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https://www.readbyqxmd.com/read/29165737/management-of-hemostasis-for-pediatric-patients-on-ventricular-assist-devices
#1
Iki Adachi, Vadim Kostousov, Lisa Hensch, Martin A Chacon-Portillo, Jun Teruya
Ventricular-assist devices (VADs) have seen increased utilization in the pediatric population. Formerly, this therapeutic modality was limited to only the pulsatile VAD, EXCOR (Berlin Heart GmbH). However, the continuous flow VAD devices, HeartMate II (Abbott Inc.) and HeartWare (Medtronic Inc.), are now increasingly used in this population. Postoperatively, VAD patients are acutely anticoagulated using unfractionated heparin, often beginning 24 to 48 hours after VAD placement. Once the patient is stabilized and ready to transition to a lower acuity or outpatient setting, low-molecular-weight heparin or warfarin therapy may be instituted...
November 17, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29159844/incidence-and-predictors-of-30-day-postoperative-readmission-in-children
#2
Daniel Vo, David Zurakowski, David Faraoni
BACKGROUND: Hospital readmissions are being used as a quality metric for hospital reimbursement without a clear understanding of the factors that contribute to readmission. OBJECTIVE: The objective of this study was to report the incidence of 30-day postsurgical readmission in children, identify the predictors for readmission, and create an algorithm to identify high-risk children. METHODS: Data from the 2012-2014 Pediatric database of the American College of Surgeons National Surgical Quality Improvement Program were analyzed using univariable and multivariable logistical regression analysis...
November 20, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29159001/a-unique-case-of-acute-cerebral-venous-sinus-thrombosis-secondary-to-primary-varicella-zoster-virus-infection
#3
Syed F Imam, Omair Ul Haq Lodhi, Zainab Fatima, Saneeya Nasim, Waseem T Malik, Muhammad Sabih Saleem
Primary varicella zoster virus (VZV) infection, predominantly in the pediatric population, presents with pyrexia and a classic pruritic vesicular rash. In adults, although less common, it is more severe and linked to more complications. Neurological complications, which account for less than 1% of all VZV complications, include meningitis, encephalitis, arterial vasculopathy, and venous thrombosis. We present a case of a 39-year-old male who developed extensive cerebral venous sinus thrombosis following primary VZV infection...
September 16, 2017: Curēus
https://www.readbyqxmd.com/read/29158047/-fatal-case-of-enterovirus-a71%C3%A2-hand-foot-and-mouth-disease-infection
#4
V Corvest, C Archimbaud, A-S L'Honneur, C Henquell, H Peigue-Lafeuille, M Decobert, A Mirand
Hand, foot, and mouth disease associated with enterovirus (EV) infections is a common pediatric pathology that is usually considered as benign. However, neurological complications of varying severity, sometimes fatal, are possible, particularly when EV-A71 is involved. Several Asian countries are regularly affected by large-scale epidemics of EV infections with substantial morbidity and mortality, where early screening and appropriate therapeutic management are a public health challenge. In 2016, Europe experienced an epidemic of unusual magnitude, associated with increasing cases of severe neurological complications in Spain and France, mainly affecting children...
November 17, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29157850/conventional-computed-tomography-and-magnetic-resonance-in-brain-concussion
#5
REVIEW
Juan Nicolas Useche, Sonia Bermudez
Conventional neuroimaging is still the mainstay in the assessment of the acute, follow-up, and chronic settings of concussion and mild traumatic brain injury (mTBI). Computed tomography (CT) is preferred for the initial assessment of acute mTBI, repeat evaluation in acute mTBI with neurologic deterioration, and cautious use in children with mTBI. Clinical rules have been developed to identify pediatric and adult patients with mTBI who can safely forego CT. Magnetic resonance (MR) imaging is mostly used in patients with acute mTBI when initial or follow-up CT is normal and there are persistent neurologic findings and in subacute or chronic mTBI...
