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Pediatric brain injury

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https://www.readbyqxmd.com/read/28323671/codeine-and-opioid-metabolism-implications-and-alternatives-for-pediatric-pain-management
#1
Vidya Chidambaran, Senthilkumar Sadhasivam, Mohamed Mahmoud
PURPOSE OF REVIEW: Use of perioperative opioids for surgical pain management of children presents clinical challenges because of concerns of serious adverse effects including life-threatening respiratory depression. This is especially true for children with history of obstructive sleep apnea. This review will explore current knowledge of clinically relevant factors and genetic polymorphisms that affect opioid metabolism and postoperative outcomes in children. RECENT FINDINGS: Within the past several years, an increasing number of case reports have illustrated clinically important respiratory depression, anoxic brain injuries and even death among children receiving appropriate weight-based dosages of codeine and other opioids for analgesia at home setting particularly following tonsillectomy...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28323555/influence-of-dopamine-related-genes-on-neurobehavioral-recovery-after-traumatic-brain-injury-during-early-childhood
#2
Amery Treble-Barna, Shari L Wade, Lisa J Martin, Valentina Pilipenko, Keith Owen Yeates, H Gerry Taylor, Brad G Kurowski
The present study examined the association of dopamine-related genes with short- and long-term neurobehavioral recovery, as well as neurobehavioral recovery trajectories over time, in children who had sustained early childhood traumatic brain injuries (TBI) relative to children who had sustained orthopedic injuries (OI). Participants were recruited from a prospective, longitudinal study evaluating outcomes of children who sustained a TBI (n = 68) or OI (n = 72) between the ages of 3 and 7 years. Parents completed ratings of child executive function and behavior at the immediate post-acute period (0-3 months after injury); 6, 12, and 18 months after injury; and an average of 3...
March 21, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28319562/translating-biomarkers-from-research-to-clinical-use-in-pediatric-neurocritical-care-focus-on-traumatic-brain-injury-and-cardiac-arrest
#3
Andrew J Prout, Michael S Wolf, Ericka L Fink
PURPOSE OF REVIEW: Traumatic brain injury (TBI) and cardiac arrest are important causes of morbidity and mortality in children. Improved diagnosis and outcome prognostication using validated biomarkers could allow clinicians to better tailor therapies for optimal efficacy. RECENT FINDINGS: Contemporary investigation has yielded plentiful biomarker candidates of central nervous system (CNS) injury, including macromolecules, genetic, inflammatory, oxidative, and metabolic biomarkers...
March 17, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28319470/symptomatic-acute-on-chronic-subdural-hematoma-a-clinicopathological-study
#4
Rudy J Castellani, Gruschenka Mojica-Sanchez, Gary Schwartzbauer, David S Hersh
The pathophysiology of acute-on-chronic subdural hematoma (ACSDH) is complex and incompletely understood. Evidence to date indicates that the overall process is initiated by rotational force with movement of the brain inside the skull, which exerts tensile strain and rupture of bridging veins, leading in turn to acute hemorrhage in the subdural potential space. This is followed by the proliferation of mesenchymal elements with angiogenesis and inflammation, which in turn becomes a substrate for repeated hemorrhage and expansion of the lesion...
March 18, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28316901/symptomatic-parietal-intradiploic-encephalocele-a-case-report-and-literature-review
#5
Chen Shi, Bruno Flores, Stephen Fisher, Samuel L Barnett
Encephalocele is a rare condition that consists of herniation of cerebral matter through openings of dura and skull. A majority of encephaloceles are congenital and manifest in childhood. We present a case of a 45-year-old man presenting with contralateral hemiparesis and found to have an extremely rare phenomenon of a symptomatic posttraumatic parietal intradiploic encephalocele (IE) manifesting 36 years following pediatric traumatic head injury. Computed tomography and magnetic resonance imaging confirmed herniation of brain tissue into the intradiploic space...
