33 Congenital Cytomegalovirus (Cmv) Infection and Intellectual Development

Abstract

CATHETERIZATION. Lois Campbel I , Stanley E. K i r k p a t r i c k The purpose of t h e study was t o determine i f mottr e r s can learn t o reduce t h e i r a n x i e t y and f u n c t i o n a s therapeutic a l l i e s in t h e h o s p i t a l t o reduce t h e s t r e s s experienced by t h e i r preschool c h i l d r e n undergoing c a r d i a c c a t h e t e r i z a t i o n . I t was designed t o compare, s i n g l y and in combination t h r e e models of p a t i e n t p r e p a r a t i o n : 1 ) d i r e c t e d a t t e n t i o n and'information about h o s p i t a l i z a t i o n and c a t h e t e r i z a t i o n , 2) s u p p o r t i v e counseling, and3) s t r e s s management t r a i n i n g . F i f t y mothers and t h e i r children were randomly assigned t o 1 of 5 experimental groups. Group E served a s t h e c o n t r o l group and received t h e c u r r e n t r o u t i n e p r e p a r a t i o n f o r c a t h e t e r i z a t i o n . Group D received t h e informat i o n model only. Group C received both t h e information and couns e l i n g models. Group B received both t h e information and s t r e s s management models. Group A received a l l t h r e e models. Assessment of treatment e f f e c t s f o r both mothers and c h i l d r e n included s e l f -r e p o r t measures completed by t h e mothers, behavioral observ a t i o n s recorded a t key s t r e s s p o i n t s by b l i n d r a t e r s and physiol o g i c responses recorded by a computerized biofeedback system. R e s u l t s i n d i c a t e d s i g n i f i c a n t treatment e f f e c t s f o r a l l intervent i o n models. The s t r e s s management model had :he g r e a t e s t e f f e c t a s measured by p o s i t i v e changes in t h e mothers s e l f -r e p o r t e d a n x i e t y s c o r e s , electromyographic readings and electrodermal responses. Both c h i l d r e n and t h e i r mothers who received t h e s t r e s s management model demonstrated more a d a p t i v e behavior in t h e h o s p i t a l and a f t e r d i s c h a r g e than those who d i d n o t . The study would suggest t h a t although information and counseling reduce s t r e s s and a n x i e t y r e l a t e d t o h o s p i t a l i z a t i o n , s t r e s s management t r a i n i n g can provide a d d i t i o n a l b e n e f i t s . Dept. of pediatrics, Phila., PA. In recent efforts directed t o t h e analysis of sensory processing in t h e newborn, neonates and adults were exposed to various reflex modification procedures. Previous work with adults had indicated that when a tone precedes a reflex eliciting stimulus by an appropriate interval the amplitude of t h e reflex is inhibited. If t h e tone is presented simultaneously with t h e reflex-eliciting event, response t o amplitude is augmented. The eye-blink eliciting device consisted of a miniature solenoid with a teflon striker which could deliver a controlled tap; a miniature photo reflective densiometer attached t o a TDH 39 earphone assessed the e y e blinks.For each experiment, 15 healthy term appropriate...

Management of congenital cytomegalovirus infection: an evidence‐based approach

“…The majority of infected neonates with CMV will be asymptomatic at birth. Four level 2 studies (1,2,6,38) have demonstrated that 6–25% of these patients are likely to develop SNHL and 13.5% will develop permanent neurological sequelae. SNHL tends to be late‐onset and progressive.…”

“…Long-term epidemiological studies have shown that 40-58% of infants with symptomatic and 13.5% of asymptomatic CCMV will have permanent neurological sequelae (1)(2)(3)(4)(5)(6)38). CMV is known to cause progressive and late-onset hearing loss.…”

“…Recommendations for prescription of antiviral medication based on the following studies(30,31,35,(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48) Absolute neutrophil count <500 cells ⁄ lL • Absolute neutrophil count <500 cells ⁄ lL • Platelet count <25 000 cells ⁄ lL• Platelet count <25 000 cells ⁄ lL Neonates with life-threatening infection should be considered for immediate treatment.…”