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neonatal neurological assessment

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https://www.readbyqxmd.com/read/27915463/the-our-hope-approach-for-ethics-and-communication-about-neonatal-neurological-injury
#1
REVIEW
Eric Racine, Emily Bell, Barbara Farlow, Steven Miller, Antoine Payot, Lisa Anne Rasmussen, Michael I Shevell, Donna Thomson, Pia Wintermark
Predicting neurological outcomes of neonates with acute brain injury is an essential component of shared decision-making, in order to guide the development of treatment goals and appropriate care plans. It can aid parents in imagining the child's future, and guide timely and ongoing treatment decisions, including shifting treatment goals and focusing on comfort care. However, numerous challenges have been reported with respect to evidence-based practices for prognostication such as biases about prognosis among clinicians...
December 4, 2016: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/27906083/neonatal-diffusion-tensor-brain-imaging-predicts-later-motor-outcome-in-preterm-neonates-with-white-matter-abnormalities
#2
Do-Yeon Kim, Hyun-Kyung Park, Nam-Su Kim, Se-Jin Hwang, Hyun Ju Lee
BACKGROUND: White matter (WM) abnormalities associated with prematurity are one of the most important causes of neurological disability that involves spastic motor deficits in preterm newborns. This study aimed to evaluate regional microstructural changes in diffusion tensor imaging (DTI) associated with WM abnormalities. METHODS: We prospectively studied extremely low birth weight (ELBW; <1000 g) preterm infants who were admitted to the Neonatal Intensive Care Unit of Hanyang University Hospital between February 2011 and February 2014...
December 1, 2016: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/27889713/prognostic-value-of-resistive-index-in-neonates-with-hypoxic-ischemic
#3
A Senthil Kumar, Aparna Chandrasekaran, Rajamannar Asokan, Kathirvelu Gopinathan
OBJECTIVE: To evaluate the role of Resistive Index measured by cranial doppler ultrasonography in predicting the risk of death/ abnormal neurodevelopmental outcomes in term neonates with hypoxic ischemic encephalopathy. METHODS: We enrolled 50 term asphyxiated neonates with hypoxic ischemic encephalopathy and measured resistive index within 72 hours from the anterior cerebral artery. Participants underwent tone and developmental assessment at 6-12 months. RESULTS: Among the 50 neonates, 25 (50%) had abnormal resistive index (<0...
November 5, 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/27889710/effect-of-withholding-phenobarbitone-maintenance-in-neonatal-seizures-a-randomized-controlled-trial
#4
Pranjali Saxena, Abhishek Singh, Amit Upadhyay, Priyanka Gupta, Sangeeta Sharma, Sreenivas Vishnubatla
OBJECTIVE: To compare the effect of withholding maintenance phenobarbitone on breakthrough seizures. DESIGN: A double blind randomized controlled trial. SETTING: Level II neonatal intensive care unit (NICU) of a teaching hospital in Northern India. PARTICIPANTS: Study population included 152 term and near term neonates (34 weeks of gestation age) with admission weight ?2 kg with clinically apparent seizures who received intravenous (IV) loading dose of 20mg/kg of phenobarbitone...
November 5, 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/27887996/effects-of-erythropoietin-on-neonatal-hypoxia-ischemia-brain-injury-in-rat-model
#5
Qing Ren, Zhong-Hui Jiang, Xing-Fang Zhang, Qiao-Zhi Yang
BACKGROUND: Hypoxic-ischemic (HI) injury to the developing brain remains a major cause of morbidity. To date, few therapeutic strategies could provide complete neuroprotection. Erythropoietin (EPO) has been shown to be beneficial in several models of neonatal HI. This study examines the effect of treatment with erythropoietin on postnatal day 2 (P2) rats introduced with HI injury. METHOD: Rats at P2 were randomized into four groups: sham, bilateral carotid artery occlusion (BCAO), BCAO + early EPO, and BCAO + late EPO groups...
