1,720,964 research outputs found
Neonatal seizures: relation of Ictal Video-electroencephalography (EEG) findings with neurodevelopmental outcome.
No full textNeonatal electroencephalographic background activity has been
found to be a predictive factor of the neurodevelopmental outcome.
The aim of our study was to identify if the electrical ictal
findings present on the first electroencephalography (EEG)
recording are related to the outcome of newborns with neonatal
seizures. The study is based on the prospective evaluation of
newborns consecutively admitted to the Neonatal Intensive
Care Unit at the University of Parma between September 2001
and September 2004. Thirty-eight subjects were enrolled in the
study on the basis of the following inclusion criteria: presence
on the first EEG of at least 1 seizure, neurodevelopmental
follow-up until 18 months of corrected age, and performance
of several ultrasound brain scans during the neonatal period and
of at least 1 cerebral MRI within the first year of life. For
each seizure, the following were considered: onset topography,
morphology of the epileptiform discharges, spread of the discharge,
number of electrographic regions of seizure onset,
number of seizures per hour, duration of the seizures, and the
Ictal Fraction (= total duration of the seizures/duration of the
EEG recording × hour). At the last follow-up, the unfavorable
neurodevelopmental outcome seems significantly related
to the moderate/severe background activity abnormalities (p =
.006), to the spread of ictal discharge to the contralateral hemisphere
(p = .02), and to the Ictal Fraction, when it exceeds 10
minutes (p = .036). In conclusion, the analysis of the propagation
of the ictal discharge and of the Ictal Fraction might suggest
significant prognostic information since the first hours of life
Mortality risk after neonatal seizures in very preterm newborns
No full textWe analyzed clinical and instrumental data of 403 consecutive newborns with gestational age from 24 to 32 weeks, admitted to the University-Hospital of Parma between January 2000 and December 2007, to evaluate the possible relationship between neonatal mortality and occurrence of neonatal seizures in very preterm newborns. Seventy-four subjects died during hospital stay. Seizures were present in 35 neonates, in whom the mortality rate was 37.1%. Multivariate analysis revealed that birth-weight <1000 g (odds ratio: 4.48; 95% confidence interval: 1.47-13.68; P <.01), cardiopulmonary resuscitation (odds ratio: 5.35; 95% confidence interval: 1.19-23.98; P =.02), and moderately and severely abnormal cerebral ultrasound scan findings (odds ratio: 2.48; 95% confidence interval: 1.02-6.05; P <.04; odds ratio: 9.56; 95% confidence interval: 3.45-26.51; P <.01, respectively) were related to the in-hospital mortality but not the presence of neonatal seizures. Our study suggests that neonatal seizures alone are not an independent risk factor for early death in very preterm newborns. © The Author(s) 2012
Care to relieve pain-stress in preterm newborns
No full textBackground and aim of the work: A variety of non-pharmacological pain-prevention and relief techniques have been studied to evaluate the pain reduction in neonates. The aim of our study was to compare the analgesic effect of sucking a pacifier with the use of eutectic mixture of local anaesthetics (EMLA) during venipuncture in preterm newborns, using physiological and behavioural parameters as indicators of pain. Methods:We analysed the reaction to invasive procedures in 17 preterm newborns. Our patients underwent repeated vein draws without pain relief, sucking a pacifier, after the application of EMLA; we also evaluated a group of patients approached for care without pricking. For each infant we recorded the average values of the physiological parameters at rest and after pain stimuli, behavioural conditions (crying or grimaces), number and time required for blood draw. Results: The maximum heart rate values, respiratory rate, and the maximum respiratory rate values presented a statistically difference only between subjects that underwent vein draws compared to subjects without pricking (p<0.01). Moreover, the SpO2 parameter presented a significant increase in the control group compared to the others (p=0.024). Analysis of behavioural parameters shows that crying seems significantly related to the duration and number of venipunctures (p=0.000). Conclusions: It is clear that pain stress is more closely related to the duration and number of venipuncture than pain relief methods. Our results suggest that limiting the number and duration of vein draws could help to reduce pain stress in preterm newborns. © Mattioli 1885
Mortality risk after neonatal seizures in very preterm newborns
No full textWe analyzed clinical and instrumental data of 403 consecutive newborns with gestational age from 24 to 32 weeks, admitted to the University-Hospital of Parma between January 2000 and December 2007, to evaluate the possible relationship between neonatal mortality and occurrence of neonatal seizures in very preterm newborns. Seventy-four subjects died during hospital stay. Seizures were present in 35 neonates, in whom the mortality rate was 37.1%. Multivariate analysis revealed that birth-weight <1000 g (odds ratio: 4.48; 95% confidence interval: 1.47-13.68; P < .01), cardiopulmonary resuscitation (odds ratio: 5.35; 95% confidence interval: 1.19-23.98; P = .02), and moderately and severely abnormal cerebral ultrasound scan findings (odds ratio: 2.48; 95% confidence interval: 1.02-6.05; P < .04; odds ratio: 9.56; 95% confidence interval: 3.45-26.51; P < .01, respectively) were related to the in-hospital mortality but not the presence of neonatal seizures. Our study suggests that neonatal seizures alone are not an independent risk factor for early death in very preterm newborns
Development of epilepsy in newborns with moderate hypoxic-ischemic encephalopathy and neonatal seizures.
