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Neonatal hypoxic ischemic encephalopathy

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https://www.readbyqxmd.com/read/29655964/infant-outcome-after-complete-uterine-rupture
#1
Iqbal Al-Zirqi, Anne Kjersti Daltveit, Siri Vangen
BACKGROUND: Complete uterine rupture is a rare peripartum complication often associated with a catastrophic outcome for both mother and child. However, little has been written based on large data sets about maternal and infant outcome after complete ruptures. This is partly due to the rarity of the event and the serious maternal and infant outcome; it is also partly due to the use of international diagnostic codes that do not differentiate between the less catastrophic partial rupture and more catastrophic complete uterine rupture...
April 12, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29648595/progesterone-as-a-postnatal-prophylactic-agent-for-encephalopathy-caused-by-prenatal-hypoxic-ischemic-insult
#2
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 since 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, GABA (γ-aminobutyric acid)A receptors or both. We examined the therapeutic potential of P4 using a newborn rat model of HIE...
April 10, 2018: Endocrinology
https://www.readbyqxmd.com/read/29625873/-lower-uterine-segment-trial-a-pragmatic-open-multicenter-randomized-trial
#3
P Rozenberg, P Deruelle, M-V Sénat, R Desbrière, N Winer, E Simon, Y Ville, G Kayem, I Boutron
BACKGROUND: The data from literature show that trial of labor and elective repeat cesarean delivery after a prior cesarean delivery both present significant risks and benefits, and these risks and benefits differ for the woman and her fetus. The benefits to the woman can be at the expense of her fetus and vice-versa. This uncertainty is compounded by the scarcity of high-level evidence that preclude accurate quantification of the risks and benefits that could help provide a fair counseling about a trial of labor and elective repeat cesarean delivery...
April 4, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29622488/cerebral-autoregulation-and-conventional-and-diffusion-tensor-imaging-magnetic-resonance-imaging-in-neonatal-hypoxic-ischemic-encephalopathy
#4
Melisa Carrasco, Jamie Perin, Jacky M Jennings, Charlamaine Parkinson, Maureen M Gilmore, Raul Chavez-Valdez, An N Massaro, Raymond C Koehler, Frances J Northington, Aylin Tekes, Jennifer K Lee
BACKGROUND: Deviation of mean arterial blood pressure (MAP) from the range that optimizes cerebral autoregulatory vasoreactivity (optimal MAP) could increase neurological injury from hypoxic-ischemic encephalopathy (HIE). We tested whether a global magnetic resonance imaging (MRI) brain injury score and regional diffusion tensor imaging (DTI) are associated with optimal MAP in neonates with HIE. METHODS: Twenty-five neonates cooled for HIE were monitored with the hemoglobin volume index...
April 2, 2018: Pediatric Neurology
https://www.readbyqxmd.com/read/29608930/atomoxetine-a-selective-norepinephrine-reuptake-inhibitor-improves-short-term-histological-outcomes-after-hypoxic-ischemic-brain-injury-in-the-neonatal-male-rat
#5
Masatake Toshimitsu, Yoshimasa Kamei, Mari Ichinose, Takahiro Seyama, Shinya Imada, Takayuki Iriyama, Tomoyuki Fujii
BACKGROUND: Despite the recent progress of perinatal medicine, perinatal hypoxic-ischemic (HI) insult remains an important cause of brain injury in neonates, and is pathologically characterized by neuronal loss and the presence of microglia. Neurotransmitters, such as norepinephrine (NE) and glutamate, are involved in the pathogenesis of hypoxic-ischemic encephalopathy via the interaction between neurons and microglia. Although it is well known that the monoamine neurotransmitter NE acts as an anti-inflammatory agent in the brain under pathological conditions, its effects on perinatal HI insult remains elusive...
March 30, 2018: International Journal of Developmental Neuroscience
https://www.readbyqxmd.com/read/29595192/blockade-of-the-swelling-induced-chloride-current-attenuates-the-mouse-neonatal-hypoxic-ischemic-brain-injury-in-vivo
#6
Raymond Wong, Ahmed Abussaud, Joseph Wh Leung, Bao-Feng Xu, Fei-Ya Li, Sammen Huang, Nai-Hong Chen, Guan-Lei Wang, Zhong-Ping Feng, Hong-Shuo Sun
Activation of swelling-induced Cl- current (ICl,swell ) during neonatal hypoxia-ischemia (HI) may induce brain damage. Hypoxic-ischemic brain injury causes chronic neurological morbidity in neonates as well as acute mortality. In this study, we investigated the role of ICl,swell in hypoxic-ischemic brain injury using a selective blocker, 4-(2-butyl-6,7-dichloro-2-cyclopentylindan-1-on-5-yl) oxybutyric acid (DCPIB). In primary cultured cortical neurons perfusion of a 30% hypotonic solution activated ICl,swell , which was completely blocked by the application of DCPIB (10 μmol/L)...
