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cerebral palsy prevention

Firooz Salami, Julia Wagner, Stefan van Drongelen, Matthias C M Klotz, Thomas Dreher, Sebastian I Wolf, Mirjam Niklasch
AIM: Flexed knee gait can be treated with distal femoral extension osteotomy (DFEO) and additional patellar tendon advancement (PTA) in children with cerebral palsy (CP). This study assesses changes in hamstring muscle tendon length (MTL) and velocity after DFEO (+PTA). METHOD: Nineteen children (mean age 13y [standard deviation 3y] at surgery) with CP and flexed knee gait who were treated with DFEO (15 limbs) or DFEO+PTA (10 limbs) were retrospectively included in this study...
March 14, 2018: Developmental Medicine and Child Neurology
Erin A S Clark, Steven J Weiner, Dwight J Rouse, Brian M Mercer, Uma M Reddy, Jay D Iams, Ronald J Wapner, Yoram Sorokin, Fergal D Malone, Mary J O'Sullivan, Alan M Peaceman, Gary D V Hankins, Donald J Dudley, Steve N Caritis
OBJECTIVE:  To evaluate the association of magnesium sulfate (MgSO4 ) exposure and candidate gene polymorphisms with adverse neurodevelopmental outcomes following preterm birth. STUDY DESIGN:  We performed a nested case-control analysis of a randomized trial of maternal MgSO4 before anticipated preterm birth for the prevention of cerebral palsy (CP). Cases were children who died within 1 year of life or were survivors with abnormal neurodevelopment at age 2 years...
March 6, 2018: American Journal of Perinatology
Megan E Paulsen, Robert M Dietz
No abstract text is available yet for this article.
March 2018: Journal of Pediatrics
Linan Zeng, Jinhui Tian, Fujian Song, Wenrui Li, Lucan Jiang, Ge Gui, Yang Zhang, Long Ge, Jing Shi, Xin Sun, Dezhi Mu, Lingli Zhang
OBJECTIVE: To determine the comparative efficacy and safety of corticosteroids in the prevention of bronchopulmonary dysplasia (BPD) in preterm infants. STUDY DESIGN: We systematically searched PubMed, EMBASE and the Cochrane Library. Two reviewers independently selected randomised controlled trials (RCTs) of postnatal corticosteroids in preterm infants. A Bayesian network meta-analysis and subgroup analyses were performed. RESULTS: We included 47 RCTs with 6747 participants...
February 23, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
P Persiani, M Murgia, F M Ranaldi, O Mazza, M Mariani, M Crostelli, C Villani
OBJECTIVE: The purpose of this study is to retrospectively evaluate a group of children affected by cerebral palsy with a recent femoral fracture, and to analyse the results and complications in relation to the treatment used. MATERIALS AND METHODS: The analysis was performed on 36 children (21 M, 15 F, 8-14 years old) with cerebral palsy (7 diplegia, 28 tetraparesis, 1 hemiplegia) with a metaphyseal or a diaphyseal femoral fracture. The patients were subdivided into two groups according to their Gross Motor Function Classification System (GMFCS) level: level 2-3 (9 patients) and level 4-5 (27 patients), evaluating the presence of complications and malunions for each group at the end of each follow up...
January 2018: La Clinica Terapeutica
Anne-Sophie Smilga, Jarred Garfinkle, Pamela Ng, John Andersen, David Buckley, Darcy Fehlings, Adam Kirton, Ellen Wood, Esias van Rensburg, Michael Shevell, Maryam Oskoui
BACKGROUND: The goal of this study was to explore the association between neonatal infection and outcomes in children with cerebral palsy. METHODS: We conducted a retrospective cohort study using the Canadian CP Registry. Neonatal infection was defined as meeting one of the following criteria: (1) septicemia, (2) septic shock, or (3) administration of antibiotics for ≥10 days. Phenotypic profiles of children with cerebral palsy with and without an antecedent neonatal infection were compared...
December 13, 2017: Pediatric Neurology
Ingran Lingam, Nicola J Robertson
Magnesium is an intracellular cation essential for many en-zymatic processes and cellular functions. Magnesium sulfate acts as an endogenous calcium channel antagonist at neuronal synapses, thought to prevent excessive activation of N-methyl-D-aspartate receptors by excitatory amino acids, such as glutamate, and by downregulation of proinflammatory pathways. Early intervention is essential in the prevention of the secondary phase of neuronal injury. The immature brain is particularly prone to excitotoxicity, and inflammation has been strongly implicated in the pathogenesis of cerebral palsy...
February 7, 2018: Developmental Neuroscience
Ester Garne, Nathali Vain-Nielsen, Anne Vinkel Hansen, Jesper Fenger-Grøn
Severe birth asphyxia is a major cause of neonatal morbidity and long-term disability and may be prevented. However, the consequences of organisational changes are rarely evaluated. 
