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Hypoxic ischemic encephalopathy in newborn

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https://www.readbyqxmd.com/read/30086156/dha-and-therapeutic-hypothermia-in-a-short-term-follow-up-piglet-model-of-hypoxia-ischemia-effects-on-h-mrs-biomarkers
#1
Marianne Ullestad Huun, Håvard Garberg, Else Marit Løberg, Javier Escobar, Jose Martinez-Orgado, Ola Didrik Saugstad, Rønnaug Solberg
BACKGROUND: Therapeutic hypothermia has become the standard of care for newborns with hypoxic-ischemic encephalopathy in high and middle income countries. Docosahexaenoic acid (DHA) has neuroprotective properties of reducing excitotoxicity, neuroinflammation and apoptosis in rodent models. We aim to study whether post hypoxic administration of i.v. DHA will reduce H+MRS biomarkers and gene expression of inflammation and apoptosis both with and without hypothermia in a large animal model...
2018: PloS One
https://www.readbyqxmd.com/read/30086107/neurometabolic-disorders-of-the-newborn
#2
Kshitij Mankad, Giacomo Talenti, Ai Peng Tan, Fabrício Guimarães Gonçalves, Carlos Robles, Elaine Y L Kan, Ata Siddiqui
There is an extensive and diverse set of medical conditions affecting the neonatal brain within the spectrum of neurometabolic disorders. As such, their clinical presentations can be rather nonspecific, and can often mimic acquired entities such as hypoxic-ischemic encephalopathy and sepsis. Similarly, the radiological findings in these entities can also be frequently nonspecific, but a more detailed analysis of imaging findings (especially magnetic resonance imaging) alongside the relevant clinical details can be a rewarding experience, thus enabling a timely and targeted diagnosis...
August 2018: Topics in Magnetic Resonance Imaging: TMRI
https://www.readbyqxmd.com/read/30060742/effect-of-hypothermia-on-interleukin-1-receptor-antagonist-pharmacodynamics-in-inflammatory-sensitized-hypoxic-ischemic-encephalopathy-of-term-newborns
#3
Mathilde Chevin, Clémence Guiraut, Guillaume Sébire
BACKGROUND: Hypothermia is increasingly tested in several neurological conditions, such as neonatal encephalopathy, stroke, traumatic brain injury, subarachnoid hemorrhage, spinal cord injury, and neurological outcomes of cardiac arrest. Current studies aim to increase benefits of hypothermia with new add-on therapies including immunomodulatory agents. Hypothermia has been shown to affect the metabolism of commonly used drugs, including those acting on neuroimmune pathways. OBJECTIVE: This study focuses on the effect of hypothermia on interleukin-1 receptor antagonist pharmacodynamics in a model of neonatal encephalopathy...
July 30, 2018: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/30053817/the-first-case-of-neonatal-priapism-during-hypothermia-for-hypoxic-ischemic-encephalopathy-and-a-literature-review
#4
REVIEW
Claudia Fanni, Maria Antonietta Marcialis, Maria Cristina Pintus, Cristina Loddo, Vassilios Fanos
Neonatal priapism is a rare condition with only 26 described cases in literature since 1879. It is defined as a persistent penile erection occurring in the first 28 days of life, lasting at least 4 h that usually happens in the first days (from 2 to 12 days). It is a very different condition compared to the adult one because in newborns it is a relatively benign phenomenon. As a result of this paucity of described cases, classification and management are not well known by most of neonatologists and currently there are no established guidelines for its management...
July 27, 2018: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/30037602/clinical-features-of-a-fatal-shoulder-dystocia-the-hypovolemic-shock-hypothesis
#5
E Cesari, S Ghirardello, G Brembilla, A Svelato, A Ragusa
Shoulder dystocia is a rare but severe obstetric complication associated with an increased risk of brachial plexus palsies, fractures of the clavicle and humerus, hypoxic-ischemic encephalopathy and, rarely, neonatal death. Here we describe a fatal case of shoulder dystocia in a term newborn, although labor was uneventful, fetal heart rate tracing was normal until the delivery of the head and the head-to-body delivery interval (HBDI) occurred within 5 min. Full resuscitation was performed for 35 min without success...
