scholarly journals Prevalence of Ocular Abnormalities in Term Infants

2021 ◽  
Author(s):  
Hatice Daldal ◽  
Mustafa Türkyılmaz ◽  
Oğuzhan Salış ◽  
Musa Yiğit ◽  
Mustafa Muhterem Ekim
Keyword(s):  
Screening Program ◽  
Treatment Options ◽  
Perinatal Period ◽  
Congenital Glaucoma ◽  
Retinal Hemorrhages ◽  
Term Infants ◽  
Congenital Ptosis ◽  
Ocular Tracking ◽  
Corneal Opacities ◽  
Indirect Ophthalmoscope

Objective: To exhibit the results of routine ophthalmologic screening in infants between 0-1 years of age referred to the ophthalmology clinic from the departments of pediatrics and family medicine. Method: Referred to the ophthalmology clinic between August 2014 and November 2019, 11196 eyes of 5598 term infants were retrospectively investigated in the study, and all participants were ophthalmologically examined at 1st, 6th, and 12th months of age. Infants’ pupils were dilated with 0.5% tropicamide and 2.5% phenylephrine. On examination, eye and face symmetries were evaluated with inspection, fixation, and ocular tracking. Pupil responses and motility were evaluated with the light source. While the red reflex test was evaluated using a direct ophthalmoscope, fundus was assessed through an indirect ophthalmoscope. Results: Congenital cataract (6), congenital glaucoma (3), strabismus (81), epiphora (426), non-specific retinal hemorrhages (42) and retinal pigmentation changes (10), coloboma (4) (one eyelid, four iris, one optical disc and three chorioretinal), optic disc abnormalities (3), congenital ptosis (13) (unilateral in 12 patients and bilateral in one patient), corneal dysgenesis (2) and microphthalmia (3) were determined in 11196 eyes of 5598 infants (2709 females, 2889 males). Conclusion: Perinatal ophthalmologic screening program is likely to diagnose several diseases earlier, such as congenital cataracts, congenital glaucoma, strabismus, corneal opacities, causing vision losses in infants. Treatment options are available, and some diseases can be treated due to early intervention. Early treatment can also eliminate the problems precluding the development of complex visual ability continuing in perinatal period. Consequently, final visual acuity may be increased.

scholarly journals Massachusetts’ Findings from Statewide Newborn Screening for Spinal Muscular Atrophy

2021 ◽  
Vol 7 (2) ◽  
pp. 26
Author(s):  
Jaime E. Hale ◽  
Basil T. Darras ◽  
Kathryn J. Swoboda ◽  
Elicia Estrella ◽  
Jin Yun Helen Chen ◽  
...  
Keyword(s):  
Spinal Muscular Atrophy ◽  
Newborn Screening ◽  
New England ◽  
Screening Program ◽  
Muscular Atrophy ◽  
Treatment Options ◽  
Newborn Screening Program ◽  
Treatment Protocols ◽  
Screening Algorithm ◽  
New Treatment

Massachusetts began newborn screening (NBS) for Spinal Muscular Atrophy (SMA) following the availability of new treatment options. The New England Newborn Screening Program developed, validated, and implemented a screening algorithm for the detection of SMA-affected infants who show absent SMN1 Exon 7 by Real-Time™ quantitative PCR (qPCR). We screened 179,467 neonates and identified 9 SMA-affected infants, all of whom were referred to a specialist by day of life 6 (average and median 4 days of life). Another ten SMN1 hybrids were observed but never referred. The nine referred infants who were confirmed to have SMA were entered into treatment protocols. Early data show that some SMA-affected children have remained asymptomatic and are meeting developmental milestones and some have mild to moderate delays. The Massachusetts experience demonstrates that SMA NBS is feasible, can be implemented on a population basis, and helps engage infants for early treatment to maximize benefit.

