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First Occurrence (first + occurrence)
Selected AbstractsFirst Occurrence of Mandarinoite in ChinaACTA GEOLOGICA SINICA (ENGLISH EDITION), Issue 2 2003Harvey E. BELKIN Abstract This report describes the first occurrence of the rare mineral mandarinoite (Fe3+2Se3O9 · 6H2O) in China. It occurs in the Lower Permian Maokou Formation carbonaceous shale in Yutangba Village east of Enshi City in southwestern Hubei Province. The shale is selenium-rich and contains native selenium, V-Mo-Cr-bearing iron oxide, clay and quartz. Weathering of the selenium in the bedrock under moderate to high redox conditions in the presence of ferric iron has formed mandarinoite. [source] Etiology, pathogenesis and prevention of neural tube defectsCONGENITAL ANOMALIES, Issue 2 2006Rengasamy Padmanabhan ABSTRACT Spina bifida, anencephaly, and encephalocele are commonly grouped together and termed neural tube defects (NTD). Failure of closure of the neural tube during development results in anencephaly or spina bifida aperta but encephaloceles are possibly post-closure defects. NTD are associated with a number of other central nervous system (CNS) and non-neural malformations. Racial, geographic and seasonal variations seem to affect their incidence. Etiology of NTD is unknown. Most of the non-syndromic NTD are of multifactorial origin. Recent in vitro and in vivo studies have highlighted the molecular mechanisms of neurulation in vertebrates but the morphologic development of human neural tube is poorly understood. A multisite closure theory, extrapolated directly from mouse experiments highlighted the clinical relevance of closure mechanisms to human NTD. Animal models, such as circle tail, curly tail, loop tail, shrm and numerous knockouts provide some insight into the mechanisms of NTD. Also available in the literature are a plethora of chemically induced preclosure and a few post-closure models of NTD, which highlight the fact that CNS malformations are of hetergeneitic nature. No Mendelian pattern of inheritance has been reported. Association with single gene defects, enhanced recurrence risk among siblings, and a higher frequency in twins than in singletons indicate the presence of a strong genetic contribution to the etiology of NTD. Non-availability of families with a significant number of NTD cases makes research into genetic causation of NTD difficult. Case reports and epidemiologic studies have implicated a number of chemicals, widely differing therapeutic drugs, environmental contaminants, pollutants, infectious agents, and solvents. Maternal hyperthermia, use of valproate by epileptic women during pregnancy, deficiency and excess of certain nutrients and chronic maternal diseases (e.g. diabetes mellitus) are reported to cause a manifold increase in the incidence of NTD. A host of suspected teratogens are also available in the literature. The UK and Hungarian studies showed that periconceptional supplementation of women with folate (FA) reduces significantly both the first occurrence and recurrence of NTD in the offspring. This led to mandatory periconceptional FA supplementation in a number of countries. Encouraged by the results of clinical studies, numerous laboratory investigations focused on the genes involved in the FA, vitamin B12 and homocysteine metabolism during neural tube development. As of today no clinical or experimental study has provided unequivocal evidence for a definitive role for any of these genes in the causation of NTD suggesting that a multitude of genes, growth factors and receptors interact in controlling neural tube development by yet unknown mechanisms. Future studies must address issues of gene-gene, gene-nutrient and gene,environment interactions in the pathogenesis of NTD. [source] An investigation of the relationship between race performance and superficial digital flexor tendonitis in the Thoroughbred racehorseEQUINE VETERINARY JOURNAL, Issue 4 2010B. O'MEARA Summary Reasons for performing study: There is limited information regarding the number of races and the period for evaluation of outcome which is critical for assessment of SDF tendonitis treatments. Objective: To evaluate the re-injury rate and racing performance of Thoroughbred racehorses that sustain SDF tendonitis in relation to matched controls in terms of number of races post treatment and maximum racing performance ratings before and after injury. Study design: Clinical records and racing histories of 401 racehorses with a first occurrence of SDF tendonitis diagnosed by ultrasonography. Controls were of the same age, sex and were horses training in the same establishment at the time of injury as the case horses and where the trainer reported that the horse had not had a previous SDF tendon injury or treatment. Results: Eighty percent of both case and control horses returned to racing after the date of injury, and the re-injury proportion within 3 years of treatment was 53%. The difference in Racing Post Rating(max) (RPR(max)) and the Racing Post