Can EEG accurately predict 2-year neurodevelopmental outcome for preterm infants?

Objective: Establish if serial, multichannel video electroencephalography (EEG) in preterm infants can accurately predict 2-year neurodevelopmental outcome.

Design And Patients: EEGs were recorded at three time points over the neonatal course for infants <32 weeks' gestational age (GA). Monitoring commenced soon after birth and continued over the first 3 days.

A standardised assessment scheme for conventional EEG in preterm infants.

Objective: To develop a standardised scheme for assessing normal and abnormal electroencephalography (EEG) features of preterm infants. To assess the interobserver agreement of this assessment scheme.

Methods: We created a standardised EEG assessment scheme for 6 different post-menstrual age (PMA) groups using 4 EEG categories.

Mathematical Analysis of EEG Concordance in Preterm Twin Infants.

Purpose: Preterm twins are at higher risk of neurodisability than preterm singletons, with monochorionic-diamniotic (MCDA) twins at higher risk than dichorionic-diamniotic (DCDA) twins. The impact of genetic influences on EEG concordance in preterm twins <32 weeks of gestational age is not established. This study aims to investigate EEG concordance in preterm MCDA and dichorionic-diamniotic twins during maturation.

Electrographic Seizures during the Early Postnatal Period in Preterm Infants.

Objective: To investigate the frequency and characteristics of electrographic seizures in preterm infants in the early postnatal period.

Study Design: Infants <32 weeks gestational age (GA) (n = 120) were enrolled for continuous multichannel electroencephalography (EEG) recording initiated as soon as possible after birth and continued for approximately up to 72 hours of age. Electrographic seizures were identified visually, annotated, and analyzed.

Heart rate variability in hypoxic ischemic encephalopathy during therapeutic hypothermia.

Background: Therapeutic hypothermia (TH) aims to ameliorate further injury in infants with moderate and severe hypoxic ischemic encephalopathy (HIE). We aim to assess the effect of TH on heart rate variability (HRV) in infants with HIE.

Methods: Multichannel video-electroencephalography (EEG) and electrocardiography were assessed at 6-72 h after birth in full-term infants with HIE, recruited prior to (pre-TH group) and following (TH group) the introduction of TH in our neonatal unit.

Timing of Therapeutic Hypothermia for Inborn and Outborn Infants with Neonatal Encephalopathy.

Therapeutic hypothermia is now the standard of care for infants with moderate to severe hypoxic ischaemic encephalopathy. Sixty-three infants received therapeutic hypothermia at Cork University Maternity Hospital (CUMH) from 2010-2014. Median gestational age was 40 weeks.

Predicting 2-y outcome in preterm infants using early multimodal physiological monitoring.

Background: Preterm infants are at risk of adverse outcome. The aim of this study is to develop a multimodal model, including physiological signals from the first days of life, to predict 2-y outcome in preterm infants.

Methods: Infants <32 wk gestation had simultaneous multi-channel electroencephalography (EEG), peripheral oxygen saturation (SpO2), and heart rate (HR) monitoring.

Heart rate variability in hypoxic ischemic encephalopathy: correlation with EEG grade and 2-y neurodevelopmental outcome.

Background: The study aims to describe heart rate variability (HRV) in neonatal hypoxic ischemic encephalopathy (HIE) and correlate HRV with electroencephalographic (EEG) grade of HIE and neurodevelopmental outcome.

Methods: Multichannel EEG and electrocardiography (ECG) were assessed at 12-48 h after birth in healthy and encephalopathic full-term neonates. EEGs were graded (normal, mild, moderate, and severe).

Overcoming the practical challenges of electroencephalography for very preterm infants in the neonatal intensive care unit.

Aim: Long-term electroencephalogram (EEG) recording is increasingly being used in the neonatal period, but application and maintenance of the EEG electrodes is challenging, especially in preterm infants. This study proposes a practical method of electrode application that can be used in the neonatal intensive care unit (NICU).

Methods: EEG recording in preterm infants of <32 weeks of gestational age is often challenging and requires careful preparation and strict adherence to NICU protocols.

Trisomy 21--incidence and outcomes in the first year, in Ireland today.

Incidence of Trisomy 21 in Ireland, 1:546 live births, is the highest in Europe. This project aimed to define the incidence of T21 amongst liveborn infants at Cork University Maternity Hospital (CUMH), and to describe neonatal outcomes and progress in their first year. Infants were identified from Social Work department records.

Global suppression of electrocortical activity in unilateral perinatal thalamic stroke.

We present an unusual case of persistent generalized electroencephalography (EEG) suppression and right-sided clonic seizures in a male infant born at 40(+2) weeks' gestation, birthweight 3240g, with an isolated unilateral thalamic stroke. The EEG at 13 hours after birth showed a generalized very low amplitude background pattern, which progressed to frequent electrographic seizures over the left hemisphere. The interictal background EEG pattern remained grossly abnormal over the next 48 hours, showing very low background amplitudes (<10μV).

Image quality associated with the use of an MR-compatible incubator in neonatal neuroimaging.

