Biomedical subjects

Gorm Greisen

Publications and source records attributed to Gorm Greisen.

41 records · Page 3Linked to original sources

PubMed2002

Intelligence in preterm children at four years of age as a predictor of school function: a longitudinal controlled study.

The aim of the study was to examine whether school performance was reduced in children with very-low birthweight beyond what could be explained by the deficit in intelligence-score at 4 years of age. Participants (n=333) examined at 4 years of age included three subgroups on the basis of birthweight: very-low birthweight (VLBW < 1501 g; n=102), low birthweight (LBW 1500-2300 g; n=139), and normal birthweight (NBW > or = 2500 g; n=92). The general cognitive index index (CGI) from the McCarthy Scales of Children's Abilities was used as an intelligence measurement at this assessment. At 18 to 20 years of age a telephone interview concerning school performance was conducted. Two hundred and fifty-seven participants (53% male, 47% female) entered the analysis. A model with School Performance score after the last year of compulsory school as the outcome variable, and McCarthy GCI and birthweight group as predicting variables, was used in linear regression analyses. Twenty-four per cent of the variance was explained. Birthweight had no influence in this model. In conclusion, the study did not find that birthweight influenced school performance beyond that represented by the McCarthy GCI found at age 4 years.

Adolescent↗

PubMed2002

Preterm birth affects the intestinal response to parenteral and enteral nutrition in newborn pigs.

Maturation of gastrointestinal (GI) function in neonates is stimulated by enteral nutrition, whereas parenteral nutrition induces GI atrophy and malfunction. We investigated whether preterm birth alters the GI responses to parenteral and enteral nutrition. Pigs were delivered either preterm (107 d gestation) or at term (115 d gestation) and fed total parenteral nutrition (TPN) or enteral sow's milk (ENT) for 6 d after birth. Immaturity of the preterm pigs was documented by reduced blood pH, oxygen saturation and neutrophil granulocyte function, impaired intestinal immunoglobulin G uptake from colostrum, and altered relative weights of visceral organs (small intestine, liver, spleen, pancreas, and adrenals). For both ages at delivery, increases occurred in pancreatic weight (30-75%) and amylase activity (0.5- to 13-fold) after birth, but much more in ENT than in TPN pigs (P < 0.05). Six days of TPN feeding was associated with reduced intestinal weight for both delivery groups (60% of values in ENT, P < 0.001), but only in term TPN pigs was the weight lower than at birth (-20%, P < 0.05). Likewise, it was only in term TPN pigs that intestinal maltase activity increased, compared with ENT, and the absorption of glucose and proline decreased. Only in preterm pigs did TPN feeding increase lactase activity (+50% compared with ENT, P < 0.05). For both delivery ages, the mRNA of lactase-phloridzin hydrolase and sodium-coupled glucose transporter 1 were increased in TPN, compared with ENT. In conclusion, the trophic effect of enteral vs. parenteral nutrition on the GI tract is also present after preterm birth, but the postnatal maturation of many GI functions is modified, compared with term birth. The effects of nutritional regimen on the maturation of the gut epithelium in neonates depend on gestational age at birth.

Animals↗

PubMed2002

Use of near infrared spectroscopy for estimation of peripheral venous saturation in newborns: comparison with co-oximetry of central venous blood.

In the intensive care of sick infants, the global oxygen reserve capacity is estimated by co-oximetry (co-ox) of blood sampled from central venous catheters. Introduction of a noninvasive alternative is desirable. Near infrared spectroscopy (NIRS) offers a technique for noninvasive bedside monitoring of tissue oxygen economy. We studied the relation between peripheral venous oxyhemoglobin saturation (SvO(2)) estimated by venous occlusion and NIRS, and the central SvO(2) measured by co-ox of central venous blood. We report the high reproducibility of NIRS with a test-retest variation of only 2.51 +/- 1.41%. After bias adjusting of NIRS SvO(2) values, a nice correlation (r = 0.96, p > 0.05) between NIRS measurements of peripheral SvO(2) and co-ox of central venous blood was found. The study indicates that NIRS is practical for monitoring relative changes in central venous saturation. This might be useful in the future clinical care of newborns.

Blood Gas Analysis↗

PubMed2002

Are some perinatal deaths in immigrant groups linked to suboptimal perinatal care services?

OBJECTIVE: To test the hypothesis that suboptimal factors in perinatal care services resulting in perinatal deaths were more common among immigrant mothers from the Horn of Africa, when compared with Swedish mothers. DESIGN: A perinatal audit, comparing cases of perinatal deaths among children of African immigrants residing in Sweden, with a stratified sample of cases among native Swedish women. POPULATION AND SETTING: Sixty-three cases of perinatal deaths among immigrant east African women delivered in Swedish hospitals in 1990-1996, and 126 cases of perinatal deaths among native Swedish women. Time of death and type of hospital were stratified. MAIN OUTCOME MEASURES: Suboptimal factors in perinatal care services, categorised as maternal, medical care and communication. RESULTS: The rate of suboptimal factors likely to result in potentially avoidable perinatal death was significantly higher among African immigrants. In the group of antenatal deaths, the odds ratio (OR) was 6.2 (95% CI 1.9-20); the OR for intrapartal deaths was 13 (95% CI 1.1-166); and the OR for neonatal deaths was 18 (95% CI 3.3-100), when compared with Swedish mothers. The most common factors were delay in seeking health care, mothers refusing caesarean sections, insufficient surveillance of intrauterine growth restriction (IUGR), inadequate medication, misinterpretation of cardiotocography (CTG) and interpersonal miscommunication. CONCLUSIONS: Suboptimal factors in perinatal care likely to result in perinatal death were significantly more common among east African than native Swedish mothers, affording insight into socio-cultural differences in pregnancy strategies, but also the suboptimal performance of certain health care routines in the Swedish perinatal care system.

Adult↗

PubMedDate not supplied

Precision of measurement of cerebral tissue oxygenation index using near-infrared spectroscopy in preterm neonates.

The use of cerebral tissue oxygenation index (c-TOI) in a clinical setting is limited by doubts concerning the accuracy of the measurements. Since there is no gold standard, validation is difficult. Our modest aim was to quantify the precision of c-TOI doing repeated measurements by reapplying the optode several times presuming no regional differences in cerebral oxygenation. Thirty-seven premature infants were examined with several measurements of c-TOI using the NIRO 300 oximeter. Three to eight measurements were done on each infant over a period of 15 to 25 min. One-way analysis of variance was used to estimate within- and between-infant variation. The median gestational age was 27.6 weeks (23.9 to 33.0). Mean c-TOI (n = 253) was 74.6+/-8.5%. The within-infant variation was 5.2% when resiting the optode. For comparison, the between-infants variation was 6.9%, while the spontaneous 2-sec variation was 2.9%. The precision of a single measurement of c-TOI was not good. By measuring five times instead of one on each subject, the precision of the mean can be assumed to be comparable to pulse oximetry. This may be too cumbersome for clinical use, but may reduce sample size in research.

Brain↗