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Pediatrics neurology

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https://www.readbyqxmd.com/read/28211198/safety-of-antifibrinolytics-in-cranial-vault-reconstructive-surgery-a-report-from-the-pediatric-craniofacial-collaborative-group
#1
Susan M Goobie, Franklyn P Cladis, Chris D Glover, Henry Huang, Srijaya K Reddy, Allison M Fernandez, David Zurakowski, Paul A Stricker
BACKGROUND: Antifibrinolytic therapy significantly decreases blood loss and transfusion in pediatric cranial vault reconstructive surgery; however, concern regarding the side effects profile limits clinical use. AIMS: The aim was to utilize the Pediatric Craniofacial Surgery Perioperative Registry database to identify the safety profile of antifibrinolytic therapy for cranial vault reconstructive surgery by reporting the incidence of adverse events as they relate to exposure to tranexamic acid and aminocaproic acid compared to no exposure to antifibrinolytics...
February 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28210835/a-10-year-review-of-cannabis-exposure-in-children-under-3-years-of-age-do-we-need-a-more-global-approach
#2
Isabelle Claudet, Mathilde Le Breton, Camille Bréhin, Nicolas Franchitto
: Pediatricians working in an emergency environment are confronted with children admitted to emergency departments for intoxication on a daily basis. We carried out a retrospective cohort study of children admitted to a pediatric emergency department due to unintentional cannabis exposure over a 10-year period from 2004 to 2014. Twenty-nine children under the age of 3 were admitted with a positive cannabis urine test. Eighty-seven percent of intoxications occurred at the family home. Resin was the main form of ingested cannabis (69%)...
February 16, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28207570/international-survey-of-critically-ill-children-with-acute-neurologic-insults-the-prevalence-of-acute-critical-neurological-disease-in-children-a-global-epidemiological-assessment-study
#3
Ericka L Fink, Patrick M Kochanek, Robert C Tasker, John Beca, Michael J Bell, Robert S B Clark, Jamie Hutchison, Monica S Vavilala, Anthony Fabio, Derek C Angus, R Scott Watson
OBJECTIVE: The international scope of critical neurologic insults in children is unknown. Our objective was to assess the prevalence and outcomes of children admitted to PICUs with acute neurologic insults. DESIGN: Prospective study. SETTING: Multicenter (n = 107 PICUs) and multinational (23 countries, 79% in North America and Europe). PATIENTS: Children 7 days to 17 years old admitted to the ICU with new traumatic brain injury, stroke, cardiac arrest, CNS infection or inflammation, status epilepticus, spinal cord injury, hydrocephalus, or brain mass...
February 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28199998/delayed-intraparenchymal-and-intraventricular-hemorrhage-requiring-surgical-evacuation-after-mri-guided-laser-interstitial-thermal-therapy-for-lesional-epilepsy
#4
Sean M Barber, Luke Tomycz, Timothy George, Dave F Clarke, Mark Lee
BACKGROUND: Symptomatic intracranial hemorrhage is a rare complication of laser interstitial thermal therapy (LITT). OBJECTIVES: To present a unique case of delayed symptomatic intracranial hemorrhage occurring after a LITT procedure for epilepsy in a high-volume center (68 LITT procedures for pediatric epilepsy have been performed). METHODS: An 18-year-old male with epilepsy underwent LITT to an area of heterotopia near the right lateral ventricle...
