Early hyperoxia burden detected by cerebral near-infrared spectroscopy is superior to pulse oximetry for prediction of severe retinopathy of prematurity.

OBJECTIVE: Fractional tissue oxygen extraction (FTOE) is a measure derived from cerebral near-infrared spectroscopy (NIRS) and simultaneous pulse oximetry (SpO2), capturing the proportion of oxygen delivered in arterial blood that is used by the target tissue. FTOE may provide a better proxy measurement of retinal hyperoxia than pulse oximetry alone and could provide insight into the risk for retinopathy of prematurity (ROP). In this study, we directly compared hyperoxia burden calculated from FTOE with hyperoxia burden calculated from SpO2 alone in order to assess the strength of association between hyperoxia and severe ROP. STUDY DESIGN: Infants born before <30 weeks and weighing <1500 g underwent synchronized SpO2 and FTOE recording over the first 4 days following birth. After error correction of the raw recording, hyperoxia burden was calculated as the percentage of the total SpO2 or FTOE recording with measurements exceeding defined thresholds (90/93/95% and 20/15/10%, respectively) and was compared with the outcome of severe ROP, defined as ROP requiring laser therapy, after controlling for important covariates. RESULT: A total of 63 infants were included with a mean±s.d. gestational age of 25.8±1.5 weeks and birth weight of 898.5±206.9 g; 13/63 (20%) had severe ROP. SpO2 hyperoxia burden was not associated with severe ROP at any threshold. FTOE hyperoxia burden was associated with severe ROP at the 15% (P=0.04) and 10% (P=0.03) thresholds. Infants with severe ROP spent 20% and 50% more time exceeding the 15% and 10% thresholds, respectively, as compared with those without severe ROP. CONCLUSION: In the first 96 h of life, FTOE but not SpO2 hyperoxia burden is associated with severe ROP. These preliminary results suggest that NIRS may be a viable alternative technology for targeted oxygen saturation guidelines.

Sensorimotor half-day cAMP.

This paper describes a half-day sensorimotor camp program for young children. The camp program initially was offered to 4 pre-kindergarten children and supervised by one registered occupational therapist and one technician. The therapeutic format of the camp was multimodal. Principles of sensory integration, neurodevelopmental treatment, and education were incorporated in a structured, but varied sensorimotor environment. The goals of the camp were to provide (1) successful group play experiences, and opportunities to participate in (2) developmental/age appropriate sensorimotor activities, (3) recreational activities and (4) activities of daily living. The half-day sensorimotor camp offered a positive and successful experience to developmentally delayed children, which is usually not possible in many community based summer programs.

Development and implementation of a Dysphagia program in a mental retardation residential facility.

This paper describes the implementation of a dysphagia program in a residential mental retardation (MR) setting. Five program phases are presented describing the staff requirements, inservice and other procedures necessary to establish the program, the evaluation procedures, treatment approaches, and documentation patterns. Specific recommendations developed at Caswell to improve implementation of such a program with a residential, multi- Randicapped population are discussed, and our initial results with evaluation procedures and therapeutic interventions in 56 residents are presented. In particular, a detailed analysis of 24 clients whose intervention was based on videofluoroscopic examination are also presented.

[Sensorimotor polyneuropathy induced by almitrine dimesylate. Anatomo-clinical study of a case]. / Polyneuropathie sensitivo-motrice induite par le bismésilate d'almitrine. Etude anatomo-clinique d'une observation.

A 65-year-old male patient with chronic obstructive long disease developed a severe motor and sensory polyneuropathy during the treatment with almitrine bismesylate (Vectarion). Electrophysiological and neuropathological investigations demonstrated a distal axonopathy. A medicamentous origin was suspected since other causal factors were lacking. Eight months after stopping of treatment, the functional recovery was complete. The authors discuss the recent data recorded in the literature concerning the neurological complications induced by this new drug, which is increasingly administered in diseases of the respiratory tract.