summer meeting of the neonatal society, 2004

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  • Abstract

    Summer meeting of the Neonatal Society, 2004

    1st2nd July, 2004

    St Johns College, Cambridge, UK

    This meeting has been approved by the RCPCH for 7 CPD Credits

    Thursday 1st July

    12.0013.35 Registration and lunch

    13.35 Welcome

    Chair: Dr Andrew Lyon

    13.45 Dr Mark Herbert, John Radcliffe Hospital

    Group B Streptococcus gene expression in nutrient limited environments

    14.00 Dr S Broughton, Kings College Hospital

    Prospective study of risk factors for healthcare utilisation and RSV infection in prematurely

    born infants

    14.15 Dr A Thakor, University of Cambridge

    The role of calcitonin gene related peptide (CGRP) in the umbilical vascular bed

    14.30 Mr J Cockerill, Imperial College London

    Breast milk attenuates poor postnatal growth in male preterm infants

    14.45 Miss R Slater, University College London

    Early Human Development 80 (2004) 169192 Dr A Lall, Hammersmith Hospital

    T regulatory lymphocytes are found in fetal blood at 29 weeks gestation, but do notNoxious Stimulation Causes Functional Activation of the Somatosensory Cortex in

    Newborn Infants

    15.00 Young Investigator Prize Lecture-Dr David Gardner

    Fetal adaptation to the intrauterine environment: short and longer term consequences for

    physiological development

    15.40 Tea

    Chair: Dr Howard Clark (Young Investigator Prize Winner 2001)doi:10.1016/ FOXP3earlhumdev.2004.07.002

  • 16.15 Dr F McCrosson, Royal Infirmary of Edinburgh

    Changes in Body Temperature Immediately After Birth in Preterm Infants Resuscitated in

    Polythene bags

    16.30 Professor C Morley, Royal Womens Hospital, Melbourne

    Resuscitating very premature lambs with a Laerdal bag without PEEP or set tidal volumes

    with PEEP: the effect on carbon dioxide and oxygenation

    16.45 Dr E Johnson, University of Cambridge

    Effect of maternal dexamethasone treatment on circulating and tissue angiotensin-converting

    enzyme concentration in fetal sheep

    Chairman: The President, Professor Andrew Wilkinson

    17.0018.00 The Tizard Lecture-Sir Iain Chalmers

    Confronting therapeutic uncertainties in neonatal care

    From 18.30 Drinks and Jazz band on lawn/patio

    20.00 Conference Dinner/Entertainment (more musicbarCambridge walkPunting)

    Friday 2nd July

    08.0008.45 Breakfast

    Chair: Dr Nicola Robertson

    08.45 Dr L E Dyet, Hammersmith Hospital

    Diffuse White Matter Abnormalities on Magnetic Resonance Imaging of the Brain in

    Preterm Infants at Term and Neurodevelopmental Outcome

    09.00 Dr K Thorngren-Jerneck, Lund University Hospital

    Cerebral glucose metabolism measure by Positron Emission Tomography (PET) Magnetic

    Resonance Imaging (MRI), diffusion weighted imaging (DWI) and 1H Spectroscopy in

    term newborn infants with Hypoxic Ischemic Encephalopathy (HIE) after birth asphyxia

    09.15 Dr O Iwata, University College London

    Delayed hypothermia is neuroprotective in moderate, but not severe, perinatal

    hypoxic-ischaemic injury

    09.30 Dr N Kennea, Hammersmith Hospital

    Functional Extrinsic and Intrinsic Apoptotic Pathways in Human Fetal Mesenchymal Stem Cells

    09.45 Dr D Todd, Westmead Hospital, Australia

    Retinopathy of prematurity in infants b30 weeks gestation in NSW and the ACT from1992 to 2002

    10.00 Dr L Dabydeen, University of Newcastle

    Additional nutrition significantly increases brain growth in babies with perinatal brain damage

    10.15 Keynote LectureDr Robert Tasker

    Hippocampal vulnerability, developmental amnesia, and what else?

    11.00 Coffee


  • Abstract 171Noxious stimulation causes functional activation of the somatosensory cortex in

    Chair: Dr Helen Budge (Young Investigator Prize Winner 2002)

    11.20 Young Investigator Prize Lecture-Dr Karen Luyt

    Metabotropic Neurotransmitter

    Receptors in Oligodendrocytes: novel potential players in white matter development,

    injury and repair

    12.00 Dr M Gnanalingham, University Hospital Nottingham

    Impact of delivery temperature on uncoupling protein-1 and -2 abundance on brown

    adipose tissue in the newborn

    12.15 Dr K L Franko, University of Cambridge

    Effect of Maternal Protein Deprivation During

    Pregnancy on Hepatic Gluconeogenic Enzyme in Rat Fetuses at Term

    12.30 Keynote lecture-Dr Dino Giussani

    Oxygen, fetal growth and cardiovascular development

    13.15 Close of meeting and lunch

    Our thanks in particular to Chiesi, and also to Draeger Medical, Fisher Paykel, S.L.E. and Vygon for

    sponsoring this meeting.newborn infants

    Rebeccah Slater1, Shiromi Gallella2, Stewart Boyd3, Judith Meek2, Maria Fitzgerald1