February 2018: Neuroimaging Clinics of North America
https://www.readbyqxmd.com/read/29157741/biventricular-support-with-intracorporeal-continuous-flow-centrifugal-ventricular-assist-devices
#6
Francisco A Arabía, Carmelo A Milano, Claudius Mahr, Edwin C McGee, Nahush A Mokadam, J Eduardo Rame, Jaime D Moriguchi, Danny Ramzy, David C Naftel, Susan L Myers, James K Kirklin
BACKGROUND: The incidence of right ventricular dysfunction requiring right ventricular assist device after left ventricular assist device placement has been reported between 10% to 30%. The mortality rate is higher compared with patients who require left ventricular assist device only; the most effective and safest biventricular assist device remains unknown. We aimed to determine the survival outcomes and frequency of adverse events in patients with two durable, intracorporeal, continuous flow centrifugal pumps for support...
November 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29157395/pediatric-multiple-sclerosis-from-recognition-to-practical-clinical-management
#7
REVIEW
Cynthia X Wang, Benjamin M Greenberg
Pediatric-onset multiple sclerosis (MS) is a rare but increasingly recognized condition that both parallels and diverges from adult-onset MS. Exposure to key risk determinants for MS disease pathogenesis may occur during childhood. The diagnosis of pediatric MS can be challenging due to potential for atypical presentations and a broad differential diagnosis. MS disease-modifying therapies have not been rigorously studied in children and raise difficult questions on how to manage a chronic inflammatory neurologic disease in a population of patients with developing central nervous and immune systems...
February 2018: Neurologic Clinics
https://www.readbyqxmd.com/read/29153658/neurological-function-in-children-born-to-preeclamptic-and-hypertensive-mothers-a-systematic-review
#8
REVIEW
Ernesto A Figueiró-Filho, Lauren E Mak, James N Reynolds, Patrick W Stroman, Graeme N Smith, Nils D Forkert, Angelina Paolozza, Matthew T Rätsep, B Anne Croy
BACKGROUND: Offspring whose mothers developed preeclampsia (PE-F1s) show developmental effects that are now being identified, such as cognitive, behavioural, and mood differences compared to offspring from non-complicated pregnancies. We hypothesize that the progressive angiokine dysregulation associated with development of preeclampsia (PE) reflects gene dysregulation in pre-implantation conceptuses, and manifests in all developing fetal tissues rather than exclusively to the placenta...
October 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29149389/autoregulation-in-paediatric-tbi-current-evidence-and-implications-for-treatment
#9
REVIEW
Joseph E Donnelly, Adam M H Young, Ken Brady
BACKGROUND: Children who survive acute traumatic brain injury are at risk of death from subsequent brain swelling and secondary injury. Strict physiologic management in the ICU after traumatic brain injury is believed to be key to survival, and cerebral perfusion pressure is a prominent aspect of post brain injury care. However, optimal cerebral perfusion pressure targets for children are not known. Autoregulation monitoring has been used to delineate individualized optimal perfusion pressures for patients with traumatic brain injury...
