Strength of the Breuer-Hering inflation reflex in term and preterm infants

1995 ◽  
Vol 79 (6) ◽  
pp. 1986-1990 ◽  
Author(s):  
J. P. De Winter ◽  
I. T. Merth ◽  
A. Berkenbosch ◽  
R. Brand ◽  
P. H. Quanjer
Keyword(s):  
Preterm Infants ◽  
Respiratory System ◽  
Gestational Age ◽  
Blood Gases ◽  
First Year ◽  
Static Compliance ◽  
Term Infants ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The effect of the presence of the respiratory distress syndrome (RDS) or related factors (static compliance of the respiratory system and transcutaneous blood gases) and gestational age on the strength of the Breuer-Hering inflation reflex (BHIR) was studied in three groups of infants. Twenty-six ventilated preterm infants with and without RDS were studied 6 h after birth (group 1). In 24 preterm infants, we followed the development of reflex strength during the first year of life (group 2). Twenty-one healthy nonintubated term infants were studied within the first week of life (group 3). The BHIR was initiated by end-inspiratory occlusions, and the strength was characterized by the ratio of expiratory time after and without preceding airway occlusion. The static compliance of the respiratory system in ventilated infants was assessed by the multiple-occlusion technique. In group 1, reflex strength declined with increasing gestational age; in the presence of RDS or low respiratory compliance, the decline was less. Transcutaneous blood gases did not affect reflex strength. At term age, reflex strength was similar in spontaneously breathing preterm (group 2) and term infants (group 3). The BHIR decreased in strength during the first year after preterm birth. We conclude that 1) the strength of the BHIR decreases with increasing gestational and postnatal ages and 2) RDS, due to changes in respiratory system mechanics, causes an increase in reflex strength.

scholarly journals Neonatal Problems and Infancy Growth of Term SGA Infants: Does “SGA” Definition Need to Be Re-evaluated?

2021 ◽  
Vol 9 ◽  
Author(s):  
Saygin Abali ◽  
Serdar Beken ◽  
Eda Albayrak ◽  
Aysegul Inamlik ◽  
Burcu Bulum ◽  
...  
Keyword(s):  
Gestational Age ◽  
Severe Hypoglycemia ◽  
Point Of View ◽  
Control Group ◽  
Term Infants ◽  
Group 3 ◽  
Group 2 ◽  
Definition Of ◽  
Neonatal Problems ◽  
Group 1

Introduction: The exact definition of small-for-gestational-age (SGA) infant is still controversial among clinicians. In this study, we aimed to understand which definition is better in terms of establishing both early postnatal problems and growth. In this way, we compared early neonatal problems and infancy growth of term infants with birth weight (BW) < -2 SDS and with BW between 10th percentile (−1.28 SDS) and −2 SDS.Methods: A single center retrospective cohort study was conducted. Preterm infants, multiple gestations and newborns with any congenital anomalies were excluded from the study. Study group was defined as Group 1 (n = 37), infants BW < −2.00 SDS; Group 2 (n = 129), between −1.28 and −2.00 SDS; and Group 3 (n = 137), randomly selected newborns with optimal-for-gestational-age (BW between −0.67 and +0.67 SDS) as a control group.Results: The incidence of severe hypoglycemia was highest in Group 1 (%10.8) and Group 2 and 3 had similar rates of severe hypoglycemia (0.8 and 0.7%, respectively). The incidence of polycythemia was 5.4% in Group 1 and was significantly higher than Group 3 (0.0%) while it was 2.3% in Group 2. Short stature (length < −2 SDS) ratio at the age of 1 and 2 years were similar in each group. Overweight/obesity ratio at the age of 1 were 9.5, 20.8 and 16.7% in each group, respectively (p = 0.509).Conclusion: This study was planned as a pilot study to determine potential differences in the problems of hypoglycemia, polycythemia, and growth according to the differences in definition. Short term disturbances such as hypoglycemia and polycythemia are found to be higher in infants with a BW SDS below −2. From this point of view, of course, it will not be possible to change the routine applications immediately, however this study will be an initiative for discussions by making long-term studies.

scholarly journals The Reliability of Ponderal Index in Predicting Short-Term Complications of Small for Gestational Age Term Infants.