November 23, 2016: Physiology & Behavior
https://www.readbyqxmd.com/read/27885575/administration-of-huperzia-quadrifariata-extract-a-cholinesterase-inhibitory-alkaloid-mixture-has-neuroprotective-effects-in-a-rat-model-of-cerebral-hypoxia-ischemia
#6
F K Odorcyk, E F Sanches, F C Nicola, J Moraes, L F Pettenuzzo, J Kolling, C Siebert, A Longoni, E L Konrath, A Wyse, C A Netto
Neonatal hypoxia-ischemia (HI) is an etiologic component of several neurologic pathologies associated to cognitive impairment. The mechanisms involved in HI-induced tissue damage start immediately after HI and extend for days. Acetylcholine is an important neurotransmitter in the central nervous system and exerts a protector effect on tissue damage by modulating inflammation, and cholinesterase inhibitors have shown neuroprotective properties and their action are often attributed to inhibition of the immune response...
November 24, 2016: Neurochemical Research
https://www.readbyqxmd.com/read/27885286/immediate-outcome-of-hypoxic-ischaemic-encephalopathy-in-hypoxiate-newborns-in-nepal-medical-college
#7
S Shrestha, G S Shrestha, A Sharma
BACKGROUND: Birth asphyxia is the fifth major cause of under-five child deaths after pneumonia, diarrhoea, neonatal infections and complications of preterm birth. It is one of the important causes of neonatal mortality and morbidity accounting up to 30% of neonatal death in Nepal. It is also an important cause of long-term neurological disability and impairment. The mortality rate due to birth asphyxia is considered a good guide to the quality of perinatal care. This study was conducted to assess the rate of birth asphyxia, risk factors and outcome of the babies who were asphyxiated at birth...
May 2016: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/27855206/zika-prvabc59-infection-is-associated-with-t-cell-infiltration-and-neurodegeneration-in-cns-of-immunocompetent-neonatal-c57bl-6-mice
#8
Mohanraj Manangeeswaran, Derek D C Ireland, Daniela Verthelyi
The recent spread of Zika virus (ZIKV) and its association with increased rates of Guillain Barre and other neurological disorders as well as congenital defects that include microcephaly has created an urgent need to develop animal models to examine the pathogenesis of the disease and explore the efficacy of potential therapeutics and vaccines. Recently developed infection models for ZIKV utilize mice defective in interferon responses. In this study we establish and characterize a new model of peripheral ZIKV infection using immunocompetent neonatal C57BL/6 mice and compare its clinical progression, virus distribution, immune response, and neuropathology with that of C57BL/6-IFNAR KO mice...
November 2016: PLoS Pathogens
https://www.readbyqxmd.com/read/27829078/sex-specific-alterations-of-white-matter-developmental-trajectories-in-infants-with-prenatal-exposure-to-methamphetamine-and-tobacco
#9
Linda Chang, Kenichi Oishi, Jon Skranes, Steven Buchthal, Eric Cunningham, Robyn Yamakawa, Sara Hayama, Caroline S Jiang, Daniel Alicata, Antonette Hernandez, Christine Cloak, Tricia Wright, Thomas Ernst
Importance: Methamphetamine is a common illicit drug used worldwide. Methamphetamine and/or tobacco use by pregnant women remains prevalent. However, little is known about the effect of comorbid methamphetamine and tobacco use on human fetal brain development. Objective: To investigate whether microstructural brain abnormalities reported in children with prenatal methamphetamine and/or tobacco exposure are present at birth before childhood environmental influences...
November 9, 2016: JAMA Psychiatry
https://www.readbyqxmd.com/read/27829004/outcome-at-two-years-of-very-preterm-infants-born-after-rupture-of-membranes-before-viability
#10
Amelie Kieffer, Gaelle Pinto Cardoso, Caroline Thill, Eric Verspyck, Stéphane Marret
PURPOSE: To compare the respiratory and neurological outcomes at two years of age of preterm children born before 33 weeks of gestation (WG) after early preterm premature rupture of membranes (EPPROM) between 14 and 24 WG with preterm children without EPPROM. DESIGN AND PATIENTS: This single-center case-control retrospective study was conducted at Rouen University Hospital between 1st January 2000 and 31st December 2010. All the cases with EPPROM born from 26WG to 32WG were included...
