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Pediatrics neurology

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https://www.readbyqxmd.com/read/28445240/evaluation-of-a-pediatric-early-warning-score-across-different-subspecialty-patients
#1
Nathan P Dean, J B Fenix, Michael Spaeder, Amanda Levin
OBJECTIVE: To evaluate the ability of a Pediatric Early Warning Score to predict deterioration in different subspecialty patient populations. DESIGN: Single center, retrospective cohort study. Patients were classified into five groups: 1) cardiac; 2) hematology/oncology/bone marrow transplant; 3) surgical; 4) neurologic; and 5) general medical. The relationship between the Pediatric Early Warning Score and unplanned ICU transfer requiring initiation of specific ICU therapies (intubation, high-flow nasal cannula, noninvasive ventilation, inotropes, or aggressive fluid hydration within 12 hr of transfer) was evaluated...
April 25, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28445083/fatigue-and-physical-functioning-in-children-with-multiple-sclerosis-and-acute-disseminated-encephalomyelitis
#2
Leontien Cc Toussaint-Duyster, Yu Yi M Wong, Monique Hm Van der Cammen-van Zijp, Daniëlle Van Pelt-Gravesteijn, Coriene E Catsman-Berrevoets, Rogier Q Hintzen, Rinze F Neuteboom
BACKGROUND AND OBJECTIVE: Fatigue and physical impairments are a major concern in children with multiple sclerosis (MS) and after acute disseminated encephalomyelitis (post-ADEM). We here aimed to evaluate the interaction between fatigue, exercise capacity, motor performance, neurological status, and quality of life (HRQoL). METHODS: In this cross-sectional study, data of 38 children (MS n = 22, post-ADEM n = 16), aged 4-17 years attending our national pediatric MS center, were studied...
April 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28444038/difficulties-in-accessing-services-that-are-of-medium-complexity-in-small-municipalities-a-case-study
#3
Camila Ribeiro Silva, Brigida Gimenez Carvalho, Luiz Cordoni, Elisabete de Fátima Pólo de Almeida Nunes
The study aimed to describe the specialized health services and to identify areas of greater difficulty of access to specialized consultations offered by SUS in small cities in the 18th Regional Health Area of Paraná State, Brazil, using case study methodology. The data were collected between January and April 2015. Managers, management teams and the board of directors of the CIS (Consórcio Intermunicipal de Saúde) were interviewed. The 21 studied specialist areas were rated like Sufficient Quota, Insufficient Quota, Inexistent Supply, and Assistance Gap...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28441281/incarcerated-medial-epicondyle-fractures-with-elbow-dislocation-risk-factors-associated-with-morbidity
#4
Carley Vuillermin, Kyna S Donohue, Patricia Miller, Andrea S Bauer, Dennis E Kramer, Yi-Meng Yen
BACKGROUND: Incarcerated medial epicondyle fractures in association with elbow trauma are rare and an absolute indication for intervention. Because of the infrequent nature, outcomes following this injury are not well documented. We studied a large cohort of these injuries to determine factors associated with functional outcomes. It was hypothesized that a greater duration between initial presentation and time of surgery would lead to poorer outcomes. METHODS: A total of 32 patients aged 18 and under who underwent surgical treatment for an incarcerated medical epicondyle fracture at a level-1 pediatric trauma center from 2003 to 2015 were identified...
April 24, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28441266/safety-of-the-inactivated-japanese-encephalitis-virus-vaccine-ixiaro%C3%A2-in-children-an-open-label-randomized-active-controlled-phase-3-study
#5
Katrin L Dubischar, Vera Kadlecek, Benjamin Sablan, Charissa Fay Borja-Tabora, Salvacion Gatchalian, Susanne Eder-Lingelbach, Zsuzsanna Mueller, Kerstin Westritschnig
BACKGROUND: Japanese encephalitis (JE) remains a serious health concern in Asian countries and has sporadically affected pediatric travelers. In the present study we monitored the safety profile of the JE virus (JEV) vaccine IXIARO in a pediatric population. METHODS: We randomized 1869 children between the age of 2 months and 17 years in an age-stratified manner to vaccination with IXIARO or one of the control vaccines, Prevnar and HAVRIX 720. Adverse events (AEs) (unsolicited and solicited local and systemic adverse events), serious AEs and medically-attended AEs were assessed up to Day 56 and Month 7 after the first dose...
