scholarly journals REKOMENDASI PERAWATAN TERKINI DALAM PENATALAKSANAAN KEJANG PADA NEONATUS

2014 ◽  
Vol 8 (2) ◽  
pp. 70-75
Author(s):  
Elfy Syahreni

AbstrakKejang adalah perilaku yang tidak terkontrol yang sering ditemukan pada neonatus. Kejang yang terjadi pada neonatus dapat mengakibatkan kerusakan otak permanen. Penyebab kejang pada neonatus sangat bervariasi di antaranya adalah hypoxic-ischaemic encehepalophaty (HIE), infeksi susunan saraf pusat, perdarahan intrakranial, dan gangguan metabolisme. Pengkajian terhadap tanda dan gejala kejang serta faktor pencetus kejang sangat penting dalam pemberian intervensi keperawatan yang tepat pada neonatus. Dampak lanjut dari kejang pada neonatus dapat menimbulkan kematian dan gejala sisa. Mengingat dampak tersebut, penatalaksanaan perawatan terkini dan berkualitas menjadi bagian penting untuk neonatus penderita kejang. AbstractSeizure is a clinical syndrome characterized by an uncontrolled behavior in neonate. The main cause of seizure in neonate is HIE, central nervous system infection, intracranial hemorrhage, and metabolic disturbance. Seizure will lead to permanent brain damage. Identified sign, symptom and risk factor of seizure are very important in order to provide an accurate nursing management in neonate. Further negative impact of seizure is sequel or death. Considering the facts above, it is necessary to provide the latest nursing care and a high quality of care to neonate who is experiencing seizure.

2018 ◽  
Vol 97 (5) ◽  
pp. 461-469
Author(s):  
I. G. Zhdanova-Zaplesvichko ◽  
Marina A. Zemlyanova ◽  
Yu. V. Koldibekova

Introduction. The priority indicator of the influence of chemical factors of the environment on the health of the population of Russia is the pollution of atmospheric air, the composition of which is largely determined by regional features of production. Material and methods. A comparative hygienic assessment of the quality of the atmospheric air of the territory with the placement of aluminum production and the territory without similar sources of emissions was conducted; a chemical-analytical and clinical laboratory examination of 135 children was carried out, with an assessment of the negative effects from the nervous system in the case of aerogenic exposure to aluminum and manganese. Results. In the conditions of the existing quality of atmospheric air in the residential area in the zone of influence of aluminum production which forms an aerogenic exposure of substances (aluminum and manganese), possessing of the unidirectional negative impact on the central nervous system, at the level of 0.0015g/(kg∙day) the share of aluminum is 93.3%, which indicates its primary impact on the population. Children of the observation group 1 showed urine aluminum content by 3.1 times more than in comparison to observation subgroup 2 and 6.9 times in relation to the comparison group (p = 0.0001). The concentration of aluminum as a marker of inhalation exposure is substantiated, and its value more than 0.053 mg/dm3 in urine may indicate an increased risk of neurotoxic exposure. An increased prevalence (1.6-5.5 times) of the negative impact on the CNS in the form of the asthenic autonomous syndrome, as a predictor of attention deficit and hyperactivity disorder, has been shown to be associated with the aerogenic exposure to aluminum. In children with an elevated aluminum content in urine comparing to the reference level, revealed laboratory abnormalities and indices were proved to be associated with an elevated concentration of aluminum in the urine relative to the children of the comparison group: an increase in the level of neuron-specific enolase in the serum indicating an increase in the activity of damage to the blood-brain barrier; an increase in the glutamic acid content by 1.3 times, characterizing the imbalance of the neurotransmitters of the central nervous system; reduction in serum phosphorus, reflecting the antagonistic effect of aluminum, followed by an increase in the level of ionized calcium in the blood. The contribution of aluminum to the biochemical and functional indices deviation from the physiological norm accounted for from 10% to 58%. On the basis of a consistent chain of reliable dependencies, a complex of biomarkers of the asthenic autonomous syndrome and attention deficit and hyperactivity disorder associated with an elevated aluminum content in urine, including glutamic acid, neuron-specific enolase, and phosphorus is substantiated.


This chapter looks at tumours of the central nervous system (CNS), covering their classification and treatment and moving on to examining the nursing care of these individuals. The primary treatment modality is surgery, supported by radiotherapy and chemotherapy, although outcomes of treatment can be very poor. Because of this, and the high levels of physical and mental disability caused by CNS tumours, this patient group can present real challenges in terms of nursing care. The management of cerebral oedema is addressed, alongside the importance of a multidisciplinary approach to the care of these complex patients. As well as primary brain tumours, the much more common presentation of brain metastases is discussed within the chapter, and a brief outline of nursing management of patients with brain metastases and the challenges faced is given.


2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii438-iii438
Author(s):  
Kathleen Dorris ◽  
Jessica Channell ◽  
Ashley Mettetal ◽  
Molly Hemenway ◽  
Natalie Briones ◽  
...  