February 16, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28193112/longitudinal-outcomes-in-the-2014-acute-flaccid-paralysis-cluster-in-canada
#5
Carmen Yea, Ari Bitnun, Joan Robinson, Aleksandra Mineyko, Michelle Barton, Jean K Mah, Jiri Vajsar, Susan Richardson, Christoph Licht, Jason Brophy, Megan Crone, Shalini Desai, Juliette Hukin, Kevin Jones, Katherine Muir, Jeffrey M Pernica, Robert Pless, Daniela Pohl, Mubeen F Rafay, Kathryn Selby, Sunita Venkateswaran, Geneviève Bernard, E Ann Yeh
We describe the presenting features and long-term outcome of an unusual cluster of pediatric acute flaccid paralysis cases that occurred in Canada during the 2014 enterovirus D68 outbreak. Children (n = 25; median age 7.8 years) presenting to Canadian centers between July 1 and October 31, 2014, and who met diagnostic criteria for acute flaccid paralysis were evaluated retrospectively. The predominant presenting features included prodromal respiratory illness (n = 22), cerebrospinal fluid lymphocytic pleocytosis (n = 18), pain in neck/back (n = 14) and extremities (n = 10), bowel/bladder dysfunction (n = 9), focal central gray matter lesions found in all regions of the spinal cord within the cohort (n = 16), brain stem lesions (n = 8), and bulbar symptoms (n = 5)...
March 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28193109/child-neurology-education-for-pediatric-residents
#6
Dara V F Albert, Anup D Patel, Maria Behnam-Terneus, Beatriz Cunill-De Sautu, Nicole Verbeck, Alisa McQueen, H Barrett Fromme, John D Mahan
The aim of this study was to evaluate whether the current state of child neurology education during pediatric residency provides adequate preparation for pediatric practice. A survey was sent to recent graduates from 3 pediatric residency programs to assess graduate experience, perceived level of competence, and desire for further education in child neurology. Responses from generalists versus subspecialists were compared. The response rate was 32%, half in general pediatric practice. Only 22% feel very confident in approaching patients with neurologic problems...
March 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28191766/concise-review-mesenchymal-stem-cell-therapy-for-pediatric-disease-perspectives-on-success-and-potential-improvements
#7
Christopher R Nitkin, Tracey L Bonfield
Mesenchymal stem cells (MSCs) represent a potentially revolutionary therapy for a wide variety of pediatric diseases, but the optimal cell-based therapeutics for such diversity have not yet been specified. The published clinical trials for pediatric pulmonary, cardiac, orthopedic, endocrine, neurologic, and hematologic diseases provide evidence that MSCs are indeed efficacious, but the significant heterogeneity in therapeutic approaches between studies raises new questions. The purpose of this review is to stimulate new preclinical and clinical trials to investigate these factors...
February 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28177849/the-clinical-evaluation-of-infantile-nystagmus-what-to-do-first-and-why
#8
Morgan Bertsch, Michael Floyd, Taylor Kehoe, Wanda Pfeifer, Arlene V Drack
INTRODUCTION: Infantile nystagmus has many causes, some life threatening. We determined the most common diagnoses in order to develop a testing algorithm. METHODS: Retrospective chart review. Exclusion criteria were no nystagmus, acquired after 6 months, or lack of examination. DATA COLLECTED: pediatric eye examination findings, ancillary testing, order of testing, referral, and final diagnoses. Final diagnosis was defined as meeting published clinical criteria and/or confirmed by diagnostic testing...
January 2017: Ophthalmic Genetics
https://www.readbyqxmd.com/read/28170143/prevalence-of-brain-injuries-and-recurrence-of-seizures-in-children-with-post-traumatic-seizures
#9
Mohamed K Badawy, Peter S Dayan, Michael G Tunik, Frances M Nadel, Kathleen A Lillis, Michelle Miskin, Dominic A Borgialli, Michael C Bachman, Shireen M Atabaki, John D Hoyle, James F Holmes, Nathan Kuppermann
OBJECTIVES: Computed tomography (CT) is often used in the emergency department (ED) evaluation of children with post-traumatic seizures (PTS); however, the frequency of traumatic brain injuries (TBI) and short-term seizure recurrence is lacking. Our main objective was to evaluate the frequency of TBI on CT and short-term seizure recurrence in children with PTS. We also aimed to determine the associations between the likelihood of TBI on CT with the timing of onset of PTS after the traumatic event and duration of PTS...
