Features that can be seen on MRI brain are: periventricular leukomalacia, basal ganglia and thalamus lesions, and multicystic encephalopathy. Besides that, diffusion MRI would show low apparent diffusion coefficient (ADC) values in the first seven days of life. This is followed by pseudonormalisation of ADC values (normalisation of ADC values despite having persistent underlying brain injuries) which can persists up to two weeks. Treatment
In the past, treatment options were limited to supportive medical therapy. Currently, neonatal encephalopathy is treated using hypothermia therapy. This has been shown to reduce brain damage, reduce future disability, and improve survival. Hypothermia therapy is also sometimes termed hypothermic neural rescue therapy. Clinical trials are taking place to investigate the effectiveness of stem cell-based interventions, which are thought to have the potential to reduce mortality and improve the long-term development of newborn infants with neonatal encephalopathy. Prognosis
HIE is a major predictor of neurodevelopmental disability in term infants. 25 percent have permanent neurological deficits. Epidemiology
Overall, the relative incidence of neonatal encephalopathy is estimated to be between 2 and 9 per 1000 term births. 40% to 60% of affected infants die by 2 years old or have severe disabilities. In 2013 it was estimated to have resulted in 644,000 deaths down from 874,000 deaths in 1990. References


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Nexafed is a formulation of pseudoephedrine developed by Acura Pharmaceuticals used to deter the use of the pseudoephedrine contained in the product for illicit methamphetamine synthesis. Nexafed uses a polymer matrix that forms a thick gel when hydrated, preventing the extraction of pseudoephedrine. Nexafed is the only meth-resistant formulation of pseudoephedrine that shows therapeutic equivalence to Sudafed.It is sold at various pharmacies in the US, including Fruth Pharmacy and Kroger, particularly in communities where illicit methamphetamine production is an issue. References


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