The Experts below are selected from a list of 309 Experts worldwide ranked by ideXlab platform
Charles R Newton - One of the best experts on this subject based on the ideXlab platform.
-
long term neurodevelopmental outcomes after intrauterine and neonatal insults a systematic review
The Lancet, 2012Co-Authors: Michael K Mwaniki, Maurine Atieno, Joy E Lawn, Charles R NewtonAbstract:Summary Background Neonatal interventions are largely focused on reduction of mortality and progression towards Millennium Development Goal 4 (child survival). However, little is known about the global burden of long-term consequences of intrauterine and neonatal insults. We did a systematic review to estimate risks of long-term neurocognitive and other Sequelae after intrauterine and neonatal insults, especially in low-income and middle-income countries. Methods We searched Medline, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, and Embase for studies published between Jan 1, 1966, and June 30, 2011, that reported neurodevelopmental Sequelae after preterm or neonatal insult. For unpublished studies and grey literature, we searched Dissertation Abstracts International and the WHO library. We reviewed publications that had data for long-term outcome after defined neonatal insults. We summarised the results with medians and IQRs, and calculated the risk of at least one Sequela after insult. Findings Of 28 212 studies identified by our search, 153 studies were suitable for inclusion, documenting 22 161 survivors of intrauterine or neonatal insults. The overall median risk of at least one Sequela in any domain was 39·4% (IQR 20·0–54·8), with a risk of at least one severe impairment in any insult domain of 18·5% (7·7–33·3), of at least one moderate impairment of 5·0% (0·0–13·3%), and of at least one mild impairment of 10·0% (1·4–17·9%). The pooled risk estimate of at least one Sequela (weighted mean) associated with one or more of the insults studied (excluding HIV) was 37·0% (95% CI 27·0–48·0%) and this risk was not significantly affected by region, duration of the follow-up, study design, or period of data collection. The most common Sequelae were learning difficulties, cognition, or developmental delay (n=4032; 59%); cerebral palsy (n=1472; 21%); hearing impairment (n=1340; 20%); and visual impairment (n=1228; 18%). Only 40 (26%) studies included data for multidomain impairments. These studies included 2815 individuals, of whom 1048 (37%) had impairments, with 334 (32%) having multiple impairments. Interpretation Intrauterine and neonatal insults have a high risk of causing substantial long-term neurological morbidity. Comparable cohort studies in resource-poor regions should be done to properly assess the burden of these conditions, and long-term outcomes, such as chronic disease, and to inform policy and programme investments. Funding The Bill & Melinda Gates Foundation, Saving Newborn Lives, and the Wellcome Trust.
James M House - One of the best experts on this subject based on the ideXlab platform.
-
enophthalmos a Sequela of maxillary sinusitis
American Journal of Neuroradiology, 1995Co-Authors: James M HouseAbstract:Enophthalmos developed in a 44-year-old woman with history of respiratory infection but not of sinus disease. Sinus roentgenograms and MR revealed opacification of the right maxillary antrum, deviation of the nasal septum to the right, obstruction of the right osteomeatal complex, and diminished volume of the right maxillary sinus.
-
enophthalmos a Sequela of maxillary sinusitis
American Journal of Neuroradiology, 1995Co-Authors: Ross T Eto, James M HouseAbstract:Enophthalmos developed in a 44-year-old woman with history of respiratory infection but not of sinus disease. Sinus roentgenograms and MR revealed opacification of the right maxillary antrum, deviation of the nasal septum to the right, obstruction of the right osteomeatal complex, and diminished volume of the right maxillary sinus.
Sergio Stagno - One of the best experts on this subject based on the ideXlab platform.