April 24, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28440997/-neisseria-meningitidis-a-clinical-case-with-multi-organ-affection
#6
Alejandro Medina-Reyes, Beatriz Díaz-Polanco, Diego Sandoval-Chávez, Manuel Nodal-Hernández, Juan R Ayala-Franco
Neisseria meningitidis (Nm) is an agent feared for decades in the medical field due to its important morbidity and mortality. Ironically between 10 and 15% of the population will be asymptomatic carriers of this germ, which will also be ready to activate and manifest itself as a sickness at the right moment. We present the case of a nine-year-old girl who arrived at the Pediatric Emergency Service (to the Hospital General Region number 35, in Ciudad Juárez, Chihuahua) with the disease in multiple organs, where the Nm was isolated in the cerebrospinal fluid and in skin injuries, displaying three serotypes of Nm...
May 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28439202/a-rare-complication-of-esophageal-dilatation-brain-abscess
#7
Nagehan Aslan, Esra Sesli, Tuba Koca, Nilgün Şenol, Mustafa Akçam
Brain abscess is an uncommon serious disease, which has been reported as a rare complication of repeated esophageal dilations; however, routine periprocedural antibiotic prophylaxis is not currently recommended. Herein, we present a brain abscess that developed after esophageal dilatation for the treatment of induced caustic esophageal strictures. The clinical presentation is non-specific, the most reported signs are high fever and neurologic findings. Cases have been reported in the literature in adult and pediatric patients...
March 2017: Türk Pediatri Arşivi
https://www.readbyqxmd.com/read/28437682/sleep-problems-in-pediatric-epilepsy-and-adhd-the-impact-of-comorbidity
#8
Ozalp Ekinci, Çetin Okuyaz, Serkan Gunes, Nuran Ekinci, Merve Kalınlı, Muhammet Emin Tan, Halenur Teke, Meltem Çobanoğulları Direk, Semra Erdoğan
AIMS: Attention-deficit hyperactivity disorder (ADHD) is a frequent comorbidity in pediatric epilepsy. Although sleep problems are commonly reported in both children with primary ADHD and epilepsy, those with epilepsy-ADHD comorbidity have not been well studied. This study aimed to compare sleep problems among three groups of children: 1) children with epilepsy, 2) children with epilepsy and ADHD (epilepsy-ADHD), and 3) children with primary ADHD. METHODS: 53 children with epilepsy, 35 children with epilepsy-ADHD, and 52 children with primary ADHD completed the Children's Sleep Habits Questionnaire (CSHQ)...
April 21, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28437378/risk-factors-for-pediatric-extubation-failure-the-importance-of-respiratory-muscle-strength
#9
Robinder G Khemani, Tro Sekayan, Justin Hotz, Rutger C Flink, Gerrard F Rafferty, Narayan Iyer, Christopher J L Newth
OBJECTIVE: Respiratory muscle weakness frequently develops during mechanical ventilation, although in children there are limited data about its prevalence and whether it is associated with extubation outcomes. We sought to identify risk factors for pediatric extubation failure, with specific attention to respiratory muscle strength. DESIGN: Secondary analysis of prospectively collected data. SETTING: Tertiary care PICU. PATIENTS: Four hundred nine mechanically ventilated children...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28433837/internal-maxillary-bypass-for-complex-pediatric-aneurysms
#10
Long Wang, Shuaibin Lu, Hai Qian, Xiang'en Shi
BACKGROUND: Complex pediatric aneurysms (PAs) are an unusual clinicopathologic entity, and data remain limited regarding the use of a bypass procedure to treat this formidable disorder. METHODS: Internal maxillary artery (IMA) to middle cerebral artery (MCA) bypass with radial artery graft (RAG) was utilized to isolate PAs. Bypass patency and aneurysm stability were evaluated using intraoperative Doppler ultrasound, indocyanine green videoangiography and postoperative angiography...