February 7, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28163432/early-primary-graft-failure-after-a-pediatric-heart-transplant-and-successful-rescue-with-plasmapheresis-immunoglobulins-and-alemtuzumab
#10
Shashi Raj, Phillip Ruiz, Paolo Rusconi
Early primary graft failure after pediatric orthotopic heart transplantation (OHT) has a high mortality rate and can occur due to several causes including but not limited to prolonged graft ischemia time, suboptimal preimplant myocardial preservation, hyperacute rejection, and maladaptation of the graft to the host's hemodynamic status. Mechanical circulatory support with either extracorporeal membrane oxygenation (ECMO) or ventricular assist device has been used for the rescue of primary graft failure in pediatric patients after heart transplant...
January 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28159744/effectiveness-of-fundoplication-or-gastrojejunal-feeding-in-children-with-neurologic-impairment
#11
Bryan Stone, Gabrielle Hester, Daniel Jackson, Troy Richardson, Matt Hall, Ramkiran Gouripeddi, Ryan Butcher, Ron Keren, Rajendu Srivastava
BACKGROUND AND OBJECTIVES: Gastroesophageal reflux (GER), aspiration, and secondary complications lead to morbidity and mortality in children with neurologic impairment (NI), dysphagia, and gastrostomy feeding. Fundoplication and gastrojejunal (GJ) feeding can reduce risk. We compared GJ to fundoplication using first-year postprocedure reflux-related hospitalization (RRH) rates. METHODS: We identified children with NI, dysphagia requiring gastrostomy tube feeding and GER undergoing initial GJ placement or fundoplication from January 1, 2007 to December 31, 2012...
February 3, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28154970/differences-in-treatment-of-anti-nmda-receptor-encephalitis-results-of-a-worldwide-survey
#12
Luca Bartolini, Eyal Muscal
The objective of the study was to identify differences in treatment strategies for anti-NMDA receptor encephalitis based on specialty of treating physicians, geographic location, and years in practice. We conducted an anonymous worldwide electronic survey through the Practice Current section of Neurology(®) Clinical Practice to appraise differences in decisions about first- and second-line treatment and timing for initiation of second-line treatment for anti-NMDA receptor encephalitis. 399 participants answered all questions of the survey and were included in the analysis...
February 2, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28153851/transverse-myelitis-as-manifestation-of-celiac-disease-in-a-toddler
#13
Hilde Krom, Fleur Sprangers, René van den Berg, Marc Alexander Benninga, Angelika Kindermann
We present a 17-month-old girl with rapidly progressive unwillingness to sit, stand, play, and walk. Furthermore, she lacked appetite, vomited, lost weight, and had an iron deficiency. Physical examination revealed a cachectic, irritable girl with a distended abdomen, dystrophic legs with paraparesis, disturbed sensibility, and areflexia. An MRI scan revealed abnormal high signal intensity on T2-weighted images in the cord on the thoracic level, without cerebral abnormalities, indicating transverse myelitis (TM)...
February 2, 2017: Pediatrics
https://www.readbyqxmd.com/read/28150290/a-review-of-the-utility-of-a-hypothermia-protocol-in-cardiac-arrests-due-to-non-shockable-rhythms
#14
Brin Freund, Peter W Kaplan
BACKGROUND: Therapeutic hypothermia and targeted temperature management are considered standard of care in the management of patients following out-of-hospital cardiac arrests due to shockable rhythms to improve neurological outcomes. In those presenting out-of-hospital cardiac arrests associated with non-shockable rhythms, the benefit of hypothermia is less clear. In this review we try to clarify the utility of implementing a hypothermia protocol after cardiac arrests due to non-shockable rhythms...
February 2, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28145649/clinical-characteristics-of-transplant-associated-encephalopathy-in-children
#15
Yun Jeong Lee, Mi Sun Yum, Eun Hee Kim, Min Jee Kim, Kyung Mo Kim, Ho Joon Im, Young Hwue Kim, Young Seo Park, Tae Sung Ko
We aimed to analyze characteristics of encephalopathy after both hematopoietic stem cell and solid organ pediatric transplantation. We retrospectively reviewed medical records of 662 pediatric transplant recipients (201 with liver transplantation [LT], 55 with heart transplantation [HT], and 67 with kidney transplantation [KT], 339 with allogeneic hematopoietic stem cell transplantation [HSCT]) who received their graft organs at Asan Medical Center between January 2000 and July 2014. Of the 662 patients, 50 (7...
