The Predictive Value of Amplitude-Integrated Electroencephalography for the Neurodevelopmental Outcomes of Preterm Newborns at 12 Months Corrected Age.

BACKGROUND: In clinical practice, it is crucial to identify diagnostic methods that can forecast the neurodevelopmental outcomes of very preterm neonates. Our study aimed to assess the predictive significance of amplitude-integrated electroencephalography (aEEG) for the neurodevelopmental outcomes of preterm infants at 12 months corrected age and to establish the cut-off score that could indicate potential neurodevelopmental impairments. METHODS: Preterm neonates born before 32 weeks of gestational age between June 2020 and July 2022 were included in a prospective manner. Amplitude-integrated electroencephalography recordings were conducted at five age intervals (days 1-3; first, second, third and fourth weeks). Recordings were analyzed using the Burdjalov scoring system. The neurodevelopment assessment with Bayley Scales of Infant Development-Second Edition was carried out at 12 months corrected age. RESULTS: A total of 140 newborns were included in the study. Neurodevelopment was assessed in 108 infants at 12 months corrected age. Higher total aEEG Burdjalov scores were observed in groups with normal cognitive and motor development. The most sensitive and specific score for prediction of cognitive impairment in 12 months corrected age was an aEEG evaluation of 5.5 according to Burdjalov score within the first three days. The most sensitive and specific score for prediction of motor impairment was 8.5 within the first week. CONCLUSIONS: According to our research there is currently not enough data to accurately foresee the development of newborns at 12 months corrected age according to early aEEG test results. However, conducting a research with bigger sample size and repeated evaluations at a later age might increase the prognostic value of aEEG. In this study cut-off scores of aEEG performed early in life to predict later neurodevelopment outcomes were determined.

Impact of Early Nutrient Intake and First Year Growth on Neurodevelopment of Very Low Birth Weight Newborns.

Optimal nutrient intake ensuring better neurodevelopment for very low birth weight (VLBW) infants remains unknown. The aim of this study was to assess the relationship between early (first 28 days) nutritional intake, first year growth, and neurodevelopment. In total, 120 VLBW infants were included into the study. A group of 95 infants completed follow-up to 12 months of corrected gestational age (CGA). Nutrient intake was assessed, and weight, length, and head circumference (HC) were measured weekly until discharge and at 3, 6, 9, and 12 months of CGA. Neurodevelopment was assessed at 12 months of CGA. Two groups-extremely preterm (EP) and very/moderately preterm (VP)-were compared. Growth before discharge was slower in the EP group than the VP group. At 12 months, there was no difference in anthropometric characteristics or neurodevelopmental scores between the groups. Higher carbohydrate intake during the first 28 days was the single significant predictor for better cognitive scores only in the EP group (ßs = 0.60, p = 0.017). Other nutrients and growth before discharge were not significant for cognitive and motor scores in either group in multivariable models, whereas post-discharge HC growth was associated with both cognitive and motor scores in the VP group. Monitoring intake of all nutrients and both pre-discharge and post-discharge growth is essential for gaining knowledge about individualized nutrition for optimal neurodevelopment.

Long-Term Outcomes of Perinatal Hypoxia and Asphyxia at an Early School Age.

Background and Objectives: Late long-term outcomes of perinatal asphyxia (PA) in school-age are often unclear. To assess long-term outcomes at an early school age in children who had experienced perinatal hypoxia or asphyxia, where therapeutic hypothermia was not applied. Materials and Methods: The case group children were 8-9-year-old children (n = 32) who were born at full term and experienced hypoxia or asphyxia at birth, where therapeutic hypothermia (TH) was not applied. The control group consisted of 8-9-year-old children (n = 16) born without hypoxia. A structured neurological examination was performed at an early school age. The neuromotor function was assessed using the Gross Motor Function Classification System (GMFCS). Health-related quality-of-life was assessed using the Health Utilities Index (HUI) questionnaire. Intellectual abilities were assessed using the Wechsler Intelligence Scale for Children (WISC). Results: The case group, compared with controls, had significantly (p = 0.002) lower mean [SD] full-scale IQ (87(16.86) vs. 107(12.15)), verbal-scale IQ (89(17.45) vs. 105(11.55)), verbal comprehension index (89(17.36) vs. 105(10.74)), working memory index (89(15.68) vs. 104(11.84)), performance IQ (87(16.51) vs. 108(15.48)) and perceptual organization index (85(15.71) vs. 105(15.93)). We did not find any significant differences in the incidence of disorders of neurological examination, movement abilities and health-related quality of life at an early school age between the case and the control group children. Conclusion: In children who experienced perinatal asphyxia but did not have cerebral paralysis (CP), where therapeutic hypothermia was not applied, cognitive assessment scores at an early school age were significantly lower compared to those in the group of healthy children, and were at a low average level.

Influence of Parenteral Nutrition Delivery Techniques on Growth and Neurodevelopment of Very Low Birth Weight Newborns: A Randomized Trial.

