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Biomedical subjects

A Calame

Publications and source records attributed to A Calame.

At least 55 records · Page 3Linked to original sources
PubMed1987

Skinfold thickness and adiposity index in premature infants.

In order to assess the validity of the weight per square of length ratio as an index of adiposity during the neonatal period, 37 premature infants (gestational age, mean +/- SD, = 31.5 +/- 1.1 weeks, birthweight, mean +/- SD, = 1.448 +/- 147 g) were studied for weight, length and skinfold thickness at 5 sites (biceps, triceps, subscapular, suprailiac and quadriceps) during their stay in the Neonatal Unit of the University Hospital in Lausanne. The results show a significant correlation between the adiposity index and the sum of 5 skinfold thickness sites in premature infants. The adiposity index gives a fair estimate of the body fat mass during the postnatal growth in premature infants.

Adipose Tissue↗
PubMed1987

Composition of weight gain during the neonatal period and longitudinal growth follow-up in premature babies.

Changes in the rate of growth and adiposity index (Quetelet index), calculated as weight/(length)2, kg/m2, were monitored from birth to 3 years in 19 premature babies (post-conceptional age 31.2 +/- 2 weeks) who were subjected during rapid growth (16 +/- 4 g/kg.day) to initial metabolic balance studies in the first weeks of life. These studies showed that the rate of fat accretion in these infants (3.3 +/- 0.9 g/kg.day) was substantially greater than that observed in fetuses of the same gestational age (2 g/kg.day) but the adiposity index was lower (9.6 +/- 1 kg/m2) than intrauterine values (11 kg/m2). Since at 6 months of age (corrected for gestational age at birth) the adiposity index was close to normality (103% of standard), the greater rate of fat accretion in early life contributed to progressively restore total body fat in premature babies. It is concluded that despite substantial fat deposition during the first weeks of life, the future evolution of these premature babies is favourable as judged from the normalization of adiposity index within the first 2 years of life.

Adipose Tissue↗
PubMed1986

Neurodevelopmental outcome and school performance of very-low-birth-weight infants at 8 years of age.

The neurodevelopmental outcome and school performance of 50 appropriate for gestational age (AGA) and 33 small for gestational age (SGA) very-low-birth-weight (VLBW) infants, compared to a control group (41 Term infants) were assessed at 8 years of age. The incidence of major handicaps among AGA and SGA/VLBW infants respectively, was 16% and 6%. No major handicap was found in the control group. The incidence of neurodevelopmental abnormalities (NDA) among AGA's (40%) and SGA's (57.6%) compared with the control group (31.7%) was found to be significantly higher. School failure occurred more frequently among VLBW infants (22.9%) and was related in children with NDA--and more particularly among AGA's--to the presence of language disorders or associated NDA. Evaluation of the consequences of NDA and school problems for later academic and professional achievement now requires further follow-up studies.

Achievement↗
PubMed1985

Periventricular leukomalacia: a correlation study between real-time ultrasound and autopsy findings. Periventricular leukomalacia in the neonate.

The aim of this study was to validate the accuracy of real-time ultrasound (US) in the diagnosis of periventricular leukomalacia (PVL). US changes of PVL were correlated with autopsy results. During a 12-month period, all premature infants of 34 weeks' gestation or less (group A) and all neonates of more than 34 weeks' gestation who presented with abnormal neurological signs (group B) were studied with an ATL mechanical sector scanner (5 and 7.5 MHz). The overall incidence of PVL was 13.3%. In group A (n = 83), 13 infants had PVL and 3 died. In group B (n = 36), three developed PVL and two died. Autopsy was performed in the five infants. US revealed the sequence of lesion: - the early stage with increased echogenicity in the periventricular white matter, - the late stage with area of reduced echogenicity appearing in the most echogenic zone and resulting in cystic cavitation. Autopsy confirmed PVL lesions in all five infants. The increased echogenicity corresponded to necrosis with either vascular congestion and/or secondary bleeding, the reduced echogenicity to cystic degeneration with gliosis. US scan be used for the detection of PVL.

Brain Diseases↗
PubMed1985

Temporal evolution of hypoxic-ischaemic brain lesions in asphyxiated full-term newborns as assessed by computerized tomography.

