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Daiani Graciosa M, Augusta Monteiro Ferronato P, Ribeiro de Lima AA, Cristina da Silva Pacheco S, Gerdi Kittel Ries L, de Jesus Manoel E. Brazilian Mother’s Practice on Infant Body Position From Birth to 6 Months Old. INTERNATIONAL JOURNAL OF CHILDBIRTH 2022. [DOI: 10.1891/ijc-2022-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
There is a gap in the understanding of what has been recommended by health professionals to Brazilian mothers regarding infant body positioning whereas the description of this parenting practice can provide criteria for guidance programs already in the maternity ward. This study aimed to record the time (hours/day) Brazilian mothers reported that their infants spent awake or sleeping in 1 of the four body postures: Prone, supine, lateral positions and sitting. The second aim of this study was to verify whether this reported time was associated with birth weight, gestational age, infant chronological age and maternal age. A cross sectional study assessed 92 mothers divided into six groups according to the age of their full-term infant, in months (Mth): 1 Mth (n= 15), 2 Mth (n= 15), 3 Mth (n= 15), 4 Mth (n= 15), 5 Mth (n= 17), and 6 Mth (n= 15). Mothers registered in a 24-hour schedule the most frequent positioning of each infant in 1 day based on the week prior to the assessment day. Infant chronological age was associated with time spent in positions reported by mothers (p< .05). 47.8% of mothers stated not placing infants in prone position anytime in the awake period. Some mothers reported that the infant slept in the prone position. Brazilian caregivers still need to be alerted that the practice of not placing infants to lay in prone might hinder developmental opportunities for them, as well as, on the risks of SIDS and the importance of supine position for infants to sleep.
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Exploration of Barriers and Facilitators to Implementing Best Practice in Exercise Medicine in Primary Pediatric Care-Pediatrician Perspectives. Pediatr Exerc Sci 2021; 33:162-169. [PMID: 34167088 DOI: 10.1123/pes.2020-0214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 02/25/2021] [Accepted: 03/14/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE Despite the known health benefits of physical activity (PA), few primary care pediatricians discuss, evaluate, or prescribe PA for children. The goal of this study was to examine pediatricians' thoughts and practices related to child PA and the perceived facilitators and barriers to implementing PA evaluation and prescription in pediatric primary care clinics. METHODS The Consolidated Framework for Implementation Research was used to explore implementation barriers and facilitators. A mixed-method design combined questionnaires and focus groups with 27 pediatricians. RESULTS Despite the pediatricians' beliefs that PA is important for patients, there was wide practice variability in their approaches to discussing PA. Several perceived barriers to implementing PA evaluation and prescription were identified, including lack of knowledge and training, managing time for PA with multiple demands, the need for a team approach and simple PA tools and resources, support for patient tailoring of PA messaging, and a need for PA best practice champions. CONCLUSION The identified barriers to implementing evidence in PA suggest several directions for improvement, including a care-team approach; quick, inexpensive, and simple PA tools; community PA partnerships; PA training in medical education; evidence-based strategies; and PA directories for families. These efforts could facilitate the implementation of PA best practices in pediatrics.
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DeGrazia M, Ahtam B, Rogers-Vizena CR, Proctor M, Porter C, Vyas R, Laurentys CT, Bergling E, McLaughlin K, Grant PE. Brain Characteristics Noted Prior to and Following Cranial Orthotic Treatment. Child Neurol Open 2020; 7:2329048X20949769. [PMID: 32884966 PMCID: PMC7440724 DOI: 10.1177/2329048x20949769] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective: This case report aims to assess a potential association between cranial asymmetry, brain deformation, and associated developmental delay. Study Design: Two infants born at ≥37 weeks pursuing cranial orthotic treatment for severe Deformational Plagiocephaly (DP) (cranial vault asymmetry index >8.75%) underwent developmental assessment using Mullen Scales of Early Learning (MSEL) and non-sedated brain structural and diffusion magnetic resonance imaging (MRI) prior to and following cranial orthotic treatment. Results: In both infants with DP, tractography results revealed alterations in the white matter pathways of the brain. Both infants also had low to low/normal visual receptivity and fine motor skills. After cranial orthotic treatment, cranial asymmetry improved but did not completely resolve, tractography demonstrated a change toward normalized white matter pathways, and visual receptivity and fine motor skills improved. Conclusions: These preliminary findings suggest a potential link between DP, altered brain structures, and developmental assessment. Further investigation with a larger sample is warranted.
