Attenuation of the Ganglion Cell Layer in a Premature Infant Revealed with Handheld Spectral Domain Optical Coherence Tomography

Purpose: To report on subclinical retinal abnormalities shown through handheld spectral domain optical coherence tomography on a premature infant. Methods: Case report. Results: The initial and follow-up exams on a premature infant revealed severely attenuated ganglion cell and nerve fiber layers. There was cystoid macular edema in both eyes at the initial visits, which resolved by the 1-year follow-up. Discussion: Optical coherence tomography can reveal significant retinal abnormalities in premature infants which are not detectable through funduscopic exam. Documenting such findings may be useful for the comprehensive management of vision problems in children with a history of premature birth

Ectopy on a single 12‐lead ECG, incident cardiac myopathy, and death in the community

BackgroundAtrial fibrillation and heart failure are 2 of the most common diseases, yet ready means to identify individuals at risk are lacking. The 12-lead ECG is one of the most accessible tests in medicine. Our objective was to determine whether a premature atrial contraction observed on a standard 12-lead ECG would predict atrial fibrillation and mortality and whether a premature ventricular contraction would predict heart failure and mortality.Methods and resultsWe utilized the CHS (Cardiovascular Health) Study, which followed 5577 participants for a median of 12 years, as the primary cohort. The ARIC (Atherosclerosis Risk in Communities Study), the replication cohort, captured data from 15 792 participants over a median of 22 years. In the CHS, multivariable analyses revealed that a baseline 12-lead ECG premature atrial contraction predicted a 60% increased risk of atrial fibrillation (hazard ratio, 1.6; 95% CI, 1.3-2.0; P<0.001) and a premature ventricular contraction predicted a 30% increased risk of heart failure (hazard ratio, 1.3; 95% CI, 1.0-1.6; P=0.021). In the negative control analyses, neither predicted incident myocardial infarction. A premature atrial contraction was associated with a 30% increased risk of death (hazard ratio, 1.3; 95% CI, 1.1-1.5; P=0.008) and a premature ventricular contraction was associated with a 20% increased risk of death (hazard ratio, 1.2; 95% CI, 1.0-1.3; P=0.044). Similarly statistically significant results for each analysis were also observed in ARIC.ConclusionsBased on a single standard ECG, a premature atrial contraction predicted incident atrial fibrillation and death and a premature ventricular contraction predicted incident heart failure and death, suggesting that this commonly used test may predict future disease

An analysis of MRI derived cortical complexity in premature-born adults : regional patterns, risk factors, and potential significance

Premature birth bears an increased risk for aberrant brain development concerning its structure and function. Cortical complexity (CC) expresses the fractal dimension of the brain surface and changes during neurodevelopment. We hypothesized that CC is altered after premature birth and associated with long-term cognitive development. One-hundred-and-one very premature-born adults (gestational age <32 weeks and/or birth weight <1500 ​g) and 111 term-born adults were assessed by structural MRI and cognitive testing at 26 years of age. CC was measured based on MRI by vertex-wise estimation of fractal dimension. Cognitive performance was measured based on Griffiths-Mental-Development-Scale (at 20 months) and Wechsler-Adult-Intelligence-Scales (at 26 years). In premature-born adults, CC was decreased bilaterally in large lateral temporal and medial parietal clusters. Decreased CC was associated with lower gestational age and birth weight. Furthermore, decreased CC in the medial parietal cortices was linked with reduced full-scale IQ of premature-born adults and mediated the association between cognitive development at 20 months and IQ in adulthood. Results demonstrate that CC is reduced in very premature-born adults in temporoparietal cortices, mediating the impact of prematurity on impaired cognitive development. These data indicate functionally relevant long-term alterations in the brain’s basic geometry of cortical organization in prematurity

Parents’ views on preparation to care for extremely premature infants at home.

