Reference ranges for neuroprotein S-100B: from infants to adolescents

Abstract: Diagnosis and treatment of mild traumatic brain injuries in children are especially problematic. At present, computed tomography (CT) is the standard method to identify if patients with intracranial lesions require inpatient monitoring. CT, however, involves exposure to high doses of X-rays, which should be avoided if possible. In adults, the serum level of neuroprotein S-100B has already been proven to be effective for the selection of patients requiring CT. The aim of the present study was to determine reference ranges for serum S-100B in a large number of healthy children.: All patients younger than 18 years with no recent history of head injuries presenting for routine operations were included in the study.: A total of 394 patients were evaluated. In children from 3 to 18 years an upper reference level of 0.16 μg/L was determined. There was a strong inverse relation between age and S-100B in patients younger than 3 years. As the values in this age group were scattered and the number of cases limited (n=65), no reference range could be calculated.: This study provides S-100B reference ranges for pediatric patients based on the largest group of healthy pediatric patients yet analyzed.Clin Chem Lab Med 2008;46:1296–9.

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Catching the snitch or the consequences? Profiling incidence of concussions in Quidditch players

Neurology ◽

10.1212/01.wnl.0000550653.12040.a6 ◽

2018 ◽

Vol 91 (23 Supplement 1) ◽

pp. S24.3-S25

Author(s):

Vi Tran ◽

Spencer Walser ◽

Jeff Wayland ◽

Adam Elwood ◽

Jose H. Posas

Keyword(s):

Brain Injuries ◽

Head Injuries ◽

Harry Potter ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Medical Evaluation ◽

Total Head ◽

Collegiate Level ◽

Recovery Times ◽

History Of

BackgroundConcussions are caused by a blow to or a violent shaking of the head or body. With increasing popularity of novel sports, such as Quidditch inspired by the Harry Potter series, it is suspected that players are commonly misdiagnosed or not seeking treatment after suffering a concussion. Here, we look at the incidence of concussion in Quidditch players.Materials/methodsAfter obtaining IRB approval we conducted an anonymous cross-sectional survey amongst players in the Major League Quidditch for the 2017 season. The survey included questions corresponding to demographics, previous medical history specific to concussions, migraines, co-morbidities, and suspected concussions whilst engaging in Quidditch.ResultsFour hundred sixty-four players were contacted via email with 34% response rate. Of 34%, 96.2% previously engaged in sports either high school or collegiate level. Twenty-six percent of males and 29% of females reported having previously medically diagnosed concussions outside of Quidditch. Fifteen percent reported never hitting their head during a Quidditch match while 19% indicated more than 10 total head injuries. Twenty-five percent of players reported a medically confirmed concussion during play, with 20% indicating a suspected concussion without medical evaluation. Thirty-four percent reported a history of depression or anxiety with 21 players reporting a history of migraines. Those with confirmed head injuries or suspected concussion, 39% indicated that they sought medical treatment while 24% responded that they did not.ConclusionMajority of Quidditch players reported having suffered a concussion prior to playing while half reported suffering a confirmed or suspected concussion during a game. Players were divided on seeking treatment. It is well documented that history of migraines or other comorbidities combined with multiple concussions leads to longer recovery times as well as higher rates of post-concussive syndrome. With the growing rate of traumatic brain injuries, it is imperative that players are diagnosed and treated to prevent future consequences.

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Radiation-induced meningioma

Neurosurgical FOCUS ◽

10.3171/foc/2008/24/5/e7 ◽

2008 ◽

Vol 24 (5) ◽

pp. E7 ◽

Cited By ~ 100

Author(s):

Felix Umansky ◽

Yigal Shoshan ◽

Guy Rosenthal ◽

Shifra Fraifeld ◽

Sergey Spektor

Keyword(s):

Neural Tissue ◽

Primary Brain Tumor ◽

X Rays ◽

Recurrence Rates ◽

Central Nervous System Neoplasms ◽

History Of ◽

Radiation Induced ◽

High Doses ◽

Nervous System Neoplasms

✓ The long-term or delayed side effects of irradiation on neural tissue are now known to include the induction of new central nervous system neoplasms. However, during the first half of the 20th century, human neural tissue was generally considered relatively resistant to the carcinogenic and other ill effects of ionizing radiation. As a result, exposure to relatively high doses of x-rays from diagnostic examinations and therapeutic treatment was common. In the present article the authors review the literature relating to radiation-induced meningiomas (RIMs). Emphasis is placed on meningiomas resulting from childhood treatment for primary brain tumor or tinea capitis, exposure to dental x-rays, and exposure to atomic explosions in Hiroshima and Nagasaki. The incidence and natural history of RIMs following exposure to high- and low-dose radiation is presented, including latency, multiplicity, histopathological features, and recurrence rates. The authors review the typical presentation of patients with RIMs and discuss unique aspects of the surgical management of these tumors compared with sporadic meningioma, based on their clinical experience in treating these lesions.

