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https://www.readbyqxmd.com/read/28811137/influence-of-guidelines-on-management-of-paediatric-mild-traumatic-brain-injury-ct-assessment-and-admission-policy
#1
J J Lenstra, A R A Pikstra, J M Fock, Z Metting, J van der Naalt
BACKGROUND: The annual number of paediatric injury-related emergency visits and application of computed tomography (CT) has substantially increased, with associated higher risk of malignancies. In 2010, a guideline for CT-assessment based on risk factors for patients with mild traumatic brain injury (mTBI) became effective in all Emergency Departments (ED) in the Netherlands. This study evaluated the influence of this guideline on the frequency of CT-assessments, hospital admissions and factors that are related to guideline adherence...
August 3, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28808845/targeted-treatment-in-severe-traumatic-brain-injury-in-the-age-of-precision-medicine
#2
Anthony A Figaji, A Graham Fieggen, Ncedile Mankahla, Nico Enslin, Ursula K Rohlwink
In recent years, much progress has been made in our understanding of traumatic brain injury (TBI). Clinical outcomes have progressively improved, but evidence-based guidelines for how we manage patients remain surprisingly weak. The problem is that the many interventions and strategies that have been investigated in randomized controlled trials have all disappointed. These include many concepts that had become standard care in TBI. And that is just for adult TBI; in children, the situation is even worse. Not only is pediatric care more difficult than adult care because physiological norms change with age, but also there is less evidence for clinical practice...
August 14, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28805771/-synergistic-application-of-zinc-and-vitamin-c-to-support-memory-attention-and-the-reduction-of-the-risk-of-the-neurological-diseases
#3
O A Gromova, I Yu Torshin, A V Pronin, M A Kilchevsky
Zinc and vitamin C supplementation of the body is important for CNS functioning. Zinc ions are involved in the neurotransmission (signal transmission from acetylcholine, catecholamine, serotonin, prostaglandin receptors) and in ubiquitin-related protein degradation. Zinc deficits are associated with Alzheimer's disease and depression. Zinc supplementation (10-30 mg daily) improves neurologic recovery rate in patients with stroke and brain injury, has a positive impact on memory and reduces hyperactivity in children...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28803128/tetrahydrobiopterin-in-antenatal-brain-hypoxia-ischemia-induced-motor-impairments-and-cerebral-palsy
#4
REVIEW
Jeannette Vasquez-Vivar, Zhongjie Shi, Kehuan Luo, Karthikeyan Thirugnanam, Sidhartha Tan
Antenatal brain hypoxia-ischemia, which occurs in cerebral palsy, is considered a significant cause of motor impairments in children. The mechanisms by which antenatal hypoxia-ischemia causes brain injury and motor deficits still need to be elucidated. Tetrahydrobiopterin is an important enzyme cofactor that is necessary to produce neurotransmitters and to maintain the redox status of the brain. A genetic deficiency of this cofactor from mutations of biosynthetic or recycling enzymes is a well-recognized factor in the development of childhood neurological disorders characterized by motor impairments, developmental delay, and encephalopathy...
August 3, 2017: Redox Biology
https://www.readbyqxmd.com/read/28783305/core-crosslinked-nanoparticles-reduce-neuroinflammation-and-improve-outcome-in-a-mouse-model-of-traumatic-brain-injury
#5
Dasom Yoo, Alexander W Magsam, Abby M Kelly, Patrick S Stayton, Forrest M Kievit, Anthony J Convertine
Traumatic brain injury (TBI) is the leading cause of death and disability in children and young adults, yet there are currently no treatments available that prevent the secondary spread of damage beyond the initial insult. The chronic progression of this secondary injury is in part caused by the release of reactive oxygen species (ROS) into surrounding normal brain. Thus, treatments that can enter the brain and reduce the spread of ROS should improve outcome from TBI. Here a highly versatile, reproducible, and scalable method to synthesize core-crosslinked nanoparticles (NPs) from polysorbate 80 (PS80) using a combination of thiol-ene and thiol-Michael chemistry is described...