2021 ◽  
Author(s):  
Secil Ercin ◽  
Yeşim Coşkun ◽  
Tuğba Gürsoy
Keyword(s):  
Gestational Age ◽  
Hospitalization Rate ◽  
Ponderal Index ◽  
Short Term ◽  
Term Infants ◽  
Severe Morbidity ◽  
Group 3 ◽  
Group 2 ◽  
Fair Assessment ◽  
Group 1

Abstract The birth weight (BW) for gestational age (GA) ensure a fair assessment of the nutritional status of small for gestational (SGA) infants. Ponderal index (PI) is used to identify wasting. This study aims to evaluate the association between PI values and short-term complications of term SGA infants and evaluate the reliability of PI. A total of 489 term SGA infants were included in this retrospective study. According to the PI values, the neonates were divided into three groups. Group 1 consisted of infants with low PI (PI < 10th percentile) (n=45), group 2 consisted of infants with appropriate PI (PI 10th-90th percentile) (n=405) and the ones with high PI (PI> 90th percentile) (n=39) constituted group 3. Demographic and clinical data of the mothers and neonates including clinical and laboratory assessments were collected and compared statistically. No difference was observed between the groups other than the incidence of hypoglycemia, jaundice requiring treatment and hospitalization rate, which were all significantly higher in low PI group than the group 2 and 3 (p=0.01, p=0.006 and p=0.04, respectively). None of the babies had severe morbidity or died.Conclusion: Although short-term complications were higher in term SGA infants with low PI, all term SGA infants should be defined as high-risk neonates and deserve special neonatal care and surveillance to prevent short-term complications.

scholarly journals Vermal Length and Transcerebellar Diameter in Gestational Age Estimation: A Guide to Forensic Expert

2019 ◽  
Vol 08 (03) ◽  
pp. 101-105
Author(s):  
Nadia Ahmad ◽  
S. L. Jethani ◽  
Deepa Singh ◽  
Ruchira Nautiyal
Keyword(s):  
Gestational Age ◽  
Age Determination ◽  
Linear Increase ◽  
Group 4 ◽  
Age Regression ◽  
Group 3 ◽  
Group 2 ◽  
Gestational Age Estimation ◽  
Formalin Fixed ◽  
Group 1

Abstract Background Transcerebellar diameter is one of the reliable, constant predicting parameters to assess the gestational age and fetal growth. Other than this, measurements of vermis, mostly the vermal length (height), have also been mentioned by authors to assess gestational age. Establishing a correlation between parameters and advancing gestation would be helpful in estimating the gestational age of fetus. Aims and Objectives To establish a correlation of vermal length and transcerebellar diameter with gestational age. Materials and Methods An observational and descriptive study conducted on 60 formalin-fixed human cerebellums. Fetuses with gross congenital/neurological abnormality were excluded. Fetuses were grouped into four groups—group 1 (13–17 weeks), group 2 (18–22 weeks), group 3 (23–27 weeks), and group 4 (28–32 weeks of gestation). Vermal length and transcerebellar diameter were measured with help of Vernier calipers. The data obtained were analyzed using statistical software SPSS version 20.0 and one-way analysis of variance. Observation A linear increase in vermal length parameters and transcerebellar diameter were seen with increasing gestational age. Regression analysis was done and regression equation was derived for each parameter. Conclusion Such correlations would help in fetal age determination in the field of forensic studies.

scholarly journals Comparison of Changes in Number of Hyperreflective Dots After İntravitreal Ranibizumab or Dexamethasone İmplant in Patients with Branch Retinal Vein Occlusion

