scholarly journals Evaluation of Pain in Adults With Childhood-Onset Disabilities and Communication Difficulties

2021 ◽  
Vol 12 ◽  
Author(s):  
Taylor Jersak ◽  
Garey Noritz
Keyword(s):  
Pediatric Population ◽  
Childhood Onset ◽  
Neurologic Impairment ◽  
Communication Difficulties ◽  
Incorrect Diagnosis ◽  
Central Nervous System Impairment ◽  
Poor Outcomes ◽  
Evidence Based Guidelines ◽  
Review Current ◽  
Experience Pain

Adults with childhood-onset disabilities, particularly those with central nervous system impairment, commonly experience pain. Because many such individuals have difficulties in communication, caregivers and medical professionals must identify and interpret non-verbal behaviors as indicators of pain. This process is challenging and can lead to poor outcomes through delayed or incorrect diagnosis and treatment. Most research in the evaluation of pain in individuals with neurologic impairment has focused on the pediatric population, and evidence-based guidelines do not exist for adults. The purpose of this paper is to review current recommendations for pain assessment in adults with communication impairment. This approach includes guidance for history-taking, pharmacologic review, physical examination, and the judicious use of laboratory and imaging tests. Finally, we discuss adult-specific diagnoses to consider when evaluating pain in adults with childhood-onset disabilities and communication difficulties.

scholarly journals The use of Clozapine in Adolescents: A Case Report

2011 ◽  
Vol 17 (1) ◽  
pp. 29
Author(s):  
Aili Hanim Hashim ◽  
Subash Kumar Pillai ◽  
Amer Siddiq Amer Nordin ◽  
Manveen Kaur
Keyword(s):  
Case Report ◽  
Pediatric Population ◽  
Childhood Onset ◽  
Childhood Onset Schizophrenia

This is a report about a child diagnosed with childhood-onset schizophrenia and subsequently treated with clozapine. Clozapine is often used as the last line of treatment for patients with schizophrenia even in the pediatric population. This report highlights the usefulness and challenges of using clozapine in children with schizophrenia.

Acute Ischemic Stroke in a 10-Month-Old Baby Recovered With Aspirin

2021 ◽  
Author(s):  
Seyed A. Hosseini ◽  
Mohammad H. Gharib ◽  
Seyed B. Mirheidari ◽  
Bahar Ghanbarzade ◽  
Parnian S. Hosseini
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Pediatric Population ◽  
Limb Weakness ◽  
Left Limb ◽  
Ct Head ◽  
Permanent Morbidity ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Evidence Based Guidelines

AbstractAcute ischemic stroke is rare in children and often brings enduring and permanent morbidity in pediatric population. While there are numerous recommendations for initial treatment, evidence on effectiveness of different therapies among children is limited. Here, we describe a 10-month-old boy who presented with fever, restlessness, seizure and postictal left limb weakness. Examination revealed left hemiplegia and hemiparesthesia. Computed tomography (CT) head showed loss of gray–white matter distinction with diffuse hypodensity in the right temporoparietal lobes and right caudate nucleus. Magnetic resonance imaging (MRI) brain demonstrated diffusion restriction in favor of acute ischemic stroke in the right middle cerebral artery (MCA) territory. Brain MR angiography (MRA) demonstrated complete occlusion of proximal aspect of M1 segment of right MCA. Genetic testing determined a homozygous 4G/4G polymorphism of the PAI-1 gene. Antiplatelet therapy was started after diagnosis and continued for 8 days with antibiotic therapy. Stroke in children and infants is an infrequent condition associated with substantial morbidity and mortality that needs clinicians' care. This case highlights the significance of awareness about stroke in children and emphasizes on further research to compile evidence-based guidelines for acute stroke therapy in children.

scholarly journals Potential Perinatally Acquired Extended Spectrum β-Lactamase Escherichia coli Urinary Tract Infection in an Infant

2020 ◽  
Vol 25 (3) ◽  
pp. 266-269 ◽  
Author(s):  
Jason Ziegler ◽  
Heather Chapman ◽  
Megan Rueth ◽  
Annette Hays ◽  
Christopher Schriever ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Pediatric Population ◽  
Treatment Options ◽  
Multidrug Resistant ◽  
Recommended Treatment ◽  
Extended Spectrum ◽  
Poor Outcomes

