Biomedical subjects

M Moya

Publications and source records attributed to M Moya.

97 records · Page 6Linked to original sources

PubMedDate not supplied

[Neuropediatrics in the context of pediatric subspecialties: bibliometric analysis].

INTRODUCTION: There is no detailed information on the scientific production in neuropediatrics (NP) in Spain, and we studied this problem by means of a model of bibliometric analysis. MATERIAL AND METHODS: Retrospective study of all the articles published in the main pediatric Spanish journal (An Esp Pediatr) over a 13 years period (1984-96). Quantitative and qualitative bibliometric indicators of the articles over NP were performed. RESULTS: NP is the subject matter in 7.8% (n = 235) of all the articles published in An Esp Pediatr, the fifth subspecialty in productivity. The main type of articles in NP are Clinical notes (55.3%), double than Originals (29.8%). It is important the absolute productivity of two hospitals (La Paz and Sant Joan de Déu), and the relative productivity of others (Xeral de Galicia, Valdecilla, Ramón y Cajal, etc.). The median of authors (5) and the references (15) per article are similar than other biomedical publications. The essential authorship of the scientific activity in NP fall on hospitals, with poor authorship on University and Health Care Centers. Two unfavorable bibliometric indicators in the articles of NP are: 1. Excessive use of English references (insularity index = 9.54%), and 2. The low statistical accessibility in Original articles (1.81), lower than greater part of the pediatric subspecialties. CONCLUSIONS: NP have a significant quantitative importance in pediatric journals, with some bibliometic indicators that it is suitable to improve: low percentage of Originals with low statistical accessibility, and low insularity index.

Bibliometrics↗

PubMedDate not supplied

[Neurological evolution of asphyctic full-term newborns with severe umbilical acidosis (pHUA <7.00)].

INTRODUCTION AND OBJECTIVE: Umbilical arterial blood pH (pHUA) has become increasingly recognized as the most reliable indication of foetal oxygenation and acid-base condition at birth. In term infants pHUA is a poor predictor of newborn complications associated with perinatal asphyxia (PA), unless the pHUA is less than 7.00. The objective of this article is to analyse the neurologic evolution of asphyctic full-term newborns with severe umbilical acidosis (pHUA < or = 7.00). PATIENTS AND METHODS: One hundred and eighty consecutive asphyxiated term infants were studied during 64 months, and classified in two cohorts: G1 (pHUA < or = 7.00, n = 18) and G2 (pHUA > 7.00, n = 162). Variables prospectively obtained on standard protocol forms from the medical records were derived from a detailed review of the obstetric record, the delivery room management, the detailed neonatal clinical history and the postneonatal follow-up. The perinatal variables were graded as prenatal (gestational and obstetric), neonatal (resuscitation, general data of the newborn, and organic manifestations of asphyxia) and postneonatal (neurologic sequelae with at lest 24 months of follow-up). PA was graded as severe and non-severe, hypoxic-ischemic encephalopathy was based on Levene's criteria, and neurologic sequelae were based on Finer and Amiel-Tisson's criteria. RESULTS: An umbilical artery pH value < or = 7.00 occurred in 0.3% of the total live full-term newborns. In G1 the mean pHUA value was 6.93 +/- 0.06 (range 6.80-7.00) and in G2 the mean pHUA value was 7.17 +/- 0.09 (range 7.01-7.46). The incidence of severe PA was significantly increased in G1 (RR = 4.74, CI 95% = 2.62-8.55, p < 0.001), with more postasphyctic neurologic (RR = 3.72, CI 95% = 2.34-5.92, p < 0.001) and extraneurologic (RR = 3.13, CI 95% = 1.65-5.94, p < 0.01) involvement. But we do not found differences in the incidence of neurologic sequelae between both cohorts. CONCLUSIONS: Term asphyctic newborns with severe umbilical acidosis have worse evolution at short term (more clinical involvement during neonatal period), but not worse evolution at long term (neurologic sequelae). The poor correlation between umbilical acidosis and neurologic prognosis persist when pHUA cut-off is < or = 7.00.

Acidosis↗

PubMedDate not supplied

[Risk factors predictive of neurological sequelae in term newborn infants with perinatal asphyxia].

