scholarly journals Clinical features and neuropsychiatric comorbidities in pediatric patients with tic disorders: a retrospective chart review study from South Korea

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eu Gene Park ◽  
Young-Hoon Kim
Keyword(s):  
Pediatric Patients ◽  
Retrospective Chart Review ◽  
Tic Disorders ◽  
Functional Impairments ◽  
Diagnostic And Statistical Manual ◽  
High Prevalence ◽  
Tic Severity ◽  
Lip Movement ◽  
The Mean ◽  
Neuropsychiatric Comorbidities

Abstract Background Tic disorders are childhood-onset neuropsychiatric disorders characterized by multiple motor or vocal tics with frequent comorbidities and a broad spectrum of phenotypic presentations. In this study, we aimed to investigate the clinical characteristics and comorbid neuropsychiatric conditions in pediatric patients with tic disorders. Methods We retrospectively reviewed the medical records of 119 pediatric patients (89 males, 30 females) who were diagnosed with tic disorders according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) at Uijeongbu St. Mary’s Hospital, Republic of Korea, between January 2012 and July 2019. Results The mean age of tic onset was 6.9 years (range, 1–14) and the mean age at diagnosis was 8 years (range, 1–17). The mean lag between tic onset and diagnosis was 13.3 months (range, 0.25–132). The most common, first-presenting tics were eye blinking (50.4%), followed by jaw or lip movement (29.4%) and throat clearing (29.4%). Thirty-seven (31.1%) patients had at least one co-occurring neuropsychiatric disorder at the time of tic diagnosis. Subtypes of tic disorders, types of initial tics, and presence of neuropsychiatric comorbidities were not associated with tic severity. Tic severity was associated with greater functional impairment and tic noticeability (p < 0.05). A relatively shorter time to diagnosis was associated with tic severity (Spearman’s ρ = − 0.14, p = 0.11). Conclusions The evolving nature of tic expression and severity, high prevalence of neuropsychiatric comorbidities, and associated functional impairments emphasize the importance of comprehensive assessment during the disease course for determining and prioritizing goals of treatment.

scholarly journals Clinical features and neuropsychiatric comorbidities in pediatric patients with tic disorders: A retrospective chart review study from South Korea

2020 ◽  
Author(s):  
Eu Gene Park ◽  
Young-Hoon Kim
Keyword(s):  
Pediatric Patients ◽  
Retrospective Chart Review ◽  
Tic Disorders ◽  
Functional Impairments ◽  
Diagnostic And Statistical Manual ◽  
High Prevalence ◽  
Tic Severity ◽  
Lip Movement ◽  
The Mean ◽  
Neuropsychiatric Comorbidities

Abstract Background: Tic disorders are childhood-onset neuropsychiatric disorders characterized by multiple motor or vocal tics with frequent comorbidities and a broad spectrum of phenotypic presentations. In this study, we aimed to investigate the clinical characteristics and comorbid neuropsychiatric conditions in pediatric patients with tic disorders. Methods: We retrospectively reviewed the medical records of 119 pediatric patients (89 males, 30 females) who were diagnosed with tic disorders according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) at Uijeongbu St. Mary’s Hospital, Republic of Korea, between January 2012 and July 2019.Results: The mean age of tic onset was 6.9 years (range, 1–14) and the mean age at diagnosis was 8 years (range, 1–17). The mean lag between tic onset and diagnosis was 13.3 months (range, 0.25–132). The most common, first-presenting tics were eye blinking (50.4%), followed by jaw or lip movement (29.4%) and throat clearing (29.4%). Thirty-seven (31.1%) patients had at least one co-occurring neuropsychiatric disorder at the time of tic diagnosis. Subtypes of tic disorders, types of initial tics, and presence of neuropsychiatric comorbidities were not associated with tic severity. Tic severity was associated with greater functional impairment and tic noticeability (p <0.05). A relatively shorter time to diagnosis was associated with tic severity (Spearman’s ρ = –0.14, p = 0.11).Conclusions: The evolving nature of tic expression and severity, high prevalence of neuropsychiatric comorbidities, and associated functional impairments emphasize the importance of comprehensive assessment during the disease course for determining and prioritizing goals of treatment.

scholarly journals Clinical features and neuropsychiatric comorbidities in pediatric patients with tic disorders: A retrospective chart review study from South Korea