2021 ◽  
Author(s):  
Aylin Karalezli ◽  
Sema Kaderli ◽  
Ahmet Kaderli ◽  
Cansu Kaya ◽  
Sabahattin Sul
Keyword(s):  
First Year ◽  
Intravitreal Ranibizumab ◽  
Retinal Layers ◽  
Vein Occlusion ◽  
Significant Difference ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Purpose: To compare the effect of intravitreal ranibizumab (IVR) or intravitreal dexamethasone implants (IVD) on regression of hyperreflective dots (HRDs) on optical coherence tomography (OCT) B-scan in patients with branch retinal vein occlusion (BRVO). Methods: 37 eyes of 37 patients with cystoid macular edema who received IVR or IVD and followed up for at least 12 months were included in this study. The patients were divided into three groups according to intravitreal treatment. Group 1 consisted of 12 eyes who received only IVD, group 2 consisted of 10 eyes who received only IVR on a pro re nata and group 3 consisted of 15 eyes who received both IVD and IVR. OCT parameters (CMT, number of HRDs, status of external limiting membrane (ELM) and ellipsoid zone (EZ)) and best-corrected visual acuity (BCVA) were compared between the groups over the follow-up time. HRDs were categorized as HRD in inner retinal layers (from the internal limiting membrane to the inner nuclear layer) or HRD in outer retinal layers (from the outer plexiform layer to the outer border of the photoreceptor layer).Results: There was no significant difference between groups in terms of BCVA, CMT, HRDs in the inner and the outer retinal layers at baseline visit. (p˃0.05 for all) Comparing the baseline values in all groups, a significant decrease was observed in CMT in the first year. (For group 1; p=0.013, group 2; p=0.010; group 3, p<0.001) The BCVA was significantly increased after 1 year in all groups. (p=0.001, p=0.006, p<0.001) The mean number of HRDs in inner and outer retinal layers were significantly decreased in group 1 and group 3. (For group 1; p<0.001, p=0.001, for group 3; p<0.001, p<0.001) However, there was no significant difference in terms of the mean number of HRDs in inner and outer retinal layers for group 2. (p=0.134, p=0.477) At the first year, the number of HRDs in inner and outer retinal layers was significantly lower in group 1 and group 3 than group 2. (For inner HRDs; group 1 vs. group 2 p=0.007, group 2 vs. group 3 p<0.001. For outer HRDs group 1 vs. group 2 p<0.001, group 2 vs. group 3 p<0.001.) The BCVA was higher in group 3 than group 2 at 1year. (p=0.048). There was no significant difference in terms of post-treatment CMT and the number of HRDs between group 1 and group3 in posthoc tests (p=0.621, p=0.876, and p=0.632).Conclusion: The reduction in HRDs at 12 months and better BCVA after IVD intimates that the HRDs should be considered as inflammatory markers in the follow-up of CME in BRVO. Thus, IVD injection could be more appropriate for patients with higher HRDs after BRVO.

Survival of Patients with High-Risk Pulmonary Arterial Hypertension Associated with Congenital Heart Disease

