Early human development最新文献

{"title":"Effectiveness of repeated pharmacological courses for patent ductus arteriosus in preterm infants","authors":"Carlo Dani ,&nbsp;Giovanni Sassudelli ,&nbsp;Carlotta Milocchi ,&nbsp;Venturella Vangi ,&nbsp;Simone Pratesi ,&nbsp;Chiara Poggi ,&nbsp;Iuri Corsini","doi":"10.1016/j.earlhumdev.2024.106167","DOIUrl":"10.1016/j.earlhumdev.2024.106167","url":null,"abstract":"<div><h3>Background</h3><div>The effectiveness of repeated drug course to close or constrict a hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants has not been studied extensively. Our aim was to assess the effectiveness of a second or third course of treatment with ibuprofen and/or paracetamol in 107 infants with gestational age &lt; 29 weeks.</div></div><div><h3>Methods</h3><div>Infants with echocardiographic diagnosis of hsPDA were treated with ibuprofen, paracetamol, or with ibuprofen plus paracetamol between 24 and 72 h of life. Echocardiography was repeated at the end of each pharmacological course.</div></div><div><h3>Results</h3><div>The failure rate of the first, second and third course of drug treatment was 38% (41/107), 76% (31/41), and 92% (24/26), respectively. Among 24 infants who failed treatment, 8 (31%) had closure or constriction of the hsPDA after &gt;3 drug courses, 15 (57%) received surgical closure, and 3 (12%) died with hsPDA. Logistic regression analyses did not show independent risk factors for the failure of the second and third course of treatment.</div></div><div><h3>Conclusions</h3><div>We found a higher failure rate of the second and third courses of drug treatment than previously reported. Planning the third and additional pharmacological courses at centers where the failure rate is very high may prolong the exposure of very preterm infants to the adverse effects of hsPDA.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"200 ","pages":"Article 106167"},"PeriodicalIF":2.2,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perinatal factors associated with sensory processing difficulties in infancy: Findings from the Etude Longitudinale Francaise depuis l'Enfance (ELFE) French national birth cohort","authors":"Emma Butler ,&nbsp;Michelle Spirtos ,&nbsp;Linda M. O'Keeffe ,&nbsp;Mary Clarke","doi":"10.1016/j.earlhumdev.2024.106166","DOIUrl":"10.1016/j.earlhumdev.2024.106166","url":null,"abstract":"<div><h3>Background</h3><div>Sensory processing involves the nervous system receiving, modulating, and responding to sensory stimuli. Clinical samples have elevated rates of sensory processing difficulties, less is known about sensory processing at population-level. We aimed to investigate patterns of sensory processing in infancy and their association with perinatal factors.</div></div><div><h3>Methods</h3><div>Data from a French prospective birth cohort of 9861 babies were used to identify latent sensory classes of 1-year-olds. Multinomial logistic regression examined whether sex, cumulative sociodemographic risk or perinatal factors, were associated with these classes.</div></div><div><h3>Results</h3><div>Three classes, ‘typical sensory’ (71.2 %), ‘definite sensory difficulties’ (21.3 %) and a ‘possible sensory difficulties’ group (7.5 %) best fit the data. The ‘typical’ group were easy to calm, adaptable, had low anxiety with no feeding concerns. The ‘definite’ group were the least easy to calm, least accepting of confined spaces, least adaptable and most anxious. They exhibited more sleeping and feeding problems. The ‘possible’ group were similar to the ‘typical’ group apart from being less adaptable with increased sleep difficulties. Dose-response relationships were observed between low 1.5 (relative risk ratio (RRR) CI 1.3–1.9), moderate 2.3 (CI 1.9–2.7) and high 3.5 (CI 2.6–4.8) sociodemographic risk and increasing number of pregnancy-specific adverse experiences:1.5 (CI 1.2–1.9), 1.9 (CI 1.5–2.5), 2.1 (CI 1.6–2.9), 2.4 (CI 1.6–3.6), 3.0 (CI 1.7–5.3) with an increasing risk of sensory difficulties.</div></div><div><h3>Conclusions</h3><div>Using public and patient involvement to guide sensory indicator selection for latent class analyses we found that post-natal sociodemographic risk and adverse pregnancy-specific experiences were most strongly associated with sensory difficulties in infants.