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Apparent Life Threatening Event

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https://www.readbyqxmd.com/read/28720729/inhibition-of-inflammasome-dependent-interleukin-1%C3%AE-production-by-streptococcal-nad-glycohydrolase-evidence-for-extracellular-activity
#1
Dóra Hancz, Elsa Westerlund, Benedicte Bastiat-Sempe, Onkar Sharma, Christine Valfridsson, Lena Meyer, John F Love, Maghnus O'Seaghdha, Michael R Wessels, Jenny J Persson
Group A Streptococcus (GAS) is a common human pathogen and the etiologic agent of a large number of diseases ranging from mild, self-limiting infections to invasive life-threatening conditions. Two prominent virulence factors of this bacterium are the genetically and functionally linked pore-forming toxin streptolysin O (SLO) and its cotoxin NAD(+)-glycohydrolase (NADase). Overexpression of these toxins has been linked to increased bacterial virulence and is correlated with invasive GAS disease. NADase can be translocated into host cells by a SLO-dependent mechanism, and cytosolic NADase has been assigned multiple properties such as protection of intracellularly located GAS bacteria and induction of host cell death through energy depletion...
July 18, 2017: MBio
https://www.readbyqxmd.com/read/28711234/sleep-related-breathing-disorders-and-indications-for-polysomnography-in-preterm-infants
#2
Koen Joosten, Robbin de Goederen, Angelique Pijpers, Karel Allegaert
There is a range of breathing problems which occur and may persist in preterm infants, such as central apneas, obstructive apneas and periodic breathing. Preterm infants may also suffer from respiratory distress syndrome and chronic lung disease necessitating prolonged use of oxygen therapy after discharge from the hospital. Due to these persistent breathing pattern abnormalities in preterm infants, there is a higher risk of altered sleep and apparent life threatening events. Polysomnography can be a helpful tool to identify those infants who have abnormalities in their breathing pattern, to identify those infants who have an increased risk to get a sleep related breathing event at home and to decide about the discontinuation of oxygen therapy...
July 12, 2017: Early Human Development
https://www.readbyqxmd.com/read/28689530/congenital-vallecular-cyst-arare-and-potentially-lethal-condition
#3
Shabbir Ahmed Mallick, Tabinda Naz Qureshi, Ajoy Methew Varghese, Mona Mohammed Al Busaidi
Congenital vallecular cyst is a rare laryngeal lesion, accounting for 10-20% of all laryngeal cysts, with a potential to cause severe upper airway obstruction, which can be fatal. It can cause stridor, apnea, cyanosis, respiratory distress, and feeding difficulties. Diagnosis requires a high level of clinical suspicion and helps in timely intervention. Direct laryngoscopy is gold standard for definitive diagnosis. Treatment options include aspiration, marsupialization, and surgical excision. Here, we report a case of 7-week-old infant with complain of recurrent episodes of cyanosis when agitated, since the age of 3 weeks, admitted with impression of apparent life-threatening events (ALTEs)...
June 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28555179/the-management-of-cyanotic-spells-in-children-with-oesophageal-atresia
#4
REVIEW
Mathieu Bergeron, Aliza P Cohen, Robin T Cotton
Cyanotic spells, also known as blue spells, dying spells, or apparent life-threatening events, refer to a bluish tone visible in the mucosal membranes and skin caused by an oxygen decrease in the peripheral circulation. Although this decrease may be transient and benign, it may also be indicative of a severe underlying problem that requires immediate intervention. Children with oesophageal atresia (OA) are at risk for a number of coexisting conditions that may trigger cyanotic spells. This current article will focus on the management of cyanotic spells both in children with innominate artery compression and those with tracheomalacia...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28438477/apnea-in-the-term-infant
#5
REVIEW
Mary Elaine Patrinos, Richard J Martin
Whereas apnea of prematurity has been well defined and its pathophysiology extensively studied, apnea in the term infant remains a greater challenge. Unfortunately, clear diagnostic criteria are lacking and pathogenesis and management vary widely. In this review we have arbitrarily organized the discussion chronologically into earlier and later postnatal periods. In the first days of life, presumed apnea may reflect physiologic events such as positional or feeding etiologies, or may be a manifestation of serious pathophysiology, such as a seizure disorder...