2020 ◽  
Author(s):  
Eu Gene Park ◽  
Young-Hoon Kim
Keyword(s):  
Pediatric Patients ◽  
Retrospective Chart Review ◽  
Tic Disorders ◽  
Functional Impairments ◽  
Diagnostic And Statistical Manual ◽  
High Prevalence ◽  
Tic Severity ◽  
Lip Movement ◽  
The Mean ◽  
Neuropsychiatric Comorbidities

Abstract Background: Tic disorders are childhood-onset neuropsychiatric disorders characterized by multiple motor or vocal tics with frequent comorbidities and a broad spectrum of phenotypic presentations. In this study, we aimed to investigate the clinical characteristics and comorbid neuropsychiatric conditions in pediatric patients with tic disorders. Methods: We retrospectively reviewed the medical records of 119 pediatric patients (89 males, 30 females) who were diagnosed with tic disorders according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) at Uijeongbu St. Mary’s Hospital, Republic of Korea, between January 2012 and July 2019.Results: The mean age of tic onset was 6.9 years (range, 1–14) and the mean age at diagnosis was 8 years (range, 1–17). The mean lag between tic onset and diagnosis was 13.3 months (range, 0.25–132). The most common, first-presenting tics were eye blinking (50.4%), followed by jaw or lip movement (29.4%) and throat clearing (29.4%). Thirty-seven (31.1%) patients had at least one co-occurring neuropsychiatric disorder at the time of tic diagnosis. Subtypes of tic disorders, types of initial tics, and presence of neuropsychiatric comorbidities were not associated with tic severity. Tic severity was associated with greater functional impairment and tic noticeability (p <0.05). A relatively shorter time to diagnosis was associated with tic severity (Spearman’s ρ = –0.14, p = 0.11).Conclusions: The evolving nature of tic expression and severity, high prevalence of neuropsychiatric comorbidities, and associated functional impairments emphasize the importance of comprehensive assessment during the disease course for determining and prioritizing goals of treatment.

scholarly journals Clinical features and neuropsychiatric comorbidities in pediatric patients with tic disorders: A retrospective chart review study from South Korea

2020 ◽  
Author(s):  
Eu Gene Park ◽  
Young-Hoon Kim
Keyword(s):  
Pediatric Patients ◽  
Retrospective Chart Review ◽  
Tic Disorders ◽  
Functional Impairments ◽  
Diagnostic And Statistical Manual ◽  
High Prevalence ◽  
Tic Severity ◽  
Lip Movement ◽  
The Mean ◽  
Neuropsychiatric Comorbidities

Abstract Background: Tic disorders are childhood-onset neuropsychiatric disorders characterized by multiple motor or vocal tics with frequent comorbidities and a broad spectrum of phenotypic presentations. In this study, we aimed to investigate the clinical characteristics and comorbid neuropsychiatric conditions in pediatric patients with tic disorders. Methods: We retrospectively reviewed the medical records of 119 pediatric patients (89 males, 30 females) who were diagnosed with tic disorders according to the Diagnostic and Statistical Manual of Mental Disorders, 5 th edition (DSM-5) at Uijeongbu St. Mary’s Hospital, Republic of Korea, between January 2012 and July 2019. Results: The mean age of tic onset was 6.9 years (range, 1–14) and the mean age at diagnosis was 8 years (range, 1–17). The mean lag between tic onset and diagnosis was 13.3 months (range, 0.25–132). The most common, first-presenting tics were eye blinking (50.4%), followed by jaw or lip movement (29.4%) and throat clearing (29.4%). Thirty-seven (31.1%) patients had at least one co-occurring neuropsychiatric disorder at the time of tic diagnosis. Subtypes of tic disorders, types of initial tics, and presence of neuropsychiatric comorbidities were not associated with tic severity. Tic severity was associated with greater functional impairment and tic noticeability (p <0.05). A relatively shorter time to diagnosis was associated with tic severity (Spearman’s ρ = –0.14, p = 0.11). Conclusions: The evolving nature of tic expression and severity, high prevalence of neuropsychiatric comorbidities, and associated functional impairments emphasize the importance of comprehensive assessment during the disease course for determining and prioritizing goals of treatment.

scholarly journals Clinical features and neuropsychiatric comorbidities in pediatric patients with tic disorders