September 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/30025402/biomarker-discovery-by-mass-spectrometry-in-cerebrospinal-fluid-and-plasma-after-global-hypoxia-ischemia-in-newborn-piglets
#6
Kasper Jacobsen Kyng, Anders Valdemar Edhager, Tine Brink Henriksen, Christer Zøylner Swan, Niels Gregersen, Johan Palmfeldt
BACKGROUND: Biomarkers may qualify diagnosis, treatment allocation, and prognostication in neonatal encephalopathy. Biomarker development is challenged by competing etiologies, inter-individual genetic variability, and a lack of specific neonatal markers. To address these challenges, we used a standardized neonatal hypoxic-ischemic (HI) encephalopathy model with pre- and post-HI sampling of cerebrospinal fluid (CSF) and plasma. OBJECTIVES: The study aimed to identify novel candidate protein biomarkers of HI encephalopathy in a newborn piglet model in CSF and plasma...
July 19, 2018: Neonatology
https://www.readbyqxmd.com/read/30022316/passive-therapeutic-hypothermia-during-ambulance-and-helicopter-secondary-neonatal-transport-in-neonates-with-hypoxic-brain-injury-a-10-year-retrospective-survey
#7
Manca Leben, Manca Nolimal, Ivan Vidmar, Štefan Grosek
BACKGROUND: Therapeutic hypothermia is a method of treatment in newborns with hypoxic ischemic encephalopathy. Hypothermia should be initiated no later than 6 h after birth. The purpose of this study was to evaluate the quality of the passive therapeutic cooling during neonatal transport. PURPOSE: The study aims to evaluate the efficiency of our transport in maintenance of target body temperature during transport. METHODS: We conducted a 10-year retrospective study in neonates, transported by helicopter or ambulance, who received therapeutic passive-induced hypothermia during transport to the Department of Pediatric Surgery and Intensive Therapy at the University Medical Centre Ljubljana between September 1, 2006, and December 31, 2016...
July 18, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29968450/brain-cooling-reduces-the-risk-of-post-neonatal-epilepsy-in-newborns-affected-by-moderate-to-severe-hypoxic-ischemic-encephalopathy
#8
Licia Lugli, Eleonora Balestri, Alberto Berardi, Isotta Guidotti, Francesca Cavalleri, Alessandra Todeschini, Marisa Pugliese, Elisa Muttini Della Casa, Laura Lucaccioni, Fabrizio Ferrari
BACKGROUND: Neonatal hypoxic-ischemic encephalopathy is still a significant cause of neonatal death and neurodevelopmental disabilities, such as cerebral palsy, mental delay, and epilepsy. After the introduction of therapeutic hypothermia, the prognosis of hypoxic-ischemic encephalopathy has improved, with reduction of death and disabilities. However, few studies evaluated whether hypothermia affects rate and severity of post-neonatal epilepsy. We evaluated rates, characteristics and prognostic markers of post-neonatal epilepsy in infants with moderate to severe hypoxic-ischemic encephalopathy treated or not with therapeutic hypothermia...
July 2, 2018: Minerva Pediatrica
https://www.readbyqxmd.com/read/29956801/tanshinone-iia-improves-hypoxic-ischemic-encephalopathy-through-tlr%C3%A2-4%C3%A2-mediated-nf%C3%A2-%C3%AE%C2%BAb-signal-pathway
#9
Chengzhi Fang, Lili Xie, Chunmei Liu, Chunhua Fu, Wei Ye, Hong Liu, Binghong Zhang
Hypoxic ischemic encephalopathy (HIE) is the most common brain injury following hypoxia and/or ischemia caused by various factors during the perinatal period, resulting in detrimental neurological deficits in the nervous system. Tanshinone IIA (Tan‑IIA) is a potential agent for the treatment of cardiovascular and cerebrovascular diseases. In this study, the efficacy of Tan‑IIA was investigated in a newborn mouse model of HIE. The dynamic mechanism of Tan‑IIA was also investigated in the central nervous system of neonate mice...
August 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29915859/neonatal-subcutaneous-fat-necrosis-with-hypercalcemia-treatment-using-calcitonin
#10
Khouloud A Alsofyani
Subcutaneous fat necrosis of newborn is a form of noninfectious panniculitis. It is an uncommon condition and mostly occurs in full-term infants within first weeks of life that have had a significant condition such as hypoxic-ischemic encephalopathy at the time of birth. Subcutaneous fat necrosis of newborn is usually a self-limiting condition but may be associated with hypercalcemia, which may lead to life threatening levels. Hypercalcemia is a significant reason of subcutaneous fat necrosis and needs an intervention involving hyperhydration, calcitonin, diuretics, steroids and sometimes bisphosphonate in resistant cases...
