Mumps: Epidemic parotitis

2020 ◽  
pp. 769-772
Author(s):  
B.K. Rima
Keyword(s):  
Young Adults ◽  
Incubation Period ◽  
Parotid Glands ◽  
Rt Pcr ◽  
Rubella Vaccine ◽  
Children And Young Adults ◽  
Rna Genome ◽  
Epidemic Parotitis

Mumps is an acute, systemic, highly infectious, communicable infection of children and young adults, caused by a paramyxovirus (with an RNA genome). Transmission is by airborne droplet spread. After an incubation period of 14–18 days, typical presentation is with fever, pain near the angle of the jaw, and swelling of the parotid glands. Complications include orchitis, meningitis, and encephalitis. Diagnosis is obvious clinically in cases with a contact history and parotitis, but serological (mumps-specific IgM and IgA) and RNA-based (RT-PCR) tests are used when this is not the case (e.g. the patient presenting with meningitis). Treatment is symptomatic. Prevention is by vaccination, often given as one component of a trivalent mumps/measles/rubella vaccine at 14–16 months of age. A follow-up vaccination is now recommended at 4–5 years of age.

Pacemaker use for the treatment of reflex-mediated syncope: 40-year experience at a single paediatric institution

2021 ◽  
pp. 1-6
Author(s):  
Thomas Huang ◽  
Edward O’Leary ◽  
Mark E. Alexander ◽  
Laura Bevilacqua ◽  
Francis Fynn-Thompson ◽  
...  
Keyword(s):  
Young Adults ◽  
Atrioventricular Block ◽  
Sinus Bradycardia ◽  
Pacemaker Implantation ◽  
Complication Rates ◽  
Single Centre Experience ◽  
Procedural Complications ◽  
Children And Young Adults ◽  
Dual Chamber Pacemakers

Abstract Introduction: Reflex-mediated syncope occurs in 15% of children and young adults. In rare instances, pacemakers are required to treat syncopal episodes associated with transient sinus pauses or atrioventricular block. This study describes a single centre experience in the use of permanent pacemakers to treat syncope in children and young adults. Materials and methods: Patients with significant pre-syncope or syncope and pacemaker implantation from 1978 to 2018 were reviewed. Data collected included the age of presentation, method of diagnosis, underlying rhythm disturbance, age at implant, type of pacemaker implanted, procedural complications and subsequent symptoms. Results: Fifty patients were identified. Median age at time of the first syncopal episode was 10.2 (range 0.3–20.4) years, with a median implant age of 14.9 (0.9–34.3) years. Significant sinus bradycardia/pauses were the predominant reason for pacemaker implant (54%), followed by high-grade atrioventricular block (30%). Four (8%) patients had both sinus pauses and atrioventricular block documented. The majority of patients had dual-chamber pacemakers implanted (58%), followed by ventricular pacemakers (38%). Median follow-up was 6.7 (0.4–33.0) years. Post-implant, 4 (8%) patients continued to have syncope, 7 (14%) had complete resolution of their symptoms, and the remaining reported a decrease in their pre-syncopal episodes and no further syncope. Twelve (24%) patients had complications, including two infections and eight lead malfunctions. Conclusions: Paediatric patients with reflex-mediated syncope can be treated with pacing. Complication rates are high (24%); as such, permanent pacemakers should be reserved only for those in whom asystole from sinus pauses or atrioventricular block has been well documented.

Long-term follow-up of children and young adults with autoimmune hepatitis treated with cyclosporine

2019 ◽  
Vol 51 (5) ◽  
pp. 712-718 ◽  
Author(s):  
Silvia Nastasio ◽  
Marco Sciveres ◽  
Lorenza Matarazzo ◽  
Cristina Malaventura ◽  
Francesco Cirillo ◽  
...  
Keyword(s):  
Young Adults ◽  
Autoimmune Hepatitis ◽  
Long Term Follow Up ◽  
Children And Young Adults

scholarly journals Endocrine Deficiency As a Function of Radiation Dose to the Hypothalamus and Pituitary in Pediatric and Young Adult Patients With Brain Tumors