2021 ◽  
Vol 104 (6) ◽  
pp. 895-901
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
High Risk ◽  
Congenital Heart ◽  
First Year ◽  
Pulmonary Arterial ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background: Pulmonary arterial hypertension (PAH) is a common complication of congenital heart disease (CHD) with uncorrected left-to-right shunts. Currently, no consensus guideline exists on the management of PAH-CHD in children, especially those who do not meet operability criteria. Objective: To compare survival between three groups of high-risk PAH-CHD, group 1: total correction including both surgical and percutaneous intervention, group 2: palliative treatment, and group 3: conservative with medical treatment group. Materials and Methods: All pediatric patients with PAH-CHD that underwent cardiac catheterization between January 1, 2008 and December 31, 2017 were retrospectively reviewed. Inclusion criteria were high risk PAH-CHD patients who had pulmonary vascular resistance (PVR) greater than 6 Wood unit·m² and PVR-to-SVR ratio greater than 0.3 evaluated in room air. Exclusion criteria were younger than three months of age, severe left side heart disease with pulmonary capillary wedge pressure greater than 15 mmHg, obstructive total pulmonary venous return, and single ventricle physiology. The Kaplan-Meier analysis was performed from the date of PAH diagnosis to the date of all-cause mortality or to censored date at last follow-up. Results: Seventy-six patients with a median age at diagnosis of 27.5 months (IQR 14.5 to 69.0 months) were included in this study. The patients were divided into three subgroups and included 38 patients (50.0%) in group 1, six patients (7.9%) in group 2, and 32 patients (42.1%) in group 3. The median follow-up time was 554 days (IQR 103 to 2,133 days). The overall mortality was 21.7%. One-year survival in patients with simple lesion in group 1 and 3 were 79.5% and 87.5% and patients with complex lesions in group 1, 2, and 3 were 93.8%, 83.3%, and 73.1%, respectively. The results showed that most mortalities occurred in the first year. There were no statistically significant differences in survival among difference types of treatment (log rank test, p=0.522). Conclusion: The mortality of high-risk PAH-CHD patients were not different among those who underwent corrective surgery, palliative, or conservative treatment. The mortality was high in the first year after PAH diagnosis and remain stable afterward. Management decision for an individual with high-risk PAH-CHD patients requires comprehensive clinical assessment to balance the risks and benefits before making individualized clinical judgment. Keywords: Pulmonary hypertension; Congenital heart disease; High-risk patients

Induction of mixed apneas by inhalation of 100% oxygen in preterm infants

1994 ◽  
Vol 77 (4) ◽  
pp. 1666-1670 ◽  
Author(s):  
R. Alvaro ◽  
J. Alvarez ◽  
K. Kwiatkowski ◽  
D. Cates ◽  
H. Rigatto
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Flow Through ◽  
Group 2 ◽  
Central Apneas ◽  
Group 1

Administration of 100% O2 to preterm infants induces an apnea that is usually central. We hypothesized that this apnea may be “mixed” at times with an obstructive component appearing late during the respiratory pause. In addition, we reasoned that obstruction would depend on the duration of the apnea. Thus, we gave 100% O2 to 61 healthy preterm infants. Group 1 was > or = 1,500 g [birth wt 1.8 +/- 0.1 (SE) kg, gestational age 32 +/- 1 wk, postnatal age 19 +/- 2 days, n = 26] and group 2 was < 1,500 g [birth wt 1.2 +/- 0.1 kg, gestational age 29 +/- 1 wk, postnatal age 30 +/- 4 days, n = 35]. Ventilation was measured using a flow-through system. Respiratory efforts in the absence of flow were detected using chest and abdominal displacements or diaphragmatic electromyography. In group 1, 19% of the central apneas became obstructive at 17 +/- 3 s, whereas in group 2, 34% did so at 12 +/- 2 s. Mixed apneas were longer than those without obstruction (28 +/- 3 vs. 12 +/- 1 s; P = 0.0001). The incidence of mixed apneas was 0, 14, and 66% in group 1 and 0, 27, and 69% in group 2 in apneas of 3–10, 11–20, and > 20 s, respectively. These findings suggest that 1) a percentage of the central apneas induced by inhaling 100% O2 became obstructive, 2) the incidence of the obstructive component increased with the duration of apnea, and 3) smaller infants became obstructed sooner and had a higher incidence of obstruction than larger infants.(ABSTRACT TRUNCATED AT 250 WORDS)

The effects of intrafetal ACTH administration on the outcome of pregnancy in the mare