March 29, 2018: Acta Pharmacologica Sinica
https://www.readbyqxmd.com/read/29579759/risk-factors-for-neonatal-hypoxic-ischemic-encephalopathy-in-the-absence-of-sentinel-events
#7
Christopher M Novak, Ahize C Eke, Maide Ozen, Irina Burd, Ernest M Graham
OBJECTIVE:  Hypoxic-ischemic encephalopathy (HIE) may be associated with intrapartum sentinel events or may be unexplained. We sought to identify risk factors for unexplained HIE cases and compare their morbidity and mortality to cases associated with sentinel events. STUDY DESIGN:  Retrospective cohort study of all neonates admitted with suspected HIE treated with whole-body hypothermia from January 2007 through July 2017. Cases of unexplained HIE were compared with those with a sentinel event...
March 26, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29571928/hemodynamic-changes-during-rewarming-phase-of-whole-body-hypothermia-therapy-in-neonates-with-hypoxic-ischemic-encephalopathy
#8
Tai-Wei Wu, Benita Tamrazi, Sadaf Soleymani, Istvan Seri, Shahab Noori
OBJECTIVE: To delineate the systemic and cerebral hemodynamic response to incremental increases in core temperature during the rewarming phase of therapeutic hypothermia in neonatal hypoxic-ischemic encephalopathy (HIE). STUDY DESIGN: Continuous hemodynamic data, including heart rate (HR), mean arterial blood pressure (MBP), cardiac output by electrical velocimetry (COEV ), arterial oxygen saturation, and renal (RrSO2 ) and cerebral (CrSO2 ) regional tissue oxygen saturation, were collected from 4 hours before the start of rewarming to 1 hour after the completion of rewarming...
March 20, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29568675/combined-prediction-of-mir-210-and-mir-374a-for-severity-and-prognosis-of-hypoxic-ischemic-encephalopathy
#9
Zhansheng Wang, Yulu Liu, Minkun Shao, Dong Wang, Ying Zhang
Background and Aim: Hypoxic-ischemic encephalopathy (HIE) is a disorder featured by hypoxic and ischemic damages during the perinatal period and its high mortality (i.e., 15%-20%) could be partly attributed to late diagnosis. Therefore, miR-210 and miR-374a were investigated to find if they could improve the diagnostic values of S100B protein and neuron-specific enolase (NSE) for HIE. Methods: Altogether 167 HIE newborns and 82 healthy newborns were recruited, and their blood were sampled for determining the levels of biomarkers...
January 2018: Brain and Behavior
https://www.readbyqxmd.com/read/29562785/extracellular-vesicles-derived-from-wharton-s-jelly-mesenchymal-stem-cells-prevent-and-resolve-programmed-cell-death-mediated-by-perinatal-hypoxia-ischemia-in-neuronal-cells
#10
Marianne S Joerger-Messerli, Byron Oppliger, Marialuigia Spinelli, Gierin Thomi, Ivana di Salvo, Philipp Schneider, Andreina Schoeberlein
Hypoxic-ischemic (HI) insult in the perinatal phase harbors a high risk of encephalopathy in the neonate. Brain cells undergo apoptosis, initiating neurodegeneration. So far, therapeutic approaches such as cooling remain limited. Transplantation of mesenchymal stem cells (MSCs) exhibits therapeutic success despite the short-time survival in the host brain, providing strong evidence that their beneficial effects are largely based on secreted factors, including extracellular vesicles (EVs). The aim of this study was to investigate the effects of human Wharton's jelly MSC (hWJ-MSC)-derived EVs on neuroprotection and neuroregeneration, using an in vitro model of oxygen-glucose deprivation/reoxygenation (OGD/R) mimicking HI injury in the mouse neuroblastoma cell line neuro2a (N2a)...