October 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29147674/pediatric-otogenic-sigmoid-sinus-thrombosis-case-report-and-literature-reappraisal
#10
Andrea Scherer, Andrew Jea
The purpose of this study was to review our experience with a single case of mastoiditis associated with sigmoid sinus thrombosis and increased intracranial pressure, and to review the experience of others through prior publications. We reviewed a case of a 6-year-old boy with an acute otitis media and mastoiditis, with associated ipsilateral sigmoid sinus and contralateral distal transverse sinus thrombosis. Based on the literature and our own experience, we conclude that most children with dural sinus thrombosis from acute otitis media and mastoiditis, in the setting of increased intracranial pressure, attain a good neurological outcome with a conservative neurosurgical approach...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/29145335/clavicle-fracture-associated-with-atlantoaxial-rotatory-displacement-type-ii-in-an-8-year-old-girl-a-case-report
#11
Jacek Karski, Łukasz Matuszewski, Paweł Jakubowski, Klaudia Karska, Grzegorz Kandzierski
RATIONALE: Fracture of the clavicle is a very common injury in children. However, association between clavicle fracture and atlantoaxial rotatory displacement is rarely observed. PATIENT CONCERNS: We present a case of an 8-year-old girl, who suffered a right clavicle fracture as a result of a sledge accident. Six weeks after figure of 8 casting for a right clavicle fracture, an 8-year-old girl was brought to the Pediatric Orthopedic Department due to torticollis...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29143272/preliminary-results-of-immune-modulating-antibody-mdv9300-pidilizumab-treatment-in-children-with-diffuse-intrinsic-pontine-glioma
#12
Iris Fried, Alex Lossos, Tal Ben Ami, Rina Dvir, Helen Toledano, Myriam Weil Ben Arush, Sergei Postovski, Abed Abu Kuidar, Michal Yalon, Michael Weintraub, Mony Benifla
Diffuse intrinsic pontine glioma (DIPG) is an incurable disease with a median overall survival of 10 months. Immune modulating antibodies have recently emerged as a highly promising treatment modality in multiple cancer types. We present results from the first study to evaluate the immune modulating antibody MDV9300 (pidilizumab) in pediatric patients with DIPG. All patients aged 3 years and older, diagnosed with DIPG between February 2014 and June 2015 in Israel, were offered to participate in the study...
November 15, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29141312/-clinical-manifestation-and-gene-analyses-of-15-patients-with-intellectual-disability-or-developmental-delay-complicated-with-congenital-nystagmus
#13
Z J Gao, Q Jiang, Q Chen, K M Xu, Z Q Liu, X B Chen, X L Chen
Objective: To analyze the clinical and genetic features of 15 cases with intellectual disability or developmental delay (ID/DD) complicated with congenital nystagmus. Method: The clinical characteristics and the results of laboratory tests, images and genetics of 15 patients with ID/DD complicated with congenital nystagmus, confirmed by gene diagnosis in the Department of Neurology, Children's Hospital Affiliated to Capital Institute of Pediatrics from March 2015 to October 2016, were retrospectively analyzed...
November 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29140931/hemispheric-cerebral-oximetry-monitoring-during-pediatric-seizure-activity-in-a-pediatric-emergency-department
#14
Thomas J Abramo, Shane McKinney, James Moore, Richard Jacobs, Gregory Albert, Mark Meredith, Nicholas Hobart Porter, Elizabeth Storm, Errin Willis, Cruz Velasco Gonzalez, Hailey Hargrave, Brad Schneider, Gergory Sharp
BACKGROUND: Sustained neuronal activity during seizures causes cellular perturbations, alterations in cerebral physiology, and potentially neurological injury, a neurological emergency. With variable clinical manifestations of seizures, frequent failure of seizure recognition by providers in pediatric and developmentally challenged patients can increase seizure complications. Neuroresuscitation should include rapid cerebral physiology assessment for increased seizure recognition and optimal neurological outcomes...
November 15, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29140276/clinical-profile-associated-with-adverse-childhood-experiences-the-advent-of-nervous-system-dysregulation
#15
Jorina Elbers, Cynthia R Rovnaghi, Brenda Golianu, Kanwaljeet J S Anand
BACKGROUND: We report the prevalence of children with multiple medical symptoms in a pediatric neurology clinic, describe their symptom profiles, and explore their association with adverse childhood experiences (ACEs). METHODS: We retrospectively reviewed 100 consecutive patients from an outpatient pediatric neurology clinic. Patients were included if they were ≥5 years old and reported ≥4 symptoms that were unexplained for ≥3-months. Symptom profiles across six functional domains were recorded: (1) executive dysfunction, (2) sleep disturbances, (3) autonomic dysregulation, (4) somatization, (5) digestive symptoms, and (6) emotional dysregulation...