INTRODUCTION: Perinatal asphyxia (PA) and its neurologic manifestations are the most important cause of brain injury and neurologic sequelae in full-term infants. The objective of this study is to analyze the perinatal risk factors of neurologic sequelae in asphyctic term newborns. PATIENTS AND METHODS: One hundred and fifty-six consecutive asphyctic term infants were studied prospectively during 40 months. PA was graded in two stages (severe and non-severe), hypoxic-ischemic encephalopathy classification was based on Levene's criteria, and neurologic sequelae was based on Finer and Amiel-Tisson's criteria. The perinatal variables were graded as prenatal (gestational and obstetrics), neonatal (resuscitation, general data of the newborn, and organic manifestations of asphyxia) and postneonatal (neurologic sequelae with at least 24 months of follow-up). The relationships between these variables are studied by univariant and multivariant analysis (Cox's regression). RESULTS: PA was graded as severe in 31 cases and non-severe in 125. Neurologic manifestations (hypoxic-ischemic encephalopathy) during neonatal period were present in 25.6%, and extraneurologic manifestations (hypoxic-ischemic disease) in 41.7% cases. The incidence of neurologic sequelae, in 115 asphyxiated full-term infants follow-up at least 24 months, was 16.5% (19 cases). The perinatal variables associated to risk of neurologic sequelae on univariate analysis are variables of neonatal resuscitation (1 minute Apgar score < or = 4, 5 minute Apgar score < or = 6, endotracheal intubation, severity of PA) and variables of systemic manifestations (hypoxic-ischemic encephalopathy, cardiovascular and multi-systemic dysfunction, and mechanical ventilation). But only two variables are independently associated on multivariate analysis: severe PA (RR = 2.82; IC = 1.07-7.39) and hypoxic-ischemic encephalopathy (RR = 4.17; IC = 1.48-11.75). CONCLUSIONS: The best predictive risk factors for the neurological prognosis at follow-up are severe PA at birth and/or evidence of encephalopathy in neonatal period.

Acidosis↗

PubMedDate not supplied

[Neonatal reflexes variability in the normal full term neonate during the neurological exam].

It has been stated that findings in neonatal neurological examinations can play a role as a pointer to adverse developmental outcome. The description of the examinations, and their presence or absence differed among authors without clear reference to their physiological variability ranges. We approached the study of some neonatal behaviours and reflexes in 143 examinations made on 113 healthy newborn babies from the maternity wards by looking at the influence that perinatal environmental factors which are considered normal, can play in these examinations. The results showed that the flexion answer of the Babinski reflex increased significantly between the first and third day of life (c2= 4.4478; p= 0.03495) in the same way there was an increase in the stepping reflex (c2= 3.999; p= 0.04552) in the righting reflex (c2= 4.9342; p= 0.02633) and in the supporting reaction (c2= 11.7874; p= 0.0006). This was significantly reduced in the caesarean section deliveries (c2= 7.1209; p= 0.0076). Head reaction was only detectable during the Brazelton behavioural states 1 to 3 (c2= 3.8911; p= 0.04854) and the same thing happened with the stepping reflex (c2= 4.9370; p= 0.02629). We discuss the utility of neonatal reflexes scoring scales in predicting the neurodevelopmental outcome of the newborn baby.

Female↗

PubMedDate not supplied

Hyperimmunoglobulinemia E syndrome of neonatal onset.

A case of hyperimmunoglobulinemia IgE with recurrent infections of neonatal onset and unfavourable evolution is described. The first clinical finding was the appearance of maculopapular rash in the skin when the child was fifteen days old. From this period onwards, respiratory and cutaneous infections were continuous, leading to a progressive deterioration of the general condition, and malnutrition, which ended fatally at the age of three years. IgE levels were measured on several occasions, this being 17 IU/ml at the onset of the symptoms; afterwards, the mean value was 17.680 IU/ml (Range: 14.9-32.710 IU/ml).

Disease Susceptibility↗

PubMedDate not supplied

[Cerebellar hypoplasia in the newborn: association with respiratory control disorders and mental retardation].

Cerebellum malformations are frequently diagnosed since the advent of the neuroradiological studies (computed tomography, magnetic resonance imaging and ultrasonography). Cerebellar hypoplasia is found in association with a wide variety of neurologic and systemic disorders. Clinical picture in newborn may be different than in other periods of life. Two characteristics are interesting in neonatal period: their relation with abnormal respiratory control and mental retardation. The pathophysiology of cerebellar hypoplasia is uncertain, however experimental studies suggest than an abnormality of the Bergman glia may lead to the observed granulle cell layer deficiency in this malformation. It is tempting to speculate that a similar migrational abnormality in the cerebrum accounts for the intellectual impairment seen in some affected patients. Respiration is a complex neural function requiring precise coordination of numerous neural circuits. Cerebellar hypoplasia may be important in the pathogenetic mechanism of abnormal respiratory control due to cerebellar respiratory control disturbance. Also diaphragmatic dysfunction may occur in association with cerebellar atrophy. We report two newborns with cerebellar hypoplasia (vermis and hemispheres) associated with central respiratory and neurological dysfunction, and mental retardation.

Body Weight↗

PubMedDate not supplied

[Variations in cerebral blood flow in various states of severe neonatal hypoxic-ischemic encephalopathy].

The clinical applications of Doppler sonography are numerous in pediatric practice. Of the all the measurements of arterial signals available, the one that has been most useful used and has proved to be of practical benefit is the Pourcelot resistance index (PI). The change in PI is more sensitive than the real-time image for documentation of the cerebral insult in full-term asphyxia. The PI is much lower and stays lower for several days in the more severely asphyxiated infants and is thus extremely useful for predicting outcome as well. But multiple factors affect the waveform and PI, and it is important to understand how physiological and pathological variables influence chances in the Doppler signal in order to better understand changes in newborn with neurological problems. We present the changes of cerebral blood flow by Doppler ultrasound in a newborn with severe perinatal asphyxia and hypoxic-ischemic encephalopathy, associated with other neurological problems; coma, seizures and hydrocephalus.

Asphyxia Neonatorum↗