Cortical Auditory-Evoked Responses in Preterm Neonates: Revisited by Spectral and Temporal Analyses.

Characteristic preterm EEG patterns of "Delta-brushes" (DBs) have been reported in the temporal cortex following auditory stimuli, but their spatio-temporal dynamics remains elusive. Using 32-electrode EEG recordings and co-registration of electrodes' position to 3D-MRI of age-matched neonates, we explored the cortical auditory-evoked responses (AERs) after 'click' stimuli in 30 healthy neonates aged 30-38 post-menstrual weeks (PMW). (1) We visually identified auditory-evoked DBs within AERs in all the babies between 30 and 33 PMW and a decreasing response rate afterwards. (2) The AERs showed an increase in EEG power from delta to gamma frequency bands over the middle and posterior temporal regions with higher values in quiet sleep and on the right. (3) Time-frequency and averaging analyses showed that the delta component of DBs, which negatively peaked around 550 and 750 ms over the middle and posterior temporal regions, respectively, was superimposed with fast (alpha-gamma) oscillations and corresponded to the late part of the cortical auditory-evoked potential (CAEP), a feature missed when using classical CAEP processing. As evoked DBs rate and AERs delta to alpha frequency power decreased until full term, auditory-evoked DBs are thus associated with the prenatal development of auditory processing and may suggest an early emerging hemispheric specialization.

[Cost comparison of two reprocessing procedures of flexible ureteroscopes at the University Hospital of Dijon]. / Comparaison de coûts de deux modalités de retraitement des urétéroscopes souples au CHU de Dijon.

INTRODUCTION: The University Hospital of Dijon has selected sterilization for some of its flexible endoscopes. The decision came as part of an acquisition of a low-temperature sterilizer. The objective is to compare the actual cost of reprocessing a heat-sensitive ureteroscope by sterilization to a high-level disinfection (HLD) in semi-automatic bench. MATERIAL AND METHODS: From June 1 to December 31, 2013, the ureteroscope has been exclusively reprocessed by low-temperature sterilization (LTS). In parallel, the theorical number of peracetic acid disinfection that should have been made was simulated. An observational study of actual costs by micro-costing technique allowed us to determine the set of resources consumed by each of these strategies. Specific costs of sterilization were from the billing terms provided with the central sterile services department. RESULTS: During the 7 months of study, the ureteroscope was used and sterilized 11 times. Thirty-two chemical disinfection procedures would have been necessary. Comparing these two strategies, a cost difference is highlighted for the LTS with a real economy of 43.8% compared with HLD (1154.77 € versus 649.40 €). CONCLUSION: All in all, this micro-economic study confirms and strengthens our previous decision for selecting LTS for heat-sensitive ureteroscopes. On top of better micro-economic outcomes, it also provides benefits in theoretical risk analysis of transmission of infection.

[Autism and prematurity: state of the art]. / Autisme et prématurité : état des lieux.

Research has shown a high rate of autism spectrum disorders among very low birth weight children over the past decade. This paper proposes a literature review on this topic. Two generations of research have followed one another. The first retrospective studies found a high rate of ASD among premature babies. The second generation of prospective studies underlined and relativized this risk. Prospective research using screening tools (M-CHAT) have found around 20 % ASD, whereas 2 studies assessing the actual diagnosis found 5 % and 8 % ASD, 10 to 12 times more than in the general population. A number of hypotheses have been put forward to explain these high rates of ASD: sensory impairment associated with prematurity, white matter abnormalities, and cerebellar impairment. The authors propose complex models that take into account neurological deficits and the effects of perinatal events on interactive dynamics between infants and their caregivers. These models aim to allow suitable prevention and care for premature children with autism, a heavy additional handicap.