P.096 Optimizing the Use of Continuous EEG Monitoring in Neonatal
                        Encephalopathy

Background: Newborns with hypoxic-ischemic encephalopathy (HIE) are at high risk for seizures, the majority of which have no clinical signs and therefore require continuous electroencephalographic (cEEG) monitoring for their detection. We sought to determine which neonates are at highest risk for seizures in order to optimize allocation of scarce cEEG resources. Methods: We identified term neonates diagnosed with HIE who underwent at least 24 hours of protocol-based cEEG monitoring between 2016 and 2019. We quantified seizure incidence, timing and burden, and correlated these with potential risk factors such as HIE severity, use of therapeutic hypothermia, preceding suspected clinical seizures, amplitude-integrated EEG (aEEG) background and patterns suspicious for seizures, and use of anti-seizure drugs. Results: cEEG monitoring was completed in 218 neonates with HIE, of whom 164 (75%) underwent therapeutic hypothermia. Preceding clinical/aEEG seizures occurred in 147 (67%), 99 (67%) of whom had been cooled but only 22 (10%) had cEEG-confirmed seizures. Characterization of seizure burden and correlation with potential risk factors is ongoing. Conclusions: Although seizures are commonly suspected in neonates with HIE, they are infrequently confirmed during cEEG monitoring, creating opportunities for more efficient risk-based allocation of cEEG resources.

Download Full-text

Epidemiological and Molecular Investigation of Ocular Fungal Infection in Equine from Egypt

Veterinary Sciences ◽

10.3390/vetsci7030130 ◽

2020 ◽

Vol 7 (3) ◽

pp. 130

Author(s):

Amin Tahoun ◽

Helmy K. Elnafarawy ◽

Ehab Kotb Elmahallawy ◽

Abdelhamed Abdelhady ◽

Amira M. Rizk ◽

...

Keyword(s):

Risk Factors ◽

Fungal Infection ◽

Prevalence Rate ◽

Clinical Signs ◽

Fungal Species ◽

Potential Risk Factors ◽

Polymerase Chain ◽

Penicillium Spp ◽

Morphological And Molecular Characterization

Diagnosis and treatment of ocular fungal infection in equine seems very challenging for owners and clinicians. The present study aimed to identify and characterize fungal species isolated from the eyes of clinically healthy and diseased equines (N = 100) from Dakahlia Governorate, Egypt. The work also involved morphological and molecular characterization of the major fungal species. In addition, correlations between the occurrence of isolated fungi and some of the potential risk factors were also investigated. Interestingly, the prevalence rate of ocular mycosis in all examined equines in the study was 28% and there were major clinical signs associated with ocular fungal infection. Moreover, the identified fungal species included Aspergillus flavus, A. fumigatus, A. niger, Penicillium spp., Mucor spp., and Alternari spp. with a corresponding prevalence rate of 63.9%, 27.8%, 15.3%, 18.1%, 13.9%, and 4.2%, respectively, in healthy equine eyes, while their prevalence in diseased equine eyes was 57.1%, 32.1%, 21.4%, 7.1%, 3.6%, and 0%. Furthermore, a statistical significant association (p < 0.05) was found between the frequency of isolation of A. fumigatus and Penicillium and several risk factors (breed, sex, and ground type), while the remaining risk factors and occurrence of fungi were not statistically correlated. A subset of the Aspergillus species samples positive by polymerase chain reaction (PCR) were sequenced and their phylogenetic analysis identified three species of Aspergillus. Taken together, our study provides novel data related to the occurrence of ocular mycosis in equine in Egypt. Given the zoonotic potential of some identified fungi, our data may be helpful for implementation of novel diagnostic and therapeutic strategies for combating this sight-threatening infection in equine.

Download Full-text

Epilepsy Outcome in Cooled Hypoxic–Ischemic Encephalopathic Newborns

Journal of Pediatric Epilepsy ◽

10.1055/s-0038-1629913 ◽

2018 ◽

Vol 07 (01) ◽

pp. 008-013

Author(s):

Barbara Podestà ◽

Eleonora Briatore ◽

Andrea Boghi ◽

Giulia Pomero ◽

Luigi Gozzoli ◽

...

