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Pediatric neurotoxicity

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https://www.readbyqxmd.com/read/27933410/magnetic-resonance-imaging-patterns-of-treatment-related-toxicity-in-the-pediatric-brain-an-update-and-review-of-the-literature
#1
REVIEW
Maria Camilla Rossi Espagnet, Luca Pasquini, Antonio Napolitano, Antonella Cacchione, Angela Mastronuzzi, Roberta Caruso, Paolo Tomà, Daniela Longo
Treatment-related neurotoxicity is a potentially life-threatening clinical condition that can represent a diagnostic challenge. Differentiating diagnoses between therapy-associated brain injury and recurrent disease can be difficult, and the immediate recognition of neurotoxicity is crucial to providing correct therapeutic management, ensuring damage reversibility. For these purposes, the knowledge of clinical timing and specific treatment protocols is extremely important for interpreting MRI patterns. Neuroradiologic findings are heterogeneous and sometimes overlapping, representing the compounding effect of the different treatments...
December 9, 2016: Pediatric Radiology
https://www.readbyqxmd.com/read/27882447/neonatal-repeated-exposure-to-isoflurane-not-sevoflurane-in-mice-reversibly-impaired-spatial-cognition-at-juvenile-age
#2
Jianhui Liu, Yanhong Zhao, Junjun Yang, Xiaoqing Zhang, Wei Zhang, Peijun Wang
Inhalation anesthetics facilitate surgical procedures in millions of children each year. However, animal studies demonstrate that exposure to the inhalation anesthetic isoflurane may cause neuronal cell death in developing brains. The long-term cytotoxic effects of sevoflurane, the most popular pediatric anesthetic, have not been compared with isoflurane. Thus, this study was designed to compare the effects of equipotent doses of these two anesthetics on neonatal long-term neurotoxicity. Postnatal 7-day-old (P7) C57/BL male mice were exposed to 1...
November 24, 2016: Neurochemical Research
https://www.readbyqxmd.com/read/27871903/review-of-preclinical-studies-on-pediatric-general-anesthesia-induced-developmental-neurotoxicity
#3
Jennifer L Walters, Merle G Paule
Thousands of infants and children undergo complicated surgical procedures that require prolonged periods of anesthesia and/or sedation each year. A growing body of preclinical research suggests pediatric anesthetics are harmful to the developing brain; yet, the extent to which these effects generalize to the clinical setting remains unclear. As there will be a continuing need for surgical and other interventions requiring sedation and/or anesthesia during the neonatal period, it seems clear that research efforts should focus on determining the extent to which general anesthetics can affect the developing brain as well as determining strategies for preventing or ameliorating the adverse effects associated with exposure to such agents...
November 18, 2016: Neurotoxicology and Teratology
https://www.readbyqxmd.com/read/27869523/nelarabine-in-the-treatment-of-pediatric-and-adult-patients-with-t-cell-acute-lymphoblastic-leukemia-and-lymphoma
#4
Tapan M Kadia, Varsha Gandhi
Introduction T-cell acute lymphoblastic leukemia (ALL) and lymphoma (LBL) are aggressive hematologic neoplasms that are treated with combination chemotherapy in the frontline, but have limited options in the relapsed or refractory setting. Based on observations in patients with purine nucleoside phosphorylase (PNP) deficiency, a guanosine nucleoside analogue, arabinosylguanine (ara-G) was developed that provided T-cell specificity. Nelarabine was developed as the water-soluble, clinically useful-prodrug of ara-G and based on its activity was approved for the treatment of relapsed or refractory T-ALL/LBL...
November 21, 2016: Expert Review of Hematology
https://www.readbyqxmd.com/read/27851909/systemic-cisplatin-exposure-during-infancy-and-adolescence-causes-impaired-cognitive-function-in-adulthood
#5
Tami John, Naomi Lomeli, Daniela A Bota
Cancer survivors diagnosed during infancy and adolescence may be at risk for chemotherapy-related cognitive impairments (CRCI), however the effects of pediatric chemotherapy treatment on adulthood cognitive function are not well understood. Impairments in memory, attention and executive function affect 15-50% of childhood leukemia survivors related to methotrexate exposure. Systemic cisplatin is used to treat a variety of childhood and adult cancers, yet the risk and extent of cognitive impairment due to platinum-based chemotherapy in pediatric patients is unknown...