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Affiliation(s)
- Michele DeGrazia
- Cardiovascular and Critical Care, Boston Children's Hospital, Boston, MA, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, USA.,Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Banu Ahtam
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA.,Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, USA.,Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, MA, USA
| | - Carolyn R Rogers-Vizena
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA.,Department of Surgery, Harvard Medical School, Boston, MA, USA
| | - Mark Proctor
- Department of Neurosurgery, Boston Children's Hospital, Boston, MA, USA.,Department of Neurosurgery, Harvard Medical School, Boston, MA, USA
| | - Courtney Porter
- Cardiovascular and Critical Care, Boston Children's Hospital, Boston, MA, USA
| | - Rutvi Vyas
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA.,Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, USA.,Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, MA, USA
| | - Cynthia T Laurentys
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA.,Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, USA.,Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, MA, USA
| | - Emily Bergling
- Cardiovascular and Critical Care, Boston Children's Hospital, Boston, MA, USA
| | | | - Patricia Ellen Grant
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA.,Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, USA.,Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, MA, USA
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Valentini NC, Pereira KRG, Chiquetti EMDS, Formiga CKMR, Linhares MBM. Motor trajectories of preterm and full-term infants in the first year of life. Pediatr Int 2019; 61:967-977. [PMID: 31293014 DOI: 10.1111/ped.13963] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 04/02/2019] [Accepted: 05/16/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Motor development occurs throughout periods of motor skill acquisition, adjustment and variability. The objectives of this study were to analyze and compare biological and health characteristics and motor skill acquisition trajectories in preterm and full-term infants during the first year of life. METHODS Two thousand, five hundred and seventy-nine infants (1,361 preterm) from 22 states were assessed using the Alberta Infant Motor Scale. Multivariate General Linear Model, t-tests, ANOVA, and Tukey tests were used. RESULTS An age × group significant interaction was found for motor scores. On follow-up tests full-term infants had higher scores in prone, supine, sitting and standing postures that require trunk control from 9 to 10 months of age; although this advantage was observed for sitting from the second month of life. CONCLUSION During the first trimester of life, preterm infants have higher scores in the supine and standing postures. Regarding motor trajectories, from newborn to 12 months, the period of higher motor acquisition was similar between full-term and preterm infants for prone (3-10 months), supine (1-6 months), and standing (6-12 months). For the sitting posture, however, full-term infants had a period of intensive motor learning of acquisition from the first to 7 months of life, whereas for preterm infants a shorter period was observed (3-7 months). CONCLUSION Although the periods of higher motor acquisition were similar, full-term infants had higher scores in more control-demanding postures. Intervention for preterm infants needs to extend beyond the first months of life, and include guidance to parents to promote motor development strategies to achieve control in the higher postures.
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Affiliation(s)
- Nadia Cristina Valentini
- Health and Human Performance, Auburn University, Auburn, Alabama, USA.,Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.,Department of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Keila Ruttnig Guidony Pereira
- PPGCMH-Human Movement Science Graduate Program, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Eloá Maria Dos Santos Chiquetti
- PPGCMH-Human Movement Science Graduate Program, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Cibelle Kayenne Martins Roberto Formiga
- Department of Medical Sciences, University of São Paulo, São Paulo, Brazil.,School of Physical Education and Physical Therapy, State University of Goiás, Goiânia, Brazil
| | - Maria Beatriz Martins Linhares
- Department of Psychology, University of São Paulo, São Paulo, Brazil.,Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
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Ahmed S, Mitchell I, Wolbring G. Analysis of sudden infant death syndrome coverage in Canadian newspapers. J Child Health Care 2018; 22:545-562. [PMID: 29606014 DOI: 10.1177/1367493518763983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sudden infant death syndrome (SIDS; also known as crib death) describes the sudden unexpected death of an infant under one year of age, which remains unexplained after a thorough investigation. SIDS is a public health concern. It is the fourth leading cause of infant death in Canada. Newspapers are a major source of health information for the public, shape public perceptions and can direct the discussion around issues. Despite the potential influence of newspapers, no study has examined the portrayal of SIDS in Canadian newspapers over time. The purpose of our study was to gain an understanding of SIDS coverage in Canadian English language newspapers using the Canadian Newsstream database from 1970 to 2015 and the historical database: The Globe and Mail from 1844 to 1977. Generating descriptive quantitative and qualitative data, we noted a decline in SIDS coverage over time. Blame and misdiagnosis were two dominant themes in the coverage of SIDS with many other aspects around SIDS missing; for example, indigenous people, who are at higher risk for SIDS, were rarely mentioned. Our findings suggest problems in the content and frequency of coverage of SIDS that have the potential to shape the public understanding of SIDS.