Rating in the race immediately before the treatment date was significantly smaller in case horses (mean = 9.6 lbs; range = 0,75) compared to control horses (mean = 17.0 lbs; range = 0,79). No significant decrease in RPR(max) was noted post injury. No difference between case and control horses was found for return to racing and racing 3 times, but control horses were significantly more likely to compete 5 races post treatment date than case horses. Conclusion and clinical relevance: Injury was associated with an individual's pre-injury maximum performance level and return to racing and completion of 3 races are not useful indicator of the outcome of horses with SDF tendonitis. The assessment of the outcome of horses with an SDF injury in a population of racehorses using the number of races post injury requires a minimum of 5 races post injury to be a useful indicator. Further, a re-injury proportion in a population of horses in training for 3 years post treatment. [source] Cumulative adversity and drug dependence in young adults: racial/ethnic contrastsADDICTION, Issue 3 2003R. Jay Turner ABSTRACT Aims To study cumulative exposure to stressors as a risk factor for drug dependence, and evaluate whether group differences in exposure contribute to differences in prevalence. Design Cross-sectional community survey of life-time adverse experiences and substance and psychiatric disorders. Setting Data collected between 1997 and 2000 in Miami,Dade County, USA. Participants A total of 1803 former Miami,Dade public school students, 93% between ages 19 and 21 years when interviewed. Males and females of Cuban origin, other Caribbean basin Hispanics, African-Americans and non-Hispanic whites are represented equally. Measurements Drug dependence disorder assessed by DSM-IV criteria using the Composite International Diagnostic Interview, and a 41-item checklist of life-time exposure to major and potentially traumatic experiences. Both measures include age at time of first occurrence. Findings Life-time rate of drug dependence disorder (total 14.3%) did not vary significantly (P > 0.05) by socio-economic group. Male rate (17.6%) was significantly greater than female rate (10.9%). The African-American rate (6.5%) was dramatically lower than non-Hispanic white (17.0%), Cuban (18.1%) and non-Cuban Hispanic (16.0%) rates despite their dramatically higher exposure to adversity. Twenty-eight of 33 individual adversities were associated with the subsequent onset of drug dependence (P < 0.05). Cumulative life-time exposure was greatest for males and for African-Americans, and was associated inversely with socio-economic level. Multivariate discrete-time event history analysis revealed significant independent effects of distal (>1 year earlier) and proximal (previous year) exposure to adverse events (P < 0.05), controlling for childhood conduct disorder, attention deficit hyperactive disorder and previous psychiatric disorder. Conclusions Life-time cumulative exposure to distant as well as more recent adversity predicts risk of subsequent drug dependence, although it does not explain ethnic group differences in risk. [source] An evaluation of current diagnostic tests for the detection of infectious salmon anaemia virus (ISAV) following experimental water-borne infection of Atlantic salmon, Salmo salar L.JOURNAL OF FISH DISEASES, Issue 3 2003M Snow Abstract Four commonly used diagnostic tests [reverse transcription polymerase chain reaction (RT-PCR), indirect fluorescent antibody test (IFAT), virus culture and light microscopy] were evaluated for their ability to detect infectious salmon anaemia virus (ISAV) or tissue pathology following experimental infection of Atlantic salmon. Fish were infected with ISAV by water-borne exposure which mimics the route of natural infection. Forty-five per cent of pre-clinical fish tested yielded positive results by RT-PCR for at least one of the organs tested (kidney, heart, gill, liver, blood). No significant difference was detected between organs in the number or time of first occurrence of positive result. Virus culture identified a total of 14% of pre-clinical fish as ISAV-infected. The presence of ISAV in heart tissue was particularly notable (13% of fish sampled) as was the inability to culture virus from spleen tissue. In the case of IFAT, 15% of fish sampled were positive, although tissue other than kidney proved unsuitable for use in this method. Only limited ISAV-specific pathology was detectable by histological examination of fish prior to the onset of clinical disease. These findings reveal important information regarding the optimal choice of both tissue sample and diagnostic test for the routine diagnosis of ISAV. [source] Occurrence of Bremia lactucae in Natural Populations of Lactuca serriolaJOURNAL OF PHYTOPATHOLOGY, Issue 7 2004I. Petr, elová Abstract In the period 1996,2001 the natural occurrence of Bremia lactucae (lettuce downy mildew) on Asteraceae plants was studied in the Czech Republic. Lactuca serriola (prickly lettuce) is the most common naturally