Hypoxic-ischaemic brain lesions may be detected as low density (LD) areas by means of computerized tomography (CT), but the clinical significance of such LD areas has been controversial. Since timing might be a critical factor, we studied the temporal evolution of LD areas in 9 asphyxiated term babies who had had two or more CT, and compared the changes to the neurodevelopmental outcome. Scans were classified according to the elapsed time after asphyxia as early (day 1-7, n = 6), intermediate (week 2-4, n = 7; week 4-7, n = 3) and late CT (3 months or more, n = 7). In early scans, no, or only ill defined, LD areas were seen in the periventricular region. In intermediate CT's, LD-zones were further diminished in those babies who later were normal. Sharply accentuated LD areas, however, appeared in those who later suffered from neurodevelopmental disorders. These LD areas, probably representing hypoxic-ischaemic lesions, were located periventricularly, extending into the subcortical white matter and the cortex, and usually involved both hemispheres symmetrically. They began to disappear at 4 to 7 weeks in some regions, possibly because of glial proliferation. LD persisting more than 4-7 weeks tended to transform into cyst-like lesions, or marked atrophy. We conclude (1) that hypoxic-ischaemic lesions appear as zones of low density on CT scans performed after the first week and (2) that the extent of such lesions can best be assessed between 9 to 23 days after asphyxia.

Asphyxia Neonatorum↗
PubMed1985

Neurodevelopmental outcome at 12 months of age related to cerebral ultrasound appearances of high risk preterm infants.

A prospective neurological and developmental assessment at 12 months of age corrected for prematurity was performed on 54 surviving preterm infants of 34 weeks' gestation or less. The babies were allocated into three groups according to their ultrasound (US) appearances: Group I (n = 29), normal scan; Group II (n = 10), isolated periventricular-intraventricular haemorrhage (PVH); Group III (n = 15), association of PVH, periventricular leukomalacia (PVL) and ventricular dilatation. The developmental outcome evaluated with the Griffiths' development quotient (DQ) was good and similar in Groups I and II, while it was worse and variable in Group III. There was also a higher incidence of neurological abnormalities in Group III, as 47% of children only were found to be normal compared to 86% and 80% in Groups I and II, respectively. A major handicap was diagnosed in 5 children of Group III. Infants with small lesions of PVH or PVL or with ventricular dilatation developed as well as children with normal US scan, whereas more diffuse or extensive US changes of PVL had a poorer prognosis. The outcome of a cerebral injury seems to depend on the type, the size and localisation of the lesion, and to some extent, on the neuroplasticity of the developing brain.

Cerebral Hemorrhage↗
PubMed1985

Prognostic value of neonatal CT scans in asphyxiated term babies: low density score compared with neonatal neurological signs.

Twenty-five asphyxiated term babies were investigated in order to evaluate the prediction of their neurodevelopmental outcome by means of computerized tomography (CT) as compared to neurological symptoms during the neonatal period. Low density (LD) areas, thought to represent hypoxicischaemic lesions, were assessed quantitatively by means of a LD score based on the extent and degree of LD, the total score ranging from 0-36. Neonatal scans were defined according to the time span elapsed between asphyxia and CT as (1) early CT (day 1-7, n = 15), and (2) intermediate CT (day 9-23: n = 14; day 29: n = 1). The newborns were classified according to the neonatal neurological findings as having mild (n = 8, 32%), moderate (n = 9, 36%), and severe (n = 8, 32%) encephalopathy, following the definition of Sarnat and Sarnat (1976). Among the twenty-two survivors, the follow-up (mean age 19.2 +/- 6.0 mts) revealed fourteen (56%) with normal outcome, two (8%) with transient neurodevelopmental anomalies during the first year, and nine (36%) with permanent abnormalities such as cerebral palsy and/or retardation (mainly global) and/or epilepsy. Early CT scans had no predictive value. Intermediate CT, however, showed distinct variations of LD areas which resulted in an LD score well correlated with the later outcome. In particular, a LD score below 14 characterized every baby who developed normally; a prediction not possible in a reliable way be means of neonatal neurological signs. For all abnormal children, the score correlated with the severity of the later neurodevelopmental disorder, except for one with the latest intermediate CT (day 29).

Asphyxia Neonatorum↗
PubMed1985

Interaction between perinatal brain damage and processes of normal brain development. Ultrasonographic and neurodevelopmental study in the first year of life.