August 7, 2017: ACS Nano
https://www.readbyqxmd.com/read/28780927/white-matter-microstructure-predicts-longitudinal-social-cognitive-outcomes-after-paediatric-traumatic-brain-injury-a-diffusion-tensor-imaging-study
#6
N P Ryan, S Genc, M H Beauchamp, K O Yeates, S Hearps, C Catroppa, V A Anderson, T J Silk
BACKGROUND: Deficits in social cognition may be among the most profound and disabling sequelae of paediatric traumatic brain injury (TBI); however, the neuroanatomical correlates of longitudinal outcomes in this domain remain unexplored. This study aimed to characterize social cognitive outcomes longitudinally after paediatric TBI, and to evaluate the use of sub-acute diffusion tensor imaging (DTI) to predict these outcomes. METHODS: The sample included 52 children with mild complex-severe TBI who were assessed on cognitive theory of mind (ToM), pragmatic language and affective ToM at 6- and 24-months post-injury...
August 7, 2017: Psychological Medicine
https://www.readbyqxmd.com/read/28780000/systemic-infusions-of-anti-interleukin-1%C3%AE-neutralizing-antibodies-reduce-short-term-brain-injury-after-cerebral-ischemia-in-the-ovine-fetus
#7
Xiaodi Chen, Virginia Hovanesian, Syed Naqvi, Yow-Pin Lim, Richard Tucker, John E Donahue, Edward G Stopa, Barbara S Stonestreet
Perinatal hypoxic-ischemic reperfusion (I/R)-related brain injury is a leading cause of neurologic morbidity and life-long disability in children. Infants exposed to I/R brain injury develop long-term cognitive and behavioral deficits, placing a large burden on parents and society. Therapeutic strategies are currently not available for infants with I/R brain damage, except for hypothermia, which can only be used in full term infants with hypoxic-ischemic encephalopathy (HIE). Moreover, hypothermia is only partially protective...
August 2, 2017: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/28774508/compliance-with-evidence-based-guidelines-for-computed-tomography-of-children-with-head-and-abdominal-trauma
#8
Ihab Halaweish, Jane Riebe-Rodgers, Amy Randall, Peter F Ehrlich
INTRODUCTION: Recently, two large prospective clinical trials developed and validated prediction rules for children at very low risk for clinically important traumatic brain injuries (ciTBI) or abdominal injury for whom CT is unnecessary. Specific criteria/guidelines were identified which if met would obviate the need for CT scanning. The purpose of this study was to assess compliance at a level one pediatric center with these guidelines as a tool for quality improvement. METHODS: Records of children admitted to our pediatric trauma center one year before and two years after publication of head (Kuppermann '09) and abdominal trauma (Holmes '13) CT imaging guidelines were reviewed...
July 14, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28767035/neuropsychological-outcome-in-perinatal-stroke-associated-with-epileptiform-discharges-in-sleep
#9
Aleksandra Mineyko, Wei Qi, Helen L Carlson, Luis Bello-Espinosa, Brian L Brooks, Adam Kirton
BACKGROUND: Patients with arterial perinatal stroke often suffer long-term motor sequelae, difficulties in language, social development, and behaviour as well as epilepsy. Despite homogeneous lesions, long-term behavioural and cognitive outcomes are variable and unpredictable. Sleep-related epileptic encephalopathies can occur after early brain injury and are associated with global developmental delays. We hypothesized that sleep-potentiated epileptiform abnormalities are associated with worse developmental outcomes after perinatal stroke...
July 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28763455/identifying-relevant-biomarkers-of-brain-injury-from-structural-mri-validation-using-automated-approaches-in-children-with-unilateral-cerebral-palsy
#10
Alex M Pagnozzi, Nicholas Dowson, James Doecke, Simona Fiori, Andrew P Bradley, Roslyn N Boyd, Stephen Rose
Previous studies have proposed that the early elucidation of brain injury from structural Magnetic Resonance Images (sMRI) is critical for the clinical assessment of children with cerebral palsy (CP). Although distinct aetiologies, including cortical maldevelopments, white and grey matter lesions and ventricular enlargement, have been categorised, these injuries are commonly only assessed in a qualitative fashion. As a result, sMRI remains relatively underexploited for clinical assessments, despite its widespread use...