    1Department of Anatomy and Developmental Biology, University College London,

    London, UK2Department of Paediatrics, University College London Hospital, London, UK3Neurosciences Unit, Institute of Child Health, London, UK

    Introduction: Noxious sensations can clearly stimulate the central nervous system,

    producing reflex movements and a biochemical response, at a very early age

    (Fitzgerald, 1999; Smith, 2000). The true experience of pain requires functional

    maturation of higher brain centres, however, it is unclear at what CNS level this

    response is produced. Here we report on the use of near infra red spectroscopy (NIRS)

    to study the maturation of the cortical response to noxious sensation.

    Aim: To use NIRS to investigate cortical pain processing in neonates using the

    haemodynamic response in the somatosensory cortex to noxious stimulation.

    Methods: Eleven preterm infants were studied during routine phlebotomy. All infants

    had normal appearances on cranial ultrasound scans. The haemodynamic response to

    the heel lance was measured using a double channel NIR spectrophotometer. The

    optodes were positioned symmetrically on each side of the head over the

    somatosensory cortex and changes in oxyhaemoglobin (HbO2), deoxyhaemoglobin

    (HHb) and total haemoglobin (HbT) concentrations were measured.

  • Table showing maximum change in HbT in the contralateral and ipsilateral

    somatosensory cortex following painful stimulation and a sample trace of the evoked

    response in one infant.

    Conclusion: Infants between 29 and 42 weeks pma show a large localised

    somatosensory response to painful stimulation. The magnitude of the evoked responses

    is similar to those obtained using visual and olfactory stimuli. This study shows that

    noxious stimulation evokes neural activity in the somatosensory cortex at this age and

    that both preterm and term infants are able to mount a cortical response to painful


    42+0 10.62 0.63


    Smith RP, Gitau R, Glover V, Fisk NM. 2000 Pain and stress in the human fetus. Eur J Obstet

    Gynecol Reprod Biol. 92:1615.

    Fitzgerald M. 1999 The developmental neurobiology of pain. The textbook of pain, 4th edition. EdResults: A haemodynamic response was successfully measured in seven infants with a

    mean post menstrual age (pma) of 36.3 weeks. Four studies were excluded due to

    motion artefact. Following the heel lance there was an increase in HbT in the

    contralateral somatosensory cortex and a decrease in the ipsilateral somatosensory



    age (weeks)

    Maximum change in contralateral HbT

    (Amol/l) during 20 s following heel lanceMaximum change in ipsilateral HbT

    (Amol/l) during 20 s following heel lance

    29+5 8.67 2.0635+5 9.49 6.0530+0 1.53 9.0835+1 2.39 0.5637+5 3.11 3.9743+2 2.11 12.98Wall PD and Melzack R, Churchill Livingstone, pp 235252.

  • Abstract 173Prospective study of risk factors for healthcare utilisation and RSV Infection in

    prematurely born infants

    Authors: Simon Broughton1, Alison Roberts1, Grenville Fox2, Mark Zuckerman3 and

    Anne Greenough1

    1Department of Child Health, Guys Kings and St Thomas Medical School, Kings

    College Hospital, Denmark Hill, London SE5 9RS, UK2Department of Child Health, Guys, Kings and St Thomas Medical School, St

    Thomas Hospital, Lambeth Palace Rd, London SE1 7EH, UK3Department of Microbiology, Guys Kings and St Thomas Medical School, Kings

    College Hospital, Denmark Hill, London SE5 9RS, UK

    Background: Prematurely born infants frequently require readmission or GP contacts

    following NICU discharge, data from retrospective studies suggests this may be increased

    following RSV infection.

    Aims: In a prospective study to determine risk factors for healthcare utilisation and RSV

    infection in babies born prematurely.

    Methods: Babies born b32 weeks of gestation were recruited if they were born withinsix months of the onset of the RSV season. Following discharge from the neonatal

    unit, data were collected regarding subsequent healthcare utilisation; the number and

    length of hospital admissions and GP consultations. The parents were asked to

    contact a member of the research team if their baby had signs of a lower respiratory

    tract infection (LRTI). In addition, all parents were contacted on a fortnightly basis

    by the research team. If either contact indicated the baby had a LRTI, a member of

    the research team visited the baby at home or at hospital and a nasopharyngeal

    aspirate (NPA) was obtained. Healthcare utilisation and RSV infection were then

    related to demographic, social and neonatal data to identify risk factors. Ethical

    approval was obtained from the ethics committee and consent was obtained from t


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