No full textBackground: Hypoxic-ischemic encephalopathy (HIE) is one of the most frequent causes of neonatal death or neurological handicaps
such as cerebral palsy, mental delay, and epilepsy. Moreover, an acute consequence of HIE are neonatal seizures which can
cause an additional brain damage. The neurodevelopmental outcome is known in the mild or severe cases of HIE, but in the moderate
conditions the predictivity results, to date, unsatisfying. Objective: The purpose of this prospective study was to appraise the
development of post-neonatal epilepsy in a cohort of term infants with moderate HIE and neonatal seizures. Methods: This study
considered all newborns admitted to Neonatal Intensive Care Unit of the University of Parma between January 2000 and December
2002 for perinatal asphyxia, then followed by Neonatal Neurology Service. In all patients, neonatal variables such as type of
delivery, birth weight, gestational age, Apgar scores, the need for resuscitation and assisted ventilation soon after birth, and arterial-
blood pH were analyzed. Results: Ninety-two newborns were enrolled in the study because of perinatal asphyxia. Of these, 27
subjects developed mild HIE, 25 moderate, and five severe HIE. Neonatal seizures were present in 13 subjects with moderate HIE
and in all newborns with severe HIE. At the last follow-up, only three infants belonging to patients with severe HIE developed epilepsy.
Conclusion: Moderate HIE seems not to be related to post-neonatal epilepsy either if associated or not with neonatal seizures
A painful stiff neck following an ear, nose, and throat surgical procedure: Case report
No full textGrisel syndrome is a rare, nontraumatic atlantoaxial subluxation, typical of developmental ages and characterized by head flexion/rotation and painful fixation. Neurological symptoms may occur. It is secondary to head/neck infections and ear, nose, and throat surgery (adenoidectomy, tonsillectomy, and mastoidectomy). Here, we report the case of a child who presented a painful stiff neck following an adenotonsillectomy, with imaging evidencing an atlantoaxial subluxation. The child showed improvement in his condition following a conservative treatment with antibiotics, anti-inflammatory, and analgesic therapy and cervical collar. We believe it is of great significance for clinicians taking into account this peculiar condition in the differential diagnosis of a stiff neck in pediatric patients, thus avoiding misdiagnosis and delays. Indeed, its diagnosis is mainly based on a focused anamnesis associated with the detection of the typical neuroradiological findings
Development of epilepsy in newborns with moderate hypoxic-ischemic encephalopathy and neonatal seizures
No full textBackground: Hypoxic-ischemic encephalopathy (HIE) is one of the most frequent causes of neonatal death or neurological handicaps such as cerebral palsy, mental delay, and epilepsy. Moreover, an acute consequence of HIE are neonatal seizures which can cause an additional brain damage. The neurodevelopmental outcome is known in the mild or severe cases of HIE, but in the moderate conditions the predictivity results, to date, unsatisfying. Objective: The purpose of this prospective study was to appraise the development of post-neonatal epilepsy in a cohort of term infants with moderate HIE and neonatal seizures. Methods: This study considered all newborns admitted to Neonatal Intensive Care Unit of the University of Parma between January 2000 and December 2002 for perinatal asphyxia, then followed by Neonatal Neurology Service. In all patients, neonatal variables such as type of delivery, birth weight, gestational age, Apgar scores, the need for resuscitation and assisted ventilation soon after birth, and arterial-blood pH were analyzed. Results: Ninety-two newborns were enrolled in the study because of perinatal asphyxia. Of these, 27 subjects developed mild HIE, 25 moderate, and five severe HIE. Neonatal seizures were present in 13 subjects with moderate HIE and in all newborns with severe HIE. At the last follow-up, only three infants belonging to patients with severe HIE developed epilepsy. Conclusion: Moderate HIE seems not to be related to post-neonatal epilepsy either if associated or not with neonatal seizures. © 2008 Elsevier B.V. All rights reserved
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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