when compared to mothers who gave birth between the ages of 26 and 35. There is significant heterogeneity in maternal longitudinal alcohol use patterns during the perinatal period. Baseline maternal characteristics and behavior associated with these heterogeneous patterns provide valuable tools to identify potential risky drinkers during this critical time period and may be synthesized to tailor pre- and postnatal clinical counseling protocols.

  17. Cord Blood Acute Phase Reactants Predict Early Onset Neonatal Sepsis in Preterm Infants.

    Directory of Open Access Journals (Sweden)

    Leena B Mithal

    Full Text Available Early onset sepsis (EOS is a major cause of morbidity and mortality in preterm infants, yet diagnosis remains inadequate resulting in missed cases or prolonged empiric antibiotics with adverse consequences. Evaluation of acute phase reactant (APR biomarkers in umbilical cord blood at birth may improve EOS detection in preterm infants with intrauterine infection.In this nested case-control study, infants (29.7 weeks gestation, IQR: 27.7-32.2 were identified from a longitudinal cohort with archived cord blood and placental histopathology. Patients were categorized using culture, laboratory, clinical, and antibiotic treatment data into sepsis groups: confirmed sepsis (cEOS, n = 12; presumed sepsis (PS, n = 30; and no sepsis (controls, n = 30. Nine APRs were measured in duplicate from cord blood using commercially available multiplex immunoassays (Bio-Plex Pro™. In addition, placental histopathologic data were linked to biomarker results.cEOS organisms were Escherichia coli, Streptococcus agalactiae, Proteus mirabilis, Haemophilus influenzae and Listeria monocytogenes. C-reactive protein (CRP, serum amyloid A (SAA, haptoglobin (Hp, serum amyloid P and ferritin were significantly elevated in cEOS compared to controls (p<0.01. SAA, CRP, and Hp were elevated in cEOS but not in PS (p<0.01 and had AUCs of 99%, 96%, and 95% respectively in predicting cEOS. Regression analysis revealed robust associations of SAA, CRP, and Hp with EOS after adjustment for covariates. Procalcitonin, fibrinogen, α-2-macroglobulin and tissue plasminogen activator were not significantly different across groups. Placental acute inflammation was associated with APR elevation and was present in all cEOS, 9 PS, and 17 control infants.This study shows that certain APRs are elevated in cord blood of premature infants with EOS of intrauterine origin. SAA, CRP, and Hp at birth have potential diagnostic utility for risk stratification and identification of infants with EOS.

  18. Progressive changes in arch width from primary to early mixed dentition period: a longitudinal study.

    Science.gov (United States)

    Sangwan, S; Chawla, H S; Goyal, A; Gauba, K; Mohanty, U

    2011-01-01

    The present study was conducted to evaluate, on a longitudinal basis, the changes in intercanine and intermolar widths form the primary to the early mixed dentition periods. A total of 38 children aged 4-5 years, with normal occlusion without any proximal caries or any dental anomalies, were selected. The impressions were recorded and casts were prepared. Intercanine and intermolar widths were measured on these dental casts with the help of a digital vernier calliper. After 3 years follow-up, the impressions were recorded again and dental casts were prepared. Intercanine and intermolar widths were measured again at this stage and were compared with the baseline data using the paired t-test and the chi square test. There is a significant increase in the intercanine (3.93 + 1.70 mm) and intermolar width (1.49 + 1.77 mm) during the transition period from primary to early mixed dentition in both the arches and both the sexes. The gender-wise comparison showed a greater increase in males than in females, but this was not statistically significant. A thorough knowledge of growth changes during various stages of the mixed dentition period are important for a pediatric dentist to make an accurate diagnosis and treatment planning during preventive and interceptive orthodontics.

  19. [An unexpected stage of alkalosis in the dynamics of the early posthemorrhagic period].

    Science.gov (United States)

    Beliaev, A V

    2000-01-01

    A study was made on acid-base metabolism in early posthemorrhagic period as exemplified by examination of patients presenting with gastrointestinal hemorrhage. It has been ascertained that hemorrhage is accompanied by a mixed variant of the acid-base state (ABS) deviation, namely metabolic lactate-acidosis and respiratory alkalosis. In the time-related course of posthemorrhagic period such deviations persist in patients with lethal outcome; with the disease running a favourable course the above deviations are found to return to normal quite soon. The development of complications leads to staging in ABC, its stages being as follows: stage I--the initial stage, stage II--persisting metabolic acidosis and respiratory alkalosis, stage III--alkalosis, stage IV--normalization, with stage III of ABS being encouraged by hypocapnia caused by function disorders of the lungs in early posthemorrhagic period, normalization of cell metabolism, increase in the rate of urination as a reflection of the third earlier identified stage of water metabolism, with the H+ excretion in the urine at the previous level. The identified ABS stage III threatens coming trouble, being accompanied by metabolic deviations together with a risk of function disorder of the myocardium.

  20. Progressive changes in arch width from primary to early mixed dentition period: A longitudinal study

    Directory of Open Access Journals (Sweden)

    S Sangwan

    2011-01-01

    Full Text Available Objective: The present study was conducted to evaluate, on a longitudinal basis, the changes in intercanine and intermolar widths form the primary to the early mixed dentition periods. Materials and Methods: A total of 38 children aged 4-5 years, with normal occlusion without any proximal caries or any dental anomalies, were selected. The impressions were recorded and casts were prepared. Intercanine and intermolar widths were measured on these dental casts with the help of a digital vernier calliper. After 3 years follow-up, the impressions were recorded again and dental casts were prepared. Intercanine and intermolar widths were measured again at this stage and were compared with the baseline data using the paired t-test and the chi square test. Results: There is a significant increase in the intercanine (3.93 + 1.70 mm and intermolar width (1.49 + 1.77 mm during the transition period from primary to early mixed dentition in both the arches and both the sexes. The gender-wise comparison showed a greater increase in males than in females, but this was not statistically significant. Conclusion: A thorough knowledge of growth changes during various stages of the mixed dentition period are important for a pediatric dentist to make an accurate diagnosis and treatment planning during preventive and interceptive orthodontics.

  1. Ventricular Septal Defect: Peculiarities of Early Neonatal and Postnatal Diagnosis, Clinical Manifestations, Treatment and Prognosis at the Contemporary Stage

    Directory of Open Access Journals (Sweden)

    K.A. Kalashnikova

    2016-05-01

    Full Text Available The article presents the literature data on the incidence, the main clinical manifestations, modern methods for early neonatal and postnatal diagnosis and treatment of ventricular septal defect in children, as well as the prognosis of this disease. According to the International Classification of Diseases, 10th revision, ventricular septal defect is classified as Q21.0 Ventricular septal defect. Incidence. In the overall structure of congenital malformations of the cardiovascular system, ventricular septal defect has about 20 %. Diagnosis. Moderate ventricular septal defect is manifested by shortness of breath, rapid fatigability during feeding, delay in physical development. Significant arterial-venous shunt in the first month of life is accompanied by a transient mild cyanosis when the baby is fed and cries. Infants develop high pulmonary hypertension, circulatory failure, malnutrition. Small noise intensity is typical for newborns in the first weeks or even months of life, which is due to physiologically increased intravascular pulmonary resistance. Systolic murmur is extended to the entire systole with maximum amplitude at the left edge of the sternum at the level of III–IV intercostal spaces. Sclerotic phase of pulmonary hypertension with ventricular septal defect is defined as Eisenmenger reaction. The clinical picture of this disorder depends on the degree of hemodynamic instability caused by the defect parameters, the pressure level in the pulmonary artery, vascular pulmonary resistance, the magnitude and direction of the shunt through the defect. Diagnosis is confirmed by characteristic changes in the electrocardiogram, echocardiography and chest radiograph. Treatment. Small muscular ventricular septal defects often close spontaneously during the first 2 years of life. Drug correction is needed in the development of congestive heart failure. The optimum age for surgery — 5–9 years.

  2. Culture-proven early-onset neonatal sepsis in Arab states in the Gulf region: two-year prospective study.

    Science.gov (United States)

    Hammoud, Majeda S; Al-Taiar, Abdullah; Al-Abdi, Sameer Y; Bozaid, Hussain; Khan, Anwar; AlMuhairi, Laila M; Rehman, Moghis Ur

    2017-02-01

    To investigate the incidence and the pattern of causative organisms of culture-proven early-onset sepsis (EOS) in Arab states in the Gulf region. Five neonatal care units participated in this 2-year prospective study in Kuwait, the United Arab Emirates, and Saudi Arabia. Data were collected prospectively using a standardized data collection form. EOS was defined as the growth of a single potentially pathogenic organism from blood or cerebrospinal fluid in infants within 72h of birth, with clinical and laboratory findings consistent with infection. Out of 67 474 live births, 102 cases of EOS occurred. The overall incidence of EOS was 1.5 (95% confidence interval 1.2-1.8) per 1000 live-births, ranging from 2.64 per 1000 live-births in Kuwait to 0.40 per 1000 live-births in King Abdulaziz Hospital in Saudi Arabia. The most common causative organism of EOS was group B Streptococcus (GBS; 60.0%), followed by Escherichia coli (13%). The incidence of invasive GBS disease was 0.90 per 1000 live-births overall and ranged from 1.4 per 1000 live-births in Kuwait to 0.6 per 1000 live-births in Dubai Hospital. The incidence of EOS and the patterns of the causative organisms in the Arab states in the Gulf region are similar to those in developed countries before the era of intrapartum antibiotic prophylaxis. Efforts should be made to improve intrapartum antibiotic prophylaxis in the Arab state setting, which could avert large numbers of GBS infections. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  3. Single variant bottleneck in the early dynamics of H. influenzae bacteremia in neonatal rats questions the theory of independent action

    Science.gov (United States)

    Shao, Xinxian; Levin, Bruce; Nemenman, Ilya

    2017-08-01

    There is an abundance of information about the genetic basis, physiological and molecular mechanisms of bacterial pathogenesis. In contrast, relatively little is known about population dynamic processes, by which bacteria colonize hosts and invade tissues and cells and thereby cause disease. In an article published in 1978, Moxon and Murphy presented evidence that, when inoculated intranasally with a mixture streptomycin sensitive and resistant (Sm S and Sm R ) and otherwise isogenic strains of Haemophilus influenzae type b (Hib), neonatal rats develop a bacteremic infection that often is dominated by only one strain, Sm S or Sm R . After ruling out other possibilities through years of related experiments, the field seems to have settled on a plausible explanation for this phenomenon: the first bacterium to invade the host activates the host immune response that ‘shuts the door’ on the second invading strain. To explore this hypothesis in a necessarily quantitative way, we modeled this process with a set of mixed stochastic and deterministic differential equations. Our analysis of the properties of this model with realistic parameters suggests that this hypothesis cannot explain the experimental results of Moxon and Murphy, and in particular the observed relationship between the frequency of different types of blood infections (bacteremias) and the inoculum size. We propose modifications to the model that come closer to explaining these data. However, the modified and better fitting model contradicts the common theory of independent action of individual bacteria in establishing infections. We suggest possible experiments that would be able to confirm or reject our proposed modification of the early infection model.

  4. Effects of neonatal paternal deprivation or early deprivation on anxiety and social behaviors of the adults in mandarin voles.

    Science.gov (United States)

    Jia, Rui; Tai, Fadao; An, Shucheng; Zhang, Xia; Broders, Hugh

    2009-11-01

    This study examined whether neonatal paternal deprivation (PD: father was removed and pups were raised just by mother) or early deprivation (ED: pups were raised by both parents except separated from not only the dam but also the peers for three hours a day from PND 0 to 13) has long-term effects on anxiety and social behaviors of adult mandarin voles. Newborn mandarin voles of F2 generation were randomly assigned to one of three groups: bi-parental care (PC: pups were raised by both parents), PD and ED. The parental care behaviors of F1 generation were observed at the age of 0, 13 and 21 days (PND 0, 13, 21) of F2 generation of PC and PD groups. Moreover, each mandarin vole of F2 generation received an open field test and a social interaction test on PND 70 and PND 75, respectively. No significant differences of parental behavior were observed between mothers and fathers from PC families, showing typical parental behavior of socially monogamous rodents. In addition, no significant differences of maternal behaviors were found between mothers from PC and PD families, indicating no maternal compensation towards pups for the absence of the paternal care. In the open field test, mandarin voles from both PD and ED families displayed higher levels of anxiety and lower locomotor activity, relative to offspring of PC family. In the social interaction test, both PD and ED mandarin voles also showed lower levels of social behavior and higher levels of anxiety. Thus, both PD and ED significantly increase anxiety and reduce social behavior of adult mandarin voles, suggesting that variation in parental investment may lead to variation in anxiety and social behaviors in rodents with different mating systems.

  5. A retrospective analysis of early experience with modified complete primary repair of exstrophy bladder (CPRE in neonates and children

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    Santosh B Kurbet

    2013-01-01

    Full Text Available Objective: To study the problems faced during the surgery and follow-up of modified complete primary repair of exstrophy (CPRE technique. Initial experience with CPRE and its short- and long-term outcomes with respect to continence status and psychosocial impact are reported. Materials and Methods: A retrospective review of the hospital case records from March 2008 to September 2012 was performed. Data of patients with bladder exstrophy managed by a single paediatric surgeon using modified CPRE technique were analysed. Quality of life and psychosocial impact of the surgery were assessed using Pediatric Quality of Life Inventory (PedsQL 4.0 and compared with those of typical peers. Results: Eight children (age 4 days-12 years underwent CPRE using modified Mitchell′s technique. Two patients (25% experienced early postoperative complications, with infection and fistula developing in one each. All the patients were doing well on follow-up, with variable continence rates and good cosmesis. Mean duration of follow-up was 18.5 months (range 6 months-4 years. Five out of seven (71% children were continent or partially continent. One case was lost to follow-up. PedsQL scores were comparable with those of age-matched peers in all domains except the social functioning domain in 8-12 years age group (83.53 ± 9.70 vs. 77.86 ± 10.22, P < 0.05. Conclusion: Our preliminary results with modified CPRE in neonates and children have been encouraging. No major complications were observed. Continence rate was satisfactory and cosmetic results were good. Though the technique is being practiced at several Indian centres, there is a paucity of comprehensive Indian data on CPRE.

  6. Early Seizures Prematurely Unsilence Auditory Synapses to Disrupt Thalamocortical Critical Period Plasticity

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    Hongyu Sun

    2018-05-01

    Full Text Available Heightened neural excitability in infancy and childhood results in increased susceptibility to seizures. Such early-life seizures are associated with language deficits and autism that can result from aberrant development of the auditory cortex. Here, we show that early-life seizures disrupt a critical period (CP for tonotopic map plasticity in primary auditory cortex (A1. We show that this CP is characterized by a prevalence of “silent,” NMDA-receptor (NMDAR-only, glutamate receptor synapses in auditory cortex that become “unsilenced” due to activity-dependent AMPA receptor (AMPAR insertion. Induction of seizures prior to this CP occludes tonotopic map plasticity by prematurely unsilencing NMDAR-only synapses. Further, brief treatment with the AMPAR antagonist NBQX following seizures, prior to the CP, prevents synapse unsilencing and permits subsequent A1 plasticity. These findings reveal that early-life seizures modify CP regulators and suggest that therapeutic targets for early post-seizure treatment can rescue CP plasticity.

  7. Early and late hot extremes, and elongation of the warm period over Greece

    Science.gov (United States)

    Founda, Dimitra; Giannakopoulos, Christos; Pierros, Fragiskos

    2017-04-01

    The eastern Mediterranean has been assigned as one of the most responsive areas in climate change, mainly with respect to the occurrence of warmer and drier conditions. In Greece in particular, observations suggest prominent increases in the summer air temperature which in some areas amount to approximately 1 0C/decade since the mid 1970s, while Regional Climate Models simulate further increases in the near and distant future. These changes are coupled with simultaneous increase in the occurrence of hot extremes. In addition to changes in the frequency and intensity of hot extrems, timing of occurrence is also of special interest. Early heat waves in particular, have been found to increase thermal risk in humans. The study explores variations and trends in timing, namely the date of first and last occurrence of hot extremes within the year, and subsequently the hot extremes period (season), defined as the time interval (number of days) between first and last hot extremes occurrence, over Greece. A case study for the area of Athens covering a longer than 100-years period (1897-2015) was conducted first, which will be extended to other Greek areas. Several heat related climatic indices were used, based either on predefined temperature thresholds such as 'tropical days' (daily maximum air temperature, Tmax >30 0C), 'tropical nights' (daily minimum air temperature, Tmin >20 0C), 'hot days' (Tmax >35 0C), or on local climate statistics such as days with Tmax (or Tmin) > 95th percentile. The analysis revealed significant changes in the period of hot extremes and specifically elongation of the period, attributed to early rather than late hot extremes occurrence. An earlier shift of the first tropical day and the first tropical night occurrence by approximately 2 days/decade was found over the study period. An overall elongation of the 'hot days' season by 2.6 days/decade was also observed, which is more prominent since the early 1980s. Over the last three decades, earlier

  8. Radiodiagnosis of vesicoureteral reflux in the early postoperative period after adenomectomy of the prostate

    International Nuclear Information System (INIS)

    Gytlan, I.D.; Shekhter, A.I.; Vinarov, A.Z.; Uskov, I.A.

    1988-01-01

    Altogether 204 patients aged 43 to 81 were examined in the early postoperative period after adenomectomy of the prostate. Passive VUR was detected by means of routine cystography, X-ray TV cystography, direct radionuclide cystography and ultrasonic investigation. The presence of VUR in ultrasonic investigation was established by the signs of dilatation of renal pelves and calycles in filling in of the bladder with antiseptic solution. Ultrasonic investigation made it possible to diagnose VUR of 3-4 degree. Active VUR was detected by miction cystography and X-ray TV miction cystography on the day of removal of drainage tubes from the bladder. Unlike the radionuclide and ultrasonic methods, these two methods made it possible to assess the state of the bladder cervix and urethra. The authors proposed an optimum sequence of the use of diagnostic methods for early detection of VUR and prevention of severe complications

  9. Valor predictivo de algunos exámenes de laboratorio clínico en la infección neonatal bacteriana precoz Prognostic value of some clinical laboratory examinations related to an early bacterial neonatal infection

    Directory of Open Access Journals (Sweden)

    Tania Roig Álvarez

    2009-06-01

    Full Text Available INTRODUCCIÓN. El diagnóstico microbiológico de la infección neonatal de inicio precoz es complejo. En la mayoría de los recién nacidos se inicia el tratamiento ante la sospecha clínica y la positividad de algunos reactantes de fase aguda y el hemograma. MÉTODOS. Se analizó el valor predictivo utilizando como método de referencia el hemocultivo periférico o el hallazgo anatomopatológico de infección de algunos exámenes de laboratorio clínico de forma aislada. El estudio se realizó en el total de los casos, 32 neonatos con infección de inicio precoz probada y probable, y por localización de la infección. RESULTADOS. Ni la proteína C-reactiva positiva ni las alteraciones de los leucocitos totales fueron buenos predictores de sepsis de inicio precoz de cualquier localización. La trombocitopenia impresionó ser un marcador competente pero no resultó así al calcular el intervalo de confianza al 95 %. Al excluir la localización pulmonar, la proteína C-reactiva positiva se convirtió en un marcador competente. Ninguno de los neonatos con infección pulmonar probada tuvo resultados positivos en los exámenes clínicos realizados. CONCLUSIONES. No se cuenta de momento con ninguna prueba de laboratorio clínico capaz de predecir con certeza la presencia de infección de inicio precoz de cualquier localización. La proteína C-reactiva cualitativa es un marcador competente de infección precoz del torrente sanguíneo y de meninges en los neonatos.INTRODUCTION: Microbiological diagnosis of neonatal infection of early onset is complex. In most of newborns diagnosis is started if there is a clinical suspicion and the positivity of some acute-phase reactants and the hemogran. METHODS: Prognostic value was analyzed using as reference method the peripheral hemoculture or the pathological anatomy findings of infection in some of clinical laboratory examinations in an isolated way. Study was performed in all the cases, in 32 neonates

  10. Incidence of double ovulation during the early postpartum period in lactating dairy cows.

    Science.gov (United States)

    Kusaka, Hiromi; Miura, Hiroshi; Kikuchi, Motohiro; Sakaguchi, Minoru

    2017-03-15

    In lactating cattle, the incidence of twin calving has many negative impacts on production and reproduction in dairy farming. In almost all cases, natural twinning in dairy cattle is the result of double ovulation. It has been suggested that the milk production level of cows influences the number of ovulatory follicles. The objective of the present study was to investigate the incidence of double ovulations during the early postpartum period in relation to the productive and reproductive performance of dairy cows. The ovaries of 43 Holstein cows (26 primiparous and 17 multiparous) were ultrasonographically scanned throughout the three postpartum ovulation sequences. The incidence of double ovulation in the unilateral ovaries was 66.7%, with a higher incidence in the right ovary than in the left, whereas that in bilateral ovaries was 33.3%. When double ovulations were counted dividing into each side ovary in which ovulations occurred, the total frequency of ovulations deviated from a 1:1 ratio (60.3% in the right side and 39.7% in the left side, P cows, double ovulation occurred more frequently than in primiparous cows (58.8% vs. 11.5% per cow and 30.0% vs. 3.8% per ovulation, respectively P cows, the double ovulators exhibited higher peak milk yield (P cows. Two multiparous cows that experienced double ovulation during the early postpartum period subsequently conceived twin fetuses. It can be speculated that the incidence of double ovulations during the early postpartum period partly contributes to the increased incidence of undesirable twin births in multiparous dairy cows. Copyright © 2016. Published by Elsevier Inc.

  11. The Effect of Fasting Pattern on Biological Performance of Quail at Early Production Period

    OpenAIRE

    Tugiyanti, Efka

    2005-01-01

    The objective of this research was to find out the effect of fasting pattern on biological performance of quail at early production period. 50 kg commercial feed, vitamins and medicine were applied on 140 heads of seven old day quail.  Four different fasting pattern were employed as treatment, i.e. ad libitum diet (Po); every two days fasting (P1); every three days fasting (P2); every four days fasting (P3); and every five days fasting (P4).   Ad libitum amount of  corn and water were offered...

  12. Endothelial dysfunction in the early postoperative period after major colon cancer surgery

    DEFF Research Database (Denmark)

    Ekeloef, S; Larsen, M H H; Schou-Pedersen, A M V

    2017-01-01

    BACKGROUND: Evidence suggests that endothelial dysfunction in the early postoperative period promotes myocardial injury after non-cardiac surgery. The aim of this study was to investigate the impact of colon cancer surgery on endothelial function and the association with the l-arginine-nitric oxide...... was attenuated in the first days after colon cancer surgery indicating acute endothelial dysfunction. Endothelial dysfunction correlated with disturbances in the L-arginine - nitric oxide pathway. Our findings provide a rationale for investigating the hypothesized association between acute endothelial...... dysfunction and cardiovascular complications after non-cardiac surgery. CLINICAL TRIAL REGISTRATION: NCT02344771....

  13. Endothelial dysfunction in the early postoperative period after major colon cancer surgery

    DEFF Research Database (Denmark)

    Ekeløf, Sara; Larsen, Mikkel Hjordt; Schou-Pedersen, Anne Marie Voigt

    2017-01-01

    Background. Evidence suggests that endothelial dysfunction in the early postoperative period promotes myocardial injury after non-cardiac surgery. The aim of this study was to investigate the impact of colon cancer surgery on endothelial function and the association with the l-arginine-nitric oxide...... was attenuated in the first days after colon cancer surgery indicating acute endothelial dysfunction. Endothelial dysfunction correlated with disturbances in the L-arginine – nitric oxide pathway. Our findings provide a rationale for investigating the hypothesized association between acute endothelial...... dysfunction and cardiovascular complications after non-cardiac surgery. Clinical trial registration. NCT02344771....

  14. The Conservation of Early Post-Medieval Period Coins Found in Estonia

    Directory of Open Access Journals (Sweden)

    Aive Viljus

    2013-02-01

    Full Text Available This article deals with archaeological find material with a low silver content and the problems of conserving such material. The aim of the research was to find the most suitable method for the conservation of poorly preserved early post-medieval period coins with varying composition. For this, first, the composition of both the metal and the corrosion products of the archaeological coins were analysed, after which comparative experiments of different cleaning methods were carried out in order to find out the least harmful and most efficient method. A test was also performed to determine the necessity and efficiency of stabilizing the surface of the coins after cleaning.

  15. Vanuatu mortuary practices over three millenia : Lapita to early European contact period

    International Nuclear Information System (INIS)

    Valentin, F.; Spriggs, M.; Bedford, S.; Buckley, H.

    2011-01-01

    New discoveries and previously-unpublished data on burials from south, central, and north Vanuatu are reviewed in this paper, offering a synthesis of mortuary practices over three millennia, from Lapita to the early European contact period. Relying on five attributes describing the practices and behaviours (body and bone treatment, position and orientation of the body, ornaments and associated artefacts, and use of single or multiple burial), the analysis emphasizes two major episodes of structural changes in the overall funerary system following initial settlement of Vanuatu. The first occurred towards the end of the Lapita period and the second is indicated by the distinctiveness of the second millennium AD burials. A possible interpretation of these changes, following the lines of Thomas's 'genealogical approach' (2001) is proposed. (author). 70 refs., 5 figs.

  16. Hepatobiliary scan in neonatal Jaundice

    International Nuclear Information System (INIS)

    Nahar, Nurun; Hasan, Mizanul; Karim, M.A.

    2002-01-01

    Jaundice is more or less common in newborn babies. Through physiological jaundice is most common cause of neonatal jaundice, possibility of obstructive jaundice especially biliary atresia should be kept in mind. Early diagnosis of biliary atresia followed by surgical treatment can save baby's life. Otherwise death is inevitable due to liver failure. Hepatobiliary scan is the imaging study of choice in neonatal jaundice especially when there is persistent conjugated hyperbilirubinaemia. Total 27 newborn babies of suspected biliary atresia, aged 14 days to 4 months were referred to Institute of Nuclear Medicine for Hepatobiliary scan. All of them had high serum bilirubin ranged from 6.0 mg/dl with an average of 9.35 ng/dl serum bilirubin level. Ultrasonography of hepatobiliary system was performed in 14 cases showing normal sized liver in 4 cases and hepatomegaly in 10 cases. Hepatobiliary scan was done with 99m Tc-Mebrofenin (Br IDA) after preparing the baby with phenobarbitone for 3-5 days. 20 (67%) cases were scan positive suggesting biliary atresia (BA) and 7(27%) cases were scan negative. In BA there will be increased hepatic uptake of the radionuclide without any significant excretion even in 24 hours delayed images. Presence of radiotracer in the bowel exclude the diagnosis of BA. Early diagnosis of biliary atresia is very important because in this condition surgery should be performed early (within 60 days of life). Studies suggest that hepatobiliary scan after hepatic stimulation with phenobarbitone for a period of 3-5 days is highly accurate for differentiating biliary atresia from other causes of neonatal jaundice. It is very important to perform hepatobiliary scan in a case of neonatal jaundice to exclude biliary atresia for the sake of baby's life.(author)

  17. Patterns of admission and factors associated with neonatal mortality among neonates admitted to the neonatal intensive care unit of University of Gondar Hospital, Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Demisse AG

    2017-05-01

    Full Text Available Abayneh Girma Demisse, Fentahun Alemu, Mahlet Abayneh Gizaw, Zemene Tigabu School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia Introduction: The neonatal period is a highly vulnerable time for an infant completing many of the physiologic adjustments required for life outside the uterus. As a result, there are high rates of morbidity and mortality. The three major causes of mortality in developing countries include prematurity, infection, and perinatal asphyxia. The aim of this study was to identify the patterns of neonatal admission and factors associated with mortality among neonates admitted at the Neonatal Intensive Care Unit (NICU of University of Gondar Hospital.Materials and methods: A retrospective cross-sectional study was conducted among all admitted neonates in the NICU of University of Gondar referral hospital from December 1, 2015 to August 31, 2016. Information was extracted retrospectively during admission from patient records and death certificates, using a pretested questionnaire. The data were entered and analyzed using SPSS version 20, and p-values <0.05 were considered statistically significant.Results: A total of 769 neonates was included in the study. There were 448 (58.3% male neonates, and 398 (51.8% neonates were rural residents. More than two-thirds of the 587 deliveries (76.3% were performed in tertiary hospitals. Neonatal morbidity included hypothermia 546 (71%, sepsis 522 (67.9%, prematurity 250 (34.9%, polycythemia 242 (31.5%, hypoglycemia 142 (18.5, meconium aspiration syndrome 113 (14.7%, and perinatal asphyxia 96 (12.5%. The overall mortality was 110 (14.3%; 95% confidence interval [CI]: 11.9–16.9 of which 69 (62.7% deaths occurred in the first 24 hours of age. In the multivariate analysis, mortality was associated with perinatal asphyxia (adjusted odds ratio [AOR]: 5.97; 95% CI: 3.06–11.64, instrumental delivery (AOR: 2.99; 95% CI: 1.08–8.31, and early onset

  18. Comparing Early Postoperative Period Analgesic Effect of Dexketoprofene Trometamol and Lornoxicam in Mediastinoscopy Cases

    Science.gov (United States)

    Sagiroglu, Gonul

    2011-01-01

    Objective: In this study, we aimed comparing early postoperative period analgesic effectiveness and the effects on opioid consumption of intravenous dexketoprofen and lornoxicam that are given preemptively. Materials and Methods: Forty patients, planned elective mediastinoscopy, were included in this prospective randomized study. These patients were classified in two groups, group D for dexketoprofene trometamol and group L for lornoxicam, randomly. 20 minutes before the operation 50 mg dexketoprofene trometamol and 8 mg lornoxicam were injected intravenously for group D and group L respectively. In postoperative intensive care unit, pain scores, mean arterial pressures, heart rates and peripheric O2 saturations of patients were recorded at 0, 10, 20, 60, 90 and 120th minutes. Results: When we evaluate the VAS score of the groups, there was a significant decrease in group D in all measured timesstatistically compairing to group L (p0.05). Conclusion: Since intravenous dexketoprofen, applied preemptively, has more potent analgesic effect and causing less opioid consumption in early postoperative period, is better than intravenous lornoxicam. PMID:25610155

  19. Pronoia in the Military Organization of the Byzantine Empire at Early Palaeologian Period (Part 2

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    Zolotovskiy Vladimir A.

    2016-06-01

    Full Text Available In the present study the author disclosed the role of pronoia in the military organization of the Byzantine Empire at early Palaeologian period. The concrete cases of the award allow recognizing the proniarety as the Byzantine military institution dealing exclusively with the military leadership. The grant of pronoia was a replacement for traditional rewards of military commanders of noble origin. However, in some cases it was identified that compulsory military service was a function of power which was granted to the proniares in addition to the tax quota. Holders of pronoia were not only the Romans military commanders but also the mercenaries. Such awards could reduce the costs of imperial treasury for direct payments. In the case of proniares-Byzantines, depending on posotis, we can talk about the conferring upon pronoia the representatives of various levels of the military leadership. The pronoias granted as a reward or the compensation for losses incurred as a result of the performance of official engagements, could be transferred to the commanders of low levels which were recruited from among stratiotes (obviously, dekarhes. Definition of the role of pronoia in military practice of the early palaeologian period which would be possible in the identification of the proportion of pronoiares and strateia contingents and the correlation of victories and defeats, won by them, is impossible in practice.

  20. Prediction of rhythmic and periodic EEG patterns and seizures on continuous EEG with early epileptiform discharges.

    Science.gov (United States)

    Koren, J; Herta, J; Draschtak, S; Pötzl, G; Pirker, S; Fürbass, F; Hartmann, M; Kluge, T; Baumgartner, C

    2015-08-01

    Continuous EEG (cEEG) is necessary to document nonconvulsive seizures (NCS), nonconvulsive status epilepticus (NCSE), as well as rhythmic and periodic EEG patterns of 'ictal-interictal uncertainty' (RPPIIU) including periodic discharges, rhythmic delta activity, and spike-and-wave complexes in neurological intensive care patients. However, cEEG is associated with significant recording and analysis efforts. Therefore, predictors from short-term routine EEG with a reasonably high yield are urgently needed in order to select patients for evaluation with cEEG. The aim of this study was to assess the prognostic significance of early epileptiform discharges (i.e., within the first 30 min of EEG recording) on the following: (1) incidence of ictal EEG patterns and RPPIIU on subsequent cEEG, (2) occurrence of acute convulsive seizures during the ICU stay, and (3) functional outcome after 6 months of follow-up. We conducted a separate analysis of the first 30 min and the remaining segments of prospective cEEG recordings according to the ACNS Standardized Critical Care EEG Terminology as well as NCS criteria and review of clinical data of 32 neurological critical care patients. In 17 patients with epileptiform discharges within the first 30 min of EEG (group 1), electrographic seizures were observed in 23.5% (n = 4), rhythmic or periodic EEG patterns of 'ictal-interictal uncertainty' in 64.7% (n = 11), and neither electrographic seizures nor RPPIIU in 11.8% (n = 2). In 15 patients with no epileptiform discharges in the first 30 min of EEG (group 2), no electrographic seizures were recorded on subsequent cEEG, RPPIIU were seen in 26.7% (n = 4), and neither electrographic seizures nor RPPIIU in 73.3% (n = 11). The incidence of EEG patterns on cEEG was significantly different between the two groups (p = 0.008). Patients with early epileptiform discharges developed acute seizures more frequently than patients without early epileptiform discharges (p = 0.009). Finally, functional

  1. Borderline Personality Disorder in the perinatal period: early infant and maternal outcomes.

    Science.gov (United States)

    Blankley, Gaynor; Galbally, Megan; Snellen, Martien; Power, Josephine; Lewis, Andrew J

    2015-12-01

    This study examines pregnancy and early infant outcomes of pregnant women with a clinical diagnosis of Borderline Personality Disorder presenting for obstetric services to a major metropolitan maternity hospital in Victoria, Australia. A retrospective case review of pregnancy and early infant outcomes on 42 women who had been diagnosed with Borderline Personality Disorder via psychiatric assessment using DSM-IV-R criteria was undertaken. Outcomes were compared with a control group of 14,313 consisting of women and infants of non-affected women from the same hospital over the same period of time. Women presenting for obstetric services with a clinical diagnosis of Borderline Personality Disorder experienced considerable psychosocial impairment. They anticipated birth as traumatic and frequently requested early delivery. High comorbidity with substance abuse was found and high rates of referral to child protective services. Mothers with Borderline Personality Disorder were significantly more likely to have negative birth outcomes such as lowered Apgar scores, prematurity and special care nursery referral when compared with controls. These findings offer preliminary evidence to be considered by clinicians in developing treatments and services for the perinatal care of women with Borderline Personality Disorder and their infants. Further research is required in order to develop evidence informed clinical guidelines for the management of women with Borderline Personality Disorder and their infants. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  2. [Angiopoietins predict long-term outcomes after aneurysmal subarachnoid hemorrhage during an early period].