growing host species of B. lactucae. Infection of plants was recorded during the whole vegetation season with the first occurrence in April and last in November. Bremia lactucae was found on host plants in all developmental stages. High percentages of naturally infected populations of L. serriola were recorded. Host plants exhibited broad variation in phenotypic expression of disease symptoms and degree of infection, however, the intensity of infection was rather low in the majority of populations. Geographic distribution of B. lactucae was studied in the two main parts of Czech Republic, central and southern Moravia, and eastern, northern and central Bohemia. Bremia lactucae was recorded in all these areas. Nevertheless, in the warmest parts of the Czech Republic (southern Moravia) only sporadic occurrence of the pathogen was recorded. Bremia lactucae infection on L. serriola and disease severity was judged also in relation to the type of habitat, and the size and density of host plant populations. However, no substantial differences among various habitats were found; only host plants growing in urban areas were frequently free of infection and the degree of infection was very low. Nevertheless, these plants were commonly infected with powdery mildew (Golovinomyces cichoracearum), which is most aggressive pathogen of this type of habitat. [source] Rationale and Design of the OPTION Study: Optimal Antitachycardia Therapy in ICD Patients without Pacing IndicationsPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 9 2010CHRISTOF KOLB M.D. Background:,Implantable cardioverter-defibrillators (ICDs) represent the treatment of choice for primary and secondary prevention of sudden cardiac death but ICD therapy is also plagued by inappropriate shocks due to supraventricular tachyarrhythmias. Dual-chamber (DC) ICDs are considered to exhibit an enhanced discrimination performance in comparison to single-chamber (SC) ICDs, which results in reduction of inappropriate detections in a short- to mid-term follow-up. Comparative data on long-term follow-up and especially on inappropriate shocks are limited. Methods:,The aim of the OPTION study is to assess whether an optimized treatment with DC ICDs improves patient outcome and decreases the rate of inappropriate shocks in comparison to SC ICDs. DC ICD therapy optimization is achieved by optimal customizing of antitachycardia therapy parameters, activation of discrimination algorithms, antitachycardia pacing in the slow ventricular tachycardia zone, and avoidance of right ventricular pacing with the SafeR algorithm mode. The OPTION study, a prospective, multicenter, randomized, single-blinded, parallel study, will randomize 450 patients on a 1:1 allocation to either an SC arm with backup pacing at VVI 40 beats per minute (bpm) or to the DC arm with SafeR pacing at 60 bpm. Patients will be followed for 27 months. Primary outcome measure is the time to first occurrence of inappropriate shock and a combined endpoint of cardiovascular morbidity and all-cause mortality. Conclusion:,The study will evaluate the relative performance of DC in comparison to SC ICDs in terms of inappropriate shock reduction and patient outcome. (PACE 2010; 33:1141,1148) [source] THE FIRST FOSSIL PROSCOPIIDAE (INSECTA, ORTHOPTERA, EUMASTACOIDEA) WITH COMMENTS ON THE HISTORICAL BIOGEOGRAPHY AND EVOLUTION OF THE FAMILYPALAEONTOLOGY, Issue 2 2008SAM W. HEADSArticle first published online: 14 MAR 200 Abstract:,Eoproscopia martilli gen. et sp. nov. is described from the Early Cretaceous (Aptian) Crato Formation Lagerstätte of Ceará State, north-east Brazil. The new taxon is assigned to the extant family Proscopiidae and represents the first occurrence of the group in the fossil record. Eoproscopia is similar to crown group proscopiids in its stick-like habitus, elongate prothorax and absence of the cryptopleuron, but differs in the presence of well-developed wings, the short head with a small, simple fastigium, the prothoracic legs being inserted near the posterior margin of the prothorax, and the absence of spines on the metathoracic tibiae. The discovery of Eoproscopia extends the geological range of the family by approximately 110 myr and confirms the presence of stem-group proscopiids in the Atlantic rift zone of South America during the Early Cretaceous. [source] TRACING BACK THE ORIGIN OF THE INDO-PACIFIC MOLLUSC FAUNA: BASAL TRIDACNINAE FROM THE OLIGOCENE AND MIOCENE OF THE SULTANATE OF OMANPALAEONTOLOGY, Issue 1 2008MATHIAS HARZHAUSER Abstract:, Two new tridacnine species are described from the Chattian and Aquitanian of the Arabian Peninsula. For these, the new names Omanidacna eos gen. et sp. nov. and Tridacna evae sp. nov. are erected. Omanidacna is interpreted as an Oligocene ancestor of Hippopus, being the oldest record of this tridacnine lineage. The Aquitanian Tridacna evae is the first occurrence of the genus Tridacna. These Arabian taxa imply that the modern tridacnine lineages are rooted in the Palaeogene and early Neogene of the East African-Arabian