Visual System Screening in Infants and Young Children

1982 ◽  
Vol 4 (3) ◽  
pp. 71-73
Author(s):  
J. Allen Gammon
Keyword(s):  
Young Children ◽  
Visual System ◽  
Early Recognition ◽  
Visual Development ◽  
Congenital Glaucoma ◽  
Laboratory Animals ◽  
Congenital Cataracts ◽  
Ocular Abnormalities ◽  
Corneal Opacities ◽  
Infants And Young Children

Many abnormalities of the visual system in infants and young children respond to treatment when instituted at an early age. Ocular abnormalities that require early recognition and therapy include congenital cataracts, congenital glaucoma, intraocular tumors, intraocular inflammation, large errors of refraction, strabismus, and corneal opacities (Figs 1 to 6). The visual prognosis for children with these problems is often directly related to early detection and treatment of the visual disorder. Visual deprivation of young laboratory animals can permanently damage their developing central nervous system. Diseases once believed hopeless, such as monocular congenital cataracts, can now be treated.1 Technologic advances, such as extended-wear contact lenses which are useful for infants who have had cataract surgery during the first few weeks of life, have facilitated visual rehabilitation of young eyes. Corneal opacities, complete ptosis, prolonged patching, and eyelid or orbit abnormalities such as large hemangiomas can cause amblyopia if the vision is obstructed. Even brief occlusion can result in irreversible amblyopia during the early months of life.2 Unilateral disruptions of vision are generally more damaging to the eye than are bilateral ocular abnormalities. Each of the young child's eyes must enjoy a clear, focused retinal image for visual development to progress normally. Early diagnosis and treatment of congenital glaucoma is important so that intraocular pressure can be lowered, thereby, avoiding irreversible anatomic damage to the eye.

scholarly journals Ocular Decompression Retinopathy : A Case Series

2018 ◽  
Vol 9 (2) ◽  
pp. 194-198 ◽  
Author(s):  
Kirti Singh ◽  
Mainak Bhattacharyya ◽  
Keerti Wali ◽  
Kartik Rana ◽  
Divya Jain
Keyword(s):  
Case Series ◽  
Cataract Extraction ◽  
Good Prognosis ◽  
Posterior Pole ◽  
Congenital Glaucoma ◽  
Traumatic Cataract ◽  
Retinal Hemorrhages ◽  
Advanced Glaucoma ◽  
Post Traumatic ◽  
Decompression Retinopathy

Introduction: Ocular decompression retinopathy (ODR) is a relatively rare entity with variable prognosis depending on extent and pre-existing condition. This article describes profile of two cases with a brief review of the condition.Case report: Case 1 highlights extensive choroidal detachment with subhyaloid haemorrhage and multiple intra-retinal hemorrhages in the posterior pole seen on first post-operative day in a 6 year old child with congenital glaucoma who underwent Trab & Trab. Case 2 describes multiple intraretinal hemorrhages seen at posterior pole on second post-operative day in a 24 year old pregnant lady with post traumatic cataract and secondary glaucoma who underwent cataract extraction with Cionni ring. Both patients had complete resolution of the haemorrhages with topical steroids.Conclusion: Ocular decompression retinopathy is mostly seen after operations on cases with advanced glaucoma and those with vulnerable blood flow fluidics. Adequate precautions to prevent this entity should be adopted during surgery and management of the manifest entity is conservative with good prognosis.

scholarly journals Transcutaneous Bilirubin Screening Program: Nomogram for Term and Near-Term Infants

2010 ◽  
Vol 15 (suppl_A) ◽  
pp. 15A-16A
Author(s):  
A Blanchard ◽  
A Carceller ◽  
J Cousineau ◽  
E Delvin
Keyword(s):  
Screening Program ◽  
Term Infants ◽  
Transcutaneous Bilirubin ◽  
Near Term

The treatment of bipolar disorder in women

2017 ◽  
Author(s):  
Danielle Balzafiore ◽  
Thalia Robakis ◽  
Sarah Borish ◽  
Vena Budhan ◽  
Natalie Rasgon
Keyword(s):  
Bipolar Disorder ◽  
Polycystic Ovary ◽  
Treatment Options ◽  
Perinatal Period ◽  
Ovary Syndrome ◽  
Behavioural Interventions ◽  
Stabilizing Agents ◽  
Specific Effects ◽  
Affective Symptoms ◽  
Efficacious Treatment

