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Pediatric stroke

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https://www.readbyqxmd.com/read/28805445/prevalence-and-predictors-of-learning-and-psychological-diagnoses-following-pediatric-arterial-ischemic-stroke
#1
Tricia S Williams, Kyla P McDonald, Samantha D Roberts, Nomazulu Dlamini, Gabrielle deVeber, Robyn Westmacott
This study examined the prevalence of learning and psychological diagnoses and associated neurological and personal-environmental risk factors following perinatal and childhood arterial ischemic stroke. In our sample of 126 children and youth, 52.4% received a diagnosis following their assessment. Specifically, 32% had a single diagnosis and 21% had two or more diagnoses. Learning disability, attention deficit-hyperactivity disorder, and intellectual disability were the most prevalent diagnoses. Associated risk factors varied by diagnosis with lower intellectual functioning being the common risk factor across categories...
August 14, 2017: Developmental Neuropsychology
https://www.readbyqxmd.com/read/28803593/predictors-of-obtaining-follow-up-care-in-the-province-of-ontario-canada-following-a-new-diagnosis-of-atrial-fibrillation-heart-failure-and-hypertension-in-the-emergency-department
#2
Clare L Atzema, Bing Yu, Noah M Ivers, Paula A Rochon, Douglas S Lee, Michael J Schull, Peter C Austin
OBJECTIVE: Patients with cardiovascular diseases are common in the emergency department (ED), and continuity of care following that visit is needed to ensure that they receive evidence-based diagnostic tests and therapy. We examined the frequency of follow-up care after discharge from an ED with a new diagnosis of one of three cardiovascular diseases. METHODS: We performed a retrospective cohort study of patients with a new diagnosis of heart failure, atrial fibrillation, or hypertension, who were discharged from 157 non-pediatric EDs in Ontario, Canada, between April 2007 and March 2014...
August 14, 2017: CJEM
https://www.readbyqxmd.com/read/28801954/an-analysis-of-inpatient-pediatric-sickle-cell-disease-incidence-costs-and-outcomes
#3
Laura M Bou-Maroun, Fabien Meta, Curtis J Hanba, Andrew D Campbell, Gregory A Yanik
OBJECTIVE: To identify characteristics of pediatric sickle cell disease (SCD) hospitalizations and to examine admission demographics and medical expenditures. METHODS: Admissions with SCD were identified from the 2009 and 2012 releases of the Healthcare and Cost Utilization Project's Kids Inpatient Database. Disease-specific secondary diagnoses including acute chest syndrome (ACS), vaso-occlusive pain crisis (VOC), splenic sequestration, and stroke/transient ischemic attack were analyzed for patient and hospital demographics...
August 12, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28801324/mechanical-thrombectomy-for-repeated-cerebral-tumor-embolism-from-a-thoracic-sarcomatoid-carcinoma
#4
Raoul Pop, Dan Mihoc, Monica Manisor, Johann Sebastian Richter, Veronique Lindner, Ralf Janssen-Langenstein, Mihaela Simu, Valerie Wolff, Remy Beaujeux
Cerebral embolism originating from intracardiac tumors represents a rare cause of stroke and has been documented in both adult and pediatric populations. We present a patient recently diagnosed with a right pulmonary hilum tumor, invading the pulmonary veins and the left atrium. Two consecutive episodes of large cerebral vessel occlusion in separate vascular territories occurred in the same day and were treated by mechanical thrombectomy. Embolic material retrieved on both occasions contained tumor fragments with peripheral endothelialization...
August 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28800001/basic-hemodynamic-monitoring-using-ultrasound-or-electrical-cardiometry-during-transportation-of-neonates-and-infants
#5
Angele Boet, Gilles Jourdain, Serge Demontoux, Sebastien Hascoet, Pierre Tissieres, Catherine Rucker-Martin, Daniele De Luca
OBJECTIVES: Electrical cardiometry and heart ultrasound might allow hemodynamic evaluation during transportation of critically ill patients. Our aims were 1) to test feasibility of stroke volume monitoring using electrical cardiometry or ultrasound during transportation and 2) to investigate if transportation impacts on electrical cardiometry and ultrasound reliability. DESIGN: Prospective, pragmatic, feasibility cohort study. SETTING: Mobile ICUs specialized for neonatal and pediatric transportation...
August 9, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28777266/ataxia-and-headache-in-a-child-a-case-of-acute-cerebellar-infarction
#6
Kathryn M Hewett, Brett Lorenzetti, Benjamin F Jackson
A 4-year-old female patient presents to the pediatric emergency department with acute onset of ataxia and occipital headache. Initial investigation, including computed tomography imaging, failed to demonstrate any focal neurologic lesion. Subsequent studies, however, reveal an acute thrombosis of the superior cerebellar artery. Further work up identified the likely causative factor to be a heterozygous mutation at the methylene tetrahydrofolate reductase gene. In this case report, we will discuss the work-up of pediatric ataxia, the evaluation and management of cerebrovascular accidents in children, and the association between stroke and mutation of the methylene tetrahydrofolate reductase gene...