November 13, 2016: Behavioural Brain Research
https://www.readbyqxmd.com/read/27816865/low-dose-thimerosal-in-pediatric-vaccines-adverse-effects-in-perspective
#6
REVIEW
José G Dórea
Vaccines are prophylactics used as the first line of intervention to prevent, control and eradicate infectious diseases. Young children (before the age of six months) are the demographic group most exposed to recommended/mandatory vaccines preserved with Thimerosal and its metabolite ethylmercury (EtHg). Particularly in the less-developed countries, newborns, neonates, and young children are exposed to EtHg because it is still in several of their pediatric vaccines and mothers are often immunized with Thimerosal-containing vaccines (TCVs) during pregnancy...
January 2017: Environmental Research
https://www.readbyqxmd.com/read/27785338/dose-dependent-effects-of-sevoflurane-exposure-during-early-lifetime-on-apoptosis-in-hippocampus-and-neurocognitive-outcomes-in-sprague-dawley-rats
#7
Xue Zhou, Wenda Li, Xiaohui Chen, Xiaoyu Yang, Zhibin Zhou, Dihan Lu, Xia Feng
Sevoflurane has become a main method for induction of anesthesia in pediatric populations. Preclinical evidence suggest the neurotoxic effect of volatile anesthetics on the developing brain including sevoflurane. This study investigates the effect of different doses of sevoflurane on the developing brain. In this study, Sprague-Dawley rats of postnatal (P) day 7 were exposed to 0.3%, 1.3% and 2.3% sevoflurane for 6 hours. 6 hours after exposure, Nissl staining was performed to observe the morphological changes of the hippocampus and western-blot was done to evaluate the expression changes in cytochrome c, cleaved caspase-3, Bcl-2 and Bax...
2016: International Journal of Physiology, Pathophysiology and Pharmacology
https://www.readbyqxmd.com/read/27784630/minimally-invasive-biomarkers-of-general-anesthetic-induced-developmental-neurotoxicity
#8
X Zhang, F Liu, W Slikker, C Wang, M G Paule
The association of general anesthesia with developmental neurotoxicity, while nearly impossible to study in pediatric populations, is clearly demonstrable in a variety of animal models from rodents to nonhuman primates. Nearly all general anesthetics tested have been shown to cause abnormal brain cell death in animals when administered during periods of rapid brain growth. The ability to repeatedly assess in the same subjects adverse effects induced by general anesthetics provides significant power to address the time course of important events associated with exposures...
October 23, 2016: Neurotoxicology and Teratology
https://www.readbyqxmd.com/read/27768675/optimal-timing-of-surgical-procedures-in-pediatric-patients
#9
Riva R Ko, Teeda Pinyavat, Steven Stylianos, Sarah M Lambert, Richard C Anderson, Pamela F Gallin, Lynne G Maxwell, Christopher G Ward, Jayant K Deshpande, Constance S Houck
The Pediatric Anesthesia Neuro Development Assessment (PANDA) team at the Anesthesiology Department at Columbia University Medical Center held its fifth biennial symposium to discuss issues regarding potential neurotoxicity of anesthetic agents in pediatric patients. Overall optimal surgical timing as well as a "critical window" for surgery on a specialty specific basis are areas of focus for the American Academy of Pediatrics Surgical Advisory Panel. An ad hoc panel of pediatric surgical experts representing general surgery, urology, neurosurgery, and ophthalmology was assembled for this meeting and provided a dialogue focused on the benefits of early intervention versus potential anesthetic risk, addressing parental concerns, and the need for continued interdisciplinary collaboration in this area...
October 2016: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/27768673/summary-of-the-update-session-on-clinical-neurotoxicity-studies
#10
Teeda Pinyavat, David O Warner, Randall P Flick, Mary Ellen McCann, Dean B Andropoulos, Danquig Hu, Jeffrey W Sall, Marisa N Spann, Caleb Ing
During the Fifth Pediatric Anesthesia Neurodevelopmental Assessment Symposium, experts and stakeholders met to present and discuss recent advances made in the study of neurodevelopmental outcomes after exposure to anesthetic drugs in infants and children. This article summarizes the update of 5 ongoing clinical studies: General Anesthesia compared to Spinal Anesthesia, Toxicity of Remifentanil and Dexmedetomidine, Mayo Anesthesia Safety in Kids, the University of California San Francisco human cohort study, and Columbia University Medical Center Neonatal Magnetic Resonance Imaging study...
