1
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Hengel H, Hannan SB, Dyack S, MacKay SB, Schatz U, Fleger M, Kurringer A, Balousha G, Ghanim Z, Alkuraya FS, Alzaidan H, Alsaif HS, Mitani T, Bozdogan S, Pehlivan D, Lupski JR, Gleeson JJ, Dehghani M, Mehrjardi MY, Sherr EH, Parks KC, Argilli E, Begtrup A, Galehdari H, Balousha O, Shariati G, Mazaheri N, Malamiri RA, Pagnamenta AT, Kingston H, Banka S, Jackson A, Osmond M, Rieß A, Haack TB, Nägele T, Schuster S, Hauser S, Admard J, Casadei N, Velic A, Macek B, Ossowski S, Houlden H, Maroofian R, Schöls L, Maroofian R, Schöls L. Bi-allelic loss-of-function variants in BCAS3 cause a syndromic neurodevelopmental disorder. Am J Hum Genet 2021; 108:1069-1082. [PMID: 34022130 PMCID: PMC8206390 DOI: 10.1016/j.ajhg.2021.04.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 04/29/2021] [Indexed: 12/27/2022] Open
Abstract
BCAS3 microtubule-associated cell migration factor (BCAS3) is a large, highly conserved cytoskeletal protein previously proposed to be critical in angiogenesis and implicated in human embryogenesis and tumorigenesis. Here, we established BCAS3 loss-of-function variants as causative for a neurodevelopmental disorder. We report 15 individuals from eight unrelated families with germline bi-allelic loss-of-function variants in BCAS3. All probands share a global developmental delay accompanied by pyramidal tract involvement, microcephaly, short stature, strabismus, dysmorphic facial features, and seizures. The human phenotype is less severe compared with the Bcas3 knockout mouse model and cannot be explained by angiogenic defects alone. Consistent with being loss-of-function alleles, we observed absence of BCAS3 in probands' primary fibroblasts. By comparing the transcriptomic and proteomic data based on probands' fibroblasts with those of the knockout mouse model, we identified similar dysregulated pathways resulting from over-representation analysis, while the dysregulation of some proposed key interactors could not be confirmed. Together with the results from a tissue-specific Drosophila loss-of-function model, we demonstrate a vital role for BCAS3 in neural tissue development.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Reza Maroofian
- Department of Neuromuscular Disorders, Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK.
| | - Ludger Schöls
- Department of Neurology and Hertie-Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany; German Center of Neurodegenerative Diseases, 72076 Tübingen, Germany.
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2
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Backman K, Mears WE, Waheeb A, Beaulieu Bergeron M, McClintock J, de Nanassy J, Reisman J, Osmond M, Hartley T, Mears AJ, Kernohan KD. A splice site and copy number variant responsible for TTC25-related primary ciliary dyskinesia. Eur J Med Genet 2021; 64:104193. [PMID: 33746037 DOI: 10.1016/j.ejmg.2021.104193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 02/08/2021] [Accepted: 03/14/2021] [Indexed: 11/26/2022]
Abstract
Primary ciliary dyskinesia (PCD) is a genetically heterogeneous disorder of motile cilia. With few exceptions, PCD is an autosomal recessive condition, and there are over 40 genes associated with the condition. We present a case of a newborn female with clinical features of PCD, specifically the Kartagener syndrome phenotype, due to variants in TTC25. This gene has been previously associated with PCD in three families. Two multi-gene panels performed as a neonate and at two years of age were uninformative. Exome sequencing was performed by the Care4Rare Canada Consortium on a research basis, and an apparent homozygous intronic variant (TTC25:c.1145+1G > A) was identified that was predicted to abolish the canonical splice donor activity of exon 8. The child's mother was a heterozygous carrier of the variant. The paternal sample did not show the splice variant, and homozygosity was observed across the paternal locus. Microarray analysis showed a 50 kb heterozygous deletion spanning the genes TTC25 and CNP. This is the first example of a pathogenic gross deletion in trans with a splice variant, resulting in TTC25-related PCD.
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Affiliation(s)
- K Backman
- Department of Pediatrics, University of Saskatchewan, Saskatoon, SK, Canada
| | - W E Mears
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - A Waheeb
- Department of Genetics, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - M Beaulieu Bergeron
- Department of Genetics, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada; Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, ON, Canada
| | - J McClintock
- Department of Pathology and Laboratory Medicine, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - J de Nanassy
- Department of Pathology and Laboratory Medicine, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - J Reisman
- Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - M Osmond
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - T Hartley
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - A J Mears
- Newborn Screening Ontario, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - K D Kernohan
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, ON, Canada; Newborn Screening Ontario, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
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- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, ON, Canada
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3
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Volkringer C, Falaise C, Devaux P, Giovine R, Stevenson V, Pourpoint F, Lafon O, Osmond M, Jeanjacques C, Marcillaud B, Sabroux JC, Loiseau T. Stability of metal–organic frameworks under gamma irradiation. Chem Commun (Camb) 2016; 52:12502-12505. [DOI: 10.1039/c6cc06878b] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We report the study of the resistance of archetypal MOFs (MILs, HKUST-1, UiO-66, and ZIF-8) under gamma irradiation.