2018 ◽  
Vol 36 (28) ◽  
pp. 2854-2862 ◽  
Author(s):  
Ralph E. Vatner ◽  
Andrzej Niemierko ◽  
Madhusmita Misra ◽  
Elizabeth A. Weyman ◽  
Claire P. Goebel ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Young Adults ◽  
Young Adult ◽  
Thyroid Hormone ◽  
Radiation Dose ◽  
Brain Tumors ◽  
Adrenocorticotropic Hormone ◽  
Hormone Deficiency ◽  
Children And Young Adults

Purpose There are sparse data defining the dose response of radiation therapy (RT) to the hypothalamus and pituitary in pediatric and young adult patients with brain tumors. We examined the correlation between RT dose to these structures and development of endocrine dysfunction in this population. Materials and Methods Dosimetric and clinical data were collected from children and young adults (< 26 years of age) with brain tumors treated with proton RT on three prospective studies (2003 to 2016). Deficiencies of growth hormone (GH), thyroid hormone, adrenocorticotropic hormone, and gonadotropins were determined clinically and serologically. Incidence of deficiency was estimated using the Kaplan-Meier method. Multivariate models were constructed accounting for radiation dose and age. Results Of 222 patients in the study, 189 were evaluable by actuarial analysis, with a median follow-up of 4.4 years (range, 0.1 to 13.3 years), with 31 patients (14%) excluded from actuarial analysis for having baseline hormone deficiency and two patients (0.9%) because of lack of follow-up. One hundred thirty patients (68.8%) with medulloblastoma were treated with craniospinal irradiation (CSI) and boost; most of the remaining patients (n = 56) received involved field RT, most commonly for ependymoma (13.8%; n = 26) and low-grade glioma (7.4%; n = 14). The 4-year actuarial rate of any hormone deficiency, growth hormone, thyroid hormone, adrenocorticotropic hormone, and gonadotropin deficiencies were 48.8%, 37.4%, 20.5%, 6.9%, and 4.1%, respectively. Age at start of RT, time interval since treatment, and median dose to the combined hypothalamus and pituitary were correlated with increased incidence of deficiency. Conclusion Median hypothalamic and pituitary radiation dose, younger age, and longer follow-up time were associated with increased rates of endocrinopathy in children and young adults treated with radiotherapy for brain tumors.

The Ozaki Procedure With CardioCel Patch for Children and Young Adults With Aortic Valve Disease: Preliminary Experience – a Word of Caution

2019 ◽  
Vol 10 (6) ◽  
pp. 724-730 ◽  
Author(s):  
Sian C. Chivers ◽  
Carine Pavy ◽  
Ricky Vaja ◽  
Cesare Quarto ◽  
Olivier Ghez ◽  
...  
Keyword(s):  
Young Adults ◽  
Aortic Valve ◽  
Adult Population ◽  
Published Data ◽  
Bovine Pericardial Patch ◽  
Valve Position ◽  
Children And Young Adults ◽  
Ischemic Attack

Background: The Ozaki procedure is a surgical technique for patients with significant aortic stenosis or regurgitation or both where valve repair cannot be performed. Individual cusps are cut from glutaraldehyde-treated autologous pericardium or bovine pericardium and implanted into the aortic valve position. Encouraging results have been reported within the adult population. There are limited published data on success of this procedure in younger patients. Methods: We present a series of five children and young adults who underwent the Ozaki procedure with neoaortic valve cusps made from CardioCel, a decellularized bovine pericardial patch treated with a monomeric glutaraldehyde. Results: There were no complications in the initial postoperative period and short inpatient stay. At a mean follow-up of 29.6 months (range: 22-36 months), 4 patients had no evidence of stenosis and 3 patients had trivial or no regurgitation from the neoaortic valve. Overall, two patients had complications related to the valve and underwent reintervention during the follow-up period with a Ross procedure. One of these patients who was not taking long-term anticoagulation experienced a transient ischemic attack. Conclusions: Our experience demonstrates that the Ozaki procedure with CardioCel in pediatric and young adult patients should be approached with caution. Further research with larger groups of pediatric patients, comparison of different graft materials, and longer follow-up is required to ascertain long-term success in children.

