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Hypotonic child

Emmanuel Ademola Anigilaje
The survival of a child with severe volume depletion at the emergency department depends on the competency of the first responder to recognize and promptly treat hypovolemic shock. Although the basic principles on fluid and electrolytes therapy have been investigated for decades, the topic remains a challenge, as consensus on clinical management protocol is difficult to reach, and more adverse events are reported from fluid administration than for any other drug. While the old principles proposed by Holliday and Segar, and Finberg have stood the test of time, recent systematic reviews and meta-analyses have highlighted the risk of hyponatraemia, and hyponatraemic encephalopathy in some children treated with hypotonic fluids...
2018: Frontiers in Pediatrics
Jennifer Fuchs, Sarah T Adams, Julie Byerley
BACKGROUND: Fluid and electrolyte therapy is an important component in the care of the hospitalized child. Previous pediatric guidelines have followed the Holliday-Segar method of calculating and delivering maintenance IV fluids, using hypotonic fluids in maintenance therapy. However, research demonstrates that hypotonic fluids can lead to iatrogenic hyponatremia and that isotonic fluid is a safer alternative. OBJECTIVE: To provide the ideal approach to intravenous (IV) fluid use in the hospitalized child and determine the safety and effectiveness of isotonic maintenance fluid therapy...
2017: Reviews on Recent Clinical Trials
Irene Stella, Matthieu Vinchon, Pierre Guerreschi, Eva De Berranger, Ikram Bouacha
PURPOSE: Osteopetrosis (OP) is a rare skeletal disease, which can affect the skull base and calvaria. A multidisciplinary approach is mandatory and patient may need neurosurgical care. Few observations have been published, and optimal management of OP is not established yet. METHOD: We report a case of an infant with OP diagnosed at 5 months, who presented signs of intracranial hypertension associated with unilateral blindness. Bone marrow allograft was performed at 6 months of age...
December 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Nursel Muratoğlu Şahin, Meliha Esra Bilici, Erdal Kurnaz, Melek Pala Akdoğan, Serdar Ceylaner, Zehra Aycan
BACKGROUND: Rhizomelic chondrodysplasia punctata (RCDP) is a rare peroxisomal disease characterised by punctate calcifications of non-ossified cartilage epiphyseal centres. The main biochemical marker of all RCDP types is a decrease in the levels of plasmalogens. Additionally, the accumulation of phytanic acid can be used as a differential marker between types of RDCP. Due to the biochemical overlap between types 1 and 5 RCDP, a genetic analysis of these genes should be performed in patients to identify the type...
August 28, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
Eylem Ulaş Saz, Ali Yurtseven, Mehmet Arda Kilinç, Yusuf Sari, Hasan Ağin
The aim of this report is to describe the successful use of pralidoxime in a pediatric patient who accidentally ingested 12 mg of rivastigmine and presented to the emergency department with weakness, drowsiness, hyporeactivity to environmental stimuli, and full cholinergic syndrome. CASE: The patient presented to the emergency department 2 hours after a suspected ingestion of rivastigmine. He was sleepy but oriented and cooperative, hypotonic, and hyporeflexic and has a Glasgow Coma Scale score of 13 (E3M6V4)...
March 21, 2017: Pediatric Emergency Care
Tolga Yakar, Mehmet Demir, Ozlem Dogan, Alper Parlakgumus, Birol Ozer, Ender Serin
PURPOSE: We aimed to evaluate and compare the efficacy and safety of high-dose furosemide+salt orally by comparing HSS+ furosemide (i.v.) and repeated paracentesis in patients with RA. METHODS: This was a prospective study of 78 cirrhotic patients with RA, randomized into three groups: Group A (n= 25) i.v. furosemide (200-300 mg bid) and 3% hypotonic saline solution (HSS) (once or twice a day); Group B (n= 26) oral furosemide tablets (360-520 mg bid) and salt (2...
