Cerebral Hemodynamics in Premature Infants

Extremely low birth weight infants remain at increased risk of intraventricular hemorrhage from the fragile vascular bed of the germinal matrix; the roles of hypotension (ischemia) and reperfusion (hyperemia) in the development of intraventricular hemorrhage are still debated. Cerebrovascular pressure autoregulation protects the brain by maintaining constant cerebral blood flow despite changes in blood pressure. The ontogeny of cerebrovascular pressure autoregulation has not been well established and uncertainty remains about the optimal arterial blood pressure required to support brain perfusion. Another important aspect of premature cerebral hemodynamics is the critical closing pressure––the arterial blood pressure at which cerebral blood flow ceases. Interestingly, in premature infants, the critical closing pressure approximates the mean arterial blood pressure. Often in this unique population, cerebral blood flow occurs only during systole when the diastolic arterial blood pressure is equal to the critical closing pressure. Moreover, the diastolic closing margin, a metric of cerebral perfusion that normalizes diastolic arterial blood pressure to the critical closing pressure, may be a better measure than arterial blood pressure for defining cerebral perfusion in premature infants. Elevated diastolic closing margin has been associated with intraventricular hemorrhage. This review summarizes the current state of understanding of cerebral hemodynamics in premature infants.

Highlights and conclusions from the Eastern Mediterranean Public Health Network [EMPHNET] Conference 2011

As a follow up of a short communication that the Eastern Mediterranean Health Journal published in December 2011, this article reports on highlights and conclusions from scientific abstracts, methodology workshops and plenary sessions that were presented as part of the Eastern Mediterranean Public Health Network [EMPHNET] conference held from 6 to 9 December 2011 in Sharm Al Sheikh, Egypt

Networking for applied field epidemiology- Eastern Mediterranean Public Health Network [EMPHNET] Conference 2011

On the occasion of the second Eastern Mediterranean Public Health Network [EMPHNET] conference that was held from 6-9 December 2011 in Sharm Al Sheikh, Egypt, this article introduces EMPHNET and its role to link Field Epidemiology Training Programs [FETP] in the region. The paper briefly describes the changing epidemiology situation in the region to illustrate the urgent need to strength`en public health systems and to build up the epidemiologist workforce