2020 ◽  
Author(s):  
Eu Gene Park ◽  
Young-Hoon Kim
Keyword(s):  
Pediatric Patients ◽  
Rank Correlation ◽  
Tic Disorders ◽  
Functional Impairments ◽  
Chi Square ◽  
Exact Test ◽  
Spearman’S Rank Correlation ◽  
Tic Severity ◽  
The Mean ◽  
Neuropsychiatric Comorbidities

Abstract Background Tic disorders are childhood-onset neuropsychiatric disorders characterized by multiple motor or vocal tics with frequent comorbidities and a broad spectrum of phenotypic presentations. In this study, we aimed to investigate the clinical characteristics and comorbid neuropsychiatric conditions in pediatric patients with tic disorders. Methods We retrospectively reviewed the medical records of 119 pediatric patients (89 males, 30 females) who were diagnosed with tic disorders according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-Ⅴ) at Uijeongbu St. Mary’s Hospital, Republic of Korea, between January 2012 and July 2019. Statistical comparisons were performed using Fisher’s exact test, Pearson’s chi-square test, Student’s t-test, and the Kruskal-Wallis test. Spearman’s rank correlation coefficient was used to conduct correlational analyses. Results The mean age of tic onset was 6.9 years (range, 1–14) and the mean age at diagnosis was 8 years (range, 1–17). The mean lag between tic onset and diagnosis was 13.3 months (range, 0.25–132). The most common, first-presenting tics were eye blinking (50.4%), followed by jaw or lip movement (29.4%) and throat clearing (29.4%). Thirty-seven (31.1%) patients had at least one co-occurring neuropsychiatric disorder at the time of tic diagnosis. Subtypes of tic disorders, types of first-presenting tics, and presence of neuropsychiatric comorbidities were not associated with tic severity. Tic severity was associated with greater functional impairment and tic noticeability (P < 0.05). A relatively shorter time to diagnosis was associated with tic severity (Spearman’s ρ = − 0.147, P = 0.110). Conclusions The evolving nature of tic expression and severity, high prevalence of neuropsychiatric comorbidities, and associated functional impairments emphasize the importance of comprehensive assessment during the disease course for determining and prioritizing goals of treatment.

scholarly journals Co-morbidities and micronutrient deficiencies in children with severe acute malnutrition

2017 ◽  
Vol 4 (4) ◽  
pp. 1225
Author(s):  
Kumar Saurabh ◽  
Shilpi Ranjan ◽  
J P Narayan
Keyword(s):  
Severe Acute Malnutrition ◽  
Retrospective Chart Review ◽  
Acute Malnutrition ◽  
Nutritional Deficiencies ◽  
Micronutrient Deficiencies ◽  
Medical College ◽  
Paediatric Unit ◽  
High Prevalence ◽  
The Mean ◽  
One Year

Background: To study the co-morbidities and nutritional deficiencies in hospitalized children of severe acute malnutrition (SAM).Methods: One year retrospective chart review of 150 cases of SAM was done in Paediatric unit of a medical college of northern India.Results: The mean age of study group was 17.3 months (6 months to 60 months’ age group). Diarrhoea (34.7%) and respiratory tract infection (31.33%) were the most common co-morbid conditions associated with this study. Tuberculosis was seen in 20% of cases whereas Measles was associated in 6.7% cases. Anaemia and Vitamin A deficiencies were common micronutrient deficiencies. A very high prevalence of intestinal helminthic infestation was present in this study. Ascaris lumbricoides being the most common parasite involved. Polyparasitism was present in 20% of cases.Conclusions: Early identification and management of co-morbidities can improve overall outcome and survival.

scholarly journals Protracted Respiratory Findings in Children Post-COVID-19 Infection

2021 ◽  
Author(s):  
Shoshana Leftin Dobkin ◽  
Joseph Collaco ◽  
Sharon McGrath-Morrow
Keyword(s):  
Lung Function ◽  
Respiratory Symptoms ◽  
Pediatric Patients ◽  
Acute Infection ◽  
Retrospective Chart Review ◽  
Exercise Intolerance ◽  
Prior History ◽  
Exertional Dyspnea ◽  
History Of ◽  
The Mean