2016: PloS One
https://www.readbyqxmd.com/read/27793105/assessment-of-risk-factors-for-cerebral-oxygen-desaturation-during-neonatal-and-infant-general-anesthesia-an-observational-prospective-study
#11
Ilona Razlevice, Danguole C Rugyte, Loreta Strumylaite, Andrius Macas
BACKGROUND: Cerebral oxygen saturation (rSO2c) decrease from baseline greater than 20 % during infant cardiac surgery was associated with postoperative neurologic changes and neurodevelopmental impairment at 1 year of age. So far, there is no sufficient evidence to support the routine monitoring of rSO2c during general surgical procedures in children. We aimed to find out the frequency of cerebral desaturation 20 % or more from baseline and to identify possible predictors of change in cerebral oxygen saturation during neonatal and infant general surgery...
October 28, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27785575/diagnosis-of-joubert-syndrome-via-ultrasonography
#12
Baris Buke, Emre Canverenler, Göksun İpek, Semiha Canverenler, Hatice Akkaya
Joubert syndrome (JS) and related disorders (JSRD) are a group of multiple congenital anomaly syndromes in which the diagnostic hallmark is the molar tooth sign (MTS), a complex midbrain malformation visible on brain imaging. Detection of the MTS should be followed by a diagnostic protocol to assess multi-organ involvement. The incidence of JSRD ranges between 1/80,000 and 1/100,000 live births, although these values may represent an underestimate. The neurological components of JSRD include hypotonia, ataxia, intellectual disability, abnormal eye movements, and neonatal breathing problems...
October 26, 2016: Journal of Medical Ultrasonics
https://www.readbyqxmd.com/read/27775148/neurobehaviour-at-term-equivalent-age-and-neurodevelopmental-outcomes-at-2-years-in-infants-born-moderate-to-late-preterm
#13
Alicia J Spittle, Jennifer M Walsh, Cody Potter, Emma Mcinnes, Joy E Olsen, Katherine J Lee, Peter J Anderson, Lex W Doyle, Jeanie L Y Cheong
AIM: To examine the association between newborn neurobehavioural assessments and neurodevelopmental outcomes at 2 years in infants born moderate-to-late preterm (MLPT). METHOD: Two-hundred and one infants born MLPT (born 32-36(+6) wks' gestation) were assessed with the Hammersmith Neonatal Neurological Examination (HNNE) and NICU Network Neurobehavioral Scale (NNNS), with suboptimal performance defined as scores lower than the 10th centile. Development was assessed at 2 years corrected age with the Bayley Scales of Infant and Toddler Development 3rd Edition, with delay defined as scores less than 1 standard deviation (SD) below the mean...
October 24, 2016: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/27746740/moderate-hyperbilirubinemia-alters-neonatal-cardiorespiratory-control-and-induces-inflammation-in-the-nucleus-tractus-solitarius
#14
Marie-Laure Specq, Mélisande Bourgoin-Heck, Nathalie Samson, François Corbin, Christian Gestreau, Maxime Richer, Hazim Kadhim, Jean-Paul Praud
Hyperbilirubinemia (HB) occurs in 90% of preterm newborns. Moderate HB can induce acute neurological disorders while severe HB has been linked to a higher incidence of apneas of prematurity. The present study aimed to test the hypothesis that even moderate HB disrupts cardiorespiratory control in preterm lambs. Two groups of preterm lambs (born 14 days prior to term), namely control (n = 6) and HB (n = 5), were studied. At day 5 of life, moderate HB (150-250 μmol/L) was induced during 17 h in the HB group after which cardiorespiratory control as well as laryngeal and pulmonary chemoreflexes were assessed during baseline recordings and during hypoxia...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/27746564/premedication-with-midazolam-prior-to-cesarean-delivery-in-preeclamptic-parturients-a-randomized-controlled-trial
#15
Ali M Mokhtar, Ahmed I Elsakka, Hassan M Ali
BACKGROUND: Anxiety is a concern in obstetrics, especially in preeclamptic mothers. Sedation is not commonly used in parturients for fear of adverse neonatal effect. We investigated maternal and neonatal outcome of midazolam as an adjuvant to spinal anesthesia for elective cesarean delivery. METHODS: A prospective randomized controlled trial, in which eighty preeclamptic parturients received either an intravenous dose of 0.035 mg/kg of midazolam or an equal volume of normal saline, 30 min before spinal anesthesia...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27743745/use-of-transcranial-doppler-for-management-of-central-nervous-system-infections-in-critically-ill-children
#16
Laurence Ducharme-Crevier, Michele G Mills, Priya M Mehta, Craig M Smith, Mark S Wainwright
BACKGROUND: The primary objective of this study was to characterize changes in cerebral blood flow measured using transcranial Doppler in children with central nervous system infections. We hypothesized that children with central nervous system infections have abnormal cerebral blood flow, associated with a greater frequency of complications and poor neurological outcome. METHODS: We conducted a single-center, retrospective study of children admitted to the neonatal or pediatric intensive care unit with central nervous system infection and undergoing transcranial Doppler as part of routine care between March 2011 and July 2015...
