Long-term effects of neonatal hypoglycemia on brain growth and psychomotor development in small-for-gestational-age preterm infants.

OBJECTIVE: To investigate the effects of neonatal hypoglycemia on physical growth and neurocognitive function.Study design: A systematic detection of hypoglycemia (<2.6 mmol/L or 47 mg/dL) was carried out in 85 small-for-gestational-age preterm neonates. Prospective serial evaluations of physical growth and psychomotor development were performed. Retrospectively, infants were grouped according to their glycemic status. RESULTS: The incidence of hypoglycemia was 72.9%. Infants with repeated episodes of hypoglycemia had significantly reduced head circumferences and lower scores in specific psychometric tests at 3.5 years of age. Hypoglycemia also caused reduced head circumferences at 18 months and lower psychometric scores at 5 years of age. Infants with moderate recurrent hypoglycemia had lower scores at 3.5 and 5 years of age compared with the group of infants who had 1 single severe hypoglycemic episode. CONCLUSION: Recurrent episodes of hypoglycemia were strongly correlated with persistent neurodevelopmental and physical growth deficits until 5 years of age. Recurrent hypoglycemia also was a more predictable factor for long-term effects than the severity of a single hypoglycemic episode. Therefore repetitive blood glucose monitoring and rapid treatment even for mild hypoglycemia are recommended for small-for-gestational-age infants in the neonatal period.

Clonal growth and demography of a hemicryptophyte alpine plant: Leontopodium alpinum Cassini

Clonally reproducing hemicryptophytic rosette plants are common in the alpine belt. However, their demography, and indirectly their growth and reproductive strategy in these harsh conditions, was rarely studied. We analysed the morphology, clonal reproduction and demography of one such species, Leontopodium alpinum, in two populations of the Swiss Alps. The species forms small colonies of 1-5 (maximum 30) sterile rosettes with a few flowering stalks. After flowering, the apical meristem dies and one or two new axillary buds grow below the previous rosette in the following year, developing into short rhizomes (<2 cm), which decay after four years. The new stalk produces sterile rosettes before flowering after two to four years, depending on climatic conditions. The apical meristem often dies during the sterile stage, and is replaced by a new axillary bud. Levkovitch matrices on two stages (sterile and flowering rosettes) showed that rosette survival and clonal reproduction maintain long-lived populations (λ = 0.96). Elasticities indicated that a change in the survival of sterile rosettes had the strongest effect on population dynamics, and this stage lasts, on average, 6.8 years at 2480 m. Altogether, L. alpinum is following Tomlinson's architectural model. This growth form appears perfectly adapted to harsh alpine conditions: the clonal ramification ensures longevity to genets and the semelparous behaviour of the rosettes allows an efficient flowering, whatever the climatic conditions. L. alpinum appears to follow a common growth model among rosette possessing hemicryptophytes in the alpine belt.