Spontaneous changes of skull morphology in premature babies: A preliminary study using plagiocephalometric analysis

Aim — to develop a reliable protocol to study the spontaneous changes in te skull morphology, specifically plagiocephaly in premature infants.Materials and methods. Evaluation of the degree of asymmetry using a plagiocephalometric tool and passive motion assessment for axial rotation and clinical examination of the neck muscles in six preterm infants. All measures are taken four times over a two months period.Results. About the placement of thermoplastic bands, a maximal variability of 3 % and 5 % was found for intra-and inter- observations respectively for the indices of interest (ODDI, CPI, CVAI). The variability of measures taken on photocopies was less than 1 %. 67 % of children had a preferential position on the third measure (T3) and 83 % on the fourth measure (T4). The prevalence of plagiocephaly was 17, 67, 33 and 50 % at T1, T2, T3 and T4 respectively considering a threshold of oblique diameters difference (ODDI) of 104 % . No influence of gender, gestational age, primiparity or asymmetry in muscle tension and/or rotation has been highlighted. In comparison with previous data, a very highly significant difference (p=0,001) was found for the index head values.Conclusion. This study has demonstrated the feasibility of the method. More consistent data should be considered, with a broader sample in order to provide a relevant analysis of the morphometric changes of the skull base. According to the criteria of the literature, three premature infants out of six had a plagiocephaly at T4 and we observed a normalization of morphometric values was observed in two infants.

Download Full-text

ACUTE KIDNEY INJURY IN PREMATURE CHILDREN WITH HEMODYNAMICALLY SIGNIFICANT OPEN ARTERIAL DUCT

Neonatology surgery and perinatal medicine ◽

10.24061/2413-4260.x.4.38.2020.2 ◽

2020 ◽

Vol 10 (4(38)) ◽

pp. 26-34

Author(s):

T. Borysova ◽

O. Obolonska ◽

D. Surkov

Keyword(s):

Acute Kidney Injury ◽

Patent Ductus Arteriosus ◽

Serum Creatinine ◽

Premature Infants ◽

Ductus Arteriosus ◽

Kidney Injury ◽

The Third ◽

Premature Babies ◽

Arterial Duct ◽

Patent Ductus

Introduction. Hemodynamically significant patent ductus arteriosus (HSPDA) leads to the “steal” phenomenon of the systemic circulation and renal hypoperfusion, which can contribute to the development of acute kidney injury (AKI). Aim of the study. To assess the frequency and severity of AKI according to the criteria of neonatal modification of KDIGO in premature infants with HSPDA. Material and research methods. We examined 74 premature infants (gestational age 29-36 weeks) who were treated in the department of anesthesiology and intensive care of newborns. The duration of observation was ten days from the first day of life. The patients were divided into three groups depending on the presence of patent ductus arteriosus (PDA) and its hemodynamic significance: group I - 40 children with HSPDA, group II - 17 children with PDA without hemodynamic disorders, group III - 17 children with closed arterial duct. Clinical examination and treatment of premature infants was carried out according to the generally accepted methods. In HSPDA, ibuprofen was used to close the ductus arteriosus for 32 premature babies, and restrictive infusion therapy for 8 ones. Doppler echocardiography was performed at 5-11 hours of life and then daily to determine the PDA, its size and hemodynamic significance. Diagnosis and stratification of the severity of acute kidney injury were carried out according to the criteria of neonatal modification KDIGO, for which the concentration of serum creatinine was studied on the first, third, fifth, seventh, tenth days and the level of urine output every 6-12 hours. Research results. AKI on the third day of life was diagnosed in 52.5% of children with HSPDA, which is 2.2 times more often than in children with PDA without hemodynamic significance (p <0.05) and 4.4 times more often than with closed arterial duct (p<0.007). On the fifth day of life, AKI was detected in two more children and their total number increased to 57.5%. On the seventh and tenth days of life, AKI in children with HSPDA was more common than in children with a closed duct (50.0% versus 11.8%, p<0.008, and 29.4% versus 0%, p<0.02, respectively). Analysis of the severity of acute kidney injury showed the effect of HSPDA on this parameter. The presence of HSPDA was a factor that led to the development of stage II AKI on the third and fifth days of life. In addition, with HSPDA, the frequency of stage III AKI increased 2.7 times within four days, while the percentage of stages I-II AKI decreased by 1.5 times. The frequency and severity of AKI in children with HSPDA depended on the size of the ductus arteriosus. With PDA up to 2 mm in diameter, on the third and fifth days of life, AKI was diagnosed in every fifth patient of stage I only, and on the tenth day of life - only in one patient. Meanwhile, in the majority of children with a PDA diameter of more than 2 mm, AKI was diagnosed on the third, fifth and seventh days; only on the tenth day of life, the number of such patients decreased 1.3 times. But the proportion of severe acute kidney injury practically did not change - acute kidney injury of stages II-III was observed on the first day in every second child with a large PDA diameter. The serum creatinine level on the third and tenth days directly depended on the size of the PDA on the first day (ρ = 0.493, p˂0.001 and ρ = 0.432, p˂0.002, respectively). With HSPDA, this dependence was more pronounced (ρ = 0.732, p˂0.001 and ρ = 0.731, p˂0.001, respectively) than in the group with PDA without hemodynamic significance (ρ = 0.285, p<0.05 and ρ = 0.324, p>0.05, respectively). The serum creatinine concentration directly correlated with the closure time of the PDA. Analysis of the connection between the rate of closure of the PDA and the presence of AKI in the HSPDA group showed that in the case of late closure of the ductus arteriosus (at 3-5 days of life), 16 (94.1%) premature infants suffered from kidney damage versus 1 (5.9%) case among children, in which the duct closed in the first two days (OR = 36.57; CI: 4.02-332.34 p<0.001). A close correlation was also established between the rate of closure of the PDA and the maximum stage of the AKI (ρ = 0.700, p˂0.001). Conclusions. HSPDA contributes to the development of AKI in premature infants. The diameter and rate of closure of the ductus arteriosus determine the frequency and severity of AKI in premature infants with HSPDA. Additional research is needed to diagnose acute kidney injury in premature babies with HSPDA earlier.