August 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28756061/assessment-of-acute-motor-deficit-in-the-pediatric-emergency-room
#7
REVIEW
Marcio Moacyr Vasconcelos, Luciana G A Vasconcelos, Adriana Rocha Brito
OBJECTIVES: This review article aimed to present a clinical approach, emphasizing the diagnostic investigation, to children and adolescents who present in the emergency room with acute-onset muscle weakness. SOURCES: A systematic search was performed in PubMed database during April and May 2017, using the following search terms in various combinations: "acute," "weakness," "motor deficit," "flaccid paralysis," "child," "pediatric," and "emergency". The articles chosen for this review were published over the past ten years, from 1997 through 2017...
July 27, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28745855/managing-acute-complications-of-sickle-cell-disease-in-pediatric-patients-digest
#8
Sathyaseelan Subramaniam, Jennifer H Chao, Pradip Chaudhari
Sickle cell disease is a chronic hematologic disease with a variety of acute, and often recurring, complications. Vaso-occlusive crisis, a unique but common presentation in sickle cell disease, can be challenging to manage. Acute chest syndrome is the leading cause of death in patients with sickle cell disease, occurring in more than half of patients who are hospitalized with a vaso-occlusive crisis. Uncommon diagnoses in children, such as stroke, priapism, and transient red cell aplasia, occur more frequently in patients with sickle cell disease and necessitate a degree of familiarity with the disease process and its management...
November 22, 2016: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28733481/focal-cerebral-arteriopathy-do-steroids-improve-outcome
#9
Maja Steinlin, Sandra Bigi, Belinda Stojanovski, Jay Gajera, Maria Regényi, Marwan El-Koussy, Mark T Mackay
BACKGROUND AND PURPOSE: Focal cerebral arteriopathy accounts for up to 35% of arterial ischemic stroke (AIS) in children and is the most important predictor of stroke recurrence. The study objective was to compare outcomes for children with focal cerebral arteriopathy treated with combined corticosteroid antithrombotic treatment (CAT) to those receiving antithrombotic treatment (AT) alone. METHODS: This multicenter retrospective Swiss/Australian cohort study analyzed consecutive children, aged 1 month to 18 years, presenting with first AIS because of a focal cerebral arteriopathy from 2000 to 2014...
July 21, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28730452/transcranial-color-doppler-in-stroke-free-adult-patients-with-sickle-cell-disease
#10
G Graziadei, F M Casoni, F Annoni, I Cortinovis, P Ridolfi, I Gandolfi, A Marcon, E Di Pierro, M D Cappellini
The threshold velocity ≥200 cm/s at transcranial Doppler (TCD) evaluation is a useful cut-off for preventing the stroke (STOP trial) in pediatric patients with sickle cell disease (SCD), term including different types of sickle genotypes. Scanty data are available for adult SCD patients. We compared intracranial blood flow velocities between adult SCD patients and controls using transcranial color Doppler (TCCD), measuring the peak of systolic velocity (PSV) with the insonation angle correction and the pulsatility index (PI), an indicator of endothelial elasticity...
September 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28726587/repair-of-tympanic-membrane-perforations-with-customized-bioprinted-ear-grafts-using-chinchilla-models
#11
Che-Ying Kuo, Emmanuel Wilson, Andrew Fuson, Nidhi Gandhi, Reza Monfaredi, Audrey Jenkins, Maria Romero, Marco Santoro, John P Fisher, Kevin Cleary, Brian Reilly
The goal of this work is to develop an innovative method that combines bioprinting and endoscopic imaging to repair tympanic membrane perforations (TMPs). TMPs are a serious health issue because they can lead to both conductive hearing loss and repeated otitis media. TMPs occur in 3 to 5% of cases after ear tube placement as well as in cases of acute otitis media (the second most common infection in pediatrics), chronic otitis media with or without cholesteatoma, or as a result of barotrauma to the ear. About 55,000 tympanoplasties, the surgery performed to reconstruct TMPs, are performed every year and the commonly used cartilage grafting technique has a success rate between 43% to 100%...
July 20, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/28715924/moyamoya-disease-in-children-results-from-the-international-pediatric-stroke-study
#12
Sarah Lee, Michael J Rivkin, Adam Kirton, Gabrielle deVeber, Jorina Elbers
This study aimed to describe children with moyamoya disease from an international multicenter stroke database, and explore risk factors for stroke recurrence. We reviewed data of children >28-days old with moyamoya disease enrolled in the International Pediatric Stroke Study from January 2003 to March 2013. A total of 174 children from 32 sites and 14 countries had moyamoya disease; median age 7.4 years, 49% male. Of these, 90% presented with ischemic stroke, 7.5% with transient ischemic attack, and 2.5% with hemorrhagic stroke...
