Our findings suggest that prenatal opioids affect later brain function, visible through changes in BOLD activation patterns. However, results should be considered preliminary until replicated in larger samples better suited to control for potential confounding factors.
Aims: To describe the care patterns of patients with repeated referrals to both mental and somatic specialist healthcare, and to study their diagnostic processes.Methods: In a previous register study patients aged 6–12 years referred to Haukeland University Hospital from 2013 to 2015, we found 922 children with at least three referrals including both somatic and mental health services. Of these, more than one in four (250) were randomly selected and observed from their first hospital episode ever and further after inclusion followed during their next three referrals or until July 2017. Data on referral patterns and diagnostics were collected from patient hospital records.Results: Mean number of referrals was 6.5 prior to inclusion and 4.2 in the follow-up period. At the end of the study period 15% of patients still had a non-specific diagnosis. During the follow-up period, more than half of the children were again referred across the border between somatic and mental healthcare.Conclusion: Very complex care patterns were found for these patients, who were repeatedly being referred and “crossing over” between mental and somatic healthcare. This indicates a need for more interdisciplinary-based approaches both within specialist care and between different care levels to broaden the perspective and achieve shorter time lag before reaching a diagnostic conclusion.Trial Registration: Data was obtained from Haukeland university hospital the patient registry system No. 2017/12470. Start of registration was April 1th 2017 and patients included was from 2013 to 15.
The extremely preterm, very preterm, and term subjects shared the same morphological pathology, revealing no specific preterm MRI pattern, but both premature cohorts had higher frequencies. Differences were mainly limited to mild pathology. Whether MRI lesions were more common in the extremely preterm than in the very preterm group is uncertain as the difference in frequency was similar in the two control groups, suggesting a lack of objective criteria for differentiating mild pathology from normality or that MRI scans normally differ at 11 and 19 years of age.
The purpose of the study was to investigate a possible association between brain activation in functional magnetic resonance imaging scans, cognition and school performance in extremely preterm children and term born controls. Twenty eight preterm and 28 term born children were scanned while performing a working memory/selective attention task, and school results from national standardized tests were collected. Brain activation maps reflected difference in cognitive skills but not in school performance. Differences in brain activation were found between children born preterm and at term, and between high and low performers in cognitive tests. However, the differences were located in different brain areas. The implication may be that lack of cognitive skills does not alone explain low performance due to prematurity.
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