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Anna Rosati, Salvatore De Masi, Renzo Guerrini
BACKGROUND: Ketamine is an emerging third-line medication for refractory status epilepticus, a medical and neurological emergency requiring prompt and appropriate treatment. Owing to its pharmacological properties, ketamine represents a practical alternative to conventional anaesthetics. OBJECTIVE: The objective of this study was to assess the efficacy and safety of ketamine to treat refractory status epilepticus in paediatric and adult populations. METHODS: We conducted a literature search using the PubMed database, Cochrane Database of Systematic Reviews and ClinicalTrials...
September 19, 2018: CNS Drugs
Hermine I Brunner, Alberto Martini, Daniel J Lovell, Nicolino Ruperto
Childhood-onset systemic lupus erythematosus (cSLE) is rare in many regions of the world, including Europe. Access to approved medications for cSLE is currently limited, among others, due to a lack of high-quality evidence from clinical trials. The objectives of the study were to evaluate the current regulatory framework regarding medication approvals, delineate barriers to clinical trial conduct, and strategies to improve access to new medications for cSLE. Relevant methodological and regulatory aspects, epidemiological data, study designs and outcome measures are reviewed, and the results of a survey among Paediatric Rheumatology International Trials Organisation/Pediatric Rheumatology Collaborative Study Group investigators are presented...
September 19, 2018: Annals of the Rheumatic Diseases
Mona Mozaffari, Elena Boyd, Olivia Whiteside
Reported is the case of a 79-year-old woman initially diagnosed with periorbital abscess on the background of a recent upper respiratory tract infection. Unexpectedly, intraoperative findings were that of a haematoma rather than an abscess. Subperiosteal orbital haematoma (SOH) is an extremely rare complication of rhinosinusitis. In contrast to the more common periorbital abscess, it is seldom listed as a complication of sinusitis. A review of reported cases suggests an older patient demographic are affected by SOH in contrast to periorbital abscess which typically affects paediatric patients...
September 18, 2018: BMJ Case Reports
Daniel Álvarez, Andrea Crespo, Fernado Vaquerizo-Villar, Gonzalo Cesar Gutierrez-Tobal, Ana Cerezo-Hernández, Verónica Barroso-García, J Mark Ansermino, Guy A Dumont, Roberto Hornero, Felix Del Campo, Ainara Garde
OBJECTIVE: This study is aimed at assessing symbolic dynamics as a reliable technique to characterise complex fluctuations of portable oximetry in the context of automated detection of childhood obstructive sleep apnoea-hypopnoea syndrome (OSAHS). APPROACH: Nocturnal oximetry signals from 142 children with suspected OSAHS were acquired using the Phone Oximeter: a portable device that integrates a pulse oximeter with a smartphone. An apnoea-hypopnoea index (AHI) ≥5 events/h from simultaneous in-lab polysomnography was used to confirm moderate-to-severe childhood OSAHS...
September 19, 2018: Physiological Measurement
Pascal Amedro, Arthur Gavotto, Delphine Gelibert, Virginie Fraysse, Gregoire De La Villeon, D'Arcy Vandenberghe, Charlene Bredy
BACKGROUND: The use of hypnosis in children has been described more than two centuries ago, with a more recent research and clinical application. There is currently a good level of evidence for the efficacy of clinical hypnosis in children for minor surgery, medical procedures or pain management. The use of clinical hypnosis, in paediatric cardiology, for invasive procedures such as transesophageal echocardiography, has not been reported. AIMS: This study evaluated the feasibility of clinical hypnosis in children undergoing transesophageal echocardiography...
September 19, 2018: European Journal of Cardiovascular Nursing
Melanie Pemberton, Carole Brady, Beth Taylor, Danielle Tyrrell, Lucy Sim, Sylwia Zawlodzka-Bednarz, Jennifer Biggs, Mitchell Peters, John Baines, Catriona Hargrave
INTRODUCTION: To implement the modulated arc total body irradiation (MATBI) technique within the existing infrastructure of a radiation oncology department. The technique needed to treat paediatric patients of all ages, some of whom would require general anaesthesia (GA). METHODS: The MATBI technique required minor modifications to be incorporated within existing departmental infrastructure. Ancillary equipment essential to the technique were identified and in some cases custom designed to meet health and safety criteria...