Download Full-text

Toleransi Minum Enteral Bayi Prematur Menggunakan Spuit 20 Ml dan Spuit 50 Ml

Jurnal Keperawatan Silampari ◽

10.31539/jks.v3i2.1119 ◽

2020 ◽

Vol 3 (2) ◽

pp. 544-555

Author(s):

Elfira Awalia Rahmawati ◽

Yeni Rustina ◽

Defi Efendi

Keyword(s):

Randomized Controlled Trial ◽

Preterm Infants ◽

Controlled Trial ◽

Intervention Group ◽

Crossover Design ◽

P Value ◽

The Third ◽

Randomized Controlled ◽

Premature Babies ◽

Significant Difference

This study aims to determine the comparison of enteral drinking by using syringes of 20 ml and 50 ml of drinking tolerance in preterm infants. The method used is a randomized controlled trial with a crossover design. The results of this study illustrate that there is a significant difference in the duration of the drinking intervention intervention group using 20 ml syringes and 50 syringes on the first and second day (p value respectively 0.036; 0.033), there is no significant difference in the intervention group giving drinking using 20 ml syringe and 50 ml syringe on the third day (p value 0.984). There were no significant differences in gastric residue on the first, second and third day in the two intervention groups. The incidence of vomiting on the first, second and third day there was no significant difference in the intervention group of drinking using a 20 ml syringe and 50 ml syringe (p value each was 1,000). Conclusion, Provision of enteral drinking by using a 20 ml syringe and 50 ml syringe have the same drinking tolerance in premature babies. Keywords: Premature Babies, Enteral Drinking, Tolerance to Drink

Download Full-text

SULFOBROMOPHTHALEIN SODIUM METABOLISM IN NEWBORN INFANTS

PEDIATRICS ◽

10.1542/peds.29.6.899 ◽

1962 ◽

Vol 29 (6) ◽

pp. 899-906

Author(s):

Sidney Sussman ◽

J. V. Carbone ◽

G. Grodsky ◽

V. Hjelte ◽

Phebe Miller

Keyword(s):

Premature Infants ◽

Standard Dose ◽

Newborn Infants ◽

Full Term ◽

Hemolytic Disease ◽

The Third ◽

Significant Difference ◽

The Mean ◽

The Difference ◽

Sodium Metabolism

With the use of a standard dose of sulfobromophthalein sodium (BSP), the metabolism of this substance was studied in a group of full-term and premature infants (normal, hypoxic, and hyperbilirubinemic). Elevated total BSP and BSP conjugate at birth in normal full-term and premature infants approached normal adult levels toward the end of the third week of life. There was no significant difference between the rate of decrease of total or conjugated BSP in the full-term and premature infant. During the first 20 days of life the decrease in total BSP levels proceeded at a faster rate than the decline in BSP conjugate in both normal groups. The mean concentrations of total BSP and BSP conjugate were higher in infants with hypoxia, hyperbilirubinemia, and hemolytic disease of the newborn than in normal infants, but the difference was not statistically significant.