Province, although their Eocene ancestors, such as Byssocardium, are Western Tethyan taxa. During the Neogene they successfully settled the Indo-Polynesian Province and became typical elements of the entire Indo-West Pacific Region. The tridacnines are thus an example of a successive transformation and gradual eastward dispersal of an originally Tethyan element contributing to late Neogene diversity in the Indo-West Pacific. [source] Phacomatosis Pigmentokeratotica: A 20-Year Follow-up with Malignant Degeneration of Both Nevus ComponentsPEDIATRIC DERMATOLOGY, Issue 1 2005Teresa Martínez-Menchón M.D. The disorder is a consequence of the so-called twin spot genetic mechanism. We describe the first occurrence involving malignant degeneration of both nevus components, giving rise to three basal cell carcinomas over the sebaceous nevus and a malignant melanoma of the superficial spreading type over the speckled lentiginous nevus. This observation, in concert with the other instances reported in the literature, points to the need for adequate patient follow-up to ensure early detection and treatment of any possible associated malignant degeneration. [source] Some alternatives in the statistical analysis of sickness absenceAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 10 2009Albert Navarro Abstract Purpose Sickness absence (SA) is a commonly used outcome in occupational health cohort studies. Without the use of statistical techniques that take into account that SA is a recurrent event, the probability of obtaining biased estimates of the effects related to SA is very high. The objective of this article is to examine the application of marginal models, comparing them to count-based models, when the outcome of interest is SA. Methods By re-sampling the data of a reference study, 1,000 samples of 1,200 individuals were generated. In each of these samples, the coefficients of two factors were estimated by fitting various models: Poisson, Negative Binomial, standard Cox model for a first occurrence, Andersen,Gill and Prentice,Williams,Peterson. Results In general, differences among the models are observed in the estimates of variances and coefficients, as well as in their distribution. Specifically, the Poisson model estimates the greatest effect for both coefficients (IRR,=,1.17 and IRR,=,1.60), and the Prentice,Williams,Peterson the least effect (HR,=,1.01 and HR,=,1.26). Conclusions Whenever possible, the instantaneous form of analysis should be used for occurrences of a recurrent event. Collection of study data should be organized in order to permit recording of the most complete information possible, particularly regarding event occurrences. This should allow the presence of within-individual heterogeneity and/or occurrence dependency to be studied, and would further permit the most appropriate model to be chosen. When there is occurrence dependence, the choice of a model using the specific baseline hazard seems to be appropriate. Am. J. Ind. Med. 52:811,816, 2009. © 2009 Wiley-Liss, Inc. [source] Litter size and infant survivorship in wild groups of cotton-top tamarins (Saguinus oedipus) in ColombiaAMERICAN JOURNAL OF PRIMATOLOGY, Issue 8 2009A. Savage Abstract Cotton-top tamains (Saguinus oedipus) are a critically endangered primate found only in Colombia. Efforts to conserve this species are centered on developing effective management plans that integrate biological information regarding population dynamics and factors that influence their survival. This study documented infants born to wild cotton-top tamarin females from 1994,2008 at two distinct field sites in northern Colombia. Our studies have shown that wild cotton-top tamarins typically give birth to one litter each year and infant survival to 6 months of age was greater in the wild than has been reported in captive colonies. However, similar to reports from captive colonies, litter size of wild cotton-top tamarins ranges from 1,3 infants, with twin litters most common. Here we report the first occurrence of triplet litters in nearly 20 years of observing wild cotton-top tamarin groups. Over the first 3 months of life, wild-born infants exhibited highest mortality during the first week of life, similar to reports from captive colonies. Infant survival in the wild also increases with successive litters as it does in captivity. However, inter-birth interval, group size, and the number of adult males in the group did not appear to influence infant survival in the wild. The value of such long-term data from field studies aids in the information that can be used to model future population trends and develop effective conservation plans for this critically endangered primate. Am. J. Primatol. 