scholarly journals CRANIAL ULTRASOUND: EFFICIENT SCREENING TOOL FOR EARLY DETECTION OF BRAIN INJURY IN PRETERM INFANTS

2021 ◽  
Vol 7 (1) ◽  
pp. 7-11
Author(s):  
Dini Rachma Erawati ◽  
Yuyun Yueniwati
Keyword(s):  
Brain Injury ◽  
Early Detection ◽  
Preterm Infants ◽  
Gestational Age ◽  
Screening Tool ◽  
Mode Of Delivery ◽  
Fisher Exact Test ◽  
Cranial Ultrasound ◽  
Cross Sectional ◽  
Ultrasound Findings

Background: Cranial ultrasound becomes an important diagnostic tool to evaluate brain injury in infants. Brain injury is a major complication for preterm birth. The brain injury of preterm infants differs from that of a term infant. Brain injury has correlation with gestational age and mode of delivery. Objective: To analyze the correlation between cranial ultrasound findings with gestational age and mode of delivery and to reveal if cranial ultrasound can be used to detect brain injury in premature infants. Methods: An observational analytic study using cross-sectional design took place in Saiful Anwar Hospital Malang, Indonesia. 38 healthy preterm infants underwent cranial ultrasound examination within the first four day of life. Fisher Exact test was used to analyze the correlation between cranial ultrasound findings with gestational age and mode of delivery. Results: Most of the healthy preterm infants (89.5%) were ≥ 32 weeks gestational age, and 52.6% of samples had caesarean section as their mode of delivery. There were three abnormal findings in cranial ultrasound; increased periventricular echogenic (5.3%), increased parenchym echogenic (5.3%), and indistinguishable of gray-white matter differentiation (5.3%). There was no significant correlation between abnormal cranial ultrasound findings with gestational age and mode of delivery (p= 0.202; p= 0.218). Conclusion: There were abnormal cranial ultrasound findings in some healthy preterm infants despite no significant correlation between ultrasound findings with gestational age and mode of delivery. Cranial ultrasound in preterm infants could become a screening tool for early detection of brain injury.

scholarly journals Incidence and Severity of Intra-Ventricular Hemorrhage (IVH) in Preterm Infants, Northeast of Iran

2016 ◽  
Vol 36 (1) ◽  
pp. 38-41
Author(s):  
Mahnaz Fouladinejad ◽  
Hadi Khorsand zak ◽  
Nematollah Nematollahi ◽  
Ehsan Alaee
Keyword(s):  
Birth Weight ◽  
Preterm Infants ◽  
Gestational Age ◽  
Very Low Birth Weight ◽  
Cross Sectional Study ◽  
Cranial Ultrasound ◽  
Academic Hospital ◽  
Cross Sectional ◽  
Portable Ultrasound ◽  
Ventricular Hemorrhage

Introduction: The incidence rate of Intra-Ventricular Haemorrhage (IVH) varies from 20% to 25% among preterm infants with a very low birth weight. IVH could compose critical disabilities which are directly associated to its grade. The aim of this study was to evaluate the incidence and severity of IVH in preterm infants referred to the academic Hospital of Gorgan, Northeast of Iran.Materials and Methods: In this cross-sectional study, we examined all preterm infants who had been referred to the academic Hospital of Gorgan, Northeast of Iran between Augusts 2014 and February 2015. Seventy one preterm infants (≤34 weeks of gestation, ≤1500g birth weight) have been included. Cranial ultrasound was done within 3-5 days of birth for all subjects and subsequent ultrasounds were performed based on their birth weight by portable ultrasound device.Results: The overall incidence of IVH was 64.8% in the present study. There was a significant relationship between IVH incidence and the gestational age (p=0.010). Also the lower birth weight was associated to the higher rate of IVH complications reported in sequential ultrasounds (p<0.05).Conclusion: Gestational age and birth weight seem to have key roles in the occurrence and severity of IVH, respectively.J Nepal Paediatr Soc 2016;36(1):38-41

67 Are NICUs too busy?

2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e47-e48
Author(s):  
Marc Beltempo ◽  
Robert Platt ◽  
Anne-Sophie Julien ◽  
Regis Blais ◽  
Bertelle Valerie ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Patient Outcomes ◽  
Gestational Age ◽  
Late Onset ◽  
Mode Of Delivery ◽  
Random Effect ◽  
Organizational Factors ◽  
Neurological Injury ◽  
Very Preterm Infants ◽  
Very Preterm

