Born Too Early and Too Small: Higher Order Cognitive Function and Brain at Risk at Ages 8-16

Prematurity presents a risk for higher order cognitive functions. Some of these deficits manifest later in development, when these functions are expected to mature. However, the causes and consequences of prematurity are still unclear. We conducted a longitudinal study to first identify clinical predictors of ultrasound brain abnormalities in 196 children born very preterm (VP; gestational age 32 weeks) and with very low birth weight (VLBW; birth weight 1500 g). At ages 8–16, the subset of VP-VLBW children without neurological findings (124) were invited for a neuropsychological assessment and an MRI scan (41 accepted). Of these, 29 met a rigorous criterion for MRI quality and an age, and gender-matched control group (n = 14) was included in this study. The key findings in the VP-VLBW neonates were: (a) 37% of the VP-VLBW neonates had ultrasound brain abnormalities; (b) gestational age and birth weight collectively with hospital course (i.e., days in hospital, neonatal intensive care, mechanical ventilation and with oxygen therapy, surgeries, and retinopathy of prematurity) predicted ultrasound brain abnormalities. At ages 8–16, VP-VLBW children showed: a) lower intelligent quotient (IQ) and executive function; b) decreased gray and white matter (WM) integrity; (c) IQ correlated negatively with cortical thickness in higher order processing cortical areas. In conclusion, our data indicate that facets of executive function and IQ are the most affected in VP-VLBW children likely due to altered higher order cortical areas and underlying W

The influence of semantic and phonological factors on syntactic decisions: An event-related brain potential study

During language production and comprehension, information about a word's syntactic properties is sometimes needed. While the decision about the grammatical gender of a word requires access to syntactic knowledge, it has also been hypothesized that semantic (i.e., biological gender) or phonological information (i.e., sound regularities) may influence this decision. Event-related potentials (ERPs) were measured while native speakers of German processed written words that were or were not semantically and/or phonologically marked for gender. Behavioral and ERP results showed that participants were faster in making a gender decision when words were semantically and/or phonologically gender marked than when this was not the case, although the phonological effects were less clear. In conclusion, our data provide evidence that even though participants performed a grammatical gender decision, this task can be influenced by semantic and phonological factors

Argentine National Registry of Cardiogenic Shock (ReNa-SHOCK)

Background: Cardiogenic shock is a severe complication of myocardial infarction and constitutes one of the leading causes of deathassociated with this condition; yet, the information available in our country is limited.Objective: The aim of this study was to learn the clinical characteristics, treatment strategies and in-hospital outcome of cardiogenicshock in Argentina.Methods: A prospective, multicenter registry of patients hospitalized with cardiogenic shock in the context of acute coronary syndromeswith and without ST-segment elevation was conducted in 64 centers of Argentina between 2013 and 2015.Results: The cohort consisted of 165 patients with mean age of 66 (58-76.5) years; 65% were men. Seventy-five percent of cases wereST-segment elevation acute coronary syndromes; 8.5% were associated with mechanical complications and 6.7% had right ventricularinvolvement. Fifty-six percent presented with cardiogenic shock on admission. Ninety five percent of patients required inotropicagents, 78% mechanical ventilation, 44% Swan-Ganz catheter insertion and 37% intra-aortic balloon pump. Eighty-four percent ofST-segment elevation acute coronary syndromes (104/124 patients) were reperfused. Median time from symptom onset to admissionwas 240 minutes (132-720) and 80% of patients underwent primary percutaneous coronary intervention. Overall in-hospital mortalitywas 54% without differences between acute coronary syndromes with or without ST-segment elevation and neither were theredifferences between both syndrome presentations in the incidence of events and use of procedures.Conclusions: The characteristics of cardiogenic shock in Argentina are similar to those of populations worldwide. Morbidity andmortality are high despite the use of available treatment strategies.El shock cardiogénico (SC) es una complicación grave del IAM y constituye una de sus principales causas de muerte. Objetivos: Conocer las características clínicas, estrategias de tratamiento y evolución intrahospitalaria del SC en Argentina. Materiales y métodos: Se realizó un registro prospectivo, multicéntrico de pacientes internados con SC en el contexto de los síndromes coronarios agudos (SCA) con y sin elevación del segmento ST entre el 2013 y 2015 en 64 centros de Argentina. Resultados: Se incluyeron 165 pacientes, edad: 66 (58-76,5) años, 65% hombres. El 75% de los casos cursaba un SCA con elevación del ST. El 8,5% estuvo asociado a complicaciones mecánicas y el 6,7% a compromiso de VD. El 56% presentaba SC al ingreso. Requirieron inotrópicos un 95%, ARM 78%, catéter de Swan Ganz 44%, balón de contrapulsación intraaórtico 37%. El 84% de los SCA con ST (104/124p) se reperfundieron. La mediana de tiempo desde el inicio de los síntomas al ingreso fue de 240min (132-720). El 80% recibió angioplastia primaria. La mortalidad intrahospitalaria global fue 54 %, sin diferencias entre los SCA con o sin ST. Asimismo, no hubo diferencia en la frecuencia de eventos y uso de procedimientos entre los SCA con o sin ST. Conclusiones: La morbi-mortalidad es elevada a pesar de la utilización de las estrategias de tratamiento disponibles

Plot of the volume (a-f), circularity form factor (g-k), and thickness (l) for the twelve studied cases; regression equation, correlation significance, and regression lines that fits the data are displayed.

<p>Hemispheric correlation (right and left) are shown in top, for MRI study. Correlation between MRI and histological measurements are shown at bottom, for right hemisphere. GM: Grey matter; WM: White matter; A: Amygdala; Hp: Hippocampus; LV: Lateral ventricle; TL: Temporal lobe; Th: Thickness (entorhinal cortex).</p

Size descriptors plot of the piamater, white matter, amygdala, hippocampus and temporal horn of the lateral ventricle by age group (LT and GT), in both MRI and histological studies, and for both right and left hemispheres.

<p>Data are mean and standard deviation.</p

Study cases.

<p>Case indicates the anonymous ordinal number of autopsy. M, man; W, woman. Age’s group: LT (lower than), less or equal to 65 years; GT (greater than), 65 years.</p><p>* (asterisk): the two cases marked (with alcoholism) did not differ in results with respect to other cases, without significant changes in results.</p><p>Study cases.</p

Plot of the size descriptors for the piamater, white matter, amygdala, hippocampus and temporal horn of the lateral ventricle sorted by groups of age (LT, lower than 65 years, and GT, greater than 65 years, see text) in both MRI and histological studies, as well as for both right and left hemispheres.

<p>Data represent mean and standard deviation.</p