scholarly journals Modern approach to diagnosis and treatment of seizures in newborns and early age children

2021 ◽  
pp. 56-75
Author(s):  
V.Yu. Martyniuk ◽  
◽  
T.K. Znamenska ◽  
V.B. Shveikina ◽  
V.A. Galagan ◽  
...  
Keyword(s):  
Young Children ◽  
Synaptic Transmission ◽  
Antiepileptic Drugs ◽  
Metabolic Disorders ◽  
Epileptiform Activity ◽  
Diagnosis And Treatment ◽  
High Tech ◽  
Early Age ◽  
Modern Approach ◽  
Epileptic Syndromes

The article is devoted to the topical problem of neonatology and pediatric neurology — the diagnosis and treatment of seizures in newborns and young children. The work presents an algorithm for the diagnosis and treatment of epileptic seizures in children. It is indicated that the therapeutic effect of most antiepileptic drugs consists of modulation of voltage-gated and ligand-gated channels of membranes of neurons of the cerebral cortex, enhancement of inhibitory synaptic transmission or inhibition of activating synaptic transmission. The issues of the pharmacokinetics and pharmacodynamics of antiepileptic drugs are considered, taking into account the age characteristics of the child's body, in particular, newborns and early age children. The problems of drug interaction were discussed. The properties of individual antiepileptic drugs, which are used in newborns and young children, are considered. Emphasized are «polar» differences in the work of phenobarbital, which depend on the stage of epileptogenesis, namely: suppression of epileptiform activity at the early stage of epileptogenesis and its enhancement in the already formed epileptic focus (epileptic system). The literature data on the differentiated treatment of certain epileptic syndromes are presented. The issues on the prospects for the treatment of genetically determined diseases, which are accompanied by seizures associated with metabolic disorders, are considered. The modern high-tech methods of treatment of these diseases are noted. The role of diet therapy, co-factor therapy in the treatment of hereditary metabolic disorders, in particular, the ketogenic diet as a method of alternative treatment for drug-resistant epilepsy in children, is shown. No conflict of interest was declared by the authors. Key words: newborn, epilepsy, epileptic encephalopathy, treatment, antiepileptic drugs, review.

Clinical Impressions of How Young Children Use AAC at Home and in Child Care Settings: A Canadian Perspective

2010 ◽  
Vol 19 (1) ◽  
pp. 21-28
Author(s):  
Kathryn Wishart
Keyword(s):  
Child Care ◽  
Young Children ◽  
High Tech ◽  
Speech Language Pathologists ◽  
Cultural Backgrounds ◽  
Community Based ◽  
Multicultural Community ◽  
Canadian Perspective ◽  
Communication Devices ◽  
Stakeholder Input

Abstract Speech-language pathologists, working in a multicultural, community-based environment for young children with special needs in Vancouver, Canada, collected information on 84 clients using AAC from a chart review. The speech-language pathologists collected additional usage information and attended a group interview to discuss barriers and facilitators of AAC. Thirty-one percent of the children were using AAC. Children aged between 16 and 72 months typically relied on multiple modes of communication, including sign, communication boards and binders, and low- and high-tech communication devices. All of the children used at least one type of unaided mode. Fifty-five percent used pictures or communication boards/displays, and 29% used technology with speech output. Similarities in usage of AAC were noted in home and child-care settings with increased use of unaided in homes and a slightly increased use of aided communication in child care settings. Speech-language pathologists reported that the time needed for AAC intervention as well as limited funding for high-tech devices continue to be major barriers. Additional research is needed to describe current AAC practices with young children particularly from minority linguistic and cultural backgrounds. Stakeholder input is needed to explore perceptions of children's usage of AAC in daily life with familiar and unfamiliar communication partners.

