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https://www.readbyqxmd.com/read/29465539/different-utilization-of-intensive-care-services-icss-for-patients-dying-of-hemorrhagic-and-ischemic-stroke-a-hospital-based-survey
#1
Vinchi Wang, Chieh-Chao Hsieh, Yen-Ling Huang, Chia-Ping Chen, Yi-Ting Hsieh, Tzu-Hao Chao
The intensive care service (ICS) saves lives and rescues the neurological function of stroke patients. We wondered the different utilization of ICS for patients with ischemic and hemorrhagic stroke, especially those who died within 30 days after stroke.Sixty-seven patients died during 2011 to 2015 due to acute stroke (42 due to intracranial hemorrhage [ICH]; 25 due to cerebral infarct [CI]). The durations of hospital stay (hospital staying days [HSDs]) and ICS staying days (ISDs) and codes of the do-not-resuscitate (DNR) were surveyed among these medical records...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29465435/clinical-manifestations-of-sickle-cell-disease-in-india-misconceptions-and-reality
#2
Dipty Jain, Dipika Mohanty
PURPOSE OF REVIEW: In the past, milder clinical manifestations of sickle cell disease (SCD) have been described from India. However, recent data from some parts of India suggest that the severity of the disease can be compared to that of African phenotypes. This review therefore describes the varied clinical manifestation of SCD, the success of newborn screening programme, prenatal diagnosis and low dose hydroxyurea therapy in India. RECENT FINDINGS: The varied clinical manifestations such as anemia, vaso-occlusive crisis, acute chest syndrome, renal involvement, stroke and so on vary from one part of the country to the other and also among different communities of India...
February 19, 2018: Current Opinion in Hematology
https://www.readbyqxmd.com/read/29461977/mosaic-ras-mapk-variants-cause-sporadic-vascular-malformations-which-respond-to-targeted-therapy
#3
Lara Al-Olabi, Satyamaanasa Polubothu, Katherine Dowsett, Katrina A Andrews, Paulina Stadnik, Agnel P Joseph, Rachel Knox, Alan Pittman, Graeme Clark, William Baird, Neil Bulstrode, Mary Glover, Kristiana Gordon, Darren Hargrave, Susan M Huson, Thomas S Jacques, Gregory James, Hannah Kondolf, Loshan Kangesu, Kim M Keppler-Noreuil, Amjad Khan, Marjorie J Lindhurst, Mark Lipson, Sahar Mansour, Justine O'Hara, Caroline Mahon, Anda Mosica, Celia Moss, Aditi Murthy, Juling Ong, Victoria E Parker, Jean-Baptiste Rivière, Julie C Sapp, Neil J Sebire, Rahul Shah, Branavan Sivakumar, Anna Thomas, Alex Virasami, Regula Waelchli, Zhiqiang Zeng, Leslie G Biesecker, Alex Barnacle, Maya Topf, Robert K Semple, E Elizabeth Patton, Veronica A Kinsler
BACKGROUND: Sporadic vascular malformations (VMs) are complex congenital anomalies of blood vessels that lead to stroke, life-threatening bleeds, disfigurement, overgrowth, and/or pain. Therapeutic options are severely limited and multi-disciplinary management remains challenging, particularly for high-flow arteriovenous malformations (AVM). METHODS: To investigate the pathogenesis of sporadic intracranial and extracranial VMs in 160 children in which known genetic causes had been excluded, we sequenced DNA from affected tissue and optimised analysis for detection of low mutant allele frequency...
February 20, 2018: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29461227/-the-differentiated-approach-to-prevention-of-neural-tube-defects-in-children
#4
N Kotova, V Maichuk, O Fedorenko
Neural tube defects occupy second place in frequency after the defects of the cardiovascular system. The folate metabolism violation and hyperhomocysteinemia in women are proved to be the leading risk factors for the NTD of the fetus. Polymorphism of the 5,10-methylenetetrahydrofolate reductase gene (MTHFR) is a genetic determinant of folate metabolism violation. Admission of folic acid in a standard dose of 0.4 mg and / or the use of fortified foods does not allow reaching the protective level of folic acid if there is a mutation of the MTHFR gene or when several risk factors combine, which requires a higher dose of folic acid...