October 2016: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/27768672/report-on-the-fifth-panda-symposium-on-anesthesia-and-neurodevelopment-in-children
#11
Tonya L K Miller, Raymond Park, Lena S Sun
On April 16 and 17, 2016, the Pediatric Anesthesia and Neurodevelopment Assessment (PANDA) study held its fifth biennial symposium at the Morgan Stanley Children's Hospital of New York. The PANDA symposium has served as a key forum for clinicians, researchers, and other major stakeholders to gather and review the current state of preclinical and clinical research related to anesthetic neurotoxicity in children. Goals of the meeting included assessing how current knowledge has translated and impacted clinical care of patients who may be at risk, and future directions for research and policy...
October 2016: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/27749795/cost-minimization-analysis-of-different-strategies-of-management-of-clinically-significant-scorpion-envenomation-among-pediatric-patients
#12
Madhumita Sinha, Dan Quan, Fred W McDonald, André Valdez
OBJECTIVE: Scorpion antivenom was recently approved for use in patients with clinically significant scorpion envenomation in the United States; no formal economic analysis on its impact on cost of management has been performed. METHODS: Three different strategies of management of scorpion envenomation with systemic neurotoxic symptoms in children were compared for cost minimization from a societal perspective. In strategy I, patients were managed with supportive care only without antivenom...
December 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27720711/posterior-reversible-encephalopathy-syndrome-a-comparative-study-of-pediatric-versus-adult-patients
#13
Kenneth Habetz, Raghu Ramakrishnaiah, Sunil Kumar Raina, Ryan T Fitzgerald, Archana Hinduja
BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) is an acute neurotoxic syndrome that, although characteristically reversible, can result in long-term disability. Our aim was to identify the clinical and radiological factors that are unique to children with PRES compared with adults with the syndrome in a single center. METHODS: We retrospectively reviewed the clinical and radiological records of all patients with PRES admitted at a tertiary care medical center from 2007 to 2014...
December 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/27668914/evaluation-and-management-of-acute-onset-hemiparesis-in-an-adolescent-with-leukemia
#14
Krishnan N Subrahmanian, Young H Shim, Mona D Shah, Brandon H Tran, Alexandra M Stevens, Andrea T Cruz
Emergency departments (EDs) are alert to the possibility of stroke and the need for early interventions to improve long-term clinical outcomes. However, new-onset hemiparesis in pediatric patients with leukemia may be due to a number of different etiologies, including most common side effects from chemotherapeutic agents. We present a case of a 15-year-old boy with pre-B acute lymphoblastic leukemia on chemotherapy, having recently received a high-dose methotrexate infusion in addition to intrathecal methotrexate therapy, who presented to our ED with acute right-sided hemiparesis...
September 23, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27664395/pediatric-chemotherapy-induced-peripheral-neuropathy-a-systematic-review-of-current-knowledge
#15
Tejaswi Kandula, Susanna B Park, Richard J Cohn, Arun V Krishnan, Michelle A Farrar
BACKGROUND: The dramatic increase in the number of childhood cancer survivors over the last 60years has made monitoring and minimising long term side effects of cancer treatment increasingly important. Chemotherapy induced peripheral neuropathy (CIPN) has been described with many commonly used chemotherapy agents. This article provides a critical overview of pediatric CIPN, its incidence, clinical manifestations, late effects, and recent advances in understanding of risk factors and pharmacogenomics as well as evaluating current assessment strategies and treatment approaches...
September 10, 2016: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/27659182/drug-interactions-may-be-important-risk-factors-for-methotrexate-neurotoxicity-particularly-in-pediatric-leukemia-patients
#16
Victoria J Forster, Frederik W van Delft, Susan F Baird, Shona Mair, Roderick Skinner, Christina Halsey
PURPOSE: Methotrexate administration is associated with frequent adverse neurological events during treatment for childhood acute lymphoblastic leukemia. Here, we present evidence to support the role of common drug interactions and low vitamin B12 levels in potentiating methotrexate neurotoxicity. METHODS: We review the published evidence and highlight key potential drug interactions as well as present clinical evidence of severe methotrexate neurotoxicity in conjunction with nitrous oxide anesthesia and measurements of vitamin B12 levels among pediatric leukemia patients during therapy...