Abstract Primary Subject area Neonatal-Perinatal Medicine Background In a health care system with limited resources, hospital organizational factors such as unit occupancy and nurse-to-patient ratios may contribute to patient outcomes. Objectives We aimed to assess the association of NICU occupancy and nurse staffing with outcomes of very preterm infants born &lt; 33 weeks gestational age (GA). Design/Methods This was a multicenter retrospective cohort study of infants born 23-32 weeks GA without major congenital anomaly, admitted within 2 days after birth to one of four Level 3 NICUs in Quebec, Canada (2015-2018). For each 8 h shift, data on unit occupancy were obtained from a central provincial database (SiteNeo) and linked to the hospital nursing hours database (Logibec). Unit occupancy rates and nursing provision ratios (nursing hours/recommended nursing hours based on patient dependency categories) were pooled for the first shift, 24 h, and 7 days of admission for each infant. Patient data were obtained from the Canadian Neonatal Network database. Primary outcome was mortality and/or morbidity (severe neurological injury, bronchopulmonary dysplasia, necrotizing enterocolitis, and late-onset sepsis, severe retinopathy of prematurity). Adjusted odds ratios (AOR) for association of exposure with outcomes were estimated using generalized linear mixed models with a random effect for center, while adjusting for confounders (gestational age, small for gestational age, sex, outborn, Score for Neonatal Acute Physiology version 2, mode of delivery, and the other organizational variables). Results Among 1870 infants included in analyses, 796 (43%) had mortality/morbidity. Median occupancy was 89% (IQR 82-94) and median nursing provision was 1.13 (IQR 0.97-1.37). Overall higher NICU occupancy on shift of admission, first 24 h, and 7 days were associated with higher odds of mortality/morbidity (Figure 1) but nursing provision was not (Figure 2). Subgroup analysis by GA (&lt; 29 and 29-32 weeks) yielded similar results (not shown). Generalized linear mixed model analyses showed that a 5% reduction in occupancy in the first 24 h of admission was associated with a 6% reduction in mortality/morbidity. Conclusion NICU occupancy is associated with mortality/morbidity among very preterm infants and may reflect lack of adequate resources in periods of high activity. Interventions aimed at reducing occupancy and maintaining adequate resources need to be considered as strategies to improve patient outcomes.

scholarly journals Predictive Value of Cranial Ultrasound for Neurodevelopmental Outcomes of Very Preterm Infants with Brain Injury

2018 ◽  
Vol 131 (8) ◽  
pp. 920-926 ◽  
Author(s):  
Xue-Hua Zhang ◽  
Shi-Jun Qiu ◽  
Wen-Juan Chen ◽  
Xi-Rong Gao ◽  
Ya Li ◽  
...  
Keyword(s):  
Brain Injury ◽  
Preterm Infants ◽  
Predictive Value ◽  
Cranial Ultrasound ◽  
Neurodevelopmental Outcomes ◽  
Very Preterm Infants ◽  
Very Preterm

scholarly journals Prevalence of small for gestational age newborns and associated factors in a Brazilian Northeast capital

2018 ◽  
Vol 18 (3) ◽  
pp. 539-547
Author(s):  
Micaely Cristina dos Santos Tenório ◽  
Marilene Brandão Tenório ◽  
Raphaela Costa Ferreira ◽  
Carolina Santos Mello ◽  
Alane Cabral Menezes de Oliveira
Keyword(s):  
Birth Weight ◽  
Hierarchical Model ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Associated Factors ◽  
Protective Factor ◽  
Mode Of Delivery ◽  
Low Frequency ◽  
Cross Sectional Study ◽  
Cross Sectional

Abstract Objectives: to analyze the factors associated with the birth of small for gestational age (SGA)infants, in a Northeastern Brazilian capital. Methods: a cross-sectional study was carried out with 331 pregnant women and their newborns attending the public health network in the city of Maceió, in 2014. Maternal antenatal data were collected (socioeconomic, lifestyle, clinical and nutritional) as well as data of the newborns (gestational age, mode of delivery, sex, birth weight and length), after delivery. Birth weight was classified according to the INTERGROWTH-21st curves, being considered SGA those below the 10th percentile according to gestational age and gender. The results were analyzed by Poisson regression using a hierarchical model and were expressed as prevalence ratios (PR) and their respective 95% confidence intervals (CI95%). Results: it was verified that 5.1% of the newborns were SGA. Regarding the associated factors, after adjustment of the hierarchical model, the variable working outside the home was associated with the endpoint studied [PR = 0.14; (CI95% = 0.02-0.75); p=0.022]. Conclusions: it was verified a low frequency of SGA infants in the evaluated population. The fact that the mother works outside the home proved to be a protective factor for this condition.