Inflammatory disease of the womans reproductive system: modern trends in diagnosis and therapy (literature review)

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 35-41
Author(s):  
T Yu Pestrikova ◽  
I V Yurasov ◽  
E A Yurasova
Keyword(s):  
Genital Tract ◽  
Inflammatory Diseases ◽  
Diagnosis And Treatment ◽  
Long Term Results ◽  
Modern Approach ◽  
Pelvic Organs ◽  
Results Of Treatment ◽  
Number Of Patients ◽  
Diagnostic Approaches

Medical, social and economic relevance of inflammatory diseases of the woman's reproductive organs requires a very careful attitude to the diagnosis and treatment of this pathology. The number of patients with genital infections and inflammatory diseases of the pelvic organs can takes the first place in structure of gynecological morbidity, and is 60.4-65.0%, and this fact is not unique to Russia, but all over the world. Incidence rate of inflammatory diseases of the pelvic organs in the first decade of the twenty-first century is increased at 1.4 times in patients who are from 18 to 24 years old and at 1.8 times in patients aged 25-29 years. At the same time, the cost of diagnosis and treatment has increased, reaching 50-60% of the total cost of providing gynecological care for population. The inflammatory diseases of pelvic organs are a collective concept. It includes of various nosological forms. There are numerous contradictions in the views on diagnostic approaches and treatment tactics, the nature of screening and control over the long-term results of treatment, the etiological and pathogenetic significance of various microorganisms found in the genital tract in patients with inflammatory diseases of the pelvic organs. Currently, there are many opinions among specialists about diagnostic approaches and treatment tactics, the type of screening and monitoring the long-term results of treatment, the etiological and pathogenetic role of various microorganisms which can be found in the genital tract in patients with inflammatory diseases. This review presents the results of a modern approach to the diagnosis, management and rehabilitation of patients with inflammatory diseases of the pelvic organs.

Features of nursing care for atopic eatures of nursing care for atopic dermatitis in young children

2020 ◽  
pp. 20-26
Author(s):  
Anna Pinigina
Keyword(s):  
Atopic Dermatitis ◽  
Young Children ◽  
Nursing Care ◽  
Diagnosis And Treatment

The article presents the results of research and synthesis of information on nursing assistance in prevention, diagnosis and treatment of atopic dermatitis in children.

I doveri della moglie secondo gli insegnamenti di alcuni predicatori e scrittori tardomedievali

2019 ◽  
Vol 110 (1) ◽  
pp. 31-45
Keyword(s):  
Mortality Rate ◽  
Young Children ◽  
Social Status ◽  
Free Time ◽  
Early Age ◽  
Social Standing ◽  
Raising Children ◽  
The Social ◽  
Medieval Europe ◽  
The Future

The society of medieval Europe had specific expectations for marriageable girls. From an early age girls were taught how to be wives and mothers, for example by being entrusted with the care of their younger siblings. The girls learned everything they would need in the future by observation. According to the teachings of preachers and writers at the time, girls, irrespective of their social status, were not meant to remain idle, as there were fears that with too much free time on their hands, they might spend it contemplating their looks, practising gestures that were to attract the attention of men or spending time alone in the streets and squares, thus exposing themselves to a variety of dangers. A wife was expected to bear a lot of children, preferably boys, because the mortality rate among young children was high at the time. Wifely duties also included raising children, at least until they were taken over by, for example, a tutor hired by the father, managing the household and ensuring every possible comfort for the husband. As Gilbert of Tournai noted, it was the mother who was expected to bring up the children in faith and to teach them good manners. The duties of the wife obviously depended on her social standing — different duties were expected from the wives of noblemen than from women lower down on the social ladder, who often had to help their husbands, in addition to doing everyday chores.