November 2016: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/27638585/clinical-electrophysiological-and-biochemical-markers-of-peripheral-and-central-nervous-system-disease-in-canine-globoid-cell-leukodystrophy-krabbe-s%C3%A2-disease
#17
Allison M Bradbury, Jessica H Bagel, Xuntian Jiang, Gary P Swain, Maria L Prociuk, Caitlin A Fitzgerald, Patricia A O'Donnell, Kyle G Braund, Daniel S Ory, Charles H Vite
Globoid cell leukodystrophy (GLD), or Krabbe's disease, is a debilitating and always fatal pediatric neurodegenerative disease caused by a mutation in the gene encoding the hydrolytic enzyme galactosylceramidase (GALC). In the absence of GALC, progressive loss of myelin and accumulation of a neurotoxic substrate lead to incapacitating loss of motor and cognitive function and death, typically by 2 years of age. Currently, there is no cure. Recent convincing evidence of the therapeutic potential of combining gene and cell therapies in the murine model of GLD has accelerated the requirement for validated markers of disease to evaluate therapeutic efficacy...
November 2016: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/27622829/emergency-use-of-uridine-triacetate-for-the-prevention-and-treatment-of-life-threatening-5-fluorouracil-and-capecitabine-toxicity
#18
Wen Wee Ma, Muhammad Wasif Saif, Bassel F El-Rayes, Marwan G Fakih, Thomas H Cartwright, James A Posey, Thomas R King, Reid W von Borstel, Michael K Bamat
BACKGROUND: Increased susceptibility to 5-fluorouracil (5-FU)/capecitabine can lead to rapidly occurring toxicity caused by impaired clearance, dihydropyrimidine dehydrogenase deficiency, and other genetic variations in the enzymes that metabolize 5-FU. Life-threatening 5-FU overdoses occur because of infusion pump errors, dosage miscalculations, and accidental or suicidal ingestion of capecitabine. Uridine triacetate (Vistogard) was approved in 2015 for adult and pediatric patients who exhibit early-onset severe or life-threatening 5-FU/capecitabine toxicities or present with an overdose...
September 13, 2016: Cancer
https://www.readbyqxmd.com/read/27571870/dexmedetomidine-pretreatment-attenuates-propofol%C3%A2-induced-neurotoxicity-in-neuronal-cultures-from-the-rat-hippocampus
#19
Yi Wei, Junhua Hu, Yubing Liang, Yuling Zhong, Dan He, Yi Qin, Li Li, Jing Chen, Qiang Xiao, Yubo Xie
Propofol is widely used for the induction and maintenance of pediatric anesthesia. Previous studies have indicated that propofol can induce apoptosis, and damage cognitive and memory functions. Dexmedetomidine is a potent α‑2 adrenoceptor agonist with high selectivity. Previous observations have shown that dexmedetomidine exhibits anti‑apoptotic qualities. The present study evaluated the neuroprotective effects of dexmedetomidine pretreatment against propofol‑induced neurotoxicity in immature hippocampal neurons...
October 2016: Molecular Medicine Reports
https://www.readbyqxmd.com/read/27564560/what-next-after-gas-and-panda
#20
Caleb Ing, Virginia A Rauh, David O Warner, Lena S Sun
On April 16 and 17, 2016, the Fifth biennial Pediatric Anesthesia & Neurodevelopment Assessment (PANDA) symposium was convened at the Morgan Stanley Children's Hospital of New York at Columbia University Medical Center. During the symposium, experts in the fields of anesthesiology, neuropsychology, and epidemiology were convened in a small group session to determine the level of confidence in the current clinical evidence and the next steps in anesthetic neurotoxicity clinical research. Among the participants in the discussion, there remained a lack of consensus on whether anesthetic exposure causes long-term neurodevelopmental deficits in children based on the current evidence...
August 25, 2016: Journal of Neurosurgical Anesthesiology
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