January 2017: Journal of Neurological Surgery Reports
https://www.readbyqxmd.com/read/28306631/thermoregulate-autoregulate-and-ventilate-brain-directed-critical-care-for-pediatric-cardiac-arrest
#6
Jonathan E Kurz, Craig M Smith, Mark S Wainwright
PURPOSE OF REVIEW: Cardiac arrest in childhood is associated with a high risk for mortality and poor long-term functional outcome. This review discusses the current evidence for neuroprotective therapies and goals for postarrest care in the context of the pathophysiology of hypoxic-ischemic injury, modalities for neurologic prognostication in these children and potential future monitoring paradigms for maximizing cerebral perfusion in the postarrest period. RECENT FINDINGS: The recent publication of the in-hospital and out-of-hospital Therapeutic Hypothermia After Cardiac Arrest trials demonstrated a lack of statistically significant benefit for the use of postarrest therapeutic hypothermia...
March 16, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28303917/reduced-regional-grey-matter-volumes-in-pediatric-obstructive-sleep-apnea
#7
Mona F Philby, Paul M Macey, Richard A Ma, Rajesh Kumar, David Gozal, Leila Kheirandish-Gozal
Pediatric OSA is associated with cognitive risk. Since adult OSA manifests MRI evidence of brain injury, and animal models lead to regional neuronal losses, pediatric OSA patients may also be affected. We assessed the presence of neuronal injury, measured as regional grey matter volume, in 16 OSA children (8 male, 8.1 ± 2.2 years, AHI:11.1 ± 5.9 events/hr), and 200 control subjects (84 male, 8.2 ± 2.0 years), 191 of whom were from the NIH-Pediatric MRI database. High resolution T1-weighted whole-brain images were assessed between groups with voxel-based morphometry, using ANCOVA (covariates, age and gender; family-wise error correction, P < 0...
March 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28302372/experiences-during-newborn-screening-for-glutaric-aciduria-type-1-diagnosis-treatment-genotype-phenotype-and-outcomes
#8
Fang-Chih Tsai, Han-Jui Lee, An-Guor Wang, Shu-Chen Hsieh, Yung-Hsiu Lu, Ming-Che Lee, Ju-Shan Pai, Tzu-Hung Chu, Chia-Feng Yang, Ting-Rong Hsu, Chih-Jou Lai, Ming-Tzu Tsai, Ping-Hsun Ho, Min-Chieh Lin, Ling-Yee Cheng, Ya-Chin Chuang, Dau-Ming Niu
BACKGROUND: Glutaric aciduria type 1 (GA-1) is an organic acidemia with potentially severe neurological sequelae. In Taiwan, newborn screening (NBS) for GA-1 began in 2001, but large-scale reporting is lacking. This study describes Taiwan's largest newborn screening population to date. METHODS: Between 2001 and 2015, 1,490,636 newborns were screened for GA-1. Confirmatory examinations included the carnitine loading test. Confirmed patients were treated with a low lysine diet, carnitine, and high-energy intake during illness...
March 13, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28300737/setting-up-of-a-cerebral-visual-impairment-clinic-for-children-challenges-and-future-developments
#9
Swetha Sara Philip
AIM: The aim of this study is to describe the setting up of a cerebral visual impairment (CVI) clinic in a tertiary care hospital in South India and to describe the spectrum of cases seen. MATERIALS AND METHODS: The CVI clinic, set up in February 2011, receives interdisciplinary input from a core team involving a pediatrician, neurologist, psychiatrist, occupational therapist, pediatric ophthalmologist, and an optometrist. All children, <18 years of age, with cerebral palsy (CP), learning disability, autism, neurodegenerative diseases, and brain trauma are referred to the clinic for functional vision assessment and opinion for further management...
January 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/28298549/diverging-white-matter-trajectories-in-children-after-traumatic-brain-injury-the-rapbi-study
#10
Emily L Dennis, Faisal Rashid, Monica U Ellis, Talin Babikian, Roza M Vlasova, Julio E Villalon-Reina, Yan Jin, Alexander Olsen, Richard Mink, Christopher Babbitt, Jeffrey Johnson, Christopher C Giza, Paul M Thompson, Robert F Asarnow
OBJECTIVE: To examine longitudinal trajectories of white matter organization in pediatric moderate/severe traumatic brain injury (msTBI) over a 12-month period. METHODS: We studied 21 children (16 M/5 F) with msTBI, assessed 2-5 months postinjury and again 13-19 months postinjury, as well as 20 well-matched healthy control children. We assessed corpus callosum function through interhemispheric transfer time (IHTT), measured using event-related potentials, and related this to diffusion-weighted MRI measures of white matter (WM) microstructure...