April 21, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28419986/hypodysfibrinogenemia-with-a-heterozygous-mutation-of-%C3%AE-cys326ser-by-the-novel-transversion-of-tgt-to-tct-in-a-patient-with-pulmonary-thromboembolism-and-right-ventricular-thrombus
#6
Akiko Ushijima, Taichi Komai, Atsuko Masukawa, Keiko Oikawa, Norishige Morita, Satomi Asai, Saki Mukai, Nobuo Okumura, Yoshinori Kobayashi, Hayato Miyachi
We encountered a 45-year-old Japanese man who suffered from pulmonary thromboembolism and huge right ventricular thrombus after inferior vena cava (IVC) filter implantation without apparent thrombus in either the deep veins or inside the IVC filter. The biochemical data showed a discrepancy in the level of fibrinogen between the immunological and thrombin time methods, suggesting hypodysfibrinogenemia. The sequencing of the fibrinogen γ-chain gene (FGG) revealed a novel heterozygous missense mutation in exon 8 - a TGT to TCT transversion in codon 326 - resulting in an amino acid substitution of serine for cysteine (γCys326Ser)...
2017: Cardiology
https://www.readbyqxmd.com/read/28385426/posterior-tracheopexy-for-severe-tracheomalacia
#7
Hester F Shieh, C Jason Smithers, Thomas E Hamilton, David Zurakowski, Lawrence M Rhein, Michael A Manfredi, Christopher W Baird, Russell W Jennings
PURPOSE: In severe tracheomalacia, aortopexy addresses anterior vascular compression, but does not directly address posterior membranous tracheal intrusion. We review patient outcomes of posterior tracheopexy for tracheomalacia with posterior intrusion to determine if there were resolution of clinical symptoms and bronchoscopic evidence of improvement in airway collapse. METHODS: All patients who underwent posterior tracheopexy from October 2012 to March 2016 were retrospectively reviewed...
June 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28115439/brief-resolved-unexplained-event-new-diagnosis-in-infants
#8
Karen Arane, Ilene Claudius, Ran D Goldman
QUESTION: For many years, the term apparent life-threatening event (ALTE) was associated with sudden infant death syndrome, and parents who described an acute event in their infants were sent to the hospital for admission. I understand that for infants new terminology is recommended. What is the current approach to a near-death experience of an infant? ANSWER: A recent clinical practice guideline revised the name and definition of an ALTE to a brief resolved unexplained event (BRUE)...
January 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28108810/independent-risk-factors-for-recurrence-of-apparent-life-threatening-events-in-infants
#9
Riyo Ueda, Osamu Nomura, Takanobu Maekawa, Hirokazu Sakai, Satoshi Nakagawa, Akira Ishiguro
The risk factors for recurrent apparent life-threatening event (ALTE) are unclear although the risk of recurrent ALTE is an important consideration for the management of ALTE patients. This study aimed to identify the risk factors for recurrent ALTE. We conducted a secondary analysis of the data from a single center retrospective cohort study in Japan conducted from March 2002 to January 2012, which included children diagnosed with ALTE at a pediatric emergency department (ED) in Tokyo. Among 112 ALTE patients, 18 (16%) had recurrences and 94 (84%) did not...
April 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28042408/an-unusual-cause-of-postabortal-fever-requiring-prompt-surgical-intervention-a-pyomyoma-and-its-imaging-features
#10
Rashmi Bagga, Rakhi Rai, Jasvinder Kalra, Pradip K Saha, Tulika Singh
Pyomyoma is an unusual complication of leiomyoma, occurring most commonly in the postpartum, postabortal, and post-menopausal periods. It develops due to infection in necrotic foci within leiomyoma, which is more common during pregnancy due to rapid growth, and in postmenopausal women due to vascular insufficiency. Other contributing factors are curettage, gynecological surgery, cervical stenosis, immunodeficiency, and recently, uterine artery embolization. It presents with a typical triad of sepsis, leiomyoma, and absence of any apparent source of infection...