Extended-spectrum β-lactamases (ESBL) are produced mainly by members of the Enterobacteriaceae family and confer resistance to most β-lactam antibiotics. Because of limited treatment options, ESBL infections are typically more challenging to treat resulting in poor outcomes, increased complications, and mortality. Because ESBL-producing organisms are primarily seen in critically ill patients, along with those patients having prolonged hospital stays, extensive courses of antimicrobials, and/or use of invasive medical devices (i.e., urinary catheters, central venous lines, or endotracheal tubes), guidelines regarding the management of ESBL-producing organisms in the pediatric population are scant. A review of current recommended treatment options for infections caused by ESBL-producing organisms centers on the use of carbapenems, with some supportive literature regarding the utility/effectiveness of other non-β-lactam therapy. We present a case report of an 8-month-old female diagnosed with a urinary tract infection due to ESBL-producing Escherichia coli successfully treated with sulfamethoxazole/trimethoprim. Multidrug resistant infections in pediatric patients without risk factors remains an important field of study because these unique infections may pose a problem when choosing an effective empiric antimicrobial therapy.

scholarly journals Submental intubation in pediatric maxillofacial surgery: report of 2 cases

1969 ◽  
Vol 48 (2) ◽  
pp. 91-95
Author(s):  
Vanessa Alejandri-Gamboa ◽  
Pedro J. Téllez-Rodríguez ◽  
María C.R. López-Fernández ◽  
Abel Sanjuan-Martínez ◽  
Lina Sarmiento
Keyword(s):  
Surgical Procedures ◽  
Current Literature ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Nasotracheal Intubation ◽  
Maxillofacial Surgery ◽  
Orotracheal Intubation ◽  
Morbidity And Mortality ◽  
Submental Intubation ◽  
Review Current

Submental intubation (SMI) is useful in surgical procedures where nasotracheal intubation is contraindicated and orotracheal intubation is not ideal, making it an alternative to tracheostomy since it is performed in less time, with less morbidity and mortality, minimal postoperatory care, as well as an aesthetically acceptable scar. We present 2 cases of pediatric patients with a successful SMI. In addition, we briefly review current literature regarding pediatric population.

scholarly journals Pediatric Allergic Rhinitis: Factors Affecting Treatment Choice

2005 ◽  
Vol 84 (3) ◽  
pp. 163-168 ◽  
Author(s):  
Erwin W. Gelfand
Keyword(s):  
Allergic Rhinitis ◽  
Large Scale ◽  
First Generation ◽  
Pediatric Population ◽  
Full Range ◽  
Cardiovascular Effects ◽  
Duration Of Action ◽  
Factors Affecting ◽  
Life Threatening ◽  
Central Nervous System Impairment

Allergic rhinitis is the most prevalent chronic allergic disease in children. Although it is not life-threatening, it can have a significantly detrimental effect on a child's quality of life, and it may exacerbate a number of common comorbidities, including asthma and sinusitis. The Allergic Rhinitis and its Impact on Asthma guidelines, an evidence-based algorithm for the treatment of allergic rhinitis, advocate the use of antihistamines for the treatment of the broad spectrum of the disease. However, first-generation antihistamines are associated with a number of adverse events, including central nervous system impairment and anticholinergic and cardiovascular effects. Moreover, these agents have not been rigorously tested in the pediatric population. Nevertheless, first-generation antihistamines remain the most frequently prescribed agents in this class of drugs. This is despite the fact that the second-generation antihistamines are largely free of the undesirable side effects associated with their predecessors and the fact that they have been shown to be effective in relieving allergic rhinitis symptoms in children in a number of large-scale clinical trials. Therefore, when selecting an antihistamine for a child, it would be prudent to consider the full range of antihistamines and to base the selection of a particular drug on its efficacy, onset and duration of action, and safety profile.

scholarly journals Therapeutic cancer vaccines for pediatric malignancies: advances, challenges, and emerging technologies

