Alistair Jan Gunn

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..7 weeks gestation (equivalent to 28-32 weeks in humans)...

..These data suggest that low-dose endotoxin exposure can impair EEG maturation in preterm fetal sheep in association with neural inflammation but without hemodynamic disturbances or cortical injury...

..To evaluate whether therapeutic hypothermia alters the prognostic value of clinical grading of neonatal encephalopathy...

..These studies, however, show that only a subset of babies seemed to benefit. The challenge for the future is to find ways of improving the effectiveness of treatment...

..g., 40 vs. 99% in the parasagittal cortex, P < 0.001). Selective head cooling, maintained throughout the secondary phase of injury, is noninvasive and safe and shows potential for improving neonatal outcome after perinatal asphyxia...

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..The key remaining issues are to finding better ways of identifying babies who are most likely to benefit, to define the optimal mode and conditions of hypothermia and to find ways to further improve the effectiveness of treatment...

..Both long-term followup studies and further large studies of whole body cooling are in progress...

..Induced hypothermia likely has potential to significantly reduce disability. Cautious, systematic trials are essential before hypothermia can be used in these vulnerable infants...

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..8% vs 11.9% at 6 wk, p = 0.37). Conclusion: Early discharge from hospital once a preterm infant can take full oral feeds does not alter later breastfeeding rates when adequate visiting nursing support is available...

..These encouraging results must be balanced against the adverse systemic effects of hypothermia. Randomised clinical trials are in progress to establish the safety and efficacy of prolonged cerebral hypothermia...

..Protection was closely associated with reduced expression of both activated caspase-3 and of reactive microglia...

..In conclusion, these data strongly suggest active regulation of cerebral metabolism during the initial response to severe hypoxia, which may help to protect the immature brain from injury...

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..Further studies are required to evaluate the long-term impact of cooling on brain growth and maturation...

..These findings suggest that head cooling may help reduce basal ganglia injury in some premature babies...

..Although white matter protection with cerebral hypothermia was associated with reduced proliferation in the white matter tracts, it did not impair proliferation in the SVZ...

..The timing of this effect in the cerebral circulation corresponds closely to abnormal EEG activity, suggesting a pathological glutaminergic activation that we speculate is related to evolving brain injury...

..Based on these concepts the impact of proposed interventions such as induced hypothermia and endogenous growth factors are likely to be complex, but potentially offer focused ways of improving the outcomes of premature birth...

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..Our goal was to evaluate whether head cooling with mild systemic hypothermia for neonatal encephalopathy is associated with greater requirement for volume or inotrope support...

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..The incidence of type 2 diabetes mellitus (T2DM) is increasing in adolescents in most western countries. The time-course of glycemic control and impact of early treatment remain poorly understood...

..Interocclusion waveform height may be a better reflection of the severity of hypoxia. The appearance of biphasic and negative waveforms between occlusions may be a useful marker for severe decompensation...

..In this study, we tested the hypothesis that opening of hemichannels after cerebral ischemia may contribute to delayed evolution of injury...

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..Despite a prolonged increase in RVR, there was only a modest effect on glomerular function...

..01; r(2)=0.7). In conclusion, endogenous inhibitory alpha(2)-adrenergic receptor activation after severe hypoxia appears to significantly limit evolving hippocampal damage in the immature brain...

..We postulate that these effects may contribute to improved neonatal outcomes...

..05]. In conclusion, dopamine infusion delayed but did not prevent terminal hypotension after severe asphyxia...

..It is important to maintain a high index of suspicion in same-sex twin pregnancies of potential congenital hypothyroidism...

..In contrast, the increase in reactive glia was related only to proliferation. Speculatively, reactive glia may partly mediate IGF-1 white matter protection...

..These data suggest a potential role for insulin-like growth factor-1 in preventing cerebral palsy due to perinatal asphyxia...

..These cardiovascular and cerebrovascular responses may contribute to the patterns of cerebral injury seen in the human preterm fetus...

..This is an important area for further research...

..We conclude that a single low-dose injection of OK-432 can be associated with risk of focal cerebral injury in the preterm fetus and chronic central and peripheral vasodilatation that does not appear to be mediated by nitric oxide...

..To assess the clinical utility of overshoot fetal heart rate (FHR) decelerations by examining their occurrence after umbilical cord occlusions of varying frequency and length in near-term fetal sheep...

..2 IU/kg/day (n = 6) but by only 4.7 +/- 9.7%, (p < 0.04) in the combined lower dose group (n = 10). In conclusion, these data suggest that moderate dose hGH therapy in mothers with lactation insufficiency can improve galactopoiesis...

..Alternatively, as IGFs play a role in wound repair, the acute changes in IGF-I and IGFBP-1 may reflect transport of IGF-I from the circulatory pool to injured tissues to promote wound repair...

..In conclusion, fetal cortisol concentrations are suppressed by adenosine A(1) receptor activity, largely though a direct adrenal mechanism. This suppression can be partially overcome by supraphysiological stimuli such as asphyxia...

..In contrast, the combination of relative cerebral deoxygenation with evolving epileptiform transients in the early recovery phase raises the possibility that these early events accelerate or worsen the subsequent mitochondrial failure...

..4. This knowledge is essential to develop and refine ways of improving perfusion of the kidneys and other vital organs in premature babies...

..Peripheral administration of GPE also prevents the loss of dopamine neurons and improves long-term functional recovery following 6-OHDA lesion. However, GPE is unlikely to contribute significantly to the direct effects of IGF-1...

..Application of this knowledge will allow us to identify strategies for early intervention and prevent the course of damage caused by hypoxic-ischemic injury...

..Such a combined approach is likely to be essential for any clinical treatment...

..To examine the clinical impact of insulin-pump therapy for children with type 1 diabetes mellitus (T1DM) in a regional paediatric service, Auckland, New Zealand...

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..To determine the neurodevelopmental outcome of infants treated with head cooling with systemic hypothermia after hypoxic-ischemic encephalopathy...

..We review the clinical and experimental evidence on how glucocorticoids may affect the developing brain and highlight the need for systematic research...

..These data suggest that posthypoxic hypoperfusion is actively mediated and reflects suppressed cerebral metabolism...

..After ischemia there was a close association of PLP mRNA labeled cells with reactive astrocytes and macrophages/microglia. In conclusion, IGF-1 can prevent delayed, postischemic oligodendrocyte cell loss and associated demyelination...

..To compare the efficacy of goserelin and leuprolide on initial deceleration of growth and weight gain during the first 12 months of GnRH analogue treatment for precocious puberty...

..The adverse metabolic profile of many of these women, particularly the Maori and Pacific Islanders, is very likely to predispose them to early cardiovascular disease...

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..Further research is needed, but on present evidence, all parents should be advised to sleep their baby in a cot or similar next to their parent's bed, until baby is at least 6 months of age...