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Value of the Chest X-Ray as a Screening Test for Elective Surgery in Children

PEDIATRICS ◽

10.1542/peds.67.4.447 ◽

1981 ◽

Vol 67 (4) ◽

pp. 447-452

Author(s):

Robert A. Wood ◽

Robert A. Hoekelman

Keyword(s):

Postoperative Complications ◽

Pediatric Patients ◽

Elective Surgery ◽

Healthy Children ◽

X Rays ◽

X Ray ◽

Chest X Ray ◽

Clinically Significant ◽

Apparently Healthy ◽

Preoperative Chest

A retrospective study was conducted to assess the value of the chest x-ray as a preoperative screening procedure in pediatric patients. Admissions for elective surgery were compared at two hospitals, one that required routine preoperative chest x-rays and one that did not. Our purpose was to determine the yield of the screening chest x-ray in detecting unknown abnormalities and to determine whether patients who had a preoperative chest x-ray taken experienced fewer anesthetic or postoperative complications than did those who did not. In all, 1,924 cases were studied; in 749 a preoperative chest film was taken. Of those 749 cases, a previously unsuspected abnormality was discovered in 35 (4.7%) patients. Nine (1.2%) of these abnormalities were considered to be clinically significant and three (0.4%) resulted in cancellation of surgery. No differences in anesthetic or postoperative complications were noted between the two groups of patients. It is recommended that the performance of routine preoperative chest x-rays on apparently healthy children be discontinued.

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Occipital tau deposition and astrogliosis following traumatic brain injuries in a kendo player

Neurology Clinical Practice ◽

10.1212/cpj.0000000000000936 ◽

2020 ◽

pp. 10.1212/CPJ.0000000000000936

Author(s):

Yuto Uchida ◽

Yoshihiko Horimoto ◽

Haruto Shibata ◽

Tomoyuki Kuno ◽

Toshihiko Usami ◽

...

Keyword(s):

Head Trauma ◽

Neurodegenerative Disorders ◽

Chronic Headache ◽

Brain Injuries ◽

Head Injuries ◽

Traumatic Brain Injuries ◽

Contact Sports ◽

History Of ◽

Clonic Seizures ◽

Trauma In Athletes

Kendo, a type of fencing using bamboo swords, is one of the most popular Japanese martial arts that is practiced by over four million people worldwide.1 Kendo players wear face masks that protect their heads, but only from front and side attacks (figure 1A). Repetitive head trauma in athletes engaged in contact sports has been associated with development of neurodegenerative disorders.2 Herein, we present the case of kendo player with a history of chronic headache, depression, and cognitive dysfunction, who developed occipital epilepsy followed by generalized tonic-clonic seizures, as a result of repetitive head injuries.

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Skull X-Rays in Minor Head Injury

Scottish Medical Journal ◽

10.1177/003693308302800207 ◽

1983 ◽

Vol 28 (2) ◽

pp. 132-137 ◽

Cited By ~ 2

Author(s):

T. C. Gibson

Keyword(s):

Head Injury ◽

Head Injuries ◽

X Rays ◽

Intracranial Haematoma ◽

Clinical Criteria ◽

Depressed Fracture ◽

Accident And Emergency ◽

History Of ◽

Accident And Emergency Department ◽

The Cost

A retrospective review of the value of skull X-rays in the management of1379 patients presenting to an accident and emergency department with minor head injuries was made. Ten skull fractures were identified in this group (an incidence of 0.7%) of which only four were identified by the casualty officer, the remainder being subsequently identified by the radiologist. Some 90 per cent of patients had no history of concussion, and 33 per cent had no external evidence of head injury. All patients with fractures were admitted because of clinical criteria so that skull X-rays played no part in determining whether patients were admitted for observation or not. Only one patient required operative intervention for a compound depressed fracture, and no patient developed an intracranial haematoma. It is concluded that there is need to educate casualty officers on the indications for, and interpretation of skull X-rays. It is hoped that this might decrease the cost to the Health Service of needless skull X-rays, without detriment to the standards of patient care.

