scholarly journals Early aEEG can predict neurodevelopmental outcomes at 12 to 18 month of age in VLBWI with necrotizing enterocolitis: a cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Si Chen ◽  
Xiuman Xiao ◽  
Su Lin ◽  
Jianghu Zhu ◽  
Lidan Liang ◽  
...  
Keyword(s):  
Necrotizing Enterocolitis ◽  
Predictive Value ◽  
Single Channel ◽  
Rank Correlation ◽  
High Specificity ◽  
Fine Motor ◽  
Control Group ◽  
Neurodevelopmental Outcomes ◽  
Neurodevelopmental Delay ◽  
Cranial Mri

Abstract Background Studies have shown that neurological damage is common in necrotizing enterocolitis (NEC) survivors. The purpose of the study was to investigate the predictive value of amplitude-integrated electroencephalogram (aEEG) for neurodevelopmental outcomes in preterm infants with NEC. Methods Infants with NEC were selected, and the control group was selected based on 1:1–2 pairing by gestational age. We performed single-channel (P3–P4) aEEG in the two groups. The Burdjalov scores were compared between the two groups. Cranial magnetic resonance imaging (MRI) was performed several months after birth. The neurological outcomes at 12 to 18 months of age were compared with the Gesell Developmental Schedules (GDS). The predictive value of aEEG scores for neurodevelopmental delay was calculated. Results There was good consistency between the two groups regarding general conditions. In the 1st aEEG examination, the patients in NEC group had lower Co (1.0 (0.0, 2.0) vs. 2.0 (2.0, 2.0), P = 0.001), Cy (1.0 (0.0, 2.0) vs. 3.0 (3.0, 4.0), P < 0.001), LB (1.0 (0.0, 2.0) vs. 2.0 (2.0, 2.0), P < 0.001), B (1.0 (1.0, 2.0) vs. 3.0 (3.0, 3.5), P < 0.001) and T (3.0 (2.0, 8.0) vs. 10.0 (10.0, 11.5), P < 0.001), than the control group. Cranial MRI in NEC group revealed a widened interparenchymal space with decreased myelination. The abnormality rate of cranial MRI in the NEC group was higher than that in the control group (P = 0.001). The GDS assessment indicated that NEC children had inferior performance and lower mean scores than the control group in the subdomains of gross motor (71 (SD = 6.41) vs. 92 (SD = 11.37), P < 0.001), fine motor (67 (SD = 9.34) vs. 96 (SD = 13.69), adaptive behavior (76 (SD = 9.85) vs. 95 (SD = 14.38), P = 0.001), language (68 (SD = 12.65) vs. 95 (SD = 11.41), P < 0.001), personal-social responses (80 (SD = 15.15) vs. 93(SD = 14.75), P = 0.037) and in overall DQ (72 (SD = 8.66) vs. 95 (SD = 11.07), P < 0.001). The logistic binary regression analysis revealed that the NEC patients had a significantly greater risk of neurodevelopmental delay than the control group (aOR = 27.00, 95% CI = 2.561–284.696, P = 0.006). Confirmed by Spearman’s rank correlation analysis, neurodevelopmental outcomes were significantly predicted by the 1st aEEG Burdjalov score (r = 0.603, P = 0.001). An abnormal 1st Burdjalov score has predictive value for neurodevelopmental delay with high specificity (84.62%) and positive predictive value (80.00%). Conclusions Children with NEC are more likely to develop neurodevelopmental delay. There is high specificity and PPV of early aEEG in predicting neurodevelopmental delay.

scholarly journals Early aEEG can Predict Neurodevelopmental Outcomes at 12- To 18- Month of Age in VLBWI with NEC: A Cohort Study

2021 ◽  
Author(s):  
Si Chen ◽  
Xiuman Xiao ◽  
Su Lin ◽  
Jianghu Zhu ◽  
Lidan Liang ◽  
...  
Keyword(s):  
Predictive Value ◽  
Single Channel ◽  
Neurodevelopmental Outcome ◽  
Rank Correlation ◽  
High Specificity ◽  
Fine Motor ◽  
Control Group ◽  
Neurodevelopmental Outcomes ◽  
Spearman’S Rank Correlation ◽  
Increased Risk