    Science.gov (United States)

    Wang, Yi; Wang, Dong; Wei, Huijie; Tian, Ye; Jiang, Rongcai; Yue, Shuyuan; Zhang, Jianning

    2015-05-19

    To evaluate the association between serum levels of angiopoietins (Ang) during an early period (within 72 h) and clinical outcomes after aneurysmal subarachnoid haemorrhage (aSAH). This prospective study was conducted at Department of Neurosurgery, Tianjin Medical University General Hospital. Blood samples from 37 aSAH patients were collected at 8 h (or GOSE). Those with GOSE > 5 were counted as a good outcome while those with GOSE ≤ 5 had a poor outcome. A total of 37 patients with aSAH and 39 healthy controls (HC) were enrolled. The aSAH patients showed a significant rise of Ang-1 within 8 h as compared with HC. The outcomes were good (n = 15) and poor (n = 22). Serum Ang-1 at 8 h (or < 8 h), 24 h and 72 h in good outcomers showed significantly higher than that in poor outcomers [(52 ± 24) vs (37 ± 17) mg/L, (62 ± 26) vs (45 ± 17) mg/L, (107 ± 27) vs (72 ± 18) mg/L]. The serum level of Ang-1 at 8 h and 24 h was one of independent risk factors for aSAH patients by multiariable Logistic regression analysis [adjected OR (95% CI) 1.095 (1.015-1.181) and 1.109 (1.016-1.211)] (P < 0.05). High serum level of Ang-1 during an early period (within 72 h) was associated with good outcomers (r = 0.627, P < 0.001). The serum levels of angiopoietins are significantly altered in aSAH patients, especially higher in good outcomers. And abnormal levels of angiopoietins may affect early brain injury (EBI) after SAH, structural integrity and recovery of blood-brain barrier (BBB) and long-term outcomes in aSAH patients.

  3. Journal “Topics in Early Childhood Special Education”: assessment of the periodical and articles

    Directory of Open Access Journals (Sweden)

    Paulo Celso Pereira

    2008-12-01

    Full Text Available Journals have the purpose of dissemination and communication of scientific knowledge. As a vehicle to the dissemination of scientific productions, it is necessary the periodical assessment to evaluate the quality of research: accuracy, reliability and seriousness. The objective of this study is to assess the journal Topics in Early Childhood Special Education, considering for the analysis the whole journal and the formal and the contents aspects of all articles. The analysis revealed that the periodical satisfactorily fulfills the normalization criterion, the authors’ instruction criterion and the articles assessment criterion. However, it was identified the need for major accuracy in the bibliographic legend that should appear on all pages of articles. Regarding the analysis of the articles it was observed the lack of keywords and a wide variety of information in the abstracts, which they were sometimes not related to the key aspects of the research. All authors and institutions are from United States of America and the type of study most published it was the research report. The participants’ characterization indicated that the journal broachs different types of special needs, but there is more studies about autism. The study data confirm the journal purpose that is providing relevant and current information on all aspects of early education for children with special needs, including their families. It was pointed the need for more articles from other countries beyond the North American continent, including the participation of researcher from other countries. Additionally, the model used for the journal assessment showed to be effective in providing data quality, reliability and accuracy of the whole periodical and the studies that it was published in the journal.

  4. Influence of ERβ selective agonism during the neonatal period on the sexual differentiation of the rat hypothalamic-pituitary-gonadal (HPG axis

    Directory of Open Access Journals (Sweden)

    Patisaul Heather B

    2012-01-01

    Full Text Available Abstract Background It is well established that sexual differentiation of the rodent hypothalamic-pituitary-gonadal (HPG axis is principally orchestrated by estrogen during the perinatal period. Here we sought to better characterize the mechanistic role the beta form of the estrogen receptor (ERβ plays in this process. Methods To achieve this, we exposed neonatal female rats to three doses (0.5, 1 and 2 mg/kg of the ERβ selective agonist diarylpropionitrile (DPN using estradiol benzoate (EB as a positive control. Measures included day of vaginal opening, estrous cycle quality, GnRH and Fos co-localization following ovariectomy and hormone priming, circulating luteinizing hormone (LH levels and quantification of hypothalamic kisspeptin immunoreactivity. A second set of females was then neonatally exposed to DPN, the ERα agonist propyl-pyrazole-triol (PPT, DPN+PPT, or EB to compare the impact of ERα and ERβ selective agonism on kisspeptin gene expression in pre- and post-pubescent females. Results All three DPN doses significantly advanced the day of vaginal opening and induced premature anestrus. GnRH and Fos co-labeling, a marker of GnRH activation, following ovariectomy and hormone priming was reduced by approximately half at all doses; the magnitude of which was not as large as with EB or what we have previously observed with the ERα agonist PPT. LH levels were also correspondingly lower, compared to control females. No impact of DPN was observed on the density of kisspeptin immunoreactive (-ir fibers or cell bodies in the arcuate (ARC nucleus, and kisspeptin-ir was only significantly reduced by the middle (1 mg/kg DPN dose in the preoptic region. The second experiment revealed that EB, PPT and the combination of DPN+PPT significantly abrogated preoptic Kiss1 expression at both ages but ARC expression was only reduced by EB. Conclusion Our results indicate that selective agonism of ERβ is not sufficient to completely achieve male

  5. Differential relationships between chronic hormone profiles in pregnancy and maternal investment in rhesus monkey mothers with hair loss in the neonatal period.

    Science.gov (United States)

    Dettmer, Amanda M; Rosenberg, Kendra; Menard, Mark T; El-Mallah, Saif N; Woodward, Ruth A; Suomi, Stephen J; Meyer, Jerrold S

    2017-01-01

    Hair loss is commonly used as an indicator of well being in primate facilities, yet it has been shown to also occur in otherwise healthy pregnant and postpartum females. There is significant variability in the incidence of hair loss during these important developmental periods, reasons for which remain unclear. We studied female rhesus monkeys (Macaca mulatta, n = 47) with and without hair loss in pregnancy/postpartum. We hypothesized that, similar to previously published reports, pregnancy would result in an increased likelihood of hair loss, and that hair loss would be correlated with higher hair cortisol concentrations (HCCs). We further hypothesized that hair loss among pregnant females is related to differential maternal investment. We studied a subset of monkeys (n = 26) from mid-to-late pregnancy through peak lactation, some of which exhibited hair loss in the perinatal period (n = 15), and some of which did not (n = 11). We examined fetal measurements, infant birth weight, infant growth rate, and milk yield volume (MYV) in the first 30 days as indices of investment. We found that pregnant monkeys showed a greater incidence of hair loss across the study year (χ 2 (2)  = 6.55, P = 0.038), and that mothers with hair loss had significantly higher HCCs in pregnancy than those without (F (2,28)  = 3.8, P = 0.017, η p 2  = 0.21). HCCs in pregnancy were correlated with severity of hair loss in the neonatal period (r (37)  = 0.42, P = 0.008). Moreover, HCCs in pregnancy were positively correlated with infant birth weight (r (12)  = 0.56, P = 0.038), infant growth rate (r (12)  = 0.64, P = 0.014), and MYV (r (11)  = 0.85, P hair loss in some monkeys, especially during the birthing season, may be a signal of greater physiological stress during pregnancy and differential investment by mothers to their offspring. Am. J. Primatol. 79:e22489, 2017. © 2015 Wiley Periodicals, Inc. © 2016 Wiley Periodicals

  6. Fatores de risco associados à hospitalização por bronquiolite aguda no período pós-neonatal Risk factors associated with hospitalization for bronchiolitis in the post-neonatal period

    Directory of Open Access Journals (Sweden)

    Elaine P Albernaz

    2003-08-01

    Full Text Available OBJETIVO: Investigar a relação entre fatores socioeconômicos, características maternas, aleitamento e hospitalização por bronquiolite no período pós-neonatal. MÉTODOS: Estudo caso-controle, aninhado a estudo de coorte de 5.304 crianças nascidas na cidade de Pelotas, RS. O estudo de coorte constitui-se de quatro subestudos, cada um com métodos e logística específicos. As mães foram entrevistadas por meio de questionário padronizado, em visitas hospitalares e domiciliares. Foram definidos como casos as crianças com idade entre 28 e 364 dias, que haviam sido hospitalizadas por bronquiolite. RESULTADOS: De 5.304 crianças da coorte, 113 (2,1% foram hospitalizadas por bronquiolite. A análise multivariada hierarquizada, realizada pela regressão logística, mostrou os seguintes resultados: renda familiar, assim como idade gestacional, estiveram inversamente relacionadas ao risco de hospitalização por bronquiolite. O aleitamento materno desempenhou um fator protetor; crianças com tempo de aleitamento materno inferior a um mês tiveram risco 7 vezes maior de serem hospitalizadas por bronquiolite aguda nos primeiros três meses de vida. O risco de hospitalização por bronquiolite foi 57% maior naquelas expostas ao fumo materno. CONCLUSÕES: A hospitalização por bronquiolite está inversamente relacionada com renda familiar, idade gestacional e tempo de aleitamento materno, e diretamente relacionada com exposição a fumo materno. Não foi evidenciada associação com paridade ou história materna de asma brônquica.OBJECTIVE: To investigate the relationship between socioeconomic factors, maternal characteristics, breastfeeding, and hospitalization for bronchiolitis in the post-neonatal period. METHODS: A nested case-control study with a cohort of 5,304 children born in the city of Pelotas, Brazil, was conducted. The cohort study consisted of four sub-studies with their own methods and logistics. Mothers were interviewed using a

  7. Proteomics mapping of cord blood identifies haptoglobin "switch-on" pattern as biomarker of early-onset neonatal sepsis in preterm newborns.

    Science.gov (United States)

    Buhimschi, Catalin S; Bhandari, Vineet; Dulay, Antonette T; Nayeri, Unzila A; Abdel-Razeq, Sonya S; Pettker, Christian M; Thung, Stephen; Zhao, Guomao; Han, Yiping W; Bizzarro, Matthew; Buhimschi, Irina A

    2011-01-01

    Intra-amniotic infection and/or inflammation (IAI) are important causes of preterm birth and early-onset neonatal sepsis (EONS). A prompt and accurate diagnosis of EONS is critical for improved neonatal outcomes. We sought to explore the cord blood proteome and identify biomarkers and functional protein networks characterizing EONS in preterm newborns. We studied a prospective cohort of 180 premature newborns delivered May 2004-September 2009. A proteomics discovery phase employing two-dimensional differential gel electrophoresis (2D-DIGE) and mass spectrometry identified 19 differentially-expressed proteins in cord blood of newborns with culture-confirmed EONS (n = 3) versus GA-matched controls (n = 3). Ontological classifications of the proteins included transfer/carrier, immunity/defense, protease/extracellular matrix. The 1(st)-level external validation conducted in the remaining 174 samples confirmed elevated haptoglobin and haptoglobin-related protein immunoreactivity (Hp&HpRP) in newborns with EONS (presumed and culture-confirmed) independent of GA at birth and birthweight (PLCA) was further used for unbiased classification of all 180 cases based on probability of "antenatal IAI exposure" as latent variable. This was then subjected to 2(nd)-level validation against indicators of adverse short-term neonatal outcome. The optimal LCA algorithm combined Hp&HpRP switch pattern (most input), interleukin-6 and neonatal hematological indices yielding two non-overlapping newborn clusters with low (≤20%) versus high (≥70%) probability of IAI exposure. This approach reclassified ∼30% of clinical EONS diagnoses lowering the number needed to harm and increasing the odds ratios for several adverse outcomes including intra-ventricular hemorrhage. Antenatal exposure to IAI results in precocious switch-on of Hp&HpRP expression. As EONS biomarker, cord blood Hp&HpRP has potential to improve the selection of newborns for prompt and targeted treatment at birth.

  8. Proteomics Mapping of Cord Blood Identifies Haptoglobin “Switch-On” Pattern as Biomarker of Early-Onset Neonatal Sepsis in Preterm Newborns

    Science.gov (United States)

    Buhimschi, Catalin S.; Bhandari, Vineet; Dulay, Antonette T.; Nayeri, Unzila A.; Abdel-Razeq, Sonya S.; Pettker, Christian M.; Thung, Stephen; Zhao, Guomao; Han, Yiping W.; Bizzarro, Matthew; Buhimschi, Irina A.

    2011-01-01

    Background Intra-amniotic infection and/or inflammation (IAI) are important causes of preterm birth and early-onset neonatal sepsis (EONS). A prompt and accurate diagnosis of EONS is critical for improved neonatal outcomes. We sought to explore the cord blood proteome and identify biomarkers and functional protein networks characterizing EONS in preterm newborns. Methodology/Principal Findings We studied a prospective cohort of 180 premature newborns delivered May 2004-September 2009. A proteomics discovery phase employing two-dimensional differential gel electrophoresis (2D-DIGE) and mass spectrometry identified 19 differentially-expressed proteins in cord blood of newborns with culture-confirmed EONS (n = 3) versus GA-matched controls (n = 3). Ontological classifications of the proteins included transfer/carrier, immunity/defense, protease/extracellular matrix. The 1st-level external validation conducted in the remaining 174 samples confirmed elevated haptoglobin and haptoglobin-related protein immunoreactivity (Hp&HpRP) in newborns with EONS (presumed and culture-confirmed) independent of GA at birth and birthweight (PLCA) was further used for unbiased classification of all 180 cases based on probability of “antenatal IAI exposure” as latent variable. This was then subjected to 2nd-level validation against indicators of adverse short-term neonatal outcome. The optimal LCA algorithm combined Hp&HpRP switch pattern (most input), interleukin-6 and neonatal hematological indices yielding two non-overlapping newborn clusters with low (≤20%) versus high (≥70%) probability of IAI exposure. This approach reclassified ∼30% of clinical EONS diagnoses lowering the number needed to harm and increasing the odds ratios for several adverse outcomes including intra-ventricular hemorrhage. Conclusions/Significance Antenatal exposure to IAI results in precocious switch-on of Hp&HpRP expression. As EONS biomarker, cord blood Hp&HpRP has potential to improve the

  9. [Clinical efficiency of Vasonat in neurometabolic therapy of patients with ischemic stroke at early rehabilitation period].

    Science.gov (United States)

    Abasova, G B; Tyksanbaeva, G U; Orazalieva, D B; Kasymova, S K

    2011-01-01

    Research of efficiency and safety of Vasonat has been carried out. 31 patients aged 46-75 years who had had hemispheric athero- thrombotic or hemodynamic schemic stroke with moderate severity and being treated in 2-5-month of early rehabilitation period have been observed. The control group of patients received placebo. Results of the study, 4 weeks treatment using Vasonat in the dosage of 500 mg/day have shown positive effect on common signs of the disease by decreasing headache intensity, dizziness, a nausea, and on focal neurological symptoms by decreasing hemiparesis degree; psychoemotional and mnestic activity (main memory and attention) improved as well. It was more distinct in patients with localization of the stroke in the right hemisphere of the brain. It was also noted more rapid improvement of motion function and quality of life of patients.

  10. Sword of the early sarmatian period from the Ik-Zay interfluve

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    Izmaylov Iskander L

    2015-06-01

    Full Text Available A sword discovered in 2001 as a stray find in the area of Chaply village (Aznakayevsky District of the Tatarstan Republic is analyzed in the article. The sword is kept at Aznakayevsky Local History Museum. The shape of its guard and blade allowed the author to suggest its Sarmatian origin. Similar artifacts of Sarmatian culture suggest dating the sword by the late 4th - late 3rd cc. A.D., i.e. by the Prohorovo (Early Sarmatian period. This find is unique for the entire South-Eastern Tatarstan and was discovered far to the north of the main distribution area of the Sarmatian artifacts. It provides grounds for inclusion of this territory into the Prohorovo cultural area and should promote a more thorough study of artifacts at interfluves of minor rivers – the Kama tributaries – in order to identify and research barrows.

  11. Physical health problems experienced in the early postoperative recovery period following total knee replacement

    DEFF Research Database (Denmark)

    Szötz, Kirsten; Pedersen, Preben Ulrich; Hørdam, Britta

    2015-01-01

    of exercising in the early recovery period after discharge from hospital following total knee replacement. METHOD: A cross-sectional survey was conducted using a questionnaire. A total of 86 patients were included following first-time elective total knee replacement. Descriptive statistics were used. RESULTS......: The majority of the patients experienced leg oedema (90.7%). Secondary to this were pain (81.4%), sleeping disorders (47.7%) problems with appetite (38.4%) and bowel function (34.9%) were the most frequently identified physical health problems. In total, 69.8% of the patients indicated that they did...... not exercise or only partly exercise as recommended, but without associated experience of pain. CONCLUSION: Patients experienced a wide range of physical health problems following total knee replacement and deviation from recommended self-training was identified. These findings are valuable for health...

  12. Greek states of the early historic period: systematizing the evidence contained in the Homeric poems

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    Olga A. Zolotnikova

    2013-06-01

    Based on the descriptions of the states occurring in the Homeric poems, it is supposed to demonstrate that, in terms of organization, a state of the early historic period presented a clear tripartite structure – a body of basileis (“kings”, a body of the elders and an assembly (“agora” of the people; an addition to those, there were also minor public offices, which could be held by representatives of the people. It is the intention of this paper to analyze these institutions with regard to their exact functions, roles, and importance in the states as described in the epic diction. In conclusion, it will be argued that a state as presented in the Homeric poems appeared as a self-governed autonomous community, which in its general features might approximate a city-state (polis; however, it was still too underdeveloped to be compared with states of that type.

  13. Early neonatal dermatoses: A study among 1260 babies delivered at a tertiary care center in South India

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    Divya Kalappa Gorur

    2016-01-01

    Conclusion: The hospital-based incidence of neonatal dermatoses was 98.5% with no sexual predilection. Although common, most of the skin lesions in newborn are self-limiting requiring no treatment. Correct diagnosis and counseling the parents may relieve the anxiety and mental trauma.

  14. Neonatal Stroke Causes Poor Midline Motor Behaviors and Poor Fine and Gross Motor Skills during Early Infancy

    Science.gov (United States)

    Chen, Chao-Ying; Lo, Warren D.; Heathcock, Jill C.

    2013-01-01

    Upper extremity movements, midline behaviors, fine, and gross motor skills are frequently impaired in hemiparesis and cerebral palsy. We investigated midline toy exploration and fine and gross motor skills in infants at risk for hemiplegic cerebral palsy. Eight infants with neonatal stroke (NS) and thirteen infants with typical development (TD)…

  15. Periodontal diseases at the transition from the late antique to the early mediaeval period in Croatia.

    Science.gov (United States)

    Vodanović, Marin; Peroš, Kristina; Zukanović, Amila; Knežević, Marjana; Novak, Mario; Slaus, Mario; Brkić, Hrvoje

    2012-10-01

    We tested the hypothesis that the transition from the late antique to the early mediaeval period in Croatia had a negative impact on the periodontal health. 1118 skulls were examined for dental calculus, alveolar bone resorption, fenestrations, dehiscences and root furcation involvement. The prevalence of teeth with calculus varied from 40.7% in the LA sample of continental parts of Croatia to 50.3% in the LA sample of Adriatic Croatia. The prevalence of alveolar bone resorption ranged between 21.2% in the EM sample from continental Croatia and 32.3% in the LA sample from Adriatic Croatia. The prevalence of individuals with alveolar bone dehiscences varied from 8.6% in the LA sample from continental Croatia up to 15.0% in the EM sample from Adriatic Croatia. The prevalence of individuals with alveolar bone fenestrations varied from 21.5% in the LA sample from Adriatic Croatia up to 36.2% in the LA sample from continental Croatia. The prevalence of individuals with exposed root bifurcations or trifurcations varied from 9.0% in the EM sample from Adriatic Croatia up to 20.7% in the EM sample from continental Croatia. Statistically significant differences were found between samples. The transition from the late antique to the early mediaeval period in Croatia did not have a negative impact on periodontal health. Studies of periodontal health of ancient populations should be performed to provide a better and more reliable reconstruction of living conditions in the past. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Prenatal cocaine exposure and neonatal/infant outcomes.

    Science.gov (United States)

    Cambell, Shelly

    2003-01-01

    Illegal drug use throughout the nation is a problem of epidemic proportion. Of particular concern is drug use among pregnant women. In most cases, these women have little hope of achieving a better life for themselves or their children. Illegal drugs, cocaine in particular, can have devastating effects on the neonate. These effects can last well into childhood and can exhibit themselves in academic, social, and family situations. Challenges for the neonatal nurse include early identification of these infants and use of available resources. This article addresses prenatal cocaine use and support services for drug-dependent women, effects of cocaine during the neonatal period, possible neonatal and infant outcomes, and implications for nursing practice.

  17. Neonatal asphyxia: A study of 210 cases

    Directory of Open Access Journals (Sweden)

    Hülya Üzel

    2012-06-01

    Full Text Available Objectives: Perinatal asphyxia remains an importantcause of neonatal morbidity and mortality. The aim of thisstudy was to investigate antenatal, natal, and postnatalrisk factors of neonatal asphyxia, relationship with knownrisk factors and stage of Sarnat and Sarnat scores, theeffect of risk factors on hospital discharge and survival forneonates with perinatal asphyxia.Materials and methods: In this study, we retrospectivelyanalyzed the hospital records of 210 patients diagnosedas perinatal asphyxia. The patients’ demographic characteristics,antepartum, intrapartum, and postpartum riskfactors and Sarnat and Sarnat clinical staging criteria ofnewborns were analyzed.Results: The risk factors for asphyxia were detectedantepartum period in 67.7% of newborns, intrapartum in91% and potpartum in of 29.5% of neonates. When caseswere examined according to the studied years, perinatalasphyxia ratio was the most frequent in 2007 as 28.1%.With a decline over the years, frequency dropped to %21in 2010. The number of patients with stage 3 and mortalityrate were significantly decreased over the years (p<0.05.Conclusions: Less preventable intrapartum causes ofbirth asphyxia are seen more frequently. Early detectionof risk factors together with appropriate prenatal, nataland postnatal care provision, reduced emergency caesareansections and will decrease considerably decreasefrequency of perinatal asphyxia. We think that followingup neonates who needed intensive care in neonatal unitssufficiently equipped will decrease complications due toasphyxia. J Clin Exp Invest 2012; 3(2: 194-198

  18. Analysis of In-hospital Neonatal Death in the Tertiary Neonatal Intensive Care Unit in China: A Multicenter Retrospective Study

    Institute of Scientific and Technical Information of China (English)

    Chen-Hong Wang; Li-Zhong Du; Xiao-Lu Ma; Li-Ping Shi; Xiao-Mei Tong; Hong Liu; Guo-Fang Ding

    2016-01-01

    Background:Globally,the proportion of child deaths that occur in the neonatal period remains a high level of 37-41%.Differences of cause in neonate death exist in different regions as well as in different economic development countries.The specific aim of this study was to investigate the causes,characteristics,and differences of death in neonates during hospitalization in the tertiary Neonatal Intensive Care Unit (NICU) of China.Methods:All the dead neonates admitted to 26 NICUs were included between January 1,2011,and December 31,2011.All the data were collected retrospectively from clinical records by a designed questionnaire.Data collected from each NICU were delivered to the leading institution where the results were analyzed.Results:A total of 744 newborns died during the l-year survey,accounting for 1.2% of all the neonates admitted to 26 NICUs and 37.6% of all the deaths in children under 5 years of age in these hospitals.Preterm neonate death accounted for 59.3% of all the death.The leading causes of death in preterm and term infants were pulmonary disease and infection,respectively.In early neonate period,pulmonary diseases (56.5%) occupied the largest proportion ofpreterm deaths while infection (27%) and neurologic diseases (22%) were the two main causes of term deaths.In late neonate period,infection was the leading cause of both preterm and term neonate deaths.About two-thirds of neonate death occurred after medical care withdrawal.Of the cases who might survive if receiving continuing treatment,parents' concern about the long-term outcomes was the main reason of medical care withdrawal.Conclusions:Neonate death still accounts for a high proportion of all the deaths in children under 5 years of age.Our study showed the majority of neonate death occurred in preterm infants.Cause of death varied with the age of death and gestational age.Accurate and prompt evaluation of the long-term outcomes should be carried out to guide the critical

  19. Treponemal disease in the middle Archaic to early Woodland periods of the western Tennessee River Valley.

    Science.gov (United States)

    Smith, Maria Ostendorf

    2006-10-01

    The high frequency of late prehistoric New World treponemal disease is attributable to the demographic changes concomitant with the adoption of agriculture. However, these demographic changes in group mobility and site density episodically preceded intensive plant domestication, suggesting possible staggered temporal change in observed treponemal disease case frequency. Thirteen convincing and an additional two probable (N = 581) cases of treponemal disease were identified in an eight-site skeletal sample spanning the Middle (6,000-3,000 BCE) to Late (2,500-ca. 1,000 to 500 BCE) Archaic and Early Woodland (500 BCE-0 CE) periods from the western Tennessee River Valley. Treponemal disease cases are infrequent in both the Middle (3/115, 2.6%) and Late (2 to 4 cases, subsistence economy across the Archaic-Woodland temporal boundary in the western Tennessee River Valley remained, as elsewhere, based on intensive hunting and collecting, the demographic corollaries of treponemal disease would apparently not be met. However, the traditional horizon marker of the Woodland period is the adoption of pottery, an activity associated with sedentism.

  20. Early MRI changes in glioblastoma in the period between surgery and adjuvant therapy.

    Science.gov (United States)

    Farace, Paolo; Amelio, Dante; Ricciardi, Giuseppe K; Zoccatelli, Giada; Magon, Stefano; Pizzini, Francesca; Alessandrini, Franco; Sbarbati, Andrea; Amichetti, Maurizio; Beltramello, Alberto

    2013-01-01

    To investigate the increase in MRI contrast enhancement (CE) occurring in glioblastoma during the period between surgery and initiation of chemo-radiotherapy, thirty-seven patients with newly diagnosed glioblastoma were analyzed by early post-operative magnetic resonance (EPMR) imaging within three days of surgery and by pre-adjuvant magnetic resonance (PAMR) examination before adjuvant therapy. Areas of new CE were investigated by use of EPMR diffusion-weighted imaging and PAMR perfusion imaging (by arterial spin-labeling). PAMR was acquired, on average, 29.9 days later than EPMR (range 20-37 days). During this period an increased area of CE was observed for 17/37 patients. For 3/17 patients these regions were confined to areas of reduced EPMR diffusion, suggesting postsurgical infarct. For the other 14/17 patients, these areas suggested progression. For 11/17 patients the co-occurrence of hyperperfusion in PAMR perfusion suggested progression. PAMR perfusion and EPMR diffusion did not give consistent results for 3/17 patients for whom small new areas of CE were observed, presumably because of the poor spatial resolution of perfusion imaging. Before initiation of adjuvant therapy, areas of new CE of resected glioblastomas are frequently observed. Most of these suggest tumor progression, according to EPMR diffusion and PAMR perfusion criteria.

  1. Low risk of pulmonary valve implantation after a policy of transatrial repair of tetralogy of Fallot delayed beyond the neonatal period: the Melbourne experience over 25 years.

    Science.gov (United States)

    d'Udekem, Yves; Galati, John C; Rolley, Glenda J; Konstantinov, Igor E; Weintraub, Robert G; Grigg, Leeanne; Ramsay, James M; Wheaton, Gavin R; Hope, Sarah; Cheung, Michael H; Brizard, Christian P

    2014-02-18

    The study sought to evaluate the late outcomes of a policy of transatrial repair delayed beyond the neonatal period. Long-term outcomes of transatrial repair of tetralogy of Fallot are unknown. The records of 675 consecutive patients undergoing a transatrial repair of tetralogy of Fallot between 1980 and 2005 were reviewed, their follow-up updated and survival confirmed from national death registries. One-third (220 of 675) had undergone previous palliation. Median age at repair was 2 years in the first 8 years, and 1 year from 1988 onward. A transannular incision was performed in 75% of cases and autologous pericardium was the material used to patch this incision in 92% of cases. There were 7 hospital deaths (1%). Eight patients died during follow-up (2 sudden unexpected and 6 noncardiac deaths). Mean follow-up was 11.7 ± 6.3 years. Twenty-five years' survival was 97% (95% confidence interval [CI]: 95% to 98%). Twenty-five years' freedom from implantation of a valved conduit was 84.6% (95% CI: 77.8% to 89.5%). By multivariable analysis, prior palliation and younger age at repair were predictive of implantation of a valved conduit (hazard ratio: 2.4, 95% CI: 1.3 to 4.6, p = 0.008; hazard ratio: 0.70, 95% CI: 0.50 to 0.96, p = 0.03, respectively). During long-term follow-up, transatrial repair of tetralogy of Fallot was associated with a minimal risk of sudden death and low rate of reintervention for right ventricular dilation and residual outflow tract obstruction. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  2. Impact of Discharge Timings of Healthy Newborns on the Rates and Etiology of Neonatal Hospital Readmissions

    International Nuclear Information System (INIS)

    Habib, H.S.

    2013-01-01

    Objective: To evaluate the effect of early hospital discharge after initial birth hospitalization on the rate and etiology of hospital readmissions during the neonatal period. Study Design: Cross-sectional analytical study. Place and Duration of Study: King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia, from October 2008 to September 2011. Methodology: Full-term normal newborns were included in this study, and all infants showing any features that would increase the chances of readmission were excluded. Initial birth hospitalization and readmission in the neonatal period were analyzed. Data was collected from the Discharge Abstract Database. Results: Overall, 12,728 normal newborns were delivered during the study period. Vaginally delivered infants were discharged early (within 48 hours), while those delivered via caesarean section had longer hospital stays (mean length of stay: 1.1 and 2.8 days, respectively). There were 166 readmissions, wherein the leading cause was neonatal sepsis (37.3%) followed by neonatal jaundice (26.5%). The readmission rate in early discharged (142 out of 9927) was significantly higher (p = 0.017) as compared to newborns who were discharged late after birth (24 out of 2801). Etiology of readmissions was not affected by discharge timings. Conclusion: Hospital discharge of neonates within 48 hours after delivery is counterproductive and significantly increases the risk for hospital readmission during the neonatal period. The pre-dominance of sepsis-related cases observed here indicates the need to explore its causes and determine an optimal prevention and management strategy. (author)

  3. Analgesic efficacy of transversus abdominis plane block in neonates and early infants for colostomy and reversal of colostomy.

    Science.gov (United States)

    Chen, Chee Kean; Teo, Shu Ching; Phui, Vui Eng; Saman, Mat Ariffin

    2015-01-01

    The application of ultrasound-guided transversus abdominis plane (TAP) block in paediatric population is gaining popularity among anaesthetists. We present a case series of ultrasound-guided TAP block in ten neonate and infants undergoing colostomy and reversal of stoma. Classical TAP as described by Hebbard was carried out and a maximum dosage of 1ml/kg of 0.25% levobupivacaine was injected. Pain score was assessed using Neonatal Infant Pain Scale for 24 hours. In all patients, the block was successful with minimal hemodynamic changes intraoperatively and no additional systemic analgesia was needed intraoperative and immediate postoperatively. Ultrasound-guided TAP block has an important role in providing safe and effective analgesia for colostomy creation and reversal of stoma surgeries in paediatric population.

  4. Sea Surface Temperatures in the Indo-Pacific Warm Pool During the Early Pliocene Warm Period

    Science.gov (United States)

    Dekens, P. S.; Ravelo, A. C.; Griffith, E. M.

    2010-12-01

    The Indo-Pacific warm pool (IPWP) plays an important role in both regional and global climate, but the response of this region to anthropogenic climate change is not well understood. While the early Pliocene is not a perfect analogue for anthropogenic climate change, it is the most recent time in Earth history when global temperatures were warmer than they are today for a sustained period of time. SST in the eastern equatorial Pacific was 2-4○C warmer in the early Pliocene compared to today. A Mg/Ca SST at ODP site 806 in the western equatorial Pacific indicates that SST were stable through the last 5Ma (Wara et al., 2005). We generated a G. sacculifer Mg/Ca record in the Indian Ocean (ODP sit 758) for the last 5 Ma, which also shows that IPWP SST has remained relatively stable through the last 5 Ma and was not warmer in the early Pliocene compared today. A recent paper suggests that the Mg/Ca of seawater may have varied through the last 5 Ma and significantly affected Mg/Ca SST estimates (Medina-Elizalde et al., 2008). However, there is considerable uncertainty in the estimates of seawater Mg/Ca variations through time. We will present a detailed examination of these uncertainties to examine the possible range of seawater Mg/Ca through the last 5 Ma. Due to the lack of culturing work of foraminifera at different Mg/Ca ratios in the growth water there is also uncertainty in how changes in seawater Mg/Ca will affect the temperatures signal in the proxy. We will explore how uncertainties in the record of seawater Mg/Ca variations through time and its effect on the Mg/Ca SST proxy potentially influence the interpretation of the Mg/Ca SST records at ODP sites 806 and 758 in the IPWP, and ODP site 847 in the eastern equatorial Pacific. We will also explore how adjustment of the Mg/Ca SST estimates (due to reconstructed Mg/Ca seawater variations) affects the δ18O of water when adjusted Mg/Ca SST estimates are paired with δ18O measurements of the same samples.

  5. Risk factors associated with neonatal deaths: a matched case-control study in Indonesia.

    Science.gov (United States)

    Abdullah, Asnawi; Hort, Krishna; Butu, Yuli; Simpson, Louise

    2016-01-01

    Similar to global trends, neonatal mortality has fallen only slightly in Indonesia over the period 1990-2010, with a high proportion of deaths in the first week of life. This study aimed to identify risk factors associated with neonatal deaths of low and normal birthweight infants that were amenable to health service intervention at a community level in a relatively poor province of Indonesia. A matched case-control study of neonatal deaths reported from selected community health centres (puskesmas) was conducted over 10 months in 2013. Cases were singleton births, born by vaginal delivery, at home or in a health facility, matched with two controls satisfying the same criteria. Potential variables related to maternal and neonatal risk factors were collected from puskesmas medical records and through home visit interviews. A conditional logistic regression was performed to calculate odds ratios using the clogit procedure in Stata 11. Combining all significant variables related to maternal, neonatal, and delivery factors into a single multivariate model, six factors were found to be significantly associated with a higher risk of neonatal death. The factors identified were as follows: neonatal complications during birth; mother noting a health problem during the first 28 days; maternal lack of knowledge of danger signs for neonates; low Apgar score; delivery at home; and history of complications during pregnancy. Three risk factors (neonatal complication at delivery; neonatal health problem noted by mother; and low Apgar score) were significantly associated with early neonatal death at age 0-7 days. For normal birthweight neonates, three factors (complications during delivery; lack of early initiation of breastfeeding; and lack of maternal knowledge of neonatal danger signs) were found to be associated with a higher risk of neonatal death. The study identified a number of factors amenable to health service intervention associated with neonatal deaths in normal and low

  6. Risk factors associated with neonatal deaths: a matched case–control study in Indonesia

    Directory of Open Access Journals (Sweden)

    Asnawi Abdullah

    2016-02-01

    Full Text Available Background: Similar to global trends, neonatal mortality has fallen only slightly in Indonesia over the period 1990–2010, with a high proportion of deaths in the first week of life. Objective: This study aimed to identify risk factors associated with neonatal deaths of low and normal birthweight infants that were amenable to health service intervention at a community level in a relatively poor province of Indonesia. Design: A matched case–control study of neonatal deaths reported from selected community health centres (puskesmas was conducted over 10 months in 2013. Cases were singleton births, born by vaginal delivery, at home or in a health facility, matched with two controls satisfying the same criteria. Potential variables related to maternal and neonatal risk factors were collected from puskesmas medical records and through home visit interviews. A conditional logistic regression was performed to calculate odds ratios using the clogit procedure in Stata 11. Results: Combining all significant variables related to maternal, neonatal, and delivery factors into a single multivariate model, six factors were found to be significantly associated with a higher risk of neonatal death. The factors identified were as follows: neonatal complications during birth; mother noting a health problem during the first 28 days; maternal lack of knowledge of danger signs for neonates; low Apgar score; delivery at home; and history of complications during pregnancy. Three risk factors (neonatal complication at delivery; neonatal health problem noted by mother; and low Apgar score were significantly associated with early neonatal death at age 0–7 days. For normal birthweight neonates, three factors (complications during delivery; lack of early initiation of breastfeeding; and lack of maternal knowledge of neonatal danger signs were found to be associated with a higher risk of neonatal death. Conclusion: The study identified a number of factors amenable to

  7. Neonatal intensive care in a Karen refugee camp: a 4 year descriptive study.

    Directory of Open Access Journals (Sweden)

    Claudia Turner

    Full Text Available A third of all deaths in children aged <5 years occur in the neonatal period. Neonatal intensive care is often considered too complex and expensive to be implemented in resource poor settings. Consequently the reductions that have been made in infant mortality in the poorest countries have not been made in the neonatal period. This manuscript describes the activities surrounding the introduction of special care baby unit (SCBU in a refugee setting and the resulting population impact.A SCBU was developed in Maela refugee camp on the Thailand-Myanmar border. This unit comprised of a dedicated area, basic equipment, drugs and staff training. Training was built around neonatal guidelines, comprising six clinical steps: recognition, resuscitation, examination, supportive medical care, specialised medical care, and counselling of parents with sick newborns.From January 2008 until December 2011, 952 infants were admitted to SCBU. The main admission diagnoses were early onset neonatal sepsis, jaundice and prematurity. Early prematurity (<34 weeks carried the highest risk of mortality (OR 9.5, 95% CI 5.4-16.5, p<0.001. There was a significant decrease in mortality from 19.3% (2008 to 4.8% (2011 among the infants admitted for prematurity (p=0.03. The neonatal mortality in Maela camp as a whole declined by 51% from 21.8 to 10.7 deaths per 1000 live births over the corresponding period (p=0.04. Staff expressed more confidence in their ability to take care of neonates and there was a more positive attitude towards premature infants.Neonatal mortality can be reduced in a resource poor setting by introduction of a simple low cost unit specialising in care of sick neonates and run by local health workers following adequate training. Training in recognition and provision of simple interventions at a high standard can increase staff confidence and reduce fatalistic attitudes towards premature neonates.