January 2018: Georgian Medical News
https://www.readbyqxmd.com/read/29459043/is-there-a-best-approach-for-extracorporeal-life-support-cannulation-a-review-of-the-extracorporeal-life-support-organization
#5
Kevin Johnson, Marcus D Jarboe, George B Mychaliska, Ryan P Barbaro, Peter Rycus, Ronald B Hirschl, Samir K Gadepalli
BACKGROUND: Neurologic complications are common, and amongst the most devastating complications in pediatric patients undergoing extracorporeal life support (ECLS). Carotid artery cannulation (CAN) has been associated with an increase in these complications, thereby shaping practices to avoid this approach in most pediatric patients in which other cannulation approaches are viable. METHODS: A retrospective review of children (0-18years) in the ELSO database was undertaken from 1989 through 2013...
January 31, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29451699/development-and-validation-of-the-pediatric-stroke-quality-of-life-measure
#6
Andrea Fiume, Gabrielle Deveber, Shu-Hyun Jang, Colleen Fuller, Shani Viner, Sharon Friefeld
AIM: To develop and validate a disease-specific parent proxy and child quality of life (QoL) measure for patients aged 2 to 18 years surviving cerebral sinovenous thrombosis (CSVT) and arterial ischaemic stroke (AIS). METHOD: Utilizing qualitative and quantitative methods, we developed a 75-item Pediatric Stroke Quality of Life Measure (PSQLM) questionnaire. We mailed the PSQLM and a standardized generic QoL measure, Pediatric Quality of Life Inventory (PedsQL), to 353 families...
February 16, 2018: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/29432248/neurologic-complications-in-the-pediatric-intensive-care-unit
#7
Mark S Wainwright
PURPOSE OF REVIEW: All critical care is directed at maintaining brain health, but recognizing neurologic complications of critical illness in children is difficult, and limited data exist to guide practice. This article discusses an approach to the recognition and management of seizures, stroke, and cardiac arrest as complications of other critical illnesses in the pediatric intensive care unit. RECENT FINDINGS: Convulsive and nonconvulsive seizures occur frequently in children after cardiac arrest or traumatic brain injury and during extracorporeal membrane oxygenation...
February 2018: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/29432241/evaluation-and-acute-management-of-ischemic-stroke-in-infants-and-children
#8
Catherine Amlie-Lefond
PURPOSE OF REVIEW: This article provides an overview of stroke in neonates, infants, and children. RECENT FINDINGS: Arterial ischemic stroke and cerebral venous sinus thrombosis are increasingly recognized in childhood as important causes of lifelong morbidity and mortality. Diagnosis of arterial ischemic stroke is frequently delayed, as acute neurologic deficits can be challenging to detect in the young child, and stroke is often not considered in the differential diagnosis...
February 2018: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/29431623/prevalence-and-risk-factors-for-venous-thromboembolism-in-children-with-sickle-cell-disease-an-administrative-database-study
#9
Riten Kumar, Joseph Stanek, Susan Creary, Amy Dunn, Sarah H O'Brien
A hypercoagulable state resulting in increased venous thromboembolism (VTE) has been described in adults with sickle cell disease (SCD), but similar data for children are lacking. The objective of this retrospective cohort study was to describe the rate of VTE and risk factors associated with VTE in children with SCD across tertiary-care children's hospitals in the United States between the years 2009 and 2015. We used the Pediatric Health Information System database to investigate all pediatric patients with SCD admitted to 1 of 48 participating institutions between 1 January 2009 and 30 September 2015...
February 13, 2018: Blood Advances
https://www.readbyqxmd.com/read/29429783/pediatric-stroke-and-its-mimics-limitations-of-a-pediatric-stroke-clinical-pathway
#10
Amy M DeLaroche, Lalitha Sivaswamy, Ahmad Farooqi, Nirupama Kannikeswaran
BACKGROUND: Acute stroke protocols improve delivery of care but it is unclear whether these resource intensive protocols are able to differentiate stroke from mimics in children. The aim of this study is to describe our institution's experience with stroke mimics identified through our pediatric stroke clinical pathway (PSCP). METHODS: The PSCP was implemented in our level 1 pediatric emergency department in June 2014 for children aged one month to 18 years. For patients managed using the PSCP from June 2014 to December 2016, demographic and clinical data were compared for patients diagnosed with stroke or a stroke mimic...