Abstract Background Studies have shown that neurological damage is not uncommon in NEC survivors. The purpose of the study was to investigate the predictive value of amplitude integrated electroencephalogram (aEEG) for neurodevelopmental outcomes in preterm infants with neonatal necrotizing enterocolitis (NEC).Methods Infants with NEC (n=13) were selected, and the control group was selected according to 1:1-2 pairing by gestational age. We performed single-channel (P3-P4) aEEG in two groups. The Burdjalov score system was evaluated and compared between the two groups. Cranial magnetic resonance imaging (MRI) was performed at term equivalent age. And the neurological outcomes at 12-18 month of age were compared with Gesell Developmental Schedules (GDS).Results There was good consistency between the two groups in general conditions, except for the highest C-reactive protein (CRP) and incidence of thrombocytopenia. In the 1st aEEG examination, the incidence of retardation in Co (7/10:0/16), Cy (8/10:0/16), LB (6/10:0/16), B (8/10:0/16) and Total score(9/10:0/16) were significantly increased in the NEC group (p≤0.01). Cranial MRI in NEC group revealed widened inter-parenchymal space with decreased myelination. The Gesell Developmental Schedules (GDS) assessment indicated that NEC children had inferior performance and lower mean scores in the sub-domains of gross motor (73.12±10.742:94.13±10.366, P<0.001), fine motor (68.15±10.323:100.04±12.608, P<0.001), adaptive behavior (74.79±9.774:100.24±12.175, P<0.001), language (68.59±12.593:96.37±11.493, P<0.001), personal-social responses (82.36±16.013:97.58±11.834, P=0.010) and in overall DQ (73.08±8.901:98.02±9.289, P<0.001). The results of the logistic binary regression analysis revealed that NEC patients had a significantly increased risk of neurodevelopmental retardation compared to no NEC patients (aOR = 27.00, 95% CI 2.561 – 284.696, P = 0.006). Confirmed by Spearman’s rank correlation analysis, the neurodevelopmental outcome was significantly affected by 1st aEEG Burdjalov score (r=0.603, p=0.001). The abnormal 1st Burdjalov score has predictive value for neurodevelopmental retardation with high specificity (84.62%) and positive predictive value (80.00%).Conclusions Early aEEG in NEC patients suggested inhibition of brain function. NEC children are more likely developing neurodevelopmental delay. And there’re high specificity and PPV of the early aEEG in predicting neurodevelopmental retardation.

scholarly journals Long-term neurodevelopmental outcome in conservatively treated congenital hyperinsulinism

2007 ◽  
Vol 157 (4) ◽  
pp. 491-497 ◽  
Author(s):  
K Mazor-Aronovitch ◽  
D Gillis ◽  
D Lobel ◽  
H J Hirsch ◽  
O Pinhas-Hamiel ◽  
...  
Keyword(s):  
Neurodevelopmental Outcome ◽  
Paternal Allele ◽  
Fine Motor ◽  
Control Group ◽  
Congenital Hyperinsulinism ◽  
Neurodevelopmental Outcomes ◽  
Partial Pancreatectomy ◽  
Diffuse Disease ◽  
Increased Risk ◽  
Motor Problems

Background: Congenital hyperinsulinism (CH) is treated surgically in many centers (near-total and partial pancreatectomy for diffuse and focal disease respectively). Most patients treated with near-total pancreatectomy developed diabetes during childhood/puberty. CH patients are at increased risk of neurodevelopmental disorders, some being severe, which are reported to occur in 14–44% of patients from highly heterogenous cohorts. Over the last few decades, we have treated children with CH conservatively without surgery. The aim of this study was to assess the neurodevelopmental outcome of these patients. Design and methods: The study included 21 Ashkenazi CH medically treated patients: 11 homozygotes (diffuse disease) and 9 heterozygotes with mutations on the paternal allele (presumed focal disease). The mean age was 13.7 years (range 8–23). Neurodevelopmental outcomes were assessed by telephone interviews of parents, using a standard questionnaire. Closest age siblings of CH patients served as controls. Results: Ten CH patients had perinatal seizures of short duration. Four had post-neonatal seizures, which remitted entirely. During early childhood, four patients (19%) had hypotonia, eight (38%) had fine motor problems, seven (33%) had gross motor problems (clumsiness), and one had mild cerebral palsy. Three patients (14%) had speech problems. Eight patients required developmental therapy, compared to one in the control group. Most of these problems were resolved by age 4–5 years. At school age, all were enrolled in regular education, some excelled in their studies, 6 out of 21 patients (29%) had learning problems (2 out of 21 controls). None had overt diabetes. Conclusions: Good neurodevelopmental outcome was observed in our conservatively treated CH patients, with no diabetes as reported in patients undergoing pancreatectomy.