  8. Comparison of Early-period Results of Nasal Splint and Merocel Nasal Packs in Septoplasty

    Science.gov (United States)

    Bingöl, Fatih; Budak, Ali; Şimşek, Eda; Kılıç, Korhan; Bingöl, Buket Özel

    2017-01-01

    Objective Several types of nasal packs are used postoperatively in septoplasty. In this study, we compared two commonly used nasal packing materials, the intranasal septal splint with airway and Merocel tampon, in terms of pain, bleeding, nasal obstruction, eating difficulties, discomfort in sleep, and pain and bleeding during removal of packing in the early period. Methods The study group included 60 patients undergoing septoplasty. Patients were divided into two groups (n=30 in each group). An intranasal splint with airway was used for the patients in the first group after septoplasty, while Merocel nasal packing was used for the second group. Patients were investigated in terms of seven different factors - pain, bleeding while the tampon was in place, nasal obstruction, eating difficulties, night sleep, pain during removal of the nasal packing, and bleeding after removal of packing. Results There was no statistically significant difference between the groups in terms of pain 24 hours after operation (p=0.05), while visual analog scale (VAS) scores for nasal obstruction, night sleep, eating difficulties, and pain during packing removal were lower in the nasal splint group with a statistically significant difference (p<0.05). There was no statistically significant difference between the groups in terms of postoperative bleeding (p=0.23). Significantly less bleeding occurred during removal of the packing in the nasal splint group (p<0.05). Conclusion Our study indicates that the nasal splint was more comfortable and effective in terms of causing lesser bleeding and pain during removal of packing. PMID:29392071

  9. Impact of Complete Parenteral Nutrition on Metabolic Processes in Cancer Patients in the Early Postoperative Period

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    O. A. Obukhova

    2011-01-01

    Full Text Available Objective: to estimate blood glucose levels during complete parenteral nutrition (CPN, by using the three-in-one system with a high glucose level. Subjects and methods. Thirty adult patients without diabetes mellitus (including 18 men were examined. Twelve and 18 patients were operated on for colonic and gastric cancers, respectively. CPN (Oliclinomel No. 7 — 1000, 1500 ml; glucose, 240 g in 1500 ml, Baxter, Belgium was carried out at the Surgery Department in the early postoperative period (3-5 postoperative days with stable hemodynamics and no organ dysfunction (acute respiratory, renal, hepatic failure. The preparation was administered at a rate of about 83 ml/h over 18 hours. Insulin was not used. Serum glucose concentrations were measured before the study and then for 24 hours at an interval of 6 hours. Results. Glucose concentrations were not found to exceed the allowable values in the majority of patients during CPN at the given rate. In 5 (16.7% patients, short-term glucose increases up to 13.3 mmol/l were corrected, by decreasing the infusion rate. There was no hypoglycemia or other complications during CPN. Conclusion. Our findings suggest that three-in-one parenteral feeding is safe and causes no metabolic disturbances if simple principles are followed, the basic ones of which are to observe the intake of an adequate total dose and the rate of administration of nutrients. Key words: parenteral feeding, hyperglycemia, metabolic disturbances.

  10. Studies on radioimmunoassay diagnosis of cow pregnancy at an early period by milk sample communication

    International Nuclear Information System (INIS)

    Wu Meiwen

    1986-01-01

    Cow pregancy was diagnosed at an early period by milk sample communication and radioimmunoassay (RIA). Liquid milk samples were converted into solid forms on filter paper and mailed to the laboratory from appointed locations, and concentrations of progesterone in milk samples were then determined by RIA method. Milks were sampled 19 and 23 days after mating. Criterion used for the judgement of cow pregnancy was as follows: When the progesterone content in milk was 5 ng/ml or less, the cow was not pregnant; when progesterone content was between 5-11 ng/ml, it was doubtful; when progesterone content was 11 ng/ml or more, it was pregnant. According to this criterion, among 215 cows, 131 were pregnant, 73 were not pregnant, and 11 were doubtful. The results were further checked by palpation 3 months after inseminations. The unpregnancy and pregnancy accuracies were 97.6% and 89.2%, respectively. Forther milk samples were collected on 44 days for above cows that had been diagnosed on 19 and 23 days showing pregnancy to diagnose embryo forming. Among 91 cows, 74 had embryo. 7 had none, and the other 10 were doubtful. The embryo and unembryo accuracies were 94.6% and 100% respectively checking by palpation 3 months after inseminations

  11. Pronoia in the Military Organization of the Byzantine Empire at Early Palaeologian Period. Part 1

    Directory of Open Access Journals (Sweden)

    Vladimir Alekseevich Zolotovskiy

    2015-10-01

    Full Text Available In the present study the author disclosed the role of pronoia in the military organization of the Byzantine Empire at early Palaeologian period. The concrete cases of the award allow recognizing the proniarety as the Byzantine military institution dealing exclusively with the military leadership. The grant of pronoia was a replacement for traditional rewards of military commanders of noble birth. However, in some cases it was identified that compulsory military service was a function of power which was granted to the proniares in addition to the tax quota. Holders of pronoia were not only the Romans military commanders but also the mercenaries. Such awards could reduce the costs of imperial treasury for direct payments. In the case of proniares-Byzantines, depending on posotis, we can talk about the conferring upon pronoia the representatives of various levels of the military leadership. The pronoias granted as a reward or the compensation for losses incurred as a result of the performance of official engagements, could be transferred to the commanders of low levels which were recruited from among stratiotes (obviously, dekarhes.

  12. Heart rate variability biofeedback intervention for reduction of psychological stress during the early postpartum period.

    Science.gov (United States)

    Kudo, Naoko; Shinohara, Hitomi; Kodama, Hideya

    2014-12-01

    This study examined the effectiveness of heart rate variability (HRV) biofeedback intervention for reduction of psychological stress in women in the early postpartum period. On postpartum day 4, 55 healthy subjects received a brief explanation about HRV biofeedback using a portable device. Among them, 25 mothers who agreed to implement HRV biofeedback at home were grouped as the biofeedback group, and other 30 mothers were grouped as the control group. At 1 month postpartum, there was a significant decrease in total Edinburgh Postnatal Depression Scale score (P biofeedback group; this change was brought about mainly by decreases in items related to anxiety or difficulty sleeping. There was also a significant increase in standard deviation of the normal heartbeat interval (P biofeedback group after adjusting for potential covariates. In conclusion, postpartum women who implemented HRV biofeedback after delivery were relatively free from anxiety and complained less of difficulties sleeping at 1 month postpartum. Although the positive effects of HRV biofeedback may be partly attributable to intervention effects, due to its clinical outcome, HRV biofeedback appears to be recommendable for many postpartum women as a feasible health-promoting measure after childbirth.

  13. Lethal Progressive Thoracic Insufficiency in a Neonate Due to Jarcho Levin Syndrome

    Science.gov (United States)

    Bhutia, Euden; Maria, Arti; Verma, Arushi; Sethi, Sidharth Kumar

    2014-01-01

    A rare case of Jarcho Levin syndrome (JLS) presenting as a lethal progressive respiratory insufficiency in early neonatal period is reported. The neonate had classical features of this syndrome including vertebral segmentation defects, typical costo-vertebral fusion defects and scoliosis resulting in small thoracic volume and limited chest expansion; all consistent with a clinical diagnosis of JLS with thoracic insufficiency. In addition, our case had a rare association of dextrocardia and acyanotic congenital heart disease. PMID:24741543

  14. NEONATES (BIRTH – 1 MONTH)

    African Journals Online (AJOL)

    Chantel

    Major defects in neonatal skin have serious consequences for the health of the baby, but fortunately these are very rare. Early diagnosis of the genodermatoses can be life-saving. Birthmarks, also known as naevi, are usually first noted in neonates, and can be very alarming for parents. A variety of infections can.

  15. Right paratesticular abscess mimicking neonatal testicular torsion ...

    African Journals Online (AJOL)

    U.O. Ezomike

    Abstract. The clinical presentation of neonatal paratesticular abscess may closely resemble that of, neonatal testicular torsion and the use of scrotal ultrasonography to differentiate the two has low, sensitivity. We propose early operative treatment of suspected neonatal testicular torsion to salvage, the testicle in cases of ...

  16. Early neonatal loss of inhibitory synaptic input to the spinal motor neurons confers spina bifida-like leg dysfunction in a chicken model

    Directory of Open Access Journals (Sweden)

    Md. Sakirul Islam Khan

    2017-12-01

    Full Text Available Spina bifida aperta (SBA, one of the most common congenital malformations, causes lifelong neurological complications, particularly in terms of motor dysfunction. Fetuses with SBA exhibit voluntary leg movements in utero and during early neonatal life, but these disappear within the first few weeks after birth. However, the pathophysiological sequence underlying such motor dysfunction remains unclear. Additionally, because important insights have yet to be obtained from human cases, an appropriate animal model is essential. Here, we investigated the neuropathological mechanisms of progression of SBA-like motor dysfunctions in a neural tube surgery-induced chicken model of SBA at different pathogenesis points ranging from embryonic to posthatch ages. We found that chicks with SBA-like features lose voluntary leg movements and subsequently exhibit lower-limb paralysis within the first 2 weeks after hatching, coinciding with the synaptic change-induced disruption of spinal motor networks at the site of the SBA lesion in the lumbosacral region. Such synaptic changes reduced the ratio of inhibitory-to-excitatory inputs to motor neurons and were associated with a drastic loss of γ-aminobutyric acid (GABAergic inputs and upregulation of the cholinergic activities of motor neurons. Furthermore, most of the neurons in ventral horns, which appeared to be suffering from excitotoxicity during the early postnatal days, underwent apoptosis. However, the triggers of cellular abnormalization and neurodegenerative signaling were evident in the middle- to late-gestational stages, probably attributable to the amniotic fluid-induced in ovo milieu. In conclusion, we found that early neonatal loss of neurons in the ventral horn of exposed spinal cord affords novel insights into the pathophysiology of SBA-like leg dysfunction.

  17. The effect of thyroxine treatment started in the neonatal period on development and growth of two-year-old Down syndrome children: A randomized clinical trial

    NARCIS (Netherlands)

    van Trotsenburg, A. S. Paul; Vulsma, Thomas; van Rozenburg-Marres, Susanne L. Rutgers; van Baar, Anneloes L.; Ridder, Jeannette C. D.; Heymans, Hugo S. A.; Tijssen, Jan G. P.; de Vijlder, Jan J. M.

    2005-01-01

    Context: Young Down syndrome children appear to have a mild form of congenital hypothyroidism that is rarely detected by neonatal screening and usually left untreated. Objective: To investigate the effects of thyroxine treatment on development and growth of young Down syndrome children. Design,

  18. Increased expression of alpha- and beta-globin mRNAs at the pituitary following exposure to estrogen during the critical period of neonatal sex differentiation in the rat

    DEFF Research Database (Denmark)

    Leffers, H; Navarro, V M; Nielsen, John E

    2006-01-01

    Deterioration of reproductive health in human and wildlife species during the past decades has drawn considerable attention to the potential adverse effects of exposure to xenosteroids during sensitive periods of sex development. The hypothalamic-pituitary (HP) unit is a key element in the neuroe......Deterioration of reproductive health in human and wildlife species during the past decades has drawn considerable attention to the potential adverse effects of exposure to xenosteroids during sensitive periods of sex development. The hypothalamic-pituitary (HP) unit is a key element......, we screened for differentially expressed genes at the pituitary and hypothalamus of rats after neonatal exposure to estradiol benzoate. Our analyses identified persistent up-regulation of alpha- and beta-globin mRNAs at the pituitary following neonatal estrogenization. This finding was confirmed...... by combination of RT-PCR analyses and in situ hybridization. Induction of alpha- and beta-globin mRNA expression at the pituitary by neonatal exposure to estrogen was demonstrated as dose-dependent and it was persistently detected up to puberty. In contrast, durable up-regulation of alpha- and beta-globin genes...

  19. [Successful continuous renal replacement therapy in a neonate with early-onset group B streptococcal sepsis and multi-organ dysfunction syndrome].

    Science.gov (United States)

    von Schnakenburg, C; Hufnagel, M; Superti-Furga, A; Rieger-Fackeldey, E; Berner, R

    2009-01-01

    Group B streptococcal early-onset sepsis (GBS EOS) in neonates has a mortality rate of approximately 5%, particularly in the presence of multi-organ dysfunction. Fluid management is crucial in these patients, and continuous venovenous haemofiltration (CVVH) should be considered a therapeutic option even in newborn babies. After an uneventful pregnancy within hours after birth, a female term infant presented with dyspnoea, irritability and cyanosis. The systemic inflammatory response syndrome (SIRS) progressed to multi-organ dysfunction with acute respiratory distress syndrome (ARDS), impaired myocardial contractility, pulmonary hypertension and fluid overload. The maximum PRISM score was 51. The child required maximal respiratory and inotropic support with high volume intravenous fluid administration. However, only by using of CVVH from day 5 to 14, we successfully resolved progressive pulmonary and cardiovascular dysfunction. The child improved directly after initiation of fluid removal, was extubated on day 17 and discharged without obvious sequelae on day 57. All microbiology studies revealed GBS. Perinatal GBS-infections remain a major life-threatening event for newborn babies. CVVH should be considered an option for reversing fluid overload even in neonates with overwhelming SIRS. Alternatively, extracorporeal membrane oxygenation (ECMO) is discussed.

  20. Central-peripheral temperature gradient: an early diagnostic sign of late-onset neonatal sepsis in very low birth weight infants.

    Science.gov (United States)

    Leante-Castellanos, José Luis; Lloreda-García, José M; García-González, Ana; Llopis-Baño, Caridad; Fuentes-Gutiérrez, Carmen; Alonso-Gallego, José Ángel; Martínez-Gimeno, Antonio

    2012-04-22

    We assessed central-peripheral temperature gradient alteration for the diagnosis of late-onset neonatal sepsis and compared earliness detection of this sign with altered blood cell count and C-reactive protein. Thirty-one preterm babies (peripheral) temperatures were continuously monitored with a thermal probe (ThermoTracer; Dräger Medical AGF & Co. KgaA, Lübeck, Germany) adjusting incubator air temperature for a thermal gradient peripheral temperature alteration was defined as a thermal gradient >2°C that could not be corrected with protocolized air temperature modifications. Proven (positive blood culture) sepsis and probable late-onset sepsis were recorded. Late-onset sepsis was diagnosed in 11 neonates (proven, 9; probable, 2). Thermal gradient alteration was present in 12 cases, in association with the onset of sepsis in 10 and concomitantly with a ductus arteriosus and stage 1 necrotizing enterocolitis in 2. Thermal gradient alteration had a sensitivity of 90.9% [95% confidence interval (CI), 62.3-98.4] and specificity of 90% (95% CI, 69.9-97.2%), and in 80% of cases, it occurred before abnormal laboratory findings. Central-peripheral temperature gradient monitoring is a feasible, non-invasive, and simple tool easily applicable in daily practice. An increase of >2°C showed a high-sensitivity and specificity for the diagnosis of late-onset sepsis.

  1. Causes of Acute Intranatal and Postnatal Hypoxia in Neonatal Infants

    Directory of Open Access Journals (Sweden)

    S. A. Perepelitsa

    2012-01-01

    Full Text Available Objective: to study the causes of acute intranatal hypoxia and reveal a relationship of placental changes to respiratory failure (RF in newborn infants. Subjects and methods. The investigation included 252 neonates with the complicated course of an early neonatal period. Their gestational age was 26 weeks to 40 weeks, birth weight varied from 850 g to 4100 g. 95.3% of the newborn infants were born with a low Apgar score and RF, which required mechanical ventilation immediately after birth. The neonatal status was clinically evaluated; the values of blood gas composition and acid-base balance were recorded; the pathogen was discharged from the tracheobronchial tree; chest X-ray survey and placental morphological examination were performed. Results. The main cause of neonatal respiratory failure is chronic intrauterine hypoxia caused by placental inflammatory changes and fetal-placental blood circulatory disorders, which gives rise to preterm delivery, cerebral hemodynamic disorders, and neonatal amniotic fluid aspiration. Bacteriological examination of tracheobronchial aspirations showed that no microflora growth occured in the majority of the newborns acute intranatal hypoxia. Enterococcus faecalis and Staphylococcus epidermidis were isolated in 12.3% and 8.7%, respectively. Growth of в-hemolytic streptococcus was observed in 2.8% of cases. The rate of microbial association specific only for rate premature infants with neonatal respiratory distress syndrome (NRDS was 4.8%. Conclusion. Placental changes causing fetal-placental circulatory disorders were ascertained to be responsible for acute intranatal and postnatal neonatal hypoxia. Placental inflammatory changes occurred in the majority of cases, as confirmed by bacteriological examinations of neonatal infants. Isolation of the varying microbial flora in infants with RF to a greater extent is, indicative of the infectious process occurring in the maternal body. Key words: acute intranatal

  2. NEWBORNS OF HIGH RISK GROUPS AND ELECTROPHYSIOLOGICAL CARDIAC ACTIVITY DURING THE PERIOD OF EARLY ADAPTATION

    Directory of Open Access Journals (Sweden)

    T. S. Tumaeva

    2014-01-01

    Full Text Available Aim: to study characteristics of electrophysiological cardiac activity in children of risk groups and to assess possibilities of Holter-electrocardiography (H-ECG in revealing of cardiac dysfunction during the period of early adaptation. Patients and methods: 250 newborns were examined. The main group consisted of 200 children with cerebral ischemia (CI. This group was divided into 2 subgroups: 100 full-term and 100 premature (at various gestation age infants. Control group contained 50 children born at 38–40th weeks of gestation with physiological course of pregnancy and delivery, APGAR score of 8–9 points. Complex examination included H-ECG according the standard technic with evaluation of the hearth rate (HR during sleep and wakefulness; HRmin, HRmax; arrhythmias, conductivity disorders, duration of the intervals; rhythm variability. Results: according to the ECG children with CI, especially premature ones, and children delivered via Cesarean section more often had ST-T disturbances, arrhythmias (sinus tachycardia, less often — sinus bradycardia and conductivity disorders, Q-Tc prolongation. H-EGC revealed decrease of sleep HR, HRmin and HRmax in children with CI especially in delivered via Cesarean section. The most common arrhythmia was supraventricular extrasystole.  Pauses in rhythms and variability were the highest in premature children delivered via Cesarean section. Conclusions: hypoxia/ischemia is a trigger for development of cardiovascular dysfuncion in newborns. Premature and children delivered via Cesarean section form a group of high risk. H-ECG widens possibilities of revealing of symptoms of cardiac dysfunction (disturbances at the basal level of functioning, of adaptation resources of the sinus node, electric instability of the myocardium and heart rate variability in children of risk group for development of cardiovascular disorders. 

  3. Prediction of acute renal allograft rejection in early post-transplantation period by soluble CD30.

    Science.gov (United States)

    Dong, Wang; Shunliang, Yang; Weizhen, Wu; Qinghua, Wang; Zhangxin, Zeng; Jianming, Tan; He, Wang

    2006-06-01

    To evaluate the feasibility of serum sCD30 for prediction of acute graft rejection, we analyzed clinical data of 231 patients, whose serum levels of sCD30 were detected by ELISA before and after transplantation. They were divided into three groups: acute rejection group (AR, n = 49), uncomplicated course group (UC, n = 171) and delayed graft function group (DGF, n = 11). Preoperative sCD30 levels of three groups were 183 +/- 74, 177 +/- 82 and 168 +/- 53 U/ml, respectively (P = 0.82). Significant decrease of sCD30 was detected in three groups on day 5 and 10 post-transplantation respectively (52 +/- 30 and 9 +/- 5 U/ml respectively, P sCD30 values on day 5 post-transplantation (92 +/- 27 U/ml vs. 41 +/- 20 U/ml and 48 +/- 18 U/ml, P sCD30 levels on day 10 post-transplantation were virtually similar in patients of three groups (P = 0.43). Receiver operating characteristic (ROC) curve demonstrated that sCD30 level on day 5 post-transplantation could differentiate patients who subsequently suffered acute allograft rejection from others (area under ROC curve 0.95). According to ROC curve, 65 U/ml may be the optimal operational cut-off level to predict impending graft rejection (specificity 91.8%, sensitivity 87.1%). Measurement of soluble CD30 on day 5 post-transplantation might offer a noninvasive means to recognize patients at risk of impending acute graft rejection during early post-transplantation period.

  4. Energy metabolism of thoracic surgical patients in the early postoperative period. Effect of posture.

    Science.gov (United States)

    Brandi, L S; Bertolini, R; Janni, A; Gioia, A; Angeletti, C A

    1996-03-01

    To determine the effect of elective thoracic surgery on energy metabolism and gas exchange and to evaluate whether the 30-degree sitting position would affect these variables. Prospective, unblinded, controlled study. Surgical ICU in a university hospital. Twenty-two adult patients undergoing elective pulmonary resection. Posture change from supine to 30-degree sitting position. Oxygen consumption (VO2), carbon dioxide production (VCO2), respiratory quotient (RQ), and energy expenditure (EE) were measured by means of computerized indirect calorimetry before and after surgery. Heart rate and respiratory frequency were measured continuously during gas exchange measurement. Blood gases were analyzed with an automated blood gas analyzer. Preoperatively, altering position did not affect energy metabolism, gas exchange, and cardiopulmonary variables. Postoperatively, the measured EE was 116% of the expected value. Mean EE and VO2 values for each position were higher than the preoperative values for the corresponding postures (pMean percent increases in EE, VO2, and VCO2 were significantly lower in the 30-degree sitting position than in the supine position (EE: 7.9+/-2.7% vs 14.4+/-2.3%; pexchange for each position were worse than the preoperative values for the corresponding postures (pMean arterial pressure, heart rate, and respiratory frequency for each position were higher than the preoperative values for the corresponding postures (pmean values of these variables occurred between the two positions postoperatively. The early postoperative period of patients undergoing elective thoracic surgery is characterized by a condition of impaired gas exchange and by a hypermetabolic state. Hypermetabolism can be partly mitigated by assuming the 30-degree sitting position.

  5. Bone metabolism dynamics in the early post-transplant period following kidney and liver transplantation.

    Science.gov (United States)

    Schreiber, Peter W; Bischoff-Ferrari, Heike A; Boggian, Katia; Bonani, Marco; van Delden, Christian; Enriquez, Natalia; Fehr, Thomas; Garzoni, Christian; Hirsch, Hans H; Hirzel, Cédric; Manuel, Oriol; Meylan, Pascal; Saleh, Lanja; Weisser, Maja; Mueller, Nicolas J

    2018-01-01

    Bone disease contributes to relevant morbidity after solid organ transplantation. Vitamin D has a crucial role for bone metabolism. Activation of vitamin D depends on the endocrine function of both, liver and kidney. Our study assessed key markers of bone metabolism at time of transplantation and 6 months after transplantation among 70 kidney and 70 liver recipients. In 70 kidney recipients 25-OH vitamin D levels did not differ significantly between peri-transplant (median 32.5nmol/l) and 6 months post-transplant (median 41.9nmol/l; P = 0.272). Six months post-transplant median 1, 25-(OH)2 vitamin D levels increased by >300% (from 9.1 to 36.5ng/l; Ptransplantation and of intact parathyroid hormone 6 months post-transplant. Among 70 liver recipients, 25-OH vitamin D, 1, 25-(OH)2 vitamin D and intact parathyroid hormone levels were not significantly altered between peri-transplant and 6 months post-transplant. Contrary to kidney recipients, median CTx increased by 60.0% (from 0.45 to 0.72 ng/ml; P = 0.002) and P1NP by 49.3% (from 84.0 to 125.4ng/ml; P = 0.001) in the longitudinal course. Assessed biomarkers didn't differ between liver recipients with and without fractures. To conclude, the assessed panel of biomarkers proved highly dynamic after liver as well as kidney transplantation in the early post-transplant period. After kidney transplantation a significant gain in 1, 25-(OH)2 vitamin D combined with a decline in iPTH, CTx and P1NP, whereas after liver transplantation an increase in CTx and P1NP were characteristic.

  6. Classifier models and architectures for EEG-based neonatal seizure detection

    International Nuclear Information System (INIS)

    Greene, B R; Marnane, W P; Lightbody, G; Reilly, R B; Boylan, G B

    2008-01-01

    Neonatal seizures are the most common neurological emergency in the neonatal period and are associated with a poor long-term outcome. Early detection and treatment may improve prognosis. This paper aims to develop an optimal set of parameters and a comprehensive scheme for patient-independent multi-channel EEG-based neonatal seizure detection. We employed a dataset containing 411 neonatal seizures. The dataset consists of multi-channel EEG recordings with a mean duration of 14.8 h from 17 neonatal patients. Early-integration and late-integration classifier architectures were considered for the combination of information across EEG channels. Three classifier models based on linear discriminants, quadratic discriminants and regularized discriminants were employed. Furthermore, the effect of electrode montage was considered. The best performing seizure detection system was found to be an early integration configuration employing a regularized discriminant classifier model. A referential EEG montage was found to outperform the more standard bipolar electrode montage for automated neonatal seizure detection. A cross-fold validation estimate of the classifier performance for the best performing system yielded 81.03% of seizures correctly detected with a false detection rate of 3.82%. With post-processing, the false detection rate was reduced to 1.30% with 59.49% of seizures correctly detected. These results represent a comprehensive illustration that robust reliable patient-independent neonatal seizure detection is possible using multi-channel EEG

  7. Survival predictors of preterm neonates: Hospital based study in Iran (2010-2011).

    Science.gov (United States)

    Haghighi, Ladan; Nojomi, Marzieh; Mohabbatian, Behnaz; Najmi, Zahra

    2013-12-01

    Preterm birth (PTB) is responsible for 70% of neonatal mortalities. Various factors influence the risk of neonatal mortality in different populations. Our objective was to evaluate neonatal survival rate of preterm infants, and to define its predictors in Iranian population. This retrospective cohort study included all preterm (26-37 weeks) infants (n=1612) born alive in Shahid Akbar-abadi university hospital, during one year period (April 2010-2011). These infants were evaluated for fetal-neonatal, maternal, and pregnancy data. Survival analysis was performed and viability threshold and risk factors of neonatal mortality were evaluated. Total overall mortality rate was 9.1%. Survival rate were 11.11% for extremely low birth weights (LBW) and 45.12% for very early PTBs. The smallest surviving infant was a 750 gr female with gestational age (GA) of 30 weeks and the youngest infants was a 970 gram female with GA of 25weeks plus 2 days. History of previous dead neonate, need to cardio-pulmonary resuscitation (CPR), need to neonatal intensive care unit (NICU) admission, postnatal administration of surfactant, presence of anomalies, Apgar score <7, multiple pregnancy, non-cephalic presentation, early PTB, very early PTB, LBW, very low birth weight (VLBW) and extremely low birth weight (ELBW), were risk factors for mortality in preterm neonates. Our study revealed that neonatal survival rate is dramatically influenced by birth weight especially under 1000grams, GA especially below 30 weeks, neonatal anomalies, history of previous dead fetus, multiple pregnancy, non- cephalic presentation, and need for NICU admission, resuscitation and respiratory support with surfactant.

  8. Neonatal Sepsis: past, present and future; a review article | Tripathi ...

    African Journals Online (AJOL)

    Sepsis is the most common cause of neonatal mortality. As per National Neonatal Perinatal Database (NNPD) 2002-2003, the incidence of neonatal sepsis in India was 30 per 1000 live birth. It is 3% among intramural babies and 39.7% among extramural admissions. The early manifestations of neonatal sepsis are vague ...

  9. Managing Neonatal and Early Childhood Syndromic Sepsis in Sub-District Hospitals in Resource Poor Settings: Improvement in Quality of Care through Introduction of a Package of Interventions in Rural Bangladesh

    Science.gov (United States)

    Iqbal, Afrin; Hoque, D. M. Emdadul; Moinuddin, Md.; Zaman, Sojib Bin; Rahman, Qazi Sadeq-ur; Begum, Tahmina; Chowdhury, Atique Iqbal; Haider, Rafiqul; Arifeen, Shams El; Kissoon, Niranjan; Larson, Charles P.

    2017-01-01

    Introduction Sepsis is dysregulated systemic inflammatory response which can lead to tissue damage, organ failure, and death. With an estimated 30 million cases per year, it is a global public health concern. Severe infections leading to sepsis account for more than half of all under five deaths and around one quarter of all neonatal deaths annually. Most of these deaths occur in low and middle income countries and could be averted by rapid assessment and appropriate treatment. Evidence suggests that service provision and quality of care pertaining to sepsis management in resource poor settings can be improved significantly with minimum resource allocation and investments. Cognizant of the stark realities, a project titled ‘Interrupting Pathways to Sepsis Initiative’ (IPSI) introduced a package of interventions for improving quality of care pertaining to sepsis management at 2 sub-district level public hospitals in rural Bangladesh. We present here the quality improvement process and achievements regarding some fundamental steps of sepsis management which include rapid identification and admission, followed by assessment for hypoxemia, hypoglycaemia and hypothermia, immediate resuscitation when required and early administration of parenteral broad spectrum antibiotics. Materials and Method Key components of the intervention package include identification of structural and functional gaps through a baseline environmental scan, capacity development on protocolized management through training and supportive supervision by onsite ‘Program Coaches’, facilitating triage and rapid transfer of patients through ‘Welcoming Persons’ and enabling rapid treatment through ‘Task Shifting’ from on-call physicians to on-duty paramedics in the emergency department and on-call physicians to on-duty nurses in the inpatient department. Results From August, 2013 to March, 2015, 1,262 under-5 children were identified as syndromic sepsis in the emergency departments; of

  10. Managing Neonatal and Early Childhood Syndromic Sepsis in Sub-District Hospitals in Resource Poor Settings: Improvement in Quality of Care through Introduction of a Package of Interventions in Rural Bangladesh.

    Directory of Open Access Journals (Sweden)

    Ahmed Ehsanur Rahman

    Full Text Available Sepsis is dysregulated systemic inflammatory response which can lead to tissue damage, organ failure, and death. With an estimated 30 million cases per year, it is a global public health concern. Severe infections leading to sepsis account for more than half of all under five deaths and around one quarter of all neonatal deaths annually. Most of these deaths occur in low and middle income countries and could be averted by rapid assessment and appropriate treatment. Evidence suggests that service provision and quality of care pertaining to sepsis management in resource poor settings can be improved significantly with minimum resource allocation and investments. Cognizant of the stark realities, a project titled 'Interrupting Pathways to Sepsis Initiative' (IPSI introduced a package of interventions for improving quality of care pertaining to sepsis management at 2 sub-district level public hospitals in rural Bangladesh. We present here the quality improvement process and achievements regarding some fundamental steps of sepsis management which include rapid identification and admission, followed by assessment for hypoxemia, hypoglycaemia and hypothermia, immediate resuscitation when required and early administration of parenteral broad spectrum antibiotics.Key components of the intervention package include identification of structural and functional gaps through a baseline environmental scan, capacity development on protocolized management through training and supportive supervision by onsite 'Program Coaches', facilitating triage and rapid transfer of patients through 'Welcoming Persons' and enabling rapid treatment through 'Task Shifting' from on-call physicians to on-duty paramedics in the emergency department and on-call physicians to on-duty nurses in the inpatient department.From August, 2013 to March, 2015, 1,262 under-5 children were identified as syndromic sepsis in the emergency departments; of which 82% were admitted. More neonates (30

  11. [The effect of breast massage at different time in the early period after cesarean section].

    Science.gov (United States)

    Chu, J Y; Zhang, L; Zhang, Y J; Yang, M J; Li, X W; Sun, L L

    2017-11-06

    Objective: To evaluate the effect of breast massage at different time in the early period on maternal lactation after cesarean section. Methods: 80 women delivered by cesarean section were randomly selected from maternity ward of a hospital in Shandong province during Jan. 2013 to Jan. 2015; which were divided into four groups, with 20 patients in each. Three groups received 3 times of breast massage every 24 hoursbeginning from 2, 12 and 24 h after cesarean section, respectively. The control group didn't receive any breast massage. The starting time and status of lactation were observed and recorded after cesarean section. 5 ml venous blood sample was drawn from each patient respectively at 2 h before cesarean, 6, 12, 24, 48 and 72 h after cesarean to test the level of serum prolactin. The lactation status of each group was compared. Results: The P (50) ( P (25)- P (75)) of starting time of lactation of the three massage groups and control group were 3 (2-6) h, 4 (2-8) h, 4 (3-12) h and 4 (2-12) h, respectively, whose differences showed no statistical significance ( H =3.32, P= 0.345).The number of delivered women with adequate lactation 24 hours after cesarean was 10 in the group who received massage beginning from 2 h after cesarean; while the number was only 2 in the control group. The number of delivered women with adequate lactation 48 hours after cesarean was 18 in the group who received massage beginning from 2 h after cesarean; while the number was 8 in the control group. The differences showed statistical significances ( P values were 0.021 and 0.008, respectively). The serum prolactin level in the group of delivered women who received massage from 2 h after cesarean was separately (195.9±78.5), (176.0±96.5), (216.4±110.0), (190.0±56.8) and (184.8±69.6) μg/L at 2, 12, 24, 48 and 72 h after cesarean, which were significantly higher than those in the control group (which were (128.8±40.6), (127.3±66.8), (162.2±58.8), (145.1±64.7) and (141.7±49

  12. Abdominal surgery in neonatal foals.

    Science.gov (United States)

    Bryant, James E; Gaughan, Earl M

    2005-08-01

    Abdominal surgery in foals under 30 days old has become more common with improved neonatal care. Early recognition of a foal at risk and better nursing care have increased the survival rates of foals that require neonatal care. The success of improved neonatal care also has increased the need for accurate diagnosis and treatment of gastrointestinal, umbilical, and bladder disorders in these foals. This chapter focuses on the early and accurate diagnosis of specific disorders that require abdominal exploratory surgery and the specific treatment considerations and prognosis for these disorders.