Sex-specific effects in the clinical presentation and course of bipolar disorder in women have important treatment implications for the management of symptoms across the menstrual cycle and reproductive lifespan. Women with bipolar disorder are particularly vulnerable to premenstrual mood symptoms, menstrual abnormalities, and polycystic ovary syndrome. Special considerations include understanding the interactions between these reproductive issues, oral contraceptives, and mood-stabilizing agents. Additionally, the management of bipolar disorder during the perinatal period requires a careful approach to psychotropic medication to optimize the maintenance of mood stability while minimizing the potential for adverse risk of fetal and neonatal outcomes. Non-pharmaceutical approaches, including electroconvulsive therapy, transcranial magnetic stimulation, selected psychotherapies, and social and behavioural interventions may represent efficacious treatment options to reduce medication burden. Lastly, women with bipolar disorder may be at particular risk for worsening of affective symptoms during the menopausal transition, and strategies to reduce sleep disruption are imperative.

scholarly journals When Fathers Begin to Falter: A Comprehensive Review on Paternal Perinatal Depression

2020 ◽  
Vol 17 (4) ◽  
pp. 1139 ◽  
Author(s):  
Antonio Bruno ◽  
Laura Celebre ◽  
Carmela Mento ◽  
Amelia Rizzo ◽  
Maria Catena Silvestri ◽  
...  
Keyword(s):  
Depressive Disorders ◽  
Transition To Parenthood ◽  
Perinatal Depression ◽  
Clinical Symptoms ◽  
Treatment Options ◽  
Well Being ◽  
Perinatal Period ◽  
Life Transition ◽  
Behavioral Disturbances ◽  
Major Life

The transition to parenthood is considered to be a major life transition that can increase the vulnerability to parental depressive disorders, including paternal perinatal depression (PPND). Although it is known that many fathers experience anxiety and depression during the perinatal period, PPND is a recent diagnostic entity and there are not enough published studies on it. Accordingly, its prevalence and epidemiology are still not well defined, although the majority of studies agree that PPND is less frequent than maternal perinatal depression and postpartum depression. Nevertheless, PPND is different from maternal perinatal mental health disorders, usually, fathers have less severe symptoms, and mood alterations are often in comorbidity with other affective disorders. Despite the absence of DSM-5 diagnostic criteria and the fluctuation of prevalence rates, clinical symptoms have been defined. The main symptoms are mood alterations and anxiety, followed by behavioral disturbances and concerns about the progress of pregnancy and the child’s health. Moreover, PPND negatively impacts on family functioning, on couples’ relationships, and on family members’ well-being. The aim of this paper is to present an overview of the current understandings on PPND and the potential screening, prevention, and treatment options.

OCULAR MANIFESTATIONS IN MENTALLY CHALLENGED CHILDREN

2021 ◽  
pp. 43-44
Author(s):  
Mohammed Ather ◽  
Farha Jabeen ◽  
Vanga Hemanth Reddy ◽  
Avvari Sowmya ◽  
Manikonda Bhoomika Rao ◽  
...  
Keyword(s):  
South India ◽  
Special School ◽  
Age Group ◽  
Congenital Ptosis ◽  
Ocular Manifestations ◽  
High Prevalence ◽  
Ocular Disorders ◽  
Corneal Opacities ◽  
The Common ◽  
Visual Problems

Purpose: To identify the ocular disorders in mentally challenged children attending a special school. Methods: A total of 100 mentally challenged children in the age group of 3-16 years attending special school in a district of South India were examined. Complete ocular examination was done. Ocular problems were identied and categorized into development related, hygiene related and IQ related problems. Results: Seventy children (70%) had ocular problems. Refractive error and strabismus were the common ocular problems seen in this study. Ocular manifestations like nystagmus, congenital ptosis, anti mongoloid slant, wide telecanthus with epicanthus, chalazia, stye, blepharitis, congenital NLD obstruction, conjunctivitis, xerosis, microcornea, corneal opacities, congenital cataracts, optic atrophy, retinitis pigmentosa were seen. An association was found between the severity of mental retardation and ocular problems (P<0.005). Conclusion: A high prevalence of ocular problems was seen in mentally retarded school children. These children should undergo annual ophthalmic evaluation. Visual function of the children should be assessed as soon as the child is admitted to the school. Earlier assessment and correction of the visual problems will have greater chance of achieving potential and will prevent visual impairment. Aim of the study: To identify the ocular disorders in mentally challenged children attending National Institute of Mental Health, a special school for such children.

