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Pediatric encephalopathy

Prabahs Prasun Giri, Joydeb Roy, Agnisekhar Saha
Aim of the Study: Scrub typhus has been globally recognized as an emerging infectious disease contributing significantly to pyrexia of unknown origin (PUO) and a potential cause of multiorgan dysfunction syndrome (MODS). We studied the incidence of scrub typhus as a cause of pediatric intensive care unit (PICU) admission and MODS in our hospital and its clinical and laboratory characteristics to measure the incidence of MODS caused by scrub typhus. Materials and Methods: This study was done in a pediatric teaching hospital in Kolkata, India...
February 2018: Indian Journal of Critical Care Medicine
Clara D M van Karnebeek, Mary Dunbar, Csilla Egri, Bryan Sayson, Janetta Milea, Sylvia Stockler-Ipsiroglu, Linda Huh, Mary B Connolly, Gabriella A Horvath
BACKGROUND: Secondary neurotransmitter deficiencies have been reported in several reviews. Our primary aim was to assess the relationship among epilepsy, antiseizure medications, and specific neurotransmitter abnormalities. We also evaluated movement disorders and brain abnormalities via magnetic resonance imaging scans in patients with secondary neurotransmitter defects. METHODS: This is a retrospective case series of 376 patients who underwent neurotransmitter analysis at BC Children's Hospital between 2009 and 2013, for a variety of neurological presentations...
March 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Xiaolin Li, Zhangning Zhao, Xiaomin Liu, Gaoting Ma, Mei-Jia Zhu
INTRODUCTION: Propofol infusion syndrome (PRIS) is a rare but potentially fatal complication of propofol infusion. It is clinically characterized by metabolic acidosis, refractory bradycardia, rhabdomyolysis, renal failure, hyperlipidemia, and hepatomegaly. Brain lesion was only reported once in a pediatric patient. We present the 1st adult case with colon polyp and cancer who was diagnosed with PRIS. Her brain magnetic resonance imaging (MRI) and computed tomography (CT) scans reveal prominent bilateral brain lesions, matching with the proposed pathophysiologic mechanism of the syndrome...
January 2018: Medicine (Baltimore)
Sherif M Hamdy, Maged Abdel-Naseer, Nevin M Shalaby, Alaa Elmazny, Marian Girgis, Mona A Nada, Amr Hassan, Husam S Mourad, Mohamed I Hegazy, Ahmed Abdelalim, Nirmeen A Kishk, Noha T Abokrysha, Shaimaa A Genedy, Ehab A Essawy, Hatem S Shehata
Introduction: Although the frequency of pediatric-onset multiple sclerosis (POMS) has increased in recent decades, it is still highly uncommon, which creates a need for the involvement of more registries from various clinical centers. Objective: To characterize the demographic, clinical, and paraclinical features of Egyptian patients with POMS. Patients and methods: A retrospective chart review study was undertaken on 237 Egyptian patients with demyelinating events which started before the age of 18 years who attended one of five tertiary referral centers in Cairo, Egypt...
2018: Neuropsychiatric Disease and Treatment
Henry H Cheng, Satish K Rajagopal, Arnold J Sansevere, Erica McDavitt, Daniel Wigmore, Jessica Mecklosky, Kristofer Andren, Kathryn Williams, Amy Danehy, Janet S Soul
BACKGROUND: While therapeutic hypothermia (TH) is an effective neuroprotective therapy for neonatal hypoxic-ischemic encephalopathy, TH has not been demonstrated to improve outcome in other pediatric populations. Patients with acquired or congenital heart disease (CHD) are at high risk of both cardiac arrest and neurodevelopmental impairments, and therapies are needed to improve neurologic outcome. The primary goal of our study was to compare safety/efficacy outcomes in post-arrest CHD patients treated with TH versus controls not treated with TH...
February 21, 2018: Resuscitation
Lyndsey E Stessman, Eric S Peeples
Emerging evidence has demonstrated that vitamin D plays an important role in many adult neurologic disorders, but is also critical in neuronal development and pruning in the neonatal and pediatric populations. Neonates are at a particularly high risk of vitamin D deficiency, in part due to the high prevalence of maternal deficiency during pregnancy. Several preclinical studies have demonstrated that infants born to vitamin D-deficient mothers are at a high risk of developing neonatal brain injury, and recent clinical studies have shown that neonates with hypoxic-ischemic encephalopathy (HIE) tend to be vitamin D-deficient...
