| 1. |
- Greisen, G, et al.
(författare)
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EEG depression and germinal layer haemorrhage in the newborn
- 1987
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Ingår i: Acta Paediatrica Scandinavica. - : Wiley. - 0001-656X .- 0803-5253 .- 1651-2227. ; 76:3, s. 519-525
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Tidskriftsartikel (refereegranskat)abstract
- Amplitude integrated EEG (aEEG) recordings from 32 mechanically ventilated infants, gestational age 32 weeks or less, were analysed. All recordings were started within 24 h of birth and continued for at least 50 h. Germinal layer haemorrhage (GLH) was diagnosed by repeated ultrasonography. In six infants neither GLH nor hypocalcaemia were diagnosed; aEEG in these infants rapidly became more active after birth: at 30 h of age continuous background activity was present for more than 20% of the time, and a seizure-like pattern was exceptional. In seven infants without GLH but with hypocalcaemia and other signs of metabolic derangement, continuous background activity appeared later and seizure-like activity was frequent. In the infants with GLH, depression of the background activity was apparent. This finding was particularly distinct in the presence of severe haemorrhages. Four infants developed GLH after 30 h of age. All these infants had depressed aEEG before the development of GLH, with less than 20% continuous activity at 30 h of age. In ten infants an analysis of the aEEG during the occurrence of GLH was possible. In six of these, cortical electrical activity decreased. Due to the limitation of GLH timing, it was not possible to decide whether this decrease closely preceded or followed GLH. We suggest that GLH primarily occurs in brains with a preceding metabolic and neurophysiologic abnormality, and that further functional deterioration is caused by the most severe haemorrhages.
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| 2. |
- Greisen, Gorm, et al.
(författare)
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Sleep-walking shifts and cerebral blood flow in stable preterm infants
- 1985
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Ingår i: Pediatric Research. - 1530-0447. ; 19:11, s. 1156-1159
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Tidskriftsartikel (refereegranskat)abstract
- Cerebral blood flow was estimated on 60 occasions in 15 well infants, 29-34 wk of gestational age, 5-17 days after birth, using 133-Xenon clearance after intravenous injection. The sleep state of the infants was determined by biparietal electroencephalography, clinical observation, and tracings of heart rate and respiration. Blood flow was 22% higher in the 11 estimations made during wakefulness, when compared to the 17 estimations made during quiet sleep. There was no difference between blood flow in active and quiet sleep. Also there was no difference between blood flow during periods of trace alternant and blood flow during periods of continuous electroencephalographic activity. It is suggested that flow-metabolism coupling is present in stable, preterm infants. The absence of an increase in cerebral blood flow during active sleep as compared with quiet sleep suggests that the neurophysiologic and neurometabolic mechanisms of rapid eye movement sleep are not yet fully developed in preterm infants.
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| 3. |
- Hanson, E, et al.
(författare)
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Non-neurogenic discoordinated voiding in children. The long-term effect of bladder retraining.
- 1987
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Ingår i: Zeitschrift für Kinderchirurgie : organ der Deutschen, der Schweizerischen und der Osterreichischen Gesellschaft für Kinderchirurgie = Surgery in infancy and childhood. - 0174-3082. ; 42:2, s. 109-11
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Tidskriftsartikel (refereegranskat)abstract
- Sixteen children with dysfunctional voiding without demonstrable neurological deviation were studied 6 months and five years after completed bladder retraining. The initial good effect on voiding symptoms and urinary tract infections/bacteriuria was confirmed. Moreover, the effect seems to last for several years. Bladder retraining can thus be considered a safe, cheap and relatively effective treatment in many children with symptoms of bladder dysfunction and/or recurrent urinary tract infections.
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| 4. |
- Hellström, Anna-Lena, 1946, et al.
(författare)
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Pad tests in children with incontinence.
- 1986
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Ingår i: Scandinavian journal of urology and nephrology. - 0036-5599. ; 20:1, s. 47-50
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Tidskriftsartikel (refereegranskat)abstract
- Different pad tests were compared in 50 incontinent children. In a 2-hour ward test with standardized activities and fluid provocation 70% were positive. In a simple 12-hour home test with 30 children 68% were positive; when a fluid provocation period was included in the home test with 20 children the frequency increased to 80%. Pad tests are easy to perform with children in the home and are valuable as screening instruments. Further, the simultaneous registration of events gives a more complete picture of the incontinence pattern.
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| 5. |
- Hellström, Anna-Lena, 1946, et al.
(författare)
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Rehabilitation of the dysfunctional bladder in children: method and 3-year followup.
- 1987
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Ingår i: The Journal of urology. - 0022-5347. ; 138:4, s. 847-9
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Tidskriftsartikel (refereegranskat)abstract
- A rehabilitation program has been developed for children with functional, nonneurogenic bladder disturbance. The basis for the program is a bladder regimen supplemented by biofeedback training if needed. Results in the first 70 children (64 girls and 6 boys) are presented. After 1 and 3 years 36 and 53 children, respectively, had completely normalized voiding patterns, that is they were continent, had no urgency, voided 3 to 6 times a day and emptied the bladder completely in 1 portion with a normal flow rate. The training program is applicable in children with varying urodynamic diagnoses and it has been used in children as young as 4 years old.
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| 6. |
- Hellström, Anna-Lena, 1946, et al.
(författare)
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Terodiline in the treatment of children with unstable bladders.