January 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/28039509/population-pharmacokinetics-of-lenalidomide-in-multiple-myeloma-patients
#11
Beatriz Guglieri-López, Alejandro Pérez-Pitarch, Dirk Jan A R Moes, Begoña Porta-Oltra, Mónica Climente-Martí, Henk Jan Guchelaar, Matilde Merino-Sanjuán
PURPOSE: Lenalidomide disease-specific toxicity profiles and potentially life-threatening adverse events support the consideration of diversity in starting doses. The aim of this study was to conduct a population pharmacokinetic analysis of lenalidomide in multiple myeloma patients to identify and evaluate non-studied covariates that could be used for dose individualization. METHODS: Blood samples were collected from 15 multiple myeloma patients. Nonlinear mixed-effects modeling was used to develop a population pharmacokinetic model and perform covariate analysis...
January 2017: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/28017711/evaluation-of-the-hypothesis-that-choking-alte-may-mimic-abusive-head-trauma
#12
Jennifer B Hansen, Terra Frazier, Mary Moffatt, Timothy Zinkus, James D Anderst
OBJECTIVE: Apparent life-threatening events (ALTEs), often accompanied by choking, have been hypothesized to cause subdural hemorrhages (SDH), retinal hemorrhages, and brain injury. If the choking/ALTE hypothesis were true, children who present with ALTE and SDH would have fewer extracranial injuries suspicious for abuse than those with SDH and no ALTE. We aimed to compare the prevalence of suspicious extracranial injuries in children who have ALTE-associated SDH to those with non-ALTE SDH...
May 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28011082/-neonatal-arterial-ischemic-stroke-review-of-the-current-guidelines
#13
E Saliba, T Debillon, S Auvin, O Baud, V Biran, J-L Chabernaud, S Chabrier, F Cneude, A-G Cordier, V Darmency-Stamboul, J-F Diependaele, T Debillon, M Dinomais, C Durand, A Ego, G Favrais, Y Gruel, L Hertz-Pannier, B Husson, S Marret, S N'Guyen The Tich, T Perez, E Saliba, J-B Valentin, C Vuillerot
Neonatal arterial ischemic stroke (NAIS) is a rare event that occurs in approximately one in 5000 term or close-to-term infants. Most affected infants will present with seizures. Although a well-recognized clinical entity, many questions remain regarding diagnosis, risk factors, treatment, and follow-up modalities. In the absence of a known pathophysiological mechanism and lack of evidence-based guidelines, only supportive care is currently provided. To address these issues, a French national committee set up by the French Neonatal Society (Société française de néonatologie) and the national referral center (Centre national de référence) for arterial ischemic stroke in children drew up guidelines based on an HAS (Haute Autorité de santé [HAS]; French national authority for health) methodology...
February 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27749633/etiology-and-outcome-of-severe-apparent-life-threatening-events-in-infants
#14
Tanja Radovanovic, Slobodan Spasojevic, Vesna Stojanovic, Aleksandra Doronjski
INTRODUCTION: An apparent life-threatening event (ALTE) is defined as "an episode that is frightening to the observer and is characterized by some combination of apnea, color change, marked change of muscle tone, choking, or gagging." OBJECTIVE: The aims of this study were to determine etiology and outcome of severe ALTE (requiring resuscitation measures) and to review diagnostic approaches in infants hospitalized after such an episode of ALTE. METHODS: Retrospective analysis included patients hospitalized at the Intensive Care Unit, Institute of Child and Youth Healthcare of Vojvodina, after an episode of severe ALTE over a 4-year period...
September 30, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27741078/the-utility-of-head-computed-tomography-in-the-evaluation-of-apparent-life-threatening-event
#15
Wayne Stark, Annie Rominger, Fred Warkentine, Kerry Caperell
OBJECTIVE: This study aimed to evaluate the diagnostic utility of empiric head computed tomography (CT) in apparent life threatening event (ALTE). METHODS: This was a retrospective chart review of children younger than 12 months presenting to an urban pediatric hospital and its suburban satellite for an ALTE from October 2009 to December 2012. The ALTE cases were identified as having had a diagnosis of ALTE (International Classification of Diseases, 9th Revision 799...