1998 ◽  
Vol 10 (4) ◽  
pp. 359 ◽  
Author(s):  
J. C. Ousey ◽  
P. D. Rossdale ◽  
F. E. Dudan ◽  
A. L. Fowden
Keyword(s):  
Gestational Age ◽  
Plasma Cortisol ◽  
Maternal Plasma ◽  
Sterile Water ◽  
Adaptive Responses ◽  
Gestational Length ◽  
Adrenocortical Activity ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Enhanced adrenocortical activity in the fetus is related to the onset of parturition in many species. The aim of this study was to determine the effect of injection of fetal ACTH on gestational length and fetal viability in the horse. Pony mares (n=23) were studied from 300 days gestation. Seven control mares (Group 1) received three consecutive intrafetal injections of sterile water, while fetuses of a further 16 mares received Depot ACTH1–24. These mares were either allowed to foal spontaneously (Group 2, n=4) or delivery was induced within 3 days of the last fetal injection (Group 3, n=7); 5 mares aborted within 48 h of intrafetal ACTH injection. Maternal plasma progestagen concentrations increased significantly (P<0.05) in Groups 2 and 3 mares following intrafetal ACTH injection, compared with Group 1 mares. All Group 1 mares delivered live foals at a median gestational age of 327 days (interquartile range, 323–334), except one that aborted 16 days after the last fetal injection. Gestational length was significantly (P<0.05) shortened in Group 2 mares (median 314 [312–314]) days compared with controls. Group 1 and Group 2 foals showed normal postnatal adaptive responses and endocrine (plasma cortisol/progestagens) patterns. Group 3 mares delivered live foals at 306 (306–308) days gestation except one that aborted. Their foals were less mature compared with Groups 1 and 2 foals. Eight ACTH-injected fetuses were meconium-stained at delivery, including four that were aborted. Eight mares had thickened placentae, including three that aborted. The data show that both precocious maturation of the equine fetus and a significant reduction in gestational length compared with controls may be achieved in pony mares by intrafetal ACTH injections. This is probably mediated via adrenal regulation of fetal maturation and production of maternal progestagens.

CHARACTERISTICS OF THE METABOLIC STATUS OF CHILDREN OF THE FIRST YEAR OF LIFE WITH PROTEIN-ENERGY DEFICIENCY DEPENDING ON THE GESTATIONAL AGE AT BIRTH

2020 ◽  
Vol 65 (7) ◽  
pp. 405-410
Author(s):  
I. V. Gorbacheva ◽  
O. U. Kuznetsova ◽  
F. N. Gilmiyarova ◽  
D. V. Pechkurov ◽  
L. N. Vinogradova
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Protein Energy Malnutrition ◽  
Transferrin Saturation ◽  
Deficiency Anemia ◽  
First Year ◽  
Content Increase ◽  
Term Infants ◽  
Protein Energy ◽  
First Year Of Life

Comparative analysis of energy-plastic exchange indicators in mature and premature children of the first year of life in the development of protein-energy malnutrition (PEM) was carried out. Unidirectional changes are revealed, including an increase in creatinine, lactate and creatine phosphokinase activity levels, suggesting a n increasing muscle mass deficit against the background of glucose anaerobic oxidation activation. In preterm infants, glucose and triacylglicerine levels decrease, which reflects uncompensated insufficiency of energy substrates and, accordingly, ATP level. Multidirectional deviations in metabolism are pyruvate and ATP content: increase in full-term infants and decrease in preterm infants, that should be taken into account when monitoring condition of children with PEM. A significant decrease of pyruvic acid in preterm infants against the background of the levels of total protein, albumin, hemoglobin, and transferrin, not exceeding reference values, can obviously testify to the active use of this integral metabolite to maintain the fund of substituted amino acids. Development of this pathology in both mature and premature infants creates a pre-morbid background for iron deficiency anemia-diagnostic panel, which should be supplemented by calculation of transferrin saturation coefficient. Regardless of gestational age in childbirth during the formation of PEM, the lipid spectrum is rearranged according to atherogenic type: at normal values of total cholesterol, there is a significant increase in low and very low density lipoproteins with an increase in the atherogenicity coefficient. This singles out children with the pathology in question as a risk group for the development of the atherosclerotic process later, which justifies the recommendation to control the lipid profile in children of the first year of life.