Introduction: Although prolonged respiratory symptoms following SARS-CoV-2 infection have been reported in adults, there is a paucity of literature describing post-acute symptoms in pediatric patients following COVID-19. In this study we describe health data and respiratory findings in pediatric patients presenting with complaints of persistent respiratory symptoms following acute COVID-19 infection. Methods: This study included patients referred to Pulmonary Clinic at the Children’s Hospital of Philadelphia between December 2020 and April 2021 (n=29). Inclusion criteria included a history of SARS-CoV-2 RNA positivity or confirmed close household contact. A retrospective chart review was performed and demographic, clinical, imaging, and functional test data were collected. Results: The mean age at presentation to clinic was 13.1 years (range: 4-19 years). Patients had persistent respiratory symptoms ranging from 1.3 to 6.7 months post-acute infection. Persistent dyspnea and/or exertional dyspnea were present in nearly all (96.6%) of the patients at the time of clinic presentation. Other reported chronic symptoms included cough (51.7%) and exercise intolerance (48.3%). Fatigue was reported in 13.7% of subjects. Many subjects were overweight or obese (62.1%) and eleven subjects had a prior history of asthma. Lung function was normal in most patients. The six-minute walk test (6MWT) revealed exercise intolerance and significant tachycardia in two-thirds of children tested. Conclusion: Exertional dyspnea, cough and exercise intolerance were the most common respiratory symptoms in children with post-acute COVID-19 respiratory symptoms seen in an outpatient pulmonary clinic. Lung function, however, was mostly normal, and exertional intolerance was frequently demonstrated using the 6MWT.

scholarly journals Evaluation of the Tolerability of Intermittent Intravenous Sildenafil in Pediatric Patients With Pulmonary Hypertension

2016 ◽  
Vol 21 (5) ◽  
pp. 419-425 ◽  
Author(s):  
Robyn A. Fender ◽  
Ty E. Hasselman ◽  
Yanzhi Wang ◽  
Aaron A. Harthan
Keyword(s):  
Blood Pressure ◽  
Pulmonary Hypertension ◽  
Adverse Events ◽  
Pediatric Patients ◽  
Retrospective Chart Review ◽  
Significant Difference ◽  
Before And After ◽  
Include Blood Pressure ◽  
The Mean ◽  
Clinical Measures

OBJECTIVES: The primary purpose of this study was to determine the tolerability of intermittent intravenous (IV) sildenafil for the treatment of pulmonary hypertension in pediatric patients. Secondary objectives were to evaluate parameters related to efficacy. METHODS: This was a retrospective chart review from January 2013 to August 2014 of pediatric patients under age 18 years treated with intermittent doses of IV sildenafil for pulmonary hypertension. Patients were excluded if they were over age 18 years or received sildenafil for other indications. Measures collected to assess tolerability include blood pressure and heart rate before and after the administration of IV sildenafil, as well as adverse events. RESULTS: Thirty-seven patients (21 females and 16 males) were identified meeting inclusion criteria, and 21 (56.8%) were on oral sildenafil prior to the initial IV dose. The mean decrease in blood pressure after the first dose of IV sildenafil was 7.16/2.74 mmHg. The decrease in systolic blood pressure was statistically significant. During the study period, 5 patients experienced medication related adverse events, primarily hypotension. Despite this, none of the patients had the medication discontinued due to these events. For secondary objectives, a statistically significant difference was not found between other clinical measures before and after intermittent IV sildenafil dosing. CONCLUSIONS: Sildenafil, when administered as intermittent IV doses, was tolerated by the majority of patients evaluated in this study. For pediatric patients with pulmonary hypertension in whom enteral or continuous IV sildenafil cannot be administered, intermittent IV sildenafil may be considered as an alternative administration option.

Baseline characteristics of gender dysphoric youth

2018 ◽  
Vol 31 (12) ◽  
pp. 1367-1369 ◽  
Author(s):  
Victoria M. Brocksmith ◽  
Rasha S. Alradadi ◽  
Melinda Chen ◽  
Erica A. Eugster
Keyword(s):  
Chart Review ◽  
Pediatric Patients ◽  
Retrospective Chart Review ◽  
Limited Information ◽  
High Prevalence ◽  
Early Expression ◽  
Z Scores ◽  
History Of ◽  
Baseline Characteristics ◽  
Male To Female