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"200 ","pages":"Article 106166"},"PeriodicalIF":2.2,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative autonomic failure in neonates with critical congenital heart disease","authors":"R.B. Govindan ,&nbsp;Stefano Pezzato ,&nbsp;Julius Ngwa ,&nbsp;Anita Krishnan ,&nbsp;Eleni Panagopoulos ,&nbsp;Venkata Chaitanya Chirumamilla ,&nbsp;Adre du Plessis","doi":"10.1016/j.earlhumdev.2024.106165","DOIUrl":"10.1016/j.earlhumdev.2024.106165","url":null,"abstract":"<div><h3>Background</h3><div>Neonates with critical congenital heart disease (cCHD) undergo a complicated transition to ex-utero life. However, continuous monitoring of autonomic tone using heart rate variability is currently lacking.</div></div><div><h3>Materials and methods</h3><div>We retrieved continuous electrocardiograms from the time of admission or from 10 days prior to surgery for neonates with dextro-transposition of the great arteries (d-TGA) and hypoplastic left heart syndrome (HLHS). Beat-to-beat intervals (RRi) were calculated and divided into 10-min epochs. Spectral metrics, including low-frequency (LF) and high-frequency (HF) powers, as well as detrended fluctuation analysis metrics (<span><math><msub><mi>α</mi><mi>S</mi></msub></math></span>, <span><math><msub><mi>α</mi><mi>L</mi></msub></math></span>, <span><math><mi>RM</mi><msub><mi>S</mi><mi>S</mi></msub></math></span>, and <span><math><mi>RM</mi><msub><mi>S</mi><mi>L</mi></msub></math></span>), were computed for RRi within each epoch and averaged over 24 h. The relationship between RRi metrics and time to surgery was analyzed using linear mixed-effects models, adjusting for prenatal and postnatal factors.</div></div><div><h3>Results</h3><div>The study included 10 neonates with HLHS and 23 with d-TGA. RRi metrics were available for 110 days. In the unadjusted models, LF power (Estimate: −4.4×<span><math><msup><mn>10</mn><mrow><mo>−</mo><mn>3</mn></mrow></msup></math></span>, <em>P</em> = 0.02), HF power (−4.1 x <span><math><msup><mn>10</mn><mrow><mo>−</mo><mn>2</mn></mrow></msup></math></span>, 5 x <span><math><msup><mn>10</mn><mrow><mo>−</mo><mn>5</mn></mrow></msup></math></span>), <span><math><mi>RM</mi><msub><mi>S</mi><mi>S</mi></msub><mspace></mspace></math></span>(−3.7 x <span><math><msup><mn>10</mn><mrow><mo>−</mo><mn>4</mn></mrow></msup></math></span>, 8.7 x <span><math><msup><mn>10</mn><mrow><mo>−</mo><mn>3</mn></mrow></msup></math></span>), and <span><math><mi>RM</mi><msub><mi>S</mi><mi>L</mi></msub></math></span>(−1.4× <span><math><msup><mn>10</mn><mrow><mo>−</mo><mn>3</mn></mrow></msup></math></span>, 0.02) were all negatively associated with time to surgery, with HF power showing the strongest association. After adjusting for covariates, HF power retained its significant negative association with time (−0.04, <em>P</em> = 0.03). The cCHD diagnosis did not significantly influence RRi metrics.</div></div><div><h3>Conclusions</h3><div>In neonates with cCHD, there is a progressive decline in autonomic function leading up to surgery. RRi metrics may serve as valuable indicators of deteriorating physiology in these patients.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"200 ","pages":"Article 106165"},"PeriodicalIF":2.2,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic bone disease in premature infants receiving parenteral nutrition: Incidence, clinical, laboratory and nutritional profile","authors":"Elen Sara Rosa dos Santos ,&nbsp;Rita de Cassia dos Santos Silveira ,&nbsp;Raquel Stocker Pérsico ,&nbsp;Luiza Ribeiro Escovar ,&nbsp;Marcel Bernard Rosa Nery ,&nbsp;Márcia Andréa Oliveira Schneider ,&nbsp;Patricia Piccoli de Mello ,&nbsp;Luciana Verçoza Viana","doi":"10.1016/j.earlhumdev.2024.106153","DOIUrl":"10.1016/j.earlhumdev.2024.106153","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic bone disease (MBD) of newborns (NB) is characterized by tissue reduction and inadequate postnatal bone mineralization with clinical, laboratory, and/or radiologic repercussions between the third and twelfth weeks of postnatal life, which, in its most severe forms, can lead to a growth deficit and fractures. The aim of our study is to evaluate the incidence of MBD in premature patients receiving parenteral nutrition for &gt;15 days in the neonatal intensive care unit (NICU) and assess their clinical and laboratory characteristics.