Levetiracetam for the Treatment of Seizures in Neonatal Hypoxic Ischemic Encephalopathy

2016 ◽  
Vol 32 (2) ◽  
pp. 210-214 ◽  
Author(s):  
Charu Venkatesan ◽  
Sarah Young ◽  
Mark Schapiro ◽  
Cameron Thomas
Keyword(s):  
Hypoxic Ischemic Encephalopathy ◽  
Loading Dose ◽  
Efficacy And Safety ◽  
Neonatal Seizures ◽  
First Line ◽  
Single Center Study ◽  
The Mean ◽  
Negative Side Effects ◽  
Ischemic Encephalopathy ◽  
Center Study

The objective of this study was to determine the efficacy and safety of levetiracetam in treatment of neonatal seizures due to hypoxic ischemic encephalopathy. Seizures often persist in neonates with hypoxic ischemic encephalopathy despite phenobarbital. A retrospective single-center study was conducted in neonates ≥36 weeks gestation with hypoxic ischemic encephalopathy. A total of 127 neonates were identified born 2008-2015. Clinical seizures occurred in 83 infants. Fifty-one neonates (61%) had cessation of seizures with only phenobarbital. Thirty-two neonates received levetiracetam after phenobarbital, and the seizures stopped in 27 of these neonates. The mean total loading dose of levetiracetam was 63 mg/kg. Mean maintenance dose of levetiracetam was 65 mg/kg/d. We found no negative side effects in neonates following levetiracetam use. Our study finds that levetiracetam is an efficacious medication in treatment of seizures in the setting of neonatal hypoxic ischemic encephalopathy. Future prospective studies should explore its use as a first-line medication.

A multi-professional approach for transition of care at discharge in hyperglycemic inpatients with covid-19: a single center study

2022 ◽  
Vol 22 ◽  
Author(s):  
Elena Castellano ◽  
Donatella Gaviglio ◽  
Micaela Pellegrino ◽  
Laura Gianotti ◽  
Giampaolo Magro ◽  
...  
Keyword(s):  
Insulin Treatment ◽  
Newly Diagnosed ◽  
Efficacy And Safety ◽  
Glucocorticoid Treatment ◽  
Single Center Study ◽  
Discharged Patients ◽  
The Mean ◽  
Glycemic Target ◽  
Discharge From Hospital ◽  
Drop Outs

Background: The discharge from hospital of insulin-treated hyperglycemic patients is always challenging. This is even more so in patients requiring glucocorticoid treatment, such as those with COVID-19. Patients and method: A retrospective monocentric study of 23 inpatients with newly diagnosed or already known diabetes mellitus (DM) who were naïve to insulin treatment, , and who were hospitalized with COVID-19 in non-critical settings and then discharged. Patients were followed-up for one month after discharge for the management of insulin treatment by a multi-professional team through phone consultations. Results: Insulin prescriptions at discharge were 24.6 ± 14 U/day injected in 2 ± 1.5 daily shots. A mean of three phone consultations were required. One month later, the mean insulin reduction was 1.5 ± 1.3 shots and 6 ± 5 U/day. All patients reached their glycemic target without hypoglycemic events, drop-outs, or readmissions. Conclusion: This study demonstrates the feasibility, efficacy, and safety of a multi-professional approach through telemedicine for managing DM patients after discharge during COVID-19.

Clinical Profile and Short-Term Outcome of Neonatal Seizures in a Tertiary Care Hospital, Kuppam – A Retrospective Study

2021 ◽  
Vol 8 (27) ◽  
pp. 2381-2386
Author(s):  
Poojitha Kancherla ◽  
Harsha P.J. ◽  
Gowtham R. ◽  
Dowlath Anwar Basha ◽  
Chandran G.P ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Clinical Profile ◽  
Hypoxic Ischemic Encephalopathy ◽  
Care Hospital ◽  
Neonatal Seizures ◽  
Metabolic Disturbances ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome ◽  
Ischemic Encephalopathy