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The Efficacy of Distraction and Counterstimulation in the Reduction of Pain Reaction to Intraoral Injection by Pediatric Patients

The Journal of Contemporary Dental Practice ◽

10.5005/jcdp-9-6-33 ◽

2008 ◽

Vol 9 (6) ◽

pp. 33-40 ◽

Cited By ~ 19

Author(s):

Naser Asl Aminabadi ◽

Rmain Mostofi Zadeh Farahani ◽

Esrafil Balayi Gajan

Keyword(s):

Pediatric Patients ◽

Clinical Investigation ◽

Inferior Alveolar Nerve ◽

Healthy Children ◽

Primary Molar ◽

Dental Patients ◽

Anesthesia Group ◽

Reduction Of Pain ◽

History Of ◽

Pain Reaction

Aim The aim of this clinical investigation was to determine the efficacy of distraction and counterstimulation in the reduction of pain during the administration of local anesthetics in pediatric dental patients. Methods and Materials A total of 78 healthy children (male: 40, female: 38) ages four to five years (mean age: 4.72 years old) without any history of previous intraoral injection were included in the present study. The subjects had at least one carious primary molar. The subjects were randomly allocated into three groups. Group SA received topical anesthesia followed by an inferior alveolar nerve block (simple anesthesia). Group C+SA received counter stimulation using intraoral and extraoral finger vibration in addition to the Group SA protocol. Group CD+SA incorporated verbal distraction in addition to topical and local anesthesia and counterstimulation. A sound, eye, and motor (SEM) scale was used for quantification of pain reaction. Data were analyzed using an analysis of variance (ANOVA). Results The SEM values for Groups SA, C+SA, and CD+SA was 8.25, 5.07, and 3.41, respectively. According to the SEM scale a severe pain reaction was observed in Group SA but not in the other groups. The pain reaction for Group SA was significantly higher than the two other groups (P<0.05). Moreover, the subjects in Group CD+SA exhibited significantly less pain compared to those in Group C+SA. Conclusion Both distraction and counterstimulation are effective in reducing pain reaction in a clinical setting. However, it may be more plausible to use both techniques simultaneously to achieve more favorable results with reference to a reduced pain reaction in pediatric dental patients. Citation Aminabadi NA, Farahani RMZ, Balayi Gajan E. The Efficacy of Distraction and Counterstimulation in the Reduction of Pain Reaction to Intraoral Injection by Pediatric Patients. J Contemp Dent Pract 2008 September; (9)6:033-040.

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Family History of Diabetes Is Associated with Increased Risk of Recurrent DKA in Pediatric Patients in Rhode Island

Diabetes ◽

10.2337/db18-1378-p ◽

2018 ◽

Vol 67 (Supplement 1) ◽

pp. 1378-P

Author(s):

JANAKI D. VAKHARIA ◽

SUNGEETA AGRAWAL ◽

JANINE BACIC ◽

LISA S. TOPOR

Keyword(s):

Family History ◽

Rhode Island ◽

Pediatric Patients ◽

Family History Of Diabetes ◽

Increased Risk ◽

History Of

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Nutritional Status of Pediatric Patients in Ramathibodi Hospital Using the WHO Child Growth Standard and the Thai Growth Reference

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2020.10.11254 ◽

2020 ◽

Vol 103 (10) ◽

pp. 1099-1106

Keyword(s):

Nutritional Status ◽

Pediatric Patients ◽

Chronically Ill ◽

Child Growth ◽

World Health ◽

Healthy Children ◽

Growth Standard ◽

Growth Reference ◽

Child Growth Standard

Background: The appropriate assessment of nutritional status in children is an essential aspect of health supervision. Currently, there are two references used for growth assessment in Thailand. The WHO child growth standard, which has been widely used since 2007, and the Thai growth reference developed by the Ministry of Public Health, which has been used since 1998. However, there were very few studies that made a direct comparison between both tools. Objective: To compare the nutritional status of healthy pediatric patients in Ramathibodi Hospital assessed by the World Health Organization (WHO) child growth standard and the Thai growth reference. Materials and Methods: The present study was a cross-sectional study. The data were collected from all pediatric patients registered in the outpatient department (OPD) of Faculty of Medicine, Ramathibodi Hospital between January 2013 and December 2018. All healthy children (aged 0 to 15 years) were included. Exclusion criteria of possibly chronically ill children were defined by those who were 1) visiting subspecialty clinics, 2) OPD and emergency room (ER) visits more than ten times per year, 3) having ICD-10 of chronic conditions, or 4) had been admitted in the hospital during the study. The weight and height or length data were extracted from the Electronic Medical Record system. All data were analyzed by the Stata Statistical Software focusing on age and sex-specific Z-scores, which references the WHO child growth standard and the Thai growth reference. Results: Sixty-two thousand one hundred four OPD visits were divided into 31,662 OPD visits for boys and 30,442 OPD visits for girls. Percent of weight for age and height or length for age more than +2 Z-score of both boys and girls when using the Thai growth reference was greater than that using the WHO child growth standard, especially for children aged 0 to 12 months. The Thai growth reference classified as overweight were approximately 10.26% to 31.12% more than using the WHO child growth standard. There was no difference in classification of height by both standards. Conclusion: There was a difference in classification of nutritional status between the Thai growth reference and the WHO child growth standard. Keywords: Nutritional status, Pediatric growth reference, Assessment tool, Overweight