scholarly journals Hypoxia-Ischemia Induced Age-Dependent Gene Transcription Effects at Two Development Stages in the Neonate Mouse Brain

2020 ◽  
Vol 13 ◽  
Author(s):  
Nicolas Dupré ◽  
Céline Derambure ◽  
Bérénice Le Dieu-Lugon ◽  
Michelle Hauchecorne ◽  
Yannick Detroussel ◽  
...  
Keyword(s):  
Cholesterol Biosynthesis ◽  
Statistical Significance ◽  
Interleukin 1 ◽  
Perinatal Period ◽  
Term Infant ◽  
Brain Lesions ◽  
Term Infants ◽  
Hypoxia Ischemia ◽  
Age Dependent ◽  
Micro Array

Human brain lesions in the perinatal period result in life-long neuro-disabilities impairing sensory-motor, cognitive, and behavior functions for years. Topographical aspects of brain lesions depend on gestational age at the time of insult in preterm or term infants and impaired subsequent steps of brain development and maturation. In mice, the Rice-Vannucci procedure of neonate hypoxia-ischemia (HI) was used at 5 days (P5) or P10, mimicking the development of 30 week-gestation fetus/preterm newborn, or full-term infant, respectively. Transcription response to HI was assessed at 3, 6, 12, and 24 h after insult, using micro-array technology. Statistical Pathway and Gene Ontology terms enrichments were investigated using DAVID®, Revigo® and Ingenuity Pathway Analysis (IPA®) to identify a core of transcription response to HI, age-specific regulations, and interactions with spontaneous development. Investigations were based on direction, amplitude, and duration of responses, basal expression, and annotation. Five major points deserve attention; (i) inductions exceeded repressions (60/40%) at both ages, (ii) only 20.3% (393/1938 records) were common to P5 and P10 mice, (iii) at P5, HI effects occurred early and decreased 24 h after insult whereas they were delayed at P10 and increased 24 h after insult, (iv) common responses at P5 and P10 involved inflammation, immunity, apoptosis, and angiogenesis. (v) age-specific effects occurred with higher statistical significance at P5 than at P10. Transient repression of 12 genes encoding cholesterol biosynthesis enzymes was transiently observed 12 h after HI at P5. Synaptogenesis appeared inhibited at P5 while induced at P10, showing reciprocal effects on glutamate receptors. Specific involvement of Il-1 (interleukin-1) implicated in the firing of inflammation was observed at P10. This study pointed out age-differences in HI responses kinetics, e.g., a long-lasting inflammatory response at P10 compared to P5. Whether the specific strong depression of cholesterol biosynthesis genes that could account for white matter-specific vulnerability at P5 or prevent delayed inflammation needs further investigation. Determination of putative involvement of Il-1 and the identification of upstream regulators involved in the delayed inflammation firing at P10 appears promising routes of research in the understandings of age-dependent vulnerabilities in the neonatal brain.

P31 Compatibility of sildenafil citrate with noradrenaline and vasopressin during simulated y-site administration

2018 ◽  
Vol 103 (2) ◽  
pp. e1.36-e1
Author(s):  
O’Brien Fiona ◽  
M Howlett Moninne ◽  
V Breatnach Cormac ◽  
Kelly Helena ◽  
Alsalman Fatemah
Keyword(s):  
Pulmonary Hypertension ◽  
Treatment Options ◽  
Multiple Drug ◽  
List Type ◽  
Chemical Compatibility ◽  
Ph Change ◽  
Term Infants ◽  
Starting Point ◽  
Inhaled Prostacyclin ◽  
Physical And Chemical