BACKGROUND Neonates presenting with seizures require long term stay in hospital and have higher chances of neuro-developmental delay later. Seizures in neonates are mostly subtle and difficult to diagnose. We wanted to study the clinical profile and short-term outcome on term and later pre-term neonates presenting with seizures. METHODS The study was a retrospective observational study done from November to December 2020 at PES Hospital, Kuppam. Retrospective data of neonatal seizures from May 2019 to April 2020 was considered for study. Details from the case records of neonates with seizures was collected. RESULTS Neonatal seizures (NS) were most common in females (53.8 %, 72/134). Subtle seizures were most common form of seizures in neonates which was seen in 64.2 % (86/134) babies followed by tonic seizures in 22.4 % (30/134). Neonatal seizures were most commonly seen in babies with hypoxic ischemic encephalopathy in 63.4 % (85/134) followed by metabolic disturbances in 15.6 % (21/134) and meningitis in 13.5 % (18/134). In babies with hypoxic ischemic encephalopathy, metabolic and meningitis subtle seizures were observed to be more common. Seizures were seen most commonly in first 72 hours of life (82.85 %, 111/134). Seizures in babies with hypoxic ischemic encephalopathy, metabolic causes most commonly occurred within first 24 hours of birth. Seizures in babies with meningitis most commonly occurred after 7 days of birth. Babies with neonatal seizures with sequelae was seen in 17.96 % (24/134) and 11.94 % babies died (16/134). CONCLUSIONS Subtle seizures were most common form and hypoxic ischemic encephalopathy was most common risk factor. Most neonatal seizures present within 72 hours of birth. Babies with meningitis presented with seizures most commonly after 72 hours of birth. KEYWORDS Hypoxic Ischemic Encephalopathy, Neonatal Seizures, Newborn, Aetiology, Outcome

scholarly journals Efficacy and safety of basiliximab as initial immunosuppression in liver transplantation: A single center study

2020 ◽  
Vol 19 (5) ◽  
pp. 541-545
Author(s):  
Mohamed Hashim ◽  
Ayman Alsebaey ◽  
Amr Ragab ◽  
Hossam Eldeen Soliman ◽  
Imam Waked
Keyword(s):  
Liver Transplantation ◽  
Efficacy And Safety ◽  
Single Center ◽  
Single Center Study ◽  
Center Study

Low Variability of Blood Pressure Predicts Abnormal Electroencephalogram in Infants with Hypoxic Ischemic Encephalopathy

2020 ◽  
Author(s):  
Abigail Flower ◽  
Daniel Vasiliu ◽  
Tianrui Zhu ◽  
Robert Andris ◽  
Maryam Abubakar ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Frequency Domain ◽  
Arterial Blood Pressure ◽  
Apgar Score ◽  
Blood Pressure Variability ◽  
Hypoxic Ischemic Encephalopathy ◽  
Arterial Blood ◽  
The Mean ◽  
Minute Apgar Score ◽  
Ischemic Encephalopathy

Objective This study aimed to evaluate the role of an objective physiologic biomarker, arterial blood pressure variability, for the early identification of adverse short-term electroencephalogram (EEG) outcomes in infants with hypoxic-ischemic encephalopathy (HIE). Study Design In this multicenter observational study, we analyzed blood pressure of infants meeting these criteria: (1) neonatal encephalopathy determined by modified Sarnat exam, (2) continuous mean arterial blood pressure (MABP) data between 18 and 27 hours after birth, and (3) continuous EEG performed for at least 48 hours. Adverse outcome was defined as moderate–severe grade EEG at 48 hours. Standardized signal preprocessing was used; the power spectral density was computed without interpolation. Multivariate binary logistic regression was used to identify which MABP time and frequency domain metrics provided improved predictive power for adverse outcomes compared with standard clinical predictors (5-minute Apgar score and cord pH) using receiver operator characteristic analysis. Results Ninety-one infants met inclusion criteria. The mean gestational age was 38.4 ± 1.8 weeks, the mean birth weight was 3,260 ± 591 g, 52/91 (57%) of infants were males, the mean cord pH was 6.95 ± 0.21, and 10/91 (11%) of infants died. At 48 hours, 58% of infants had normal or mildly abnormal EEG background and 42% had moderate or severe EEG backgrounds. Clinical predictor variables (10-minute Apgar score, Sarnat stage, and cord pH) were modestly predictive of 48 hours EEG outcome with area under curve (AUC) of 0.66 to 0.68. A composite model of clinical and optimal time- and frequency-domain blood pressure variability had a substantially improved AUC of 0.86. Conclusion Time- and frequency-domain blood pressure variability biomarkers offer a substantial improvement in prediction of later adverse EEG outcomes over perinatal clinical variables in a two-center cohort of infants with HIE. Key Points