2017: PloS One
https://www.readbyqxmd.com/read/28762893/overlapping-microrna-expression-in-saliva-and-cerebrospinal-fluid-accurately-identifies-pediatric-traumatic-brain-injury
#11
Steven Daniel Hicks, Jeremiah Johnson, Molly C Carney, Harry Bramley, Robert P Olympia, Andrea C Loeffert, Neal J Thomas
Objectives To assess the accuracy and physiologic relevance of circulating microRNA (miRNA) as a biomarker of pediatric concussion, we compared changes in salivary miRNA and cerebrospinal fluid (CSF) miRNA following childhood traumatic brain injury (TBI). Study Design A case-cohort design was used to compare longitudinal miRNA concentrations in CSF of seven children with severe TBI against three controls without TBI. The miRNAs "altered" in CSF were interrogated in saliva of 60 children with mild TBI and compared with 18 age- and gender- matched controls...
August 1, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28762891/coping-strategies-used-by-parents-of-children-with-traumatic-brain-injury-a-cross-sectional-study-of-palestinians-and-israelis
#12
Wedad Masalha, Gail Auslander
This study examined the use and helpfulness of coping strategies and patterns among parents of children with traumatic brain injury (TBI). Participants were 122 Arab-Israeli, Jewish-Israeli, and Palestinian parents of 65 children with TBI following their discharge from pediatric rehabilitation hospital. Family-focused strategies were highly prevalent and most helpful among both mothers and fathers. Jewish mothers reported that support coping pattern (but not medical or family) was more helpful than did Arab-Israeli and Palestinian mothers...
August 1, 2017: Social Work in Health Care
https://www.readbyqxmd.com/read/28759710/functional-integrity-in-children-with-anoxic-brain-injury-from-drowning
#13
Mariam Ishaque, Janessa H Manning, Mary D Woolsey, Crystal G Franklin, Elizabeth W Tullis, Christian F Beckmann, Peter T Fox
Drowning is a leading cause of accidental injury and death in young children. Anoxic brain injury (ABI) is a common consequence of drowning and can cause severe neurological morbidity in survivors. Assessment of functional status and prognostication in drowning victims can be extremely challenging, both acutely and chronically. Structural neuroimaging modalities (CT and MRI) have been of limited clinical value. Here, we tested the utility of resting-state functional MRI (rs-fMRI) for assessing brain functional integrity in this population...
July 31, 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/28759667/early-life-epilepsies-and-the-emerging-role-of-genetic-testing
#14
Anne T Berg, Jason Coryell, Russell P Saneto, Zachary M Grinspan, John J Alexander, Mariana Kekis, Joseph E Sullivan, Elaine C Wirrell, Renée A Shellhaas, John R Mytinger, William D Gaillard, Eric H Kossoff, Ignacio Valencia, Kelly G Knupp, Courtney Wusthoff, Cynthia Keator, William B Dobyns, Nicole Ryan, Tobias Loddenkemper, Catherine J Chu, Edward J Novotny, Sookyong Koh
Importance: Early-life epilepsies are often a consequence of numerous neurodevelopmental disorders, most of which are proving to have genetic origins. The role of genetic testing in the initial evaluation of these epilepsies is not established. Objective: To provide a contemporary account of the patterns of use and diagnostic yield of genetic testing for early-life epilepsies. Design, Setting, and Participants: In this prospective cohort, children with newly diagnosed epilepsy with an onset at less than 3 years of age were recruited from March 1, 2012, to April 30, 2015, from 17 US pediatric hospitals and followed up for 1 year...
July 31, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28745861/mass-spectrometric-imaging-of-ceramides-tracks-therapeutic-response-in-traumatic-brain-injury
#15
Damon Christopher Barbacci, Aurélie Roux, Ludovic Muller, Shelley N Jackson, Jeremy Post, Kathrine Baldwin, Barry Hoffer, Carey Balaban, Shawn Gouty, Brian M Cox, Amina S Woods
Traumatic brain injury (TBI) is a serious public health problem and the leading cause of death in children and young adults. It also contributes to a substantial number of cases of permanent disability. As lipids make up over 50% of the brain mass and play a key role in both membrane structure and cell signaling, their profile is of particular interest. In this study, we show that advanced mass spectrometry imaging (MSI) has sufficient technical accuracy and reproducibility to demonstrate the anatomical distribution of 50 micron diameter microdomains that show changes in brain ceramide levels in a rat model of controlled cortical impact (CCI) 3 days post injury with and without treatment...