  13. Contrast-Enhanced Ultrasound and Near-Infrared Spectroscopy of the Neonatal Bowel: Novel, Bedside, Noninvasive, and Radiation-Free Imaging for Early Detection of Necrotizing Enterocolitis.

    Science.gov (United States)

    Al-Hamad, Suzanne; Hackam, David J; Goldstein, Seth D; Huisman, Thierry A G M; Darge, Kassa; Hwang, Misun

    2018-05-31

    Despite extensive research and improvements in the field of neonatal care, the morbidity and mortality associated with necrotizing enterocolitis (NEC) have remained unchanged over the past three decades. Early detection of ischemia and necrotic bowel is vital in improving morbidity and mortality associated with NEC; however, strategies for predicting and preventing NEC are lacking. Contrast-enhanced ultrasound (CEUS) and near-infrared spectroscopy (NIRS) are novel techniques in pediatrics that have been proven as safe modalities. CEUS has benefits over conventional ultrasound (US) by its improved real-time evaluation of the micro- and macrovascularities of normally and abnormally perfused tissue. US has been implemented as a useful adjunct to X-ray for earlier evaluation of NEC. NIRS is another noninvasive technique that has shown promise in improving early detection of NEC. The purpose of this article is to review the current understanding of changes in bowel perfusion in NEC, discuss the accuracy of abdominal US in detecting NEC, and explain how the use of CEUS and NIRS will enhance the precise and early detection of altered/pathological bowel wall perfusion in the initial development and course of NEC. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  14. New Plants at Prague Castle and Hradčany in the Early Modern Period. A History of Selected Species

    Czech Academy of Sciences Publication Activity Database

    Beneš, J.; Čulíková, Věra; Kosňovská, J.; Frolík, Jan; Matiášek, Josef

    2012-01-01

    Roč. 3, č. 1 (2012), s. 103-114 ISSN 1804-848X Institutional research plan: CEZ:AV0Z80020508 Keywords : Prague Castle * Early Modern Period * archaeobotany Subject RIV: AC - Archeology, Anthropology, Ethnology http://www.iansa.eu/papers/IANSA-2012-01-benes.pdf

  15. The rise of the managerial state in Indonesia : institutional transition during the early independence period. 1950-1965

    NARCIS (Netherlands)

    Fakih, Farabi

    2014-01-01

    The dissertation analyzes the production of a new elite group in Indonesia, the managers, during the early independence period. Indonesia faced lack of expertise and a government incapable of managing a national plan. The expansion of the managerial class was the result of the lack of leadership of

  16. Tuberculosis neonatal

    OpenAIRE

    Pastor Durán, Xavier

    1986-01-01

    PROTOCOLOS TERAPEUTICOS. TUBERCULOSIS NEONATAL 1. CONCEPTO La tuberculosis neonatal es la infección del recién nacido producida por el bacilo de Koch. Es una situación rara pero grave que requiere un diagnóstico precoz y un tratamiento enérgico..

  17. Stress levels and depressive symptoms in NICU mothers in the early postpartum period.

    Science.gov (United States)

    Alkozei, Anna; McMahon, Erin; Lahav, Amir

    2014-11-01

    This study examined whether particular maternal and infant factors can identify mothers at risk for increased stress upon admission to the neonatal intensive care unit (NICU). Eighty-five mothers of preterm infants (25-34 weeks gestation) were assessed using the Parental Stressor Scale (PSS:NICU) and the Edinburgh Postnatal Depression Scale (EPDS) within 3.24 ± 1.58 d postpartum. Hierarchical linear regression models were used to determine the extent to which maternal stress is influenced by individual factors. Fifty-two percent of mothers experienced increased stress (PSS:NICU score ≥3) and 38% had significant depressive symptoms (EPDS score ≥10). Stress related to alterations in parental role was the most significant source of stress among NICU mothers. Distance from the hospital and married marital status were significant predictors for stress related to alterations in parental role (p = 0.003) and NICU sights and sounds (p = 0.01), respectively. Higher stress levels were associated with higher depressive scores (p = 0.001). Maternal mental health factors, demographic factors, pregnancy factors and infant characteristics were not associated with increased stress. Elevated stress levels and depressive symptoms are already present in mothers of preterm infants upon NICU admission. Being married or living long distance from the hospital is associated with higher stress. Future work is needed to develop effective interventions for alleviating stress in NICU mothers and preventing its potential development into postnatal depression.

  18. Ultrasonography of Neonatal Cholestasis

    Energy Technology Data Exchange (ETDEWEB)

    Cheon, Jung Eun [Seoul National University Hospital, Seoul (Korea, Republic of)

    2012-06-15

    Ultrasonography (US) is as an important tool for differentiation of obstructive and non-obstructive causes of jaundice in infants and children. Beyond two weeks of age, extrahepatic biliary atresia and neonatal hepatitis are the two most common causes of persistent neonatal jaundice: differentiation of extrahepatic biliary atresia, which requires early surgical intervention, is very important. Meticulous analysis should focus on size and configuration of the gallbladder and anatomical changes of the portahepatis. In order to narrow the differential diagnosis, combined approaches using hepatic scintigraphy, MR cholangiography, and, at times, percutaneous liver biopsy are necessary. US is useful for demonstrating choledochal cyst, bile plug syndrome, and spontaneous perforation of the extrahepatic bile duct

  19. Early efforts in modeling the incubation period of infectious diseases with an acute course of illness

    Directory of Open Access Journals (Sweden)

    Nishiura Hiroshi

    2007-05-01

    Full Text Available Abstract The incubation period of infectious diseases, the time from infection with a microorganism to onset of disease, is directly relevant to prevention and control. Since explicit models of the incubation period enhance our understanding of the spread of disease, previous classic studies were revisited, focusing on the modeling methods employed and paying particular attention to relatively unknown historical efforts. The earliest study on the incubation period of pandemic influenza was published in 1919, providing estimates of the incubation period of Spanish flu using the daily incidence on ships departing from several ports in Australia. Although the study explicitly dealt with an unknown time of exposure, the assumed periods of exposure, which had an equal probability of infection, were too long, and thus, likely resulted in slight underestimates of the incubation period. After the suggestion that the incubation period follows lognormal distribution, Japanese epidemiologists extended this assumption to estimates of the time of exposure during a point source outbreak. Although the reason why the incubation period of acute infectious diseases tends to reveal a right-skewed distribution has been explored several times, the validity of the lognormal assumption is yet to be fully clarified. At present, various different distributions are assumed, and the lack of validity in assuming lognormal distribution is particularly apparent in the case of slowly progressing diseases. The present paper indicates that (1 analysis using well-defined short periods of exposure with appropriate statistical methods is critical when the exact time of exposure is unknown, and (2 when assuming a specific distribution for the incubation period, comparisons using different distributions are needed in addition to estimations using different datasets, analyses of the determinants of incubation period, and an understanding of the underlying disease mechanisms.

  20. Early efforts in modeling the incubation period of infectious diseases with an acute course of illness.

    Science.gov (United States)

    Nishiura, Hiroshi

    2007-05-11

    The incubation period of infectious diseases, the time from infection with a microorganism to onset of disease, is directly relevant to prevention and control. Since explicit models of the incubation period enhance our understanding of the spread of disease, previous classic studies were revisited, focusing on the modeling methods employed and paying particular attention to relatively unknown historical efforts. The earliest study on the incubation period of pandemic influenza was published in 1919, providing estimates of the incubation period of Spanish flu using the daily incidence on ships departing from several ports in Australia. Although the study explicitly dealt with an unknown time of exposure, the assumed periods of exposure, which had an equal probability of infection, were too long, and thus, likely resulted in slight underestimates of the incubation period. After the suggestion that the incubation period follows lognormal distribution, Japanese epidemiologists extended this assumption to estimates of the time of exposure during a point source outbreak. Although the reason why the incubation period of acute infectious diseases tends to reveal a right-skewed distribution has been explored several times, the validity of the lognormal assumption is yet to be fully clarified. At present, various different distributions are assumed, and the lack of validity in assuming lognormal distribution is particularly apparent in the case of slowly progressing diseases. The present paper indicates that (1) analysis using well-defined short periods of exposure with appropriate statistical methods is critical when the exact time of exposure is unknown, and (2) when assuming a specific distribution for the incubation period, comparisons using different distributions are needed in addition to estimations using different datasets, analyses of the determinants of incubation period, and an understanding of the underlying disease mechanisms.

  1. Neonates with Bartter syndrome have enormous fluid and sodium requirements.

    Science.gov (United States)

    Azzi, Antonio; Chehade, Hassib; Deschênes, Georges

    2015-07-01

    Managing neonatal Bartter syndrome by achieving adequate weight gain is challenging. We assessed the correlation between weight gain in neonatal Bartter syndrome and the introduction of fluid and sodium supplementations and indomethacin during the first 4 weeks of life. Daily fluid and electrolytes requirements were analysed using linear regression and Spearman correlation coefficients. The weight gain coefficient was calculated as daily weight gain after physiological neonatal weight loss. We studied seven infants. The highest weight gain coefficients occurred between weeks two and four in the five neonates who either received prompt amounts of fluid (maximum 810 mL/kg/day) and sodium (maximum 70 mmol/kg/day) or were treated with indomethacin. For the two patients with the highest weight gain coefficient, water and sodium supplementations were decreased in weeks two to four leading to a significant negative Spearman correlation between weight gain and fluid supplements (r = -0.55 and -0.68) and weight gain and sodium supplementations (r = -0.96 and -0.72). The two patients with the lowest weight gain coefficient had positive Spearman correlation coefficients between weight gain and fluid and sodium supplementations. Infants with neonatal Bartter syndrome required rapid and enormous fluid and sodium supplementations or the early introduction of indomethacin treatment to achieve adequate weight gain during the early postnatal period. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  2. Effect of radiation on the early period of gametogenesis in Tilapia mossambika Peters

    International Nuclear Information System (INIS)

    Chmilevskij, D.A.; Ivojlov, A.A.

    1978-01-01

    Tilapia mossambica Peters larvae 10 days after hatching were X-irradiated at 350 R, and the number of germinative cells at different stages of development was followed. In the control, 10-day larvae possessed primordial germ cells and gonia; 15-day larvae had mostly gonia; in 20-day larvae some gonia were entering early prophase of meiosis; 25-day larvae possessed gonia and early meiotic prophase oocytes; and 30-day larvae had oogonia, oocytes at early prophase and at the previtellogenesis stage. After the irradiation, 13- and 14-day larvae showed some mitotic disturbances; however the mass death of germ cells was observed after their entering the pachytene stage in fishes 25 days old

  3. Clinical study of electrophysiological changes of optic nerves in early period of type 1 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Quan-Liang Zhao

    2016-07-01

    Full Text Available AIM:To investigate the value of pattern visual evoked potential(PVEPand flash electroretinogram(FERGin early diagnosis and prevention of diabetic retinopathy(DR, analyzing the correlation of early stage DR with PVEP and FERG.METHODS:Sixty patients, 30 males and 30 females, participated in observation group. Their average age was 19.42±7.78years. The duration of DM was RESULTS:In observation group, P100 amplitude decreased and P100 latency increased, compared to those of control group(PPCONCLUSION: PVEP are sensitive to optic neuron damage; FERG is desirable to detect the lesion of Müller cells and bipolar cells. P100 amplitude by PVEP, b-wave amplitude by FERG may be the most sensitive parameter for DR at early stage.

  4. Peculiaridades da circulação mesentérica em recém-nascidos e suas implicações em doenças gastrintestinais do período neonatal Mesenteric circulation peculiarities in infant newborns and its implications in gastrointestinal illnesses of the neonatal period

    Directory of Open Access Journals (Sweden)

    Chang Yin Chia

    2009-06-01

    flow by the Doppler ultrasound method. DATA SOURCES: Textbooks and publications listed in Medline and SciELO from the last 20 years were searched using the key-words: "mesenteric artery", "intestinal superior mesenteric artery", "newborn circulation", "necrotizing enterocolitis", and "Doppler flow velocimetry". DATA SYNTHESIS: Alterations in the mesenteric flow are predisposing factors for necrotizing enterocolitis, which is a neonatal illness with high morbidity and mortality that occurs mainly in premature infants. The mesenteric circulation is peculiar at the neonatal period regarding its baseline status as well as its response from physiological stimulation. Mesenteric irrigation varies according to the proper phase of intestinal vascular development. Mesenteric irrigation can be damaged by perinatal factors, such as placental insufficiency, asphyxia, infection, umbilical catheters, drugs (indomethacin and caffeine, phototherapy, artificial feeding and fast diet progression. Doppler flow velocimetry allows the study of gut irrigations and may quantify blood flow and vascular resistance. The exam can predict risk situations for gastrointestinal illnesses during the neonatal period. CONCLUSIONS: The newborn infant presents peculiarities on gastrointestinal blood circulation. Superior mesenteric artery Doppler ultrasound provides non-invasive measures of the intestinal circulatory conditions.

  5. Neonatal hypertension.

    Science.gov (United States)

    Sharma, Deepak; Farahbakhsh, Nazanin; Shastri, Sweta; Sharma, Pradeep

    2017-03-01

    Neonatal hypertension (HT) is a frequently under reported condition and is seen uncommonly in the intensive care unit. Neonatal HT has defined arbitrarily as blood pressure more than 2 standard deviations above the base as per the age or defined as systolic BP more than 95% for infants of similar size, gestational age and postnatal age. It has been diagnosed long back but still is the least studied field in neonatology. There is still lack of universally accepted normotensive data for neonates as per gestational age, weight and post-natal age. Neonatal HT is an important morbidity that needs timely detection and appropriate management, as it can lead to devastating short-term effect on various organs and also poor long-term adverse outcomes. There is no consensus yet about the treatment guidelines and majority of treatment protocols are based on the expert opinion. Neonate with HT should be evaluated in detail starting from antenatal, perinatal, post-natal history, and drug intake by neonate and mother. This review article covers multiple aspects of neonatal hypertension like definition, normotensive data, various etiologies and methods of BP measurement, clinical features, diagnosis and management.

  6. Two critical periods in early visual cortex during figure–ground segregation

    Science.gov (United States)

    Wokke, Martijn E; Sligte, Ilja G; Steven Scholte, H; Lamme, Victor A F

    2012-01-01

    The ability to distinguish a figure from its background is crucial for visual perception. To date, it remains unresolved where and how in the visual system different stages of figure–ground segregation emerge. Neural correlates of figure border detection have consistently been found in early visual cortex (V1/V2). However, areas V1/V2 have also been frequently associated with later stages of figure–ground segregation (such as border ownership or surface segregation). To causally link activity in early visual cortex to different stages of figure–ground segregation, we briefly disrupted activity in areas V1/V2 at various moments in time using transcranial magnetic stimulation (TMS). Prior to stimulation we presented stimuli that made it possible to differentiate between figure border detection and surface segregation. We concurrently recorded electroencephalographic (EEG) signals to examine how neural correlates of figure–ground segregation were affected by TMS. Results show that disruption of V1/V2 in an early time window (96–119 msec) affected detection of figure stimuli and affected neural correlates of figure border detection, border ownership, and surface segregation. TMS applied in a relatively late time window (236–259 msec) selectively deteriorated performance associated with surface segregation. We conclude that areas V1/V2 are not only essential in an early stage of figure–ground segregation when figure borders are detected, but subsequently causally contribute to more sophisticated stages of figure–ground segregation such as surface segregation. PMID:23170239

  7. Two critical periods in early visual cortex during figure-ground segregation.

    Science.gov (United States)

    Wokke, Martijn E; Sligte, Ilja G; Steven Scholte, H; Lamme, Victor A F

    2012-11-01

    The ability to distinguish a figure from its background is crucial for visual perception. To date, it remains unresolved where and how in the visual system different stages of figure-ground segregation emerge. Neural correlates of figure border detection have consistently been found in early visual cortex (V1/V2). However, areas V1/V2 have also been frequently associated with later stages of figure-ground segregation (such as border ownership or surface segregation). To causally link activity in early visual cortex to different stages of figure-ground segregation, we briefly disrupted activity in areas V1/V2 at various moments in time using transcranial magnetic stimulation (TMS). Prior to stimulation we presented stimuli that made it possible to differentiate between figure border detection and surface segregation. We concurrently recorded electroencephalographic (EEG) signals to examine how neural correlates of figure-ground segregation were affected by TMS. Results show that disruption of V1/V2 in an early time window (96-119 msec) affected detection of figure stimuli and affected neural correlates of figure border detection, border ownership, and surface segregation. TMS applied in a relatively late time window (236-259 msec) selectively deteriorated performance associated with surface segregation. We conclude that areas V1/V2 are not only essential in an early stage of figure-ground segregation when figure borders are detected, but subsequently causally contribute to more sophisticated stages of figure-ground segregation such as surface segregation.

  8. Two critical periods in early visual cortex during figure-ground segregation

    NARCIS (Netherlands)

    Wokke, M.E.; Sligte, I.G.; Scholte, H.S.; Lamme, V.A.F.

    2012-01-01

    .The ability to distinguish a figure from its background is crucial for visual perception. To date, it remains unresolved where and how in the visual system different stages of figure-ground segregation emerge. Neural correlates of figure border detection have consistently been found in early visual

  9. Mortality after discharge from the intensive care unit during the early weekend period

    DEFF Research Database (Denmark)

    Obel, N; Schierbeck, J; Pedersen, L

    2007-01-01

    BACKGROUND: As a result of a shortage of intensive care capacity, patients may be discharged prematurely early during weekends which may lead to an increased mortality and risk of readmission to intensive care units (ICU). We examined whether discharge from the ICU during the first part...

  10. The Origin of the Soul from Antiquity to the early Modern Period

    NARCIS (Netherlands)

    Spruit, L.

    2014-01-01

    The origin of the soul became a systematic subject of speculation in Greek philosophy and medicine. In early Christian thought, three theories evolved: the soul was held to be either generated from the parents (traducianism) or it was believed to be formed by a special act of creation on God’s part

  11. How Silent Is the "Silent Period" for Young Bilinguals in Early Years Settings in England?

    Science.gov (United States)

    Drury, Rose

    2013-01-01

    During the first decade of the twenty-first century there have been increasing numbers of bilingual children entering early years settings, many of whom are new to English. Twelve percent of school children in the UK are identified as having a mother tongue other than English and this number rises to 50% in urban areas such as inner London. In…

  12. Sex-dependent role of vesicular glutamate transporter 3 in stress-regulation and related anxiety phenotype during the early postnatal period.

    Science.gov (United States)

    Balázsfi, Diána; Farkas, Lívia; Csikota, Péter; Fodor, Anna; Zsebők, Sándor; Haller, József; Zelena, Dóra

    2016-07-01

    Stress and related disorders are in the focus of interest and glutamate is one of the most important neurotransmitters that can affect these processes. Glutamatergic neurons are characterized by vesicular glutamate transporters (VGluT1-3) among which vGluT3 is unique contributing to the non-canonical, neuromodulatory effect of glutamate. We aimed to study the role of vGluT3 in stress axis regulation and related anxiety during the early postnatal period using knockout (KO) mice with special focus on sex differences. Anxiety was explored on postnatal day (PND) 7-8 by maternal separation-induced ultrasonic vocalization (USV). Stress-hormone levels were detected 60 min after intraperitoneal lipopolysaccharide (LPS) injection 7 days later. Both genotypes gained weight, but on PND 14-15 KO mice pups had smaller body weight compared to wild type (WT). vGluT3 KO mice reacted to an immune stressor with enhanced adrenocorticotropin (ACTH) and corticosterone secretion compared to WT. Although there was a tendency for enhanced anxiety measured by more emitted USV, this did not reach the level of significance. The only sex-related effect was the enhanced corticosterone reactivity in male pups. For the HPA axis regulation in neonates vGluT3 expression seems to be dispensable under basal conditions, but is required for optimal response to immune stressors, most probably through an interaction with other neurotransmitters. Disturbance of the fine balance between these systems may result in a borderline enhanced anxiety-like behavior in vGluT3 KO pups.

  13. Neonatal Intestinal Obstruction-Four Year Experience

    Directory of Open Access Journals (Sweden)

    D. Rathore

    2015-06-01

    Full Text Available Aim of study: To study the aetiology and frequency, sex incidence, age of presentation, management and outcome of neonatal intestinal obstruction. Material and Methods: This prospective study of 316 neonates with intestinal obstruction was conducted over a period of 4 years from November 2009 to October 2013 at single institute. These cases were managed by various surgical procedures. Their epidemiology, day of presentation, associated anomalies and outcomes were studied. Results: A total of 316 neonates (277 males and 39 females were operated for intestinal obstruction. 268(84.81% neonates presented in the 1st week of life. Imperforate anus occurred in 206 (65.19%.Small bowel atresia accounted for23 (7.27% cases while duodenal atresia was seen in19 (6.01% patients. Infantile hypertrophic pyloric stenosis and Malrotation each occurred in 14 (4.43% patients; Hirschsprung’s disease in 18(5.69%, Necrotising Enterocolitis in 12(3.79%, Meconium disease of newborn in 9(2.85% while colonic atresia was seen in one (0.3% patient. Colostomy was performed in 145(45.88%, Pouchostomy in 15(4.74% and Cutback anoplasty in 56(17.72% patients. Ramsted’s Pyloromyotomy in 13(4.11%% neonates, Laparoscopic Pyloromyotomy in 1(0.3%,Kimura’s Duodenoduodenostomy in 19(6.01% ,End to Back anastomosis in 24(7.59% , End to End anastomosis in 7(2.21% , Multiple anastomosis in 2(0.6% , Enterotomy with irrigation in 7(2.21% , Ladd’s procedure in 14(4.43% , ,Single stage transanal pull through in 8(2.53% , Ileostomy in 2(0.6% , Single stage Abdominoperineal pull through in 2(0.6%, Levelling colostomy in 6(1.89% ,Peritoneal drain insertion under Local anaesthesia in 5(1.58% . Overall mortality was 13.60%. Conclusion: Intestinal Obstruction is the most common surgical emergency in neonatal period. Early and accurate diagnosis is paramount for proper patient management. The etiology, mode of presentation, morbidity and outcome of surgery of intestinal obstruction in

  14. iNICU - Integrated Neonatal Care Unit: Capturing Neonatal Journey in an Intelligent Data Way.

    Science.gov (United States)

    Singh, Harpreet; Yadav, Gautam; Mallaiah, Raghuram; Joshi, Preetha; Joshi, Vinay; Kaur, Ravneet; Bansal, Suneyna; Brahmachari, Samir K

    2017-08-01

    Neonatal period represents first 28 days of life, which is the most vulnerable time for a child's survival especially for the preterm babies. High neonatal mortality is a prominent and persistent problem across the globe. Non-availability of trained staff and infrastructure are the major recognized hurdles in the quality care of these neonates. Hourly progress growth charts and reports are still maintained manually by nurses along with continuous calculation of drug dosage and nutrition as per the changing weight of the baby. iNICU (integrated Neonatology Intensive Care Unit) leverages Beaglebone and Intel Edison based IoT integration with biomedical devices in NICU i.e. monitor, ventilator and blood gas machine. iNICU is hosted on IBM Softlayer based cloud computing infrastructure and map NICU workflow in Java based responsive web application to provide translational research informatics support to the clinicians. iNICU captures real time vital parameters i.e. respiration rate, heart rate, lab data and PACS amounting for millions of data points per day per child. Stream of data is sent to Apache Kafka layer which stores the same in Apache Cassandra NoSQL. iNICU also captures clinical data like feed intake, urine output, and daily assessment of child in PostgreSQL database. It acts as first Big Data hub (of both structured and unstructured data) of neonates across India offering temporal (longitudinal) data of their stay in NICU and allow clinicians in evaluating efficacy of their interventions. iNICU leverages drools based clinical rule based engine and deep learning based big data analytical model coded in R and PMML. iNICU solution aims to improve care time, fills skill gap, enable remote monitoring of neonates in rural regions, assists in identifying the early onset of disease, and reduction in neonatal mortality.

  15. [Dietary prevention of protein-energy malnutrition during early postoperative period in elderly patients with gastroduodenal diseases].

    Science.gov (United States)

    Baranovskiĭ, A Iu; Protopopova, O B

    2012-01-01

    The modified diet of postoperative rehabilitation program in elderly patients with gastroduodenal ulcers and prognosis of development of protein-energy malnutrition (PEM) is presented. It is shown that early initiated special diet in postoperative period, blocks mechanisms of malnutrition and can significantly improve the functional status of the small intestine and activate, thus, membrane digestion, which leads to normalization of all types of metabolism in elderly patients. In comparison with control group, where 72% of patients in postoperative period had malnutrition, malnutrition in the study group revealed a mild degree in only 17.3% of patients.

  16. Advancing Neurologic Care in the Neonatal Intensive Care Unit with a Neonatal Neurologist

    Science.gov (United States)

    Mulkey, Sarah B.; Swearingen, Christopher J.

    2014-01-01

    Neonatal neurology is a growing sub-specialty area. Given the considerable amount of neurologic problems present in the neonatal intensive care unit, a neurologist with expertise in neonates is becoming more important. We sought to evaluate the change in neurologic care in the neonatal intensive care unit at our tertiary care hospital by having a dedicated neonatal neurologist. The period post-neonatal neurologist showed a greater number of neurology consultations (Pneurology encounters per patient (Pneurology became part of the multi-disciplinary team providing focused neurologic care to newborns. PMID:23271754

  17. Torsional oscillations and observed rotational period variations in early-type stars

    Czech Academy of Sciences Publication Activity Database

    Krtička, J.; Mikulášek, Z.; Henry, G.W.; Kurfürst, P.; Karlický, Marian

    2017-01-01

    Roč. 464, č. 1 (2017), s. 933-939 ISSN 0035-8711 R&D Projects: GA ČR(CZ) GA16-01116S; GA ČR GAP209/12/0103 Institutional support: RVO:67985815 Keywords : MHD * chemically peculiar stars * early-type stars Subject RIV: BN - Astronomy, Celestial Mechanics, Astrophysics OBOR OECD: Astronomy (including astrophysics,space science) Impact factor: 4.961, year: 2016

  18. Two critical periods in early visual cortex during figure–ground segregation

    OpenAIRE

    Wokke, Martijn E; Sligte, Ilja G; Steven Scholte, H; Lamme, Victor A F

    2012-01-01

    .The ability to distinguish a figure from its background is crucial for visual perception. To date, it remains unresolved where and how in the visual system different stages of figure-ground segregation emerge. Neural correlates of figure border detection have consistently been found in early visual cortex (V1/V2). However, areas V1/V2 have also been frequently associated with later stages of figure-ground segregation (such as border ownership or surface segregation). To causally link activit...

  19. The English and the Control of Christianity in the Early Edo Period

    OpenAIRE

    SCREECH, Timon

    2012-01-01

    The history of Japan's de-Christianization in the early seventeenth century has often been told, but is here re-examined using new data, much of it previously unknown. The turn against Catholicism is variously attributed to fear of invasion or cultural difference, but most scholars agree the Dutch played little role, seldom engaging with theological issues. Neglected has been the activities of the English, whose East India Company was in Japan 1613-1626. Investigation of its records reveal...

  20. Maternal depression and suicide at immediate prenatal and early postpartum periods and psychosocial risk factors.

    Science.gov (United States)

    Shi, Peixia; Ren, Hui; Li, Hong; Dai, Qin

    2018-03-01

    Maternal depression has been intensively explored; however, less attention has been paid to maternal suicide. No studies to date have observed maternal depression and suicide at immediate prenatal and early postpartum stages. In total, 213 Chinese women were recruited in hospitals after they were admitted for childbirth. All completed a short-term longitudinal survey at perinatal stages. Women reported lower depression scores (6.65) and higher suicidal ideation incidence (11.74%) after childbirth. Prenatal depression raised the possibility of prenatal suicidal ideation, while prenatal depression and suicidal ideation increased postpartum depression and suicidal ideation. At immediate prenatal stage, marital satisfaction protected women from depression, while miscarriage experiences and self-esteem increased the risk. At early postpartum stage, in contrast, being first-time mother, marital satisfaction, and harmony with mother-in-law prevented them from depression. Our study is among the first to confirm that women have decreased depression but increased suicidal ideation at early postpartum, and a causal relationship between them, which are worthy of public attention. Potential protective (marital satisfaction, being first-time mother, and harmony with mother-in-law) or risk factors (miscarriage experiences and self-esteem) of maternal depression and suicidal ideation are identified at perinatal stages. This offers reliable guidance for clinical practice of health care. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. EARLY OPTICAL OBSERVATIONS OF GAMMA-RAY BURSTS BY THE TAROT TELESCOPES: PERIOD 2001-2008

    International Nuclear Information System (INIS)

    Klotz, A.; Boer, M.; Atteia, J. L.; Gendre, B.

    2009-01-01

    The Telescopes a Action Rapide pour les Objets Transitoires telescopes are two robotic observatories designed to observe the prompt optical emission counterpart and the early afterglow of gamma-ray bursts (GRBs). We present data acquired between 2001 and 2008 and discuss the properties of the optical emission of GRBs, noting various interesting results. The optical emission observed during the prompt GRB phase is rarely very bright: we estimate that 5%-20% of GRBs exhibit a bright optical flash (R < 14) during the prompt gamma-ray emission, and that more than 50% of the GRBs have an optical emission fainter than R = 15.5 when the gamma-ray emission is active. We study the apparent optical brightness distribution of GRBs at 1000 s showing that our observations confirm the distribution derived by other groups. The combination of these results with those obtained by other rapid slewing telescopes allows us to better characterize the early optical emission of GRBs and to emphasize the importance of very early multiwavelength GRB studies for the understanding of the physics of the ejecta.

  2. Neonatal brucellosis and breast milk.

    Science.gov (United States)

    Ceylan, Abdullah; Köstü, Murat; Tuncer, Oğuz; Peker, Erdal; Kırımi, Ercan

    2012-03-01

    In this case report the authors present an extremely low birth weight premature infant with neonatal brucellosis whose mother had been treated for brucellosis during pregnancy. Infant developed mild respiratory distress syndrome soon after birth. At 2nd wk of postnatal age findings of bronchopulmonary dysplasia were evident and she and her mother were diagnosed to have brucellosis at the same time. After commencement of antibrucellosis therapy and nonspesific treatment for bronchopulmonary dysplasia, infant was completely cured of the symptoms related to both brucellosis and bronchopulmonary dysplasia. The results of the present case and a review of the literature have let to conclude that Brucella might have role in development of prematurity and bronchoplumonary dysplasia. Since discovery of brucella bacilli in early periods of 20th century, fetotoxicity of brucella bacilli seems to increase gradually suggesting an increasing virulance of the bacilli or vanishing host defense of human beings.

  3. DNA biosynthesis content and intensiveness in mice thymus at early periods following fast neutron irradiation with different energy rate

    International Nuclear Information System (INIS)

    Indyk, V.M.; Antonenko, G.I.; Parnovskaya, N.V.

    1988-01-01

    Biosynthesis of dna of the thymic glands of animals irradiated by fast neutrons with different energy values in the early post-irradiation period is investigated. It is shown that the rate of mass recovery in organs, their cellular nature, dna content and indices of their specific activity have the dose and time dependences, as well as they considerably differ at different neutron energies and different quality radiation. With the increase of neutron energy value their biological effectiveness decreases

  4. Early action to reduce greenhouse gas emissions before the commitment period of the Kyoto protocol: advantages and disadvantages.

    Science.gov (United States)

    Michaelowa, A; Rolfe, C

    2001-09-01

    Current "business as usual" projections suggest greenhouse gas emissions from industrialized nations will grow substantially over the next decade. However, if it comes into force, the Kyoto Protocol will require industrialized nations to reduce emissions to an average of 5% below 1990 levels in the 2008-2012 period. Taking early action to close this gap has a number of advantages. It reduces the risks of passing thresholds that trigger climate change "surprises." Early action also increases future generations' ability to choose greater levels of climate protection, and it leads to faster reductions of other pollutants. From an economic sense, early action is important because it allows shifts to less carbon-intensive technologies during the course of normal capital stock turnover. Moreover, many options for emission reduction have negative costs, and thus are economically worthwhile, because of paybacks in energy costs, healthcare costs, and other benefits. Finally, early emission reductions enhance the probability of successful ratification and lower the risk of noncompliance with the protocol. We discuss policy approaches for the period prior to 2008. Disadvantages of the current proposals for Credit for Early Action are the possibility of adverse selection due to problematic baseline calculation methods as well as the distributionary impacts of allocating a part of the emissions budget already before 2008. One simple policy without drawbacks is the so-called baseline protection, which removes the disincentive to early action due to the expectation that businesses may, in the future, receive emission rights in proportion to past emissions. It is particularly important to adopt policies that shift investment in long-lived capital stock towards less carbon-intensive technologies and to encourage innovation and technology development that will reduce future compliance costs.

  5. Formation of the Periotic Space During the Early Fetal Period in Humans.

    Science.gov (United States)

    Ishikawa, Aoi; Ohtsuki, Sae; Yamada, Shigehito; Uwabe, Chigako; Imai, Hirohiko; Matsuda, Tetsuya; Takakuwa, Tetsuya

    2018-04-01

    The inner ear is a very complicated structure, composed of a bony labyrinth (otic capsule; OC), membranous labyrinth, with a space between them, named the periotic labyrinth or periotic space. We investigated how periotic tissue fluid spaces covered the membranous labyrinth three-dimensionally, leading to formation of the periotic labyrinth encapsulated in the OC during human fetal development. Digital data sets from magnetic resonance images and phase-contrast X-ray tomography images of 24 inner ear organs from 24 human fetuses from the Kyoto Collection (fetuses in trimesters 1 and 2; crown-rump length: 14.4-197 mm) were analyzed. The membranous labyrinth was morphologically differentiated in samples at the end of the embryonic period (Carnegie stage 23), and had grown linearly to more than eight times in size during the observation period. The periotic space was first detected at the 35-mm samples, around the vestibule and basal turn of the cochlea, which elongated rapidly to the tip of the cochlea and semicircular ducts, successively, and almost covered the membranous labyrinth at the 115-mm CRL stage or later. In those samples, several ossification centers were detected around the space. This article thus demonstrated that formation of the membranous labyrinth, periotic space (labyrinth), and ossification of the OC occurs successively, according to an intricate timetable. Anat Rec, 301:563-570, 2018. © 2018 Wiley Periodicals, Inc. © 2018 Wiley Periodicals, Inc.

  6. Temporal trends of latency period and perinatal survival after very early preterm premature rupture of fetal membranes.