October 6, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27741062/oropharyngeal-dysphagia-is-strongly-correlated-with-apparent-life-threatening-events
#16
Daniel R Duncan, Janine Amirault, Paul Mitchell, Kara Larson, Rachel L Rosen
OBJECTIVES: The aim of this study was to investigate the prevalence of oropharyngeal dysfunction with resultant aspiration in patients admitted after apparent life-threatening event (ALTE) and to determine if historical characteristics could predict this oropharyngeal dysphagia and aspiration risk. METHODS: We retrospectively reviewed the records of all patients admitted to Boston Children's Hospital between 2012 and 2015 with a diagnosis of ALTE to determine the frequency of evaluation for oropharyngeal dysphagia using videofluoroscopic swallow studies (VFSS) and clinical feeding evaluations, to determine the prevalence of swallowing dysfunction in subjects admitted after ALTE and to compare presenting historical characteristics to swallow study results RESULTS:: 188 children were admitted with a diagnosis of ALTE of which 29% (n = 55) had an assessment of swallowing by VFSS...
October 12, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27737774/exploring-the-safety-and-efficacy-of-targeted-temperature-management-amongst-infants-with-out-of-hospital-cardiac-arrest-due-to-apparent-life-threatening-events
#17
Kathleen Meert, Russell Telford, Richard Holubkov, Beth S Slomine, James R Christensen, J Michael Dean, Frank W Moler
OBJECTIVE: To explore the safety and efficacy of targeted temperature management amongst infants with out-of-hospital cardiac arrest due to an apparent life threatening event (ALTE) recruited to the Therapeutic Hypothermia after Paediatric Cardiac Arrest Out-of-Hospital trial. METHODS: Fifty-four infants (48h to <1year of age) with ALTE who received chest compressions for ≥2min, were comatose, and required mechanical ventilation after return of circulation were included...
December 2016: Resuscitation
https://www.readbyqxmd.com/read/27736023/b12-deficiency-is-common-in-infants-and-is-accompanied-by-serious-neurological-symptoms
#18
T Irevall, I Axelsson, E Naumburg
AIM: Adverse neurological symptoms have been linked to vitamin B12 deficiency in infants. This explorative study described the clinical presentation associated with vitamin B12 deficiency in this age group. METHODS: The study comprised infants who were born between 2004 and 2012 and were tested for vitamin B12 levels after they were admitted to a hospital with neurological symptoms at less than one year of age. Vitamin B12 deficiency was defined as low cobalamin in serum and/or increased homocysteine and/or increased methylmalonate...
January 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/27726123/psychological-therapies-for-children-and-adolescents-exposed-to-trauma
#19
REVIEW
Donna Gillies, Licia Maiocchi, Abhishta P Bhandari, Fiona Taylor, Carl Gray, Louise O'Brien
BACKGROUND: Children and adolescents who have experienced trauma are at high risk of developing post-traumatic stress disorder (PTSD) and other negative emotional, behavioural and mental health outcomes, all of which are associated with high personal and health costs. A wide range of psychological treatments are used to prevent negative outcomes associated with trauma in children and adolescents. OBJECTIVES: To assess the effects of psychological therapies in preventing PTSD and associated negative emotional, behavioural and mental health outcomes in children and adolescents who have undergone a traumatic event...
October 11, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27722004/alte-and-feeding-intolerance-as-a-presentation-of-double-aortic-arch
#20
Rekha Krishnasarma, Liza Green Golan Mackintosh, Francine Bynum
Many children who are admitted to pediatric hospitals with the chief complaint of apparent life-threatening event (ALTE) are, in fact, well appearing by the time the inpatient medical team evaluates the patient. This presents a diagnostic and therapeutic challenge. We describe a case of a six-month-old full-term female presenting with an ALTE and found to have a double aortic arch, a congenital anomaly that usually presents with a more progressive onset of symptoms such as chronic cough, positional stridor, and feeding difficulties...
2016: Case Reports in Pediatrics
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