Ultrasound Measurements of Intracranial Structures in Growth-Restricted Neonates with Fetal Blood Flow Redistribution: A Pilot Observational Study

Neonatology ◽  
2020 ◽  
Vol 117 (4) ◽  
pp. 446-452
Author(s):  
Pramod Pharande ◽  
Mohan Krishnamurthy ◽  
Gillian Whiteley ◽  
Arun Sasi ◽  
Atul Malhotra
Keyword(s):  
Blood Flow ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Brain Structures ◽  
Cranial Ultrasound ◽  
Fetal Blood ◽  
The Impact ◽  
The Brain ◽  
Blood Flow Redistribution

<b><i>Background:</i></b> Fetal growth restriction (FGR) is associated with neonatal and long-term neuro-morbidity. Preferential redistribution of blood flow to the brain is a common antenatal adaptation in FGR. The impact of this “brain sparing,” which may signify severity of FGR, on the growth of brain structures has not been studied. <b><i>Aim:</i></b> To compare corpus callosum (CC), cerebellar, and ventricular measurements of FGR neonates with evidence of fetal blood flow redistribution with those of gestation-matched appropriately grown (AGA) neonates. <b><i>Methods:</i></b> This was a pilot, prospective observational study conducted at a tertiary level neonatal unit in Melbourne, Australia. Cranial ultrasound was done between days 1 and 3 of life in FGR and AGA neonates. <b><i>Results:</i></b> Cranial ultrasound on 20 FGR, gestation (mean ± SD) 31.4 ± 3.1 weeks, weight 1,205 ± 463 g, and 20 AGA neonates, 31.1 ± 3.0 weeks, 1,668 ± 490 g, was performed. CC length was significantly decreased in FGR neonates as compared to AGA neonates (35.28 ± 3.47 vs. 38.83 ± 4.05 mm, <i>p</i> = 0.0002). CC was significantly thinner at genu (3.36 ± 0.66 vs. 4.04 ± 0.83 mm, <i>p</i> = 0.007), body (1.97 ± 0.36 vs. 2.27 ± 0.39 mm, <i>p</i> = 0.02), and splenium (4.07 ± 0.76 vs. 4.72 ± 0.75 mm, <i>p</i> = 0.003) in FGR vs. AGA neonates. CC-fastigium length was also significantly decreased (39.65 ± 3.87 vs. 41.96 ± 4.50 mm, <i>p</i> = 0.04). Similarly, FGR neonates showed decreased transverse cerebellar diameter (36.15 ± 5.51 vs. 38.81 ± 7.21 mm, <i>p</i> = 0.02), but ventricular measurements were comparable. In multivariate analysis, these differences were evident independent of the birth weight. <b><i>Conclusions:</i></b>CC and cerebellar measurements are significantly smaller in FGR neonates with fetal blood flow redistribution, which warrants further study.

scholarly journals Acute and chronic stage adaptations of vascular architecture and cerebral blood flow in a mouse model of TBI

2018 ◽  
Author(s):  
Joe Steinman ◽  
Lindsay S. Cahill ◽  
Margaret M. Koletar ◽  
Bojana Stefanovic ◽  
John G. Sled
Keyword(s):  
Blood Flow ◽  
Ex Vivo ◽  
Vessel Density ◽  
Vascular Architecture ◽  
Two Photon ◽  
Brain Vasculature ◽  
The Impact ◽  
The Brain ◽  
Time Point

AbstractThe 3D organization of cerebral blood vessels determines the overall capacity of the cerebral circulation to meet the metabolic requirements of the brain. This study used Arterial Spin Labeling (ASL) MRI with a hypercapnic challenge and ex vivo Serial Two-Photon Tomography (STPT) to examine the relationship between blood flow and 3D microvascular structure following traumatic brain injury (TBI) in a mouse. Mice were exposed to a controlled cortical impact TBI and allowed to recover for either 1 day or 4 weeks. At each time point, ASL MRI was performed to quantify cerebral perfusion and the brain vasculature was imaged in 3D with STPT. Registration of ASL to STPT enabled flow changes to be related to the underlying microvascular structure in each ASL voxel. Hypoperfusion under rest and hypercapnia was observed both 1 day and 4 weeks post-TBI. Vessel density and vascular volume were reduced 1 day post-TBI, recovering by 4 weeks; however, the reorganized vasculature at the latter time point possessed an abnormal radial pattern. Our findings demonstrate functionally significant long-term changes in the vascular architecture following injury and illustrate why metrics beyond traditional measures of vessel density are required to understand the impact of vascular structure on function.

