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      Language in Children with Neonatal Hypoxic-Ischemic Encephalopathy

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          Abstract

          Introduction Neonatal hypoxic-ischemic encephalopathy (NHIE) is a common neurologic injury, and it may compromise the child's language and cognition. Understanding the process of language acquisition becomes possible with concise knowledge about children's global development.

          Objective The aim of this study was to observe if language acquisition and development are impaired in children with NHIE.

          Methods Seventy children with NHIE from 1 to 24 months old were analyzed in a Pediatric Neurology Service of Hospital of Porto Alegre, South of Brazil using the Brunet-Lezine Scale. Statistical analysis used SPSS 13.0 software.

          Results Twenty-four (60%) of the subjects were boys, with mean gestational age of 35.8 weeks (standard deviation of 4.6) and mean Apgar score of 6.0 at 1 minute and 7.1 at 5 minutes. The variables age versus language showed significant inverse correlation ( r =  − 0.566; p = 0.028). As the subjects aged, language tasks became more specific and dependent on the subject's direct action, rather than the subjective interpretation of their guardian. This correlation seems to be closely associated with scale configuration and with consequences of neurologic disorder, evincing the delays in language development.

          Conclusion This study achieved the goals proposed and highlights the necessity of greater attention by professionals to language skills during the initial period of child development.

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          Most cited references36

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          Language functions in preterm-born children: a systematic review and meta-analysis.

          Preterm-born children (<37 weeks' gestation) have higher rates of language function problems compared with term-born children. It is unknown whether these problems decrease, deteriorate, or remain stable over time. The goal of this research was to determine the developmental course of language functions in preterm-born children from 3 to 12 years of age.
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            The Apgar score.

            , (2006)
            The Apgar score provides a convenient shorthand for reporting the status of the newborn infant and the response to resuscitation. The Apgar score has been used inappropriately to predict specific neurologic outcome in the term infant. There are no consistent data on the significance of the Apgar score in preterm infants. The Apgar score has limitations, and it is inappropriate to use it alone to establish the diagnosis of asphyxia. An Apgar score assigned during resuscitation is not equivalent to a score assigned to a spontaneously breathing infant. An expanded Apgar score reporting form will account for concurrent resuscitative interventions and provide information to improve systems of perinatal and neonatal care.
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              Determinants of outcomes after head cooling for neonatal encephalopathy.

              The goal of this study was to evaluate the role of factors that may determine the efficacy of treatment with delayed head cooling and mild systemic hypothermia for neonatal encephalopathy. A total of 218 term infants with moderate to severe neonatal encephalopathy plus abnormal amplitude-integrated electroencephalographic recordings, assigned randomly to head cooling for 72 hours, starting within 6 hours after birth (with the rectal temperature maintained at 34.5 +/- 0.5 degrees C), or conventional care, were studied. Death or severe disability at 18 months of age was assessed in a multicenter, randomized, controlled study (the CoolCap trial). Treatment, lower encephalopathy grade, lower birth weight, greater amplitude-integrated electroencephalographic amplitude, absence of seizures, and higher Apgar score, but not gender or gestational age, were associated significantly with better outcomes. In a multivariate analysis, each of the individually predictive factors except for Apgar score remained predictive. There was a significant interaction between treatment and birth weight, categorized as > or =25th or or =38 degrees C) in control infants was associated with adverse outcomes. Although there was a small correlation with birth weight, the adverse effect of greater birth weight in control infants remained significant after adjustment for pyrexia and severity of encephalopathy. Outcomes after hypothermic treatment were strongly influenced by the severity of neonatal encephalopathy. The protective effect of hypothermia was greater in larger infants.
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                Author and article information

                Journal
                Int Arch Otorhinolaryngol
                Int Arch Otorhinolaryngol
                10.1055/s-00025477
                International Archives of Otorhinolaryngology
                Thieme Publicações Ltda (Rio de Janeiro, Brazil )
                1809-9777
                1809-4864
                10 February 2014
                July 2014
                : 18
                : 3
                : 255-259
                Affiliations
                [1 ]Departamento de Fonoaudiologia, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
                [2 ]Faculdade Nossa Senhora de Fátima, Caxias do Sul, RS, Brazil
                [3 ]Departamento de Neurologia, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
                [4 ]Departamento da Pró-reitoria de Extensão de Assuntos Comunitários, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
                Author notes
                Address for correspondence Chenia Martinez Departamento de Fonoaudiologia, Universidade Federal de Ciências da Saúde de Porto Alegre, Rua Sarmento Leite 245 Porto Alegre, Rio Grande do Sul 90050170Brazil chenia.martinez@ 123456gmail.com
                Article
                0040or
                10.1055/s-0034-1366976
                4297029
                25992102
                522842a8-4803-4c98-838e-96403817360c
                © Thieme Medical Publishers
                History
                : 09 October 2013
                : 08 December 2013
                Categories
                Article

                language development,hypoxia,brain,brain ischemia,neurology,speech,language,and hearing sciences

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