April 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28433581/therapeutic-burst-suppression-coma-in-pediatric-febrile-refractory-status-epilepticus
#11
Jainn-Jim Lin, Cheng-Che Chou, Shih-Yun Lan, Hsiang-Ju Hsiao, Yu Wang, Oi-Wa Chan, Shao-Hsuan Hsia, Huei-Shyong Wang, Kuang-Lin Lin
BACKGROUND: Evidence for the beneficial effect of therapeutic burst-suppression coma in pediatric patients with febrile refractory status epilepticus is limited, and the clinical outcomes of this treatment strategy are largely unknown. Therefore, the aim of this study was to explore the outcomes of therapeutic burst-suppression coma in a series of children with febrile refractory status epilepticus. METHODS: We retrospectively reviewed consecutive pediatric patients with febrile refractory status epilepticus admitted to our pediatric intensive care unit between January 2000 and December 2013...
April 19, 2017: Brain & Development
https://www.readbyqxmd.com/read/28433098/wilson-disease-in-children
#12
Eve A Roberts, Piotr Socha
Wilson disease (WD) is an inherited disorder mainly of hepatocellular copper disposition, due to dysfunction of the Wilson ATPase, a P1B-ATPase encoded by the gene ATP7B. In children, as in older age brackets, clinical disease is highly diverse. Although hepatic disease is the common presentation in children/adolescents, neurologic, psychiatric, and hematologic clinical presentations do occur. Very young children may have clinically evident liver disease due to WD. Early diagnosis, preferably when the child/adolescent is asymptomatic, is most likely to result in near-normal longevity with generally good health so long as the patient tolerates effective medication, is adherent to the lifelong treatment regimen, and has consistent access to the medication...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28426698/extensive-alterations-of-blood-metabolites-in-pediatric-cerebral-malaria
#13
Sanchit Gupta, Karl Seydel, Miguel A Miranda-Roman, Catherine M Feintuch, Alex Saidi, Ryung S Kim, Gretchen L Birbeck, Terrie Taylor, Johanna P Daily
Cerebral malaria (CM) presents as an encephalopathy and is due to infection with Plasmodium falciparum. Patients are comatose, often with fever, recurrent seizures and this condition is associated with a high mortality rate. The etiology of the coma and seizures are poorly understood. Circulating small molecules and lipids have bioactive functions and alterations in their concentrations have been implicated in seizure disorders and other forms of encephalopathy. We carried out a comprehensive analysis of blood metabolites during CM to explore a biochemical basis of this encephalopathy...
2017: PloS One
https://www.readbyqxmd.com/read/28426650/neural-injury-markers-in-intrauterine-growth-restriction-and-their-relation-to-perinatal-outcomes
#14
E Mazarico, E Llurba, R Cumplido, A Valls, J C Melchor, M Iglesias, L Cabero, E Gratacós, Md Gómez Roig
BACKGROUND: The aims of this study were to: (1) compare the concentrations of two neural injury markers, S100B protein and neuron-specific enolase (NSE), in intrauterine growth-restricted fetuses (IUGR) and in fetuses with appropriate growth-for-gestational-age (AGA), and (2) investigate potential relationships between concentrations of these markers, Doppler abnormalities, and adverse perinatal or neonatal outcomes. METHODS: This was a case-controlled, cooperative, prospective study among Spanish Maternal and Child Health Network (Retic SAMID) hospitals...
April 20, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28426648/pregnancy-swimming-causes-short-and-long-term-neuroprotection-against-hypoxia-ischemia-in-very-immature-rats
#15
Eduardo Farias Sanches, Luz Elena Duran Carabali, Andrea Tosta, Fabrício Nicola, Felipe Schmitz, André Rodrigues, Cassiana Siebert, Angela Wyse, Carlos Alexandre Netto
BACKGROUND: Hypoxia-ischemia (HI) is a major cause of neurological damage in preterm. Pregnancy swimming alters the pup's brain development. We tested the effects of swimming during pregnancy in the very immature rat brain. METHODS: Female Wistar rats (n=12) were assigned to sedentary (SE, n=6) or swimming groups (SW, n=6). From the gestational day 0 (DG0) to GD21 they performed 20 min/daily swimming sessions. HI on postnatal day 3 rat cause sensorimotor and cognitive impairments...