71:707,711, 2009. © 2009 Wiley-Liss, Inc. [source] Long QT Syndrome in Patients over 40 Years of Age: Increased Risk for LQTS-Related Cardiac Events in Patients with Coronary DiseaseANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 4 2008Edward Sze B.A. Background: Previous studies of long QT syndrome (LQTS) have focused primarily on the clinical course of affected patients up to 40 years of age to avoid the confounding influence of acquired heart disease on LQTS-related cardiac events in this genetic disorder. Methods: Patients were identified as having coronary disease if they had a history of hospitalization for myocardial infarction, coronary angioplasty, coronary artery bypass graft surgery, or were treated with medication for angina. LQTS-related cardiac events included the first occurrence of syncope, aborted cardiac arrest, or sudden cardiac death without evidence suggestive of an acute coronary event. Cox proportional hazards regression modeling was used to analyze the independent contribution of coronary disease to LQTS-related cardiac events. Results: Time-dependent coronary disease was associated with an increased risk of LQTS-related cardiac events (hazard ratio 2.24, 95% confidence interval 1.23,4.07, P = 0.008) after adjustment for syncopal history before age 40, QTc, and gender. Factors such as diabetes and hypertension that increase the risk for coronary disease were not associated with an increased risk for LQTS-related cardiac events. Conclusions: This is the first study to demonstrate that coronary disease augments the risk for LQTS-related cardiac events in LQTS. The findings highlight the need for more focused preventive therapy in LQTS patients above the age of 40. [source] Wheels in a land of camels: another look at the chariot in ArabiaARABIAN ARCHAEOLOGY AND EPIGRAPHY, Issue 2 2009M.C.A. Macdonald A rock drawing in north-west Arabia shows a rider, a chariot and a foot soldier in battle. It is exceptional not only for its subject (at present unique) but for its use of a mixture of the artistic conventions employed in Arabian rock art and those used in Neo-Assyrian and Egyptian art. The three different parts of the composition have ,captions' in the Thamudic B script identifying the artists and the subjects, including the first occurrence of an Ancient North Arabian word for chariot. [source] The burden of coronary heart disease in M,ori: population-based estimates for 2000-02AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 4 2009Martin Tobias Abstract Objective: To estimate coronary heart disease (CHD) incidence, prevalence, survival, case fatality and mortality for M,ori, in order to support service planning and resource allocation. Methods: Incidence was defined as first occurrence of a major coronary event, i.e. the sum of first CHD hospital admissions and out-of-hospital CHD deaths in people without a hospital admission for CHD in the preceding five years. Data for the years 2000-02 were sourced from the New Zealand Health Information Service and record linkage was carried out using a unique national identifier, the national health index. Results: Compared to the non-M,ori population, M,ori had both elevated CHD incidence and higher case fatality. Median age at onset of CHD was younger for M,ori, reflecting both higher age specific risks and younger population age structure. The lifetable risk of CHD for M,ori was estimated at 37% (males) and 34% (females), only moderately higher than the corresponding estimates for the non-M,ori population, despite higher M,ori CHD incidence. This reflects the offsetting effect of the higher ,other cause' mortality experienced by M,ori. Median duration of survival with CHD was similar to that of the non-M,ori population for M,ori males but longer for M,ori females, which is most likely related to the earlier age of onset. Conclusions: This study has generated consistent estimates of CHD incidence, prevalence, survival, case fatality and mortality for M,ori in 2000-02. The inequality identified in CHD incidence calls for a renewed effort in primary prevention. The inequality in CHD case fatality calls for improvement in access for M,ori to secondary care services. [source] A Mixture Point Process for Repeated Failure Times, with an Application to a Recurrent DiseaseBIOMETRICAL JOURNAL, Issue 7 2003O. Pons Abstract We present a model that describes the distribution of recurring times of a disease in presence of covariate effects. After a first occurrence of the disease in an individual, the time intervals between successive cases are supposed to be independent and to be a mixture of two distributions according to the issue of the previous treatment. Both sub-distributions of the model and the mixture proportion are allowed to involve covariates. Parametric inference is considered and we illustrate the methods with data of a recurrent disease and with simulations, using piecewise constant baseline hazard functions. [source] Nonparametric Estimation in a Markov "Illness,Death" Process from Interval Censored Observations with Missing Intermediate Transition StatusBIOMETRICS, Issue 1 2009Halina Frydman Summary In many clinical trials patients are intermittently assessed for the transition to an intermediate state, such as occurrence of a disease-related nonfatal event, and death. Estimation of the distribution of nonfatal event free survival