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4
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Monsanglant-Louvet C, Osmond M, Ferreux L, Liatimi N, Maulard A, Picolo JL, Marcillaud B, Gensdarmes F. Production of reference sources of radioactive aerosols in filters for proficiency testing. Appl Radiat Isot 2014; 95:13-22. [PMID: 25464171 DOI: 10.1016/j.apradiso.2014.09.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 09/18/2014] [Accepted: 09/26/2014] [Indexed: 10/24/2022]
Abstract
In the framework of the organization of proficiency testing, filters with deposits of 137Cs and 90Sr+90Y radioactive aerosols have been submitted to laboratories for radionuclide measurement. Procedures for the special preparation and characterization of filters have been developed. The different steps of filter preparation, determination of the deposited radionuclide activity and characterization of the homogeneity of these deposits are presented. This method of filter preparation can also be used in the production of secondary standards, whose properties are more adapted to the needs of laboratories measuring radioactivity in filters than are the solid sources that they typically use.
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Affiliation(s)
- C Monsanglant-Louvet
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSN-RES/SCA, Gif-sur-Yvette, 91192, France
| | - M Osmond
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSN-RES/SCA, Gif-sur-Yvette, 91192, France
| | - L Ferreux
- Commissariat à l'énergie atomique et aux énergies alternatives (CEA), LNE-LNHB, Gif-sur-Yvette, 91191, France
| | - N Liatimi
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSN-RES/SCA, Gif-sur-Yvette, 91192, France
| | - A Maulard
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PRP- ENV/STEME, Le Vésinet, 78116, France
| | - J L Picolo
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PRP- ENV/STEME, Le Vésinet, 78116, France
| | - B Marcillaud
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSN-RES/SCA, Gif-sur-Yvette, 91192, France
| | - F Gensdarmes
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSN-RES/SCA, Gif-sur-Yvette, 91192, France
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5
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Vallotton P, Angel B, McCall M, Osmond M, Kirby J. Imaging nanoparticle-algae interactions in three dimensions using Cytoviva microscopy. J Microsc 2014; 257:166-9. [PMID: 25421539 DOI: 10.1111/jmi.12199] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 10/21/2014] [Indexed: 11/28/2022]
Abstract
Plasmonic resonances of metal-based nanoparticles are increasingly used for ultrasensitive imaging assays. In this context, the Cytoviva(TM) microscopy platform has greatly gained in popularity. In essence, Cytoviva is an optimized dark field microscope that permits detection of particles down to a few nanometers in size. A significant limitation of Cytoviva up to now has been that it only provided for single plane imaging. The datasets produced by this technique therefore only show a partial view of the sample - not ideally suited to analysis. Here we explain how to overcome this limitation by mounting the Cytoviva condenser on an automated microscope with Z-scanning capability. Our method allows three-dimensional mapping of nanoparticles in their full three-dimensional cellular context. We apply this technique to study the interaction of silver and cerium dioxide nanoparticles with cells of the green alga, Pseudokirchneriella subcapitata, a system of significant environmental relevance because algae underlie much of the aquatic food chain. Our objective was to develop a technique to visualize in detail the interaction of nanoparticles with cells in three dimensions, such that one may, for example, determine whether a particular nanoparticle is inside a cell, at its very surface, or at a distance from it.