July 26, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/28745856/severe-traumatic-brain-injury-in-children-an-evidence-based-review-of-emergency-department-management-digest
#16
Kirsten Morrissey, Hilary Fairbrother, Michelle N Vazquez
More than 1.7 million traumatic brain injuries occur in adults and children each year in the United States, with approximately 30% occurring in children aged < 14 years. Traumatic brain injury is a significant cause of morbidity and mortality in pediatric trauma patients. Early identification and management of severe traumatic brain injury is crucial in decreasing the risk of secondary brain injury and optimizing outcome. The main focus for early management of severe traumatic brain injury is to mitigate and prevent secondary injury, specifically by avoiding hypotension and hypoxia, which have been associated with poorer outcomes...
October 22, 2016: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28744846/extubation-failure-and-tracheostomy-placement-in-children-with-acute-neurocritical-illness
#17
Ellen C Cohn, Tammy S Robertson, Stacey A Scott, Andre M Finley, Rong Huang, Darryl K Miles
BACKGROUND: There is a lack of data describing the risk factors for extubation failure (EF) or tracheostomy placement in pediatric neurocritical care (NCC) patients. METHODS: A retrospective chart review of children admitted to the pediatric intensive care unit who were intubated for >24 h with an acute neurocritical illness and had an extubation attempt. Bivariate and multivariate statistical analysis was performed to determine significant associations of demographic, neurologic, pulmonary, and clinical variables with EF and tracheostomy placement...
July 25, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28743724/changes-in-white-matter-microstructure-impact-cognition-by-disrupting-the-ability-of-neural-assemblies-to-synchronize
#18
Sonya Bells, Jérémie Lefebvre, Steven A Prescott, Colleen Dockstader, Eric Bouffet, Jovanka Skocic, Suzanne Laughlin, Donald J Mabbott
Cognition is compromised by white matter injury but the neurophysiological alterations linking them remain unclear. We hypothesized that reduced neural synchronization caused by disruption of neural signal propagation is involved. To test this, we evaluated group differences in: diffusion tensor white matter (WM) microstructure measures within the optic radiations, primary visual area (V1) and cuneus; neural phase synchrony to a visual attention cue during visual-motor task, and; reaction time (RT) to a response cue during the same task between 26 pediatric patients (17/9: male/female) treated with cranial radiation treatment for a brain tumor [12...
July 25, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28738850/brain-biomarkers-and-pre-injury-cognition-are-associated-with-long-term-cognitive-outcome-in-children-with-traumatic-brain-injury
#19
Amy A Wilkinson, Maureen Dennis, Nevena Simic, Margot J Taylor, Benjamin R Morgan, Helena Frndova, Karen Choong, Craig Campbell, Douglas Fraser, Vicki Anderson, Anne-Marie Guerguerian, Russell Schachar, Jamie Hutchison
BACKGROUND: Children with traumatic brain injury (TBI) are frequently at risk of long-term impairments of attention and executive functioning but these problems are difficult to predict. Although deficits have been reported to vary with injury severity, age at injury and sex, prognostication of outcome remains imperfect at a patient-specific level. The objective of this proof of principle study was to evaluate a variety of patient variables, along with six brain-specific and inflammatory serum protein biomarkers, as predictors of long-term cognitive outcome following paediatric TBI...
July 24, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28733619/maternal-dendrimer-based-therapy-for-inflammation-induced-preterm-birth-and-perinatal-brain-injury
#20
Jun Lei, Jason M Rosenzweig, Manoj K Mishra, Wael Alshehri, Flavia Brancusi, Mike McLane, Ahmad Almalki, Rudhab Bahabry, Hattan Arif, Rayyan Rozzah, Ghada Alyousif, Yahya Shabi, Nader Alhehaily, Wenyu Zhong, Andrea Facciabene, Sujatha Kannan, Rangaramanujam M Kannan, Irina Burd
Preterm birth is a major risk factor for adverse neurological outcomes in ex-preterm children, including motor, cognitive, and behavioral disabilities. N-acetyl-L-cysteine therapy has been used in clinical studies; however, it requires doses that cause significant side effects. In this study, we explore the effect of low dose N-acetyl-L-cysteine therapy, delivered using a targeted, systemic, maternal, dendrimer nanoparticle (DNAC), in a mouse model of intrauterine inflammation. Our results demonstrated that intraperitoneal maternal DNAC administration significantly reduced the preterm birth rate and altered placental immune profile with decreased CD8(+) T-cell infiltration...
July 21, 2017: Scientific Reports
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