September 19, 2018: Journal of Medical Radiation Sciences
Suttikarn Santiwatana, Pat Mahachoklertwattana, Chanin Limwongse, Patcharin Khlairit, Sarunyu Pongratanakul, Ekkapong Roothumnong, Kanjana Prangphan, Lulin Choubtum, Duantida Songdej, Preamrudee Poomthavorn
OBJECTIVE: Skewed X chromosome inactivation (XCI) was associated with female predominance in adult autoimmune thyroid disease (ATD). In normal females, skewed XCI is increased with age. Whether early-onset skewed XCI is associated with childhood ATD remains unknown. This study aimed to determine XCI skewing in paediatric ATD. DESIGN, PATIENTS AND MEASUREMENTS: Ninety-one female ATD patients, aged 3-20 years and 57 age-matched, female controls were enrolled. XCI was analysed by enzymatic digestion of DNA with methylation-sensitive enzymes followed by PCR of the polymorphic CAG repeat in the androgen receptor gene...
September 19, 2018: Clinical Endocrinology
Rolf Kramer, Marina Sabatier, Thierry Wirth, Maxime Pichon, Bruno Lina, Isabelle Schuffenecker, Laurence Josset
BackgroundUnderstanding enterovirus D68 (EV-D68) circulation patterns as well as risk factors for severe respiratory and neurological illness is important for developing preventive strategies. Methods : Between 2010 and 2016, 11,132 respiratory specimens from hospitalised patients in Lyon, France, were screened for EV-D68 by PCR. Phylogenetic relationships of the viral-protein-1 sequences were reconstructed using maximum-likelihood and Bayesian-Markov-Chain-Monte-Carlo approaches. Results: Overall, 171 infections with a biennial pattern were detected, including seven, one, 55, none, 42, one and 65 cases annually during 2010-16...
September 2018: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
Amanda Phoon Nguyen, Norman Firth, Sophie Mougos, Omar Kujan
An otherwise healthy 20-year-old male presented with an exophytic, polypoid, yellowish lesion involving the dorsal surface of his tongue, which he reported being present since birth and unchanged. This was removed by surgical excision and diagnosed as a leiomyomatous hamartoma. Histological examination revealed a combination of fibrovascular connective tissue, conspicuous smooth-muscle bundles, adipose tissue, minor salivary gland tissue, blood vessels, lymphoid tissue, peripheral nerves, and normal skeletal muscle...
2018: Case Reports in Dentistry
Y S de Boer, R Liberal, D Vergani, G Mieli-Vergani
Background and aims: Juvenile autoimmune liver disease (JAILD) includes paediatric forms of autoimmune hepatitis (AIH) and autoimmune sclerosing cholangitis (ASC). Since evidence is scarce, there are currently no evidence-based management guidelines for juvenile AIH. This survey was carried out amongst the paediatric members of the International AIH Group (IAIHG) to describe their practices in the management of JAILD. Methods: An online survey questionnaire was distributed to members of the IAIHG with active practice (https://www...
August 2018: United European Gastroenterology Journal
Giovanni Di Nardo, Carlo Calabrese, Roberto Conti Nibali, Arianna De Matteis, Emanuele Casciani, Luigi Martemucci, Giuseppe Pagliaro, Nico Pagano
Introduction: Device-assisted enteroscopy is a new endoscopic technique for the evaluation of small bowel in adults and children. Data in pediatric population are limited. This review aims to identify diagnostic and therapeutic benefits of enteroscopy in children. Methods: We have analysed paediatric literature on device-assisted enteroscopy focusing on indications, technical aspects and complications, with attention given to adult publications that may be applicable to the paediatric population...
August 2018: United European Gastroenterology Journal
David S Curragh, Clara E McAvoy, Madeleine Rooney, Eibhlin McLoone
BACKGROUND/OBJECTIVES: Uveitis is an uncommon manifestation of post-streptococcal syndrome (PSUS). Despite reports, the condition is often not well recognised. The purpose of this study is to report a case series of children with post-streptococcal uveitis. SUBJECTS/METHODS: In this retrospective case series, all cases of PSUS were identified from all new paediatric patients diagnosed with uveitis over a 6-year period. Diagnosis of PSUS was based on the following diagnostic criteria: unilateral or bilateral uveitis with positive anti-streptolysin O titres (ASOT) or anti-deoxyribonuclease (anti-DNase) titres, and negative routine investigations for other causes of uveitis...
September 18, 2018: Eye
Gavin McClean, Nathan R Riding, Guido Pieles, Victoria Watt, Carmen Adamuz, Sanjay Sharma, Keith P George, David Oxborough, Mathew G Wilson
OBJECTIVE: Historically, electrocardiographic (ECG) interpretation criteria for athletes were only applicable to adults. New international recommendations now account for athletes ≤16 years, but their clinical appropriateness is unknown. We sought to establish the diagnostic accuracy of new international ECG recommendations against the Seattle criteria and 2010 European Society of Cardiology (ESC) recommendations in paediatric athletes using receiver operator curve analysis. Clinical context was calculated using Bayesian analysis...