December 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/27718891/erythropoietin-reduces-white-matter-damage-in-two-day-old-rats-exposed-to-hypoxic-ischemia-injury
#17
Qing Ren, Xing-Fang Zhang, Jin-Ying Yang
OBJECTIVE: The aim of the study was to investigate whether erythropoietin (EPO) could protect against white matter damage (WMD) in a preterm equivalent neonatal rat hypoxic-ischemia (HI) model. METHODS: 113 two-day-old male rat pups were divided randomly into three groups: sham-treated, bilateral carotid artery occlusion (BCAO)-treated, BCAO + EPO-treated group. EPO (50 U/10 g body weight) or saline alone was administered intraperitoneally immediately after BCAO surgery...
October 8, 2016: Neurological Research
https://www.readbyqxmd.com/read/27704703/umbilical-lactate-as-a-measure-of-acidosis-and-predictor-of-neonatal-risk-a-systematic-review
#18
E R Allanson, T Waqar, Crh White, Ö Tunçalp, J E Dickinson
BACKGROUND: Umbilical cord lactate is one approach to measuring acidosis and intrapartum hypoxia, knowledge of which may be helpful for clinicians involved in the care of women and newborns. OBJECTIVE: To synthesise the evidence on accuracy of umbilical cord lactate in measuring acidosis and predicting poor neonatal outcome. SEARCH STRATEGY: Studies published and unpublished between 1990 and 2014 from PubMed/Medline, EMBASE, Cochrane Central Register of Controlled Trials, and clinicaltrials...
October 5, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27697761/high-dose-micafungin-for-preterm-neonates-and-infants-with-invasive-and-central-nervous-system-candidiasis
#19
Cinzia Auriti, Marco Falcone, Maria Paola Ronchetti, Bianca Maria Goffredo, Sara Cairoli, Rosamaria Crisafulli, Fiammetta Piersigilli, Tiziana Corsetti, Andrea Dotta, Manjunath P Pai
High doses of micafungin are advocated in neonates with systemic candidiasis, but limited pharmacokinetic (PK) and safety data are available to support their use. Eighteen preterm neonates and infants with systemic candidiasis, three of whom had meningitis, were treated for at least 14 days with 8 to 15 mg/kg of body weight/day of intravenous micafungin. Plasma micafungin concentrations (four measurements for each patient) were determined after the third dose, and the cerebrospinal fluid (CSF) micafungin concentrations in three patients were also obtained...
December 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27648460/interplay-of-brain-structure-and-function-in-neonatal-congenital-heart-disease
#20
Ala Birca, Vasily A Vakorin, Prashob Porayette, Sujana Madathil, Vann Chau, Mike Seed, Sam M Doesburg, Susan Blaser, Dragos A Nita, Rohit Sharma, Emma G Duerden, Edward J Hickey, Steven P Miller, Cecil D Hahn
OBJECTIVE: To evaluate whether structural and microstructural brain abnormalities in neonates with congenital heart disease (CHD) correlate with neuronal network dysfunction measured by analysis of EEG connectivity. METHODS: We studied a prospective cohort of 20 neonates with CHD who underwent continuous EEG monitoring before surgery to assess functional brain maturation and network connectivity, structural magnetic resonance imaging (MRI) to determine the presence of brain injury and structural brain development, and diffusion tensor MRI to assess brain microstructural development...
September 2016: Annals of Clinical and Translational Neurology
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