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Affiliation(s)
- P Vallotton
- CSIRO - Digital Productivity & Services, Locked Bag 17, North Ryde, New South Wales, 1670, Australia
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6
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Burns E, Osmond M, Williams K. Scalp Hematoma in Pediatric Minor Head Injury: More Than Just a Bump on the Head? Paediatr Child Health 2013. [DOI: 10.1093/pch/18.suppl_a.16a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - E Burns
- Paediatrics, CHEO, Ottawa, Ontario
| | - M Osmond
- Paediatrics, CHEO, Ottawa, Ontario
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7
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Kulkarni AA, Osmond M, Bapir M, Riddell A, Smith C, Lee CA, Kadir RA. The effect of labour on the coagulation system in the term neonate. Haemophilia 2013; 19:533-8. [DOI: 10.1111/hae.12115] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2013] [Indexed: 11/30/2022]
Affiliation(s)
- A. A. Kulkarni
- Department of Obstetrics and Gynaecology; Royal Free Hospital; London; UK
| | - M. Osmond
- Department of Obstetrics and Gynaecology; Royal Free Hospital; London; UK
| | - M. Bapir
- Department of Obstetrics and Gynaecology; Royal Free Hospital; London; UK
| | - A. Riddell
- Haemophilia Centre and Haemostasis Unit; Royal Free Hospital; London; UK
| | - C. Smith
- Research Department of Infection and Population Health; University College London; London; UK
| | - C. A. Lee
- Haemophilia Centre and Haemostasis Unit; Royal Free Hospital; London; UK
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8
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9
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Macpherson AK, White HL, Mongeon S, Grant VJ, Osmond M, Lipskie T, Mackay MJ. Examining the sensitivity of an injury surveillance program using population-based estimates. Inj Prev 2008; 14:262-5. [DOI: 10.1136/ip.2008.018374] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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10
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Osmond M, Dalgleish D, Lawson K, MacDonald T, Clifford T, Gaboury I, Correll R, Pitters C. An Assessment of Knowledge, and Beliefs of Pediatric Emergency Nurses Towards the use of Metered-dose Inhaler and Spacer (MDI+S) for the Treatment of Acute Asthma Before and 12 Months after a Practice Change. Acad Emerg Med 2007. [DOI: 10.1197/j.aem.2007.03.960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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11
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Bailey B, Osmond M, Klassen T, Stiell I, Correll R. Characteristics of Children with Headache Two Weeks after a Minor Head Injury. Acad Emerg Med 2007. [DOI: 10.1197/j.aem.2007.03.953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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12
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Osmond M, Stiell I, Nesbitt L, Clement C, Campbell S, Munkley D, Luinstra-Toohey L, Maloney J, Wells G, Study Group. Multicenter Controlled Clinical Trial to Evaluate the Impact of Advanced Life Support on Children with Out-of-hospital Respiratory Distress. Acad Emerg Med 2007. [DOI: 10.1197/j.aem.2007.03.1174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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13
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Osmond M, Stiell I, Nesbitt L, Clement C, Campbell S, Munkley D, Luinstra-Toohey L, Maloney J, Wells G, Study Group. What is the Impact of Advanced Life Support on the Management and Outcomes of Out-of-hospital Seizures in Children? Acad Emerg Med 2007. [DOI: 10.1197/j.aem.2007.03.959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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14
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15
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Kattwinkel J, Niermeyer S, Nadkarni V, Tibballs J, Phillips B, Zideman D, Van Reempts P, Osmond M. An advisory statement from the Pediatric Working Group of the International Liaison Committee on Resuscitation. Middle East J Anaesthesiol 2001; 16:315-51. [PMID: 11789468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
The International Liaison Committee on Resuscitation (ILCOR), with representation from North America, Europe, Australia, New Zealand, Africa, and South America, was formed in 1992 to provide a forum for liaison between resuscitation organizations in the developed world. This consensus document on resuscitation extends previously published ILCOR advisory statements on resuscitation to address the unique and changing physiology of the newly born infant within the first few hours after birth and the techniques for providing advanced life support. After careful review of the international resuscitation literature and after discussion of key and controversial issues, consensus was reached on almost all aspects of neonatal resuscitation, and areas of controversy and high priority for additional research were delineated. Consensus on resuscitation for the newly born infant included the following principles: Personnel trained in the basic skills of resuscitation should be in attendance at every delivery. A minority (fewer than 10%) of newly born infants require active resuscitative interventions to establish a vigorous cry and regular respirations, maintain a heart rate > 100 beats per minute (bpm), and maintain good color and tone. When meconium is present in the amniotic fluid, it should be suctioned from the hypopharynx on delivery of the head. If the meconium-stained newly born infant has absent or depressed respirations, heart rate, or muscle tone, residual meconium should be suctioned from the trachea. Attention to ventilation should be of primary concern. Assisted ventilation with attention to oxygen delivery, inspiratory time, and effectiveness judged by chest rise should be provided if stimulation does not achieve prompt onset of spontaneous respirations and/or the heart rate is < 100 bpm. Chest compressions should be provided if the heart rate is absent or remains < 60 bpm despite adequate assisted ventilation for 30 seconds. Chest compressions should be coordinated with ventilations at a ratio of 3:1 and a rate of 120 "events" per minute to achieve approximately 90 compressions and 30 rescue breaths per minute. Epinephrine should be administered intravenously or intratracheally if the heart rate remains < 60 bpm despite 30 seconds of effective assisted ventilation and chest compression circulation. Common or controversial medications (epineprine, volume expansion, naloxone, bicarbonate), special resuscitation circumstances affecting care of the newly born, continuing care of the newly born after resuscitation, and ethical considerations for initiation and discontinuation of resuscitation are discussed. There was agreement that insufficient data exist to recommend changes to current guidelines regarding the use of 21% versus 100% oxygen, neuroprotective interventions such as cerebral hypothermia, use of a laryngeal mask versus endotracheal tube, and use of high-dose epinephrine. Areas of controversy are identified, as is the need for additional research to improve the scientific justification of each component of current and future resuscitation guidelines.