October 31, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/29429778/hydrocephalus-in-pediatric-traumatic-brain-injury-national-incidence-risk-factors-and-outcomes-in-124-444-hospitalized-patients
#11
Kavelin Rumalla, Vijay Letchuman, Kyle A Smith, Paul M Arnold
BACKGROUND: Hydrocephalus is a life-threatening sequela of traumatic brain injury (TBI) with poorly defined epidemiology in children. Here, we report the national incidence, risk factors, and outcomes associated with post-traumatic hydrocephalus (PTH). METHODS: The Kids Inpatient Database (2003, 2006, 2009, 2012) was queried using the International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) codes to identify all patients (age 0 to 20) with TBI (850...
December 11, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/29428506/8-year-retrospective-analysis-of-intravenous-arginine-therapy-for-acute-metabolic-strokes-in-pediatric-mitochondrial-disease
#12
Rebecca D Ganetzky, Marni J Falk
BACKGROUND: Intravenous (IV) arginine has been reported to ameliorate acute metabolic stroke symptoms in adult patients with Mitochondrial Encephalopathy with Lactic Acidosis and Stroke-like Episodes (MELAS) syndrome, where its therapeutic benefit is postulated to result from arginine acting as a nitric oxide donor to reverse vasospasm. Further, reduced plasma arginine may occur in mitochondrial disease since the biosynthesis of arginine's precursor, citrulline, requires ATP. Metabolic strokes occur across a wide array of primary mitochondrial diseases having diverse molecular etiologies that are likely to share similar pathophysiologic mechanisms...
February 2, 2018: Molecular Genetics and Metabolism
https://www.readbyqxmd.com/read/29411418/feasibility-trial-for-primary-stroke-prevention-in-children-with-sickle-cell-anemia-in-nigeria-spin-trial
#13
Najibah A Galadanci, Shehu Umar Abdullahi, Leah D Vance, Abdulkadir Musa Tabari, Shehi Ali, Raymond Belonwu, Auwal Salihu, Aisha Amal Galadanci, Binta Wudil Jibir, Halima Bello-Manga, Kathleen Neville, Fenella J Kirkham, Yu Shyr, Sharon Phillips, Brittany V Covert, Adetola A Kassim, Lori C Jordan, Muktar H Aliyu, Michael R DeBaun
No abstract text is available yet for this article.
March 2018: American Journal of Hematology
https://www.readbyqxmd.com/read/29406768/using-the-international-classification-of-functioning-disability-and-health-model-to-gain-perspective-of-the-benefits-of-yoga-in-stroke-multiple-sclerosis-and-children-to-inform-practice-for-children-with-cerebral-palsy-a-meta-analysis
#14
Diana Veneri, Mary Gannotti, Matteo Bertucco, Sarah E Fournier Hillman
OBJECTIVE: Research pertaining to yoga and children with cerebral palsy (CP) is negligible. The primary purpose of this study was to determine the domains of the International Classification of Functioning, Disability, and Health (ICF) model and levels of evidence for yoga and adults with stroke and multiple sclerosis (MS), and children. A secondary purpose was to decide whether any inferences could be made for children with CP. DESIGN: This study included a meta-analysis...
February 6, 2018: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/29405840/changes-in-transcranial-ultrasound-velocities-in-children-with-sickle-cell-disease-undergoing-adenotonsillectomy
#15
Griffin Santarelli, Sarah C DeShields, Stacey L Ishman, Michael Randall, Tina D Cunningham, Cristina M Baldassari
Objectives (1) To assess for changes in cerebral blood flow velocity in children with sickle cell disease and obstructive sleep apnea (OSA) following adenotonsillectomy. (2) To determine if clinical factors such as OSA severity affect cerebral blood flow velocity values. Study Design Case series with chart review over 10 years. Settings Two tertiary children's hospitals. Subjects and Methods Children aged 2 to 18 years with a history of sickle cell disease and OSA, as defined by an apnea hypopnea index (AHI) >1 on polysomnography, were eligible for inclusion...
