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Biomedical subjects

R W Coen

Publications and source records attributed to R W Coen.

32 records · Page 2Linked to original sources
PubMed1976

Training of personnel-pediatrics.

The educational programs that have been developed in newborn special care facilities have two purposes: first, they teach personnel the manual skills that are necessary to manage the sick newborn infant; second, they provide personnel with a better understanding of neonatal pathophysiology so that they can begin to recognize the subtle responses of the sick neonate. With these skills and knowledge, the nursery staff assumes a more active role in the team's effort to preserve a child's life.

Education, Continuing↗
PubMedDate not supplied

Prognostic value of EEG in neonatal meningitis: retrospective study of 29 infants.

Neonatal meningitis is associated with significant neurologic sequelae. Previous studies from our laboratory and others demonstrated electroencephalography (EEG) to be a useful tool in predicting long-term neurologic outcome in at-risk neonates. We, therefore, retrospectively studied 29 infants with culture-proved neonatal meningitis who died in the neonatal period or survived to follow-up at a mean of 34.4 months. Seventy-five EEGs were obtained during the acute phase of infection; the degree of EEG background abnormality proved to be an accurate predictor of outcome. Infants who had normal or mildly abnormal backgrounds had normal outcomes, whereas those with markedly abnormal EEGs died or manifested severe neurologic sequelae at follow-up. When the EEG was considered with the presence or absence of seizures and the level of consciousness, an accurate prediction of neurologic outcome was obtained in 27 infants (93%). Although the EEG patterns were generally nonspecific, some abnormalities, such as positive rolandic sharp waves, persistent hemispheric or focal voltage attenuation, suggested more specific pathology (i.e., deep white matter necrosis, large-vessel infarction and abscess, respectively). EEG was also valuable for the recognition of subtle and subclinical seizures. Therefore, we conclude that EEG is a valuable tool for predicting the long-term prognoses of infants with neonatal meningitis.

Birth Weight↗
PubMedDate not supplied

Survival of a preterm twin following infarction of the right hepatic lobe.

Survival following hemorrhagic necrosis of a lobe of the liver in preterm infants is very uncommon. We present the clinical and radiologic findings of such a case, discuss the clinical management of the hemorrhage that resulted in the infant's survival, and present a basis for the evolution of the liver pathology.

Diseases in Twins↗
PubMedDate not supplied

Focal necrosis of the white matter (periventricular leukomalacia): sonographic, pathologic, and electroencephalographic features.

Eleven preterm infants (gestational ages 27-35 weeks) with echogenic paraventricular white matter identified shortly after birth were studied with serial echoencephalograms to fully delineate the sonographic findings characterizing the pathologic stages of white-matter necrosis. Echoencephalograms were compared with autopsy findings and CT scans. Cerebral function was assessed by electroencephalograms and later by neurodevelopmental evaluations. Echogenic areas were observed in the paraventricular white matter in the acute stage. Microscopically, the echogenic white matter consisted of vascular congestion and petechial hemorrhages, but not always with foci of necrosis. Anechoic areas, which characterized the chronic stage, corresponded to cavitary lesions, and these generally appeared within 2 weeks of birth. However, six infants had anechoic lesions by day 4, suggesting that the onset of white-matter damage was antenatal. CT showed mildly decreased attenuation when paraventricular echogenic areas alone or in association with small anechoic areas were observed. Markedly decreased attenuation on CT scans corresponded to large anechoic areas. Resolution of the sonographic and CT findings did not indicate normalization of the white matter since all surviving infants were neurologically abnormal at 1 year. Electroencephalograms with central (rolandic) positive sharp waves were associated with echogenic white matter alone or with evolving anechoic areas. All patients with positive sharp waves on electroencephalograms had large anechoic areas in later studies. Early and serial echoencephalograms are necessary to evaluate white-matter necrosis in preterm infants. When echogenic white matter is identified, electroencephalography can suggest the presence of white-matter necrosis.

Echoencephalography↗
PubMedDate not supplied

Bilirubinemia in asphyxiated term infants. A clinical observation.

Recent clinical observations suggested that serum bilirubin levels remain low following perinatal asphyxia. This study was performed to determine the peak serum bilirubin concentrations in asphyxiated term infants and to compare these levels with those in a group of non-asphyxiated term infants. The medical records of 28 asphyxiated (Apgar < 7 at 5 minutes) and 947 non-asphyxiated term infants born during the same period of time were reviewed to obtain data on peak serum bilirubin concentrations for statistical comparison. The statistical mean for the peak serum bilirubin concentrations in the 28 asphyxiated infants was 5.0 mg/dl (+3.1 SD) while that for the 947 non-asphyxiated infants was 8.9 mg/dl (+3.7, p < .001). The findings in this study indicate that low peak bilirubin levels should be expected in asphyxiated term infants and may be helpful as a biochemical marker before the mechanism of action is known.

Asphyxia↗