    Science.gov (United States)

    González-Mesa, Ernesto; Herrera, José A; Urgal, Amaya; Lazarraga, Cristina; Benítez, María J; Gómez, Cristina

    2012-08-01

    This paper shows temporal trends of latency period and perinatal survival after preterm premature rupture of membranes at or before 28 weeks (very early PPROM). We have studied retrospectively medical records of all cases of very early PPROM attended in our Obstetric Department from January 1, 2000 to December 31, 2010. A total of 327 cases of very early PPROM were attended, representing 0.4 % of all deliveries, 3.68 % of all preterm births and 15 % of cases all of PPROM. The mean gestational age at delivery was 27 weeks (range 20-34). The mean duration of latency period for the total of 327 cases was 12.1 days (range 0-83, SD 13.3), with a clear trend to its increase from 2005 (p 2000-2010, perinatal deaths reached 30.6 % of all cases, with a clear trend to decrease as gestational age at diagnosis increased, and over the years of study. We have also found a high rate of obstetric complications and a high rate of cesarean deliveries. The upward trend in the duration of latency period in all groups over the years of study and the encouraging perinatal survival observed, even in previable PPROM, are incentives to follow expectant/conservative management in these cases.

  7. Neonatal Nursing

    OpenAIRE

    Crawford, Doreen; Morris, Maryke

    1994-01-01

    "Neonatal Nursing" offers a systematic approach to the nursing care of the sick newborn baby. Nursing actions and responsibilities are the focus of the text with relevant research findings, clinical applications, anatomy, physiology and pathology provided where necessary. This comprehensive text covers all areas of neonatal nursing including ethics, continuing care in the community, intranatal care, statistics and pharmokinetics so that holistic care of the infant is described. This book shou...

  8. Radiological evaluation of surgical emergencies in neonate

    International Nuclear Information System (INIS)

    Suh, C. O.; Oh, K. K.; Park, C. Y.

    1980-01-01

    Most pathologic conditions requiring emergent operation in neonate are congenital anomalies and delayed diagnosis and associated anomaly are important factors which have contributed to the high mortality rate of congenital anomalies. To prevent this delay, early recognition of the danger signals, adequate roentagenologic examination and accurate diagnosis should be made. Furthermore radiologists should be aware of developing mechanism, clinical manifestations and roentgenographic findings of those neonatal emergencies. 135 cases of neonatal emergencies were analyzed at this point of view, which verified by surgery and pathologic examination at Yonsei University College of Medicine, Severance Hospital since 1968. Embryology and characteristic roentgenographic pictures of each disease were discussed. The conclusions are as follows; 1. Most cases (110/135) presented intestinal obstruction. Imperforate anus (29 cases) was most common disease which followed by infantile hypertrophic pyloric stenosis (25 cases), small bowel atresia and stenosis (18 cases), congenital megacolon (15 cases) and esophageal atresia (14 cases). 2. Clinical Type and time of occurrence of symptoms and signs were so characteristic that these were helpful for differential diagnosis. 3. In infantile hypertrophic pyloric stenosis, confirmative diagnosis could be made in plain abdominal film, when 'Caterpillar sign' was seen. 4. When small bowel obstruction was suspected in plain abdominal film, barium enema examination was more helpful than upper G-I study. When microcolon was found, lower small bowel obstruction was highly suggested. 5. Diagnosis of midgut malrotation was possible in larger cases (4/7). Upper G-I examination was more valuable than barium enema study, because duodenal obstruction due to Ladd's band was common problem in neonate. 6. In neonatal period, diagnosis of aganglionosis could be made with the finding of barium stasis on 24-48 hours delay film, even though no demonstration of

  9. Two novel cases of cerebral haemorrhages at the neonatal period associated with inherited factor VII deficiency, one of them revealing a new nonsense mutation (Ser52Stop).

    Science.gov (United States)

    Giansily-Blaizot, Muriel; Aguilar-Martinez, Patricia; Briquel, Marie-Elisabeth; d'Oiron, Roseline; De Maistre, Emmanuel; Epelbaum, Serge; Schved, Jean-François

    2003-02-01

    Factor VII (FVII) is a plasma glycoprotein that plays a key role in the initiation of blood coagulation cascade. Inherited FVII deficiency is a rare autosomal recessive disorder with a wide heterogeneous clinical pattern. The severe form may be associated with intracranial haemorrhages occurring closely to birth with a high mortality rate. In the present article, we report two novel cases of neonatal intracerebral bleeding associated with FVII activity levels below 1% of normal. FVII genotyping investigations revealed particular genotypes including the deleterious Cys135Arg mutation and a novel Ser52Stop nonsense mutation at the homozygous state. Both mutations, through different mechanisms, are expected to be inconsistent with the production of functional FVII. These putative mechanisms are discussed through a review of the literature on phenotypic and genotypic characteristics of cerebral haemorrhages in severe inherited FVII deficiency.

  10. Reference Ranges of Serum Blood Urea Nitrogen, Creatinine Concentration and Ultrasonographic Measurement of the Kidneys in Term Healthy Newborns in the Neonatal Period

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    Şebnem Kader

    2017-12-01

    Full Text Available Objective: Acute kidney injury is an important problem in neonates. We conducted a cross-sectional prospective study to determine normal serum blood urea nitrogen, creatinine reference ranges and ranges of ultrasonographic measurement of kidneys in healthy term newborns. Study Design: Blood samples were collected from total 357 healthy newborns at birth (n=45, 1st (n=30, 3rd (n=61, 7th (n=34, 10th (n=132, 14th (n=36, and 28th (n=19 days of life. Renal ultrasonographic was performed by the same two radiologists on 81 newborns aged 10 days. Results: Serum blood urea nitrogen and creatinine concentrations have reached to the highest level at the first day of life and have returned to cord level at the third day of life. There were gradually decrease in serum blood urea nitrogen and creatinine levels after the first day of life. There were significant difference in both right and left renal length, width, and volumes in terms of gender and these parameters were statistically higher in boys than girls (p<0.05. Birth weight of the boys (3548±539g was statistically higher than girls (3307±405 g (p=0.028. There was a positive correlation between birth weight and right (r=0.38, p=0.000 and left kidney volumes (r=0.44, p=0.000. Conclusion: Our findings showed that measured blood urea nitrogen and creatinine levels changed in accordance with postnatal days and there was a positive correlation between kidney volume and birth weight of newborns. We concluded that these findings are important for evaluation of acute kidney injury and for screening of for urinary tract anomalies in neonates

  11. Early detection by MRI and conservative therapy of lumbar spondylolysis in the growing period

    International Nuclear Information System (INIS)

    Yoshida, Tohru; Namba, Hiromichi; Kasai, Tsutomu; Ohta, Susumu

    1996-01-01

    Since 1991 the early cases of spondylolysis in the growing stage have been diagnosed with MRI and treated conservatively by the authors. The final results were obtained in 153 cases (207 arches). The fusion rate of the separated part of these arches was 82% of the total. Treatment consisted mainly of prohibition of exercise and wearing a hard brace. The brace was more effective when worn not only during the day but also throughout the night. On MRI T 1 -weighted images low signal intensity changes of the pars interarticularis proved that bony fusion had been attained with conservative therapy. (author)

  12. Early detection by MRI and conservative therapy of lumbar spondylolysis in the growing period

    Energy Technology Data Exchange (ETDEWEB)

    Yoshida, Tohru; Namba, Hiromichi; Kasai, Tsutomu; Ohta, Susumu [Yoshida Orthopaedic Hospital, Toyota, Aichi (Japan)

    1996-07-01

    Since 1991 the early cases of spondylolysis in the growing stage have been diagnosed with MRI and treated conservatively by the authors. The final results were obtained in 153 cases (207 arches). The fusion rate of the separated part of these arches was 82% of the total. Treatment consisted mainly of prohibition of exercise and wearing a hard brace. The brace was more effective when worn not only during the day but also throughout the night. On MRI T{sub 1}-weighted images low signal intensity changes of the pars interarticularis proved that bony fusion had been attained with conservative therapy. (author)

  13. Favorable neonatal outcomes among immigrants in Taiwan: evidence of healthy immigrant mother effect.

    Science.gov (United States)

    Hsieh, Wu-Shiun; Hsieh, Chia-Jung; Jeng, Suh-Fang; Liao, Hua-Fang; Su, Yi-Ning; Lin, Shio-Jean; Chang, Pei-Jen; Chen, Pau-Chung

    2011-07-01

    Although racial/ethnic disparities in neonatal and infant health are well known, positive associations between migration and perinatal health exist among immigrant mothers in western countries. There are unique marriage migration, East Asia culture, universal national health insurance system, and adequate social support in Taiwan that may differ from the situation in western countries. We aimed to assess the neonatal outcomes among live births to married immigrant mothers in recent years in Taiwan. We conducted a population-based analysis among all the live births in Taiwan during the period 1998-2003 to assess neonatal outcomes, including incidence of low birth weight and preterm birth and of early and late neonatal mortality, according to maternal nationality. Logistic regression was used to estimate the odds ratios (ORs) associated with low birth weight and preterm birth, and Cox proportional hazards were used to estimate the relative risks (RRs) associated with mortality in the neonatal period. There were a total of 1,405,931 single live births, including 6.6% born to immigrant mothers and 93.4% born to Taiwanese mothers. Disparities existed among the intercultural couples, including paternal age, parental educational level, and residential distribution. Fewer low birth weight and fewer preterm babies were born to immigrant mothers than to Taiwanese mothers. In addition, babies born to immigrant mothers had lower early neonatal and neonatal mortalities than those born to Taiwanese mothers. There were lower risks of having a low birth weight (adjusted OR [AOR] 0.73, 95% confidence interval [CI] 0.70-0.75) or preterm (AOR 0.72, 95% CI 0.69-0.74) baby and lower hazard ratios (HRs) of having an early neonatal death (adjusted HR [AHR] 0.68, 95% CI 0.56-0.82) or neonatal death (AHR 0.74, 95% CI 0.64-0.87) in babies born to immigrant mothers. There is a gradual increase in the risks of adverse neonatal outcomes associated with increases in length of residence

  14. Exposure of Neonatal Mice to Tobacco Smoke Disturbs Synaptic Proteins and Spatial Learning and Memory from Late Infancy to Early Adulthood.

    Directory of Open Access Journals (Sweden)

    Larissa Helena Torres

    Full Text Available Exposure to environmental tobacco smoke (ETS in the early postnatal period has been associated with several diseases; however, little is known about the brain effects of ETS exposure during this critical developmental period or the long-term consequences of this exposure. This study investigated the effects of the early postnatal ETS exposure on both reference and working memory, synaptic proteins and BDNF from late infancy to early adulthood (P3-P73. BALB/c mice were exposed to ETS generated from 3R4F reference research cigarettes (0.73 mg of nicotine/cigarette from P3 to P14. Spatial reference and working memory were evaluated in the Morris water maze during infancy (P20-P29, adolescence (P37-P42 and adulthood (P67-P72. Synapsin, synaptophysin, PSD95 and brain-derived neurotrophic factor (BDNF were assessed at P15, P35 and P65 by immunohistochemistry and immunoblotting. Mice that were exposed to ETS during the early postnatal period showed poorer performance in the spatial reference memory task. Specifically, the ETS-exposed mice exhibited a significantly reduced time and distance traveled in the target quadrant and in the platform location area than the controls at all ages evaluated. In the spatial working memory task, ETS disrupted the maintenance but not the acquisition of the critical spatial information in both infancy and adolescence. ETS also induced changes in synaptic components, including decreases in synapsin, synaptophysin, PSD95 and BDNF levels in the hippocampus. Exposure to ETS in the early postnatal period disrupts both spatial reference and working memory; these results may be related to changes in synaptogenesis in the hippocampus. Importantly, most of these effects were not reversed even after a long exposure-free period.

  15. Sensory Deprivation during Early Postnatal Period Alters the Density of Interneurons in the Mouse Prefrontal Cortex

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    Hiroshi Ueno

    2015-01-01

    Full Text Available Early loss of one sensory system can cause improved function of other sensory systems. However, both the time course and neuronal mechanism of cross-modal plasticity remain elusive. Recent study using functional MRI in humans suggests a role of the prefrontal cortex (PFC in cross-modal plasticity. Since this phenomenon is assumed to be associated with altered GABAergic inhibition in the PFC, we have tested the hypothesis that early postnatal sensory deprivation causes the changes of inhibitory neuronal circuit in different regions of the PFC of the mice. We determined the effects of sensory deprivation from birth to postnatal day 28 (P28 or P58 on the density of parvalbumin (PV, calbindin (CB, and calretinin (CR neurons in the prelimbic, infralimbic, and dorsal anterior cingulate cortices. The density of PV and CB neurons was significantly increased in layer 5/6 (L5/6. Moreover, the density of CR neurons was higher in L2/3 in sensory deprived mice compared to intact mice. These changes were more prominent at P56 than at P28. These results suggest that long-term sensory deprivation causes the changes of intracortical inhibitory networks in the PFC and the changes of inhibitory networks in the PFC may contribute to cross-modal plasticity.

  16. Early Period Results and Clinical Characteristics of Upper Gastrointestinal Endoscopy in Sivrihisar State Hospital

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    Ozgur Turk

    2014-12-01

    Full Text Available Aim: Our aim was to identify the characteristics of the patient that performed upper gastrointestinal endoscopy in a new established endoscopy unit of a state hospital. We want to present the spectrum of gastrointestinal diseases in our hospitals region. Material and Method: We analyzed patients upper endoscopy results according to age, sex, complaints, clinical characteristics, type of anesthesia, and the necessity of biopsy. We reviewed 256 patients data between 2013 December-2014 July. All endoscopies were performed by same surgeon. Results: The highest complaint was epigastric pain (n=112, 43, 8%. Other complaints were followed as dyspepsia (n=84, 32.8%, heartburn (n=42, 16.4%, nausea (n=4, 1.6%, vomiting (n=2, 0.8%, dysphagia (n=6, 2.3%. We determined 218 gastritis (85.2%, 64 hiatal hernia (25%, 120 esophagitis (46.9%, 76 duodenitis (29.7%, 4 gastric ulcer (1.6%, 18 duodenal ulcers (7%, 20 bile reflux (7.8%, 26 Gastro esophageal reflux disease (GERD in patients (10.2%. 10 patients reported as normal (3.9%. Biopsy was performed in 186 of the patients. Discussion: Endoscopy can become an early diagnostic examination by increasing the availability of endoscopy. Also alarm symptoms should not be ignored and endoscopy should perform immediately in symptomatic patients. As an early result of upper gastrointestinal endoscopies that performed in this study; gastritis, esophagitis, duodenitis and hiatal hernia are common gastrointestinal diseases in our region.

  17. Interceptive orthopedics for the correction of maxillary transverse and sagittal deficiency in the early mixed dentition period

    Directory of Open Access Journals (Sweden)

    Ashok Kumar Talapaneni

    2011-01-01

    Full Text Available Dentofacial Orthopedics directed to a hypoplastic maxilla in the prepubertal period redirects growth of the maxilla in the vertical, transverse and sagittal planes of space. The orthopedic correction of maxillary hypoplasia in the early mixed dentition period thus intercepts the establishment of permanent structural asymmetry in the mandible and helps in the achievement of optimal dentofacial esthetics. This paper presents the growth redirection in a hypoplastic maxilla of an 8-year-old girl with simultaneous rapid maxillary expansion and protraction headgear therapy for a period of 11 months which corrected the posterior unilateral cross-bite, the positional asymmetry of the mandible and established an orthognathic profile in the individual.

  18. Risk of Porphyromonas gingivalis recolonization during the early period of periodontal maintenance in initially severe periodontitis sites.

    Science.gov (United States)

    Fujise, Osamu; Miura, Mayumi; Hamachi, Takafumi; Maeda, Katsumasa

    2006-08-01

    Porphyromonas gingivalis is considered a critical pathogen of periodontal diseases including recurrent periodontitis. The profound effects of active periodontal treatment (APT) on P. gingivalis elimination were previously demonstrated and revealed that the subsequent P. gingivalis-free or -suppressed status seems to be maintained during early periodontal maintenance (PMT). The aim of the present study was to show the occurrence of microbial recolonization during this early PMT period. In total, 128 sites from 11 generalized chronic periodontitis patients and one generalized aggressive periodontitis patient underwent clinical and microbiologic examination at baseline (Exam-I), after APT (Exam-II), and in PMT (Exam-III). Exam-III was carried out an average of 4.5 +/- 3.5 months after Exam-II. Detection and quantification of putative pathogens were performed using a polymerase chain reaction-based method. The PMT used was effective in maintaining the clinical conditions improved by APT. However, in microbiological examinations, Exam-III showed higher detection frequency and levels of P. gingivalis than Exam-II. This suggests that a P. gingivalis recolonization started in the early PMT period. P. gingivalis-increased sites then showed significantly more severe signs of periodontitis in Exam-I than P. gingivalis-stable sites (bleeding on probing frequency: 76.7% versus 56.5%; suppuration frequency: 41.9% versus 12.9%). On the other hand, in Exam-II, no significant differences of clinical parameters were noted between P. gingivalis-increased and -stable sites. Severe periodontitis sites before APT seemed to place them at risk of P. gingivalis recolonization in the early PMT period, and this microbial restoration could be a cause of recurrent periodontitis.

  19. Neonatal Marfan syndrome: Report of two cases.

    Science.gov (United States)

    Jurko, Tomas; Jurko, Alexander; Minarik, Milan; Micieta, Vladimir; Tonhajzerova, Ingrid; Kolarovszka, Hana; Zibolen, Mirko

    2017-07-01

    Marfan syndrome is rarely diagnosed in the neonatal period because of variable expression and age-dependent appearance of clinical signs. The prognosis is usually poor due to high probability of congestive heart failure, mitral and tricuspid regurgitations with suboptimal response to medical therapy and difficulties in surgical management. The authors have studied two cases of Marfan syndrome in the newborn period. Two cases of neonatal Marfan syndrome, one male and one female, were diagnosed by characteristic physical appearance. Both infants had significant cardiovascular abnormalities diagnosed by ultrasonography. Genetic DNA analysis in the second case confirmed the mutations in the fibrillin-1 gene located on chromosome 15q21 which is responsible for the development of Marfan syndrome. The boy died at six weeks of age with signs of rapidly progressive left ventricular failure associated with pneumonia. The second infant was having only mild signs of congestive heart failure and has been treated with beta blockers. At the age of 4 years her symptoms of congestive heart failure had worsened due to progression of mitral and tricuspid insufficiency and development of significant cardiomegaly. Mitral and tricuspid valvuloplasy had to be done at that time. Early diagnosis of Marfan syndrome in the newborn period can allow treatment in the early stages of cardiovascular abnormalities and may improve the prognosis. It also helps to explain to the family the serious health problem of their child.

  20. Mitral restenosis in the early postoperative period of a patient with systemic lupus erythematosus

    Directory of Open Access Journals (Sweden)

    Pomerantzeff Pablo Maria Alberto

    1999-01-01

    Full Text Available A forty eight year old woman, who had undergone mitral comissurotomy and subsequently developed early restenosis, presented with major comissural fusion and verrucous lesions on the cuspid edges of the mitral valve, with normal subvalvar apparatus. Patient did well for the first six months after surgery when she began to present dyspnea on light exertion. A clinical diagnosis of restenosis was made, which was confirmed by an echocardiogram and cardiac catheterization. She underwent surgery, and a stenotic mitral valve with verrucous lesions suggesting Libman-Sacks' endocarditis was found. Because the diagnosis of systemic lupus erythematosus (SLE had not been confirmed at that time, a bovine pericardium bioprosthesis (FISICS-INCOR was implanted. The patient did well in the late follow-up and is now in NYHA Class I .

  1. Mitral restenosis in the early postoperative period of a patient with systemic lupus erythematosus.

    Science.gov (United States)

    Pomerantzeff, P M; Corrêa, J D; Brandão, C M; de Assis, R V; Jatene, A D

    1999-04-01

    A forty-eight year old woman, who had undergone mitral comissurotomy and subsequently developed early restenosis, presented with major comissural fusion and verrucous lesions on the cuspid edges of the mitral valve, with normal subvalvar apparatus. Patient did well for the first six months after surgery when she began to present dyspnea on light exertion. A clinical diagnosis of restenosis was made, which was confirmed by an echocardiogram and cardiac catheterization. She underwent surgery, and a stenotic mitral valve with verrucous lesions suggesting Libman-Sacks' endocarditis was found. Because the diagnosis of systemic lupus erythematosus (SLE) had not been confirmed at that time, a bovine pericardium bioprosthesis (FISICS-INCOR) was implanted. The patient did well in the late follow-up and is now in NYHA Class I.

  2. Efeito do uso de pentoxifilina no período neonatal sobre a produção espermática em ratos Wistar adultos Effect of pentoxifylline during neonatal period on spermatic production in adult Wistar rats

    Directory of Open Access Journals (Sweden)

    T.A.P. Moraes

    2009-02-01

    Full Text Available Utilizaram-se doses crescentes de pentoxifilina em ratos Wistar neonatos visando aumentar a produção espermática em animais adultos. Trinta e sete animais foram distribuídos de acordo com os tratamentos: não tratados (n=10 e tratados com 1mg/kg (n=10, 5mg/kg (n=9 e 10mg/kg (n=8 de pentoxifilina (IP. Aos 90 dias, os animais foram anestesiados e perfundidos intracardiacamente com solução fixadora. Os testículos foram processados rotineiramente para inclusão em resina plástica à base de glicol metacrilato. Cortes histológicos de 4µm de espessura foram corados em azul de toluidina/borato de sódio a 1% e analisados histometricamente. O número de células de Sertoli por secção transversal diminuiu nos grupos tratados com 5mg/kg e 10mg/kg em relação aos grupos controle e tratado com 1mg/kg. O índice de células de Sertoli aumentou nos animais tratados com 5mg/kg em comparação aos do grupo-controle. A utilização da pentoxifilina não foi capaz de induzir aumento na população das células de Sertoli e produção espermática em ratos adultos.Increasing doses of pentoxifylline were administrated to newborn Wistar rats in order to augment Sertoli cell number and sperm production in the adult rats. Thirty-seven neonate Wistar rats were distributed in four groups: control (n=10 and treated with 1mg/kg (n=10, 5mg/kg (n=9, and 10mg/kg (n=8 of pentoxifylline. At 90 days, the animals were submitted to anesthesia and intracardiac perfusion. Testes were colleted and routinely processed for inclusion in plastic resin with glycol methacrylate. Histological sections (4µm were stained in toluidine blue/sodium borate (1% and analyzed. Number of Sertoli cell per transversal section of seminiferous tubule had significant reduction in the groups treated with 5mg/kg and 10mg/kg of pentoxifylline as compared to control and the group that received 1mg/kg (P<0.05. The Sertoli cell index significantly increased in the group treated with 5mg

  3. Colonial Figures: Memories of Street Traders in the Colonial and Early Post-colonial Periods

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    Sheri Lynn Gibbings

    2012-12-01

    Full Text Available This article explores post-colonial memories about street traders among individuals who lived in the former colony of the Dutch East Indies. It argues that these narratives romanticize the relationship between Europeans and indigenous peoples. Street vendors are also used to differentiate between periods within colonial and post-colonial history. The nostalgic representation of interracial contact between Europeans and traders is contrasted with representations of other figures such as the Japanese and the nationalist. A recurring feature of these representations is the ability of Europeans to speak with street traders and imagine what they wanted and needed. The traders are remembered as a social type that transgressed politics and represented the neutrality of the economic sphere as a place for shared communication. The article concludes that the figure of the street vendor contributes to the nostalgic reinvention of the colony but is also used in narratives to differentiate between and mark changes across the colonial and post-colonial periods.

  4. Impact of perinatal systemic hypoxic-ischemic injury on the brain of male offspring rats: an improved model of neonatal hypoxic-ischemic encephalopathy in early preterm newborns.

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    Yuejun Huang

    Full Text Available In this study, we attempted to design a model using Sprague-Dawley rats to better reproduce perinatal systemic hypoxic-ischemic encephalopathy (HIE in early preterm newborns. On day 21 of gestation, the uterus of pregnant rats were exposed and the blood supply to the fetuses of neonatal HIE groups were thoroughly abscised by hemostatic clamp for 5, 10 or 15 min. Thereafter, fetuses were moved from the uterus and manually stimulated to initiate breathing in an incubator at 37 °C for 1 hr in air. We showed that survival rates of offspring rats were decreased with longer hypoxic time. TUNEL staining showed that apoptotic cells were significant increased in the brains of offspring rats from the 10 min and 15 min HIE groups as compared to the offspring rats in the control group at postnatal day (PND 1, but there was no statistical difference between the offspring rats in the 5 min HIE and control groups. The perinatal hypoxic treatment resulted in decreased neurons and increased cleaved caspase-3 protein levels in the offspring rats from all HIE groups at PND 1. Platform crossing times and the percentage of the time spent in the target quadrant of Morris Water Maze test were significantly reduced in the offspring rats of all HIE groups at PND 30, which were associated with decreased brain-derived neurotrophic factor levels and neuronal cells in the hippocampus of offspring rats at PND 35. These data demonstrated that perinatal ischemic injury led to the death of neuronal cells and long-lasting impairment of memory. This model reproduced hypoxic ischemic encephalopathy in early preterm newborns and may be appropriate for investigating therapeutic interventions.

  5. Impact of Perinatal Systemic Hypoxic–Ischemic Injury on the Brain of Male Offspring Rats: An Improved Model of Neonatal Hypoxic–Ischemic Encephalopathy in Early Preterm Newborns

    Science.gov (United States)

    Xu, Hongwu; Wu, Weizhao; Lai, Xiulan; Ho, Guyu; Ma, Lian; Chen, Yunbin

    2013-01-01

    In this study, we attempted to design a model using Sprague-Dawley rats to better reproduce perinatal systemic hypoxic-ischemic encephalopathy (HIE) in early preterm newborns. On day 21 of gestation, the uterus of pregnant rats were exposed and the blood supply to the fetuses of neonatal HIE groups were thoroughly abscised by hemostatic clamp for 5, 10 or 15 min. Thereafter, fetuses were moved from the uterus and manually stimulated to initiate breathing in an incubator at 37 °C for 1 hr in air. We showed that survival rates of offspring rats were decreased with longer hypoxic time. TUNEL staining showed that apoptotic cells were significant increased in the brains of offspring rats from the 10 min and 15 min HIE groups as compared to the offspring rats in the control group at postnatal day (PND) 1, but there was no statistical difference between the offspring rats in the 5 min HIE and control groups. The perinatal hypoxic treatment resulted in decreased neurons and increased cleaved caspase-3 protein levels in the offspring rats from all HIE groups at PND 1. Platform crossing times and the percentage of the time spent in the target quadrant of Morris Water Maze test were significantly reduced in the offspring rats of all HIE groups at PND 30, which were associated with decreased brain-derived neurotrophic factor levels and neuronal cells in the hippocampus of offspring rats at PND 35. These data demonstrated that perinatal ischemic injury led to the death of neuronal cells and long-lasting impairment of memory. This model reproduced hypoxic ischemic encephalopathy in early preterm newborns and may be appropriate for investigating therapeutic interventions. PMID:24324800

  6. Criteria for radiologic diagnosis of hypochondroplasia in neonates

    Energy Technology Data Exchange (ETDEWEB)

    Saito, Tomoko; Nagasaki, Keisuke; Wada, Masaki; Nyuzuki, Hiromi; Saitoh, Akihiko [Niigata University Graduate School of Medical and Dental Sciences, Division of Pediatrics, Department of Homeostatic Regulation and Development (Japan); Nishimura, Gen [Tokyo Metropolitan Children' s Medical Center, Department of Radiology, Tokyo (Japan); Takagi, Masaki [Tokyo Metropolitan Children' s Medical Center, Department of Endocrinology, Tokyo (Japan); Keio University School of Medicine, Department of Pediatrics, Tokyo (Japan); Hasegawa, Tomonobu; Amano, Naoko [Keio University School of Medicine, Department of Pediatrics, Tokyo (Japan); Murotsuki, Jun [Tohoku University Graduate School of Medicine, Miyagi Children' s Hospital, Department of Maternal and Fetal Medicine, Sendai (Japan); Sawai, Hideaki [Hyogo College of Medicine, Departments of Obstetrics and Gynecology, Hyogo (Japan); Yamada, Takahiro [Hokkaido University Hospital, Departments of Obstetrics and Gynecology, Hokkaido (Japan); Sato, Shuhei [Aomori Rosai Hospital, Department of Obstetrics and Gynecology, Aomori (Japan)

    2016-04-15

    A radiologic diagnosis of hypochondroplasia is hampered by the absence of age-dependent radiologic criteria, particularly in the neonatal period. To establish radiologic criteria and scoring system for identifying neonates with fibroblast growth factor receptor 3 (FGFR3)-associated hypochondroplasia. This retrospective study included 7 hypochondroplastic neonates and 30 controls. All subjects underwent radiologic examination within 28 days after birth. We evaluated parameters reflecting the presence of (1) short ilia, (2) squared ilia, (3) short greater sciatic notch, (4) horizontal acetabula, (5) short femora, (6) broad femora, (7) metaphyseal flaring, (8) lumbosacral interpedicular distance narrowing and (9) ovoid radiolucency of the proximal femora. Only parameters 1, 3, 4, 5 and 6 were statistically different between the two groups. Parameters 3, 5 and 6 did not overlap between the groups, while parameters 1 and 4 did. Based on these results, we propose a scoring system for hypochondroplasia. Two major criteria (parameters 3 and 6) were assigned scores of 2, whereas 4 minor criteria (parameters 1, 4, 5 and 9) were assigned scores of 1. All neonates with hypochondroplasia in our material scored ≥6. Our set of diagnostic radiologic criteria might be useful for early identification of hypochondroplastic neonates. (orig.)

  7. Neonatal Hemodynamics: From Developmental Physiology to Comprehensive Monitoring

    Directory of Open Access Journals (Sweden)

    Sabine L. Vrancken

    2018-04-01

    Full Text Available Maintenance of neonatal circulatory homeostasis is a real challenge, due to the complex physiology during postnatal transition and the inherent immaturity of the cardiovascular system and other relevant organs. It is known that abnormal cardiovascular function during the neonatal period is associated with increased risk of severe morbidity and mortality. Understanding the functional and structural characteristics of the neonatal circulation is, therefore, essential, as therapeutic hemodynamic interventions should be based on the assumed underlying (pathophysiology. The clinical assessment of systemic blood flow (SBF by indirect parameters, such as blood pressure, capillary refill time, heart rate, urine output, and central-peripheral temperature difference is inaccurate. As blood pressure is no surrogate for SBF, information on cardiac output and systemic vascular resistance should be obtained in combination with an evaluation of end organ perfusion. Accurate and reliable hemodynamic monitoring systems are required to detect inadequate tissue perfusion and oxygenation at an early stage before this result in irreversible damage. Also, the hemodynamic response to the initiated treatment should be re-evaluated regularly as changes in cardiovascular function can occur quickly. New insights in the understanding of neonatal cardiovascular physiology are reviewed and several methods for current and future neonatal hemodynamic monitoring are discussed.

  8. Criteria for radiologic diagnosis of hypochondroplasia in neonates

    International Nuclear Information System (INIS)

    Saito, Tomoko; Nagasaki, Keisuke; Wada, Masaki; Nyuzuki, Hiromi; Saitoh, Akihiko; Nishimura, Gen; Takagi, Masaki; Hasegawa, Tomonobu; Amano, Naoko; Murotsuki, Jun; Sawai, Hideaki; Yamada, Takahiro; Sato, Shuhei

    2016-01-01

    A radiologic diagnosis of hypochondroplasia is hampered by the absence of age-dependent radiologic criteria, particularly in the neonatal period. To establish radiologic criteria and scoring system for identifying neonates with fibroblast growth factor receptor 3 (FGFR3)-associated hypochondroplasia. This retrospective study included 7 hypochondroplastic neonates and 30 controls. All subjects underwent radiologic examination within 28 days after birth. We evaluated parameters reflecting the presence of (1) short ilia, (2) squared ilia, (3) short greater sciatic notch, (4) horizontal acetabula, (5) short femora, (6) broad femora, (7) metaphyseal flaring, (8) lumbosacral interpedicular distance narrowing and (9) ovoid radiolucency of the proximal femora. Only parameters 1, 3, 4, 5 and 6 were statistically different between the two groups. Parameters 3, 5 and 6 did not overlap between the groups, while parameters 1 and 4 did. Based on these results, we propose a scoring system for hypochondroplasia. Two major criteria (parameters 3 and 6) were assigned scores of 2, whereas 4 minor criteria (parameters 1, 4, 5 and 9) were assigned scores of 1. All neonates with hypochondroplasia in our material scored ≥6. Our set of diagnostic radiologic criteria might be useful for early identification of hypochondroplastic neonates. (orig.)

  9. Neonatal neurosonography

    Energy Technology Data Exchange (ETDEWEB)

    Riccabona, Michael, E-mail: michael.riccabona@klinikum-graz.at

    2014-09-15

    Paediatric and particularly neonatal neurosonography still remains a mainstay of imaging the neonatal brain. It can be performed at the bedside without any need for sedation or specific monitoring. There are a number of neurologic conditions that significantly influence morbidity and mortality in neonates and infants related to the brain and the spinal cord; most of them can be addressed by ultrasonography (US). However, with the introduction of first CT and then MRI, neonatal neurosonography is increasingly considered just a basic first line technique that offers only orienting information and does not deliver much relevant information. This is partially caused by inferior US performance – either by restricted availability of modern equipment or by lack of specialized expertise in performing and reading neurosonographic scans. This essay tries to highlight the value and potential of US in the neonatal brain and briefly touching also on the spinal cord imaging. The common pathologies and their US appearance as well as typical indication and applications of neurosonography are listed. The review aims at encouraging paediatric radiologists to reorient there imaging algorithms and skills towards the potential of modern neurosonography, particularly in the view of efficacy, considering growing economic pressure, and the low invasiveness as well as the good availability of US that can easily be repeated any time at the bedside.

  10. Neonatal pain

    Science.gov (United States)

    Walker, Suellen M

    2014-01-01

    Effective management of procedural and postoperative pain in neonates is required to minimize acute physiological and behavioral distress and may also improve acute and long-term outcomes. Painful stimuli activate nociceptive pathways, from the periphery to the cortex, in neonates and behavioral responses form the basis for validated pain assessment tools. However, there is an increasing awareness of the need to not only reduce acute behavioral responses to pain in neonates, but also to protect the developing nervous system from persistent sensitization of pain pathways and potential damaging effects of altered neural activity on central nervous system development. Analgesic requirements are influenced by age-related changes in both pharmacokinetic and pharmacodynamic response, and increasing data are available to guide safe and effective dosing with opioids and paracetamol. Regional analgesic techniques provide effective perioperative analgesia, but higher complication rates in neonates emphasize the importance of monitoring and choice of the most appropriate drug and dose. There have been significant improvements in the understanding and management of neonatal pain, but additional research evidence will further reduce the need to extrapolate data from older age groups. Translation into improved clinical care will continue to depend on an integrated approach to implementation that encompasses assessment and titration against individual response, education and training, and audit and feedback. PMID:24330444

  11. X-irradiation of mice in the early fetal period. Pt. 2

    International Nuclear Information System (INIS)

    Kriegel, H.; Weber, L.; Schmahl, W.

    1979-01-01

    Pregnant NMRI mice were X-irradiated with 50, 100 and 200 R, respectively, on the twelfth gestational day. The brains of their offspring were weighed and examined for acetylcholinesterase and Na,K-ATPase activities from birth until the 64th postnatal day. The postnatal brain weights were influenced by the prenatal irradiation in a dose-dependent manner. At birth the brains of the treated animals weighed less than those of the controls. After a limited period of restitution (postnatal days 3 to 10), weights fell again, as compared to the controls, and persisted at subnormal levels. This was assumed to be a sequel of surplus neuron cell formation and their speedy degradation as soon as neuronal function had been established. The curves of the activites (per gram of brain tissue) of acetylcholinesterase as well as Na,K-ATPase showed oscillating compensatory responses to the prenatal irradiation. Activities were preferentially found at supernormal levels, the oscillation lasting as long as the restitution period of the brain weights. With the 50 R and 100 R groups, enzyme activities were steadily above the control levels from the 16th until the 48th day after birth. On the 64th postnatal day all enzyme activities but one (200 R, Na,K-ATPase) had returned to the control levels. Oscillating responses to prenatal X-irradiation have been described for the DNA-synthesis in livers and brains of mice during the first three postnatal weeks. From this perspective, our results are discussed as the outcome of radiation-induced alterations in genome activity. (orig.) [de

  12. [Pathology of amniogenesis in the early prenatal period of human development].