scholarly journals Head Growth and Neurodevelopment of Preterm Infants with Surgical Necrotizing Enterocolitis and Spontaneous Intestinal Perforation

Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 833
Author(s):  
Seung-Han Shin ◽  
Ee-Kyung Kim ◽  
Seh-Hyun Kim ◽  
Hyun-Young Kim ◽  
Han-Suk Kim
Keyword(s):  
Preterm Infants ◽  
Necrotizing Enterocolitis ◽  
Intestinal Perforation ◽  
Fine Motor ◽  
Neurodevelopmental Outcomes ◽  
Head Growth ◽  
Single Center Study ◽  
Ages And Stages Questionnaire ◽  
Bayley Scales ◽  
Spontaneous Intestinal Perforation

Spontaneous intestinal perforation (SIP) and surgical necrotizing enterocolitis (NEC) are intestinal conditions requiring surgical intervention in preterm infants. We aimed to compare the head growth and neurodevelopment of preterm infants with SIP and surgical NEC. A retrospective single-center study was performed in preterm infants born at less than 32 weeks of gestation and who had undergone surgery for NEC or SIP. Data from the Bayley Scales of Infant and Toddler Development 3rd Edition (Bayley-III) at 24 months of corrected age (CA) and the Korean Ages and Stages Questionnaire (K-ASQ) or Korean Developmental Screening Test (K-DST) at 36 months were collected. Among 82 eligible infants, 60 infants had surgical NEC, and 22 infants were diagnosed with SIP. Head growth was faster until CA 4 months in preterm infants with SIP than in those with surgical NEC. At 36 months, abnormal findings in the K-ASQ or K-DST were more prevalent in the NEC group than in the SIP group in the gross motor (48.2% vs. 0%, p = 0.015), fine motor (40.7% vs. 0%, p = 0.037), cognitive (55.6% vs. 12.5%, p = 0.047), and social domains (44.4% vs. 0%, p = 0.032). More studies evaluating the neurodevelopmental outcomes of preterm infants with surgical NEC and SIP are required.

scholarly journals Role of Topiramete in Moderate to Severe Perinatal Asphyxia - A Randomized Controlled Clinical Trial

2020 ◽  
Vol 35 (2) ◽  
pp. 135-140
Author(s):  
Naznin Akther ◽  
M Monir Hossain ◽  
Ahmed Ferdous Jahangir ◽  
Shayla Imam Kanta ◽  
Sayeeda Mehnaz Masud
Keyword(s):  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Intervention Group ◽  
Treatment Protocol ◽  
Fine Motor ◽  
Control Group ◽  
Neurodevelopmental Outcomes ◽  
Randomized Controlled ◽  
And Control

Background: Topiramate is an anticonvulsant drugs that has multiple mode of mechanism of action. Topiramate appears to be effective as both an anti-seizure and neuroprotective agent in animal models of newborn brain injury. Objectives: To determine the neurological outcome of oral topiramate with moderate to severe hypoxic ischemic encephalopathy. Methods: This one year randomized controlled trial was carried out in the Neonatal ward and ICU of a tertiary care specialized hospital. A total of 64 neonate were enrolled in this study and were randomly assigned intervention group (Group-A, n=32) and control group (Group B=32). In case group oral topiramate 10mg/kg was given for 3 consecutive days along with standard treatment protocol. And control was given only standard protocol. Finally outcomes are compared. Results: Baseline clinical characteristics, age, sex, mode of delivery, arterial pH, residence, basic status of HIE cases were matched in both groups. This study has shown significant reduction of neurological impairment in all domain (gross motor, fine motor, vision hearing, speech) at 1 and 3 months in case than control. There is also early seizure control, early initiation of feeding, short duration of hospital stay in case (treatment) than control without any side effects. Conclusion: Early administration of topiramate to infants with moderate and severe HIE in perinatal asphyxia was very effective in controlling seizures, improving USG findings, and producing favorable neurodevelopmental outcomes at1 and 3 months of age. DS (Child) H J 2019; 35(2) : 135-140