AimOff-label use of IV sildenafil (Revatio) is one of the limited treatment options available in the treatment of Pulmonary Hypertension in the paediatric and neonatal population. The lack of compatibility data on the co-administration of IV sildenafil with other drugs in critical care means a dedicated line is required for sildenafil. However, in critically unwell patients multiple drug infusions are commonly administered and the dedication of an IV line for sildenafil could be problematic and can further increase the risks of adverse events.1,2 Our Lady’s Children’s Hospital Crumlin in Dublin Ireland, identified the following five drugs as critical and commonly encountered in PICU; Adrenaline, Noradrenaline, Vasopressin, Milrinone and Heparin. The aim of this study is to determine the physical and chemical compatibility of Noradrenaline and Vasopressin in combination with Sildenafil.MethodTo simulate Y-site conditions the drugs were mixed in a 1:1 ratio as previously demonstrated by Allen et al.3 Clear glass tubes as specified by the EP, were used to allow for the investigation of compatibility at specific time-points across a 24 hour period at room temperature. Drugs were prepared in accordance with clinical practice; Noradrenaline 60 micrograms/ml, vasopressin 0.4 units/ml and sildenafil 800 micrograms/ml. Different diluents: NaCl 0.9% w/v, Glucose 5% w/v and Glucose 10% w/v were examined. Chemical compatibility was assessed using HPLC and physical by pH determination and visual inspection of contents. Drugs were deemed compatible if concentrations of both remained between 90% and 110% of the original concentration3 and if no signs of physical incompatibility was noted (i.e. pH change, haze or cloudiness).ResultsNo physical incompatibility was noted between the compounds with stable pH and no visual changes. Concentrations of vasopressin, noradrenaline and sildenafil were all within concentration limits indicating chemical compatibility.ConclusionThe limited and incomplete data presented in the literature for the compatibility of drugs administered via Y-site in combination with sildenafil, makes studies such as this one invaluable to clinicians. The overall aim of this work is to provide a complete compatibility chart of all five drugs identified as critical in combination with Sildenafil at RT and at 37°C. This preliminary data provides a starting point in the investigation of the compatibility of Sildenafil in combination with commonly used ICU drug infusions.ReferencesFender RA, Hasselman TE, Wang Y, Harthan AA. Evaluation of the tolerability of intermittent intravenous sildenafil in paediatric patients with pulmonary hypertension. JPPT2016;21(5):419–25.Kelly LK, Porta NFM, Goodman DM, Carroll CL, Steinhorn RH. Inhaled prostacyclin for term infants with persistent pulmonary hypertension refractory to inhaled nitric oxide. JPeds2002;141(6):830–2.Allen LV, Jr., Levinson RS, Phisutsinthop D. Compatibility of various admixtures with secondary additives at Y-injection sites of intravenous administration sets. Am J Hosp Pharm1977;34(9):939–43.

scholarly journals Microglia and Stem-Cell Mediated Neuroprotection after Neonatal Hypoxia-Ischemia

2021 ◽  
Author(s):  
Catherine Brégère ◽  
Bernd Schwendele ◽  
Boris Radanovic ◽  
Raphael Guzman
Keyword(s):  
Stem Cell ◽  
Animal Studies ◽  
Treatment Options ◽  
Neurological Deficits ◽  
Potential Contribution ◽  
Term Infants ◽  
Brain Repair ◽  
Neonatal Hypoxia ◽  
Microglial Phenotype ◽  
Hypoxia Ischemia

AbstractNeonatal hypoxia-ischemia encephalopathy (HIE) refers to a brain injury in term infants that can lead to death or lifelong neurological deficits such as cerebral palsy (CP). The pathogenesis of this disease involves multiple cellular and molecular events, notably a neuroinflammatory response driven partly by microglia, the brain resident macrophages. Treatment options are currently very limited, but stem cell (SC) therapy holds promise, as beneficial outcomes are reported in animal studies and to a lesser degree in human trials. Among putative mechanisms of action, immunomodulation is considered a major contributor to SC associated benefits. The goal of this review is to examine whether microglia is a cellular target of SC-mediated immunomodulation and whether the recruitment of microglia is linked to brain repair. We will first provide an overview on microglial activation in the rodent model of neonatal HI, and highlight its sensitivity to developmental age. Two complementary questions are then addressed: (i) do immune-related treatments impact microglia and provide neuroprotection, (ii) does stem cell treatment modulates microglia? Finally, the immune-related findings in patients enrolled in SC based clinical trials are discussed. Our review points to an impact of SCs on the microglial phenotype, but heterogeneity in experimental designs and methodological limitations hamper our understanding of a potential contribution of microglia to SC associated benefits. Thorough analyses of the microglial phenotype are warranted to better address the relevance of the neuroimmune crosstalk in brain repair and improve or advance the development of SC protocols in humans. Graphical abstract

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