December 1, 2016: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
Hélène Chan, Marie-Noëlle Delyfer, Jacmine Pechmeja, Clémence Andrèbe, Audrey-Elodie Mercier, Cyril Dutheil, Jean-François Korobelnik, Clément Paya
We report the rare case of an 8-year-old boy with spontaneous scleral perforation secondary to an isolated congenital chorioretinal coloboma. Visual acuity was 20/200 and examination revealed severe hypotony with subcapsular cataract, complete exudative retinal detachment, hypotonous optic nerve swelling, and hypotony retinal fold. In the temporal periphery, there was a chorioretinal coloboma with a central full-thickness defect. The scleral defect was successfully treated with an autologous temporalis fascia graft...
February 2017: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Sinead Keane, Eileen Butler
AIMS: To determine the effect, if any, that hyper-hydration with hypotonic fluids has on sodium balance in paediatric haematology/oncology patients receiving cytotoxic chemotherapy treatment for malignancies. METHODS: A literature review was carried out and a snapshot of current practice across paediatric haematology/oncology centres in the UK was obtained. A prospective study was carried out in a tertiary paediatric haematology/oncology centre. A total of 98 patient episodes involved hyper-hydration with isotonic 0...
September 2016: Archives of Disease in Childhood
Efrat Ben-Shalom, Ori Toker, Shepard Schwartz
BACKGROUND: Hypernatremic dehydration is a common and potentially life-threatening condition in children. There is currently no consensus as to the optimal strategy for fluid management. OBJECTIVES: To describe the relationship between the type, route and rate of fluids administered and the rate of decline in serum sodium (Na+) concentration. METHODS: We reviewed the medical records of all children under the age of 2 years who were hospitalized with hypernatremic dehydration (serum Na+ ≥ 155 mEq/L) in Shaare Zedek Medical Center during the period 2001-2010...
February 2016: Israel Medical Association Journal: IMAJ
R Masson, S Guerra, R Cerini, V Pensato, C Gellera, F Taroni, A Simonati
We describe the clinical findings and MRI features observed in a child who presented a two-step disease course: he was hypotonic at birth and soon afterwards developed seizures, which were partially responsive to treatment; he subsequently showed developmental delay and a progressive neurological deterioration with the onset of severe seizures at around three years of age. Head MRI at age 20 days was unremarkable, whereas at 25 months it showed bilateral hyperintensity of the deep cerebellar nuclei; five months later, the signal hyperintensity was also present in the cerebellar white matter and ventral pontine fibre tracts...
May 2016: European Journal of Paediatric Neurology: EJPN
Rami S Alazab, Rola S Saqan, Faris Abu Shamma
Underactive bladder in children is characterized by low voiding frequency; straining, hypotonic high capacity bladder, and significant residual urine. The usual presentation is recurrent urinary tract infections. Accurate evidence-based diagnosis and treatment is crucial. Subjective and objective improvement and regain of normal voiding can be achieved in response to bladder rehabilitation program and correction of serious complications.
March 2015: Urology Case Reports
Shantiranjan Sanyal, Sharmila Duraisamy, Umesh Chandra Garga
Objective Hypotonia is a common clinical entity well recognized in pediatric age group, which demands experienced clinical assessment and an extensive array of investigations to establish the underlying disease process. Neuroimaging comes as great help in diagnosing the disease process in rare cases of central hypotonia due to structural malformations of brain and metabolic disorders and should always be included as an important investigation in the assessment of a floppy child. In this article, we discuss the MRI features of eight cases of central and two cases of combined hypotonia and the importance of neuroimaging in understanding the underlying disease in a hypotonic child...
2015: Iranian Journal of Child Neurology
S Koirala, A Poudel, R Basnet, K Subedi
Infantile hypotonia or floppy infant is a diagnostic challenge when it presents with other presenting complaints such as fever, cough or diarrhea. Many times the hypotonia goes unnoticed when other symptom covers the hypotonia and child continues to receive the treatment for other symptoms. We report a rare case from Nepal of infantile Pompe disease who presented with the history of fever and cough in the recent earthquake disaster camp at remote part of Sindhupalchowk, Nepal. He was being treated as a case of pneumonia...