September 18, 2018: Heart: Official Journal of the British Cardiac Society
Li Gao, Chunhua Jia, Huiwen Huang
BACKGROUND: Massage therapy has been used by many traditional Chinese medicine physicians to treat acute diarrhoea in children. Since no relevant systematic reviews assessed the clinical effectiveness or the risk of massage therapy, in this study, a meta-analysis was conducted to evaluate the efficacy of paediatric massage for the treatment of acute diarrhoea in children. METHODS: In this meta-analysis, paediatric patients who were diagnosed with acute diarrhoea were included...
September 18, 2018: BMC Complementary and Alternative Medicine
Victoria Scott-Warren, Anju Bendon, Iain A Bruce, Lise Henderson, Jacques Diacono
Congenital long QT syndrome (cLQTS) is an inherited cardiac ion channelopathy characterized by a long corrected-QT interval on the ECG, associated with a risk of syncope and sudden death as a result of arrhythmias. The archetypal arrhythmia associated with cLQTS is torsade de pointes which may degenerate into ventricular fibrillation. Children with Jervell and Lange-Neilsen syndrome have the combination of cLQTS and congenital sensorineural deafness and may present for cochlear implantation (CI). Sympathetic stimulation and administration of QT-prolonging medications may trigger arrhythmias in children with cLQTS and thus the perioperative period is a time of increased risk of adverse events, with deaths reported in the CI literature...
September 19, 2018: Cochlear Implants International
Rebecca Barwise-Munro, Heather Morgan, Steve Turner
BACKGROUND: The number of acute medical paediatric emergency admissions is rising. We undertook qualitative interviews with parents and clinicians to better understand what factors, other than the health status of the child, may influence decision making leading to emergency admission. METHODS: Semi-structured interviews were conducted with parents; clinicians working in general practice, out-of-hours or the emergency department (referring clinicians); and doctors working in acute medical paediatrics (receiving clinicians)...
September 17, 2018: Healthcare (Basel, Switzerland)
M Janickova, D Statelova, K Mikuskova, M Jesenak, I Malachovsky
OBJECTIVE: The use of biodegradable materials represents a new option in the treatment of paediatric facial skeleton fractures. The benefits of a resorbable system include reductions in time for long-term stability, diminished immobilisation period, and elimination of painful procedures for implant removal. The resorption of the material did not influence bone repair and growth. Bioresorbable plates and screws get completely excreted through physiological routes. MATERIAL AND METHODS: The age of the patients ranges from that of pre-schoolers till 18 years...
2018: Bratislavské Lekárske Listy
Jody A Porter, Karen E MacKenzie, Brian A Darlow, Ross Butler, Andrew S Day
AIM: Delayed gastric emptying (GE) has been demonstrated in adults with type 1 diabetes mellitus (T1DM). Little is known about GE in children with T1DM. Most methods to measure GE are invasive, that is, scintigraphy, or are only indirectly related to GE, that is, electrogastrography. Carbon-13 breath testing is a non-invasive, very low-risk procedure that accurately correlates with GE time. This was a pilot study to determine the feasibility of using carbon-13 breath testing to measure GE in children with T1DM and healthy controls...
September 17, 2018: Journal of Paediatrics and Child Health
Alaa A Hussein Al-Algawy, Adil Hasan Aliakbar, Ibrahim H N Witwit
Supracondylar fracture of the humerus is a common displaced type childhood fracture that is treated by two methods. To compare open and closed methods of reduction with 2 cross k-wire fixation, a retrospective comparative study of 66 paediatric patients with type III supracondylar fracture of the humerus, who were treated in two different hospitals utilizing two different protocols, was conducted. Group 1 was treated with open reduction and 2 cross k-wire fixation, and group 2 received the closed reduction and k-wire fixation protocol...
September 17, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Agnes Maria Ciplea, Stephanie Laeer, Bjoern Bengt Burckhardt
Background: Variability in pre-analytical procedures such as blood sampling, sample preparation and transport can substantially influence bioanalytical results and subsequently impair reliability of data gathered during clinical trials. Especially in vulnerable populations, all efforts should be made to facilitate high-quality data extraction excluding unnecessary or repeated intervention. Methods: The EU-funded LENA project (Labeling of Enalapril from Neonates up to Adolescents) included a feasibility study in its preparatory procedures prior to first-in-child studies...
December 2018: Contemporary Clinical Trials Communications
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