April 20, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28425688/pediatric-epilepsy-and-psychiatric-comorbidity-preliminary-observational-data-from-a-prospective-study
#16
Michela Gatta, Alessia Raffagnato, Stefania Mannarini, Laura Balottin, Irene Toldo, Marilena Vecchi, Clementina Boniver
BACKGROUND: Several studies have confirmed psychiatric comorbidity and a worse quality of life in children with epilepsy, but the clinical assessment and monitoring of these patients often pays insufficient attention to their psychological aspects alongside their neurological issues. The present study aims to describe the distribution of psychopathologies and their clinical evolution over 18 months in a sample of children followed up since the onset of their epilepsy. METHODS: After being diagnosed with epilepsy, 49 subjects (age 4-18y) were followed up with psychiatric and psychological assessments based on the use of dimensional and categorical psychometric tools...
April 20, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28425334/remifentanil-for-sedation-of-children-with-traumatic-brain-injury
#17
James L Hungerford, Nicole O'Brien, Melissa Moore-Clingenpeel, Eric A Sribnick, Cheryl Sargel, Mark Hall, Jeffrey R Leonard, Joseph D Tobias
OBJECTIVE: To determine whether remifentanil would provide adequate sedation while allowing frequent and reproducible neurologic assessments in children admitted to the pediatric intensive care unit (PICU) with traumatic brain injury (TBI) during mechanical ventilation. DESIGN: Retrospective review. SETTING: Tertiary care PICU. PATIENTS: Thirty-eight patients over a 30-month period. MEASUREMENTS AND MAIN RESULTS: Median age was 9 years (interquartile range [IQR] 2...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28424604/mapping-critical-language-sites-in-children-performing-verb-generation-whole-brain-connectivity-and-graph-theoretical-analysis-in-meg
#18
Vahab Youssofzadeh, Brady J Williamson, Darren S Kadis
A classic left frontal-temporal brain network is known to support language processes. However, the level of participation of constituent regions, and the contribution of extra-canonical areas, is not fully understood; this is particularly true in children, and in individuals who have experienced early neurological insult. In the present work, we propose whole-brain connectivity and graph-theoretical analysis of magnetoencephalography (MEG) source estimates to provide robust maps of the pediatric expressive language network...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28424016/acute-brain-injury-following-illicit-drug-abuse-in-adolescent-and-young-adult-patients-spectrum-of-neuroimaging-findings
#19
Shai Shrot, Andrea Poretti, Elizabeth W Tucker, Bruno P Soares, Thierry Agm Huisman
The use of illicit drugs is currently a major medical problem among adolescents. Several illicit drugs have a high abuse potential and can be neurotoxic causing high morbidity and mortality. The clinical manifestation of adolescents with acute drug-induced neurotoxicity is often characterized by non-specific symptoms and findings. Early diagnosis is important to prevent death and permanent long-term neurological impairments. We report on clinical and neuroimaging findings in five adolescents with acute brain imaging following illicit drug intoxication to highlight the role of neuroimaging findings in the diagnostic work-up of pediatric acute drug-induced neurotoxicity...
April 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28422950/application-of-high-resolution-array-comparative-genomic-hybridization-in-children-with-unknown-syndromic-microcephaly
#20
Eirini Tsoutsou, Maria Tzetis, Krinio Giannikou, Maria Braoudaki, Anastasis Mitrakos, Stella Amenta, Nikoletta Selenti, Emmanouil Kanavakis, Dimitrios Zafeiriou, Sophia Kitsiou-Tzeli, Helena Fryssira
BACKROUND: Microcephaly can be either isolated or coexists with other neurological entities and/or multiple congenital anomalies, known as syndromic microcephaly. Although many syndromic cases can be classified based on the characteristic phenotype, some others remain uncertain and require further investigation. The present study describes the application of array-Comparative Genomic Hybridization (array-CGH) as a diagnostic tool for the study of patients with clinical unknown syndromic microcephaly...
April 19, 2017: Pediatric Research
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