Objectives: MRI in the neonate poses significant challenges associated with patient transport and monitoring, and the potential for diminished image quality owing to patient motion. The objective of this study was to evaluate the usefulness of a dedicated MR-compatible incubator with integrated radiofrequency coils in improving image quality of MRI studies of the brain acquired in term and preterm neonates using standard MRI equipment.

Methods: Subjective and objective analyses of image quality of neonatal brain MR examinations were performed before and after the introduction of an MR-compatible incubator.

Neurologic outcomes in very preterm infants undergoing surgery.

Objective: To investigate the relationship between surgery in very preterm infants and brain structure at term equivalent and 2-year neurodevelopmental outcome.

Study Design: A total of 227 infants born at <30 weeks gestation or at a birth weight of <1250 g were prospectively enrolled into a longitudinal observational cohort for magnetic resonance imaging and developmental follow-up. The infants were categorized retrospectively into either a nonsurgical group (n=178) or a surgical group (n=30).

[Relationship of the flexor hallucis longus and flexor digitorum longus tendons in the plantar midfoot. An anatomical cadaver study].

Purpose Of The Study: To verify, in cadaver specimens, the precise anatomic structure of cross-connection between the flexor hallucis longus (FHL) and flexor digitorum longus (FDL) tendons and to identify its position in relation to orientation points in the foot in view of the surgical technique for tendon transfer, including the necessity of subsequent tendon suture.

Material And Methods: A hundred cadaver legs (50 cadavers of 29 men and 21 women, all Caucasians) were dissected by an extensive medio-plantar approach. The anatomical relationship of the FHL and FDL tendons was studied.

Impact of antenatal diagnosis of hypoplastic left heart syndrome on the clinical presentation and surgical outcomes: the Australian experience.

Aim: Antenatal diagnosis of severe congenital heart disease enables planning of perinatal care of affected infants. Congenital heart surgery is highly centralised in Australia, and surgery for hypoplastic left heart syndrome (HLHS) currently takes place at a single institution, in order to ensure case volume. The study aims to review the impact of antenatal diagnosis on the early clinical course of infants with HLHS in Australia.

Single versus bihemispheric amplitude-integrated electroencephalography in relation to cerebral injury and outcome in the term encephalopathic infant.

Background: The demand for early diagnosis and prognostication of cerebral injury in the encephalopathic term infant is increasing to facilitate appropriate management. The single-channel amplitude-integrated electroencephalogram (S-aEEG) has been shown to have predictive utility for the severely encephalopathic infant. New bedside aEEG devices with more channels are entering the neonatal environment.

Intraoperative navigation in hip surface arthroplasty: a radiographic comparative analysis study.

Background: The goal of the current prospective randomised radiological study was to determine the accuracy of conventional and computer-assisted femoral component implantation in surface arthroplasty (SRA).

Methods: We analysed on standard radiographs the femoral component positions after 30 conventional instrumented (Group 1) and 30 navigated (Group 2) SRA femoral components. We evaluated: varus or valgus orientation, horizontal femoral offset and translation of the component.

SPECT scan is a reliable tool for selection of patients undergoing unicompartmental knee arthroplasty.

Purpose: Was to determine the relationship between pre-operative SPECT and intra-operative assessments of tibio-femoral chondral changes.

Methods: One hundred cases had been selected on the following criteria: (1) marked Tc-99 m uptake on the medial compartment and (2) its normal uptake laterally. The cartilage macroscopic condition of tibio-femoral compartments were then recorded during the surgery.

Monitoring the neonatal brain: a survey of current practice among Australian and New Zealand neonatologists.

Aims: There is considerable variation in the use of brain imaging and electrophysiological monitoring of encephalopathic term infants. The aims of this study were (i) to document the current practice among Australian and New Zealand neonatologists; and (ii) to identify the factors that influence local practice.

Methods: A postal questionnaire was sent to all 152 neonatologists in Australia and New Zealand.

[Precise, computed-assisted leg angle correction with open-wedge high tibial osteotomy].

Aim: This prospective study investigates open-wedge high tibial osteotomy performed with the aid of a kinematic computer-guided navigation system. After the X-ray control the osteotomy was stabilized by internal LCP fixation. The aim of the study was to demonstrate the accuracy of the navigation system and to prove the reliability of the LCP fixation.

Neonatal hypoglycemia and occipital cerebral injury.

Occipital brain injury associated with neonatal hypoglycemia can result in long-term disability, epilepsy, and visual impairment. The etiology of this pattern of injury is unclear; however, transient hyperinsulinism may be an independent risk factor. Magnetic resonance brain imaging can delineate the extent of brain injury and guide follow-up.

Combination pharmacotherapy for severe neonatal pulmonary hypertension.

Pulmonary hypertension can complicate the early clinical course in newborn infants with congenital diaphragmatic hernia. We report the successful use of combination therapy with enteral sildenafil and intravenous prostaglandin E1 in a preterm infant with severe pulmonary hypertension and right heart failure early after congenital diaphragmatic hernia repair.

[Minimally invasive and navigated implantation for total knee arthroplasty: X-ray analysis and early clinical results].

Total knee arthroplasty (TKA) alignment is one of the most important factors in long-term prosthesis survival. Minimally invasive surgical (MIS) procedures are becoming more common. There may be an increased overall complication rate, especially component malpositioning, due to poor visualisation.