</div></div><div><h3>Methods</h3><div>Single-center retrospective cohort study. From 2015 to 2020, patients &lt;33 weeks of gestational age or &lt;1500 g birth weight receiving parenteral nutrition for &gt;15 days who met the metabolic bone disease criteria (alkaline phosphatase &gt;800 U/L and phosphorus &lt;3.5 mg/dL and/or compatible radiological alterations) were evaluated. Exclusion criteria: skeletal dysplasia, orthopedic surgeries, intraventricular hemorrhage grades III and IV, periventricular leukomalacia and chronic renal failure or severe liver disease. Clinical, laboratory and radiological data were collected during the first 90 days of life and/or discharge/death.</div></div><div><h3>Results</h3><div>The MBD incidence was 17.7 % over a five-year period. The gestational age at birth was 26 ± 1.41 weeks; birth weight was 745 (592–858) grams; maximum alkaline phosphatase level was 1091 ± 243.87 U/L and phosphorus nadir was 2.45 ± 0.48 md/dL. Among the 14 patients with metabolic bone disease, twelve had laboratory diagnosis, six had radiological and four had both; two patients had fractures; 42 % of patients received enteral calcium and phosphorus supplementation, and 50 % received intravenous calcium replacement.</div></div><div><h3>Conclusions</h3><div>Metabolic bone disease incidence was in accordance with international literature. The metabolic bone disease diagnosis was, in most cases, based on surveillance of laboratory tests. However, treatment for metabolic bone disease requires more active and preventive measures in risk groups.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"200 ","pages":"Article 106153"},"PeriodicalIF":2.2,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective study of left and right ventricular strain mechanics among neonates undergoing therapeutic hypothermia for neonatal encephalopathy","authors":"Justin B. Jin ,&nbsp;Wei Liu ,&nbsp;Sreenivas Karnati ,&nbsp;Ibrahim Sammour ,&nbsp;Rukmini Komarlu","doi":"10.1016/j.earlhumdev.2024.106163","DOIUrl":"10.1016/j.earlhumdev.2024.106163","url":null,"abstract":"<div><h3>Purpose</h3><div>Early diagnosis of impaired myocardial function and timely therapeutic hypothermia is vital among patients with Neonatal Encephalopathy (NE). Traditional markers of myocardial function (Left Ventricular Ejection Fraction (LV EF) &amp; LV Fractional Shortening (LV FS) can be variably reduced. Speckle tracking echocardiography (STE) is a more sensitive marker for impairment but remains inadequately studied in this patient population.</div></div><div><h3>Methods</h3><div>A retrospective study of neonates who underwent therapeutic hypothermia (TH) for NE from 2009 to2020 were matched 1:1 with normal neonates with normal echocardiograms performed for indications other than NE. Matching was based on gestational age, birth weight, days of age, and sex. Left ventricular 4 Chamber (4Ch) strain, right ventricular 4 Chamber (RV 4Ch), and RV free wall strain (RV FWS) were measured offline using vendor independent strain software (TomTec, GMBH, Munich, Germany).</div></div><div><h3>Results</h3><div>Ninety pairs of NE patients and controls were studied. Compared to controls, RV 4Ch strain (−17.3 % vs. -19.6 %), RV FWS (−18.8 % vs. -21.9 %), and RV fractional area change (FAC) (35 % vs. 37 %) were lower in NE cases (all <em>p</em> &lt; 0.001), while differences in LV 4Ch strain, LV EF, and LV FS did not reach statistical significance. Moderate/severe NE (72 %) was associated with lower LV 4Ch strain compared to mild NE (−22.2 %/−19.3 % vs. -25.4 %, <em>p</em> = 0.004). RV 4Ch strain (−14.9 % vs. -18.8 %, <em>p</em> = 0.020) and RV FAC (27 % vs. 36 %, <em>p</em> = 0.006) were lower in severe NE compared to mild NE. Lower LV 4Ch was associated with need for chest compressions (−18.5 % vs. -23.3 %), epinephrine at delivery (−19.3 % vs. -23.4 %), and decreased survival to discharge (−15.9 % vs. -22.7 %).