November 15, 2017: Children
https://www.readbyqxmd.com/read/29138020/moyamoya-syndrome-in-a-pediatric-patient-with-congenital-human-immunodeficiency-virus-type-1-infection-resulting-in-intracranial-hemorrhage
#16
Junko Yamanaka, Ikuma Nozaki, Mizue Tanaka, Hideko Uryuu, Noriko Sato, Takeji Matsushita, Hiroyuki Shichino
In the era of Antiretroviral Therapy (ART) in which human immunodeficiency virus type 1 (HIV-1) infection affected children can expect a better prognosis, the importance of careful follow up of pediatric HIV-1 cases for neurological complications has been growing. We present a case of hemorrhagic Moyamoya syndrome in a child with congenital HIV-1 infection. A 10-year-old girl was referred to our hospital for the treatment of Pneumocystis Jirovecii Pneumonia (PCP: Pneumocystis pneumonia). Her HIV-1 control was poor and Moyamoya syndrome was found during the opportunistic infection screening at admission...
November 11, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29135901/clinical-factors-associated-with-pediatric-brain-neoplasms-versus-primary-headache-a-case-control-analysis
#17
David C Sheridan, Bethany Waites, Bradley Lezak, Robert J Coryell, Kellie J Nazemi, Amber L Lin, Rongwei Fu, Matthew L Hansen
OBJECTIVE: Pediatric headaches are a common presentation to emergency departments accounting for almost half a million annual visits. Providers are left with the difficult task of deciding who has a secondary headache etiology that warrants neuroimaging. METHODS: We conducted a retrospective case-control study. Patients from a pediatric neuro-oncology clinic database with brain cancer and a headache at presentation were identified as cases. Controls were patients from 2 local pediatric tertiary care emergency departments with a final diagnosis of headache after negative neuroimaging...
November 14, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29132771/-neonatal-herpes-epidemiology-clinical-manifestations-and-management-guidelines-for-clinical-practice-from-the-french-college-of-gynecologists-and-obstetricians-cngof
#18
L Renesme
OBJECTIVES: To describe the epidemiology of neonatal herpes and its risk factors, clinical and paraclinic manifestations, propose guidelines for a newborn at risk of neonatal herpes, describe treatment modalities, describe post-natal transmission and its prevention. METHODS: Bibliographic search from Medline, Cochrane Library databases and research of international clinical practice guidelines. RESULTS: Neonatal herpes is rare (about 20 cases per year in France) and mainly due to HSV 1 (level of evidence LE3)...
November 10, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29131920/congenital-hyperinsulinism
#19
Elena Minakova, Alison Chu
Congenital hyperinsulinism is a rare disorder that commonly presents in the immediate postnatal period as persistent hypoglycemia. The condition is frequently resistant to medical therapies, and the genetic mutations implicated in the disorder can be predictive of response to therapy. Evaluation of hypoglycemia in the illustrative case presented in this article led to genetic testing identifying recessive mutations in the potassium channel subunits of the beta-islet pancreatic cells. Potassium channel defects are often refractory to medical therapies, so near-total pancreatectomy is usually indicated; however, genetic mutations leading to metabolic dysregulation within the beta-islet pancreatic cells are usually responsive to medical therapy...
November 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/29128319/a-proteomic-investigation-into-mechanisms-underpinning-corticosteroid-effects-on-neural-stem-cells
#20
Rawaa S Al-Mayyahi, Luke D Sterio, Joanne B Connolly, Christopher F Adams, Wa'il A Al-Tumah, Jon Sen, Richard D Emes, Sarah R Hart, Divya M Chari
Corticosteroids (CSs) are widely used clinically, for example in pediatric respiratory distress syndrome, and immunosuppression to prevent rejection of stem cell transplant populations in neural cell therapy. However, such treatment can be associated with adverse effects such as impaired neurogenesis and myelination, and increased risk of cerebral palsy. There is increasing evidence that CSs can adversely influence key biological properties of neural stem cells (NSCs) but the molecular mechanisms underpinning such effects are largely unknown...
November 9, 2017: Molecular and Cellular Neurosciences
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