Abstract Background Limited information is available regarding baseline characteristics of children and adolescents with gender dysphoria (GD). The purpose of this retrospective study was to describe baseline characteristics of pediatric patients referred for GD. Methods A retrospective chart review of pediatric patients with GD referred to the pediatric endocrine clinic between 2002 and 2017 was conducted. Body mass index (BMI) percentiles and z-scores were calculated based on height and weight at the initial visit. Results Seventy-eight patients aged 14.9±2.37 years were identified. Of these, affirmed gender was more often male than female (63% vs. 37%, p=0.024). Although no difference was seen in average BMI z-scores between female to male (FTM) and male to female (MTF) patients, approximately 50% were overweight or obese. A higher incidence of anxiety was present in FTM compared with MTF youth (p=0.05). Fifty-six patients were referred in January 2014 or later, of whom 27% had a history of early expression of GD compared with 55% of those seen prior to 2014 (p=0.061). Conclusions The high prevalence of overweight in TG youth at baseline represents a potential risk for adverse health consequences. There appears to be a change in the age of first manifestation of GD over time.

scholarly journals Recombinant Factor VIIa for Bleeding in Non-hemophiliac Pediatric Patients

2009 ◽  
Vol 14 (1) ◽  
pp. 38-47
Author(s):  
Elizabeth M. Oen ◽  
Kathleen A. Doan ◽  
Chad A. Knoderer ◽  
Holly M. Knoderer
Keyword(s):  
Chart Review ◽  
Pediatric Patients ◽  
Recombinant Factor Viia ◽  
Factor Viia ◽  
Retrospective Chart Review ◽  
Efficacy Data ◽  
Safety Studies ◽  
The Mean

OBJECTIVE To evaluate the use of recombinant factor VIIa (rFVIIa) for the treatment of bleeding in nonhemophiliac children. METHODS This was a retrospective chart review of all patients &lt; 18 years of age who received rFVIIa over a 2 year period. RESULTS Twenty-four pediatric patients received a total of 240 doses of rFVIIa for treatment of bleeding. Recombinant factor VIIa was effective in achieving bleeding resolution in 54% of patients. The mean age of patients in the bleeding non-resolution versus resolution group was 50% younger (5.5 vs. 10.3 years, P = 0.104). CONCLUSIONS Bleeding resolution can be achieved with recombinant factor VIIa using similar doses to those recommended for children with hemophilia. Widespread use of rFVIIa for bleeding in children without hemophilia is not warranted given this efficacy data. Further safety studies are needed with rFVIIa in this population to clarify thrombotic risks.

Dysphagia in Pediatric Patients with Tracheostomy

2021 ◽  
pp. 000348942110251
Author(s):  
Kimberly Luu ◽  
Michael A. Belsky ◽  
Harish Dharmarajan ◽  
Thomas Kaffenberger ◽  
Jennifer L. McCoy ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Pediatric Population ◽  
Upper Airway ◽  
Retrospective Chart Review ◽  
Barium Swallow ◽  
Thickened Liquids ◽  
Level Of Evidence ◽  
Swallowing Function ◽  
The Mean ◽  
Oral Diet

Objective: Post-tracheotomy swallowing function has not been well described in the pediatric population. This study aims to (1) determine differences in swallowing functioning pre- and post-tracheotomy and (2) examine the association between postoperative dysphagia and indication for tracheotomy, age at the time of tracheotomy, and time between tracheotomy and modified barium swallow (MBS). Methods: A retrospective chart review was performed on 752 patients who underwent a tracheotomy from 2003 to 2018 and had adequate documentation for review. Patients were included if they received a post-operative MBS. Descriptive statistics, logistic regression, and Fisher’s exact test were used to analyze the data. Results: The cohort included 233 patients. The mean age at the time of tracheotomy was 25 months (±50.5). The indications for the tracheotomy were upper airway obstruction (110/233, 47.2%), chronic respiratory failure (104/233, 44.6%), and neurologic disease (19/233, 8.2%). The mean time from tracheotomy to post-operative MBS was 224 days (±297.7). Of the patients who had documented pre- and post-tracheotomy diets, nearly half of patients had improvement in their swallowing function after tracheotomy placement (82/195; 42.1%). Post-tracheotomy MBS recommended thickened liquids in 30.9% of the patients (72/233) and 42.5% (99/233) were recommended thin liquids. The remainder (62/233, 26.6%) remained nothing by mouth (NPO). Patients with neurological disease as the indication for the tracheotomy were more likely to remain NPO ( P = .039). Conclusion: A tracheotomy can functionally and anatomically affect swallowing in pediatric patients. The majority of our studied cohort was able to resume some form of an oral diet postoperatively based on MBS. This study highlights the need for objective measurements of swallowing in the postoperative tracheotomy patient to allow for safe and timely commencement of an oral diet. Level of Evidence Level 3.

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