Clinical and neurosonographic signs of c entral nervous system in newborns

Despite of significant progress in the development of technologies of clinical monitoring and the fetus and newborn pathology study, perinatal asphyxia or, more accurately – cerebral ischemia (CI) remain serious condition, causing significant mortality and long-term morbidity. Chi-acquired syndrome characterized by clinical and laboratory signs of acute brain injury due to asphyxia (ie, hypoxia, acidosis). The paper reflects the main clinical signs and neurosonographic lesion of the Central nervous system (CNS) in neonatal newborn infants with different gestational age who underwent CI mild to moderate severity.

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A proposal for a tailored protocol for focal suppurative infection of the central nervous system: analysis of an institutional experience in pediatric patients

Neurosurgical FOCUS ◽

10.3171/2019.5.focus19277 ◽

2019 ◽

Vol 47 (2) ◽

pp. E11 ◽

Cited By ~ 1

Author(s):

Suhas Udayakumaran ◽

Ticini Joseph

Keyword(s):

Central Nervous System ◽

Nervous System ◽

System Analysis ◽

Clinical Signs ◽

Treatment Protocol ◽

Response To Treatment ◽

Research Centre ◽

Short Term ◽

The Central Nervous System

OBJECTIVEThe incidence of focal suppurative infections (FSIs) of the brain has significantly decreased owing to the better health and fundamental conditions of the population on the one hand and earlier detection and the availability of more potent antibiotics on the other. Interestingly, the antibiotic protocols have not been well defined in terms of duration despite a prompter diagnosis, definitive management of the etiology, and the advent of various higher-generation antibiotics. In this study, the authors evaluated the current treatment protocol. Their aim was to optimize management protocols for FSIs of the central nervous system based on clinical parameters.METHODSThe study was a retrospective analysis of all children who had undergone surgical management for an FSI at the Division of Paediatric Neurosurgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, in the period from January 2001 to February 2018. In addition to demographic characteristics, the details of culture reports and antibiotic regimens were collected. The response to treatment was compared to changes in the infective profile (C-reactive protein) and imaging. Instances of reaspiration were compared with clinical signs, imaging findings, and infective profiles. Treatment response was separated into two groups: responders within or at 2 weeks and responders beyond 2 weeks. The clinical characteristics of these two groups were compared.RESULTSForty-eight children were treated in the study period. Nineteen patients benefited from the 2-week (short-term) protocol of intravenous antibiotics. Twenty-nine patients required more than 2 weeks (approximately 4 weeks; long-term protocol) for resolution. Of those requiring more than 2 weeks, 69% had cardiogenic etiology. All patients were followed up with a minimum of 3 weeks of oral antibiotics. In a comparative analysis between short-term and long-term responders, only etiology was significantly different. None of the patients who had the short-term protocol had a recurrence.CONCLUSIONSA shorter antibiotic protocol can be used successfully in carefully selected patients who are surgically treated and followed up. It is clear that the 2-week intravenous antibiotic protocol is more suitable for immunocompetent patients who have a noncardiogenic etiology.

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Systemic and immunomodulatory effects of whole body therapeutic hypothermia

Orvosi Hetilap ◽

10.1556/oh.2011.29086 ◽

2011 ◽

Vol 152 (15) ◽

pp. 575-580 ◽

Cited By ~ 5

Author(s):

Vince Pongor ◽

Gergely Toldi ◽

Miklós Szabó ◽

Barna Vásárhelyi

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Therapeutic Hypothermia ◽

Cell Activation ◽

Perinatal Asphyxia ◽

Whole Body ◽

Hla Dr ◽

Cytokine Levels ◽

The Central Nervous System

Several neurobiological mechanisms contribute to the development of ischemic-reperfusion damage of the central nervous system that may be modulated by hypothermia. Nowadays hypothermia is a therapeutic tool for the treatment of stroke and perinatal asphyxia. Hypothermia does not only affect the central nervous system, but also has systemic effects. It influences the muscular and cardiovascular system, the systematic metabolism, induces electrolyte changes, and decreases inflammation. This review summarizes the effects of therapeutic hypothermia on the immune system. Experiments on cell lines and in animals along with human experience indicate that short term (2-4 hours) hypothermia increases the levels of anti-inflammatory cytokines and decreases that of proinflammatory cytokines. Long term (>24 hours) hypothermia, however, increases proinflammatory cytokine levels. Furthermore, hypothermia inhibits lymphocyte proliferation and decreases HLA-DR expression associated with cell activation. These results suggest that therapeutic hypothermia has a systemic immunomodulatory effect. Further research is required to determine the contribution of immunomodulation to the defense of the central nervous system. Orv. Hetil., 2011, 152, 575–580.