January 1, 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28710246/trajectories-of-motor-recovery-in-the-first-year-after-pediatric-arterial-ischemic-stroke
#13
Anna N Cooper, Vicki Anderson, Stephen Hearps, Mardee Greenham, Michael Ditchfield, Lee Coleman, Rod W Hunt, Mark T Mackay, Paul Monagle, Anne L Gordon
BACKGROUND: Neuromotor impairments are common after pediatric stroke, but little is known about functional motor outcomes. We evaluated motor function and how it changed over the first 12 months after diagnosis. We also examined differences in outcome according to age at diagnosis and whether fine motor (FM) or gross motor (GM) function at 12 months was associated with adaptive behavior. METHODS: This prospective, longitudinal study recruited children (N = 64) from The Royal Children's Hospital, Melbourne who were diagnosed with acute arterial ischemic stroke (AIS) between December 2007 and November 2013...
August 2017: Pediatrics
https://www.readbyqxmd.com/read/28688998/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#14
Alain Cariou, Jean-Francois Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
July 5, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28686127/effectiveness-of-surgical-revascularization-for-stroke-prevention-in-pediatric-patients-with-sickle-cell-disease-and-moyamoya-syndrome
#15
Wuyang Yang, Risheng Xu, Jose L Porras, Clifford M Takemoto, Syed Khalid, Tomas Garzon-Muvdi, Justin M Caplan, Geoffrey P Colby, Alexander L Coon, Rafael J Tamargo, Judy Huang, Edward S Ahn
OBJECTIVE Sickle cell disease (SCD) in combination with moyamoya syndrome (MMS) represents a rare complication of SCD, with potentially devastating neurological outcomes. The effectiveness of surgical revascularization in this patient population is currently unclear. The authors' aim was to determine the effectiveness of surgical intervention in their series of SCD-MMS patients by comparing stroke recurrence in those undergoing revascularization and those undergoing conservative transfusion therapy. METHODS The authors performed a retrospective chart review of patients with MMS who were seen at the Johns Hopkins Medical Institution between 1990 and 2013...
July 7, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28676245/epidemiology-clinical-presentation-and-prognosis-of-posterior-circulation-ischemic-stroke-in-children
#16
Samantha Carey, Jens Wrogemann, Frances A Booth, Mubeen F Rafay
BACKGROUND: Anterior and posterior circulation strokes are often different in terms of presentation and recurrence risk, but there are few studies that focused on posterior circulation stroke. METHODS: We performed a longitudinal retrospective study of children, birth to 18 years, with posterior circulation ischemic stroke at the Children's Hospital Winnipeg from January 1992 to December 2012. Clinical and radiological features and outcomes were collected using standardized tools...
May 19, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28674685/risk-factors-prophylaxis-and-treatment-of-venous-thromboembolism-in-congenital-heart-disease-patients
#17
REVIEW
Michael Silvey, Leonardo R Brandão
Congenital heart disease (CHD) is a common condition in the pediatric population, affecting up to 1% of all live births (i.e., around 40,000 newborns/year in the United States). Although CHD does have a wide range of severity, by the age of 5 years approximately 80% of patients will require at least one surgical intervention to achieve a complete/palliative cardiac repair. Today, in light of their much-improved surgical survival, the care of these patients focuses on morbidity prevention and/or treatment...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28643997/brain-monitoring-in-adult-and-pediatric-ecmo-patients-the-importance-of-early-and-late-assessments
#18
Roberto Lorusso, Fabio S Taccone, Mirko Belliato, Thijs Delnoij, Paolo Zanatta, Mirjana Cvetkovic, Mark Davidson, Jan Belohlavek, Nashwa Matta, Carl Davis, Hanneke Ijsselstijn, Thomas Mueller, Ralf Muellenbach, Dirk Donker, Piero David, Matteo Di Nardo, Dirk Vlasselaers, Dinis Dos Reis Miranda, Aparna Hoskote
Monitoring brain integrity and neuro-cognitive function is a new and important target for the management of a patient treated with extracorporeal membrane oxygenation (ECMO), in particular because of the increasing awareness of cerebral abnormalities that may potentially occur in this setting. Continuous regular monitoring, as well as repeated assessment for cerebral complications has become an essential element of the ECMO patient management. Besides well-known complications, like bleeding, ischemic stroke, seizures, and brain hypoperfusion, other less defined yet relevant injury and clinical manifestations are increasingly reported and impacting on ECMO patient prognosis at short term...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28631089/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#19
REVIEW
Alain Cariou, Jean-François Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28621582/assessment-of-pulmonary-arterial-compliance-evaluated-using-harmonic-oscillator-kinematics
#20
Yasunobu Hayabuchi, Akemi Ono, Yukako Homma, Shoji Kagami
We hypothesized that KPA, a harmonic oscillator kinematics-derived spring constant parameter of the pulmonary artery pressure (PAP) profile, reflects PA compliance in pediatric patients. In this prospective study of 33 children (age range = 0.5-20 years) with various cardiac diseases, we assessed the novel parameter designated as KPA calculated using the pressure phase plane and the equation KPA = (dP/dt_max)(2)/([Pmax - Pmin])/2)(2), where dP/dt_max is the peak derivative of PAP, and Pmax - Pmin is the difference between the minimum and maximum PAP...
June 16, 2017: Pulmonary Circulation
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