Download Full-text

Chest-to-Back Skin-to-Skin Contact to Regulate Body Temperature for Low Birth Weight and/or Premature Babies: A Crossover Randomized Controlled Clinical Trial

International Journal of Pediatrics ◽

10.1155/2021/8873169 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Sisay Gere ◽

Yemane Berhane ◽

Alemayehu Worku

Keyword(s):

Clinical Trial ◽

Birth Weight ◽

Body Temperature ◽

Low Birth Weight ◽

Premature Infants ◽

Low Income ◽

Skin Contact ◽

Premature Babies ◽

Significant Difference ◽

Skin To Skin

Skin-to-skin contact (SSC) is one of the critical components of kangaroo mother care (KMC), which is an intervention to enhance the survival of low birth weight (LBW) and/or premature infants in low-income settings. Chest-to-chest (CC) contact has been practiced widely; however, mothers face practical challenges to continuously provide CC-SSC. Hence, we assessed the efficacy of chest-to-back (CB) SSC as an alternative to CC-SSC in regulating body temperature for LBW and/or premature babies in Ethiopia. We applied a noninferiority clinical trial among LBW and/or premature infants admitted to a referral hospital neonatal intensive care unit (NICU) in Ethiopia. The study randomized the infants into two crossover arms; arm 1 applied first CB-SSC followed by CC-SSC, and arm 2 applied first CC-SSC followed by CB-SSC. The outcome measure was a change in skin temperature. We used a linear mixed-effect model for analysis. The result showed no statistically significant difference in the mean temperature between the comparison arms. In conclusion, we found that the CB-SSC was not inferior to the CC-SSC in regulating body temperature of the babies. Thus, CB-SSC can be further investigated as an alternative to CC-SSC in the kangaroo care model in low-income settings.

Download Full-text

Changes of Walking Activity During the First Cycle Phases of COVID-19 Pandemic: A Case Study of Seoul, Korea

HERD Health Environments Research & Design Journal ◽

10.1177/19375867211026571 ◽

2021 ◽

pp. 193758672110265

Author(s):

Youngjun Park ◽

Haekwon Chung ◽

Sohyun Park

Keyword(s):

Public Health ◽

Physical Inactivity ◽

Voluntary Participation ◽

Walking Activity ◽

Significant Difference ◽

Before And After ◽

Acceleration And Deceleration ◽

Preliminary Study ◽

The Government

Aim: This study explores the changes in regular walking activities during the phases of the pandemic. Background: With the spread of COVID-19 transmission, people are refraining from going out, reducing their physical activity. In South Korea, COVID-19 broke out in the 4th week of 2020 and experienced the first cycle phases of the pandemic, such as outbreak, widespread, and decline. In response to the pandemic, the government encouraged voluntary participation in social distancing campaigns, and people reduced their outside activities. Methods: This article examines the decrease and increase of the Prevalence of Regular Walking (≥30 min of moderate walking a day, on ≥5 days a week) by the COVID-19 phases. This study is based on weekly walking data for 15 weeks in 2020, via the smartphone healthcare app, which is managed by 25 public health offices of the Seoul government. Results: According to the findings, the level of prevalence of regular walking (PRW) has a significant difference before and after the outbreak, and every interval of the four-stage COVID-19 phases, that is, pre-pandemic, initiation, acceleration, and deceleration. The level of PRW sharply decreased during initiation and acceleration intervals. In the deceleration interval of COVID-19, the PRW kept increasing, but it has not yet reached the same level as the previous year when the COVID-19 did not exist. Conclusions: As a preliminary study, this study explains empirically how COVID-19 changed PRW in Seoul. It would be helpful to enhance our understanding of the changes in physical inactivity in the pandemic period.

Download Full-text

Publication activity of chief and consultant general/visceral surgeons in German university hospitals—a ten-year analysis

Langenbeck s Archives of Surgery ◽

10.1007/s00423-021-02241-6 ◽

2021 ◽

Author(s):

Eva C. Böckmann ◽

E. S. Debus ◽

R. T. Grundmann

Keyword(s):