Keyword(s):

Status Epilepticus ◽

Therapeutic Hypothermia ◽

Hypoxic Ischemic Encephalopathy ◽

Neurologically Impaired ◽

Continuous Eeg ◽

Continuous Eeg Monitoring ◽

Spontaneous Improvement ◽

Eeg Recordings ◽

Magnetic Resonance Imaging Mri ◽

Ischemic Encephalopathy

AbstractEpilepsy is a frequent consequence of neonatal hypoxic–ischemic encephalopathy. It is not yet known if the introduction of therapeutic hypothermia modifies the rate and the characteristics of epilepsy. We report on 59 infants who suffered from hypoxic–ischemic encephalopathy and underwent therapeutic hypothermia. Birth, physiological and biochemical data, frequent electroencephalography (EEG) recordings or continuous EEG monitoring, and magnetic resonance imaging (MRI) were documented in the neonatal period. Prechtl's General Movements evaluation was performed and the Griffiths Scales of Mental Development were applied at 3 and 24 months of age, respectively. Children were followed up for at least 3 years (mean 5 ± 1.6 years). Six children (10%) developed epilepsy. All of them had a severe hypoxic–ischemic encephalopathy and were neurologically impaired at 2 years of age. Furthermore, all of them had a severe pattern of MRI injury and poor neonatal EEG backgrounds. Four of them suffered from neonatal status epilepticus. Four out of six showed a similar epileptic pattern: their epilepsy started early; it was drug resistant; it required an aggressive polytherapy; and it showed a spontaneous improvement after 2 years. The rate of epilepsy in our cooled infants was similar to those reported in other studies on noncooled ones. Only severe hypoxic–ischemic encephalopathy predisposed the cooled infants toward epilepsy. Neonatal status epilepticus and persisting poor EEG backgrounds were predictive of the development of epilepsy in our sample.

Download Full-text

Characterization of Meibomian Gland Atrophy and the Potential Risk Factors for Middle Aged to Elderly Patients With Cataracts

Translational Vision Science & Technology ◽

10.1167/tvst.9.7.48 ◽

2020 ◽

Vol 9 (7) ◽

pp. 48

Author(s):

Xiaolei Lin ◽

Yue Wu ◽

Yiqin Chen ◽

Yuyu Zhao ◽

Linfeng Xiang ◽

...

Keyword(s):

Risk Factors ◽

Elderly Patients ◽

Potential Risk ◽

Meibomian Gland ◽

Middle Aged ◽

Potential Risk Factors ◽

Gland Atrophy

Download Full-text

Premature Arterial Disease Associated with Familial Antithrombin III Deficiency

Thrombosis and Haemostasis ◽

10.1055/s-0038-1645677 ◽

1990 ◽

Vol 63 (01) ◽

pp. 013-015 ◽

Cited By ~ 15

Author(s):

E J Johnson ◽

C R M Prentice ◽

L A Parapia

Keyword(s):

Risk Factors ◽

Venous Thromboembolism ◽

Potential Risk ◽

Antithrombin Iii ◽

Arterial Disease ◽

Coagulation System ◽

Early Age ◽

Arterial Thromboembolism ◽

Potential Risk Factors ◽

Antithrombin Iii Deficiency

SummaryAntithrombin III (ATIII) deficiency is one of the few known abnormalities of the coagulation system known to predispose to venous thromboembolism but its relation to arterial disease is not established. We describe two related patients with this disorder, both of whom suffered arterial thrombotic events, at an early age. Both patients had other potential risk factors, though these would normally be considered unlikely to lead to such catastrophic events at such an age. Thrombosis due to ATIII deficiency is potentially preventable, and this diagnosis should be sought more frequently in patients with arterial thromboembolism, particularly if occurring at a young age. In addition, in patients with known ATIII deficiency, other risk factors for arterial disease should be eliminated, if possible. In particular, these patients should be counselled against smoking.

Download Full-text