March 15, 2017: Neurology
https://www.readbyqxmd.com/read/28278259/prognostic-value-of-cerebral-tissue-oxygen-saturation-during-neonatal-extracorporeal-membrane-oxygenation
#11
Marie-Philippine Clair, Jérôme Rambaud, Adrien Flahault, Romain Guedj, Julia Guilbert, Isabelle Guellec, Amélie Durandy, Maryne Demoulin, Sandrine Jean, Delphine Mitanchez, François Chalard, Chiara Sileo, Ricardo Carbajal, Sylvain Renolleau, Pierre-Louis Léger
OBJECTIVES: Extracorporeal membrane oxygenation support is indicated in severe and refractory respiratory or circulatory failures. Neurological complications are typically represented by acute ischemic or hemorrhagic lesions, which induce higher morbidity and mortality. The primary goal of this study was to assess the prognostic value of cerebral tissue oxygen saturation (StcO2) on mortality in neonates and young infants treated with ECMO. A secondary objective was to evaluate the association between StcO2 and the occurrence of cerebral lesions...
2017: PloS One
https://www.readbyqxmd.com/read/28277891/comparing-the-weefim-and-pedi-in-neurorehabilitation-for-children-with-acquired-brain-injury-a-systematic-review
#12
Katie S Williams, David K Young, G A Amos Burke, Daniel M Fountain
INTRODUCTION: We sought to compare the suitability of the Functional Independence Measure for Children (WeeFIM) and the Pediatric Evaluation of Disability Inventory (PEDI) as outcome measures in rehabilitation of children with acquired brain injury (ABI). METHODS: We performed a systematic review of the evidence base using five databases. PRISMA guidelines were adhered to and the review was registered with the PROSPERO international prospective register of systematic reviews (registration number CRD42015025370)...
March 9, 2017: Developmental Neurorehabilitation
https://www.readbyqxmd.com/read/28271316/psychometric-evaluation-of-the-pediatric-and-parent-proxy-patient-reported-outcomes-measurement-information-system-and-the-neurology-and-traumatic-brain-injury-quality-of-life-measurement-item-banks-in-pediatric-traumatic-brain-injury
#13
Hilary Bertisch, Frederick P Rivara, Pamela A Kisala, Jin Wang, Keith Owen Yeates, Dennis Durbin, Mark R Zonfrillo, Michael J Bell, Nancy Temkin, David S Tulsky
PURPOSE: The primary objective is to provide evidence of convergent and discriminant validity for the pediatric and parent-proxy versions of the Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety, Depression, Anger, Peer Relations, Mobility, Pain Interference, and Fatigue item banks, the Neurology Quality of Life measurement system (Neuro-QOL) Cognition-General Concerns and Stigma item banks, and the Traumatic Brain Injury Quality of Life (TBI-QOL) Executive Function and Headache item banks in a pediatric traumatic brain injury (TBI) sample...
March 7, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28255067/reducing-head-ct-use-for-children-with-head-injuries-in-a-community-emergency-department
#14
Rebecca M Jennings, Jennifer J Burtner, Joseph F Pellicer, Deepthi K Nair, Miranda C Bradford, Michele Shaffer, Neil G Uspal, Joel S Tieder
BACKGROUND AND OBJECTIVE: Clinical decision rules have reduced use of computed tomography (CT) to evaluate minor pediatric head injury in pediatric emergency departments (EDs). CT use remains high in community EDs, where the majority of children seek medical care. We sought to reduce the rate of CT scans used to evaluate pediatric head injury from 29% to 20% in a community ED. METHODS: We evaluated a quality improvement (QI) project in a community ED aimed at decreasing the use of head CT scans in children by implementing a validated head trauma prediction rule for traumatic brain injury...
March 2, 2017: Pediatrics
https://www.readbyqxmd.com/read/28252524/development-and-prospective-validation-of-tools-to-accurately-identify-neurosurgical-and-critical-care-events-in-children-with-traumatic-brain-injury
#15
Tellen D Bennett, Peter E DeWitt, Rebecca R Dixon, Cory Kartchner, Yamila Sierra, Diane Ladell, Rajendu Srivastava, Jay Riva-Cambrin, Allison Kempe, Desmond K Runyan, Heather T Keenan, J Michael Dean
OBJECTIVE: To develop and validate case definitions (computable phenotypes) to accurately identify neurosurgical and critical care events in children with traumatic brain injury. DESIGN: Prospective observational cohort study, May 2013 to September 2015. SETTING: Two large U.S. children's hospitals with level 1 Pediatric Trauma Centers. PATIENTS: One hundred seventy-four children less than 18 years old admitted to an ICU after traumatic brain injury...