Magnesium sulfate exposure increases fetal blood flow redistribution to the brain during acute non-acidemic hypoxemia in goats

2006 ◽  
Vol 82 (9) ◽  
pp. 597-602 ◽  
Author(s):  
Shigeki Tanaka ◽  
Hiroshi Sameshima ◽  
Tsuyomu Ikenoue ◽  
Hiroshi Sakamoto
Keyword(s):  
Blood Flow ◽  
Magnesium Sulfate ◽  
Fetal Blood ◽  
The Brain ◽  
Blood Flow Redistribution

scholarly journals The Long-Term Buffering Effect of Sense of Coherence on Psychopathological Symptoms During the COVID-19 Pandemic: Findings from a Prospective Observational Study

2021 ◽  
Author(s):  
Sarah Schäfer ◽  
Roxanne Sopp ◽  
Marco Koch ◽  
Anja S. Göritz ◽  
Tanja Michael
Keyword(s):  
Mental Health ◽  
Observational Study ◽  
Sense Of Coherence ◽  
Prospective Observational Study ◽  
Critical Time ◽  
Growth Mixture Modeling ◽  
Psychopathological Symptoms ◽  
The Impact ◽  
Over Time

Background: The COVID-19 pandemic is a multidimensional long-term stressor. Consequently, research demonstrated a negative impact of COVID-19 on mental health in parts of the general population. However, not all people are affected equally making the identification of resilience factors modulating the pandemic’s impact on mental health an important research agenda. One of these factors is sense of coherence (SOC), the key component of the salutogenesis framework. Objective: The current study aimed at investigating the long-term relationship between SOC and psychopathology, and the impact of COVID-19-related rumination as its moderator. Methods: The prospective observational study assessed psychopathology and SOC before the COVID-19 outbreak in Germany (February 2020) and at six critical time points during the pandemic (n = 1,479). Bivariate latent change score models and latent growth mixture modeling were used to analyze changes in psychopathology and SOC along with their interaction and to differentiate trajectories of COVID-19-related rumination. Results: A model allowing for unidirectional coupling from SOC to psychopathology demonstrated best fit. In the total sample, psychopathological symptoms increased significantly over time. Previous SOC predicted later changes in psychopathology, whereby a stronger SOC was associated with a decrease in symptoms over time, while a weaker SOC with an increase in symptoms. The same pattern of results was evident in the high-rumination (17.2%) but not in the low-rumination group (82.8%). Conclusions: Our findings demonstrate that SOC is an important predictor and modulator of psychopathology during the COVID-19 pandemic, particularly for those respondents that ruminate about the pandemic.

New data in turner syndrome: Results from a long-term prospective observational study from diagnosis to adulthood

2020 ◽  
Author(s):  
Francesca Corzani ◽  
Carolina Cecchetti ◽  
Claudia Oriolo ◽  
Paola Altieri ◽  
Annamaria Perri ◽  
...  
Keyword(s):  
Observational Study ◽  
Turner Syndrome ◽  
Prospective Observational Study

Mo2003 Long-Term Prospective Observational Study of Cancer Risk Among Pantoprazole Users

2015 ◽  
Vol 148 (4) ◽  
pp. S-765
Author(s):  
Douglas A. Corley ◽  
Francesca Kolitsopoulos ◽  
Jennifer L. Schneider
Keyword(s):  
Cancer Risk ◽  
Observational Study ◽  
Prospective Observational Study

Long-term outcomes in patients with schizophrenia treated with risperidone long-acting injection or oral antipsychotics in Spain: Results from the electronic Schizophrenia Treatment Adherence Registry (e-STAR)