Abstract BACKGROUND Cannabinoids, including cannabidiol (CBD) and tetrahydrocannabinol (THC), are a class of compounds found in marijuana. Numerous studies in adults have examined cannabinoid use in management of cancer-related symptoms such as nausea, anorexia, and pain. Less is known about the use in the pediatric oncology population. METHODS A prospective observational study has been ongoing since 2016 at Children’s Hospital Colorado to evaluate cannabinoids’ impact using PedsQL™ modules on quality of life of pediatric patients with central nervous system (CNS) tumors who are 2–18 years old. Laboratory assessments of T-cell activity and pharmacokinetics of CBD, THC and associated metabolites are in process. Diaries with exploratory information on cannabinoid use patterns are being collected. RESULTS Thirty-three patients (14:19; male:female) have been enrolled with a median age of 6.4 years (range, 2.9–17.7 years). The most common tumor type in enrolled patients is embryonal tumors (13/33; 39%). Nine (27%) patients have low-grade glial/glioneuronal tumors, and eight (24%) had high-grade/diffuse midline gliomas. The remaining patients had ependymoma or craniopharyngioma. The median time on cannabinoids is 9 months. Most (n=20) patients have used oral products with CBD and THC. One patient continues on cannabinoid therapy in follow up. Preliminary immune function analyses identified impaired neutrophil superoxide anion production and chemotaxis in patients taking cannabinoids at early time points on therapy. CONCLUSIONS Families of children with various CNS tumors are pursuing cannabinoid therapy for both antitumor and supportive care purposes. Analysis of the impact of cannabinoids on patients’ quality of life is ongoing.


IDCases ◽  
2021 ◽  
Vol 23 ◽  
pp. e01016
Author(s):  
Ruixue Sun ◽  
Hui Zhang ◽  
Yingchun Xu ◽  
Huadong Zhu ◽  
Xuezhong Yu ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Canyang Zhan ◽  
Lihua Chen ◽  
Lingling Hu

Abstract Background Neonatal meningitis is a severe infectious disease of the central nervous system with high morbidity and mortality. Ureaplasma parvum is extremely rare in neonatal central nervous system infection. Case presentation We herein report a case of U. parvum meningitis in a full-term neonate who presented with fever and seizure complicated with subdural hematoma. After hematoma evacuation, the seizure disappeared, though the fever remained. Cerebrospinal fluid (CSF) analysis showed inflammation with CSF pleocytosis (1135–1319 leukocytes/μl, mainly lymphocytes), elevated CSF protein levels (1.36–2.259 g/l) and decreased CSF glucose (0.45–1.21 mmol/l). However, no bacterial or viral pathogens in either CSF or blood were detected by routine culture or serology. Additionally, PCR for enteroviruses and herpes simplex virus was negative. Furthermore, the CSF findings did not improve with empirical antibiotics, and the baby experienced repeated fever. Thus, we performed metagenomic next-generation sequencing (mNGS) to identify the etiology of the infection. U. parvum was identified by mNGS in CSF samples and confirmed by culture incubation on mycoplasma identification medium. The patient’s condition improved after treatment with erythromycin for approximately 5 weeks. Conclusions Considering the difficulty of etiological diagnosis in neonatal U. parvum meningitis, mNGS might offer a new strategy for diagnosing neurological infections.


2021 ◽  
Author(s):  
A McCauley Massie ◽  
Jonathan Ebelhar ◽  
Kristen E Allen ◽  
Nicholas P DeGroote ◽  
Karen Wasilewski-Masker ◽  
...  

Abstract Background Children with brain and central nervous system (CNS) tumors experience substantial challenges to their quality of life during their disease course. These challenges are opportunities for increased subspecialty palliative care (PC) involvement. Palliative opportunities have been defined in the pediatric oncology population, but the frequency, timing, and factors associated with palliative opportunities in pediatric patients with CNS tumors are unknown. Methods A single-institution retrospective review was performed on children ages 0-18 diagnosed with a CNS tumor who died between 01/01/2012-11/30/2017. Nine palliative opportunities were defined prior to data collection (progression; relapse; admission for severe symptoms; intensive care admission; bone marrow transplant; phase 1 trial; hospice; do-not-resuscitate (DNR) order). Demographic, disease, treatment, palliative opportunity, and end-of-life data were collected. Opportunities were evaluated over quartiles from diagnosis to death. Results Amongst 101 patients with a median age at death of eight years (Interquartile range, IQR=8.0, range 0-22), there was a median of seven (IQR=6) palliative opportunities per patient, which increased closer to death. PC consultation occurred in 34 (33.7%) patients, at a median of 2.2 months before death, and was associated with having a DNR order (p=0.0028). Hospice was involved for 72 (71.3%) patients. Conclusion Children with CNS tumors suffered repeated events warranting PC yet received PC support only one-third of the time. Mapping palliative opportunities over the cancer course promotes earlier timing of PC consultation which can decrease suffering and resuscitation attempts at the end-of-life.


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