-
congenital cytomegalovirus infection following first trimester maternal infection symptoms at birth and outcome
Journal of Clinical Virology, 2006Co-Authors: Robert F Pass, Karen B Fowler, Suresh B Boppana, William J Britt, Sergio StagnoAbstract:Background: The relationship between gestational age at time of maternal cytomegalovirus (CMV) infection and outcome of fetal infection is not well defined because the timing of maternal infection is usually not known. Objective: To determine whether congenital cytomegalovirus (CMV) infection following primary maternal infection during the first trimester of pregnancy is more likely to lead to central nervous system (CNS) Sequelae than fetal infection due to maternal infection later in pregnancy. Study design: Using serum collected during pregnancy from mothers of newborns with congenital CMV infection, maternal infection was categorized as first trimester (<13 weeks) or later based on dates and results of IgG and IgM assays for CMV antibody. Outcome of congenital CMV infection was assessed by longitudinal fotlow-up of the infected cohort. Results: Sensorineural hearing loss was found in 8/34 (24%) of children in the first trimester group, compared with 1/40 (2.5%) in the later infection group (P = 0.01, relative risk, 9.6). Considering any CNS Sequela (hearing loss, mental retardation, cerebral palsy, seizures, chorioretinitis) 11/34 (32%) first trimester cases were affected compared with 6/40 (15%) in the later infection group ( P = 0.07, relative risk 2.2). None of the later group had more than one Sequela, compared with 4 (12%) of the first trimester group ( P = 0.04). Conclusions: Children with congenital CMV infection following first trimester maternal infection are more likely to have CNS Sequelae, especially sensorineural hearing loss, than are those whose mothers were infected later in pregnancy. However, some degree of CNS impairment can follow even late gestational infection. © 2005 Elsevier B.V. All rights reserved.
Ross T Eto - One of the best experts on this subject based on the ideXlab platform.
-
enophthalmos a Sequela of maxillary sinusitis
American Journal of Neuroradiology, 1995Co-Authors: Ross T Eto, James M HouseAbstract:Enophthalmos developed in a 44-year-old woman with history of respiratory infection but not of sinus disease. Sinus roentgenograms and MR revealed opacification of the right maxillary antrum, deviation of the nasal septum to the right, obstruction of the right osteomeatal complex, and diminished volume of the right maxillary sinus.
Louis-rachid Salmi - One of the best experts on this subject based on the ideXlab platform.
-
Hygiene promotion might be better than serological screening to deal with Cytomegalovirus infection during pregnancy: a methodological appraisal and decision analysis
BMC Infectious Diseases, 2020Co-Authors: Agathe Billette De Villemeur, Pierre Tattevin, Louis-rachid SalmiAbstract:Background: Cytomegalovirus infection is the most frequent viral congenital infection, with possible consequences such as deafness, or psychomotor retardation. In 2016, the French High Council of Public Health was mandated to update recommendations regarding prevention of cytomegalovirus infection in pregnant women. We summarize a critical appraisal of knowledge and deterministic decision analysis comparing the current no-screening situation to serological screening during pregnancy, and to hygiene promotion. Methods: Screening was defined as systematic serological testing, during the first trimester, with repeated tests as needed, to all pregnant women. Outcomes were: 1) severe Sequela: intellectual deficiency with IQ ≤ 50 or hearing impairment < 70 dB or sight impairment (≤ 3/10 at best eye); 2) moderate Sequela: any level of intellectual, hearing or sight deficiency; and 3) death or termination of pregnancy. We simulated the one-year course of cytomegalovirus infection in a cohort of 800,000 pregnant women. We developed a deterministic decision model, using best and min-max estimates, extracted from systematic reviews or original studies. Results: Relevant data were scarce or imprecise. We estimated that 4352 maternal primary infections would result in 1741 foetal infections, and an unknown number of maternal reinfections would result in 1699 foetal infections. There would be 788 cytomegalovirus-related consequences, including 316 foetal deaths or terminations of pregnancy, and 424 moderate and 48 severe Sequelae. Screening would result in a 1.66-fold increase of poor outcomes, mostly related to a 2.93-fold increase in deaths and terminations of pregnancy, not compensated by the decrease in severe symptomatic newborns. The promotion of hygiene would result in a 0.75-fold decrease of poor outcomes, related to both a decrease in severe Sequelae among symptomatic newborns (RR = 0.75; min-max: 1.00-0.68), and in deaths and terminations of pregnancy (RR = 0.75; min-max: 0.97-0.68). Conclusions: Prevention of cytomegalovirus infection during pregnancy should promote hygiene; serological screening should not be recommended.