    Science.gov (United States)

    Kulazhenko, V P; Bragina, Z N

    1989-08-01

    Morphological and, in a number of cases, cytogenetical investigation has been performed in 420 intact embryonal sacs and in embryos 7-8-week-old, obtained at spontaneous abortions (272) and at tubal pregnancy (148). Among these cases 202 (48.1%) intact empty embryonal sacs, 75 (17.9%) embryos with panorganodysplasia, 25 (6%) embryos with isolated developmental defects and 118 (28%) phenotypically normal embryos have been revealed. Pathology of amniogenesis such as aplasia or hypoplasia of the amniotic cavity is noted in 136 (32.4%) cases. Among 75 embryos with panorganodysplasia anomalies such as hypoplasia of the amniotic cavity in combination with a partial extra-amniotic++ position of the embryos in exocelom (10.7%), aplasia (5.3%) or hypoplasia (17.3%) amniotic peduncle is present in 43 (57.3%) observations. Out of 40 such cases at spontaneous abortions, cytogenetically investigated, in 27 (67.5%) chromosomal disorders (tetraploidy, triploidy, autosomal trisomy and monosomy) are revealed. Aplasia and hypoplasia of the amniotic cavity are considered as pathology of histogenesis at the tissue stage of the early human ontogenesis, that most evidently occurs as a result of asplasia, destruction or anomaly of embryoblast during the first phase of gastrulation on the 7th-11th day of the intrauterine development.

  13. Prediction of Late Postoperative Hemorrhage after Whipple Procedure Using Computed Tomography Performed During Early Postoperative Period.

    Science.gov (United States)

    Han, Ga Jin; Kim, Suk; Lee, Nam Kyung; Kim, Chang Won; Seo, Hyeong Il; Kim, Hyun Sung; Kim, Tae Un

    2018-01-01

    Postpancreatectomy hemorrhage (PPH) is an uncommon but serious complication of Whipple surgery. To evaluate the radiologic features associated with late PPH at the first postoperative follow up CT, before bleeding. To evaluate the radiological features associated with late PPH at the first follow-up CT, two radiologists retrospectively reviewed the initial postoperative follow-up CT images of 151 patients, who had undergone Whipple surgery. Twenty patients showed PPH due to vascular problem or anastomotic ulcer. The research compared CT and clinical findings of 20 patients with late PPH and 131 patients without late PPH, including presence of suggestive feature of pancreatic fistula (presence of air at fluid along pancreaticojejunostomy [PJ]), abscess (fluid collection with an enhancing rim or gas), fluid along hepaticojejunostomy or PJ, the density of ascites, and the size of visible gastroduodenal artery (GDA) stump. CT findings including pancreatic fistula, abscess, and large GDA stump were associated with PPH on univariate analysis ( p ≤ 0.009). On multivariate analysis, radiological features suggestive of a pancreatic fistula, abscess, and a GDA stump > 4.45 mm were associated with PPH ( p ≤ 0.031). Early postoperative CT findings including GDA stump size larger than 4.45 mm, fluid collection with an enhancing rim or gas, and air at fluid along PJ, could predict late PPH.

  14. The Preboreal-like Asian monsoon climate in the early last interglacial period recorded from the Dark Cave, Southwest China

    Science.gov (United States)

    Jiang, Xiuyang; He, Yaoqi; Wang, Xiaoyan; Sun, Xiaoshuang; Hong, Hui; Liu, Juan; Yu, Tsai-Luen; Li, Zhizhong; Shen, Chuan-Chou

    2017-08-01

    Transitions of glacial-interglacial cycles are critical periods for Quaternary climate shifts. Here, we present new, decadal resolution Asian summer monsoon (ASM) record from three stalagmites obtained from the Dark Cave in southwestern China over 130-114 thousand years ago (ka, before CE 1950). Chronology was anchored by 28 230Th dates with typical uncertainties of ±0.3-1.0 kyr, allowing an assessment of timing and transition of climate changes during the onset and end of the last interglacial. An agreement between this new and previous stalagmite δ18O records supports that summer insolation predominates orbital-scale ASM evolution. A 2-3 kyr-long gradually increasing ASM period, analogous to the classical Preboreal episode in the early Holocene, follows the termination of a weak monsoon interval at 129.0 ± 0.8 ka. This finding suggests a strong influence of high-latitude ice-sheet dynamics on Asian monsoonal conditions during the early interglacial period. An abrupt end of the marine isotope stage 5e at 118.8 ± 0.6 ka was probably caused by the internal climate system threshold effects.

  15. Late Archaic–Early Formative period microbotanical evidence for potato at Jiskairumoko in the Titicaca Basin of southern Peru

    Science.gov (United States)

    Rumold, Claudia Ursula

    2016-01-01

    The data presented in this paper provide direct microbotanical evidence concerning the early use of potato (Solanum tuberosum) within its botanical locus of origin in the high south-central Andes. The data derive from Jiskairumoko, an early village site in the western Titicaca Basin dating to the Late Archaic to Early Formative periods (∼3,400 cal y BC to 1,600 cal y BC). Because the site reflects the transition to sedentism and food production, these data may relate to potato domestication and early cultivation. Of 141 starch microremains recovered from 14 groundstone tools from Jiskairumoko, 50 are identified as consistent with cultivated or domesticated potato, based on reference to published materials and a study of wild and cultivated potato starch morphology. Along with macro- and microbotanical evidence for chenopod consumption and grinding tool data reflecting intensive use of this technology throughout site occupation, the microbotanical data reported here suggest the intensive exploitation, if not cultivation, of plant resources at Jiskairumoko. Elucidating the details of the trajectory of potato domestication is necessary for an overall understanding of the development of highland Andean agriculture, as this crop is central to the autochthonous agricultural suite. A paucity of direct botanical evidence, however, has hindered research efforts. The results of the modern and archaeological starch analyses presented here underscore the utility of this method in addressing questions related to the timing, mode, and context of potato origins. PMID:27849582

  16. Late Archaic-Early Formative period microbotanical evidence for potato at Jiskairumoko in the Titicaca Basin of southern Peru.

    Science.gov (United States)

    Rumold, Claudia Ursula; Aldenderfer, Mark S

    2016-11-29

    The data presented in this paper provide direct microbotanical evidence concerning the early use of potato (Solanum tuberosum) within its botanical locus of origin in the high south-central Andes. The data derive from Jiskairumoko, an early village site in the western Titicaca Basin dating to the Late Archaic to Early Formative periods (∼3,400 cal y BC to 1,600 cal y BC). Because the site reflects the transition to sedentism and food production, these data may relate to potato domestication and early cultivation. Of 141 starch microremains recovered from 14 groundstone tools from Jiskairumoko, 50 are identified as consistent with cultivated or domesticated potato, based on reference to published materials and a study of wild and cultivated potato starch morphology. Along with macro- and microbotanical evidence for chenopod consumption and grinding tool data reflecting intensive use of this technology throughout site occupation, the microbotanical data reported here suggest the intensive exploitation, if not cultivation, of plant resources at Jiskairumoko. Elucidating the details of the trajectory of potato domestication is necessary for an overall understanding of the development of highland Andean agriculture, as this crop is central to the autochthonous agricultural suite. A paucity of direct botanical evidence, however, has hindered research efforts. The results of the modern and archaeological starch analyses presented here underscore the utility of this method in addressing questions related to the timing, mode, and context of potato origins.

  17. A new anti-microbial combination prolongs the latency period, reduces acute histologic chorioamnionitis as well as funisitis, and improves neonatal outcomes in preterm PROM.

    Science.gov (United States)

    Lee, JoonHo; Romero, Roberto; Kim, Sun Min; Chaemsaithong, Piya; Park, Chan-Wook; Park, Joong Shin; Jun, Jong Kwan; Yoon, Bo Hyun

    2016-03-01

    Antibiotic administration is a standard practice in preterm premature rupture of membranes (PROM). Specific anti-microbial agents often include ampicillin and/or erythromycin. Anaerobes and genital mycoplasmas are frequently involved in preterm PROM, but are not adequately covered by antibiotics routinely used in clinical practice. Our objective was to compare outcomes of PROM treated with standard antibiotic administration versus a new combination more effective against these bacteria. A retrospective study compared perinatal outcomes in 314 patients with PROM 23 ng/mL). (1) Patients treated with regimen 2 had a longer median antibiotic-to-delivery interval than those with regimen 1 [median (interquartile range) 23 d (10-51 d) versus 12 d (5-52 d), p acute histologic chorioamnionitis (50.5% versus 66.7%, p hemorrhage (IVH) and cerebral palsy (CP) were significantly lower in patients allocated to regimen 2 than regimen 1 (IVH: 2.1% versus 19.0%, p acute histologic chorioamnionitis/funisitis, and improved neonatal outcomes in patients with preterm PROM. These findings suggest that the combination of anti-microbial agents (ceftriaxone, clarithromycin, and metronidazole) may improve perinatal outcome in preterm PROM.

  18. Semantic Wavelet-Induced Frequency-Tagging (SWIFT Periodically Activates Category Selective Areas While Steadily Activating Early Visual Areas.

    Directory of Open Access Journals (Sweden)

    Roger Koenig-Robert

    Full Text Available Primate visual systems process natural images in a hierarchical manner: at the early stage, neurons are tuned to local image features, while neurons in high-level areas are tuned to abstract object categories. Standard models of visual processing assume that the transition of tuning from image features to object categories emerges gradually along the visual hierarchy. Direct tests of such models remain difficult due to confounding alteration in low-level image properties when contrasting distinct object categories. When such contrast is performed in a classic functional localizer method, the desired activation in high-level visual areas is typically accompanied with activation in early visual areas. Here we used a novel image-modulation method called SWIFT (semantic wavelet-induced frequency-tagging, a variant of frequency-tagging techniques. Natural images modulated by SWIFT reveal object semantics periodically while keeping low-level properties constant. Using functional magnetic resonance imaging (fMRI, we indeed found that faces and scenes modulated with SWIFT periodically activated the prototypical category-selective areas while they elicited sustained and constant responses in early visual areas. SWIFT and the localizer were selective and specific to a similar extent in activating category-selective areas. Only SWIFT progressively activated the visual pathway from low- to high-level areas, consistent with predictions from standard hierarchical models. We confirmed these results with criterion-free methods, generalizing the validity of our approach and show that it is possible to dissociate neural activation in early and category-selective areas. Our results provide direct evidence for the hierarchical nature of the representation of visual objects along the visual stream and open up future applications of frequency-tagging methods in fMRI.

  19. Neonatal mucolipidosis 2. The spontaneous evolution of early bone lesions and the effect of vitamin D treatment

    International Nuclear Information System (INIS)

    Pazzaglia, U.E.; Zatti, G.; Pagani, G.

    1989-01-01

    Evolution of the early bone lesions in two children with mucolipidosis 2 was followed from birth. The progression of the bone changes did not differ from healing of rickets. Low levels of 1,25-OH 2 -D3 were found in one child and he was treated with vitamin D; resolution of the rachitic changes was more rapid than in the untreated child. It is suggested that in mucolipidosis 2 bone reacts to two independent factors, one controlling calcium metabolism, the other depending on the primary lysosomal enzyme defect. Since ricket-like features are not present in the other mucolipidoses or mucopolysaccharidoses, the defect of calcium metabolism seems to be related to the specific enzyme defect of mucolipidosis 2. (orig.)

  20. The Specific Features of an Early Period after Minimally Invasive Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    V. A. Shmyrev

    2014-01-01

    Full Text Available Objective: to comparatively evaluate the perioperative clinical period in patients operated on via miniinvasive access and median sternotomy.Subjects and methods. A retrospective analysis included all patients who had undergone correction of mitral valve defect with or without tricuspid valve correction and atrial ablation. 121 and 112 patients were operated on through miniinvasive access (a study group and median sternothomy (a control group, respectively.Results. The duration (median [25; 75 percentiles] of aortic occlusion in the study group (89 [71; 120] min was significantly longer than that in the control group (65 [52; 84] min; р<0.01. Acute heart failure complicated the clinical course in 28 (23.1% and 15 (13.4% cases in the study and control groups, respectively; р=0.06. In the miniinvasiveaccess group, two deaths were caused by intraoperative aortic dissection. There was no significant difference in the length of stay in the intensive care unit and in that of hospitalization between the groups.Conclusion. The findings are generally correlated with the world data obtained while implementing the procedure. The frequency and pattern of complications due to miniinvasive correction of mitral valve defect require additional financial expenditures and human resources. It is necessary to analyze the longterm results of treatment for the reasonable evaluation of the efficiency and expediency of using this procedure.

  1. The radioimmunological determination of the insulin level in the early postnatal period of the pigs

    International Nuclear Information System (INIS)

    Nowak, J.; Staszak, B.; Slebodzinski, A.

    1980-01-01

    The insulin level determined by means of the radioimmunoassay, in piglets, 1 - 21 days of age revealed marked changes with age of the animals, as illustrated by the hormonal profiles. In general, the postnatal insuline profile was characterized by a quick rise in the serum hormone concentration - the postnatal hiperinsulinemia - observed already in some litters within the first 48 hours of life. The peak of the hormone concentration was followed by a decrease to a relatively constant but low level, between the third day and 10 - 14 day. In the absolute terms, the insulin concentration at 0 - 6 hours averaged from 3.3+-1.42 to 11.0+-1.44 μU/ml and then increased to the maximum from 19.8+-1.44 to 30.3+-8.81 μU/ml (means +- S.E., p<0.01) found between 12 - 36 hour of life. In some of the pigs a low or a high insulin level came by turns. Any insulin level above 16 μU/ml was classified as ''an insulin peak'' and that below 8 μU/ml as ''an insulin depression''. The frequency of the peaks and the depressions per day was the highest during the first 2 days of life, that is during the period known from the highest mortality in this species. The preliminary observation suggest that a high frequency of the insulin depressions is somewhat related to the lower vitality or to the hypoglycemia state. (author)

  2. CYTOMORPHOLOGICAL EVALUATION AND PROGNOSIS OF BRONCHOPULMONARY COMPLICATIONS IN ACUTE AND EARLY PERIODS OF SPINAL CORD TRAUMA

    Directory of Open Access Journals (Sweden)

    I.A. Norkin

    2009-09-01

    Full Text Available There were investigated 50 cytological preparations after fibro-optic bronchoscopy of 10 patients with cervical spinal cord injuries. The dynamics of broncho-pulmonary complications of spinal cord injuries was estimated on the basis of cytological broncho-alveolar lavage fluid investigations. In the work there were used clinico-neurologic methods, radiological (computer tomography and magnetic resonance imaging, endoscopic (fibro-optic bronchoscopy and cytomorphological investigations. Cytomorphological investigations of broncho-alveolar lavage fluid were carried out on the 3-4, 7, 14, 30th days. Cellular composition of the broncho-alveolar wash-out (endopulmonary cytogramme was estimated by calculation of more than 100 cells in 3 fields of the immersion microscope coverage. Quantitative changes of cellular elements were taken into account with respect to normal cell amount. The results were analyzed according to the average out method. Quantitative changes of inflammatory elements in endopulmonary cytogramme were determined by the degree of endobronchitic manifestations and were corresponding to clinico-radiological picture of development of broncho-pulmonary complications in different periods of spinal cord injury

  3. [The complex approach to the rehabilitation of post-stroke patients with movement disorders in the early rehabilitation period].

    Science.gov (United States)

    Khabirov, F A; Khaĭbullin, T I; Grigor'eva, O V

    2011-01-01

    We studied 110 patients, aged 34-71 years, in the early rehabilitation period after stroke who were admitted to a rehabilitation neurologic department of Kazan. The rehabilitation approach was based on the combination of several methods: kinesitherapy, transcranial magnetic stimulation and cerebrolysin treatment. This complex reanimation allowed to achieve the marked functional restoration of movement abilities in many cases that was correlated with the normalization of brain bioelectric activity (the increase of alpha-rhythm spectral power, the decrease of slow-wave EEG components). The combined use of these three methods was more effective than a combination of any two of them.

  4. Effects of Gentamicin on Urinary Electrolyte Excretion in Admitted Neonate

    Directory of Open Access Journals (Sweden)

    B. Falakolaflaki

    2008-01-01

    Full Text Available Introduction & Objective: Gentamicin is an aminoglycoside antibiotic widely used during the neonatal period. It is associated with nephrotoxic effects in neonates, including glomerular impairment and renal tubular dysfunction. Electrolyte balance is very important, especially in the sick premature neonate receiving aminoglycosides. The purpose of this study was early diagnosis of gentamicin nephrotoxicity. Materials & Methods: This quasi-experimental study was performed on 23 neonates (11 full – term and 12 preterm with suspected sepsis who were admitted and treated with gentamicin. Blood and urine samples were collected before infusion and on the 3rd day of treatment. Serum and urine concentration of Na, K, creatinine (Cr and urine concentration of Ca were measured. Then fractional excretion of Na and K were estimated. Ca excretion was estimated as the UCa/UCr ratio. Then the collected data were analyzed using SPSS package.Results: In all neonates, increase in fractional excretion of Na and UCa/UCr, in the 3rd day of treatment were observed as compared to those of before infusion (P=0.01 and P=0.02 respectively. Serum creatinine levels decreased in all patients. Serum level of electrolytes during therapy was normal.Conclusion: The results of this study clearly demonstrate an effect of gentamicin infusion on renal sodium and calcium excretion. These results may be of clinical importance especially for sick preterm neonates receiving treatment with gentamicin. These babies are usually salt-losers and are also more susceptible to early onset hypocalcemia. Gentamicin can aggravate these complications.

  5. Ictericia Neonatal

    OpenAIRE

    Blanco de la Fuente, María Isabel

    2014-01-01

    El motivo que ha llevado a la realización de este trabajo fin de grado sobre el tema de la ICTERICIA NEONATAL se debe a la elevada frecuencia de su aparición en la población. Un porcentaje elevado de RN la padecen al nacer siendo, en la mayor parte de los casos, un proceso fisiológico resuelto con facilidad debido a una inmadurez del sistema hepático y a una hiperproducción de bilirrubina. La ictericia neonatal es la pigmentación de color amarillo de la piel y mucosas en ...

  6. Micophenolat Mofetil Versus Azathioprine: Effects on Renal Graft Function in Early Posttransplant Period

    Directory of Open Access Journals (Sweden)

    Farid Ljuca

    2009-05-01

    Full Text Available All conventional immunosuppressive tree drugs-protocols are based on Cyclosporine; consisting of low doses of Cyclosporine (CsA, Azathioprine (AZA or Mycophenolate Mofetil (MMF and Prednisolone, AZA has been used in clinical transplantation for more than 30 years and was the first immunosuppres-sive agent to achieve widespread use in organ transplantation. MMF was introduced in clinical practice in 1995 after several clinical trials proved that it was more efficient than AZA for prevention of acute rejection episodes. Our aim was to evaluate influence of AZA and MMF on renal graft function in early post-transplant stage. Study recruited 74 patients who underwent kidney transplantation in University Clinical Centre Tuzla. All patients received CsA and corticosteroid-based immunosuppression, as a part of triple immunosuppressive regiment, 40 patients received AZA and 34 MMF. In order to assess renal graft function, following parameters were evaluated: glomerular filtration rate GFR (ml/min creatinine clearance (CrCl (ml/min, 24 h urine output (ml/day, and from the serum potassium, sodium, urea and creatinine (mmol/dm3. Significantly higher average values of 24 hour urine output were recorded during first seven postoperative days in patients receiving MMF compared to those treated with AZA. Serum creatinine values showed statistically significant decrease, starting with the second postoperative day, in MMF vs. AZA group (168,7±70,5 vs. 119,9±42,6; p<0,0007. GFR was significantly higher in MMF compared to the AZA group of patients. On the first post-transplant day CrCl was higher in AZA group (24,3±10 vs. 17,5±7,3; p=0,01, next six days situation is reversed CrCl is significantly higher in the MMF group (43,7±15 vs. 53, 4±22, 8 p=0,006. MMF vs. AZA therapy was associated with protective effect against worsening of renal function in first seven post-transplant days.

  7. Effect of the Nerve Growth Factor Mimetic GK-2 on Brain Structural and Functional State in the Early Postresuscitation Period

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    M. Sh. Avrushchenko

    2012-01-01

    Full Text Available Objective: to evaluate the efficacy of the nerve growth factor mimetic GK-2 used to improve the structural and functional state of the brain in the early postresuscitation period. Material and methods. Cardiac arrest was induced in mature male albino rats for 12 minutes, followed by resuscitation. The neurological state of the resuscitated animals was assessed by a scoring scale. On postresuscitation day 7, the density and composition of neuronal populations of Purkinje cells in the lateral cerebellar region and pyramidal neurons in the hippocampal CA1 sector were determined by a differential morphometric analysis. The results were statistically processed using the ANOVA method. Results. The use of GK-2 was found to accelerate neurological recovery in the resuscitated animals. On day 7 after 12-minute cardiac arrest, the resuscitated animals showed neuronal dystrophic changes and death in the neuronal populations highly susceptible to ischemia. It was shown that the systemic administration of the nerve growth factor mimetic GK-2 contributed to a reduction in the magnitude and depth of postresuscitation changes in the cerebellar Purkinje cells and prevented dystrophic changes in the pyramidal cells of the hippocampal CA1 sector. The findings suggest that GK-2 has a neuroprotective effect in the recovery period after total body ischemia. Conclusion. The results of this study indicate the efficiency of the systemic administration of the nerve growth factor mimetic GK-2 in improving the brain structural and functional state in the early postresuscitation period. This determines perspectives for the use of GK-2 to prevent and correct posthypoxic encephalopathies. Key words: the nerve growth factor mimetic GK-2, postresuscitation period, neuronal dystrophic changes and death, neurological status.

  8. Carotid chemoreceptor development and neonatal apnea.

    Science.gov (United States)

    MacFarlane, Peter M; Ribeiro, Ana P; Martin, Richard J

    2013-01-01

    The premature transition from fetal to neonatal life is accompanied by an immature respiratory neural control system. Most preterm infants exhibit recurrent apnea, resulting in repetitive oscillations in O(2) saturation (intermittent hypoxia, IH). Numerous factors are likely to play a role in the etiology of apnea including inputs from the carotid chemoreceptors. Despite major advances in our understanding of carotid chemoreceptor function in the early neonatal period, however, their contribution to the initiation of an apneic event and its eventual termination are still largely speculative. Recent findings have provided a detailed account of the postnatal changes in the incidence of hypoxemic events associated with apnea, and there is anecdotal evidence for a positive correlation with carotid chemoreceptor maturation. Furthermore, studies on non-human animal models have shown that chronic IH sensitizes the carotid chemoreceptors, which has been proposed to perpetuate the occurrence of apnea. An alternative hypothesis is that sensitization of the carotid chemoreceptors could represent an important protective mechanism to defend against severe hypoxemia. The purpose of this review, therefore, is to discuss how the carotid chemoreceptors may contribute to the initiation and termination of an apneic event in the neonate and the use of xanthine therapy in the prevention of apnea. Published by Elsevier B.V.

  9. 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

  10. Determinants of HIV-induced brain changes in three different periods of the early clinical course: A data mining analysis

    Directory of Open Access Journals (Sweden)

    Bokai Cao

    2015-01-01

    Full Text Available To inform an understanding of brain status in HIV infection, quantitative imaging measurements were derived at structural, microstructural and macromolecular levels in three different periods of early infection and then analyzed simultaneously at each stage using data mining. Support vector machine recursive feature elimination was then used for simultaneous analysis of subject characteristics, clinical and behavioral variables, and immunologic measures in plasma and CSF to rank features associated with the most discriminating brain alterations in each period. The results indicate alterations beginning in initial infection and in all periods studied. The severity of immunosuppression in the initial virus host interaction was the most highly ranked determinant of earliest brain alterations. These results shed light on the initial brain changes induced by a neurotropic virus and their subsequent evolution. The pattern of ongoing alterations occurring during and beyond the period in which virus is suppressed in the systemic circulation supports the brain as a viral reservoir that may preclude eradication in the host. Data mining capabilities that can address high dimensionality and simultaneous analysis of disparate information sources have considerable utility for identifying mechanisms underlying onset of neurological injury and for informing new therapeutic targets.

  11. Delayed diagnosis of childhood deafness: the value of false negatives in the Programme for Early Detection of Neonatal Hearing Loss.

    Science.gov (United States)

    Martínez-Pacheco, María C; Ferrán de la Cierva, Luis; García-Purriños, Francisco J

    Despite its importance, the existence of false negatives (patients who are told they hear well, but they have some degree of hipacusia) is rarely evaluated in programs for early detection of hearing loss. The aim of this study is to determine the variables that can lead to a delayed diagnosis, especially the existence of false negatives and the lack of registration of risk factors. A retrospective study of prevalence has been carried out, in which the medical records of children diagnosed with sensorineural hearing loss born within 2005 and 2012 in the health centers of study have been analyzed. Of the 32 children with sensorineural hearing loss, 16 passed the OAE, 12 did not passed the OAE, and in four they were not carried out. Of the children who passed the OAE, 57% have severe hearing loss. 66% of children with hearing loss presented a risk factor for hearing loss at birth, being the most frecuent family history of hearing loss, but only 7% of those with family history of hearing loss were included in the risk group. The results of the study indicate that the late diagnosis of hearing loss is related to the presence of false negatives to the OAE and the non-registration of risk factors. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  12. [Neonatal tumours and congenital malformations].

    Science.gov (United States)

    Berbel Tornero, O; Ortega García, J A; Ferrís i Tortajada, J; García Castell, J; Donat i Colomer, J; Soldin, O P; Fuster Soler, J L

    2008-06-01

    The association between pediatric cancer and congenital abnormalities is well known but, there is no exclusive data on the neonatal period and the underlying etiopathogenic mechanisms are unknown. First, to analyze the frequency of neonatal tumours associated with congenital abnormalities; and second, to comment on the likely etiopathogenic hypotheses of a relationship between neonatal tumours and congenital abnormalities. Historical series of neonatal tumours from La Fe University Children's Hospital in Valencia (Spain), from January 1990 to December 1999. Histological varieties of neonatal tumours and associated congenital abnormalities were described. A systematic review of the last 25 years was carried out using Medline, Cancerlit, Index Citation Science and Embase. The search profile used was the combination of "neonatal/congenital-tumors/cancer/neoplasms" and "congenital malformations/birth defects". 72 neonatal tumours were identified (2.8% of all pediatric cancers diagnosed in our hospital) and in 15 cases (20.8%) there was some associated malformation, disease or syndrome. The association between congenital abnormalities and neonatal tumours were: a) angiomas in three patients: two patients with congenital heart disease with a choanal stenosis, laryngomalacia; b) neuroblastomas in two patients: horseshoe kidney with vertebral anomalies and other with congenital heart disease; c) teratomas in two patients: one with cleft palate with vertebral anomalies and other with metatarsal varus; d) one tumour of the central nervous system with Bochdaleck hernia; e) heart tumours in four patients with tuberous sclerosis; f) acute leukaemia in one patient with Down syndrome and congenital heart disease; g) kidney tumour in one case with triventricular hydrocephaly, and h) adrenocortical tumour: hemihypertrophy. The publications included the tumours diagnosed in different pediatric periods and without unified criteria to classify the congenital abnormalities. Little data

  13. Accelerated radiochemotherapy in pancreatic cancer is not necessarily related to a pathologic pancreatic function decline in the early period

    International Nuclear Information System (INIS)

    Horst, Eckehard; Seidel, Matthias; Micke, Oliver; Ruebe, Christian; Glashoerster, Marco; Schaefer, Ulrich; Willich, Normann A.

    2002-01-01

    Purpose: To evaluate the functional effects of ionizing radiation in patients with unresectable pancreatic cancer in the early period after accelerated radiochemotherapy (ART). Methods and Materials: To analyze the exocrine component, the amino acid consumption test and fecal elastase 1 were performed in 13 patients immediately before and 4-8 weeks after ART. Pancreatic duct morphology was evaluated before therapy. Weight loss and clinical steatorrhea were recorded. Endocrine parameters were examined according to standardized criteria. Results: The relative change of the amino acid consumption test results and the median elastase concentration was 41.2% and 56.4%, respectively. Five patients still had normal test results after ART and 5 patients developed pathologic values. The median relative weight loss of the total body weight was 7.7% ± 4.5%. No steatorrhea occurred. Of the 5 patients with normal values, 3 had a mean organ dose of 41 Gy. The endocrine function measurements remained unchanged. Conclusion: Although a nominal reduction of exocrine function parameters occurred in most patients, ART was not necessarily related to a pathologic level in the early period. Diabetes was not established. The functional impairment that was existent in the patient population presumably contributed to the weight loss. Pancreatic enzyme preparations may also play a role in maintaining an anabolic state during and after radiochemotherapy

  14. Neonatal Jaundice

    DEFF Research Database (Denmark)

    Maimburg, Rikke Damkjær; Væth, Michael; Schendel, Diana

    2008-01-01

    In a previous study, we found that infants transferred to a neonatal ward after delivery had an almost twofold increased risk of being diagnosed with infantile autism later in childhood in spite of extensive controlling of obstetric risk factors. We therefore decided to investigate other reasons ...

  15. Estimation of efficiency of new local rehabilitation method at the early post-operative period after dental implantation

    Directory of Open Access Journals (Sweden)

    A. V. Pasechnik

    2017-01-01

      Summary Despite of success of dental implantation, there are often complications at the early post-operative period of implant placing associated with wound damage and aseptic inflammation. Purpose of the work is studying clinical efficiency of combined local application of new mucosal gel “Apior” and magnetotherapy at the early post-operative period after dental implantation. Combined local application of the mucosal gel “Apior” and pulsating low-frequency electromagnetic field in the complex medical treatment of patients after conducting an operation of setting dental implants favourably affects the common state of patients and clinical symptoms of inflammation in the area of operating wound. As compared with patients who had traditional anti-inflammatory therapy, the patients treated with local application of apigel and magnetoterapy had decline of edema incidence, of gingival mucosa hyperemia, of discomfort in the area of conducted operation. There occurred more rapid improvement of inflammation painfulness, which correlated with the improvement of hygienic state of oral cavity and promoted to prevention of bacterial content of damaged mucous surfaces. Estimation of microvasculatory blood stream by the method of ultrasonic doppler flowmetry revealed more rapid normalization of volume and linear high systole speed of blood stream in the periimplant tissues in case of use of new complex local rehabilitation method, that testified to the less pronounced inflammation of oral mucosa after the operation. The authors came to conclusion that the local application of the offered method of medical treatment of early post-operative complications of dental implantation reduces terms of renewal of structural-functional integrity of oral mucosa, helps in preventing development of inflammatory complications and strengthening endosseus implant. The inclusion in the treatment management of a new combined method of application of mucosal gel “Apior” and

  16. Morte neonatal precoce segundo complexidade hospitalar e rede SUS e não-SUS na Região Metropolitana de São Paulo, Brasil Early neonatal mortality according to level of hospital complexity in Greater Metropolitan São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Zilda Pereira da Silva

    2010-01-01

    Full Text Available O objetivo foi analisar o perfil dos recém-nascidos, mães e mortalidade neonatal precoce, segundo complexidade do hospital e vínculo com o Sistema Único de Saúde (SUS, na Região Metropolitana de São Paulo, Brasil. Estudo baseado em dados de nascidos vivos, óbitos e cadastro de hospitais. Para obter a tipologia de complexidade e o perfil da clientela, empregaram-se análise fatorial e de clusters. O SUS atende mais recém-nascidos de risco e mães com baixa escolaridade, pré-natal insuficiente e adolescentes. A probabilidade de morte neonatal precoce foi 5,6‰ nascidos vivos (65% maior no SUS, sem diferenças por nível de complexidade do hospital, exceto nos de altíssima (SUS e média (não-SUS complexidade. O diferencial de mortalidade neonatal precoce entre as duas redes é menor no grupo de recém-nascidos 2.500g. Há uma concentração de nascimentos de alto risco na rede SUS, contudo a diferença de mortalidade neonatal precoce entre a rede SUS e não-SUS é menor nesse grupo de recém-nascidos. Novos estudos são necessários para compreender melhor a elevada mortalidade de recém-nascidos > 2.500g no SUS.The aim of this study was to analyze the profile of newborns, mothers, and early neonatal mortality according to the hospital's complexity and affiliation (or lack thereof with the Unified National Health System (SUS in Greater Metropolitan São Paulo, Brazil. The study was based on data for live births, deaths, and hospital registries. Factor and cluster analysis were used to obtain the typology of hospital complexity and user profile. The SUS treats more high-risk newborns and mothers with low schooling, insufficient prenatal care, and teenage mothers. The probability of early neonatal death was 5.6‰ live births (65% higher in the SUS, with no significant differences by level of hospital complexity, except those with extremely high (SUS and medium (non-SUS complexity. The difference in early neonatal mortality between the

  17. [Group B streptococcal early-onset neonatal sepsis in the area of Barcelona (2004-2010). Analysis of missed opportunities for prevention].

    Science.gov (United States)

    Giménez, Montserrat; Sanfeliu, Isabel; Sierra, Montserrat; Dopico, Eva; Juncosa, Teresa; Andreu, Antonia; Lite, Josep; Guardià, Cèlia; Sánchez, Ferran; Bosch, Jordi

    2015-01-01

    To study the evolution of the incidence of early-onset neonatal sepsis (EOS) by Streptococcus agalactiae in the area of Barcelona and to analyze failure of compliance with the prevention protocol. A retrospective review was carried out on EOS cases in 8 Health-Care Centers in the Barcelona area between 2004 and 2010. Forty-nine newborns from 48 mothers were diagnosed with EOS. The incidence was 0.29‰ living newborns (0.18-0.47‰), with no significant differences in the fluctuations along the 7 years. The mortality rate was 8.16%. In 68.5% cases the maternal colonization studies were negative, and in 21% these studies were not performed. No risk factors were detected in 58.3% of pregnant women, and 22.9% of births were premature. In 58% of cases intra-partum antibiotic prophylaxis was not administered because it was not indicated, and in 42% due to failure to follow the protocol (3 strains were resistant to erythromycin). Resistance to clindamycin was 33.3%. The Streptococcus agalactiae serotypes more frequently isolated were iii, v, and ia. No significant changes were detected in the incidence of Streptococcus agalactiae EOS in the 7 years of the study. The increased sensitivity of screening methods with the use of molecular techniques, the performance of susceptibility testing of strains isolated from pregnant women, and the improvement of communication between Health-Care Centers, can contribute to a better implementation of the protocol, as well as to reduce the incidence of EOS. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  18. Effects of dry period length and dietary energy source on metabolic status and hepatic gene expression of dairy cows in early lactation

    NARCIS (Netherlands)

    Chen, J.C.; Gross, J.J.; Dorland, van H.A.; Remmelink, G.J.; Bruckmaier, R.M.; Kemp, B.; Knegsel, van A.T.M.