2021 ◽  
Author(s):  
Hannah E Olsen ◽  
Geoffrey M Lynn ◽  
Pablo A Valdes ◽  
Christian D Cerecedo Lopez ◽  
Andrew S Ishizuka ◽  
...  
Keyword(s):  
Cancer Vaccines ◽  
Viral Vectors ◽  
Tumor Antigens ◽  
Pediatric Population ◽  
Vaccine Platform ◽  
Therapeutic Modalities ◽  
Pediatric Cancer Patients ◽  
Outcomes For Children ◽  
Poor Outcomes ◽  
Therapeutic Cancer Vaccines

Abstract Though outcomes for pediatric cancer patients have significantly improved over the past several decades, too many children still experience poor outcomes and survivors suffer lifelong, debilitating late-effects after conventional chemotherapy, radiation, and surgical treatment. As such, there has been a renewed focus on developing novel targeted therapies to improve survival outcomes. Cancer vaccines are a promising type of immunotherapy that leverage the immune system to mediate targeted, tumor-specific killing through recognition of tumor antigens, thereby minimizing off-target toxicity. As such, cancer vaccines are orthogonal to conventional cancer treatments and can therefore be used alone or in combination with other therapeutic modalities to maximize efficacy. To date, cancer vaccination has remained largely understudied in the pediatric population. In this review, we discuss the different types of tumor antigens and vaccine technologies (dendritic cells, peptides, nucleic acids and viral vectors) evaluated in clinical trials, with a focus on those used in children. We conclude with perspectives on how advances in combination therapies, tumor antigen (e.g., neoantigen) selection, and vaccine platform optimization can be translated into clinical practice to improve outcomes for children with cancer.

Unilateral Facial Palsy in an Adolescent with Guillain–Barré Syndrome

2020 ◽  
Author(s):  
Emanuela Claudia Turco ◽  
Benedetta Piccolo ◽  
Francesco Pisani
Keyword(s):  
Facial Palsy ◽  
Pediatric Population ◽  
Guillain Barre Syndrome ◽  
Childhood Onset ◽  
Peripheral Facial Palsy ◽  
Nerve Involvement ◽  
Guillain Barré Syndrome ◽  
Potential Indicator ◽  
Guillain Barré ◽  
Work Up

AbstractGuillain–Barré syndrome (GBS) is the most common and most severe acute demyelinating polyneuropathy with ∼0.8 to 1.1/100,000 incidence in pediatric population. Unlike adult patients, incidence of facial nerve involvement in children with GBS has not yet been determined possibly because of rare use of magnetic resonance imaging in childhood-onset GBS. In the present study, we describe a girl with GBS who presented unilateral peripheral facial palsy, confirmed by neuroimaging and electrophysiological evaluation. We suggest that both neuroimaging and detailed electrophysiological evaluation should be integrated into the work-up of such patients. We also wish to highlight the importance of evaluating cranial nerve involvement as a potential indicator of severity of disease.

Evidence-Based Guidelines: Tympanostomy Tube Insertion and Adenotonsillectomy

2018 ◽  
Vol 14 (02) ◽  
pp. 029-036
Author(s):  
Matthew Brigger ◽  
Justin Wilson
Keyword(s):  
Pediatric Population ◽  
Tube Placement ◽  
Evidence Based ◽  
Tympanostomy Tube ◽  
Tube Insertion ◽  
The Past ◽  
The Common ◽  
Common Nature ◽  
Surgical Treatments ◽  
Evidence Based Guidelines

AbstractMyringotomy with tympanostomy tube placement and tonsillectomy (with or without adenoidectomy) are two of the most common procedures performed in the pediatric population. Indications for these surgical treatments are for correspondingly prevalent conditions affecting children, including middle ear and adenotonsillar disease, which are treated by many specialty groups spanning family physicians, pediatricians, emergency care physicians, and otolaryngologists. Despite the common nature of these diseases and respective indicated surgeries, their management has in the past had limited evidence-based guidelines. This article consolidates the most up-to-date evidence from the otolaryngology, pediatric, and infectious disease literature to guide the management with tympanostomy tube insertion and adenotonsillectomy in the pediatric population.

Sign in / Sign up

Export Citation Format

Share Document