March 1, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28248802/repeat-head-imaging-in-blunt-pediatric-trauma-patients-is-it-necessary
#16
E Patricia Hill, P J Stiles, Jared Reyes, R Joseph Nold, Stephen D Helmer, James M Haan
BACKGROUND: Children with confirmed brain injury usually undergo follow-up computed tomography scan (CT) of the head within 24 hours of admission. To date, no evidence exists to validate the diagnostic or therapeutic value of these repeat CTs. The purpose of this study was to: (1) evaluate progression of traumatic brain injuries, (2) determine if routine repeat imaging changes management, and (3) compare the efficacy of recognizing worsening hemorrhage with serial neurologic examination versus repeat imaging...
February 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28239020/a-pediatric-profile-of-a-homeless-patient-in-san-jose-california
#17
Angela Bymaster, Joyce Chung, Andrea Banke, Hee Jae Choi, Chelsea Laird
The causes of homelessness are complex and poorly understood. This paper describes the homeless population in Santa Clara County, California in terms of Adverse Childhood Events, Traumatic Brain Injuries (TBIs), and family breakdown. Respondents reported severely traumatic childhoods; 78.7% grew up in a household with a person with drug or alcohol dependence and 64.6% endured psychological abuse as a child. Seventy-six percent of subjects recalled at least one TBI, 58.4% with loss of consciousness. Nineteen percent were in foster care as children and 40...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28237248/the-potential-for-advanced-magnetic-resonance-neuroimaging-techniques-in-pediatric-stroke-research
#18
REVIEW
Trish Domi, Arastoo Vossough, Nicholas V Stence, Ryan J Felling, Jackie Leung, Pradeep Krishnan, Christopher G Watson, P Ellen Grant, Andrea Kassner
BACKGROUND: This article was written to provide clinicians and researchers with an overview of a number of advanced neuroimaging techniques in an effort to promote increased utility and the design of future studies using advanced neuroimaging in childhood stroke. The current capabilities of advanced magnetic resonance imaging techniques provide the opportunity to build on our knowledge of the consequences of stroke on the developing brain. These capabilities include providing information about the physiology, metabolism, structure, and function of the brain that are not routinely evaluated in the clinical setting...
January 24, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28230712/updating-evidence-for-using-hypothermia-in-pediatric-severe-traumatic-brain-injury-conventional-and-bayesian-meta-analytic-perspectives
#19
Robert C Tasker, Frederick W Vonberg, Elizabeth D Ulano, Alireza Akhondi-Asl
OBJECTIVE: To evaluate clinical trials of hypothermia management on outcome in pediatric patients with severe traumatic brain injury using conventional and Bayesian meta-analyses. DATA SOURCES: Screening of PubMed and other databases to identify randomized controlled trials of hypothermia for pediatric severe traumatic brain injury published before September 2016. STUDY SELECTION: Four investigators assessed and reviewed randomized controlled trial data...
February 20, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28224079/altered-structural-brain-changes-and-neurocognitive-performance-in-pediatric-hiv
#20
Santosh K Yadav, Rakesh K Gupta, Ravindra K Garg, Vimala Venkatesh, Pradeep K Gupta, Alok K Singh, Sheema Hashem, Asma Al-Sulaiti, Deepak Kaura, Ena Wang, Francesco M Marincola, Mohammad Haris
Pediatric HIV patients often suffer with neurodevelopmental delay and subsequently cognitive impairment. While tissue injury in cortical and subcortical regions in the brain of adult HIV patients has been well reported there is sparse knowledge about these changes in perinatally HIV infected pediatric patients. We analyzed cortical thickness, subcortical volume, structural connectivity, and neurocognitive functions in pediatric HIV patients and compared with those of pediatric healthy controls. With informed consent, 34 perinatally infected pediatric HIV patients and 32 age and gender matched pediatric healthy controls underwent neurocognitive assessment and brain magnetic resonance imaging (MRI) on a 3 T clinical scanner...
2017: NeuroImage: Clinical
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