time, that is, the time to the first occurrence of the nonfatal event or death, is the primary focus of the data analysis. The difficulty with this estimation is that the intermittent assessment of patients results in two forms of incompleteness: the times of occurrence of nonfatal events are interval censored and, when a nonfatal event does not occur by the time of the last assessment, a patient's nonfatal event status is not known from the time of the last assessment until the end of follow-up for death. We consider both forms of incompleteness within the framework of an "illness,death" model. We develop nonparametric maximum likelihood (ML) estimation in an "illness,death" model from interval-censored observations with missing status of intermediate transition. We show that the ML estimators are self-consistent and propose an algorithm for obtaining them. This work thus provides new methodology for the analysis of incomplete data that arise from clinical trials. We apply this methodology to the data from a recently reported cancer clinical trial (Bonner et al., 2006, New England Journal of Medicine354, 567,578) and compare our estimation results with those obtained using a Food and Drug Administration recommended convention. [source] A Middle,Upper Devonian Boundary Section in the Open Platform, Platform Margin Facies of Guilin, South ChinaACTA GEOLOGICA SINICA (ENGLISH EDITION), Issue 3 2009Hua LI Abstract: The Caiziyan Middle and Upper Devonian boundary section is located approximately 30 km northeast of Guilin. It hosts relatively abundant benthic and common-rare pelagic fossils, including brachiopods, corals, tentaculites, and conodonts, which may serve as a better suitable section for pelagic and neritic stratigraphic correlation. In this section, 10 "standard" conodont zones are recognized across the Givetian,Frasnian boundary, including, in descending order, the Lower hassi Zone, punctata Zone, transitans Zone, the Upper falsiovalis Zone, the Lower falsiovalis Zone, disparilis Zone, the Upper hermanni,cristatus Zone, the Lower hermanni,cristatus Zone, the Upper varcus Zone, and the Middle varcus Zone, all of which are defined by the first occurrence of their defining conodont species. The Middle,Upper Devonian (Givetian,Frasnian) boundary is defined by the first occurrence of Ancyrodella pristina in accordance with the Global Stratotype Section and Point (GSSP), which is assigned at 6.2m above the base of bed 19 in the Caiziyan section. [source] First Occurrence of Mandarinoite in ChinaACTA GEOLOGICA SINICA (ENGLISH EDITION), Issue 2 2003Harvey E. BELKIN Abstract This report describes the first occurrence of the rare mineral mandarinoite (Fe3+2Se3O9 · 6H2O) in China. It occurs in the Lower Permian Maokou Formation carbonaceous shale in Yutangba Village east of Enshi City in southwestern Hubei Province. The shale is selenium-rich and contains native selenium, V-Mo-Cr-bearing iron oxide, clay and quartz. Weathering of the selenium in the bedrock under moderate to high redox conditions in the presence of ferric iron has formed mandarinoite. [source] Benign neonatal sleep myoclonus in newborn infants of opioid dependent mothersACTA PAEDIATRICA, Issue 1 2009Katrin Held-Egli Abstract Objective: The aim of our study was to evaluate the incidence, duration and risk factors for benign neonatal sleep myoclonus (BNSM) in infants with neonatal abstinence syndrome (NAS) treated with opioids or sedatives, compared with control infants. Methods: This is a single centre observational case control study. Seventy-eight near term and term infants with neonatal opiate abstinence syndrome confirmed by meconium analysis were included. Exclusion criteria were cerebral malformation, intracranial haemorrhage and perinatal asphyxia. The babies were assessed eight hourly with a modified Finnegan score that included sleep myoclonus. Seventy-eight infants not exposed to opiates during pregnancy, hospitalized for at least 14 days and matched for gestational age were used as controls. Results: The median gestational age was 38 1/7 (95% CI: 35 3/7,41 2/7) weeks, birth weight 2730 (95% CI: 1890,3600) g, umbilical artery pH 7.25 (CI 7.10,7.37) and Apgar score at 5 minutes 9 (95% CI: 7,10). The control infants did not differ in these characteristics. Sleep myoclonus was diagnosed in 52 (67%) of the infants with NAS and 2 (2.6%) of the controls (OR 26 [95% CI: 7,223], p < 0.001). Myoclonus appeared as early as day 2 and as late as day 56 of life (median day 6) and lasted for 1 to 93 days (median 13 days). All infants had serum glucose > 2.5 mmol/L at first occurrence. The neurological examinations as well as cerebral ultrasound scans were normal. An electroencephalogram (EEG) carried out in 18 infants showed no signs of epileptic activity. Conclusion: BNSM has a high incidence in infants with NAS. The diagnosis can be made clinically. In the absence of other neurological symptoms further investigations such as EEG are not necessary and anticonvulsive treatment is not indicated. [source] | |||||||||||||||||||