    2015-01-01

    In a prior study, we observed that cows with a 0-d dry period had greater energy balance and lower milk production compared with cows with a 30- or 60-d dry period in early lactation. The objective of the current study was to evaluate the influence of dry period length on metabolic status and

  19. Factors infleuncing neonatal septicaemia in Maiduguri, north ...

    African Journals Online (AJOL)

    BACKGROUND: Neonatal septicaemia is a leading cause of morbidity and mortality worldwide, especially in the tropics. The risk factors vary, and the clinical features of neonatal septicaemia may be vague and nonspecific, therefore a high index of suspicion is vital to early diagnosis and treatment. The aetiological agents ...

  20. Motives for early retirement of self-employed GPs in the Netherlands: a comparison of two time periods

    Directory of Open Access Journals (Sweden)

    Van Greuningen Malou

    2012-12-01

    Full Text Available Abstract Background The high cost of training and the relatively long period of training for physicians make it beneficial to stimulate physicians to retire later. Therefore, a better understanding of the link between the factors influencing the decision to retire and actual turnover would benefit policies designed to encourage later retirement. This study focuses on actual GP turnover and the determining factors for this in the Netherlands. The period 2003–2007 saw fewer GPs retiring from general practice than the period 1998–2002. In addition, GPs’ retirement age was higher in 2003–2007. For these two periods, we analysed work perception, objective workload and reasons for leaving, and related these with the probability that GPs would leave general practice at an early age. Methods In 2003, a first retrospective survey was sent to 520 self-employed GPs who had retired between 1998 and 2002. In 2008, the same survey was sent to 405 GPs who had retired between 2003 and 2007. The response rates were 60% and 54%, respectively. Analyses were done to compare work perception, objective workload, external factors and personal reasons for retiring. Results For both male and female GPs, work perception was different in the periods under scrutiny: both groups reported greater job satisfaction and a lower degree of emotional exhaustion in the later period, although there was no notable difference in subjective workload. The objective workload was lower in the second period. Moreover, most external factors and personal reasons that may contribute to the decision to retire were reported as less important in the second period. There was a stronger decrease in the probability that female GPs leave general practice within one year than for male GPs. This underscores the gender differences and the need for disaggregated data collection. Conclusions The results of this study suggest that the decrease in the probability of GPs leaving general practice

  1. Establishing the volatile profile of pig carcasses as analogues for human decomposition during the early postmortem period

    Directory of Open Access Journals (Sweden)

    P. Armstrong

    2016-02-01

    Full Text Available Following a mass disaster, it is important that victims are rapidly located as the chances of survival decrease greatly after approximately 48 h. Urban search and rescue (USAR teams may use a range of tools to assist their efforts but detector dogs still remain one of the most effective search tools to locate victims of mass disasters. USAR teams can choose to deploy human scent dogs (trained to locate living victims or human remains detection (HRD dogs (trained to locate deceased victims. However, little is known about the variation between live human scent and postmortem human remains scent and the timeframe during which one type of scent transitions to the other. The aim of the current study was to measure the change in the scent profile of human decomposition analogues during the first 72 h postmortem by measuring the volatile organic compounds (VOCs that comprise the odour. Three pig carcasses (Sus scrofa domesticus L. were placed on a soil surface and allowed to decompose under natural conditions. Decomposition odour was sampled frequently up to 75 h postmortem and analysed using comprehensive two-dimensional gas chromatography – time-of-flight mass spectrometry (GC×GC-TOFMS. A total of 105 postmortem VOCs were identified during the early postmortem period. The VOC profile during the early postmortem period was highly dynamic, changing both hourly and daily. A transition period was observed after 43 h postmortem, where the VOC profile appeared to shift from a distinct antemortem odour to a more generalised postmortem odour. These findings are important in informing USAR teams and their use of detector dogs for disaster victim recovery.

  2. Period doubling cascades of limit cycles in cardiac action potential models as precursors to chaotic early Afterdepolarizations.

    Science.gov (United States)

    Kügler, Philipp; Bulelzai, M A K; Erhardt, André H

    2017-04-04

    Early afterdepolarizations (EADs) are pathological voltage oscillations during the repolarization phase of cardiac action potentials (APs). EADs are caused by drugs, oxidative stress or ion channel disease, and they are considered as potential precursors to cardiac arrhythmias in recent attempts to redefine the cardiac drug safety paradigm. The irregular behaviour of EADs observed in experiments has been previously attributed to chaotic EAD dynamics under periodic pacing, made possible by a homoclinic bifurcation in the fast subsystem of the deterministic AP system of differential equations. In this article we demonstrate that a homoclinic bifurcation in the fast subsystem of the action potential model is neither a necessary nor a sufficient condition for the genesis of chaotic EADs. We rather argue that a cascade of period doubling (PD) bifurcations of limit cycles in the full AP system paves the way to chaotic EAD dynamics across a variety of models including a) periodically paced and spontaneously active cardiomyocytes, b) periodically paced and non-active cardiomyocytes as well as c) unpaced and spontaneously active cardiomyocytes. Furthermore, our bifurcation analysis reveals that chaotic EAD dynamics may coexist in a stable manner with fully regular AP dynamics, where only the initial conditions decide which type of dynamics is displayed. EADs are a potential source of cardiac arrhythmias and hence are of relevance both from the viewpoint of drug cardiotoxicity testing and the treatment of cardiomyopathies. The model-independent association of chaotic EADs with period doubling cascades of limit cycles introduced in this article opens novel opportunities to study chaotic EADs by means of bifurcation control theory and inverse bifurcation analysis. Furthermore, our results may shed new light on the synchronization and propagation of chaotic EADs in homogeneous and heterogeneous multicellular and cardiac tissue preparations.

  3. LONG-ORBITAL-PERIOD PREPOLARS CONTAINING EARLY K-TYPE DONOR STARS. BOTTLENECK ACCRETION MECHANISM IN ACTION

    International Nuclear Information System (INIS)

    Tovmassian, G.; González–Buitrago, D.; Zharikov, S.; Reichart, D. E.; Haislip, J. B.; Ivarsen, K. M.; LaCluyze, A. P.; Moore, J. P.; Miroshnichenko, A. S.

    2016-01-01

    We studied two objects identified as cataclysmic variables (CVs) with periods exceeding the natural boundary for Roche-lobe-filling zero-age main sequence (ZAMS) secondary stars. We present observational results for V1082 Sgr with a 20.82 hr orbital period, an object that shows a low luminosity state when its flux is totally dominated by a chromospherically active K star with no signs of ongoing accretion. Frequent accretion shutoffs, together with characteristics of emission lines in a high state, indicate that this binary system is probably detached, and the accretion of matter on the magnetic white dwarf takes place through stellar wind from the active donor star via coupled magnetic fields. Its observational characteristics are surprisingly similar to V479 And, a 14.5 hr binary system. They both have early K-type stars as donor stars. We argue that, similar to the shorter-period prepolars containing M dwarfs, these are detached binaries with strong magnetic components. Their magnetic fields are coupled, allowing enhanced stellar wind from the K star to be captured and channeled through the bottleneck connecting the two stars onto the white dwarf’s magnetic pole, mimicking a magnetic CV. Hence, they become interactive binaries before they reach contact. This will help to explain an unexpected lack of systems possessing white dwarfs with strong magnetic fields among detached white+red dwarf systems

  4. LONG-ORBITAL-PERIOD PREPOLARS CONTAINING EARLY K-TYPE DONOR STARS. BOTTLENECK ACCRETION MECHANISM IN ACTION

    Energy Technology Data Exchange (ETDEWEB)

    Tovmassian, G.; González–Buitrago, D.; Zharikov, S. [Instituto de Astronomía, Universidad Nacional Autónoma de México, Apartado Postal 877, Ensenada, Baja California, 22800 México (Mexico); Reichart, D. E.; Haislip, J. B.; Ivarsen, K. M.; LaCluyze, A. P.; Moore, J. P. [Department of Physics and Astronomy, University of North Carolina at Chapel Hill, Campus Box 3255, Chapel Hill, NC 27599 (United States); Miroshnichenko, A. S., E-mail: gag@astro.unam.mx, E-mail: dgonzalez@astro.unam.mx, E-mail: zhar@astro.unam.mx [Department of Physics and Astronomy, University of North Carolina at Greensboro, Greensboro, NC 27402-6170 (United States)

    2016-03-01

    We studied two objects identified as cataclysmic variables (CVs) with periods exceeding the natural boundary for Roche-lobe-filling zero-age main sequence (ZAMS) secondary stars. We present observational results for V1082 Sgr with a 20.82 hr orbital period, an object that shows a low luminosity state when its flux is totally dominated by a chromospherically active K star with no signs of ongoing accretion. Frequent accretion shutoffs, together with characteristics of emission lines in a high state, indicate that this binary system is probably detached, and the accretion of matter on the magnetic white dwarf takes place through stellar wind from the active donor star via coupled magnetic fields. Its observational characteristics are surprisingly similar to V479 And, a 14.5 hr binary system. They both have early K-type stars as donor stars. We argue that, similar to the shorter-period prepolars containing M dwarfs, these are detached binaries with strong magnetic components. Their magnetic fields are coupled, allowing enhanced stellar wind from the K star to be captured and channeled through the bottleneck connecting the two stars onto the white dwarf’s magnetic pole, mimicking a magnetic CV. Hence, they become interactive binaries before they reach contact. This will help to explain an unexpected lack of systems possessing white dwarfs with strong magnetic fields among detached white+red dwarf systems.

  5. Anatomy in Cologne--Institutional development and body supply from the Weimar Republic to the early post-war period.

    Science.gov (United States)

    Kaiser, Stephanie; Gross, Dominik

    2015-07-01

    The Anatomical Institute of the University of Cologne was founded in 1925. This paper highlights its institutional development and the sources from which it procured bodies for dissection. A comparison is drawn between the first years of the institute's existence during the Weimar Republic (1925-1932) and its rebuilding after war damage in the early post-war period (1947-1954). The institute and its procurement of bodies have not previously been investigated for these two time periods. The Third Reich, for which a detailed study already exists, will be mentioned as well to allow better evaluation of the periods before and after National Socialism. Based on newly evaluated archival material and body journals which will be examined both quantitatively and qualitatively, it becomes apparent that the Cologne institute experienced a chronic shortage of bodies both during the Weimar Republic and the first post-war decade (even though the delivery facilities were mostly the same). However, the situation of the institute in terms of structure, organization and personnel as well as body supply in the aftermath of World War II proved much more challenging than during the time of the Weimar Republic. Copyright © 2015 Elsevier GmbH. All rights reserved.

  6. An audit of some health facilities and equipment for neonatal ...

    African Journals Online (AJOL)

    Background: Neonatal Mortality rates continue to be high in spite of the general decline in under-5 mortality rates in Nigeria. Available evidence has shown that the availability of a skilled birth attendant and equipment for basic neonatal resuscitation is necessary for the prevention of early neonatal death which accounts for ...

  7. Neonatal perforated Amyand's hernia presenting as an enterocutaneous scrotal fistula

    Directory of Open Access Journals (Sweden)

    Antonios Panagidis

    2015-07-01

    Full Text Available Perforation of the vermiform appendix in a septic neonate with an Amyand's hernia resulted in the formation of a scrotal enterocutaneous fistula. In conclusion from this exceptional complication, active parental awareness for any neonatal scrotal swelling is required, and an early operative policy for the neonatal inguinal hernia is significant.

  8. Is the Predictability of New-Onset Postpartum Depression Better During Pregnancy or in the Early Postpartum Period? A Prospective Study in Croatian Women.

    Science.gov (United States)

    Nakić Radoš, Sandra; Herman, Radoslav; Tadinac, Meri

    2016-01-01

    The researchers' aim was to examine whether it was better to predict new-onset postpartum depression (PPD) during pregnancy or immediately after childbirth. A prospective study conducted in Croatia followed women (N = 272) from the third trimester of pregnancy through the early postpartum period (within the first 3 postpartum days), to 6 weeks postpartum. Questionnaires on depression, anxiety, stress, coping, self-esteem, and social support were administered. Through regression analyses we showed that PPD symptoms could be equally predicted by variables from pregnancy (30.3%) and the early postpartum period (34.0%), with a small advantage of PPD prediction in the early postpartum period.

  9. The early postnatal period: Exploring women's views, expectations and experiences of care using focus groups in Victoria, Australia

    Directory of Open Access Journals (Sweden)

    Rayner Jo

    2008-07-01

    Full Text Available Abstract Background There is growing evidence from Australia and overseas that the care provided in hospital in the early postnatal period is less than ideal for both women and care providers. Many health services face increasing pressure on hospital beds and have limited physical space available to care for mothers and their babies. We aimed to gain a more in-depth understanding of women's views, expectations and experiences of early postnatal care. Methods We conducted focus groups in rural and metropolitan Victoria, Australia in 2006. Fifty-two people participated in eight focus groups and four interviews. Participants included eight pregnant women, of whom seven were pregnant with their first baby; 42 women who were in the postpartum period (some up to twelve months after the birth of their baby; and two partners. All participants were fluent in English. Focus group guides were developed specifically for the study and explored participants' experiences and/or expectations of early postnatal care in hospital and at home, with an emphasis on length of hospital stay, professional and social support, continuity of care, and rest. Discussions were audio-taped and transcribed verbatim. A thematic network was constructed to describe and connect categories with emerging basic, organizing, and global themes. Results Global themes that emerged were: anxiety and/or fear; and the transition to motherhood and parenting. The needs of first time mothers were considered to be different to the needs of women who had already experienced motherhood. The women in this study were generally concerned about the safety of their new baby, and lacked confidence in themselves as new mothers regarding their ability to care for their baby. There was a consistent view that the physical presence and availability of professional support helped alleviate these concerns, and this was especially the case for women having a first baby. Conclusion Women have anxieties and fears

  10. Effects of brief daily periods of unrestricted vision during early monocular form deprivation on development of visual area 2.

    Science.gov (United States)

    Zhang, Bin; Tao, Xiaofeng; Wensveen, Janice M; Harwerth, Ronald S; Smith, Earl L; Chino, Yuzo M

    2011-09-14

    Providing brief daily periods of unrestricted vision during early monocular form deprivation reduces the depth of amblyopia. To gain insights into the neural basis of the beneficial effects of this treatment, the binocular and monocular response properties of neurons were quantitatively analyzed in visual area 2 (V2) of form-deprived macaque monkeys. Beginning at 3 weeks of age, infant monkeys were deprived of clear vision in one eye for 12 hours every day until 21 weeks of age. They received daily periods of unrestricted vision for 0, 1, 2, or 4 hours during the form-deprivation period. After behavioral testing to measure the depth of the resulting amblyopia, microelectrode-recording experiments were conducted in V2. The ocular dominance imbalance away from the affected eye was reduced in the experimental monkeys and was generally proportional to the reduction in the depth of amblyopia in individual monkeys. There were no interocular differences in the spatial properties of V2 neurons in any subject group. However, the binocular disparity sensitivity of V2 neurons was significantly higher and binocular suppression was lower in monkeys that had unrestricted vision. The decrease in ocular dominance imbalance in V2 was the neuronal change most closely associated with the observed reduction in the depth of amblyopia. The results suggest that the degree to which extrastriate neurons can maintain functional connections with the deprived eye (i.e., reducing undersampling for the affected eye) is the most significant factor associated with the beneficial effects of brief periods of unrestricted vision.

  11. Early enrichment effects on brain development in hatchery-reared Atlantic salmon (Salmo salar): no evidence for a critical period

    DEFF Research Database (Denmark)

    Näslund, Joacim; Aarestrup, Kim; Thomassen, Søren T.

    2012-01-01

    was released into nature and recaptured at smoltification. These stream-reared smolts developed smaller brains than the hatchery reared smolts, irrespective of initial enrichment treatment. These novel findings do not support the hypothesis that there is a critical early period determining the brain growth...... trajectory. In contrast, our results indicate that brain growth is plastic in relation to environment. In addition, we show allometric growth in brain substructures over juvenile development, which suggests that comparisons between groups of different body size should be made with caution. These results can......In hatcheries, fish are normally reared in barren environments, which have been reported to affect their phenotypic development compared with wild conspecifics. In this study, Atlantic salmon (Salmo salar) alevins were reared in conventional barren hatchery trays or in either of two types...

  12. Neonatal mortality in Bavaria during 1972 to 1990

    International Nuclear Information System (INIS)

    Irl, C.; Schoetzau, A.; Steinhilber, B.; Grosche, B.; Jahraus, H.; Santen, E. van.

    1993-03-01

    The present report deals with the neonatal mortality in Bavaria during 1972 to 1990, the last period of which coincided with the reactor accident of Chernobyl. The question arose whether there was an increase in neonatal mortality in the more heavily exposed regions of Bavaria as an aftermath to this accident. The results of the study may be summarized as follows: During the period of interest there was a decrease in neonatal mortality in the Federal Republic of Germany (former Federal Lands) and in Bavaria from 22 permille (1972) to less than one third of this value. With a mortality rate of 6.2 permille . Bavaria was below the Federal average of 7.1 permille . in 1990. This decrease is mainly due to a decline in early mortality. Mortality during the first year of life was higher in male than in female infants. 57% of the deceased infants were male, 43% female. The spatial distribution of neonatal mortality in Bavaria showed large regional differences. Following standardisation of the raw data the lowest value of a rural district averaged over the 19 years covered was 7.1 permille , the highest being 21 permille . When the infant mortality rates of regions in Southern Bavaria which were defined as being more heavily exposed to radiation after the Chernobyl accident (> 30 kBq/m 2 Cs- 137), no statistically significant difference was detected for any of the year between 1980 to 1990. Similarly, no statistical correlation could be found between neonatal mortality and proximity of the residence to one of the five sites of nuclear reactors in Bavaria. Out of the further environmental variables included in the study the factors 'urbanity' and 'unemployment' showed a statistical correlation with the infant mortality rate. Over the entire study period (1972 to 1990) the infant mortality rate was found to be significantly increased in towns (constituting administrative districts of their own) compared to rural districts. (orig./MG) [de

  13. Two Neonates with Congenital Hydrocolpos

    Directory of Open Access Journals (Sweden)

    Vydehi Murthy

    2013-01-01

    Full Text Available Introduction. Neonatal hydrocolpos is a rare condition. Hydrocolpos is cystic dilatation of the vagina with fluid accumulation due to a combination of stimulation of secretary glands of the reproductive tract and vaginal obstruction. The differential for a neonatal presentation of lower abdominal mass includes urogenital anomalies, Hirschsprung’s, disease or sacrococcygeal teratoma. Prenatal diagnosis and early newborn imaging studies leads to early detection and treatment of these cases. Case. We report here two cases of neonatal hydrocolpos with prenatal diagnosis of lower abdominal mass. Postnatally, ultrasound, MRI imaging, and cystoscopy confirmed large cystic mass as hydrocolpos with distal vaginal obstruction. Both patients had enlarged renal system secondary to mass effect. Conclusion. High index of suspicion for hydrocolpos in a newborn presenting with fetal diagnosis of infraumbilical abdominal mass will facilitate timely intervention and prevention of complications.

  14. Neonatal Kraniefraktur

    DEFF Research Database (Denmark)

    Johannesen, Katrine Marie Harries; Stantchev, Hristo

    2015-01-01

    During the latest decades the incidence of birth traumas has decreased significantly. Even so the traumas still contribute to an increased mortality and morbidity. We present a case of spontaneous neonatal skull fracture following a normal vaginal delivery. Abnormal facial structure was seen, and......, and the fracture was identified with an MRI. The fractures healed without neurosurgical intervention. Case reports show that even in uncomplicated vaginal deliveries skull fractures can be seen and should be suspected in children with facial abnormalities....

  15. CLINICAL AND IMMUNOLOGICAL FEATURES OF KIDNEY TRANSPLANT RECIPIENTS WITH CYTOMEGALOVIRUS INFECTION MANIFESTATION IN THE EARLY POSTOPERATIVE PERIOD

    Directory of Open Access Journals (Sweden)

    L. V. Limareva

    2013-01-01

    Full Text Available Aim. To optimize the management of postoperative renal allograft recipients through the introduction of methods for predicting risk of manifestation of cytomegalovirus infection on the basis of a comprehensive assessment of the clinical and immunological status. Materials and methods. We retrospectively analyzed the medical records of 303 patients with end-stage renal disease, among them – were the recipients of renal allograft – 136, among whom 29 within 2 months after the operation had clinical signs of CMV infection. Assessable "CMV syndrome", laboratory evidence of CMV infection, the incidence of antigens (genes of HLA A, B and DRB *1, calculated goodness of fit χ2 and relative risk RR, changes MCP-1 in urine. Results. In renal allograft recipients with clinical and laboratory evidence of CMV infection in the early postoperative period, significantly more (χ2 > 3,8 met antigen B35. A positive association with CMV infection was detected also for DRB1 * 08, B21, B22, B41, A24 (9, B51 (5, DRB1*14 and DRB1*15. Protective effects possessed antigens / alleles of genes A26 (10, B14, B38 (16 B61 (40 and DRB1*16. MCP-1 levels in this group of recipients were raised to 2174,7 ± 296,3 pg/ml with a strong negative correlation with the levels of urea and creatinine in serum (r = 0,9, p < 0.001. Conclusion. Immunological markers of risk manifestation of CMV infection in recipients of kidneys in the early postoperative period are: the carriage of В35 и В55,56(22, В49(21, В41, DRB1*08 и DRB1*15, an increase of levels of MCP-1 in urine without increasing the levels of urea and creatinine in the serum. 

  16. Using CT perfusion during the early baseline period in aneurysmal subarachnoid hemorrhage to assess for development of vasospasm

    International Nuclear Information System (INIS)

    Sanelli, Pina C.; Jou, Austin; Reichman, Melissa; Greenberg, Edward; Cayci, Zuzan; Gold, Rachel; John, Majnu; Ugorec, Igor; Rosengart, Axel

    2011-01-01

    The aim of this study is to evaluate computed tomography perfusion (CTP) during admission baseline period (days 0-3) in aneurysmal subarachnoid hemorrhage (A-SAH) for development of vasospasm. Retrospective analysis was performed on A-SAH patients from Dec 2004 to Feb 2007 with CTP on days 0-3. Cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) maps were analyzed for qualitative perfusion deficits. Quantitative analysis was performed using region-of-interest placement to obtain mean CTP values. Development of vasospasm was determined by a multistage hierarchical reference standard incorporating both imaging and clinical criteria. Student's t test and threshold analysis were performed. Seventy-five patients were included, 37% (28/75) were classified as vasospasm. Mean CTP values in vasospasm compared to no vasospasm groups were: CBF 31.90 ml/100 g/min vs. 39.88 ml/100 g/min (P < 0.05), MTT 7.12 s vs. 5.03 s (P < 0.01), and CBV 1.86 ml/100 g vs. 2.02 ml/100 g (P = 0.058). Fifteen patients had qualitative perfusion deficits with 73% (11/15) developed vasospasm. Optimal threshold for CBF is 24-25 mL/100 g/min with 91% specificity and 50% sensitivity, MTT is 5.5 s with 70% specificity and 61% sensitivity and CBV is 1.7 mL/100 g with 89% specificity and 36% sensitivity. These initial results support our hypothesis that A-SAH patients who develop vasospasm may demonstrate early alterations in cerebral perfusion, with statistically significant CBF reduction and MTT prolongation. Overall, CTP has high specificity for development of vasospasm. Future clinical implications include using CTP during the baseline period for early identification of A-SAH patients at high risk for vasospasm to prompt robust preventative measures and treatment. (orig.)

  17. Developmental Thyroid Hormone Insufficiency Reduces Expression of Brain-Derived Neurotrophic Factor (BDNF) in Adults But Not in Neonates

    Science.gov (United States)

    Brain-derived neurotrophic factor (BDNF) is a neurotrophin critical for many developmental and physiological aspects of CNS function. Severe hypothyroidism in the early neonatal period results in developmental and cognitive impairments and reductions in mRNA and protein expressio...

  18. Tei index in neonatal respiratory distress and perinatal asphyxia

    OpenAIRE

    Ahmed Anwer Attia Khattab

    2015-01-01

    Cardiovascular compromise is a common complication of neonatal respiratory distress and perinatal asphyxia. Tei index is a Doppler-derived index for the assessment of overall left ventricular function that combines systolic and diastolic time intervals. Aim: Assess the role of MPI versus cardiac troponin I as early indicator of hypoxic cardiac damage in neonates with respiratory distress or perinatal asphyxia. The present work was conducted on forty neonates, 15 with neonatal respiratory dist...

  19. Barbarians in the City: Burials of the Germans in the Urban Cemeteries of Northern Illyricum in the Early Byzantine Period

    Directory of Open Access Journals (Sweden)

    Miсhеl Kazanskiy

    2017-11-01

    Full Text Available In this paper we consider the topography of the burials of the Early Byzantine period (5th – 6th centuries, containing in their inventory items of German origin found in some cities of Northern Illyricum, whose necropolises were subjected to extensive excavations: Sirmium, Singidunum, Viminacium (present-day Northern Serbia. Two different types of burial places with German objects were witnessed on these city burials: isolated burials on cemeteries common to the whole population and separate cemeteries with the predominance of the German element. It can be assumed that these different types of organization of the funerary space correspond to different forms of settling of barbarians in the cities of the northern borderland of the Late Roman / Early Byzantine Illyricum. The barbarous presence in the urban burial context is very slight. In Syrmium, which repeatedly fell under the power of the barbarians (priests, gepids, a few barbarous burials were committed in cemeteries, which belonged mainly to the Roman city population, which indicates a fairly deep integration of the outgoing barbarians into the urban late-antique environment. In Singidunum and Viminacium, the frontier fortresses on the Danube, special “barbarian” cemeteries stand out, since the barbarians settled here were primarily a military force, that is, a separate social group with its own structure. It is also possible that unlike Sirmium, where archaeological traces of the presence of the Roman population are clearly revealed, barbarian mercenaries and their families accounted for a numerical majority in the garrison towns of the Danube borderland.

  20. Early life adversity during the infant sensitive period for attachment: Programming of behavioral neurobiology of threat processing and social behavior

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    Maya Opendak

    2017-06-01

    Full Text Available Animals, including humans, require a highly coordinated and flexible system of social behavior and threat evaluation. However, trauma can disrupt this system, with the amygdala implicated as a mediator of these impairments in behavior. Recent evidence has further highlighted the context of infant trauma as a critical variable in determining its immediate and enduring consequences, with trauma experienced from an attachment figure, such as occurs in cases of caregiver-child maltreatment, as particularly detrimental. This review focuses on the unique role of caregiver presence during early-life trauma in programming deficits in social behavior and threat processing. Using data primarily from rodent models, we describe the interaction between trauma and attachment during a sensitive period in early life, which highlights the role of the caregiver’s presence in engagement of attachment brain circuitry and suppressing threat processing by the amygdala. These data suggest that trauma experienced directly from an abusive caregiver and trauma experienced in the presence of caregiver cues produce similar neurobehavioral deficits, which are unique from those resulting from trauma alone. We go on to integrate this information into social experience throughout the lifespan, including consequences for complex scenarios, such as dominance hierarchy formation and maintenance.

  1. Early childhood development when second-trimester ultrasound dating disagrees with last menstrual period: a prospective cohort study

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    Grewal Jagteshwar

    2012-04-01

    Full Text Available Abstract Background When an ultrasound-based estimate of gestational age (GA is less (greater than an estimate based on a definite last menstrual period, the fetus may grow slower (faster than average. While the association between these discrepancies in GA estimates and adverse perinatal outcomes has been examined extensively, there is scant evidence about long-term effects, such as child neurodevelopment. Methods Using data from a prospective cohort study titled, NICHD Study of Successive Small-for-Gestational Age Births, we examined if GA discrepancies in early second trimester of pregnancy (17 weeks’ gestation are associated with: (1 impaired motor and mental function at 13 months (measured using Bayley Scales of Infant Development (Bayley, and (2 impaired cognitive development at five years (assessed by Wechsler Preschool and Primary Scale of Intelligence – Revised Intelligence Quotient (WPPSI-R in the infant. The study population consisted of 572 (30% of the overall sample of 1,945 women who presented for prenatal care in Norway and Sweden between 1986 and 1988. Results Our results showed that GA discrepancies in early second trimester are significantly associated with birthweight. We found no significant relationship, however, with the Bayley development scores at 13 months and with the WPPSI-R IQ measures at five years. Conclusions GA discrepancies at 17 weeks’ gestation are not associated child neurodevelopment. These discrepancies do, however, relate to birthweights, providing a basis for detecting fetal growth patterns early in the second trimester of pregnancy. Our study, however, was unable to evaluate the impact of first-trimester discrepancies on impaired neurodevelopment in the infant.

  2. Colonización por estreptococo beta hemolítico del grupo b durante el embarazo y prevención de enfermedad neonatal Group B streptococcus colonization during pregnancy and prevention of early onset of disease

    Directory of Open Access Journals (Sweden)

    José Sad Larcher

    2005-06-01

    Full Text Available El estreptococo beta-hemolítico del grupo B (SGB es uno de los principales agentes causantes de sepsis neonatal precoz. La mortalidad de los afectados oscila entre el 6 y el 20%, y la tasa de secuela neurológica llega al 30%. En 1996 el Centro de Prevención y Control de Enfermedades de Atlanta, el Colegio Americano de Obstetras y Ginecólogos y la Academia Americana de Pediatría sugirieron en consenso que el personal de atención de salud materna-neonatal debía adoptar una estrategia para la prevención de la sepsis por este germen. Los objetivos del presente trabajo prospectivo fueron determinar el porcentaje de colonización por SGB en las pacientes gestantes asistidas del 1° de julio de 2001 al 31 de diciembre de 2002 e implementar un programa de prevención de sepsis neonatal precoz por SGB a través de profilaxis antibiótica intraparto basado en cultivos. Sobre 1756 pacientes, se realizaron cultivos con hisopado vaginal y anal a 1228 (69.9%. El porcentaje de colonización materna por SGB fue del 1.4% (17 pacientes. Se presentó un caso de sepsis neonatal compatible con SGB (0.6‰ en una madre con cultivo negativo. Sólo una paciente portadora de SGB presentó factores de riesgo. Los resultados nos sugieren continuar con la estrategia de prevención basada en cultivos debido a que la mayoría de las pacientes colonizadas no presentaron factores de riesgo. Son necesarios estudios de relación costo-beneficio en nuestro medio para definir si esta estrategia de prevención es aplicable a la realidad sanitaria argentina.Group B Streptococcus (GBS is the most frequent cause of early onset of neonatal sepsis. Case-fatality rate is 6-20% for newborns. Neurological sequel occurs in 30% of survivors. In 1996, the Centers for Disease Control and Prevention (CDC, the American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics recommended that obstetrics providers should adopt either a culture-based or a risk

  3. Trepanation in South-Central Peru during the early late intermediate period (ca. AD 1000-1250).

    Science.gov (United States)

    Kurin, Danielle S

    2013-12-01

    This study evaluates trepanations from five well-contextualized prehistoric sites in the south-central highlands of Andahuaylas, Peru. The emergence of trepanation in this region coincides with the collapse of the Wari Empire, ca. ad 1000. Thirty-two individuals from Andahuaylas, AMS radiocarbon dated to the early Late Intermediate Period (ca. ad 1000-1250), were found to have 45 total trepanations. Various surgical techniques were being employed concurrently throughout the region. Scraping trepanations evinced the highest survival rate; circular grooving, drilling and boring, and linear cutting were far less successful. Evidence of perioperative procedures like hair shaving, poultice application, and possible cranioplasty use aimed to ensure the survival of a trepanation recipient. Postmortem trepanations, also present in Andahuaylas, were likely executed on corpses as a means of better understanding cranial anatomy and improving techniques. Similarities in trepanation patterns throughout the region attest to common motivations to engage in surgery. Although moderate physical head trauma seems to be the impetus for intervention in many cases of trepanation, other motivations included physiological and possibly psychosomatic factors. Nevertheless, treatment was not for everyone. In Andahuaylas, trepanations were withheld from subadults, females, and those individuals who practiced cranial modification. Copyright © 2013 Wiley Periodicals, Inc.

  4. System and method for implementing periodic early discard in on-chip buffer memories of network elements

    Science.gov (United States)

    Francini, Andrea

    2013-05-14

    An advance is made over the prior art in accordance with the principles of the present invention that is directed to a new approach for a system and method for a buffer management scheme called Periodic Early Discard (PED). The invention builds on the observation that, in presence of TCP traffic, the length of a queue can be stabilized by selection of an appropriate frequency for packet dropping. For any combination of number of TCP connections and distribution of the respective RTT values, there exists an ideal packet drop frequency that prevents the queue from over-flowing or under-flowing. While the value of the ideal packet drop frequency may quickly change over time and is sensitive to the series of TCP connections affected by past packet losses, and most of all is impossible to compute inline, it is possible to approximate it with a margin of error that allows keeping the queue occupancy within a pre-defined range for extended periods of time. The PED scheme aims at tracking the (unknown) ideal packet drop frequency, adjusting the approximated value based on the evolution of the queue occupancy, with corrections of the approximated packet drop frequency that occur at a timescale that is comparable to the aggregate time constant of the set of TCP connections that traverse the queue.

  5. Efficacy of drainage blood reinfusion in early postoperative period after total hip arthroplasty in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    N B Shelokova

    2008-01-01

    Full Text Available To study effect of drainage blood reinfusion in early postoperative period (EPP after total hip arthroplasty (THA in patients with rheumatoid arthritis (RA. Material and methods. Primary THA was performed in 51 RA pts with hip damage (49 female, 2 male aged from 26 to 68 years. 42 THA were performed with “Endosystems and Implants” (ESI endoprosthesis, and 21 — with “Mathys” endoprosthesis. The pts were divided into two groups. Standard infusion-transfusion therapy with donor blood components was performed in group 1 pts (n=26 to compensate blood loss in EPP. In group 2 pts (n=25 drainage blood reinfusion was done with active aspiration system Handy Vac TM ATS (Unomedical. Group 1 pts had more prominent circulatory and neurologic disturbances in EPP: hypodynamic variant of circulation with elevation of peripheral vascular resistance till 5-7 day of postoperative period, prominent hypersympathicotonia and a large number of posttransfusion reactions. Evaluation of hemodynamic and vegetative disturbances showed advantage of blood loss compensation and vegetative disturbances normalization with drainage blood reinfusion in EPP after THA in comparison with standard pts management.