June 2018: Saudi Medical Journal
https://www.readbyqxmd.com/read/29889725/introduction-of-continuous-video-eeg-monitoring-into-2-different-nicu-models-by-training-neonatal-nurses
#11
Ipsita Goswami, Luis Bello-Espinosa, Jeffrey Buchhalter, Harish Amin, Alexandra Howlett, Michael Esser, Sumesh Thomas, Cathy Metcalfe, Jan Lind, Norma Oliver, Silvia Kozlik, Khorshid Mohammad
BACKGROUND: Continuous video electroencephalographic (EEG) (cvEEG) monitoring is emerging as the standard of care for diagnosis and management of neonatal seizures. However, cvEEG is labor-intensive and the need to initiate and interpret studies on a 24-hour basis is a major limitation. PURPOSE: This study aims at establishing consistency in monitoring of newborns admitted to 2 different neonatal intensive care units (NICUs) managed by the same neurocritical care team...
August 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29875342/anti-cytokine-therapy-to-attenuate-ischemic-reperfusion-associated-brain-injury-in-the-perinatal-period
#12
REVIEW
Clémence Disdier, Xiaodi Chen, Jeong-Eun Kim, Steven W Threlkeld, Barbara S Stonestreet
Perinatal brain injury is a major cause of morbidity and long-standing disability in newborns. Hypothermia is the only therapy approved to attenuate brain injury in the newborn. However, this treatment is unfortunately only partially neuroprotective and can only be used to treat hypoxic-ischemic encephalopathy in full term infants. Therefore, there is an urgent need for adjunctive therapeutic strategies. Post-ischemic neuro-inflammation is a crucial contributor to the evolution of brain injury in neonates and constitutes a promising therapeutic target...
June 7, 2018: Brain Sciences
https://www.readbyqxmd.com/read/29867713/cerebral-lactate-concentration-in-neonatal-hypoxic-ischemic-encephalopathy-in-relation-to-time-characteristic-of-injury-and-serum-lactate-concentration
#13
Tai-Wei Wu, Benita Tamrazi, Kai-Hsiang Hsu, Eugenia Ho, Aaron J Reitman, Matthew Borzage, Stefan Blüml, Jessica L Wisnowski
Background: Cerebral lactate concentration can remain detectable in neonatal hypoxic-ischemic encephalopathy (HIE) after hemodynamic stability. The temporal resolution of regional cerebral lactate concentration in relation to the severity or area of injury is unclear. Furthermore, the interplay between serum and cerebral lactate in neonatal HIE has not been well defined. The study aims to describe cerebral lactate concentration in neonatal HIE in relation to time, injury, and serum lactate...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29789056/the-six-hour-window-how-the-community-hospital-nursery-can-optimize-outcomes-of-the-infant-with-suspected-hypoxic-ischemic-encephalopathy
#14
Dafina Ibrani, Shanon Molacavage
Perinatal hypoxia is a devastating event before, during, or immediately after birth that deprives an infant's vital organs of oxygen. This injury at birth often requires a complex resuscitation and increases the newborn's risk of hypoxic-ischemic encephalopathy (HIE). The resuscitation team in a community hospital nursery may have less experience with complex resuscitation and post-resuscitation care of this infant than a NICU. This article provides the neonatal nurse in a Level I or Level II nursery with information about resuscitation and post-resuscitation care of an infant at risk of HIE while awaiting transport to a NICU for therapeutic cooling...
May 1, 2018: Neonatal Network: NN
https://www.readbyqxmd.com/read/29769612/hypothermia-broadens-the-therapeutic-time-window-of-mesenchymal-stem-cell-transplantation-for-severe-neonatal-hypoxic-ischemic-encephalopathy
#15
So Yoon Ahn, Yun Sil Chang, Dong Kyung Sung, Se In Sung, Won Soon Park
Recently, we have demonstrated that concurrent hypothermia and mesenchymal stem cells (MSCs) transplantation synergistically improved severe neonatal hypoxic ischemic encephalopathy (HIE). The current study was designed to determine whether hypothermia could extend the therapeutic time window of MSC transplantation for severe neonatal HIE. To induce HIE, newborn rat pups were exposed to 8% oxygen for 2 h following unilateral carotid artery ligation on postnatal day (P) 7. After approving severe HIE involving >50% of the ipsilateral hemisphere volume, hypothermia (32 °C) for 2 days was started...