Impact Factor ◽

Publication Activity ◽

University Hospitals ◽

Cumulative Impact ◽

University Departments ◽

The Third ◽

Publication Number ◽

Significant Difference ◽

The Mean ◽

Number Of Publications

Abstract Purpose The publication activity of 38 German general/visceral surgery university departments, documented by first or last authorship from staff surgeons (chief and consultants), was evaluated. Methods The observation period extended from 2007 to 2017 and all PubMed-listed publications were considered. Impact factor (IF) was evaluated through the publishing journal’s 5-year IF in 2016, as was the IF for each individual publication. Ranking was expressed in quartiles. Results The staff surgeons of the 38 departments comprised 442 surgeons, of which only 351 (79.4%) were active as first or last authors. Four thousand six hundred and ninety-nine publications published in 702 journals were recorded. The four leading departments in publication number published as much as the last 20 departments (1330 vs. 1336 publications, respectively). The mean of the first (most active) department quartile was 19.6 publications, the second 15.4, the third 11.0, and the last quartile 7.6 per publishing surgeon. The total cumulative impact factor was 14,130. When examining the mean number of publications per publishing surgeons per the 10 year period, the mean of the first quartile was 57.9 cumulative IF, the second 45.0, the third 29.5, and the fourth quartile 17.1. With 352 (7.5%) publications, the most frequently used journal was Chirurg, followed by Langenbeck’s Archives of Surgery with 274 (5.8%) publications. Pancreas-related topics led in terms of publication number and IF generated per individual publication. Conclusion A significant difference in publication performance of individual departments was apparent that cannot be explained by staff number. This indicates that there are as yet unknown factors responsible for minor publication activity in many university departments.

Download Full-text

Preliminary Study on Gold Recovery from High Grade E-Waste by Thiourea Leaching and Electrowinning

Minerals ◽

10.3390/min11030235 ◽

2021 ◽

Vol 11 (3) ◽

pp. 235

Author(s):

Nicolò Maria Ippolito ◽

Ionela Birloaga ◽

Francesco Ferella ◽

Marcello Centofanti ◽

Francesco Vegliò

Keyword(s):

Sulfuric Acid ◽

Leach Solution ◽

High Grade ◽

Gold Dissolution ◽

Plastic Part ◽

The Third ◽

Current Consumption ◽

Different Types ◽

Preliminary Study ◽

A Current

The present paper is focused on the extraction of gold from high-grade e-waste, i.e., spent electronic connectors and plates, by leaching and electrowinning. These connectors are usually made up of an alloy covered by a layer of gold; sometimes, in some of them, a plastic part is also present. The applied leaching system consisted of an acid solution of diluted sulfuric acid (0.2 mol/L) with thiourea (20 g/L) as a reagent and ferric sulfate (21.8 g/L) as an oxidant. This system was applied on three different high-grade e-waste, namely: (1) Connectors with the partial gold-plated surface (Au concentration—1139 mg/kg); (2) different types of connectors with some of which with completely gold-plated surface (Au concentration—590 mg/kg); and (3) connectors and plates with the completely gold-plated surface (Au concentration—7900 mg/kg). Gold dissolution yields of 52, 94, and 49% were achieved from the first, second, and third samples, respectively. About 95% of Au recovery was achieved after 1.5 h of electrowinning at a current efficiency of only 4.06% and current consumption of 3.02 kWh/kg of Au from the leach solution of the third sample.

Download Full-text

Construct Stability of C2 Replacement Strategies

Advances in Bioengineering ◽

10.1115/imece2003-42893 ◽

2003 ◽

Author(s):

Christian M. Puttlitz ◽

Robert P. Melcher ◽

Vedat Deviren ◽

Dezsoe Jeszenszky ◽

Ju¨rgen Harms

Keyword(s):

Repeated Measures ◽

Posterior Instrumentation ◽

Statistical Significance ◽

Axial Rotation ◽

Posterior Fixation ◽

Camera Motion ◽

Anterior Plate ◽

Intact Specimen ◽

Strut Graft ◽

Significant Difference

Reconstruction of C2 after tumor destruction and resection remains a significant challenge. Most constructs utilize a strutgraft with plate or screw fixation. A novel C2 prosthesis combining a titanium mesh cage with bilateral C1 shelves and a T-plate has been used successfully in 18 patients. Supplemental posterior instrumentation includes C0-C3 or C1-C3. Biomechanical comparisons of this C2 prosthesis with traditional fixation options have not been reported. Five fresh-frozen human cadaveric cervical spines (C0-C5) were tested intact. Next, the C2 prosthesis, and strut graft and anterior plate constructs were tested with occiput-C3 and C1-C3 posterior fixation. Pure moment loads (up to 1.5 N-m) were applied in flexion and extension, lateral bending, and axial rotation. C1-C3 motion was evaluated using 3 camera motion analysis. Statistical significance was evaluated using one-way repeated measures ANOVA with Student-Newman-Keuls post hoc pairwise comparisons. All constructs provided a statistically significant decrease in motion in this C2 corpectomy model as compared to the intact condition. There was no significant difference in C1-C3 motion between the 4 constructs, regardless of whether the occiput was included in the fixation. Under these loading conditions, both the C2 prostheisis and strut-graft-plate constructs provided initial C1-C3 stability beyond that of the intact specimen. The occiput does not need to be included in the posterior instrumentation.