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16
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Osmond M. 'I had lost all joy and hope'. Newsweek 2001; 138:28-9. [PMID: 11447812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
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17
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Kattwinkel J, Niermeyer S, Nadkarni V, Tibballs J, Phillips B, Zideman D, Van Reempts P, Osmond M. ILCOR advisory statement: resuscitation of the newly born infant. An advisory statement from the pediatric working group of the International Liaison Committee on Resuscitation. Circulation 1999; 99:1927-38. [PMID: 10199894 DOI: 10.1161/01.cir.99.14.1927] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- J Kattwinkel
- American Academy of Pediatrics, Neonatal Resuscitation Program, American Heart Association, Dallas, Texas, USA
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18
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Kattwinkel J, Niermeyer S, Nadkarni V, Tibballs J, Phillips B, Zideman D, Van Reempts P, Osmond M. An advisory statement from the Pediatric Working Group of the International Liaison Committee on Resuscitation. Pediatrics 1999; 103:e56. [PMID: 10103348 DOI: 10.1542/peds.103.4.e56] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The International Liaison Committee on Resuscitation (ILCOR), with representation from North America, Europe, Australia, New Zealand, Africa, and South America, was formed in 1992 to provide a forum for liaison between resuscitation organizations in the developed world. This consensus document on resuscitation extends previously published ILCOR advisory statements on resuscitation to address the unique and changing physiology of the newly born infant within the first few hours after birth and the techniques for providing advanced life support. After careful review of the international resuscitation literature and after discussion of key and controversial issues, consensus was reached on almost all aspects of neonatal resuscitation, and areas of controversy and high priority for additional research were delineated. Consensus on resuscitation for the newly born infant included the following principles: Common or controversial medications (epinephrine, volume expansion, naloxone, bicarbonate), special resuscitation circumstances affecting care of the newly born, continuing care of the newly born after resuscitation, and ethical considerations for initiation and discontinuation of resuscitation are discussed. There was agreement that insufficient data exist to recommend changes to current guidelines regarding the use of 21% versus 100% oxygen, neuroprotective interventions such as cerebral hypothermia, use of a laryngeal mask versus endotracheal tube, and use of high-dose epinephrine. Areas of controversy are identified, as is the need for additional research to improve the scientific justification of each component of current and future resuscitation guidelines.
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19
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Kattwinkel J, Niermeyer S, Nadkarni V, Tibballs J, Phillips B, Zideman D, Van Reempts P, Osmond M. Resuscitation of the newly born infant: an advisory statement from the Pediatric Working Group of the International Liaison Committee on Resuscitation. Eur J Pediatr 1999; 158:345-58. [PMID: 10206142 DOI: 10.1007/s004310051090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The International Liaison Committee on Resuscitation (ILCOR), with representation from North America, Europe, Australia, New Zealand, Africa, and South America, was formed in 1992 to provide a forum for liaison between resuscitation organizations in the developed world. This consensus document on resuscitation extends previously published ILCOR advisory statements on resuscitation to address the unique and changing physiology of the newly born infant within the first few hours following birth and the techniques for providing advanced life support.
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Affiliation(s)
- J Kattwinkel
- University of Virginia Health System, Department of Pediatrics, Charlottesville 22908, USA.
