Current recommendations for obtaining blood from neonates advise avoidance of the midline area of the heel and are based on postmortem studies. Objective: Because of the potential pain and tissue damage from repeated ...Current recommendations for obtaining blood from neonates advise avoidance of the midline area of the heel and are based on postmortem studies. Objective: Because of the potential pain and tissue damage from repeated heel pricking in the same area, to investigate using ultrasonography whether the distance from skin to calcaneus is less at the midline than at the borders. Methods: One hundred consecutive healthy preterm and 105 consecutive healthy term neonates were studied 48- 72 hours after delivery. The skin to perichondrium distance (SPD) was measured on two occasions by ultrasound at the external, midline, and internal areas of the heel. Findings: Mean SPD was 0.2 mm less at the midline than at the other sites. The proportion of measurements < 3 mm at any of the three sites was the same. Depth was < 3 mm in less than 3% of the term and 20% of the preterm infants. The SPD correlated only with gestational age. Of children < 33 weeks gestational age, 38% had an SPD < 3 mm compared with 8% of older preterm infants. The proportions of preterm infants of ≥ 33 weeks gestation and term infants with an SPD < 3 mm were similar (8% v 3% ). Interpretation: With the use of automated lancets of 2.2 mm length or less, the whole heel plantar surface is safe for obtaining blood in term and preterm infants of ≥ 33 weeks gestation. This means that soft tissue damage and pain from repeated pricking in the same area can be reduced.展开更多
Objective: To differentiate between primary and secondary bilateral synchrony( PBS and SBS, respectively) in generalized spike-and-wave discharges (GSWD),we applied independent component analysis (ICA) to GSWD, and an...Objective: To differentiate between primary and secondary bilateral synchrony( PBS and SBS, respectively) in generalized spike-and-wave discharges (GSWD),we applied independent component analysis (ICA) to GSWD, and analyzed the character istic patterns of independent components. Methods: EEGs from 19 patients with GS WD (9 PBS patients, 10 SBS patients)were studied. Thirty GSWD epochs were selected and concatenated to construct an EEG datamatrix that was subjected to ICA. Se lected independent components were localized by mapping them on a spherical mode l of the head by means of brain electrical source analysis (BESA) to define dipo le sources.Results: Epileptic components of GSWD were clearly separated by the I CA algorithm in all patients. Between one and three components per patient were responsible for GSWD. In PBS patients, 70.6%of the independent components had d ipole sources within the dorsolateral frontal region, and 56.5%of the independe nt components in SBS patients were within the medial frontal region (P=0.012). T he orientation of all of the independent components in PBS patients was radial, whereas 47.8%of the independent components in SBS patients were tangential;this difference was statistically significant (P=0.001). Conclusions:Spatiotemporal decomposition of GSWD by using ICA might be helpful for differentiating SBS from PBS. Significance: The localization of the dipole sources of the independent co mponents may provide insight into the pathophysiological origins of GSWD.展开更多
基金supported by the USTC Research Funds of the Double First-Class Initiative(YD3420002004)the National Natural Science Foundation of China(42125402,41974174,42188101,41831071,42174183,and 41904135)+4 种基金the B-type Strategic Priority Program of CAS(XDB41000000)the Project of Stable Support for Youth Team in Basic Research Field,CAS(YSBR-018)the Fundamental Research Funds for the Central Universitiesthe Anhui Provincial Natural Science Foundation(2008085MD113)the Joint Open Fund of Mengcheng National Geophysical Observatory(MENGO202209).
文摘Current recommendations for obtaining blood from neonates advise avoidance of the midline area of the heel and are based on postmortem studies. Objective: Because of the potential pain and tissue damage from repeated heel pricking in the same area, to investigate using ultrasonography whether the distance from skin to calcaneus is less at the midline than at the borders. Methods: One hundred consecutive healthy preterm and 105 consecutive healthy term neonates were studied 48- 72 hours after delivery. The skin to perichondrium distance (SPD) was measured on two occasions by ultrasound at the external, midline, and internal areas of the heel. Findings: Mean SPD was 0.2 mm less at the midline than at the other sites. The proportion of measurements < 3 mm at any of the three sites was the same. Depth was < 3 mm in less than 3% of the term and 20% of the preterm infants. The SPD correlated only with gestational age. Of children < 33 weeks gestational age, 38% had an SPD < 3 mm compared with 8% of older preterm infants. The proportions of preterm infants of ≥ 33 weeks gestation and term infants with an SPD < 3 mm were similar (8% v 3% ). Interpretation: With the use of automated lancets of 2.2 mm length or less, the whole heel plantar surface is safe for obtaining blood in term and preterm infants of ≥ 33 weeks gestation. This means that soft tissue damage and pain from repeated pricking in the same area can be reduced.
文摘Objective: To differentiate between primary and secondary bilateral synchrony( PBS and SBS, respectively) in generalized spike-and-wave discharges (GSWD),we applied independent component analysis (ICA) to GSWD, and analyzed the character istic patterns of independent components. Methods: EEGs from 19 patients with GS WD (9 PBS patients, 10 SBS patients)were studied. Thirty GSWD epochs were selected and concatenated to construct an EEG datamatrix that was subjected to ICA. Se lected independent components were localized by mapping them on a spherical mode l of the head by means of brain electrical source analysis (BESA) to define dipo le sources.Results: Epileptic components of GSWD were clearly separated by the I CA algorithm in all patients. Between one and three components per patient were responsible for GSWD. In PBS patients, 70.6%of the independent components had d ipole sources within the dorsolateral frontal region, and 56.5%of the independe nt components in SBS patients were within the medial frontal region (P=0.012). T he orientation of all of the independent components in PBS patients was radial, whereas 47.8%of the independent components in SBS patients were tangential;this difference was statistically significant (P=0.001). Conclusions:Spatiotemporal decomposition of GSWD by using ICA might be helpful for differentiating SBS from PBS. Significance: The localization of the dipole sources of the independent co mponents may provide insight into the pathophysiological origins of GSWD.
