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发布于:2018-6-14 19:23:50  访问:3 次 回复:0 篇
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Apparently You Also Make These Kinds Of Mistakes With FG-4592 !
Children with longer insults tended to have damage both to the deep grey matter and to the subcortical white matter. Barkovich‘s group in San Francisco21 have impressive experience of MRI, studying over 6000 cases of neonatal encephalopathy in term and near-term babies. Their carefully performed and sequential MRI studies, which include spectroscopy, were targeted at determining when the insult occurred, not how long it lasted. These interesting serial studies show that some babies probably Quetiapine sustain their brain damage 2�C3 days before birth but they do not shed much light on the duration of insult required to damage the neonatal brain. A review of the literature22 reporting fetal survival after maternal cardiac arrest reveals that few infants delivered >10 minutes after maternal collapse requiring resuscitation survive to be healthy individuals, although there were some normal survivors in the group delivered between 11�C15 minutes afterwards. Uterine rupture can be a catastrophic event for the fetus, particularly if it results in extrusion from the uterus; the human fetus is probably exposed to a situation that is close to that of the primate experiments. In a retrospective study23 of 106 cases Selleckchem BIRB 796 of uterine rupture between 1983 and 1992, five babies were diagnosed as having asphyxia (there was no long-term follow up or MRI). A prolonged deceleration was defined as a fetal heart rate <90 for more than a minute, but there was only one such case in the asphyxiated group that did not have prior CTG abnormalities. The authors concluded that fetuses who were exposed to prolonged deceleration could survive without asphyxia if they were delivered before 17 minutes had elapsed, but several babies developed neonatal morbidity after 10 minutes of a prolonged deceleration if there had been previous late FG-4592 clinical trial decelerations (range 36�C90 minutes). These data support the evidence provided by the primate studies regarding a worse outcome if an acute near-total insult is superimposed on a previous episode of partial hypoxia. More recently, a study of 23 cases of complete uterine rupture in Quebec24 showed that a diagnosis of hypoxic ischaemic encephalopathy was made in three and a further baby died. The three babies with hypoxic ischaemic encephalopathy were delivered 15,16 and 23 minutes after the onset of a prolonged fetal heart rate deceleration; all three were completely extruded from the uterus, had a metabolic acidosis at birth and developed motor delay. Phelan and Ahn25 found that permanent brain injury occurred after 18 minutes with a heart rate <60 bpm (this was the shortest known duration of insult in this study). Pasternak and Gorey5 describe a baby born after a uterine rupture and 10�C15 minutes of bradycardia who never developed the ability to feed and who died before discharge.
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