Effects of antiepileptic drugs on induced epileptiform activity in a rat model of dysplasia

2002 ◽  
Vol 50 (3) ◽  
pp. 251-264 ◽  
Author(s):  
Matthew D Smyth ◽  
Nicholas M Barbaro ◽  
Scott C Baraban
Keyword(s):  
Antiepileptic Drugs ◽  
Rat Model ◽  
Epileptiform Activity

THE UMBILICAL POLYP, A REMNANT OF THE OMPHALOMESENTERIC DUCT

PEDIATRICS ◽  
1957 ◽  
Vol 20 (1) ◽  
pp. 98-100
Author(s):  
Stanley E. Crawford
Keyword(s):  
Young Children ◽  
Intestinal Obstruction ◽  
Neonatal Period ◽  
Meckel’S Diverticulum ◽  
Meckel's Diverticulum ◽  
Recent Case ◽  
Early Age ◽  
Review Of The Literature ◽  
Omphalomesenteric Duct ◽  
Umbilical Polyp

THE PURPOSE of this paper is to report a recent case of an umbilical polyp and intestinal obstruction during the neonatal period. Umbilical polyps are rare. When present, they may be associated with Meckel's diverticulum because both are remnants of the omphalomesenteric duct. The presence of the visible polyp may give an external clue to otherwise obscure intraabdominal symptoms. A review of the literature earlier than 1916 is well summarized in a book by Thomas Cullen. This unusual volume lists six cases of umbilical polyp accompanied by other pathologic complications of Meckel's diverticulum. This author stressed that in these cases it should be pointed out to either the patient or his parents that possible intra-abdominal duct remnants may, at any time, give rise to symptoms such as intestinal obstruction. Penberthy and Benson reported a 9-year-old male with an umbilical polyp which had been present since birth and was without discharge. This youngster died following operation for intestinal obstruction due to volvulus about the diverticulum and its fibrous connection with the umbilical polyp. These authors pleaded for early elective operations in these cases prior to such complications. Gross gave other reasons for observation, and exploration at a reasonably early age, if a Meckel's diverticulum is suspected. Peritonitis from a ruptured Meckel's diverticulum is peculiarly dangerous; in young children the protecting omentum is inadequate and the migrating nature of the anomaly adds to the danger. Fluid from perforation of a diverticulum is usually of greater volume than that found in appendiceal rupture and abscess.

scholarly journals KCNQ/Kv7 Channel Regulation of Hippocampal Gamma-Frequency Firing in the Absence of Synaptic Transmission

2006 ◽  
Vol 95 (5) ◽  
pp. 3105-3112 ◽  
Author(s):  
S. Piccinin ◽  
A. D. Randall ◽  
J. T. Brown
Keyword(s):  
Synaptic Transmission ◽  
High Frequency ◽  
Epileptiform Activity ◽  
Hippocampal Slices ◽  
Neuronal Firing ◽  
Population Spike ◽  
Channel Blockers ◽  
Kv7 Channels ◽  
Population Spikes ◽  
Gamma Frequency

Synchronous neuronal firing can be induced in hippocampal slices in the absence of synaptic transmission by lowering extracellular Ca2+ and raising extracellular K+. However, the ionic mechanisms underlying this nonsynaptic synchronous firing are not well understood. In this study we have investigated the role of KCNQ /Kv7 channels in regulating this form of nonsynaptic bursting activity. Incubation of rat hippocampal slices in reduced (<0.2 mM) [Ca2+]o and increased (6.3 mM) [K+]o, blocked synaptic transmission, increased neuronal firing, and led to the development of spontaneous periodic nonsynaptic epileptiform activity. This activity was recorded extracellularly as large (4.7 ± 1.9 mV) depolarizing envelopes with superimposed high-frequency synchronous population spikes. These intraburst population spikes initially occurred at a high frequency (about 120 Hz), which decayed throughout the burst stabilizing in the gamma-frequency band (30–80 Hz). Further increasing [K+]o resulted in an increase in the interburst frequency without altering the intraburst population spike frequency. Application of retigabine (10 μM), a Kv7 channel modulator, completely abolished the bursts, in an XE-991–sensitive manner. Furthermore, application of the Kv7 channel blockers, linopirdine (10 μM) or XE-991 (10 μM) alone, abolished the gamma frequency, but not the higher-frequency population spike firing observed during low Ca2+/high K+ bursts. These data suggest that Kv7 channels are likely to play a role in the regulation of synchronous population firing activity.