scholarly journals Neurodevelopmental Outcomes and Gut Bifidobacteria in Term Infants Fed an Infant Formula Containing High sn-2 Palmitate: A Cluster Randomized Clinical Trial

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 693
Author(s):  
Wei Wu ◽  
Ai Zhao ◽  
Biao Liu ◽  
Wen-Hui Ye ◽  
Hong-Wen Su ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Palmitic Acid ◽  
Randomized Clinical Trial ◽  
Motor Skills ◽  
Relative Abundance ◽  
Fine Motor ◽  
Control Group ◽  
Neurodevelopmental Outcomes ◽  
Term Infants ◽  
Cluster Randomized

A few studies suggested high stereo-specifically numbered (sn)-2 palmitate in a formula might favor the gut Bifidobacteria of infants. The initial colonization and subsequent development of gut microbiota in early life might be associated with development and later life functions of the central nervous system via the microbiota–gut–brain axis, such as children with autism. This study aims to assess the hypothesized effect of increasing the amount of palmitic acid esterified in the sn-2 position in infant formula on neurodevelopment in healthy full-term infants and to explore the association of this effect with the altered gut Bifidobacteria. One hundred and ninety-nine infants were enrolled in this cluster randomized clinical trial: 66 breast-fed (BF group) and 133 formula-fed infants who were clustered and randomly assigned to receive formula containing high sn-2 palmitate (sn-2 group, n = 66) or low sn-2 palmitate (control group, n = 67), where 46.3% and 10.3% of the palmitic acid (PA) was sn-2-palmitate, respectively. Infants’ neurodevelopmental outcomes were measured by the Ages and Stages Questionnaire, third edition (ASQ-3). Stool samples were collected for the analysis of Bifidobacteria (Trial registration number: ChiCTR1800014479). At week 16, the risk of scoring close to the threshold for fine motor skills (reference: scoring above the typical development threshold) was significantly lower in the sn-2 group than the control group after adjustment for the maternal education level (p = 0.036) but did not differ significantly versus the BF group (p = 0.513). At week 16 and week 24, the sn-2 group (week 16: 15.7% and week 24: 15.6%) had a significantly higher relative abundance of fecal Bifidobacteria than the control group (week 16: 6.6%, p = 0.001 and week 24:11.2%, p = 0.028) and did not differ from the BF group (week 16: 14.4%, p = 0.674 and week 24: 14.9%, p = 0.749). At week 16, a higher relative abundance of Bifidobacteria was associated with the decreased odds of only one domain scoring close to the threshold in the formula-fed infants group (odds ratio (OR), 95% confidence interval (CI): 0.947 (0.901–0.996)). Elevating the sn-2 palmitate level in the formula improved infants’ development of fine motor skills, and the beneficial effects of high sn-2 palmitate on infant neurodevelopment was associated with the increased gut Bifidobacteria level.

Screening for haemorrhagic disorders in paediatric patients by means of a questionnaire

2009 ◽  
Vol 29 (S 01) ◽  
pp. S87-S89 ◽  
Author(s):  
I. Music ◽  
M. Novak ◽  
B. Acham-Roschitz ◽  
W. Muntean
Keyword(s):  
Predictive Value ◽  
Laboratory Diagnosis ◽  
Von Willebrand Disease ◽  
Control Group ◽  
Older Children ◽  
Mild Disease ◽  
History Of ◽  
Von Willebrand ◽  
Specific Symptoms ◽  
Infants And Young Children