Background and Objectives: In very low birth weight (VLBW) newborns, parenteral nutrition (PN) is delivered via a peripheral venous catheter (PVC), a central venous catheter (CVC), or a peripherally inserted central venous catheter (PICC). Up to 45% of PICCs are accompanied by complications, the most common being sepsis. A PVC is an unstable PN delivery technique requiring frequent change. The growth and neurodevelopment of VLBW newborns may be disturbed because of catheters used for early PN delivery and complications thereof. The aim of the conducted study was to evaluate the effect of two PN delivery techniques (PICC and PVC) on anthropometric parameters and neurodevelopment of VLBW newborns. Materials and Methods: A prospective randomized clinical trial was conducted in VLBW (≥750⁻<1500 g) newborns that met the inclusion criteria and were randomized into two groups: PICC and PVC. We assessed short-term outcomes (i.e., anthropometric parameters from birth until corrected age (CA) 36 weeks) and long-term outcomes (i.e., anthropometric parameters from CA 3 months to 12 months as well as neurodevelopment at CA 12 months according to the Bayley II scale). Results: In total, 108 newborns (57 in the PICC group and 51 in the PVC group) were randomized. Short-term outcomes were assessed in 47 and 38 subjects, and long-term outcomes and neurodevelopment were assessed in 38 and 33 subjects of PICC and PVC groups, respectively. There were no differences observed in anthropometric parameters between the subjects of the two groups in the short- and long-term. Mental development index (MDI) < 85 was observed in 26.3% and 21.2% (p = 0.781), and psychomotor development index (PDI) < 85 was observed in 39.5% and 54.5% (p = 0.239) of PICC and PVC subjects, respectively. Conclusions: In the short- and long-term, no differences were observed in the anthropometric parameters of newborns in both groups. At CA 12 months, there was no difference in neurodevelopment in both groups.

The relationship between pain catastrophizing, kinesiophobia and subjective knee function during rehabilitation following anterior cruciate ligament reconstruction and meniscectomy: A pilot study.

BACKGROUND AND OBJECTIVE: Psychological responses to the initial injury and rehabilitation might be an important additional determinant of functional level outcomes after knee surgery. The objectives of this study were (1) to measure pain catastrophizing and kinesiophobia levels and (2) determine their association with self-reported subjective knee function during rehabilitation, following anterior cruciate ligament reconstruction (ACLR) and meniscectomy. MATERIALS AND METHODS: The study involved 41 participants. The levels of catastrophizing (Pain Catastrophizing Scale [PCS]), kinesiophobia (Tampa Scale of Kinesiophobia [TSK-11]), pain (Numeric Pain Rating Scale [NRS]), and subjective knee function (the Knee Injury and Osteoarthritis Outcome Score [KOOS]) were assessed before and after completion of 14-session rehabilitation program. RESULTS: The mean level of catastrophizing changed from 5.8 (SD, 0.9) to 4.2 (SD, 0.5) during rehabilitation (P<0.05). The mean level of kinesiophobia changed from 22.7 (SD, 0.7) to 18.4 (SD, 0.6) (P<0.05). There was a moderate negative correlation between the PCS and the KOOS pain, function in daily living, knee-related quality of life subscales before and after rehabilitation (P<0.05). There was a moderate negative correlation between the TSK-11 score and the KOOS function in daily living subscale before and after rehabilitation (P<0.05). CONCLUSIONS: Pain catastrophizing and kinesiophobia decreased during rehabilitation. A higher pain catastrophizing level correlated with a greater level of knee pain during activities, more difficulties experienced during daily activities before and after rehabilitation. A high level of kinesiophobia correlated with more difficulties experienced in daily activities and poorer knee-related quality of life before and after rehabilitation.

Epidemiology of paediatric burns in Lithuania: focus on a vulnerable population exposed to the risk of scalds at home without hot tap water supply.

OBJECTIVE: To describe the epidemiology of paediatric burns in Lithuania, identify the trends of burn occurrence, the vulnerable population and aetiology. METHODS: This study was based on all inclusive national information obtained from the National Health Insurance database for the period of 2001-2010. Information on the burns aetiology was collected in the Hospital of Lithuanian University of Heath Sciences Kauno Klinikos. FINDINGS: 7146 children in the age group of 0-14 were hospitalized in Lithuania and constituted 44% of all admissions due to burns. The incidence among boys was 149.8 and among girls 99.9 per 100,000. The highest risk of burns was observed from 11 to 15 months of age. Scalding in 0-1 years age group composed 96% of all burns in this age group. CONCLUSION: Children younger than 2 years of age are a vulnerable population of burns in Lithuania. Scalding was main cause of their burns. The aetiological subgroups of scalding were scalding with hot drinks/food and scalding with hot water meant for household. The major part of scalding with hot drinks was due to scalding with parents' drinks. Scalding with hot water meant for household is associated with the lack of hot water supply.

Effect of visual feedback information on isometric contraction of forearm flexor muscles in men and women after ischemic stroke.