January 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29402615/improving-call-to-door-time-using-school-based-intervention-by-emergency-medical-technicians-the-akashi-project
#16
Takuro Arimizu, Chiaki Yokota, Shinya Tomari, Tenyu Hino, Shinichi Wada, Hideyuki Ohnishi, Kazunori Toyoda, Kazuo Minematsu
BACKGROUND: Identification of stroke signs by emergency medical technicians (EMTs) is important for initiating the "stroke chain of survival." The aim of the present study was to clarify the effect of EMT-led lessons on stroke awareness for schoolchildren in the Akashi project on the transportation time to arrive at the hospital. METHODS: Stroke lessons were given by EMTs to 887 elementary school children in elementary schools between September 2014 and October 2015...
February 2, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29401500/mobile-direct-observation-of-therapy-mdot-a-rapid-systematic-review-and-pilot-study-in-children-with-asthma
#17
Michael D Shields, Fahad ALQahtani, Michael P Rivey, James C McElnay
We describe, for the first time, the use of a mobile device platform for remote direct observation of inhaler use and technique. The research programme commenced with a rapid systematic review of mobile device (or videophone) use for direct observation of therapy (MDOT). Ten studies (mainly pilots) were identified involving patients with tuberculosis, sickle cell disease and Alzheimer's disease. New studies are ongoing (ClinicalTrials.gov website) in TB, stroke, sickle cell disease, HIV and opioid dependence...
2018: PloS One
https://www.readbyqxmd.com/read/29397159/placental-pathology-in-neonatal-stroke-a-retrospective-case-control-study
#18
Miya E Bernson-Leung, Theonia K Boyd, Emily E Meserve, Amy R Danehy, Kush Kapur, Cameron C Trenor, Laura L Lehman, Michael J Rivkin
OBJECTIVE: To assess the association of placental abnormalities with neonatal stroke. STUDY DESIGN: This retrospective case-control study at 3 academic medical centers examined placental specimens for 46 children with neonatal arterial or venous ischemic stroke and 99 control children without stroke, using a standard protocol. Between-group comparisons used χ 2 and Fisher exact t test. Correlations used Spearman correlation coefficient. RESULTS: Case placentas were more likely than controls to meet criteria for ≥1 of 5 major categories of pathologic abnormality (89% vs 62%; OR, 5...
January 31, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29396624/is-the-1298a-c-polymorphism-in-the-mthfr-gene-a-risk-factor-for-arterial-ischaemic-stroke-in-children-the-results-of-meta-analysis
#19
Beata Sarecka-Hujar, Ilona Kopyta, Michal Skrzypek
An elevated level of homocysteine is a risk factor for vascular diseases, brain atrophy and several other disorders. The 1298A>C polymorphism (rs1801131) leads to mildly decreased MTHFR activity. Previously, it was observed that the MTHFR 1298A>C polymorphism in combined analysis with the MTHFR 677C>T polymorphism increases homocysteine levels. However, conflicting results on its relation to ischaemic stroke in children can be found. We conducted a meta-analysis to analyse possible connections between the MTHFR 1298A>C polymorphism and ischaemic stroke in paediatric patients...
February 2, 2018: Clinical and Experimental Medicine
https://www.readbyqxmd.com/read/29395751/early-stroke-post-heart-transplant-is-associated-with-decreased-survival-in-children
#20
Cheryl Cammock, Swati Choudhry, Chesney M Castleberry, Noor Al-Hammadi, Pirooz Eghtesady, Charles E Canter, Kathleen E Simpson
BACKGROUND: Major neurologic events (MNEs) after heart transplantation (HTx) and their effect on survival have not been well described in children. In this study we aimed to characterize early MNEs (stroke, isolated seizures not from stroke and posterior reversible leukoencephalopathy [PRES] within 1 year after primary pediatric HTx) and evaluate their impact on 1-year post-HTx survival. We hypothesized that early an MNE after HTx is associated with decreased 1-year patient survival. METHODS: We performed a pediatric, single-center, retrospective analysis of 345 consecutive patients aged 0 to 22 years who underwent primary HTx during the period from November 1, 1994 to October 31, 2015...
January 9, 2018: Journal of Heart and Lung Transplantation
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