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Affiliation(s)
- Sadia Ahmed
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ian Mitchell
- Department of Paediatrics, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Gregor Wolbring
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Lennartsson F, Nordin P, Ahlberg BM. Integrating new knowledge into practice: An evaluation study on a continuing education for Swedish child health nurses on non-synostotic plagiocephaly. Nurs Open 2018; 5:329-340. [PMID: 30062027 PMCID: PMC6056432 DOI: 10.1002/nop2.142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 02/15/2018] [Indexed: 11/10/2022] Open
Abstract
AIM The aim of this study was to assess what knowledge on non-synostotic plagiocephaly prevention and reversal intervention and control group nurses imparted to parents and parents integrated in infant care. DESIGN A group of nurses participated in a continuing education on non-synostotic plagiocephaly in one-to-one or small group sessions at their workplace and received guidelines to follow. An evaluation was conducted with 35 intervention group and 15 control group nurses by asking them two open-ended questions 1 year later; 181 intervention group and 90 control group parents were also asked two open-ended questions and to rate their infant's head shape. METHODS Data were collected during the year 2013. Qualitative content analysis and case-by-case analysis were conducted using a process-oriented approach. RESULTS Intervention group nurses imparted both regular and newly introduced knowledge on positioning strategies to parents. Intervention group parents who perceived severe cranial asymmetry when infants were 3-4 months old reported implementing regular and new infant positioning recommendations.
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Affiliation(s)
- Freda Lennartsson
- Institutionen for kliniska vetenskaperAvdelning för pediatrikGöteborgs universitetGöteborgSweden
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Faigenbaum AD, MacDonald JP. Dynapenia: it's not just for grown-ups anymore. Acta Paediatr 2017; 106:696-697. [PMID: 28235140 DOI: 10.1111/apa.13797] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 01/12/2017] [Accepted: 02/21/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Avery D. Faigenbaum
- Department of Health and Exercise Science; The College of New Jersey; Ewing NJ USA
| | - James P. MacDonald
- Division of Sports Medicine; Nationwide Children's Hospital; Ohio State University College of Medicine; Columbus OH USA
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Abstract
BACKGROUND The high prevalence of prematurity and low birth-weight places twin infants at increased risk for sudden unexpected infant death (SUID) and/or sudden infant death syndrome (SIDS). Risk for these SUID and SIDS is affected by a combination of nonmodifiable intrinsic risk factors and modifiable extrinsic stressors including infant care practices related to sleep. Although adherence to the full scope of American Academy of Pediatrics (AAP) 2011 recommendations is intended to decrease risk, these recommendations are aimed at singleton infants and may require tailoring for families with multiple infants. PURPOSE The study describes infant care practices reported by mothers of twins in the first 6 months postpartum. METHODS Mothers caring for twin infants (N = 35) were surveyed online both longitudinally (at 2, 8, 16, and 24 weeks after infant hospital discharge) and cross-sectionally. AAP recommendations (2011) guided survey content. RESULTS The degree of adherence to AAP recommendations varied over time. For example, mothers of twins reported 100% adherence to placing twins supine for sleep initially, but many reported putting babies on their stomachs for naps as twins became older. Sharing a parent's bedroom decreased over time as did frequency of crib sharing. Fewer than half of mothers offered a pacifier most or all of the time for sleep. IMPLICATIONS FOR PRACTICE Opportunities exist for development of an educational program geared specifically for postpartum parents of twins. IMPLICATIONS FOR RESEARCH Barriers affecting adherence to AAP recommendations and effectiveness of educational programs addressing needs of this unique population need further exploration.
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MOIR CHRIS, MEREDITH-JONES KIM, TAYLOR BARRYJ, GRAY ANDREW, HEATH ANNELOUISEM, DALE KELLY, GALLAND BARBARA, LAWRENCE JULIE, SAYERS RACHELM, TAYLOR RACHAELW. Early Intervention to Encourage Physical Activity in Infants and Toddlers. Med Sci Sports Exerc 2016; 48:2446-2453. [DOI: 10.1249/mss.0000000000001055] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Lennartsson F, Nordin P, Wennergren G. Teaching Parents How to Prevent Acquired Cranial Asymmetry in Infants. J Pediatr Nurs 2016; 31:e252-61. [PMID: 26825249 DOI: 10.1016/j.pedn.2015.12.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 12/16/2015] [Accepted: 12/18/2015] [Indexed: 11/16/2022]
Abstract
Acquired cranial asymmetry is prevalent in infants today. This is largely attributed to the supine sleep position recommended for infant safety. The condition can become permanent, so prevention and early detection are important. A prevention project was initiated where guidelines for Swedish child health nurses were developed, tested in a pilot study, revised, and then incorporated into a short cranial asymmetry prevention program for nurses. The program included detailed information on what to teach parents of newborns. An intervention study was initiated where one group of nurses was taught according to the program and the other group followed the standard recommendations. The aim of this survey was to compare intervention and control group parents' responses regarding the cranial asymmetry prevention information that they had received from their nurses during their infant's first four months. Participants included 272 parents (180 intervention group, 92 control group) at 26 child health centers. A checklist was distributed to parents in conjunction with infants' four month health checkup. A significantly higher percentage of intervention group parents were aware of regular recommendations - alternate direction of the infant's head when putting the child to bed (82%: 64%, p=0.001), which pillow to use (92%: 80%, p=0.01), and when to remove the pillow (48%: 31%, p=0.006) - and five newly introduced recommendations compared to controls. Results indicate that educating child health nurses on prevention of cranial asymmetry works to increase parental awareness of what to do and how to do it safely.