</div></div><div><h3>Conclusions</h3><div>RV and LV strain mechanics are impaired in NE patients. Lower RV Strain and LV 4Ch strain were associated with need for increased medical support and decreased survival to discharge.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"200 ","pages":"Article 106163"},"PeriodicalIF":2.2,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of outcome in patients with cerebral palsy following selective dorsal rhizotomy","authors":"Max Weinbrecht-Mischkewitz ,&nbsp;Elisa Wittmack ,&nbsp;Franziska Hentschel ,&nbsp;Akosua Sarpong-Bengelsdorf ,&nbsp;Julia Funk ,&nbsp;Matthias Schulz ,&nbsp;Simone Wolter ,&nbsp;Joanna Schneider ,&nbsp;Ulrich-Wilhelm Thomale ,&nbsp;Angela M. Kaindl ,&nbsp;Petra Bittigau ,&nbsp;Anne K. van Riesen","doi":"10.1016/j.earlhumdev.2024.106154","DOIUrl":"10.1016/j.earlhumdev.2024.106154","url":null,"abstract":"<div><h3>Background</h3><div>To identify outcome predictors of selective dorsal rhizotomy (SDR) in children with spastic cerebral palsy (CP) using logistic regression models.</div></div><div><h3>Methods</h3><div>A retrospective single-center study was conducted on children with spastic CP who had undergone SDR. Two outcomes were defined, one representing children not improving in motor function and spasticity and one representing children improving in motor function two years after surgery. Baseline variables were chosen based on established regressors and clinical considerations and tested for being predictors using multivariate logistic regression.</div></div><div><h3>Results</h3><div>We included 96 patients (mean age [SD] 6y 9 m [2y 5 m], range 2y to 17y) in the study. Significant predictors of non-improvement in motor function and spasticity two years after SDR were higher age at surgery and higher preoperative Gross Motor Function Measure-88 (GMFM-88) score. Significant predictors of motor function improvement after SDR were lower preoperative Modified Ashworth Scale (MAS) scores, higher preoperative passive range of motion (pROM) and lower age at surgery.</div></div><div><h3>Conclusions</h3><div>For the first time, pROM and preoperative spasticity were identified as predictors of SDR outcome. We confirmed motor function and age as predictors. These variables will be useful for future patient selection. Adjusting for the GMFM-88's ceiling effect, children with higher motor function can still profit significantly from SDR.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"200 ","pages":"Article 106154"},"PeriodicalIF":2.2,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding developmental progress in young children: Exploring demographic and dietary influences through a cross-sectional study","authors":"Hafiz Haris Ahmad ,&nbsp;Blake Peck ,&nbsp;Daniel Terry","doi":"10.1016/j.earlhumdev.2024.106152","DOIUrl":"10.1016/j.earlhumdev.2024.106152","url":null,"abstract":"<div><h3>Background</h3><div>Developmental surveillance is a crucial task aimed at monitoring and ensuring children's age-appropriate progression. However, demographics and dietary factors can significantly influence the developmental progress of young children.</div></div><div><h3>Methods</h3><div>We employed a cross-sectional study design, enrolling children aged 2–5 years from early childhood education settings. Their age-appropriate development was assessed using the Ages and Stages Questionnaires.</div></div><div><h3>Results</h3><div>Our study revealed that children demonstrated adequate development across all assessed domains. Notably, communication skills exhibited the highest mean score (Mean: 53.09, SD: 7.34) compared to other domains. Sex-based analysis revealed substantial disparities between young boys and girls, particularly in regard to fine motor and social-emotional skills, with differences exceeding 20 %. Additionally, fathers' education and socio-economic status were found to influence developmental outcomes. Fruit and vegetable consumption positively correlated with development, while dairy intake demonstrated a negative association.