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20
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Kattwinkel J, Niermeyer S, Nadkarni V, Tibballs J, Phillips B, Zideman D, Van Reempts P, Osmond M. Resuscitation of the newly born infant: an advisory statement from the Pediatric Working Group of the International Liaison Committee on Resuscitation. Resuscitation 1999; 40:71-88. [PMID: 10225280 DOI: 10.1016/s0300-9572(99)00012-x] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The International Liaison Committee on Resuscitation (ILCOR), with representation from North America, Europe, Australia, New Zealand, Africa, and South America, was formed in 1992 to provide a forum for liaison between resuscitation organizations in the developed world. This consensus document on resuscitation extends previously published ILCOR advisory statements on resuscitation to address the unique and changing physiology of the newly born infant within the first few hours following birth and the techniques for providing advanced life support. After careful review of the international resuscitation literature and after discussion of key and controversial issues, consensus was reached on almost all aspects of neonatal resuscitation, and areas of controversy and high priority for additional research were delineated. Consensus on resuscitation for the newly. born infant included the following principles. (i) Personnel trained in the basic skills of resuscitation should be in attendance at every delivery. A minority (fewer than 10%) of newly born infants require active resuscitative interventions to establish a vigorous cry and regular respirations, maintain a heart rate greater than 100 beats per minute (bpm), and maintain good color and tone. (ii) When meconium is present in the amniotic fluid, it should be suctioned from the hypopharynx on delivery of the head. If the meconium-stained newly born infant has absent or depressed respirations, heart rate, or muscle tone, residual meconium should be suctioned from the trachea. (ii) Attention to ventilation should be of primary concern. Assisted ventilation with attention to oxygen delivery, inspiratory time, and effectiveness judged by chest rise should be provided if stimulation does not achieve prompt onset of spontaneous respirations and/or the heart rate is less than 100 bpm. (iv) Chest compressions should be provided if the heart rate is absent or remains less than 60 bpm despite adequate assisted ventilation for 30 s. Chest compressions should be coordinated with ventilations at a ratio of 3:1 and a rate of 120 'events' per minute to achieve approximately 90 compressions and 30 rescue breaths per minute. (v) Epinephrine should be administered intravenously or intratracheally if the heart rate remains less than 60 bpm despite 30 s of effective assisted ventilation and chest compression circulation. Common or controversial medications (epinephrine, volume expansion, naloxone, bicarbonate), special resuscitation circumstances affecting care of the newly born, continuing care of the newly born after resuscitation, and ethical considerations for initiation and discontinuation of resuscitation are discussed. There was agreement that insufficient data exist to recommend changes to current guidelines regarding the use of 21% versus 100% oxygen, neuroprotective interventions such as cerebral hypothermia, use of a laryngeal mask versus endotracheal tube, and use of high-dose epinephrine. Areas of controversy are identified, as is the need for additional research to improve the scientific justification of each component of current and future resuscitation guidelines.
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Affiliation(s)
- J Kattwinkel
- American Academy of Pediatrics, Elk Grove Village, IL, USA.
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21
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Abstract
During the early development of the chick embryo, specific groups of cells die in characteristic patterns. In this study, Nile Blue sulphate staining was used to reveal a novel pattern of segmentally repeated cell death in the paraxial mesoderm of the chick prior to stage 23. This pattern varies according to the developmental stage of the embryo and shifts rostrocaudally, corresponding to progressing somite differentiation. Initially, during early somite differentiation, cell death is restricted to the rostral half of the somite (the rostral pattern of cell death). After the somite has differentiated into dermomyotome and sclerotome, dead cells appear in superficial tissues in a pyramidal pattern which lies in register (rostrocaudally) with the central part of the sclerotome. Finally, small bands of dying cells are seen between the neural tube and the expanding sclerotome. This third pattern (the ventral path) lies in register with the rostral part of the caudal half of the sclerotome. We show by fluorescent labelling of the migrating neural crest that these patterns of cell death correspond to the routes of neural crest migration. In addition, serial sectioning of stage 23 chick embryos confirms that the position of dying cells correlates with the known routes of neural crest migration and with the sites of development of certain neural crest-derived tissues.
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Affiliation(s)
- P Jeffs
- Department of Anatomy, University of Cambridge, UK
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22
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Abstract
The rhombencephalic neural crest, crucial to the patterning and development of many craniofacial structures, migrates laterally from the dorsal hindbrain, but not as a continuous sheet. We have used a vital dye to demonstrate a discontinuous pattern of cell death in the dorsal midline of the avian rhombencephalon associated with the migration of the neural crest. Whilst cell death commences in the dorsal midline of the presumptive mesencephalon at stage 8, two distinct domains of cell death are apparent in the rhombencephalon by stage 11. The rostral domain lies over primary rhombomere RhA1 and rhombomere rh3, while the caudal domain occurs on the neural midline between the otic vesicles, in the region of rh5. Using a marker for the neural crest, we show that the rostral and caudal domains of cell death correlate with the absence of neural crest migration from rh3 and rh5. Thus segment-specific cell death in the dorsal region of particular rhombomeres may account for their subsequent failure to contribute to the cranial neural crest.
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Affiliation(s)
- P Jeffs
- Department of Anatomy, University of Cambridge, UK
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