  6. Effect of healthcare associated infections and broad spectrum antibiotic use in newborn period on development of asthma, allergic rhinitis and atopic dermatitis in early childhood

    Directory of Open Access Journals (Sweden)

    Hacer Yapicioglu Yildizdas

    2017-03-01

    Full Text Available Purpose: The iam of this study was to investigate the effect of healthcare associated infections (HAIs and broad spectrum antibiotic use in newborn period on asthma, allergic rhinitis and atopic dermatitis. Material and Methods: Seventy three children treated for HAIs in newborn period in Neonatal Intesive Care Unitin a 6 years period, and their 41 siblings who were healthy in newborn period were included in the study. Parents answered a detailed questionnaire, children were examined and complete blood count, serum total Ig E and specific Ig E levels were studied. Results: Ventilator associated pneumonia was observed in 32 (45.2%, blood stream infection in 28 (38.4% and clinic sepsis in 12 (16.4% of 73 children with HAIs. Asthma was significantly higher in HAIs group compared to sibling group (32.9% vs. 4.9, whereas there was no significant difference in allergic rhinitis (4.1% vs.2.4% and atopic dermatitis (6.8% vs. 0% among groups. When non-allergic 85 subjects and allergic 29 children compared, children who had been hospitalised and treated with broad-spectrum antibiotics in newborn period were almost 11.5 times as likely to have an allergic disease. Conclusion: Asthma was significantly higher in HAI group, and allergic disease risk seems to increase in children treated with broad-spectrum antibiotics for HAIs in newborn period. [Cukurova Med J 2017; 42(1.000: 132-139

  7. The Relation Between the View on the Language and Educational Ideology in the Early Meiji Period in Japan Through the Discourse of Regionalism

    Directory of Open Access Journals (Sweden)

    Yufuko ICHIMIYA

    2011-05-01

    Full Text Available In this article, the Japanese language situation in early Meiji period will be analysed from the viewpoint of the provinces. In concrete terms, the origin of the idea that "an opaque language yields an unlcear ideology" – we can often find such a discourse through Meiji, Taisho and early Showa period – will be searched for by using primary sources in northern Kyushu, the southern part of Japan. This kind of idea can be seen in the writings of teachers and professors. Consequently, educational theories and teaching methods which had spread over the country in that period will be clues to analyse this subject. Moreover, I will try to compare the concept of "opaque language" in the Taisho period, during which dialects were considered as the representative example of such a language, with what was considered "opaque language" in the early Meiji period, when the definition of dialect and the concrete form of the standard language were still vague.

  8. Neurological status in severely jaundiced Zimbabwean neonates

    NARCIS (Netherlands)

    Wolf, M. J.; Beunen, G.; Casaer, P.; Wolf, B.

    1998-01-01

    Neurological status was studied in 50 jaundiced infants with a total serum bilirubin of > 400 mumol/l (23.4 mg/dl). Infants were assessed in the neonatal period with the Neonatal Neurological Examination and 4 months of age with the Infant Motor Screen. Twenty-six (52 per cent) infants were

  9. Neonatal malaria complicated by hypoglycaemia and ...

    African Journals Online (AJOL)

    There is no established and widely accepted guidelines for clinical management of severe neonatal malaria. The aim of this paper is to raise the alertness of physicians regarding the occurrence of severe malaria in the neonatal period and to describe the treatment modality we adopted (in the absence of an internationally ...

  10. Effect of provision of an integrated neonatal survival kit and early cognitive stimulation package by community health workers on developmental outcomes of infants in Kwale County, Kenya: study protocol for a cluster randomized trial.

    Science.gov (United States)

    Pell, Lisa G; Bassani, Diego G; Nyaga, Lucy; Njagi, Isaac; Wanjiku, Catherine; Thiruchselvam, Thulasi; Macharia, William; Minhas, Ripudaman S; Kitsao-Wekulo, Patricia; Lakhani, Amyn; Bhutta, Zulfiqar A; Armstrong, Robert; Morris, Shaun K

    2016-09-08

    Each year, more than 200 million children under the age of 5 years, almost all in low- and middle-income countries (LMICs), fail to achieve their developmental potential. Risk factors for compromised development often coexist and include inadequate cognitive stimulation, poverty, nutritional deficiencies, infection and complications of being born low birthweight and/or premature. Moreover, many of these risk factors are closely associated with newborn morbidity and mortality. As compromised development has significant implications on human capital, inexpensive and scalable interventions are urgently needed to promote neurodevelopment and reduce risk factors for impaired development. This cluster randomized trial aims at evaluating the impact of volunteer community health workers delivering either an integrated neonatal survival kit, an early stimulation package, or a combination of both interventions, to pregnant women during their third trimester of pregnancy, compared to the current standard of care in Kwale County, Kenya. The neonatal survival kit comprises a clean delivery kit (sterile blade, cord clamp, clean plastic sheet, surgical gloves and hand soap), sunflower oil emollient, chlorhexidine, ThermoSpot(TM), Mylar infant sleeve, and a reusable instant heater. Community health workers are also equipped with a portable hand-held electric scale. The early cognitive stimulation package focuses on enhancing caregiver practices by teaching caregivers three key messages that comprise combining a gentle touch with making eye contact and talking to children, responsive feeding and caregiving, and singing. The primary outcome measure is child development at 12 months of age assessed with the Protocol for Child Monitoring (Infant and Toddler version). The main secondary outcome is newborn mortality. This study will provide evidence on effectiveness of delivering an innovative neonatal survival kit and/or early stimulation package to pregnant women in Kwale County

  11. Amnioinfusion in very early preterm prelabor rupture of membranes (AMIPROM): pregnancy, neonatal and maternal outcomes in a randomized controlled pilot study.

    Science.gov (United States)

    Roberts, D; Vause, S; Martin, W; Green, P; Walkinshaw, S; Bricker, L; Beardsmore, C; Shaw, N; McKay, A; Skotny, G; Williamson, P; Alfirevic, Z

    2014-05-01

    To assess short- and long-term outcomes of pregnant women with very early rupture of membranes randomized to serial amnioinfusion or expectant management, and to collect data to inform a larger, more definitive clinical trial. This was a prospective non-blinded randomized controlled trial with randomization stratified for pregnancies in which the membranes ruptured between 16 + 0 and 19 + 6 weeks' gestation and 20 + 0 and 23 + 6 weeks' gestation to minimize the risk of random imbalance in gestational age distribution between randomized groups. Intention-to-treat analysis was used. The study was conducted in four UK hospital-based fetal medicine units (Liverpool Women's NHS Trust, St Mary's Hospital Manchester, Birmingham Women's NHS Foundation Trust and Wirral University Hospitals Trust). The participants were women with confirmed preterm prelabor rupture of membranes at 16 + 0 to 24 + 0 weeks' gestation. Women with multiple pregnancy, fetal abnormality or obstetric indication for immediate delivery were excluded. Participants were randomly allocated to either serial weekly transabdominal amnioinfusions if the deepest pool of amniotic fluid was amnioinfusion and 28 to expectant management) recruited between 2002 and 2009. There was no significant difference in perinatal mortality (19/28 vs 19/28; relative risk (RR) 1.0 (95% CI, 0.70-1.43)) and maternal or neonatal morbidity. The overall chance of surviving without long-term respiratory or neurodevelopmental disability was 4/56 (7.1%); 4/28 (14.3%) in the amnioinfusion group and 0/28 in the expectant group (RR 9.0 (95% CI, 0.51-159.70)). This pilot study found no major differences in maternal, perinatal or pregnancy outcomes. The study was not designed to show a difference between the groups and the number of survivors was too small to draw any conclusions about long-term outcomes. It does, however, signal that a larger definitive study to evaluate amnioinfusion for improvement in healthy

  12. Implementation of a cost-effective strategy to prevent neonatal early-onset group B haemolytic streptococcus disease in the Netherlands.

    Science.gov (United States)

    Kolkman, Diny G E; Rijnders, Marlies E B; Wouters, Maurice G A J; van den Akker-van Marle, M Elske; van der Ploeg, Cpb Kitty; de Groot, Christianne J M; Fleuren, Margot A H

    2013-07-30

    Early-onset Group B haemolytic streptococcus infection (EOGBS) is an important cause of neonatal morbidity and mortality in the first week of life. Primary prevention of EOGBS is possible with intra-partum antibiotic prophylaxis (IAP.) Different prevention strategies are used internationally based on identifying pregnant women at risk, either by screening for GBS colonisation and/or by identifying risk factors for EOGBS in pregnancy or labour. A theoretical cost-effectiveness study has shown that a strategy with IAP based on five risk factors (risk-based strategy) or based on a positive screening test in combination with one or more risk factors (combination strategy) was the most cost-effective approach in the Netherlands. IAP for all pregnant women with a positive culture in pregnancy (screening strategy) and treatment in line with the current Dutch guideline (IAP after establishing a positive culture in case of pre-labour rupture of membranes or preterm birth and immediate IAP in case of intra-partum fever, previous sibling with EOGBS or GBS bacteriuria), were not cost-effective. Cost-effectiveness was based on the assumption of 100% adherence to each strategy. However, adherence in daily practice will be lower and therefore have an effect on cost-effectiveness. The aims are to: a.) implement the current Dutch guideline, the risk-based strategy and the combination strategy in three pilot regions and b.) study the effects of these strategies in daily practice. Regions where all the care providers in maternity care implement the allocated strategy will be randomised. Before the introduction of the strategy, there will be a pre-test (use of the current guideline) involving 105 pregnant women per region. This will be followed by a post-test (use of the allocated strategy) involving 315 women per region. The outcome measures are: 1.) adherence to the specific prevention strategy and the determinants of adherence among care providers and pregnant women, 2.) outcomes

  13. RISK FACTORS IN NEONATAL ANAEROBIC INFECTIONS

    Directory of Open Access Journals (Sweden)

    M. S. Tabib

    2008-06-01

    Full Text Available Anaerobic bacteria are well known causes of sepsis in adults but there are few studies regarding their role in neonatal sepsis. In an attempt to define the incidence of neonatal anaerobic infections a prospective study was performed during one year period. A total number of 400 neonates under sepsis study were entered this investigation. Anaerobic as well as aerobic cultures were sent. The patients were subjected to comparison in two groups: anaerobic culture positive and anaerobic culture negative and this comparison were analyzed statistically. There were 7 neonates with positive anaerobic culture and 35 neonates with positive aerobic culture. A significant statistical relationship was found between anaerobic infections and abdominal distention and pneumonia. It is recommended for those neonates with abdominal distention and pneumonia refractory to antibiotic treatment to be started on antibiotics with anaerobic coverage.

  14. Impact of exposure to cooking fuels on stillbirths, perinatal, very early and late neonatal mortality - a multicenter prospective cohort study in rural communities in India, Pakistan, Kenya, Zambia and Guatemala.

    Science.gov (United States)

    Patel, Archana B; Meleth, Sreelatha; Pasha, Omrana; Goudar, Shivaprasad S; Esamai, Fabian; Garces, Ana L; Chomba, Elwyn; McClure, Elizabeth M; Wright, Linda L; Koso-Thomas, Marion; Moore, Janet L; Saleem, Sarah; Liechty, Edward A; Goldenberg, Robert L; Derman, Richard J; Hambidge, K Michael; Carlo, Waldemar A; Hibberd, Patricia L

    2015-01-01

    Consequences of exposure to household air pollution (HAP) from biomass fuels used for cooking on neonatal deaths and stillbirths is poorly understood. In a large multi-country observational study, we examined whether exposure to HAP was associated with perinatal mortality (stillbirths from gestation week 20 and deaths through day 7 of life) as well as when the deaths occurred (macerated, non-macerated stillbirths, very early neonatal mortality (day 0-2) and later neonatal mortality (day 3-28). Questions addressing household fuel use were asked at pregnancy, delivery, and neonatal follow-up visits in a prospective cohort study of pregnant women in rural communities in five low and lower middle income countries participating in the Global Network for Women and Children's Health's Maternal and Newborn Health Registry. The study was conducted between May 2011 and October 2012. Polluting fuels included kerosene, charcoal, coal, wood, straw, crop waste and dung. Clean fuels included electricity, liquefied petroleum gas (LPG), natural gas and biogas. We studied the outcomes of 65,912 singleton pregnancies, 18 % from households using clean fuels (59 % LPG) and 82 % from households using polluting fuels (86 % wood). Compared to households cooking with clean fuels, there was an increased risk of perinatal mortality among households using polluting fuels (adjusted relative risk (aRR) 1.44, 95 % confidence interval (CI) 1.30-1.61). Exposure to HAP increased the risk of having a macerated stillbirth (adjusted odds ratio (aOR) 1.66, 95%CI 1.23-2.25), non-macerated stillbirth (aOR 1.43, 95 % CI 1.15-1.85) and very early neonatal mortality (aOR 1.82, 95 % CI 1.47-2.22). Perinatal mortality was associated with exposure to HAP from week 20 of pregnancy through at least day 2 of life. Since pregnancy losses before labor and delivery are difficult to track, the effect of exposure to polluting fuels on global perinatal mortality may have previously been underestimated. Clinical

  15. Spectrum Of Congenital Heart Disease In Full Term Neonates.

    Science.gov (United States)

    Bibi, Saima; Hussain Gilani, Syed Yasir; Bibi, Shawana

    2018-01-01

    Congenital heart disease is a significant problem world over especially in neonates. Early diagnosis and prompt interventions in neonatal period precludes the mortality associated with this disorder. The objective of this study was to highlight the diversity of congenital cardiac defects in our region so that appropriate interventions are devised to minimize significant morbidity and mortality associated with this disorder. This descriptive cross-sectional study was conducted at the Neonatology Unit of Department of Paediatrics, Ayub Teaching Hospital from January 2015 to December 2016. Approval of ethical committee was taken. All fullterm neonates of either gender who presented in department of neonatology including those delivered in hospital or received from other sources (private settings, home deliveries), diagnosed as having congenital heart disease on echocardiography were included in the study. Preterm neonates of either gender were excluded from the study. Patient characteristics were recorded in a designed proforma. Data was entered in SPSS version 20 and analysed. A total of 89 neonates were included in the study. Mean age of presentation was 6.34±7.058 days and range of 1-28 days. There was a male preponderance with 57 (64%) male patients as compared to 32 (36%) female patients. Ventricular septal defect (VSD) was the commonest cardiac lesion being present in 34 (38.2%) patients. Other defects included complex congenital heart disease in 8 (9%), atrial septal defect (ASD) and transposition of great arteries (TGA) in 7 (7.9%) each, atrioventricular septal defect (AVSD) in 6 (6.7%) and Fallots's tetralogy (TOF) and hypoplastic left heart syndrome in 5 (5.6%) each.. Congenital heart disease is a problem of profound importance. It constitutes approximately one third of the total major congenital malformations. There is a diversity of cardiac lesions in our region that warrant early and prompt interventions so that the disease is recognized and treated at

  16. A Pediatrician’s Practical Guide to Diagnosing and Treating Hereditary Spherocytosis in Neonates

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    Yaish, Hassan M.; Gallagher, Patrick G.

    2015-01-01

    Newborn infants who have hereditary spherocytosis (HS) can develop anemia and hyperbilirubinemia. Bilirubin-induced neurologic dysfunction is less likely in these neonates if the diagnosis of HS is recognized and appropriate treatment provided. Among neonates listed in the USA Kernicterus Registry, HS was the third most common underlying hemolytic condition after glucose-6-phosphate dehydrogenase deficiency and ABO hemolytic disease. HS is the leading cause of direct antiglobulin test (direct Coombs) negative hemolytic anemia requiring erythrocyte transfusion in the first months of life. We anticipate that as physicians become more familiar with diagnosing HS in the newborn period, fewer neonates with HS will develop hazardous hyperbilirubinemia or present to emergency departments with unanticipated symptomatic anemia. We predict that early suspicion, prompt diagnosis and treatment, and anticipatory guidance will prevent adverse outcomes in neonates with HS. The purpose of this article was to review the neonatal presentation of HS and to provide practical and up-to-date means of diagnosing and treating HS in neonates. PMID:26009624

  17. Neonatal infection produces significant changes in immune function with no associated learning deficits in juvenile rats.

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    Osborne, Brittany F; Caulfield, Jasmine I; Solomotis, Samantha A; Schwarz, Jaclyn M

    2017-10-01

    The current experiments examined the impact of early-life immune activation and a subsequent mild immune challenge with lipopolysaccharide (LPS; 25µg/kg) on hippocampal-dependent learning, proinflammatory cytokine expression in the brain, and peripheral immune function in juvenile male and female rats at P24, an age when hippocampal-dependent learning and memory first emerges. Our results indicate that neonatal infection did not produce learning deficits in the hippocampal-dependent context pre-exposure facilitation effect paradigm in juvenile males and females, contrary to what has been observed in adults. Neonatal infection produced an increase in baseline IL-1β expression in the hippocampus (HP) and medial prefrontal cortex (mPFC) of juvenile rats. Furthermore, neonatally infected rats showed exaggerated IL-1β expression in the HP following LPS treatment as juveniles; and juvenile females, but not males, showed exaggerated IL-1β expression in the mPFC following LPS treatment. Neonatal infection attenuated the production of IL-6 expression following LPS treatment in both the brain and the spleen, and neonatal infection decreased the numbers of circulating white blood cells in juvenile males and females, an effect that was further exacerbated by subsequent LPS treatment. Together, our data indicate that the consequences of neonatal infection are detectable even early in juvenile development, though we found no concomitant hippocampal-dependent learning deficits at this young age. These findings underscore the need to consider age and associated on-going neurodevelopmental processes as important factors contributing to the emergence of cognitive and behavioral disorders linked to early-life immune activation. © 2017 Wiley Periodicals, Inc. Develop Neurobiol 77: 1221-1236, 2017. © 2017 Wiley Periodicals, Inc.

  18. Neonatal hemophilia: a rare presentation

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    Nuno Ferreira

    2015-12-01

    Full Text Available Hemophilia A is a X-linked hereditary condition that lead to decreased factor VIII activity, occurs mainly in males. Decreased factor VIII activity leads to increased risk of bleeding events. During neonatal period, diagnosis is made after post-partum bleeding complication or unexpected bleeding after medical procedures. Subgaleal hemorrhage during neonatal period is a rare, severe extracranial bleeding with high mortality and usually related to traumatic labor or coagulation disorders. Subgaleal hemorrhage complications result from massive bleeding. We present a neonate with unremarkable family history and uneventful pregnancy with a vaginal delivery with no instrumentation, presenting with severe subgaleal bleeding at 52 hours of life. Aggressive support measures were implemented and bleeding managed. The unexpected bleeding lead to a coagulation study and the diagnosis of severe hemophilia A. There were no known sequelae. This case shows a rare hemophilia presentation reflecting the importance of coagulation studies when faced with unexplained severe bleeding.

  19. The correlation between variation of visual acuity and the anterior chamber depth in the early period after phacoemulsification

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    Kai-jian CHEN

    2011-04-01

    Full Text Available Objective To investigate the correlation between the visual acuity variation and the anterior chamber depth in the early period after phacoemulsification.Methods Thirty-six eyes of 32 patients with age-related cataract underwent 3.2mm clear corneal incision phacoemulsification and intraocular lens(IOL implantation.The visual acuity was examined and horizontal curvature(K1,vertical curvature(K2,corneal astigmatism,and anterior chamber depth were measured with IOL-master preoperatively and also on 1,3,7 and 15 postoperative days.The changes in parameters were compared,and the correlations among visual acuity,corneal astigmatism and anterior chamber depth were analyzed.Results Before operation and 1d,3d,7d and 15d after operation,the corneal astigmatism was-0.87±0.40D,-1.92±1.38D,-1.69±1.13D,-1.45±0.79D and-1.36±0.74D;the anterior chamber depth was 3.08±0.35mm,4.04±0.38mm,4.28±0.29mm,4.22±0.17mm and 4.22±0.16mm;the visual acuity was 0.18±0.10,0.44±0.14,0.59±0.12,0.61±0.11 and 0.62±0.14.Significant difference was found between pre-operative and postoperative visual acuity,corneal astigmatism and anterior chamber depth,and it was also found in corneal astigmatism between 1d and 15d post operation(P < 0.05,as well as in anterior chamber depth and visual acuity between 1d and 3d post operation(P < 0.05.A positive correlation was found between visual acuity and corneal astigmatism on 1d(r=0.42,P < 0.05,3d(r=0.35,P < 0.05 and 7d(r=0.35,P < 0.05 post operation;and a negative correlation was found between visual acuity and anterior chamber depth on 3d(r=-0.29,P < 0.05,7d(r=-0.43,P < 0.01 and 15d(r=-0.37,P < 0.05 post operation.Conclusion Both the corneal astigmatism and the anterior chamber depth are correlated with the visual acuity variation in the early period after phacoemulsification.

  20. Effect of insulin-like growth factor-I during the early postnatal period in intrauterine growth-restricted rats.

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    Ikeda, Naho; Shoji, Hiromichi; Suganuma, Hiroki; Ohkawa, Natsuki; Kantake, Masato; Murano, Yayoi; Sakuraya, Koji; Shimizu, Toshiaki

    2016-05-01

    Insulin-like growth factor-I (IGF-I) is essential for perinatal growth and development; low serum IGF-I has been observed during intrauterine growth restriction (IUGR). We investigated the effects of recombinant human (rh) IGF-I in IUGR rats during the early postnatal period. Intrauterine growth restriction was induced by bilateral uterine artery ligation in pregnant rats. IUGR pups were divided into two groups injected daily with rhIGF-I (2 mg/kg; IUGR/IGF-I, n = 16) or saline (IUGR/physiologic saline solution (PSS), n = 16) from postnatal day (PND) 7 to 13. Maternal sham-operated pups injected with saline were used as controls (control, n = 16). Serum IGF-I and IGF binding proteins (IGFBP) 3 and 5 were measured on PND25. The expression of Igf-i, IGF-I receptor (Igf-ir), Igfbp3, and 5 mRNA in the liver and brain was measured using real-time polymerase chain reaction on PND25. Immunohistochemical staining of the liver for IGF expression was performed. Mean bodyweight on PND3 and PND25 in the IUGR pups (IUGR/IGF-I and IUGR/PSS) was significantly lower than that of the control pups. Serum IGF-I and hepatic Igf-ir mRNA in the IUGR pups were significantly lower than those in the control pups. In the IUGR/IGF-I group, hepatic Igfbp3 mRNA and liver immunohistochemical staining were increased. In the IUGR/PSS and control pups, there were no significant differences between these two groups in serum IGFBP3 and IGFBP5, hepatic Igf-i and Igfbp-5 mRNA, or brain Igf mRNA. No benefits on body and brain weight gain but an effective increase in hepatic IGFBP-3 was observed after treatment with 2 mg/kg rhIGF-I during the early postnatal period. © 2015 Japan Pediatric Society.

  1. Limitation of the Predominant-Period Estimator for Earthquake Early Warning and the Initial Rupture of Earthquakes

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    Yamada, T.; Ide, S.

    2007-12-01

    Earthquake early warning is an important and challenging issue for the reduction of the seismic damage, especially for the mitigation of human suffering. One of the most important problems in earthquake early warning systems is how immediately we can estimate the final size of an earthquake after we observe the ground motion. It is relevant to the problem whether the initial rupture of an earthquake has some information associated with its final size. Nakamura (1988) developed the Urgent Earthquake Detection and Alarm System (UrEDAS). It calculates the predominant period of the P wave (τp) and estimates the magnitude of an earthquake immediately after the P wave arrival from the value of τpmax, or the maximum value of τp. The similar approach has been adapted by other earthquake alarm systems (e.g., Allen and Kanamori (2003)). To investigate the characteristic of the parameter τp and the effect of the length of the time window (TW) in the τpmax calculation, we analyze the high-frequency recordings of earthquakes at very close distances in the Mponeng mine in South Africa. We find that values of τpmax have upper and lower limits. For larger earthquakes whose source durations are longer than TW, the values of τpmax have an upper limit which depends on TW. On the other hand, the values for smaller earthquakes have a lower limit which is proportional to the sampling interval. For intermediate earthquakes, the values of τpmax are close to their typical source durations. These two limits and the slope for intermediate earthquakes yield an artificial final size dependence of τpmax in a wide size range. The parameter τpmax is useful for detecting large earthquakes and broadcasting earthquake early warnings. However, its dependence on the final size of earthquakes does not suggest that the earthquake rupture is deterministic. This is because τpmax does not always have a direct relation to the physical quantities of an earthquake.

  2. Early motor outpatient service intervention for postural control in preterm neonates Intervenção motora precoce ambulatorial para neonatos prematuros no controle postural

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    Clarissa Balbão Almeida

    2008-12-01

    Full Text Available Objective: To insure the motor acquisitions related to the Axial Spontaneous Not Communicative Development, which means postural control and displacement. This was done through an early motor intervention physiotherapy program in preterm neonates born at HSL-PUCRS. Materials and Methods: the interventional program included tasks of visual harassment, toys manipulation and postural control, based on Bobath concept. All five preterms who have participated in the program were evaluated by the physiotherapy service, using The Brazilian Scale of Child behavior Development in the First Year of Life, in the beginning of the study and repeated every two months. Results: The study shows no statistical significant results in relation to postural tasks, dynamic balance and displacement. However, a progression in the preterm’s classification evaluations was demonstrated. In the first month of evaluation the median was 3 (regular classification and in the third and fifth month of evaluation the median maintained in 4 (good classification. Conclusion: The early motor intervention provided a progression in the evaluation`s classification of motor acquisitions of the preterms development, however, no statistical significant results related to postural tasks, dinamic balance and displacemen was shown.Objetivo: Verificar as aquisições motoras relacionadas ao desenvolvimento axial espontâneo não comunicativo, ou seja, controle postural e deslocamento. Isto foi feito através de um programa de intervenção motora fisioterapêutica precoce em neonatos prematuros nascidos no Hospital São Lucas - PUCRS. Materiais e Métodos: Tarefas de perseguição visual, manipulação de brinquedos e de controle postural, baseados no conceito Bobath, foram implementadas no programa interventivo. Todos os 5 prematuros que participaram deste estudo foram avaliados pelo serviço de fisioterapia por meio da Escala de Desenvolvimento do Comportamento da Criança no Primeiro Ano

  3. Early Life Exposure to Fructose Alters Maternal, Fetal and Neonatal Hepatic Gene Expression and Leads to Sex-Dependent Changes in Lipid Metabolism in Rat Offspring

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    Clayton, Zoe E.; Vickers, Mark H.; Bernal, Angelica; Yap, Cassandra; Sloboda, Deborah M.

    2015-01-01

    Aim Fructose consumption is associated with altered hepatic function and metabolic compromise and not surprisingly has become a focus for perinatal studies. We have previously shown that maternal fructose intake results in sex specific changes in fetal, placental and neonatal outcomes. In this follow-up study we investigated effects on maternal, fetal and neonatal hepatic fatty acid metabolism and immune modulation. Methods Pregnant rats were randomised to either control (CON) or high-fructose (FR) diets. Fructose was given in solution and comprised 20% of total caloric intake. Blood and liver samples were collected at embryonic day 21 (E21) and postnatal day (P)10. Maternal liver samples were also collected at E21 and P10. Liver triglyceride and glycogen content was measured with standard assays. Hepatic gene expression was measured with qPCR. Results Maternal fructose intake during pregnancy resulted in maternal hepatic ER stress, hepatocellular injury and increased levels of genes that favour lipogenesis. These changes were associated with a reduction in the NLRP3 inflammasome. Fetuses of mothers fed a high fructose diet displayed increased hepatic fructose transporter and reduced fructokinase mRNA levels and by 10 days of postnatal age, also have hepatic ER stress, and elevated IL1β mRNA levels. At P10, FR neonates demonstrated increased hepatic triglyceride content and particularly in males, associated changes in the expression of genes regulating beta oxidation and the NLRP3 inflammasome. Further, prenatal fructose results in sex-dependant changes in levels of key clock genes. Conclusions Maternal fructose intake results in age and sex-specific alterations in maternal fetal and neonatal free fatty acid metabolism, which may be associated in disruptions in core clock gene machinery. How these changes are associated with hepatic inflammatory processes is still unclear, although suppression of the hepatic inflammasome, as least in mothers and male neonates may

  4. Congenital hypothyroidism in neonates

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    Aneela Anjum

    2014-01-01

    Full Text Available Context: Congenital hypothyroidism (CH is one of the most common preventable causes of mental retardation in children and it occurs in approximately 1:2,000-1:4,000 newborns. Aims and Objectives: The aim of this study is to determine the frequency of CH in neonates. Settings and Design: This cross-sectional study was conducted in neonatal units of the Department of Pediatrics Unit-I, King Edward Medical University/Mayo Hospital, Lahore and Lady Willington Hospital Lahore in 6 months (January-June 2011. Materials and Methods: Sample was collected by non-probability purposive sampling. After consent, 550 newborn were registered for the study. Demographic data and relevant history was recorded. After aseptic measures, 2-3 ml venous blood analyzed for thyroid-stimulating hormone (TSH level by immunoradiometric assay. Treatment was started according to the individual merit as per protocol. Statistical Analysis Used: Data was analyzed by SPSS 17 and Chi-square test was applied to find out the association of CH with different variables. Results: The study population consisted of 550 newborns. Among 550 newborns, 4 (0.8% newborns had elevated TSH level. CH had statistically significant association with mother′s hypothyroidism (P value 0.000 and mother′s drug intake during the pregnancy period (P value 0.013. Conclusion: CH is 0.8% in neonates. It has statistically significant association with mother′s hypothyroidism and mother′s drug intake during pregnancy.

  5. Prediction of Mesiodistal Width of Unerupted Lateral Incisors, Canines and Premolars in Orthodontic Patients in Early Mixed Dentition Period

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    Mohammad Hossein Toodehzaeim

    2017-01-01

    Full Text Available Objectives: Proper diagnosis and prevention of malocclusion are superior to treatment. Discrepancy between arch length and tooth size in mixed dentition period is a condition requiring timely diagnosis. Estimating the mesiodistal width of unerupted teeth according to the size of erupted ones can lead to earlier diagnosis of malocclusion. On the other hand, the best timing for serial extractions is before the eruption of lateral incisors. The aim of this study was to present prediction formulas for mesiodistal width of unerupted lateral incisors, canines and premolars in an Iranian population based on the width of erupted permanent mandibular central incisors and maxillary first molars.Materials and Methods: A total of 120 dental models (60 males, 60 females of orthodontic patients between 11-25 years were evaluated in Yazd city. The measurements were made by a digital caliper on the widest mesiodistal width of teeth at the interproximal contacts. Data were analyzed to calculate the prediction equation.Results: The prediction equation in the upper jaw was y=0.57x+10.82 for males, y=0.7x+6.37 for females and y=0.64x+8.46 for both sexes. The equation for the lower jaw was y=0.76x+2.86 for males, y=0.74x+3.53 for females and y=0.77x+2.7 for both sexes.Conclusions: The prediction equations suggested in this study can predict the mesiodistal width of unerupted lateral incisors, canines and premolars in an Iranian population in early mixed dentition period without taking radiographs.Keywords: Dentition, Mixed; Dentition, Permanent; Tooth, Unerupted

  6. Neonatal hypoglycemia.

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    Straussman, Sharon; Levitsky, Lynne L

    2010-02-01

    Hypoglycemia in the newborn may be associated with both acute decompensation and long-term neuronal loss. Studies of the cause of hypoglycemic brain damage and the relationship of hypoglycemia to disorders associated with hyperinsulinism have aided in our understanding of this common clinical finding. A recent consensus workshop concluded that there has been little progress toward a precise numerical definition of neonatal hypoglycemia. Nonetheless, newer brain imaging modalities have provided insight into the relationship between neuronal energy deficiency and central nervous system damage. Laboratory studies have begun to reveal the mechanism of hypoglycemic damage. In addition, there is new information about hyperinsulinemic hypoglycemia of genetic, environmental, and iatrogenic origin. The quantitative definition of hypoglycemia in the newborn remains elusive because it is a surrogate marker for central nervous system energy deficiency. Nonetheless, the recognition that hyperinsulinemic hypoglycemia, which produces profound central nervous system energy deficiency, is most likely to lead to long-term central nervous system damage, has altered management of children with hypoglycemia. In addition, imaging studies on neonates and laboratory evaluation in animal models have provided insight into the mechanism of neuronal damage.

  7. Pneumomediastinum, Subcutaneous Emphysema, and Tracheal Tear in the Early Postoperative Period of Spinal Surgery in a Paraplegic Achondroplastic Dwarf

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    Sinan Kahraman

    2013-01-01

    Full Text Available Achondroplasia was first described in 1878 and is the most common form of human skeletal dysplasia. Spinal manifestations include thoracolumbar kyphosis, foramen magnum, and spinal stenosis. Progressive kyphosis can result in spinal cord compression and paraplegia due to the reduced size of spinal canal. The deficits are typically progressive, presenting as an insidious onset of paresthesia, followed by the inability to walk and then by urinary incontinence. Paraplegia can be the result of direct pressure on the cord by bone or the injury to the anterior spinal vessels by a protruding bone. Surgical treatment consists of posterior instrumentation, fusion with total wide laminectomy at stenosis levels, and anterior interbody support. Pedicle screws are preferred for spinal instrumentation because wires and hooks may induce spinal cord injury due to the narrow spinal canal. Pedicle lengths are significantly shorter, and 20–25 mm long screws are appropriate for lower thoracic and lumbar pedicles in adult achondroplastic There is no information about the appropriate length of screws for the upper thoracic pedicles. Tracheal injury due to inappropriate pedicle screw length is a rare complication. We report an extremely rare case of tracheal tear due to posterior instrumentation and its management in the early postoperative period.

  8. A rare case of os odontoideum from an Early Intermediate period tomb at the Huacas de Moche, Peru.

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    Titelbaum, A R; Castillo, S Uceda

    2015-12-01

    Os odontoideum is an uncommon vertebral anomaly where there is a smoothly corticated ossicle independent from a shortened odontoid peg. An example of os odontoideum was observed in an Early Intermediate period skeleton excavated from the Huacas de Moche (Moche IV, AD 400-700), Peru. The affected individual is a middle adult male who presents additional minor developmental anomalies of the axial skeleton. This individual was interred with a middle adult female who also has developmental anomalies of the axial skeleton, including block cervical vertebra (Klippel-Feil). Os odontoideum is infrequently reported in the medical literature and there continues to be debate about whether it is acquired or congenital. Unlike clinical cases, archaeological cases present an opportunity to examine the entirety of the skeleton. In the present case, there does not appear to be macroscopic or radiographic evidence for a healed fracture, and since the individual has multiple minor axial developmental anomalies, a congenital etiology is plausible. This case is the first to be described from the archaeological context of South America and one of few paleopathological examples worldwide. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Functional deterioration from the premorbid period to 2 years after the first episode of psychosis in early-onset psychosis.

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    Del Rey-Mejías, Ángel; Fraguas, David; Díaz-Caneja, Covadonga M; Pina-Camacho, Laura; Castro-Fornieles, Josefina; Baeza, Inmaculada; Espliego, Ana; Merchán-Naranjo, Jessica; González-Pinto, Ana; de la Serna, Elena; Payá, Beatriz; Graell, Montserrat; Arango, Celso; Parellada, Mara

    2015-12-01

    The aim of the study was to analyze changes in functional adjustment from childhood to 2 years after the first episode of psychosis (FEP) in patients with early-onset schizophrenia spectrum disorders (SSD) and affective psychoses (AFP) and a good or intermediate level of premorbid adjustment. We followed 106 adolescents (aged 12-17 years) with FEP for 2 years after recruitment. Premorbid adjustment in childhood was assessed in 98 patients with the childhood subscale of the Cannon-Spoor Premorbid Adjustment Scale (c-PAS). Global functioning was assessed 2 years after the FEP with the Children's Global Assessment Scale (c-GAS) or the Global Assessment of Functioning scale (GAF), as appropriate. Functional deterioration was defined as a downward shift in the level of functional adjustment from childhood to 2 years after the FEP. In patients with good or intermediate premorbid adjustment, functional deterioration was observed in 28.2 % (26.5 % of the AFP group, 29.4 % of the SSD group). Longer duration of untreated psychosis (Beta = 0.01; P = 0.01) and higher symptom severity at the FEP, as measured with the Clinical Global Impression Scale (Beta = 1.12; P = 0.02), significantly predicted the presence of functional deterioration, accounting for 21.4 % of the variance. Irrespective of diagnosis (SSD or AFP), almost one-third of adolescents with FEP and good or intermediate premorbid adjustment showed functional deterioration from the premorbid period to 2 years after the FEP.