Download Full-text

Analysis of intracranial hemorrhage grade in preterm singleton pregnancies delivered vaginally or by cesarean section

Vojnosanitetski pregled ◽

10.2298/vsp1303255l ◽

2013 ◽

Vol 70 (3) ◽

pp. 255-258 ◽

Cited By ~ 1

Author(s):

Sasa Ljustina ◽

Ivana Berisavac ◽

Milica Berisavac ◽

Ljudmila Kovacevic-Vukolic ◽

Vesna Velickovic-Aleksic ◽

...

Keyword(s):

Cesarean Section ◽

Perinatal Outcome ◽

Intraventricular Hemorrhage ◽

Mode Of Delivery ◽

Preterm Neonates ◽

Delivery Methods ◽

Premature Babies ◽

Significant Difference ◽

Vertex Presentation ◽

Singleton Pregnancies

Background/Aim. Preterm birth is the leading cause of neonatal mortality. Periventricular hemorrhage-intraventricular hemorrhage (PVH-IVH) remains a significant cause of both morbidity and mortality in infants prematurely born. The aim of the study was to evaluate the perinatal outcome regarding IVH of premature babies according to the mode of delivery. Methods. A total of 126 women in preterm singleton pregnancies with vertex presentation and 126 neonates weighted from 750 g to 1,500 g at birth were enrolled. The outcomes of 64 neonates born vaginally were compared to 62 neonates born by cesarean section. Results. There was no significant difference in the incidence of IVH among both groups. Conclusion. Our data is consistent with the hypothesis that the mode of delivery does not influence IVH and consenquently perinatal outcome in preterm neonates.

Download Full-text

Treatment of Dentin Hypersensitivity Using Nano-Hydroxyapatite Pastes: A Randomized Three-Month Clinical Trial

Operative Dentistry ◽

10.2341/15-145-c ◽

2016 ◽

Vol 41 (4) ◽

pp. E93-E101 ◽

Cited By ~ 20

Author(s):

L Wang ◽

AC Magalhães ◽

LF Francisconi-dos-Rios ◽

MP Calabria ◽

DFG Araújo ◽

...

Keyword(s):

Clinical Trial ◽

Home Care ◽

General Linear Model ◽

Potassium Nitrate ◽

Dentin Hypersensitivity ◽

Analog Scale ◽

The Third ◽

Significant Difference ◽

Final Score ◽

Nested Analysis

SUMMARY Objectives: This randomized clinical trial tested the three-month desensitizing effect of two protocols using nano-hydroxyapatite formulations compared with Pro-Argin and fluoride varnish. Methods: Twenty-eight subjects with 137 teeth presenting dentin exposure with a minimal hypersensitivity of four on the visual analog scale (VAS) took part of this study. The subjects were randomly assigned to four groups: Desensibilize Nano-P paste (20% hydroxyapatite [HAP], potassium nitrate, and sodium fluoride [NaF]; 9000 ppm fluoride [F]); Desensibilize Nano-P associated with experimental home-care pastes (10% HA, potassium nitrate, and NaF; 900 ppm F); Pro-Relief professional paste (8% arginine with Pro-Argin technology) associated with home-care toothpaste (8% arginine, sodium monofluorophosphate, 1450 ppm F); and Duraphat professional varnish (NaF varnish, 22,600 ppm F). The professional treatments were performed in weekly appointments over three weeks. The home-care products were used continuously for three months. A VAS was used to assess the tooth sensitivity response after standardized evaporative stimulus at baseline and after one month and three months. The baseline score was deducted from the final score, and the means were analyzed using nested analysis of variance, while the comparison between times was performed by a general linear model (p<0.05). Results: At the first month all treatments were effective, but there were no significant differences among them (p=0.94). At the third month, despite the fact that NaF varnish had the lowest effect in reducing hypersensitivity, no significant difference was found among the treatments (p=0.09). Only Pro-Relief increased its effect over time (p=0.049). Conclusions: Nano-hydroxyapatite formulations (with or without home->care product association) were as effective as the other treatments in reducing dentin hypersensitivity over three months.

Download Full-text