May 16, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29710738/medico-legal-implications-of-hypothermic-neuroprotection-in-the-newborn
#16
S M Donn, J M Fanaroff
Hypoxic-ischemic encephalopathy (HIE) continues to be a significant source of long term neurological sequelae in infants born at or near term. In the past decade, selective head or whole body cooling has shown promising benefit in ameliorating some of the brain injury from intrapartum asphyxial insults and has become standard care in most developed countries. A decision to offer neuroprotective hypothermia (NPH) may engender subsequent litigation because it presupposes an acute intrapartum injury. Conversely, failing to offer cooling may be interpreted as a violation in the standard of care...
2018: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/29710737/cerebral-glucose-deficiency-versus-oxygen-deficiency-in-neonatal-encephalopathy
#17
A M Rudolph
Hypoxic-ischemic encephalopathy (HIE) in newborn infants is generally considered to result from decreased arterial oxygen content or cerebral blood flow. Cerebral injury similar to that of HIE has been noted with hypoglycemia. Studies in fetal lambs have shown that ventilation with 3% oxygen did not change cerebral blood flow, but ventilation with 100% oxygen resulted in marked reduction in cerebral blood flow, glucose delivery and glucose consumption. Blood glucose concentration falls markedly after birth; this, associated with the fall in cerebral blood flow, greatly reduces glucose supply to the brain...
2018: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/29702712/development-of-a-neuronicu-with-a-broader-focus-on-all-newborns-at-risk-of-brain-injury-the-first-2-years
#18
Krisa P Van Meurs, Elisabeth S Yan, Kathi S Randall, Valerie Y Chock, Alexis S Davis, Cecelia S Glennon, Catherine L Clark, Courtney J Wusthoff, Sonia L Bonifacio
OBJECTIVE:  Many critically ill neonates have an existing brain injury or are at risk of neurologic injury. We developed a "NeuroNICU" (neurologic neonatal intensive care unit) to better provide neurologically focused intensive care. STUDY DESIGN:  Demographic and clinical variables, services delivered, and patient outcomes were recorded in a prospective database for all neonates admitted to the NeuroNICU between April 23, 2013, and June 25, 2015. RESULTS:  In total, 546 neonates were admitted to the NeuroNICU representing 32% of all NICU admissions...
April 27, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29668681/a-longitudinal-1h-nmr-metabolomics-analysis-of-urine-from-newborns-with-hypoxic-ischemic-encephalopathy-undergoing-hypothermia-therapy-clinical-and-medical-legal-insights
#19
Emanuela Locci, Antonio Noto, Melania Puddu, Giulia Pomero, Roberto Demontis, Cristina Dalmazzo, Antonio Delogu, Vassilios Fanos, Ernesto d'Aloja, Paolo Gancia
Perinatal asphyxia is an event affecting around four million newborns worldwide. The 0.5 to 2 per 1000 of full term asphyxiated newborns suffer from hypoxic-ischemic encephalopathy (HIE), which is a frequent cause of death or severe disability and, as consequence, the most common birth injury claim for obstetrics, gynaecologists, and paediatricians. Perinatal asphyxia results from a compromised gas exchange that leads to hypoxemia, hypercapnia, and metabolic acidosis. In this work, we applied a metabolomics approach to investigate the metabolic profiles of urine samples collected from full term asphyxiated newborns with HIE undergoing therapeutic hypothermia (TH), with the aim of identifying a pattern of metabolites associated with HIE and to follow their modifications over time...
2018: PloS One
https://www.readbyqxmd.com/read/29648595/progesterone-as-a-postnatal-prophylactic-agent-for-encephalopathy-caused-by-prenatal-hypoxic-ischemic-insult
#20
Yoshimasa Kawarai, Hirokazu Tanaka, Tatsuya Kobayashi, Makio Shozu
Brain damage caused by hypoxic ischemic insult during the perinatal period causes hypoxic ischemic encephalopathies (HIEs). Therapeutic hypothermia is indicated for HIE, but because the therapeutic burden is large for its limited therapeutic effectiveness, another strategy is needed. Progesterone (P4) plays a neuroprotective role through the actions of its metabolite, allopregnanolone (Allo), on P4 receptor, γ-aminobutyric acid type A receptors or both. We examined the therapeutic potential of P4 using a newborn rat model of HIE...
June 1, 2018: Endocrinology
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