scholarly journals Effect of Elevated Temperature on Immediate Neurodevelopmental Outcome in Term Neonates with Hypoxic-Ischemic Encephalopathy

2019 ◽  
Vol 9 (3) ◽  
pp. 160-165
Author(s):  
Bithi Debnath ◽  
Naila Zaman Khan ◽  
Dilara Begum ◽  
Asma Begum Shilpi ◽  
Shaheen Akter
Keyword(s):  
Elevated Temperature ◽  
Rectal Temperature ◽  
Neurodevelopmental Outcome ◽  
Hypoxic Ischemic Encephalopathy ◽  
Neurodevelopmental Outcomes ◽  
Term Infants ◽  
Term Neonates ◽  
Risk Of Death ◽  
The Mean ◽  
Ischemic Encephalopathy

Background: Among term infants, hypoxic-ischemic encephalopathy due to acute perinatal asphyxia remains an important cause of neurodevelopmental deficits in childhood. Treatment is currently limited to supportive intensive care, without any specific brain-oriented therapy. Objective: To determine whether the risk of death or moderate/severe neurodevelopmental impairment in term infants with hypoxic-ischemic encephalopathy increases with relatively high skin or rectal temperature between 12 and 72 hours of birth. Materials and Methods: This was a prospective observational study. Asphyxiated newborns who came within 12 hours of birth were enrolled in this study. Both axillary and rectal temperature were recorded 6 hourly for 72 hours and each infant`s temperature for each site were rank ordered. Then mean of all axillary and rectal temperatures of each neonate was calculated. Outcomes were related to temperatures in logistic regression analyses for the elevated/relatively high temperatures and normal/low temperatures group, with adjustment of the level of encephalopathy and gender. Results: The mean axillary temperature was 36.07 ± 6.10C and in 25.71%, 11.92% and 6.32% cases axillary temperatures were >370C, >37.50C and >380C respectively. The mean rectal temperature was 36.8 ± 60C, and in 43.53%, 30.02% and 19.97% cases rectal temperatures were >370C, >37.50C and >380C respectively. Mean ambient temperature was 26.170C. There was significant correlation between axillary and rectal temperatures (r=0.889). For elevated temperature, the odds of death or moderate to severe impairment increased 8.9-fold (CI 0.906–88.18) and the odds of death alone increased 4.6-fold (CI 0.373–56.83). The odds of impairment increased 1.84-fold (CI 0.45– 7.50). Conclusion: Relatively high temperature during usual care after hypoxic-ischemia in term neonates was associated with adverse neurodevelopmental outcomes. J Enam Med Col 2019; 9(3): 160-165

Efficacy and Safety of Sesame Oral Immunotherapy—A Real-World, Single-Center Study

2019 ◽  
Vol 7 (8) ◽  
pp. 2775-2781.e2 ◽  
Author(s):  
Liat Nachshon ◽  
Michael R. Goldberg ◽  
Michael B. Levy ◽  
Michael Y. Appel ◽  
Naama Epstein-Rigbi ◽  
...  
Keyword(s):  
Real World ◽  
Oral Immunotherapy ◽  
Efficacy And Safety ◽  
Single Center ◽  
Single Center Study ◽  
Center Study
Sign in / Sign up

Export Citation Format

Share Document