Neonatal brain MRI and short-term outcomes after acute provoked seizures

OBJECTIVE: We investigated how diagnosis and injury location on neonatal brain MRI following onset of acute provoked seizures was associated with short term outcome. STUDY DESIGN: A multicenter cohort of neonates with acute provoked seizures enrolled in the Neonatal Seizure Registry. MRIs were centrally evaluated by a neuroradiologist for location of injury and radiologic diagnosis. Clinical outcomes were determined by chart review. Multivariate logistic regression was used to examine the association between MRI findings and outcomes. RESULTS: Among 236 newborns with MRI at median age 4 days (IQR 3-8), 91% had abnormal MRI. Radiologic diagnoses of intracranial hemorrhage (OR 3.2 [1.6-6.5], p \u3c 0.001) and hypoxic-ischemic encephalopathy (OR 2.7 [1.4-5.4], p \u3c 0.003) were associated with high seizure burden. Radiologic signs of intracranial infection were associated with abnormal neurologic examination at discharge (OR 3.9 [1.3-11.6], p \u3c 0.01). CONCLUSION: Findings on initial MRI can help with expectant counseling on short-term outcomes following acute provoked neonatal seizures

Neonatal encephalopathy: Case definition & guidelines for data collection, analysis, and presentation of maternal immunisation safety data.

To improve comparability of vaccine safety data, the acute neonatal encephalopathy working group has developed a case definition and guidelines neonatal encephalopathy applicable in study settings with different availability of resources, in healthcare settings that differ by availability of and access to health care, and in different geographic regions

L ennox‐ G astaut syndrome of unknown cause: Phenotypic characteristics of patients in the E pilepsy P henome/ G enome P roject

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/101778/1/epi12395.pd

Sleep‐disordered breathing is common among term and near term infants in the NICU

ObjectiveAmong older infants and children, sleep‐disordered breathing (SDB) has negative neurocognitive consequences. We evaluated the frequency and potential impact of SDB among newborns who require intensive care.Study DesignTerm and near‐term newborns at risk for seizures underwent 12‐h attended polysomnography in the neonatal intensive care unit (NICU). Bayley Scales of Infant Development, third edition (Bayley‐III) were administered at 18‐22 months.ResultThe 48 newborns (EGA 39.3 ± 1.6) had a median pediatric apnea‐hypopnea index (AHI) of 10.1 (3.3‐18.5) and most events were central (vs obstructive). Maternal and prenatal factors were not associated with AHI. Moreover, neonatal PSG results were not associated with Bayley‐III scores (P > 0.05).ConclusionSDB is common among term and near‐term newborns at risk for seizures. Follow‐up at ages when more nuanced testing can be performed may be necessary to establish whether neonatal SDB is associated with long‐term neurodevelopmental disability.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149248/1/ppul24266.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149248/2/ppul24266_am.pd

Interrater agreement in the interpretation of neonatal electroencephalography in hypoxic‐ischemic encephalopathy

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136482/1/epi13661_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136482/2/epi13661.pd

Impact of hands‐on care on infant sleep in the neonatal intensive care unit

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135460/1/ppul23513_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/135460/2/ppul23513.pd

Clavicular stress fracture in a cricket fast bowler: A case report

<p>Abstract</p> <p>Introduction</p> <p>Whilst rare, stress fractures of the clavicle have been described in other sports. To our knowledge, this is the first reported case of a stress fracture of the clavicle occurring in a cricket fast bowler.</p> <p>Case presentation</p> <p>A 23-year-old professional cricket fast bowler presented with activity related shoulder pain. Imaging demonstrated a stress fracture of the lateral third of the clavicle. This healed with rest and rehabilitation allowing a full return to professional sport.</p> <p>Conclusion</p> <p>This injury is treated with activity modification and technique adaptation. In a professional sportsman, this needs to be recognised early so that return to play can be as quick as possible.</p

Associations between age and sleep apnea risk among newborn infants

ObjectiveAmong older children, sleep‐disordered breathing (SDB) is associated with measurable neurocognitive consequences. However, diagnostic SDB thresholds are lacking for infants < 12 months. We sought to evaluate the relationship between SDB indices, gestational age (GA), and postmenstrual age (PMA) for infants who underwent clinically‐indicated polysomnograms at a tertiary care center.MethodsEvery infant < 3‐months chronological age whose first clinically‐indicated polysomnogram was between 2/2012 and 2/2017 was included. Linear regression was used to evaluate associations between apnea‐hypopnea index (AHI), obstructive‐apnea index (OAI), and GA and PMA for infants with and without obvious clinical risk factors for SDB (eg, micrognathia and cleft palate).ResultsFor 53 infants without obvious SDB risk factors (GA 35.6 ± 4.5 weeks; PMA 41.2 ± 4.0 weeks), mean AHI was 27 ± 18 and OAI 2.9 ± 4.5. There was a weak inverse relationship between AHI and PMA (r2 = 0.12, P = 0.01), but AHI was not predicted by GA (r2 = 0.04, P = 0.13). Conversely, OAI was more strongly associated with GA (r2 = 0.33, P < 0.0001) than PMA (r2 = 0.08, P = 0.036). For 28 infants with congenital structural anomalies that predispose to SDB (GA 38.0 ± 3.1 weeks, PMA 43.1 ± 3.3 weeks, AHI 37.7 ± 30, OAI 8.2 ± 11.8), neither AHI nor OAI were related to PMA or GA.ConclusionsAmong infants who received clinically‐indicated polysomnograms but did not have obvious structural risk for SDB, AHI declined with advancing PMA, but obstructive‐apnea was best predicted by prematurity. In contrast, the SDB risk did not improve with increasing GA or PMA for infants with congenital structural risk factors; such infants may not outgrow their risk for SDB.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/150552/1/ppul24354_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/150552/2/ppul24354.pd