ORCID Profile
0000-0002-1970-7247
Current Organisation
Royal Brisbane and Women's Hospital
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Publisher: Springer Science and Business Media LLC
Date: 23-02-2022
DOI: 10.1038/S41390-022-01992-2
Abstract: Foetal growth restriction (FGR) and being born small for gestational age (SGA) are associated with neurodevelopmental delay. Early diagnosis of neurological damage is difficult in FGR and SGA neonates. Electroencephalography (EEG) has the potential as a tool for the assessment of brain development in FGR/SGA neonates. In this review, we analyse the evidence base on the use of EEG for the assessment of neonates with FGR or SGA. We found consistent findings that FGR/SGA is associated with measurable changes in the EEG that present immediately after birth and persist into childhood. Early manifestations of FGR/SGA in the EEG include changes in spectral power, symmetry/synchrony, sleep–wake cycling, and the continuity of EEG litude. Later manifestations of FGR/SGA into infancy and early childhood include changes in spectral power, sleep architecture, and EEG litude. FGR/SGA infants had poorer neurodevelopmental outcomes than appropriate for gestational age controls. The EEG has the potential to identify FGR/SGA infants and assess the functional correlates of neurological damage. FGR/SGA neonates have significantly different EEG activity compared to AGA neonates. EEG differences persist into childhood and are associated with adverse neurodevelopmental outcomes. EEG has the potential for early identification of brain impairment in FGR/SGA neonates.
Publisher: Elsevier BV
Date: 12-2018
DOI: 10.1016/J.EARLHUMDEV.2018.09.015
Abstract: Very preterm infants are at risk of cognitive impairment, but current capacity to predict at-risk infants is sub-optimal. Electroencephalography (EEG) has been used to assess brain function in development. This review investigates the relationship between EEG and cognitive outcomes in very preterm infants. Two reviewers independently conducted a literature search in April 2018 using PubMed, CINAHL, PsycINFO, Cochrane Library, Embase and Web of Science. Studies included very preterm infants (born ≤34 weeks gestational age, GA) who were assessed with EEG at ≤43 weeks postmenstrual age (PMA) and had cognitive outcomes assessed ≥3 months of age. Data on the subjects, EEG, cognitive assessment, and main findings were extracted. Meta-analysis was undertaken to calculate pooled sensitivity and specificity. 31 studies (n = 4712 very preterm infants) met the inclusion criteria. The age of EEG, length of EEG recording, EEG features analysed, age at follow-up, and follow-up assessments were erse. The included studies were then ided into categories based on their analysed EEG feature(s) for meta-analysis. Only one category had an adequate number of studies for meta-analysis: four papers (n = 255 very preterm infants) reporting dysmature/disorganised EEG patterns were meta-analysed and the pooled sensitivity and specificity for predicting cognitive outcomes were 0.63 (95% CI: 0.53-0.72) and 0.83 (95% CI: 0.74-0.89) respectively. There is preliminary evidence that background EEG features can predict cognitive outcomes in very preterm infants. Reported findings were however too heterogeneous to determine which EEG features are best at predicting cognitive outcome.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-11-2021
Publisher: Elsevier BV
Date: 2022
DOI: 10.2139/SSRN.4102751
Publisher: Wiley
Date: 06-01-2022
DOI: 10.1111/JPC.15860
Abstract: To determine if any cases of culture‐positive neonatal early‐onset sepsis (EOS) would be missed using the neonatal EOS calculator, when compared with current guidelines and practices. Retrospective audit of all neonates born at ≥35 weeks and admitted to Royal Brisbane and Women's Hospital with EOS from January 2014 to December 2020. A missed case was defined as antibiotic therapy not being recommended within 24 h of birth. Management recommendations according to the neonatal EOS calculator were compared with current guidelines and current practices. There were significantly more missed cases using the neonatal EOS calculator compared to the current guideline and current management groups. Using the neonatal EOS calculator, 11 neonates (35%, 95% confidence interval 19.2–54.6%) would not have received antibiotics by 24 h of age. In comparison, only one neonate (3%, 95% confidence interval 0.1–16.7%) would not have received antibiotics by 24 h of age using the current guidelines. In terms of the current practice in the cohort of patients, two neonates (6%) did not receive antibiotics by 24 h of age. The significantly higher rate of missed cases using the neonatal EOS calculator compared with current guidelines and practice supports the concerns many neonatologists have regarding safety of the neonatal EOS calculator.
Publisher: Wiley
Date: 05-05-2022
DOI: 10.1111/JPC.15992
Abstract: Herpes simplex CNS infection is a rare but important cause of neurological disability. Long term outcomes after HSV CNS infection in Australia have not yet been fully described. We sought to provide a comprehensive review of HSV CNS infection in children using a retrospective 13‐year evaluation of statewide laboratory and clinical records and a parent survey conducted at least one year after the initial infection. All positive PCR HSV 1 and 2 results from cerebrospinal fluid (CSF) or brain tissue were obtained from Queensland pathology providers for children aged 0–16 years between 1 January 2005 and 31 December 2017. Clinical data were obtained from patient records and longer‐term outcomes via parent survey at least 1 year after initial infection. Forty‐three children were identified over the 13‐year period, 17 (39.5%) neonates and 26 (60.4%) non‐neonates. The annual incidence for HSV CNS infection in Queensland children aged ≤16 years was 0.3/100 000 (95% confidence intervals (CIs): 0.2–0.4) with neonates at highest risk (incidence 2.5/100 000 live births, 95% CI: 1.5–3.9). HSV 1 was the predominant serotype in both neonates and non‐neonates (9/17, 52.9% neonates and 19/26, 73.1% non‐neonates). Seven (16.3%) children died, five (5/17, 29.4% neonates), directly attributable to HSV CNS infection (all neonates). Twenty‐five (58.1%) had neurological morbidity at discharge (9/17 neonates (52.9%) vs. 16/26 (61.5%) non‐neonates) and 20/27 (74.1%) reported long‐term neurological morbidity at follow‐up (5/9 neonates (55.6%) vs. 15/18 non‐neonates (83.3%)). Seven children (two neonates and four non‐neonates) with long‐term neurological sequelae had no neurological morbidity identified at discharge. Significant long‐term neurologic sequelae were seen in children with HSV CNS infection even in children with no neurological disability identified at discharge from hospital. Careful neurodevelopmental follow‐up of all children is recommended.
Publisher: University of Queensland Library
Date: 2021
DOI: 10.14264/6A534E0
Publisher: Elsevier BV
Date: 05-2022
DOI: 10.1016/J.EARLHUMDEV.2022.105571
Abstract: To determine the variability of overnight oximetry parameters in a group of normal, healthy term infants to enable the calculation of the number of subjects required to produce reliable reference ranges for neonatal overnight oximetry. A convenience s le of normal, healthy term neonates was recruited. Each had overnight oximetry using the Masimo SET Radical oximeter (data downloaded using Profox software). The report included the number of oxygen desaturation events (an absolute decrease in SpO 21 babies were recruited with data available from 19. 32% were female 68% born by vaginal delivery 37% fully breast feeding, 53% bottle and 11% by a combination of both. The mean (SD) GA was 39.2 (0.79) weeks, the mean (SD) BW was 3477 (240) grams. The median (IQR) post-natal age at the time the oximetry recording started was 31 (28-41) hours four babies were <24 h old. All babies had some desaturation events ranging from 4 to 36 times per hour. On average babies spent 3.0% (SD 2.3) of the time with an SpO In a cohort of healthy term neonates, as assessed by overnight oximetry, the mean SpO
No related grants have been discovered for Melissa Lai.