March 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28141723/anxiety-associated-with-asthma-exacerbations-and-overuse-of-medication-the-role-of-cultural-competency
#16
Yousuke T Horikawa, Tina Y Udaka, Janet K Crow, John I Takayama, Martin T Stein
Toshi, a 14-year-old Japanese boy, had uncontrolled asthma after relocating from Japan with his family 1 year ago. In Japan, he was diagnosed with moderate, persistent asthma, which was controlled with salmeterol and albuterol on an as needed basis. Since moving to the United States, Toshi complained of frequent dyspnea.Initially, he was seen by a Japanese physician who prescribed 200 mg of fluticasone 3 times a day and albuterol nebulization as needed. When Toshi came to the Pediatric Primary Care Clinic, he reported using his nebulizer up to 25 times daily...
February 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28140493/cerebral-high-intensity-transient-signals-during-pediatric-cardiac-catheterization-a-pilot-study-using-transcranial-doppler-ultrasonography
#17
Kerri L LaRovere, Kush Kapur, Doff B McElhinney, Alexander Razumovsky, Barry D Kussman
BACKGROUND AND PURPOSE: Cerebral emboli are one potential cause of acute brain injury in children with congenital heart disease (CHD) undergoing cardiac catheterization. In this pilot study using transcranial Doppler (TCD) ultrasonography, we sought to evaluate the incidence, burden, and circumstances of cerebral high-intensity transient signals (HITS), presumably representing emboli, during pediatric cardiac catheterization. METHODS: Emboli monitoring of the right middle cerebral artery was performed in five children...
January 31, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/28131553/-end-of-life-in-specialized-medical-pediatrics-department-a-french-national-survey
#18
Alice Ravanello, Isabelle Desguerre, Sandra Frache, Philippe Hubert, Daniel Orbach, Régis Aubry
AIMS: In France, most of children die in the hospital. This national survey aimed to achieve better understanding of end-of life care in specialized medical pediatrics departments for children facing the end-of-life, identify the available resources, put forward the difficulties encountered by professionals and describe end-of-life paths of children who died in these departments. MATERIAL AND METHODS: This study is based on a nationwide survey conducted among all existing specialized medical pediatrics departments (onco-haematology, neurology, reanimation) in France in 2015...
January 25, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28127511/high-angular-resolution-diffusion-imaging-tractography-of-cerebellar-pathways-from-newborns-to-young-adults
#19
Thomas J Re, Jacob Levman, Ashley R Lim, Andrea Righini, Patricia Ellen Grant, Emi Takahashi
INTRODUCTION: Many neurologic and psychiatric disorders are thought to be due to, or result in, developmental errors in neuronal cerebellar connectivity. In this connectivity analysis, we studied the developmental time-course of cerebellar peduncle pathways in pediatric and young adult subjects. METHODS: A cohort of 80 subjects, newborns to young adults, was studied on a 3T MR system with 30 diffusion-weighted measurements with high-angular resolution diffusion imaging (HARDI) tractography...
January 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28127172/orocraniofacial-findings-of-a-pediatric-patient-with-joubert-syndrome
#20
Mridula Goswami, Anju S Rajwar, Mahesh Verma
: Joubert syndrome (JS) is a very rare autosomal recessive disorder, involving agenesis or dysgenesis of cerebellar vermis and brain stem. The neurological features of JS include hypotonia, ataxia, developmental delay, intellectual disability, abnormal eye movements, and neonatal breathing dysregulation. These may be associated with multiorgan involvement, mainly retinal dystrophy, nephronophthisis, hepatic fibrosis, and polydactyly. An obligatory hallmark feature associated with JS is the molar tooth sign (MTS), a complex midbrain-hindbrain malformation visible on brain imaging...
October 2016: International Journal of Clinical Pediatric Dentistry
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