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Affiliation(s)
- Freda Lennartsson
- Department of Pediatrics, University of Gothenburg, Gothenburg, Sweden.
| | - Per Nordin
- The Skaraborg Institute for Research and Development, Skövde, Sweden
| | - Göran Wennergren
- Department of Pediatrics, University of Gothenburg, Gothenburg, Sweden; Queen Silvia Children's Hospital, Gothenburg, Sweden
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Use of the Cranial Cup to Correct Positional Head Shape Deformities in Hospitalized Premature Infants. J Obstet Gynecol Neonatal Nurs 2016; 45:542-52. [DOI: 10.1016/j.jogn.2016.03.141] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2016] [Indexed: 11/21/2022] Open
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Maestri RN, Nunes ML. The uptake of safe infant sleep practices by Brazilian pediatricians: a nationwide cross-sectional survey. Sleep Med 2016; 20:123-8. [DOI: 10.1016/j.sleep.2015.12.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 12/15/2015] [Accepted: 12/23/2015] [Indexed: 11/24/2022]
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DeGrazia M, Giambanco D, Hamn G, Ditzel A, Tucker L, Gauvreau K. Prevention of Deformational Plagiocephaly in Hospitalized Infants Using a New Orthotic Device. J Obstet Gynecol Neonatal Nurs 2015; 44:28-41. [DOI: 10.1111/1552-6909.12523] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Cesar JA, Cunha CF, Sutil AT, Santos GBD. Opiniao das maes sobre a posicao do bebe dormir apos campanha nacional: estudo de base populacional no extremo sul do Brasil. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2013. [DOI: 10.1590/s1519-38292013000400005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVOS: avaliou-se o conhecimento materno sobre a posição do bebê dormir após campanha nacional. MÉTODOS: aplicou-se questionário padronizado às mães que tiveram filho em 2010 em Rio Grande, RS. RESULTADOS: dentre as 2395 mães entrevistadas, 20% referiram conforme campanha o decúbito dorsal como a melhor posição para o bebê dormir. Destas, 39% disseram ter obtido este conhecimento junto à campanha nacional. Dentre aquelas que indicaram o decúbito lateral como posição correta, 74% disseram ter aprendido com suas mães. CONCLUSÕES: evidencia-se potencial impacto da campanha nacional e importante influência da avó materna sobre a opinião das mães em colocar o bebê para dormir em decúbito dorsal.
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Intact numbers of cerebellar purkinje and granule cells in sudden infant death syndrome: a stereologic analysis and critical review of neuropathologic evidence. J Neuropathol Exp Neurol 2013; 72:861-70. [PMID: 23965745 DOI: 10.1097/nen.0b013e3182a31c31] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Despite much research during recent decades, the etiology and pathogenesis of sudden infant death syndrome (SIDS) remain unknown. Because of the role of the cerebellum in respiratory and cardiovascular control, it has been proposed that it plays an important role in the pathogenesis of SIDS. To date, 5 postmortem studies on the cerebellum of SIDS cases have yielded conflicting results. Using a rigorous design-based stereologic approach, we investigated postmortem cerebella from 9 SIDS patients who died between 2 and 10 months of age and from 9 age- and sex-matched control children. Neither the volumes of the cerebellar external granule cell layer, molecular layer, internal granule cell layer (including the Purkinje cell layer), and white matter nor the total numbers of Purkinje cells, granule cells in the internal granule cell layer, and the number of granule cells per Purkinje cell showed statistically significant differences between the SIDS cases and the controls. Based on these observations, we conclude that structural alterations in cerebellar development are not involved in the etiology and pathogenesis of SIDS.
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Ohman A. A pilot study, a specially designed pillow may prevent developmental plagiocephaly by reducing pressure from the infant head. Health (London) 2013. [DOI: 10.4236/health.2013.56a2006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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