- 1989
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Ingår i: British journal of urology. - 0007-1331. ; 63:4, s. 358-62
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Tidskriftsartikel (refereegranskat)abstract
- A double-blind study of terodiline compared with placebo was performed in 58 children aged 6 to 14 years with urgency or urge incontinence. All had an unstable bladder at cystometry. A bladder regimen was emphasised during the study. Continence was improved according to micturition charting and a pad test in both groups. Terodiline at 25 mg/day, however, gave significantly better results than placebo. In patients with a subnormal bladder capacity (less than or equal to 150 ml), a significant increase in capacity was recorded on cystometry during medication with terodiline but not with placebo. The improved continence seen in the placebo group was probably due to the non-specific bladder training achieved by the child's increased awareness and adult involvement during treatment. The even better results attained in the terodiline group shows this drug to be a valuable adjunct to a bladder regimen in children with urge incontinence, particularly since no important adverse effects were noted during an 8-week period.
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| 7. |
- Hellström-Westas, Lena, et al.
(författare)
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Cerebral complications detected by EEG-monitoring during neonatal intensive care
- 1989
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Ingår i: Acta paediatrica Scandinavica. Supplement. - : Wiley. - 0300-8843. ; 78:S360, s. 83-86
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Tidskriftsartikel (refereegranskat)abstract
- The report describes the clinical use and value of continuous EEG-monitoring during different clinical circumstances that are not usually related to changes in EEG. Three infants with pneumothorax, hypoglycaemia, and severe hyaline membrane, respectively, are presented.
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| 8. |
- Hellström-Westas, Lena, et al.
(författare)
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Lidocaine for treatment of severe seizures in newborn infants. I. Clinical effects and cerebral electrical activity monitoring
- 1988
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Ingår i: Acta Paediatrica Scandinavica. - : Wiley. - 0001-656X .- 0803-5253 .- 1651-2227. ; 77:1, s. 79-84
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Tidskriftsartikel (refereegranskat)abstract
- The anticonvulsive effect of lidocaine was evaluated in 46 newborn infants with severe, recurrent seizures. Before the lidocaine all infants were being given phenobarbital, and 22 infants were also treated with diazepam. Different dosages of lidocaine were tested. A loading dose of 2 mg/kg followed by i.v. infusion of 6 mg/kg/hour was the most effective dosage and had an immediate anticonvulsive effect in 18 of 25 infants; within 30 min the same effect was attained in another five of the infants, with an overall seizure control in 92% of the sample population. During the lidocaine treatment cerebral electrical activity was followed continuously with a cerebral function monitor (CFM), which also enabled evaluation of the treatment. No serious side effects on blood-pressure, heart-rate or cerebral electrical activity were registered. For newborn infants with severe recurrent seizures not responding to other drugs, lidocaine is an effective additional mode of treatment.
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| 9. |
- Hellström-Westas, Lena, et al.
(författare)
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Silent seizures in sick infants in early life. Diagnosis by continuous cerebral function monitoring
- 1985
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Ingår i: Acta Paediatrica Scandinavica. - : Wiley. - 0001-656X .- 0803-5253 .- 1651-2227. ; 74:5, s. 741-748
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Tidskriftsartikel (refereegranskat)abstract
- Cerebral electric activity was surveilled with a Cerebral Function Monitor (CFM) technique in 87 newborn infants under neonatal intensive care. A total of 26 infants had electrographical signs of repeated seizure activity. Among these infants 14 had periods of one hour or more of silent seizures activity. Among these infants 14 had periods of one hour or more of silent seizures, i.e. typical pattern of ictal epileptic activity on CFM without clinical symptoms or signs of convulsions. The occurrence of silent seizures and their pattern in relation to the clinical condition and management was unpredictable in most cases. Besides general limpness or flaccidity in an outward quiet baby these infants showed no clinical fits or clonic convulsions. The findings indicate that anticonvulsive therapy in small infants may be insufficient and need re-evaluation, since the long-term effect of silent seizures on cerebral function and activity is still uncertain.
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| 10. |
- Svenningsen, N W, et al.
(författare)
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Neonatal outcome of extremely small low birthweight liveborn infants below 901 g in a Swedish population
- 1989
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Ingår i: Acta Paediatrica Scandinavica. - : Wiley. - 0001-656X .- 0803-5253 .- 1651-2227. ; 78:2, s. 180-188
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Tidskriftsartikel (refereegranskat)abstract
- In a regional population of 32,120 liveborn newborn infants 65 (0.2%) had a birthweight less than or equal to 900 g (extremely small low birthweight = ESLBW) with mean gestational age 26.4 (range 22-31) completed weeks of gestation. The total 0-1 year survival rate was 48%. For the 42 infants treated in the Level III regional neonatal intensive care unit (NICU) the 0-1 year survival rate was 55% versus 34% for 23 infants not transferred to the Level III unit. In the ESLBW infants treated in the regional NICU the major complications were respiratory disorders requiring artificial ventilation (73%), bronchopulmonary dysplasia (26%), intracranial haemorrhages (40%), symptomatic persistent ductus arteriosus (36%) and sepsis (14%), persistent retinopathy of prematurity (8%). Duration of NICU treatment was 51 days (range 10-95) for survivors. Mode of delivery and rate of perinatal complications did not differ between survivors and non-survivors. Previous legal abortion occurred in 24%, fertility problems in 29% and 21% of the mothers were immigrants. Otherwise no significant abnormalities were found in maternal or socioeconomic conditions. Factors deciding neonatal outcome in the tiniest babies seem to be a combination of prenatal circumstances and neonatal minute fine care procedures.
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