scholarly journals Deep brain stimulation in children and young adults with secondary dystonia: the Children's Hospital Los Angeles experience

2013 ◽  
Vol 35 (5) ◽  
pp. E7 ◽  
Author(s):  
Joffre E. Olaya ◽  
Eisha Christian ◽  
Diana Ferman ◽  
Quyen Luc ◽  
Mark D. Krieger ◽  
...  
Keyword(s):  
Young Adults ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Secondary Dystonia ◽  
Benefit Evaluation ◽  
Generalized Dystonia ◽  
Children And Young Adults ◽  
The Mean ◽  
Deep Brain

Background Dystonia is a movement disorder in which involuntary sustained or intermittent muscle contractions cause twisting and repetitive movements, abnormal postures, or both. It can be classified as primary or secondary. There is no cure for dystonia and the goal of treatment is to provide a better quality of life for the patient. Surgical intervention is considered for patients in whom an adequate trial of medical treatment has failed. Deep brain stimulation (DBS), specifically of the globus pallidus interna (GPi), has been shown to be extremely effective in primary generalized dystonia. There is much less evidence for the use of DBS in patients with secondary dystonia. However, given the large number of patients with secondary dystonia, the significant burden on the patients and their families, and the potential for DBS to improve their functional status and comfort level, it is important to continue to investigate the use of DBS in the realm of secondary dystonia. Object The objective of this study is to review a series of cases involving patients with secondary dystonia who have been treated with pallidal DBS. Methods A retrospective review of 9 patients with secondary dystonia who received treatment with DBS between February 2011 and February 2013 was performed. Preoperative and postoperative videos were scored using the Barry-Albright Dystonia Scale (BADS) and Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) by a neurologist specializing in movement disorders. In addition, the patients' families completed a subjective questionnaire to assess the perceived benefit of DBS. Results The average age at DBS unit implantation was 15.1 years (range 6–20 years). The average time to follow-up for the BADS evaluation from battery implantation was 3.8 months (median 3 months). The average time to follow-up for the subjective benefit evaluation was 10.6 months (median 9.5 months). The mean BADS scores improved by 9% from 26.5 to 24 (p = 0.04), and the mean BFMDRS scores improved by 9.3% (p = 0.055). Of note, even in patients with minimal functional improvement, there seemed to be decreased contractures and spasms leading to improved comfort. There were no complications such as infections or hematoma in this case series. In the subjective benefit evaluation, 3 patients' families reported “good” benefit, 4 reported “minimal” benefit, and 1 reported no benefit. Conclusions These early results of GPi stimulation in a series of 9 patients suggest that DBS is useful in the treatment of secondary generalized dystonia in children and young adults. Objective improvements in BADS and BFMDRS scores are demonstrated in some patients with generalized secondary dystonia but not in others. Larger follow-up studies of DBS for secondary dystonia, focusing on patient age, history, etiology, and patterns of dystonia, are needed to learn which patients will respond best to DBS.

scholarly journals Surgical management of renovascular hypertension in children and young adults: a 13-year experience

2019 ◽  
Vol 29 (5) ◽  
pp. 746-752 ◽  
Author(s):  
Oktay Peker ◽  
Fazil Tuncay Aki ◽  
Ulas Kumbasar ◽  
Murat Guvener ◽  
Mustafa Yılmaz ◽  
...  
Keyword(s):  
Young Adults ◽  
Renovascular Hypertension ◽  
Thoracic Aorta ◽  
Surgical Management ◽  
Arterial Stenosis ◽  
Aortic Bypass ◽  
Abdominal Aortic ◽  
Surgical Methods ◽  
Children And Young Adults