scholarly journals Awareness of oral cancer and potentially malignant oral disorder among final year medical and dental undergraduate students of Chitwan Medical College, Nepal

2019 ◽  
Vol 9 (1) ◽  
pp. 20-26
Author(s):  
Sushil Subedi ◽  
Bijayata Shrestha
Keyword(s):  
Oral Cancer ◽  
Early Detection ◽  
Undergraduate Students ◽  
Dental Students ◽  
Fisher Exact Test ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Potentially Malignant ◽  
Medical And Dental Students

Background: Oral Cancer (OCA) is a common malignancy in South East Asia and the burden of the disease is increasing. OCA is usually preceded by Potentially Malignant Oral Disorder (PMOD). The early detection of these diseases may limit the high mortality and morbidity. The objectives of this study were to assess the awareness of burden, associated risk fac­tors, early detection and prognosis of OCA and OPMD among final year medical and dental students.. Methods: This cross sectional study was conducted among final year Medical and Dental undergraduate students of Chitwan Medical College, Nepal in April 2017 using a pre tested self-administered questionnaires. All the final year students present at their respective classes (Dental= 50 and Medical=75 students) responded to the questionnaires after giving informed consent. Data entered in SPPS 20 software was analyzed using Pearson Chi Square test and Fisher exact test. Results: Dental students had better awareness concerning PMOD. Yet, the dental students did not differ significantly from their medical coun­terpart in most of the responses related to OCA. Surprisingly, more Dental students had misconception that OCA is not preventable and early detec­tion is difficult. Few of both groups were confident in having sufficient knowledge in OCA prevention and detection. Only 18.6% of Medical stu­dents had examined PMOD and few students of both groups had exam­ined OCA. Conclusions: This study revealed the deficient aspect in the knowledge concerning OCA and OPMD among Medical and Dental students indicat­ing the need to emphasize on these aspects of medical education.

scholarly journals Reference values for N-terminal Pro-brain natriuretic peptide in premature infants during their first weeks of life

2020 ◽  
Author(s):  
Agnes-Sophie Fritz ◽  
Titus Keller ◽  
Angela Kribs ◽  
Christoph Hünseler
Keyword(s):  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Preterm Infants ◽  
Premature Infants ◽  
Reference Values ◽  
Gestational Age ◽  
Temporal Distribution ◽  
Cross Sectional ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Abstract The aim of our study was to observe the temporal distribution of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) in premature infants of ≤ 31 weeks of gestational age (GA) during the first weeks of life. NT-proBNP values of 118 preterm infants born ≤ 31 weeks GA were determined during the first week of life, after 4 ± 1 weeks of life, and at a corrected GA of 36 ± 2 weeks. Infants were divided into two groups: those without relevant complications and those with complications related to prematurity. NT-proBNP values of infants without complications define our exploratory reference values. The Median NT-proBNP level of these infants was 1896 ng/l (n = 27, interquartile range (IQR): 1277–5200) during the first week of life, 463 ng/l (n = 26, IQR: 364–704) at 4 ± 1 weeks of life, and 824 ng/l (n = 33, IQR: 714–1233) at a corrected GA of 36 ± 2 weeks. Infants born < 28 + 0 weeks GA had significantly higher NT-proBNP values (n = 9, median: 5200, IQR: 1750–8972) than infants born ≥ 28 + 0–31 weeks GA (n = 18, median: 1528, IQR: 838–3052; p = 0.017). Growth restriction or PDA status could not account for the difference in NT-proBNP values between GA groups. Conclusions: The results of our observational and cross-sectional study describe exploratory reference values for NT-proBNP levels in preterm infants of ≤ 31 weeks GA according to postnatal age. NT-proBNP levels during the first week of life are high and widely distributed in preterm infants and decrease subsequently to reach a distinctly lower and stable plateau at around 1 month of life. Our results suggest an influence of GA on NT-proBNP values in the first week of life. What is Known:• Several complications related to prematurity, e.g., hemodynamically significant PDA, pulmonary hypertension, bronchopulmonary dysplasia, and retinopathy of prematurity, have been associated with a temporary rise in NT-proBNP values in preterm infants during their first weeks of life.What is New:• This observational study provides reference values for NT-proBNP levels of very and extremely preterm infants during their first weeks of life.• In premature infants without complications, NT-proBNP values during their first week of life depend on gestational age at birth.

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