</div></div><div><h3>Conclusion</h3><div>This research underscores the significance of addressing developmental disparities related to sex and emphasises the necessity of investigating the role of the modern diet in child development, with specific attention to milk and dairy consumption.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"200 ","pages":"Article 106152"},"PeriodicalIF":2.2,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is neutrophil to lymphocyte ratio an accurate predictor of neonatal sepsis in premature infants?","authors":"Rachel Binny ,&nbsp;Despina Kotsanas ,&nbsp;Jim Buttery ,&nbsp;Tony Korman ,&nbsp;Kenneth Tan","doi":"10.1016/j.earlhumdev.2024.106147","DOIUrl":"10.1016/j.earlhumdev.2024.106147","url":null,"abstract":"<div><h3>Background</h3><div>Sepsis is a significant cause of neonatal mortality. Both clinical and laboratory markers are often non- specific, and a blood culture contaminant may confuse management of the infant. This study aims to use an existing, inexpensive test, the neutrophil-to-lymphocyte ratio (NLR), to predict culture positivity and thus optimise antibiotic management.</div></div><div><h3>Methods</h3><div>Data on infants born ≤32 weeks gestation from 2015 to 2020 who were treated for sepsis were analyzed. Episodes were categorised based on culture positivity: i) positive with known pathogens, ii) true positive with coagulase-negative staphylococci (CoNS), iii) false positive with CoNS contaminants, iv) positive with other contaminants, and v) negative culture. NLR was compared with late C-reactive protein (CRP) and immature-to-total neutrophil ratio (ITR). Receiver operating curve (ROC) analysis was performed in this study. A cut- off value of 1.2 was chosen for NLR to detect culture.</div></div><div><h3>Results</h3><div>A total of 2024 infants were included in the study, with no significant differences in demographics between groups. Infants with positive blood cultures of known pathogens had higher median NLR of 1.44 compared with those with contaminants (0.75) or negative cultures (0.84). A NLR cut-off value of 1.2 gave a sensitivity of 65.7 % and specificity of 63.7 %.The area under the curve (AUC) for NLR, late CRP and ITR were 0.71, 0.64 and 0.57 respectively. Combining NLR with late CRP would increase the AUC to 0.78 (95 % C·I 0.75–0.82, <em>p</em> &lt; 0.01), whereas the addition of ITR to NLR and late CRP would not improve this. In a secondary analysis, between true and contaminant CoNS positivity, NLR and ITR could not be used to differentiate between these groups (<em>p</em> &lt; 0.05 and 0.33), but late CRP could (<em>p</em> &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>Clinicians should consider the use of NLR as an adjunct biomarker to late CRP in detecting culture positive sepsis in premature neonates. The use of ITR does not improve diagnostic accuracy for sepsis.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"200 ","pages":"Article 106147"},"PeriodicalIF":2.2,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early pain findings in infants with brachial plexus birth injury: Relationship with function and comorbidities, and cut-off point for fractures","authors":"Kıvanç Delioğlu ,&nbsp;Akin Uzumcugil ,&nbsp;Ebru Ozturk ,&nbsp;Mintaze Kerem Gunel","doi":"10.1016/j.earlhumdev.2024.106150","DOIUrl":"10.1016/j.earlhumdev.2024.106150","url":null,"abstract":"<div><h3>Background</h3><div>Infants with birth brachial plexus injury (BPBI) may have various comorbidities such as fractures, torticollis, plagiocephaly, central nervous system disorders. In infants with BPBI, it is important to identify fractures, which are common among comorbidities, objectively assess pain, and investigate factors that may be associated with pain.</div></div><div><h3>Aim</h3><div>The aim of this study is to determine the pain level, comorbidities, and motor function in infants with BPBI and to examine the relationship between these parameters. The second aim is to determine the cut-off value of the pain score that may be a sign of fracture in patients with BPBI, in order to suspect and predict a fracture in the shoulder region and to request additional examinations.