SummaryAim: In children, screening for haemorrhagic disorders is further complicated by the fact that infants and young children with mild disease in many cases most likely will not have a significant history of easy bruising or bleeding making the efficacy of a questionnaire even more questionable. Patients, methods: We compared the questionnaires of a group of 88 children in whom a haemorrhagic disorder was ruled out by rigorous laboratory investigation to a group of 38 children with mild von Willebrand disease (VWD). Questionnaires about child, mother and father were obtained prior to the laboratory diagnosis on the occasion of routine preoperative screening. Results: 23/38 children with mild VWD showed at least one positive question in the questionnaire, while 21/88 without laboratory signs showed at least one positive question. There was a trend to more specific symptoms in older children. Three or more positive questions were found only in VWD patients, but only in a few of the control group. The question about menstrual bleeding in mothers did not differ significantly. Sensitivity of the questionnaire for a hemostatic disorder was 0.60, while specifity was 0.76. The negative predictive value was 0.82, but the positive predictive value was only 0.52. Conclusions: Our small study shows, that a questionnaire yields good results to exclude a haemostatic disorder, but is not a sensitive tool to identify such a disorder.

Evaluation of the clot burden score (cbs) for acute ischemic stroke (ais) in intent-to-treat patients.

2019 ◽  
Vol 1 (1) ◽  
pp. 11-15 ◽  
Author(s):  
Sarah Yaziz ◽  
Ahmad Sobri Muda ◽  
Wan Asyraf Wan Zaidi ◽  
Nik Azuan Nik Ismail
Keyword(s):  
Ischemic Stroke ◽  
Clinical Outcome ◽  
Acute Ischemic Stroke ◽  
Predictive Value ◽  
Area Under The Curve ◽  
Rank Correlation ◽  
Treatment Decision ◽  
Roc Curves ◽  
Significant Negative Correlation ◽  
Clot Burden

Background : The clot burden score (CBS) is a scoring system used in acute ischemic stroke (AIS) to predict patient outcome and guide treatment decision. However, CBS is not routinely practiced in many institutions. This study aimed to investigate the feasibility of CBS as a relevant predictor of good clinical outcome in AIS cases. Methods:  A retrospective data collection and review of AIS patients in a teaching hospital was done from June 2010 until June 2015. Patients were selected following the inclusion and exclusion criteria. These patients were followed up after 90 days of discharge. The Modified Rankin scale (mRS) was used to assess their outcome (functional status). Linear regression Spearman Rank correlation was performed between the CBS and mRS. The quality performance of the correlations was evaluated using Receiver operating characteristic (ROC) curves. Results: A total of 89 patients with AIS were analysed, 67.4% (n=60) male and 32.6% (n=29) female. Twenty-nine (29) patients (33.7%) had a CBS ?6, 6 patients (6.7%) had CBS <6, while 53 patients (59.6%) were deemed clot free. Ninety (90) days post insult, clinical assessment showed that 57 (67.6%) patients were functionally independent, 27 (30.3%) patients functionally dependent, and 5 (5.6%) patients were deceased. Data analysis reported a significant negative correlation (r= -0.611, p<0.001). ROC curves analysis showed an area under the curve of 0.81 at the cut-off point of 6.5. This showed that a CBS of more than 6 predicted a good mRS clinical outcome in AIS patients; with sensitivity of 98.2%, specificity of 53.1%, positive predictive value (PPV) of 76%, and negative predictive value (NPV) of 21%. Conclusion: CBS is a useful additional variable for the management of AIS cases, and should be incorporated into the routine radiological reporting for acute ischemic stroke (AIS) cases.

Condition of the psychoemotional and vegetative status at women with a repeated placental dysfuction

2016 ◽  
pp. 50-52
Author(s):  
D.A. Govseev ◽  
Keyword(s):  
Nervous System ◽  
Single Channel ◽  
Clinical Laboratory ◽  
Cardiac Activity ◽  
Psychological Status ◽  
Control Group ◽  
Vegetative Nervous System ◽  
Previous Pregnancy ◽  
Placental Dysfunction ◽  
Vegetative Status