2009 ◽  
Vol 24 (5) ◽  
pp. 287-296 ◽  
Author(s):  
J.M. Olivares ◽  
A. Rodriguez-Morales ◽  
J. Diels ◽  
M. Povey ◽  
A. Jacobs ◽  
...  
Keyword(s):  
Observational Study ◽  
Treatment Adherence ◽  
Prospective Observational Study ◽  
Clinical Symptoms ◽  
Retrospective Chart Review ◽  
Treatment Retention ◽  
Severity Scores ◽  
Long Term Treatment ◽  
Long Acting

AbstractBackgroundThe electronic Schizophrenia Treatment Adherence Registry (e-STAR) is a prospective, observational study of patients with schizophrenia designed to evaluate long-term treatment outcomes in routine clinical practice.MethodsParameters were assessed at baseline and at 3 month intervals for 2 years in patients initiated on risperidone long-acting injection (RLAI) (n = 1345) or a new oral antipsychotic (AP) (n = 277; 35.7% and 36.5% on risperidone and olanzapine, respectively) in Spain. Hospitalization prior to therapy was assessed by a retrospective chart review.ResultsAt 24 months, treatment retention (81.8% for RLAI versus 63.4% for oral APs, p < 0.0001) and reduction in Clinical Global Impression Severity scores (−1.14 for RLAI versus −0.94 for APs, p = 0.0165) were significantly higher with RLAI. Compared to the pre-switch period, RLAI patients had greater reductions in the number (reduction of 0.37 stays per patient versus 0.2, p < 0.05) and days (18.74 versus 13.02, p < 0.01) of hospitalizations at 24 months than oral AP patients.ConclusionsThis 2 year, prospective, observational study showed that, compared to oral antipsychotics, RLAI was associated with better treatment retention, greater improvement in clinical symptoms and functioning, and greater reduction in hospital stays and days in hospital in patients with schizophrenia. Improved treatment adherence, increased efficacy and reduced hospitalization with RLAI offer the opportunity of substantial therapeutic improvement in schizophrenia.

scholarly journals Impact of Post-Stroke Recanalization on General and Upper Limb Functioning: A Prospective, Observational Study

2021 ◽  
Vol 13 (1) ◽  
pp. 46-58
Author(s):  
João Paulo Branco ◽  
Filipa Rocha ◽  
João Sargento-Freitas ◽  
Gustavo C. Santo ◽  
António Freire ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Observational Study ◽  
Acute Ischemic Stroke ◽  
Upper Limb ◽  
Functional Recovery ◽  
Prospective Observational Study ◽  
Positive Impact ◽  
Rehabilitation Program ◽  
Patient Functioning ◽  
The Impact

The objective of this study is to assess the impact of recanalization (spontaneous and therapeutic) on upper limb functioning and general patient functioning after stroke. This is a prospective, observational study of patients hospitalized due to acute ischemic stroke in the territory of the middle cerebral artery (n = 98). Patients completed a comprehensive rehabilitation program and were followed-up for 24 weeks. The impact of recanalization on patient functioning was evaluated using the modified Rankin Scale (mRS) and Stroke Upper Limb Capacity Scale (SULCS). General and upper limb functioning improved markedly in the first three weeks after stroke. Age, gender, and National Institutes of Health Stroke Scale (NIHSS) score at admission were associated with general and upper limb functioning at 12 weeks. Successful recanalization was associated with better functioning. Among patients who underwent therapeutic recanalization, NIHSS scores ≥16.5 indicate lower general functioning at 12 weeks (sensibility = 72.4%; specificity = 78.6%) and NIHSS scores ≥13.5 indicate no hand functioning at 12 weeks (sensibility = 83.8%; specificity = 76.5%). Recanalization, either spontaneous or therapeutic, has a positive impact on patient functioning after acute ischemic stroke. Functional recovery occurs mostly within the first 12 weeks after stroke, with greater functional gains among patients with successful recanalization. Higher NIHSS scores at admission are associated with worse functional recovery.

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