Methods: A cohort study comparing morbidity and mortality for term-born infants born with severe birth asphyxia, defined as an Apgar score ≤ 5 at 5 min., before and after major changes in the organisation of births in a Danish district.
 Results: The study included 77 infants born in 1997-2004 and 40 infants born in 2009-2013 who were admitted to a neonatal intensive care unit with an Apgar score ≤ 5 at 5 min...
February 2018: Danish Medical Journal
Olaf Verschuren, Ana R P Smorenburg, Yvette Luiking, Kristie Bell, Lee Barber, Mark D Peterson
In individuals with cerebral palsy (CP), smaller muscle and atrophy are present at young age. Many people with CP also experience a decline in gross motor function as they age, which might be explained by the loss of muscle mass. The clinical observation of muscle wasting has prompted a comparison with sarcopenia in older adults, and the term accelerated musculoskeletal ageing is often used to describe the hallmark phenotype of CP through the lifespan. However, there has been very little research emphasis on the natural history of ageing with CP and even less with respect to the determinants or prevention of muscle loss with CP...
February 2, 2018: Journal of Cachexia, Sarcopenia and Muscle
Junichi Hasegawa, Tomoaki Ikeda, Satoshi Toyokawa, Emi Jojima, Shoji Satoh, Kiyotake Ichizuka, Nanako Tamiya, Akihito Nakai, Keiya Fujimori, Tsugio Maeda, Hideaki Masuzaki, Satoru Takeda, Hideaki Suzuki, Shigeru Ueda, Tsuyomu Ikenoue
AIM: The study identifies the relevant obstetric factors associated with fetal heart rate (FHR) monitoring for cerebral palsy (CP) in pregnant women with hypertensive disorders of pregnancy (HDP). METHODS: The subjects were neonates with CP (birth weight ≥ 2000 g, gestational age ≥ 33 weeks) who were approved for compensation for CP by the Operating Organization of the Japan Obstetric Compensation System between 2009 and 2012. After selection of women with antepartum HDP, obstetric characteristics associated with FHR monitoring were analyzed...
January 23, 2018: Journal of Obstetrics and Gynaecology Research
Takahiro Seyama, Yoshimasa Kamei, Takayuki Iriyama, Shinya Imada, Mari Ichinose, Masatake Toshimitsu, Tomoyuki Fujii, Hiroaki Asou
AIM: Antenatal maternal administration of magnesium sulfate (MgSO4 ) reduces cerebral palsy in preterm infants. However, it remains controversial as to whether it also reduces occurrence of white matter damage, or periventricular leukomalacia. We assessed the effect of MgSO4 against white matter damage induced by hypoxic-ischemic insult using a neonatal rat model and culture of premyelinating oligodendrocytes (pre-OL). METHODS: Rat pups at postnatal day (P) 6 were administered either MgSO4 or vehicle intraperitoneally before hypoxic-ischemic insult (unilateral ligation of the carotid artery followed by 6% oxygen for 1 h)...
January 23, 2018: Journal of Obstetrics and Gynaecology Research
Aaron S Fox, Christopher P Carty, Luca Modenese, Lee A Barber, Glen A Lichtwark
Altered neural control of movement and musculoskeletal deficiencies are common in children with spastic cerebral palsy (SCP), with muscle weakness and contracture commonly experienced. Both neural and musculoskeletal deficiencies are likely to contribute to abnormal gait, such as equinus gait (toe-walking), in children with SCP. However, it is not known whether the musculoskeletal deficiencies prevent normal gait or if neural control could be altered to achieve normal gait. This study examined the effect of simulated muscle weakness and contracture of the major plantarflexor/dorsiflexor muscles on the neuromuscular requirements for achieving normal walking gait in children...
January 12, 2018: Gait & Posture
Dane A De Silva, Anne R Synnes, Peter von Dadelszen, Tang Lee, Jeffrey N Bone, Laura A Magee
BACKGROUND: Evidence supports magnesium sulphate (MgSO4) for women at risk of imminent birth at < 32-34 weeks to reduce the likelihood of cerebral palsy in the child. MAGnesium sulphate for fetal neuroprotection to prevent Cerebral Palsy (MAG-CP) was a multifaceted knowledge translation (KT) strategy for this practice. METHODS: The KT strategy included national clinical practice guidelines, a national online e-learning module and, at MAG-CP sites, educational rounds, focus group discussions and surveys of barriers and facilitators...