The objective: studying of features of the psychoemotional and vegetative status at women with placental dysfunction at the previous pregnancy. Patients and methods. Complex clinical-laboratory examination of 89 women, from which was conducted: control group – 42 obstetrically and somatically healthy multipara, delivery through natural patrimonial ways; І group – 47 women with placental dysfunction at the previous pregnancy. Carried out a cardiointervalografia by means of a single-channel electrocardiograph and used a scale questionnaire of a condition of the pregnant woman. Results. It is established that regulation of cardiac rhythm at women at the previous pregnancy happens to placental dysfunction in the conditions of an autonomous contour which controls normal work of heart and vegetative nervous system. Further, there is an expressed strain of regulatory mechanisms that is shown by centralization of management of cardiac activity and sharp rising of activity of sympathetic nervous system. At the final stage influence of the central contour considerably decreases and patofunctionale vegetative equilibrium is again formed. Conclusions. The received results need to be considered when developing tactics of conducting pregnancy at these women. Key words: placental dysfunction, vegetative and psychological status.

scholarly journals Calcium Carbonate Nanoparticles—Toxicity and Effect of In Ovo Inoculation on Chicken Embryo Development, Broiler Performance and Bone Status

Animals ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 932
Author(s):  
Arkadiusz Matuszewski ◽  
Monika Łukasiewicz ◽  
Jan Niemiec ◽  
Maciej Kamaszewski ◽  
Sławomir Jaworski ◽  
...  
Keyword(s):  
Calcium Carbonate ◽  
Embryo Development ◽  
Bone Quality ◽  
Chicken Embryo ◽  
Broiler Chickens ◽  
Selection Procedure ◽  
High Specificity ◽  
Control Group ◽  
In Ovo

The use of intensive selection procedure in modern broiler chicken lines has led to the development of several skeletal disorders in broiler chickens. Therefore, current research is focused on methods to improve the bone quality in birds. In ovo technology, using nanoparticles with a high specificity to bones, is a potential approach. The present study aimed to evaluate the effect of in ovo inoculation (IOI) of calcium carbonate nanoparticles (CCN) on chicken embryo development, health status, bone characteristics, and on broiler production results and bone quality. After assessing in vitro cell viability, the IOI procedure was performed with an injection of 500 μg/mL CCN. The control group was not inoculated with CCN. Hatchability, weight, and selected bone and serum parameters were measured in embryos. Part of hatchlings were reared under standard conditions until 42 days, and production results, meat quality, and bone quality of broilers were determined. CCN did not show cytotoxicity to cells and chicken embryo and positively influenced bone parameters of the embryos and of broilers later (calcification) without negatively affecting the production results. Thus, the IOI of CCN could modify the molecular responses at the stage of embryogenesis, resulting in better mineralization, and could provide a sustained effect, thereby improving bone quality in adult birds.

scholarly journals The Predictive Value of the Mother’s Risk Factors in Formation of Fetal Developmental Delay

2021 ◽  
Vol 8 ◽  
pp. 2333794X2199914
Author(s):  
Maka Chigladze
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Predictive Value ◽  
Negative Impact ◽  
Deficiency Anemia ◽  
Control Group ◽  
Case Group ◽  
Retrospective Case ◽  
Standards Of Living ◽  
Poor Nutrition

The research aimed at studying the mother’s social-hygienic and medical biological risk factors and determining their predictive value. The retrospective case-control study was conducted with 142 pregnant women participating in it. In the case group there were involved 92 mothers whose pregnancy was completed by the birth of a newborn baby suffering from the intrauterine growth restriction. The control group was made of 50 pregnant women, whose pregnancy was completed by the birth of a healthy neonate. The research resulted in specifying the risk factors of high priority: the low standards of living (OR 3.61), chronic stress (OR-3.06), sleeping disorder (OR-3.33) and poor nutrition (OR-3.81). As regards the coexisting pathology the following was revealed: endocrine pathology (OR-3.27), ischemic heart disease (OR-4.35), arterial hypertension (OR-6.47), iron deficiency anemia (OR-4.11), pathology of respiratory system (OR-3.42), chronic genital inflammatory and infectious processes. The preeclampsia (92%) and low amniotic fluid (89%) were detected to have the high predictive value. The awareness of risk factors allows us to employ the timely measures for the reduction of negative impact on the fetus and neonate.

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