April 2015: Kathmandu University Medical Journal (KUMJ)
Sun-Joung Leigh An
[Purpose] The purpose of this case report is to present the effects of vestibular stimulation on a child with hypotonic cerebral palsy through the use of swings. [Case Description] The subject was a 19-month-old boy with a diagnosis of hypotonic cerebral palsy (CP) and oscillating nystagmus. The subject had received both physical therapy and occupational therapy two times per week since he was 5 months old but showed little to no improvement. [Methods] Pre and post-intervention tests were completed by the researcher using the Bayley Scales of Infant and Toddler Development II...
April 2015: Journal of Physical Therapy Science
Amy Armstrong-Javors, Catherine J Chu
No abstract text is available yet for this article.
October 21, 2014: Neurology
Mercedes Cemeli-Cano, José Luis Peña-Segura, Ruth Fernando-Martínez, Silvia Izquierdo-Álvarez, Lorena Monge-Galindo, Javier López-Pisón
INTRODUCTION: Legius syndrome is an autosomal dominant disorder caused by the mutation in the SPRED1 gene involving a negative regulator of the RAS-MAPK pathway, similar to neurofibromin and therefore shows some clinical similarities to neurofibromatosis type I (NF1) but less severe. These patients have multiple cafe-au-lait spots, sometimes associated with skin fold freckling, dysmorphic features, lipomas, and mild learning disabilities. However, this syndrome is not associated with neurofibromas, optic gliomas, Lisch nodules or tumor predisposition...
September 1, 2014: Revista de Neurologia
Min A Joo, Eun Young Kim
Hyponatremia is the most common electrolyte disorder that requires careful management. Water intoxication with hyponatremia is rare condition that originated from overhydration. Water intoxication, also known as dilutional hyponatremia, develops only because the intake of water exceeds the kidney's ability to eliminate water. Causes of this water intoxication include psychiatric disorder, forced water intake as a form of child abuse and iatrogenic infusion of excessive hypotonic fluid. We experienced and reported a case of symptomatic hyponatremia by forced water intake as a form of child abuse...
June 2013: Annals of Pediatric Endocrinology & Metabolism
Jingjing Wang, Erdi Xu, Yanfeng Xiao
OBJECTIVE: To assess evidence from randomized controlled trials (RCTs) on the safety of isotonic versus hypotonic intravenous (IV) maintenance fluids in hospitalized children. METHODS: We searched PubMed, Embase, Cochrane Library, and (up to April 11, 2013) for RCTs that compared isotonic to hypotonic maintenance IV fluid therapy in hospitalized children. Relative risk (RR), weighted mean differences, and 95% confidence intervals (CIs) were calculated based on the effects on plasma sodium (pNa)...
January 2014: Pediatrics
Hong-Yun Zhang, Fei Du
OBJECTIVE: To observe the clinical effect of electroacupuncture (EA) combined with sitting training for cerebral palsy (CP) children with parafunctional sitting position. METHODS: A total of 120 parafunctional sitting CP child patients were randomly and equally divided into sitting training (control) group and EA plus sitting training (EA) group. The sitting training included assistant-sitting, legs-crossing-sitting, sitting with one-leg extending, long-term sitting, balancing-sitting, chair-climbing, and pron and hand-supporting, twice daily...
October 2013: Zhen Ci Yan Jiu, Acupuncture Research
Jordan M Virbalas, John P Bent, Hillel W Cohen, Sanjay R Parikh
IMPORTANCE: Children with poor muscle tone may demonstrate upper airway obstruction due to several mechanisms including obstructive sleep apnea, laryngopharyngeal reflux, and laryngomalacia. Though hypotonia has been shown to compromise the pediatric airway, and some authors suggest that neurologic deficits can compromise the success of laryngotracheal reconstruction (LTR), to our knowledge no studies have evaluated the effect of neurologic diagnoses or hypotonia on outcomes in LTR. OBJECTIVE: To determine whether hypotonic children with subglottic stenosis have lower rates of successful decannulation after LTR compared with children without neurologic deficit...
December 2013: JAMA Otolaryngology—Head & Neck Surgery
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