Outcomes among preterm infants with patent ductus arteriosus: Relationship with treatment, gestational age, hemodynamic status and timing of treatment

2021 ◽  
pp. 1-9
Author(s):  
S.M. Chikkabyrappa ◽  
N. Chaudhary ◽  
A. Agarwal ◽  
D. Rastogi ◽  
P. Filipov ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Ductus Arteriosus ◽  
Retrospective Case ◽  
Chi Square ◽  
Hemodynamic Status ◽  
Group 3 ◽  
Group 2 ◽  
Patent Ductus ◽  
Group 1

BACKGROUND: There remains controversy regarding the outcomes resulting from treatment versus conservative management of patent ductus arteriosus (PDA) among preterm infants. The effects of extreme prematurity, hemodynamic status of the PDA, and age at treatment remain poorly defined. STUDY DESIGN: This retrospective case-control study including infants <  1250 gm who were categorized into 3 groups: Group 1: without PDA, Group 2: with untreated PDA, and Group 3: treated PDA. Diagnosis and treatment of PDA extracted from the medical records. Demographics, clinical characteristics, and outcomes compared using chi-square and analysis of variance. Logistic regression used to estimate adjusted odds ratios. RESULTS: The study included 734 infants, with 141(19%) in Group 1, 329 (45%) in 2, and 264 (36%) in 3. Group 3 had higher incidence of bronchopulmonary dysplasia (BPD) (aOR, 2.9; 95%CI 1.7–4.8). Infant treated for hemodynamically significant PDA (HSPDA) had higher incidence of BPD (aOR, 1.9; 95%CI 1.0–3.8) and retinopathy of prematurity (ROP) (aOR, 3.4; 95%CI 1.6–6.9). There were no differences in outcome associated with treatment among≤26 weeks gestation and the age when treated. CONCLUSION: Infants with PDA who were treated had higher incidence of BPD. Among those who were treated, those with HSPDA had a higher incidence of BPD and ROP.

scholarly journals Evaluation of the Efficiency of Three Different Types of Bonded Retainers Used in Orthodontics

2019 ◽  
Vol 70 (8) ◽  
pp. 2769-2776 ◽  
Author(s):  
Luminita Ligia Vaida ◽  
Dana Festila ◽  
Abel Emanuel Moca ◽  
Bianca Ioana Todor ◽  
Bianca Negrutiu ◽  
...  
Keyword(s):  
Relapse Rate ◽  
Laser Sintering ◽  
Dental Arch ◽  
First Year ◽  
Retention System ◽  
Different Types ◽  
Group 3 ◽  
Group 2 ◽  
Bonded Retainers ◽  
Group 1

The bonded retainers are mainly used for the mandibular dental arch. This study aims to analyse the efficiency of three different types of fixed retainers, multistranded 0.0195-in wire, Australian wire and Starbond CoS laser sintering retainer, as well as the relapse rate for each type of retainer used over a period of two years. The sample consisted of 159 patients, of whom 55 patients (Group 1) had multistranded 0.0195-in wire, 53 patients (Group 2) Australian wire, and 51 patients (Group 3) laser-sintering retainers. 16 partial or complete detachments were recorded in the first year of the retention phase, of which 5 retainers from Group 1, 6 from Group 2 and 5 from Group 3, in the case of lasers-sintering retainers only total detachments were noticed, and 2 of the multistranded retainers suffered deformations. The results show that there are no statistically significant differences between the three types of retainers in the first year of retention period, but laser-sintering retainer had a statistically significant better evolution compared to multistranded retainer (p=0.018) after two years of retention. No statistically significant differences were found between the three types of retainers regarding the rate of relapse (10.9% for Group 1, 7.5% for Group 2 and 7.8% for Group 3). In the second year of the retention phase, the relapse rate did not present a statistically significant change from the first year, but it increased slightly in patients from Group 1 and it decreased slightly in patients from Group 3. No fixed retention system is perfect, everything has its drawbacks.

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