The amplitude of the Achilles tendon reflex in infants is related to body position

Bruggink, Janneke L M; Bos, Arend F.; Hoeven, Johannes H. vd; Brouwer, Oebele F.; Sollie, Krystyna M.; Sival, Deborah A

doi:10.1016/j.earlhumdev.2006.03.001

Cited by 1 publication

(1 citation statement)

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“…We compared scores between age‐ and lesion‐matched fSBA and nSBA groups. As the Achilles’ tendon reflex is not consistently present in healthy neonates and infants, 19 we excluded it from the analysis.…”

Section: Methodsmentioning

confidence: 99%

Fetal endoscopic myelomeningocele closure preserves segmental neurological function

Verbeek

Heep

Maurits

et al. 2011

Develop Med Child Neuro

104

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Bonn, Germany) performed 19 fetal endoscopic procedures. Three procedures resulted in fetal death, three procedures were interrupted by iatrogenic hemorrhages and 13 procedures were successful. We matched each successfully treated fSBA infant with another nSBA infant of the same age and level of lesion, resulting in 13 matched pairs (mean age 14mo; SD 16mo; f ⁄ m=1.6; female-16, male-10). Matched fSBA and nSBA pairs were compared in terms of segmental neurological function and leg muscle ultrasound density (MUD). We also determined intraindividual difference in MUD (dMUD) between myotomes caudal and cranial to the myelomeningocele (reflecting neuromuscular damage by the myelomeningocele) and compared dMUD between fSBA and nSBA infants. Finally, we correlated dMUD with segmental neurological function. RESULTSWe found that, on average, the fSBA group were born at a lower gestational age than the nSBA group (median 32wks [range 25-34wks] vs 39wks [34-41wks]; p=0.001) and experienced more complications (chorioamnionitis, premature rupture of the amniotic membranes, oligohydramnios, and infant respiratory distress syndrome necessitating intermittent positive-pressure ventilation). Neurological function was better preserved after fSBA than after nSBA (median motor and sensory gain of two segments; better preserved knee-jerk [p=0.006] and anal [p=0.032] reflexes). The dMUD was smaller in fSBA than in nSBA infants (mean difference 24, 95% confidence interval [CI] 15-33; p<0.05), which was associated with better preserved segmental muscle function.INTERPRETATION Fetal endoscopic surgery is associated with spinal segmental neuroprotection, but it results in more complications. Before considering clinical implementation of fetal endoscopic myelomeningocele closure as standard care, the frequency of complications should be appropriately reduced and results assessed in larger groups over a longer period of time.

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Section: Methodsmentioning

confidence: 99%