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The clinical relevance of the microelements content in newborns after perinatal asphyxia

Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics) ◽

10.21508/1027-4065-2019-64-6-53-56 ◽

2020 ◽

Vol 64 (6) ◽

pp. 53-56

Author(s):

S. Sh. Gasanov ◽

Sh. A. Sadigova ◽

B. A. Babaeva

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Trace Elements ◽

Blood Serum ◽

Muscle Tone ◽

Perinatal Asphyxia ◽

Clinical Signs ◽

Full Term ◽

Clinical Indicators ◽

The Central Nervous System

Research purpose. To identify the correlation between the clinical signs of neonatal adaptation in the dynamics and the content of trace elements in the serum of newborns of different gestational ages who underwent perinatal asphyxia (main group): 41 premature infants and 27 full-term children.Results. It was found that there was a direct significant correlation between the concentration of trace elements (Mg, Fe, Zn, Cu), gestational age and Apgar grades (5th minute) in n prematurely born babies during the period of acute adaptation (3-5 days). Reliable feedback was established between the clinical signs of posthypoxic damage to the central nervous system, suppression syndrome and the content of Fe, Mg and Zn, as well as a weakening of muscle tone and the content of Zn and Mg. In full-term babies, the correlation between the content of Fe, Zn, Mg in the blood serum and clinical indicators was expressed more clearly. In these children, a significant positive correlation was observed between the Ca content in the blood and the syndrome of neuro-reflex excitability.Conclusion. The determination of trace elements in blood serum in newborns in the dynamics of the neonatal period (3-5th and 21-28th days of life) makes it possible to predict the course and severity of hypoxic-ischemic damage to the Central nervous system.

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Self-buffering capacity of a human sulfatase for central nervous system delivery

Scientific Reports ◽

10.1038/s41598-021-86178-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yi Wen ◽

Nazila Salamat-Miller ◽

Keethkumar Jain ◽

Katherine Taylor

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Buffering Capacity ◽

The Self ◽

High Concentration ◽

Formulation Design ◽

The Central Nervous System ◽

Therapeutic Enzymes ◽

Intrathecal Space

AbstractDirect delivery of therapeutic enzymes to the Central Nervous System requires stringent formulation design. Not only should the formulation design consider the delicate balance of existing ions, proteins, and osmolality in the cerebrospinal fluid, it must also provide long term efficacy and stability for the enzyme. One fundamental approach to this predicament is designing formulations with no buffering species. In this study, we report a high concentration, saline-based formulation for a human sulfatase for its delivery into the intrathecal space. A high concentration formulation (≤ 40 mg/mL) was developed through a series of systematic studies that demonstrated the feasibility of a self-buffered formulation for this molecule. The self-buffering capacity phenomenon was found to be a product of both the protein itself and potentially the residual phosphates associated with the protein. To date, the self-buffered formulation for this molecule has been stable for up to 4 years when stored at 5 ± 3 °C, with no changes either in the pH values or other quality attributes of the molecule. The high concentration self-buffered protein formulation was also observed to be stable when exposed to multiple freeze–thaw cycles and was robust during in-use and agitation studies.

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Coxsackievirus Group B Antibodies in the Ventricular Fluid of Infants with Severe Anatomic Defects in the Central Nervous System

PEDIATRICS ◽

10.1542/peds.76.1.64 ◽

1985 ◽

Vol 76 (1) ◽

pp. 64-68

Author(s):

Charles J. Gauntt ◽

Richard J. Gudvangen ◽

Yves W. Brans ◽

Arthur E. Marlin

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Newborn Infants ◽

Neutralizing Antibody ◽

Detectable Level ◽

Immunoglobulin M ◽

Congenital Infections ◽

The Central Nervous System ◽

Group B

Ventricular fluids from four of 28 newborn infants who were initially seen with severe congenital anatomic defects in the central nervous system contained neutralizing antibody to at least one serotype of coxsackieviruses group B. Two of the four infants with anticoxsackieviruses group B antibody in the ventricular fluid did not have a detectable level of the same antibody(ies) in their serum. The ventricular fluid of one of the infants had immunoglobulin M neutralizing antibody directed against coxsackievirus B6. Of 11 mother-infant pairs that had neutralizing antibody to coxsackieviruses group B in both sera, nearly half had antibodies directed against more than one serotype. These data suggest the possibility of an association between congenital infections with coxsackieviruses group B and rare severe CNS defects.

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