Abstract OBJECTIVES In this study, we aimed to evaluate the early and mid-term outcomes of surgery for renovascular hypertension (RVH) at our institution, within the last 13 years. METHODS We retrospectively reviewed 19 patients who underwent surgery for RVH, between 2005 and 2017. The age at operation, clinical characteristics, cause of arterial stenosis, diagnostic workup, surgical management and outcomes during the follow-up were analysed. The continuous variables were expressed as mean ± standard deviation. RESULTS Twelve female and 7 male patients underwent surgery for RVH. Their mean age was 17.07 ± 11.9 years (range 4–42 years). Nine patients had renal arterial stenosis, and 10 patients had midaortic syndrome (MAS). Aortorenal bypass with the saphenous vein was performed in 6 patients with renal arterial stenosis and 1 patient with MAS. An isolated thoracic aorta-abdominal aortic bypass was performed in 1 patient with MAS, and thoracic aorta-abdominal aortic bypass combined with unilateral aortarenal bypass was performed in 9 patients with MAS. The other surgical procedures performed were 2 autotransplantations and 2 unilateral nephrectomies. Among the patients with MAS, 4 underwent reoperation. The mean follow-up duration was 45.58 ± 32.7 months. Hypertension was cured in 3 patients and improved in 14 patients. The postoperative follow-up creatinine levels were similar to preoperative creatinine levels. All bypasses were patent on mid-term follow-up. One patient who underwent aortorenal bypass died 14 months postoperatively. CONCLUSIONS Surgical management is a suitable option for patients with RVH, who were unresponsive to medical and/or endovascular management. Surgical methods are safe and effective in children and young adults with RVH.

scholarly journals Associations with kidney transplant survival and eGFR decline in children and young adults in the United Kingdom: a retrospective cohort study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Alexander J. Hamilton ◽  
Lucy A. Plumb ◽  
Anna Casula ◽  
Manish D. Sinha
Keyword(s):  
Young Adults ◽  
Cohort Study ◽  
Young Adulthood ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Graft Loss ◽  
Glomerular Diseases ◽  
Children And Young Adults ◽  
Egfr Decline

Abstract Background Although young adulthood is associated with transplant loss, many studies do not examine eGFR decline. We aimed to establish clinical risk factors to identify where early intervention might prevent subsequent adverse transplant outcomes. Methods Retrospective cohort study using UK Renal Registry and UK Transplant Registry data, including patients aged < 30 years transplanted 1998–2014. Associations with death-censored graft failure were investigated with multivariable Cox proportional hazards. Multivariable linear regression was used to establish associations with eGFR slope gradients calculated over the last 5 years of observation per individual. Results The cohort (n = 5121, of whom n = 371 received another transplant) was 61% male, 80% White and 36% had structural disease. Live donation occurred in 48%. There were 1371 graft failures and 145 deaths with a functioning graft over a 39,541-year risk period. Median follow-up was 7 years. Fifteen-year graft survival was 60.2% (95% CI 58.1, 62.3). Risk associations observed in both graft loss and eGFR decline analyses included female sex, glomerular diseases, Black ethnicity and young adulthood (15–19-year and 20–24-year age groups, compared to 25–29 years). A higher initial eGFR was associated with less risk of graft loss but faster eGFR decline. For each additional 10 mL/min/1.73m2 initial eGFR, the hazard ratio for graft loss was 0.82 (95% CI 0.79, 0.86), p < 0.0001. However, compared to < 60 mL/min/1.73m2, higher initial eGFR was associated with faster eGFR decline (> 90 mL/min/1.73m2; − 3.55 mL/min/1.73m2/year (95% CI -4.37, − 2.72), p < 0.0001). Conclusions In conclusion, young adulthood is a key risk factor for transplant loss and eGFR decline for UK children and young adults. This study has an extended follow-up period and confirms common risk associations for graft loss and eGFR decline, including female sex, Black ethnicity and glomerular diseases. A higher initial eGFR was associated with less risk of graft loss but faster rate of eGFR decline. Identification of children at risk of faster rate of eGFR decline may enable early intervention to prolong graft survival.

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