Aim: To gain insight into the post-discharge experiences of parents in relation to the adequacy of preparation for caring for their extremely premature infant at home. Method: A narrative approach was drawn on to facilitate data collection, via face-to-face semi-structured interviews, with fourteen parents of extremely premature infants. Findings: Constant comparative analysis was employed to allow the emergence of five key research themes: Emotional and mental health of parents; uncertain outcomes; on-going health needs of the baby; education needs of health professionals; parental support and preparation for transition home. Conclusion: Parental experience of being discharged home with a premature baby can be emotionally challenging necessitating a range of support mechanisms to assist them to cope with this period of transition

Premature thoughts on writing disorders

Three papers appeared in the 19th century describing the dissociation between speech and writing: Marce (1856), Ogle (1867) and Pitres (1884). An account of the convincing evidence of dissociations put forward in these papers is presented. Three explanations are proposed as to the reason why the observations reported by these authors were overlooked or rejected by their contemporaries, namely: (a) in the first half of the century it seems that very little knowledge of the processes underlying writing (as opposed to speech) was available, (b) the debates focussed on the independence of speech versus motor control and language versus the intellect, (c) parallelisms between phylogeny, ontogeny and aphasia impeded the application of the principle of double dissociations, including the dissociations between speech and writing. It is argued that this phenomenon in the history of aphasia is best captured by the concept of prematurity in scientific discovery proposed by Stent (1972, 2003)

FAKTOR­-FAKTOR RISIKO TERJADINYA ASFIKSIA NEONATORUM DI RSD JOMBANG PERIODE 1 JANUARI ­- 31 DESEMBER 2007

Neonatal Asphyxia is an emergency condition when the baby failed to breath spontaneously and regularly after they were born. Neonatal asphyxia remains the main cause of neonatal mortality as well as permanent neurological abnormality. With informed consideration about risk factors, more than half baby who need resuscitation could be identified prior to birth. Objectives: to identify antepartum and intrapartum risk factors in neonatal asphyxia. Sample: mother who delivered an asphyxia neonatal baby in Jombang General Hospital since January 1st to December 31st 2007 (total sampling). Result: the incidence of neonatal asphyxia was 12,56%. The antepartum factors which increased the risk of neonatal asphyxia were premature baby (48.94%), small for gestational of age baby (39,53%), mother’s age <16 &>35 accompanied by other risk \ud factor (14.89%), maternal hypertension (14.89%) and postmature baby (12.77%). lntrapartum factors were meconeum stained of amnion fluid (29.79%) and premature amnion fluid broke accompanied by other risk factor (21.28%). Conclusion: premature baby, small for gestational of age (SGA) baby, meconium stained of amnion fluid, premature broke of amnion fluid accompanied by other risk factor, mother’s age <16 &>35 years old accompanied by other risk \ud factor and maternal hypertension increased the risk of neonatal asphyxia

HNRNPK maintains epidermal progenitor function through transcription of proliferation genes and degrading differentiation promoting mRNAs.

Maintenance of high-turnover tissues such as the epidermis requires a balance between stem cell proliferation and differentiation. The molecular mechanisms governing this process are an area of investigation. Here we show that HNRNPK, a multifunctional protein, is necessary to prevent premature differentiation and sustains the proliferative capacity of epidermal stem and progenitor cells. To prevent premature differentiation of progenitor cells, HNRNPK is necessary for DDX6 to bind a subset of mRNAs that code for transcription factors that promote differentiation. Upon binding, these mRNAs such as GRHL3, KLF4, and ZNF750 are degraded through the mRNA degradation pathway, which prevents premature differentiation. To sustain the proliferative capacity of the epidermis, HNRNPK is necessary for RNA Polymerase II binding to proliferation/self-renewal genes such as MYC, CYR61, FGFBP1, EGFR, and cyclins to promote their expression. Our study establishes a prominent role for HNRNPK in maintaining adult tissue self-renewal through both transcriptional and post-transcriptional mechanisms

Therapeutic Environment and Premature newborns Development

Introduction: Prematurity is the leading cause of neonatal mortality, however, the survival of preterm infants is guaranteed. Prolonged exposure to numerous sensory stimuli during early neonatal intensive care units contributes to the increased likelihood of organic and/or psychological sequelae. Objectives: Identify the best measures to minimize the impact that the sensorial environment of neonatal intensive care units has on the development of premature newborns. Methods: An integrative literature review was carried out in CINAHL, PubMed and MEDLINE databases, according to the PICOD methodology (participants, intervention, context, results and design). Results: The analysis of the 6 articles included in the study showed a set of environmental measures to be included in the care of premature newborns. The main recommendations mentioned were organized into categories, namely, physical environment, sensory environment, technology and parental training. Conclusion: From this review emerges the need to define consistent and consensual strategies for the optimization of the therapeutic environment in neonatal intensive care units