January 2018: Cell Transplantation
https://www.readbyqxmd.com/read/29561203/n-acetylcysteine-rapidly-replenishes-central-nervous-system-glutathione-measured-via-magnetic-resonance-spectroscopy-in-human-neonates-with-hypoxic-ischemic-encephalopathy
#11
Hunter G Moss, Truman R Brown, Donald B Wiest, Dorothea D Jenkins
Persistent oxidative stress depletes reduced glutathione (GSH), an intracellular antioxidant and an important determinant of CNS injury after hypoxia ischemia. We used standard, short echo time Stimulated Echo Acquisition Mode (STEAM) to detect GSH by magnetic resonance spectroscopy (MRS) in 24 term neonates with hypoxic-ischemic encephalopathy (HIE), on day of life 5-6, after rewarming from therapeutic hypothermia. MRS demonstrated reliable, consistent GSH of 1·64 ± 0·20 mM in the basal ganglia immediately before intravenous infusion of N-acetylcysteine...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29556412/incidence-and-short-term-outcomes-of-neonates-with-hypoxic-ischemic-encephalopathy-in-a-peri-urban-teaching-hospital-uganda-a-prospective-cohort-study
#12
Hellen Namusoke, Maria Musoke Nannyonga, Robert Ssebunya, Victoria Kirabira Nakibuuka, Edison Mworozi
Background: Hypoxic Ischemic Encephalopathy carries high case fatality rates ranging between 10-60%, with 25% of survivors have an adverse long-term neurodevelopment outcome. Despite the above, there is paucity of data regarding its magnitude and short term outcomes in a low resource setting like Uganda. Therefore we set out to determine the incidence and short term outcomes of Newborns with Hypoxic Ischemic Encephalopathy at St.Francis Hospital, Nsambya. Methods: This was a Prospective Cohort study conducted between October 2015 and January 2016 at St...
2018: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/29551690/acute-and-long-term-ncx-activation-reduces-brain-injury-and-restores-behavioral-functions-in-mice-subjected-to-neonatal-brain-ischemia
#13
Pierpaolo Cerullo, Paola Brancaccio, Serenella Anzilotti, Antonio Vinciguerra, Ornella Cuomo, Ferdinando Fiorino, Beatrice Severino, Paola Di Vaio, Gianfranco Di Renzo, Lucio Annunziato, Giuseppe Pignataro
Hypoxic-ischemic encephalopathy (HI) accounts for the majority of developmental, motor and cognitive deficits in children, leading to life-long neurological impairments. Since the plasmamembrane sodium/calcium exchanger (NCX) plays a fundamental role in maintaining ionic homeostasis during adult brain ischemia, in the present work we aimed to demonstrate (1)the involvement of NCX in the pathophysiology of neonatal HI and (2)a possible NCX-based pharmacological intervention. HI was induced in neonatal mice at postnatal day 7(P7) by unilateral cut of the right common carotid artery, followed by 60 min exposure to 8%O2 ...
March 15, 2018: Neuropharmacology
https://www.readbyqxmd.com/read/29530758/tert-butylhydroquinone-post-treatment-attenuates-neonatal-hypoxic-ischemic-brain-damage-in-rats
#14
Juan Zhang, Lorelei Donovan Tucker, DongYan, Yujiao Lu, Luodan Yang, Chongyun Wu, Yong Li, Quanguang Zhang
Hypoxic-ischemic (HI) encephalopathy is a leading cause of dire mortality and morbidity in neonates. Unfortunately, no effective therapies have been developed as of yet. Oxidative stress plays a critical role in pathogenesis and progression of neonatal HI. Previously, as a Nrf2 activator, tert-butylhydroquinone (TBHQ) has been demonstrated to exert neuroprotection on brain trauma and ischemic stroke models, as well as oxidative stress-induced cytotoxicity in neurons. It is, however, still unknown whether TBHQ administration can protect against oxidative stress in neonatal HI brain injury...
March 9, 2018: Neurochemistry International
https://www.readbyqxmd.com/read/29519539/autonomic-dysfunction-in-neonates-with-hypoxic-ischemic-encephalopathy-undergoing-therapeutic-hypothermia-impairs-physiological-responses-to-routine-care-events
#15
Heather Campbell, Rathinaswamy B Govindan, Srinivas Kota, Tareq Al-Shargabi, Marina Metzler, Nickie Andescavage, Taeun Chang, Gilbert Vezina, Adre du Plessis, An N Massaro
OBJECTIVE: To evaluate whether infants with hypoxic-ischemic encephalopathy and evidence of autonomic dysfunction have aberrant physiological responses to care events that could contribute to evolving brain injury. STUDY DESIGN: Continuous tracings of heart rate (HR), blood pressure (BP), cerebral near infrared spectroscopy, and video electroencephalogram data were recorded from newborn infants with hypoxic-ischemic encephalopathy who were treated with hypothermia...