A systematic ultrasonographic study and a prospective neurodevelopmental assessment were carried out in a population of high-risk neonates. In group A (82 preterm infants of 34 weeks gestation or less), periventricular-intraventricular hemorrhage (PVH) and periventricular leukomalacia (PVL) were the commonest lesions. The association of PVH, PVL and ventricular dilatation had a variable outcome and the prognosis was found to be poorer in the presence of diffuse or extensive PVL. In group B (115 neonates of more than 34 weeks gestation), miscellaneous ultrasound changes were observed (malformations, infections, hemorrhages and hypoxic-ischemic lesions). Malformations, hypoxic-ischemic damage and prenatal infections had a gloomy prognosis. The main targets of hypoxic-ischemic damage in the immature infant were the germinal layer and the periventricular white matter, while in the mature infant the cortex and basal ganglia were more vulnerable. A relation between the localization and the size of the lesion could be established. In conclusion, basic forms of cerebral damage should therefore be understood in terms of brain maturation, type and timing of the insult, extent and localization of the lesion.

Brain↗
PubMed1985

Agenesis of the corpus callosum: real-time ultrasonographic diagnosis and autopsy findings.

Ultrasonographic appearances of agenesis of corpus callosum and its associated abnormalities are described in four cases. Clinical data, ultrasonographic diagnostic criteria, and correlation with neuropathological findings are presented. Ultrasound is the method of first choice in the neonatal period for the detection of cerebral malformations and more particularly of agenesis of corpus callosum.

Agenesis of Corpus Callosum↗
PubMed1984

Neurodevelopmental abnormalities in preschool children with high perinatal risk. Prognostic value and consequences on education at 8 years of age.

Two groups of 41 children with high perinatal risk were studied. All children of the study group (SG) had neurodevelopmental abnormalities (NDA) at the age of 5 years, without major handicap. The control group (CG) consisted of 41 children matched for sex, neonatal pathology, birthweight, gestational age and socioeconomic status, without NDA at 5 years. In the SG 85.4% of the children had persistent NDA at school age. In the CG 36.6% of the children presented NDA, but less severe than those of the SG. The SG children had more often associated NDA than those of the CG. The outcome of NDA diagnosed at preschool age and the results of psychometric tests are described. Associated NDA or a borderline IQ, with emotional and behavioral problems, have a gloomy school prognosis. 46.3% of the children in the SG had major schooling problems and 12.2% of children in the CG. These results show the possibility to detect children at risk of school achievement problems before school entrance; they might be useful in counselling and preventing behavioral and educational difficulties.

Achievement↗
PubMed1984

[Prognostic value of the neurodevelopmental status in the first year of life in children with increased perinatal risk].

Among 503 high-risk newborns followed-up systematically in a prospective study up to 5 years of age, abnormalities of the development of posture, of maturation of tone and of psychomotor development were diagnosed at the age of 6 months in 70 children (13.9%) who form the study group. Among the other 433 high-risk newborns who presented a normal psychomotor development at the age of 6 months, 73 were selected at random and form the control group. In the study group, 59% of the children had a development which became normal during the second year of life (transitory disorders), 21% had persistent minor neurological abnormalities at the age of 5 years, and 20% evolved towards cerebral palsy and/or mental retardation. In the control group, 97.3% of the children remained normal and 2.7% presented minor neurological abnormalities at 5 years. Three parameters are important to estimate the prognosis of the children in the study group. These are: the presence of neurological disorders during the neonatal period, the type of neurodevelopmental abnormalities diagnosed at the age of 6 months, and the evolution of these abnormalities during the second semester of life. Among the 14 major handicaps, 13 were found in children who presented neurological neonatal disorders and 12 appeared in children who had an abnormality of muscular tonus associated with cognitive and social retardation at the age of 6 months. 52% of the children, whose status had not been "normalized" at 12 months, had a major handicap at 5 years. However, a hypertonia predominating in the lower limbs and observed at 6 months has a good prognosis; it disappears during the second year of life in 81.2% of cases (transitory disorders) and is associated with persistent minor neurological abnormalities in 18.8% of cases.--This study gives useful information for the establishment of an early prognosis and a rational management of the high-risk newborn children who present neurodevelopmental abnormalities during their first year of life.

Cerebral Palsy↗