January 11, 2018: Implementation Science: IS
Robert W Dettman, Derin Birch, Augusta Fernando, John A Kessler, Maria L V Dizon
Hypoxic-ischemic injury (HI) to the neonatal human brain results in myelin loss that, in some children, can manifest as cerebral palsy. Previously, we had found that neuronal overexpression of the bone morphogenic protein (BMP) inhibitor noggin during development increased oligodendroglia and improved motor function in an experimental model of HI utilizing unilateral common carotid artery ligation followed by hypoxia. As BMPs are known to negatively regulate oligodendroglial fate specification of neural stem cells and alter differentiation of committed oligodendroglia, BMP signaling is likely an important mechanism leading to myelin loss...
January 12, 2018: Developmental Neuroscience
Dirk Bassler, Eric S Shinwell, Mikko Hallman, Pierre-Henri Jarreau, Richard Plavka, Virgilio Carnielli, Christoph Meisner, Corinna Engel, Alexander Koch, Karen Kreutzer, Johannes N van den Anker, Matthias Schwab, Henry L Halliday, Christian F Poets
BACKGROUND: The long-term effects on neurodevelopment of the use of inhaled glucocorticoids in extremely preterm infants for the prevention or treatment of bronchopulmonary dysplasia are uncertain. METHODS: We randomly assigned 863 infants (gestational age, 23 weeks 0 days to 27 weeks 6 days) to receive early (within 24 hours after birth) inhaled budesonide or placebo. The prespecified secondary long-term outcome was neurodevelopmental disability among survivors, defined as a composite of cerebral palsy, cognitive delay (a Mental Development Index score of <85 [1 SD below the mean of 100] on the Bayley Scales of Infant Development, Second Edition, with higher scores on the scale indicating better performance), deafness, or blindness at a corrected age of 18 to 22 months...
January 11, 2018: New England Journal of Medicine
Sophy T F Shih, Utsana Tonmukayakul, Christine Imms, Dinah Reddihough, H Kerr Graham, Liz Cox, Rob Carter
AIM: Economic appraisal can help guide policy-making for purchasing decisions, and treatment and management algorithms for health interventions. We conducted a systematic review of economic studies in cerebral palsy (CP) to inform future research. METHOD: Economic studies published since 1970 were identified from seven databases. Two reviewers independently screened abstracts and extracted data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
January 10, 2018: Developmental Medicine and Child Neurology
Mehmet Deliktaş, Hacer Ergin, Aydın Demiray, Hakan Akça, Özmert M A Özdemir, Mehmet Bülent Özdemir
OBJECTIVE: Unconjugated bilirubin (UCB) may cause neurotoxicity in preterm neonates due to immaturity of UGT1A1 leading to bilirubin accumulation in the brain. Caffeine used in the treatment of apnea of prematurity was reported to decrease mechanical ventilation requirement, the frequencies of bronchopulmonary dysplasia, patent ductus arteriosus, cerebral palsy and neurodevelopmental disorders in very low birth weight infants. However, the effect of caffeine on hyperbilirubinemia was not yet clarified...
January 2, 2018: Journal of Maternal-fetal & Neonatal Medicine
Claire Thuillier, Sophie Roy, Violaine Peyronet, Thibaud Quibel, Aurélie Nlandu, Patrick Rozenberg
BACKGROUND: The dramatic rise in cesarean delivery (CD) rates worldwide in recent decades, without evidence of a concomitant decrease in cerebral palsy rates, has raised concerns about its potential negative consequences for maternal and infant health. In 2014, the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine jointly published an Obstetric Care Consensus for safe prevention of the primary cesarean delivery. OBJECTIVE: We sought to assess whether modification of our protocol to implement these recommendations helped to decrease our primary CD rate safely...
December 29, 2017: American Journal of Obstetrics and Gynecology
Sofia Lundh, Salmir Nasic, Jacques Riad
INTRODUCTION: Few studies on fatigue, quality of life and walking ability in adults with cerebral palsy (CP) are available. It is unclear whether these variables are associated. AIM: The aim was to study the influence of CP on fatigue, quality of life, and gait of adult patients. MATERIAL AND METHODS: Three-dimensional gait analysis was performed on 24 women and 26 men, mean age 32.1 (range 21.7-67.2), 23 with unilateral and 27 with bilateral CP...
December 16, 2017: Gait & Posture
M Rodríguez Mariblanca, R Cano de la Cuerda
INTRODUCTION: Cerebral palsy (CP) is one of the most common developmental disorders. Technological development has enabled a transformation of the healthcare sector, which can offer more individualised, participatory, and preventive services. Within this context of new technology applied to the healthcare sector, mobile applications, or apps, constitute a very promising tool for the management of children with CP. OBJECTIVE: The purpose of this article is to perform a systematic review of the information published about various mobile applications either directly related to CP or with potential to be useful in the context of the disease, and to describe, analyse, and classify these applications...
December 21, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
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