</div></div><div><h3>Subjects and measurements</h3><div>59 infants with BPBI aged 15–90 days were included in the study. Comorbidities, active joint movements, and total upper extremity function assessed with the Active Movement Scale and pain scores measured with the FLACC Pain Scale were retrospectively analyzed. In addition, pain, comorbidities and motor function were investigated according to types of Narakas, which indicates the degree of nerve injury.</div></div><div><h3>Results</h3><div>Of the 59 participants, 18 (30.5 %) had at least one comorbidity and 12 (20.3 %) had fractures. The number of comorbidities (p = 0.41), the number of fractures (p = 0.84), and the level of pain (p = 0.71) did not differ by types of Narakas. There was a moderate negative correlation between pain level and upper extremity motor function in upper trunk injuries (p &lt; 0.5, −0.67 &lt; r &lt; −0.46). There was a difference in pain level measured by palpation (p &lt; 0.01) and passive joint movement (p &lt; 0.01) in infants with and without comorbidities. To suspect a fracture in the shoulder region and to request further evaluation, the cut-off value of the Flacc pain level, which may predict a fracture, was 3.5 points for palpation and passive shoulder abduction and 4.5 points for passive external rotation.</div></div><div><h3>Conclusion</h3><div>This is the first study in the BPBI to measure pain in infants using a quantifiable and widely used assessment. Pain level was ranked from high to low as infants with fractures, infants with comorbidities other than fractures and infants without comorbidities. Increased pain adversely affects motor function and pain above the cut-off values is a predictor of fracture.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"199 ","pages":"Article 106150"},"PeriodicalIF":2.2,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of normal and abnormal fetal renal microvascular flow characteristics of three-dimensional MV-flow imaging","authors":"Caixin Huang ,&nbsp;Lihe Zhang ,&nbsp;Yuting Jiang,&nbsp;Qiao Zheng,&nbsp;Ting Lei,&nbsp;Liu Du,&nbsp;Hongning Xie","doi":"10.1016/j.earlhumdev.2024.106149","DOIUrl":"10.1016/j.earlhumdev.2024.106149","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the applicability of three-dimensional MV-Flow imaging for prenatal renal diagnosis.</div></div><div><h3>Method</h3><div>This prospective study included normal and abnormal kidneys ranging from 20 to 40 weeks gestation between April and July 2023. All participants underwent conventional ultrasound and three-dimensional MV-Flow examinations. The renal volume and microvascular indexes were obtained by the three-dimensional MV-Flow.</div></div><div><h3>Results</h3><div>A total of 207 normal kidneys from 154 fetuses and 67 abnormal kidneys from 53 fetuses, with conditions such as renal cystic diseases, hyperechoic kidney, large kidney, and small kidney were included. Normal renal volume, vascularization index, and vascularization-flow index increased slightly with gestational age (<em>p</em> &lt; 0.001). No correlation was found between gestational age and flow index (<em>p</em> = 0.604). The microvascular indexes decreased in the fetal renal cystic disease group while renal volume increased. Higher vascularization index and vascularization-flow index were observed in the hyperechoic kidney group. The microvascular indexes of the large and small kidney groups were within the reference range for normal kidneys. Only the autosomal dominant polycystic kidney disease exhibited an absence of distinct subcapsular microvascular flow in the MV-Flow image, referred to as the “thick shell sign”.</div></div><div><h3>Conclusion</h3><div>Fetal renal volume, vascularization index, and vascularization-flow index increase with gestational age. Quantitative evaluation using 3D MV-Flow imaging reveals varying renal volume and microvascular perfusion characteristics among different fetal renal abnormalities.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"199 ","pages":"Article 106149"},"PeriodicalIF":2.2,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}