February 21, 2018: Neonatology
Haro Kaoru, Ryota Igarashi, Takayuki Hoshina, Masumi Kojiro, Koichi Kusuhara
BACKGROUND: The necessity of lumbar puncture for the differentiation of central nervous system (CNS) infection in children with febrile status epilepticus (FSE) remains controversial. The aim of the present study is to investigate the diagnostic necessity of lumbar puncture for children with FSE after the introduction of bacterial conjugate vaccines into the infant immunization program. METHODS: Our retrospective cohort study was performed in children aged 6 to 60 months who were admitted to the pediatric ward at Kitakyushu General Hospital from January 1, 2011 to December 31, 2015 for seizures with fever...
February 15, 2018: Pediatric Infectious Disease Journal
Kirti Gupta, Charul S Purani, Anirban Mandal, Amitabh Singh
Introduction: Acute febrile encephalopathy (AFE) in children is a medical emergency and could be a manifestation of many systemic and central nervous system pathologies. The clinical features of AFE are nonspecific and etiological spectrum variable depending on the studied population. Materials and Methods: A prospective, observational study was carried out including children aged between 1 month and 12 years with AFE admitted to the Pediatric Intensive Care Unit of a tertiary care hospital in Western India...
January 2018: Journal of Neurosciences in Rural Practice
Emad E Ghobrial, Salma Z Elhouchi, Sarah S Eltatawy, Lilian O Beshara
Acute kidney injury (AKI) in the newborn is a common problem in the neonatal intensive care unit with many underlying factors such as asphyxia, respiratory distress syndrome (RDS), and urogenital anomalies. The aim of this study is to highlight possible risk factors and profile of neonates developing AKI in the Neonatal Intensive Care Unit (NICU) of Cairo University Pediatric Hospital. The study was carried out on 90 neonates (30 patients and 60 controls), among neonates admitted to NICU. The study was done over two months, from January 2015 to March 2015...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
Scheilla Bayitondere, Francois Biziyaremye, Catherine M Kirk, Hema Magge, Katrina Hann, Kim Wilson, Christine Mutaganzwa, Eric Ngabireyimana, Fulgence Nkikabahizi, Evelyne Shema, David B Tugizimana, Ann C Miller
BACKGROUND: In Africa, a high proportion of children are at risk for developmental delay. Early interventions are known to improve outcomes, but they are not routinely available. The Rwandan Ministry of Health with Partners In Health/Inshuti Mu Buzima created the Pediatric Development Clinic (PDC) model for providing interdisciplinary developmental care for high-risk infants in rural settings. As retention for chronic care has proven challenging in many settings, this study assesses factors related to retention to care after 12 months of clinic enrollment...
February 16, 2018: BMC Pediatrics
Phillip L Pearl
PURPOSE OF REVIEW: Epilepsy syndromes are an important clinical construct in pediatric epilepsy, as they encompass recognizable patterns seen in patients with epilepsies, whether of the more benign variety or associated with encephalopathy. RECENT FINDINGS: Syndromes may be organized by age of onset: neonatal, infantile, childhood, or adolescent. The assignment of a syndrome has specific implications for diagnosis, management, and prognostication. The 2010 revised classification of the epilepsies by the International League Against Epilepsy preserved the syndrome approach, while progress in genetics continues to advance our understanding of the pathophysiology and overlap of the epilepsy syndromes...
February 2018: Continuum: Lifelong Learning in Neurology
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
Federico Piñero, Yu Cheang, Manuel Mendizabal, Joaquín Cagliani, Ariel Gonzalez Campaña, Josefina Pages, Carla Colaci, Mariano Barreiro, Cristina Alonso, Ivone Malla, Martín Fauda, Jose Bueri, Luis G Podesta, Marcelo Silva
Controversy exists whether NE after LT are more frequently observed in children or adults. We aimed to compare the incidence and outcomes for NE after LT in pediatric and adult recipients. A single-center cohort study, including all LT between 2001 and 2013, was performed. Definition of NE included impaired consciousness, delirium, seizures, focal neurologic deficit, visual impairment, or slurred speech. A cohort of 443 consecutive LT recipients was included: 307 adults and 136 children. Cumulative incidence of NE was similar between adults 15% (n = 41) and children 16% (n = 20; P = ...
February 7, 2018: Pediatric Transplantation
Iga N Gray, Ana G Cristancho, Daniel J Licht, Grant T Liu
A 5-year-old girl presented with acute, rapidly progressive encephalopathy following minor head trauma and was found to have ocular dipping. Her encephalopathy was secondary to a channelopathy caused by a CACNA1A mutation. This is the first reported case of ocular dipping in an encephalopathic child with CACNA1A-confirmed hemiplegic migraine. [J Pediatr Ophthalmol Strabismus. 2018;55:e4-e6.].