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Evaluation of Hypersensitivity Reactions in Pediatric Patients Using Biological Drugs

International Archives of Allergy and Immunology ◽

10.1159/000515500 ◽

2021 ◽

pp. 1-8

Author(s):

Ozge Yilmaz Topal ◽

Volkan Kose ◽

Banu Acar ◽

Umut Selda Bayrakci ◽

Derya Ozyoruk ◽

...

Keyword(s):

Pediatric Patients ◽

Additional Treatment ◽

Hypersensitivity Reactions ◽

Biological Drugs ◽

Rheumatologic Diseases ◽

Culprit Drug ◽

Dose Infusion ◽

History Of ◽

Oncologic Diseases ◽

Biologic Drug

Introduction: Biological drugs are currently used for the treatment of chronic inflammatory, autoimmune, and neoplastic diseases. With their expanding indication spectrum and increasing use, hypersensitivity reactions to these drugs are also becoming more frequent. The present study aimed to report the incidence and the features of such reactions in pediatric patients using biologicals for the treatment of various diseases. Methods: The medical records of pediatric patients treated with biological agents between October 1, 2011 and August 31, 2019 were reviewed and adverse reactions were evaluated retrospectively. Results: During the study period, 211 patients (116 boys, 55%) used 21 different biological drugs for the treatment of various diseases. Their median age at the time of the first treatment was 139.9 (IQR: 92.2–187.8) months. Hematologic-oncologic diseases were the most common indication for biological therapy (97/211; 46.0%), followed by rheumatologic diseases (82/211; 38.9%). Of the 211 patients, 14 (6.64%) experienced reactions to biological drugs. The most common culprit agent was rituximab (57.1%). Most of the patients (85.7%) had a history of reactions either during the infusion or within 1 h after taking the drug. Five patients underwent desensitization to the culprit drug, while 7 other patients continued treatment with a reduced dose/infusion rate or premedication. Also 1 patient continued to take the drug without any additional treatment. Conclusion: It was reported that 6.64% of the patients who received biologic drug therapy for various reasons in our hospital had hypersensitivity. The most common culprit agent was rituximab, and most of the reactions were immediate reactions.

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Is Micro X-ray Computer Tomography a Suitable Non-Destructive Method for the Characterisation of Dental Materials?

Polymers ◽

10.3390/polym13081271 ◽

2021 ◽

Vol 13 (8) ◽

pp. 1271

Author(s):

Andreas Koenig ◽

Leonie Schmohl ◽

Johannes Scheffler ◽

Florian Fuchs ◽

Michaela Schulz-Siegmund ◽

...

Keyword(s):

Flexural Strength ◽

Computer Tomography ◽

Mechanical Performance ◽

Dental Materials ◽

Three Dimensional ◽

X Rays ◽

Scanning Calorimetry ◽

X Ray ◽

Multiple Measurements ◽

High Doses

The aim of the study was to investigate the effect of X-rays used in micro X-ray computer tomography (µXCT) on the mechanical performance and microstructure of a variety of dental materials. Standardised bending beams (2 × 2 × 25 mm3) were forwarded to irradiation with an industrial tomograph. Using three-dimensional datasets, the porosity of the materials was quantified and flexural strength was investigated prior to and after irradiation. The thermal properties of irradiated and unirradiated materials were analysed and compared by means of differential scanning calorimetry (DSC). Single µXCT measurements led to a significant decrease in flexural strength of polycarbonate with acrylnitril-butadien-styrol (PC-ABS). No significant influence in flexural strength was identified for resin-based composites (RBCs), poly(methyl methacrylate) (PMMA), and zinc phosphate cement (HAR) after a single irradiation by measurement. However, DSC results suggest that changes in the microstructure of PMMA are possible with increasing radiation doses (multiple measurements, longer measurements, higher output power from the X-ray tube). In summary, it must be assumed that X-ray radiation during µXCT measurement at high doses can lead to changes in the structure and properties of certain polymers.

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