Enhanced NMDAR-dependent epileptiform activity is controlled by oxidizing agents in a chronic model of temporal lobe epilepsy

1996 ◽  
Vol 76 (6) ◽  
pp. 4185-4189 ◽  
Author(s):  
J. C. Hirsch ◽  
O. Quesada ◽  
M. Esclapez ◽  
H. Gozlan ◽  
Y. Ben-Ari ◽  
...  
Keyword(s):  
Synaptic Transmission ◽  
Ex Vivo ◽  
Epileptiform Activity ◽  
Hippocampal Slices ◽  
Nmda Antagonist ◽  
Pyramidal Cells ◽  
Resting Membrane Potential ◽  
Postsynaptic Potentials ◽  
Epileptiform Discharges ◽  
Late Part

1. Graded N-methyl-D-aspartate receptor (NMDAR)-dependent epileptiform discharges were recorded from ex vivo hippocampal slices obtained from rats injected a week earlier with an intracerebroventricular dose of kainic acid. Intracellular recordings from pyramidal cells of the CA1 area showed that glutamate NMDAR actively participated in synaptic transmission, even at resting membrane potential. When NMDAR were pharmacologically isolated, graded burst discharges could still be evoked. 2. The oxidizing reagent 5,5'-dithiobis(2-nitrobenzoic acid) (DTNB, 200 microM, 15 min) suppressed the late part of the epileptiform burst that did not recover after wash but could be reinstated by the reducing agent tris (2-carboxyethyl) phosphine (TCEP, 200 microM, 15 min) and again abolished with the NMDA antagonist D-2-amino-5-phosphonovaleric acid (D-APV). 3. Pharmacologically isolated NMDAR-mediated responses were decreased by DTNB (56 +/- 10%, mean +/- SD, n = 6), an effect reversed by TCEP. 4. When only the fast glutamateric synaptic component was blocked, NMDA-dependent excitatory postsynaptic potentials (EPSPs) could be evoked despite the presence of underlying fast and slow inhibitory postsynaptic potentials (IPSPs). DTNB decreased EPSPs to 48 +/- 12% (n = 5) of control. 5. Since a decrease of the NMDAR-mediated response by +/- 50% is sufficient to suppress the late part of the burst, we suggest that epileptiform activity can be controlled by manipulation of the redox sites of NMDAR. Our observations raise the possibility of developing new anticonvulsant drugs that would spare alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid-R (AMPAR)-mediated synaptic responses and decrease NMDAR-mediated synaptic transmission without blocking it completely.

scholarly journals Ten-year experience of the Pirogov Center in the organization of oncological care in a multi-field hospital

2019 ◽  
Vol 24 (3) ◽  
pp. 115-123
Author(s):  
Yu. L. Shevchenko ◽  
O. E. Karpov ◽  
V. O. Sarzhevskiy ◽  
S. A. Fateev ◽  
P. S. Vetshev ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Medical Care ◽  
Cancer Patients ◽  
Multidisciplinary Approach ◽  
Diagnosis And Treatment ◽  
High Tech ◽  
Care Organization ◽  
Field Hospital ◽  
National Medical ◽  
Oncological Care

Organizational aspects of specialized including high-tech oncological medical care in a multi-field hospital are shown. A 10-year experience of the Pirogov National Medical and Surgical Center regarding optimization of the treatment of cancer patients is reported. Effectiveness of oncological care organization in a multi-field hospital is preliminary concluded. It is emphasized that multidisciplinary approach is essential for selecting a personalized program of cancer treatment in these patients. The need for further searching for ways to improve the diagnosis and treatment of cancer patients by accumulating and analyzing large clinical material is marked.

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