January 31, 2018: Journal of Pediatric Ophthalmology and Strabismus
Meera Vyshni Suresh, Barath Jagadisan, Preeti Kandasamy, Gandhipuram Periyasamy Senthilkumar
OBJECTIVES: Minimal Hepatic encephalopathy (MHE) has been reported in children with extra hepatic portal vein obstruction (EHPVO). MHE assessment is restricted to research situations as neuropsychiatric tests are time-intensive. Computerised Stroop Test (CST) has been used in cirrhotic adults for MHE screening. The study aims to assess MHE frequency in young Indian children with EHPVO and validate CST for MHE screening in pediatric EHPVO METHODS:: 37 children with EHPVO between 7-12 years of age and 37 age and gender matched controls were enrolled...
January 25, 2018: Journal of Pediatric Gastroenterology and Nutrition
Damiano Baroncini, Mauro Zaffaroni, Lucia Moiola, Lorena Lorefice, Giuseppe Fenu, Pietro Iaffaldano, Marta Simone, Fulvia Fanelli, Francesco Patti, Emanuele D'Amico, Marco Capobianco, Antonio Bertolotto, Paolo Gallo, Monica Margoni, Silvia Miante, Nicoletta Milani, Maria Pia Amato, Isabella Righini, Paolo Bellantonio, Cinzia Scandellari, Gianfranco Costantino, Elio Scarpini, Roberto Bergamaschi, Giulia Mallucci, Giancarlo Comi, Angelo Ghezzi
BACKGROUND: Few data are available on very long-term follow-up of pediatric multiple sclerosis (MS) patients treated with disease modifying treatments (DMTs). OBJECTIVES: To present a long-term follow-up of a cohort of Pediatric-MS patients starting injectable first-line agents. METHODS: Data regarding treatments, annualized relapse rate (ARR), Expanded Disability Status Scale (EDSS) score, and serious adverse event were collected. Baseline characteristics were tested in multivariate analysis to identify predictors of disease evolution...
January 1, 2018: Multiple Sclerosis: Clinical and Laboratory Research
Ehab Saad Aldin, Parren McNeely, Yusuf Menda
We present a case of posterior reversible encephalopathy syndrome (PRES) in a pediatric patient with Burkitt's lymphoma predominantly involving the bone marrow. F-FDG PET/CT scan obtained after the first cycle of chemotherapy, complicated by acute kidney injury, hypertension, tumor lysis syndrome, and lethargy with focal neurological symptoms, showed a favorable marrow and lymph node response but increased FDG uptake in the bilateral frontal and occipital cortical/subcortical regions. Brain MRI was consistent with PRES...
January 19, 2018: Clinical Nuclear Medicine
Monica L Koncicki, Philip Zachariah, Adam R Lucas, Jeffrey D Edwards
OBJECTIVES: To characterize a multi-institutional cohort of children with chronic respiratory failure that use long-term, non-invasive respiratory support, perform a time-to-event analysis of transitions to transtracheal ventilation and identify factors associated with earlier transition to transtracheal ventilation. STUDY DESIGN: A retrospective cohort study of patients less than 21 years of age with diagnoses associated with chronic respiratory failure and discharged on non-invasive respiratory support was performed using data from the Pediatric Health Information System (PHIS) between 2007 and 2015...
January 17, 2018: Pediatric Pulmonology
Akira Komori, Daisuke Mizu, Koichi Ariyoshi
BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) is a condition characterized by seizures, altered consciousness, visual disturbances, and headache. Characteristic findings on neuroimaging include cerebral edema, typically involving the parieto-occipital white matter. PRES has been associated with hypertension, autoimmune disease, and Henoch-Schölein purpura (HSP), but few cases have been reported, and fewer cases of PRES have been reported in children. CASE REPORT: We report the case of a 4-year-old girl who presented with blindness and semi-consciousness...
January 12, 2018: Journal of Emergency Medicine
Sidharth Totadri, Amita Trehan, Deepak Bansal, Richa Jain
Context: Survival rates exceed 90% in Wilms' tumor (WT). Actinomycin-D (ACT-D) which is indispensable in the management of WT is associated with the development of sinusoidal obstruction syndrome (SOS), a potentially fatal complication. Aims: The aim is to study the presentation, management, and outcome of SOS complicating ACT-D administration in WT. Settings and Design: Retrospective file review conducted in a Pediatric Hematology-Oncology unit...
October 2017: Indian Journal of Medical and Paediatric Oncology
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