March 6, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29515049/human-amniotic-fluid-stem-cells-therapeutic-potential-for-perinatal-patients-with-intractable-neurological-disease
#16
Daigo Ochiai, Hirotaka Masuda, Yushi Abe, Toshimitsu Otani, Marie Fukutake, Tadashi Matsumoto, Kei Miyakoshi, Mamoru Tanaka
Mesenchymal stem cells (MSCs) have generated great interest in the fields of regenerative medicine and immunotherapy because of their unique biological properties. Among MSCs, amniotic fluid stem cells (AFS) have a number of characteristics that make them attractive candidates for tissue engineering and cell replacement strategies, particularly for perinatal medicine. If various neonatal conditions, including birth asphyxia, preterm birth, and congenital abnormalities, which result in long-lasting severe impairments, could be predicted during pregnancy, it would allow collection of small samples of amniotic fluid cells by amniocentesis...
March 6, 2018: Keio Journal of Medicine
https://www.readbyqxmd.com/read/29514165/high-dose-erythropoietin-for-asphyxia-and-encephalopathy-heal-a-randomized-controlled-trial-background-aims-and-study-protocol
#17
Sandra E Juul, Bryan A Comstock, Patrick J Heagerty, Dennis E Mayock, Amy M Goodman, Stephanie Hauge, Fernando Gonzalez, Yvonne W Wu
BACKGROUND: Hypoxic-ischemic encephalopathy (HIE) remains an important cause of neonatal death and frequently leads to significant long-term disability in survivors. Therapeutic hypothermia, while beneficial, still leaves many treated infants with lifelong disabilities. Adjunctive therapies are needed, and erythropoietin (Epo) has the potential to provide additional neuroprotection. OBJECTIVES: The aim of this study was to review the current incidence, mechanism of injury, and sequelae of HIE, and to describe a new phase III randomized, placebo-controlled trial of Epo neuroprotection in term and near-term infants with moderate to severe HIE treated with therapeutic hypothermia...
March 7, 2018: Neonatology
https://www.readbyqxmd.com/read/29510382/enteral-feeding-as-an-adjunct-to-hypothermia-in-neonates-with-hypoxic-ischemic-encephalopathy
#18
Lilly L Chang, James L Wynn, Marisa J Pacella, Candace C Rossignol, Felix Banadera, Neil Alviedo, Alfonso Vargas, Jeffrey Bennett, Melissa Huene, Nicole Copenhaver, Livia Sura, Kimberly Barnette, Jayne Solomon, Nikolay A Bliznyuk, Josef Neu, Michael D Weiss
BACKGROUND: Withholding enteral feedings during hypothermia lacks supporting evidence. OBJECTIVES: We aimed to determine if minimal enteral nutrition (MEN) during hypothermia in patients with hypoxic-ischemic encephalopathy was associated with a reduced duration of parenteral nutrition, time to full oral feeds, and length of stay, but would not be associated with increased systemic inflammation or feeding complications. METHODS: We performed a pilot, retrospective, matched case-control study within the Florida Neonatal Neurologic Network from December 2012 to May 2016 of patients who received MEN during hypothermia (n = 17) versus those who were not fed (n = 17)...
March 6, 2018: Neonatology
https://www.readbyqxmd.com/read/29504433/therapeutic-hypothermia-for-neonatal-hypoxic-ischemic-encephalopathy-magnetic-resonance-imaging-findings-and-neurological-outcomes-in-a-brazilian-cohort
#19
Renato S Procianoy, Andrea Lucia A Corso, Maria Gabriela Longo, Leonardo Vedolin, Rita C Silveira
OBJECTIVE: To determine the neurodevelopment outcomes after Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy (HIE) and identify the neonatal Magnetic Resonance Imaging (MRI) findings associated with neurological outcome in a middle-income country. STUDY DESIGN: All infants born after 35 completed weeks' gestation with signs of moderate to severe encephalopathy and evidence of perinatal asphyxia before 6 hours of life were submitted to whole-body hypothermia and were imaged at 18 ± 8...
March 4, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29502714/targeted-temperature-management-in-brain-injured-patients
#20
REVIEW
Fred Rincon
Evidence from animal models indicates that lowering temperature by a few degrees can produce substantial neuroprotection. In humans, hypothermia has been found to be neuroprotective with a significant impact on mortality and long-term functional outcome only in cardiac arrest and neonatal hypoxic-ischemic encephalopathy. Clinical trials have explored the potential role of maintaining normothermia and treating fever in critically ill brain injured patients. This review concentrates on basic concepts to understand the physiologic interactions of thermoregulation, effects of thermal modulation in critically ill patients, proposed mechanisms of action of temperature modulation, and practical aspects of targeted temperature management...
April 2018: Neurosurgery Clinics of North America
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