UNLABELLED: The aim of this study was to determine the effect of visual feedback information (VFI) on the isometric contraction of the forearm flexor muscles in men and women after an ischemic stroke when doing a physical load at 20% of strength. MATERIAL AND METHODS: The study included healthy subjects (n=20) and subjects after ischemic stroke (n=20). The study was conducted in Lithuanian Sports University. The measurements of maximum voluntary strength (MVS) and accurate isometric contraction were performed using an isokinetic dynamometer Biodex System Pro 3. RESULTS: The absolute errors of isometric contraction of the right arm muscles at 20% of MVS were similar in all the groups during the attempt with visual feedback information. The smallest absolute errors of the healthy subjects were 1.42±0.35 Nm when the task was performed with visual feedback and the greatest absolute errors were 4.69±0.95 Nm (P<0.01) while performing the task without visual feedback. Meanwhile, the smallest and greatest absolute errors of the subjects after ischemic stroke were 1.32±0.45 Nm and 5.05±0.63 Nm, respectively, while performing the task without visual feedback (P<0.01). CONCLUSIONS: Maximum voluntary strength was greater in all the groups of men. The absolute errors of isometric contractions of the right and left arm muscles tended to increase in both the men and the women when there was no visual feedback information. The women and the men after an ischemic stroke produced greater absolute errors when performing the task with the right and left arm without visual feedback information than the healthy subjects.

Gender-dependent bimanual task performance.

BACKGROUND AND OBJECTIVE: Many studies have suggested that each hand has a different special talent; however, there is a lack of data in the area of goal-directed bimanual hand coordination and its dependence on gender. The aim of this paper was to investigate gender-dependent bimanual speed-accuracy task performance. MATERIAL AND METHODS: Twelve healthy young males and twelve healthy young females (all right-handed) performed protractile movements with both arms simultaneously by pushing joysticks toward two targets as quickly and accurately as possible. RESULTS: Though no significant difference was observed in the reaction time during a unimanual speed-accuracy task between the left and right hands as well as men and women, during a bimanual task, the reaction time of both the hands was significantly longer in women than men. There was no significant difference in the velocity of both the hands during a bimanual speed-accuracy task between men and women, while the accuracy of the left hand was significantly greater in men than women. There was no significant difference in intraindividual variability in the reaction time, maximal velocity, and path of movement between men and women as well as the left and right hands, but variability in the average velocity of the right hand both in women and men was significantly greater compared with their left hand. CONCLUSIONS: Whereas people typically look at the target location for a reaching movement, it is possible that two objects are simultaneously fixated.

[The evaluation of psychomotor development in preterm infants]. / Pirma laiko gimusiu kudikiu psichomotorines raidos ivertinimas.

UNLABELLED: The aim of this study was to assess psychomotor development of very-low-birth-weight infants. MATERIAL AND METHODS: A prospective study was carried out in the Clinic of Neonatology, Kaunas University of Medicine Hospital. Two groups of infants were selected: the study group consisted of 79 preterm infants treated in the Clinic of Neonatology; the control group consisted of 31 term infants. Psychomotor development of the infants was evaluated five times at the age of 1, 3, 6, 9, and 12 months by using the Bayley Scales of Infant Development. RESULTS: The results showed that at the age of 1 month, a significantly delayed psychomotor development was noted in 15.2% of preterm infants and in none of term infants; moderately delayed development - in 25.3% of preterm infants and in none of term infants; normal - in 54.4% and 90.3%, respectively; and accelerated development - 5.1% and 9.7%, respectively. At the age of 12 months, 21.8% of preterm infants and none of term infants showed a significantly delayed psychomotor development; 26.9% of study group patents and none in control group - moderately delayed development; 51.3% and 93.5%, respectively - normal development; and 6.5% and none, respectively - accelerated development. CONCLUSION: Psychomotor development of preterm infants is retarded during all first year of life.

[The assessment of infant motor development disorders in primary health care institutions]. / Vaiku motorines raidos sutrikimu vertinimas pirmineje sveikatos prieziuros grandyje.

OBJECTIVE: The delay or disorders of infant motor development require early screening and treatment. The objective of this study was to investigate the possibilities to assess infant motor development disorders in primary health care institutions of central part of Lithuania. MATERIALS AND METHODS: The original questionnaires were sent to primary health care institutions of Kaunas district. One-hundred-forty-eight questionnaires with answers of General Practitioners and Pediatricians returned to investigators. RESULTS: Analysing the data we found that one physician in average takes care of 28.8 +/- 18.4 infants, among these infants 3.55 +/- 4.2 have disorders of motor development. Most of the doctors (92.6%) evaluate the infant motor development, but use only the method of routine clinical assessment. Very few physicians (4.8%) use very precise methods of assessment (Munich diagnostic scheme or Bobath method). Among all doctors 66.9% expressed the will to asses infant motor development by themselves in primary health care clinic. CONCLUSIONS: We conclude, that General Practitioners and Pediatricians feel the lack of competence and assistant aids for the assessment of motor development disorders in infants.