Diagnostic Criteria and Lipid Screening of Dyslipidemia in Children

Obesity is associated with significant morbidities and life-threatening conditions. Evidence shows that obesity in the pediatric population has increased by ten folds recently. This has been attributed to the remarkable recent alternations in socioeconomic factors and the overall increase in the incidence of obesity among the different populations. The pathogenesis of atherosclerosis and cardiovascular diseases is usually initiated in childhood. Previous studies indicates that early identification and proper treatment of dyslipidemia in the pediatric population can significantly reduce the risk of developing cardiovascular diseases and associated morbidities. Therefore, it is vital to screen children's lipid profiles to identify dyslipidemia and apply better interventions. This can significantly reduce the risk of premature cardiovascular diseases and accelerated atherosclerosis. The present study aims to identify the diagnostic criteria and various lipid screening approaches proposed in the literature to identify dyslipidemia in children. Two main approaches for screening dyslipidemia in children were reported. These include universal and selective screening approaches. While the latter is recommended to identify high-risk children, universal screening is also recommended to identify children missed by targeted screening (usually treated by pharmacological modalities).

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Intraorbital Abscess: A Rare Cause of Orbit Compression

FACE ◽

10.1177/27325016211005062 ◽

2021 ◽

pp. 273250162110050

Author(s):

Samuel Ruiz ◽

Rizal Lim

Keyword(s):

Pediatric Population ◽

Rare Complication ◽

Disease Process ◽

Rare Condition ◽

External Drainage ◽

Direct Extension ◽

Life Threatening ◽

History Of ◽

High Index Of Suspicion ◽

Prompt Diagnosis

Introduction: Intraorbital abscess is a rare complication of rhinosinusitis that affects most commonly the pediatric population. It is thought to be caused by direct extension or venous spread of infections from contiguous sites and can lead to life-threatening complications, like permanent visual loss and cerebral abscesses. Objectives: Intraorbital abscess is a rare condition that requires prompt diagnosis and treatment to avoid serious complications. Our objectives are to provide an overview of this rare disease process and its management including our successful treatment experience. Case Description: We present a 2 case report of a 13-year-old pediatric male and a 66-year-old male with history of chronic sinusitis who presented with a right intraorbital abscess successfully treated with external drainage with decompression of the orbit. Conclusion: When intraorbital abscess is encountered, a high index of suspicion is needed to allow prompt and accurate diagnosis for this infrequent condition. Timely surgical drainage of the abscess is needed to prevent the development of fatal complications.

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Impact of new diagnostic criteria for diabetes on different populations

Diabetes Care ◽

10.2337/diacare.22.5.762 ◽

1999 ◽

Vol 22 (5) ◽

pp. 762-766 ◽

Cited By ~ 73

Author(s):

J. E. Shaw ◽

M. de Courten ◽

E. J. Boyko ◽

P. Z. Zimmet

Keyword(s):

Diagnostic Criteria ◽

Different Populations

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Fatal case of toxic epidermal necrolysis induced by ciproflfl oxacin in a child

Our Dermatology Online ◽

10.7241/ourd.2021s1.6 ◽

2021 ◽

Vol 12 (Supp 1) ◽

pp. 26-29

Author(s):

Thomas Schiestel

Keyword(s):

Case Report ◽

Toxic Epidermal Necrolysis ◽

Adverse Reactions ◽

Pediatric Population ◽

Fatal Case ◽

Stevens Johnson Syndrome ◽

Delayed Treatment ◽

Drug Eruptions ◽

Johnson Syndrome ◽

Life Threatening

Bullous drug eruptions such as Toxic Epidermal Necrolysis (TEN) and Stevens-Johnson syndrome (SJS) are rare but known adverse reactions of fluoroquinolones. Although uncommon, TEN can be life-threatening for the patient, especially in the context of delayed treatment and in fragile patients such as the pediatric population. In the present case, TEN occurred in a 13-year-old girl with no medical history following initiation of ciprofloxacin treatment for an inguinal cyst. We hope that the case report will make interrogate the practices concerning the use of antibiotics, in particular fluoroquinolones in the context of an use not prescribed by the Marketing Authorization of the drug in children.

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Neurobiological Impact of EMDR in Cancer

Journal of EMDR Practice and Research ◽

10.1891/1933-3196.10.3.153 ◽

2016 ◽

Vol 10 (3) ◽

pp. 153-161 ◽

Cited By ~ 1

Author(s):

Sara Carletto ◽

Marco Pagani

Keyword(s):

Stress Disorder ◽

Brain Structures ◽

Traumatic Experience ◽

Patients With Cancer ◽

Posttraumatic Symptoms ◽

Clinical Level ◽

Oncological Patients ◽

Oncological Diseases ◽

Life Threatening ◽

Different Populations

The exposure to a life-threatening disease such as cancer may constitute a traumatic experience that in some cases may lead to the development of posttraumatic stress disorder (PTSD). In recent years, several studies investigated this syndrome in patients with cancer, but few focused on the underlying neurobiology. The aim of this work was to review the current literature of neurobiology of PTSD in oncological diseases, focusing on a comparison with the results of neurobiological studies on PTSD in non-oncological patients and on treatments resulted effective for such disorder. Brain structures having a role in the appearance of PTSD in psycho-oncology, and in particular, in intrusive symptoms, seem to be the same involved in non-oncologic PTSD. These findings may have important implications also at clinical level, suggesting that psychotherapies found to be effective to treat PTSD in different populations may be offered also to patients with cancer-induced posttraumatic symptoms. Further studies are needed to deepen our knowledge about cancer-related PTSD neurobiology and its treatment, aiming at transferring the results into clinical practice.

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Efficacy of Zoster Immune Globulin

PEDIATRICS ◽

10.1542/peds.53.4.476 ◽

1974 ◽

Vol 53 (4) ◽

pp. 476-480

Author(s):

Richard G. Judelsohn ◽

Joel D. Meyers ◽

Robert J. Ellis ◽

Elaine K. Thomas

Keyword(s):

High Risk ◽

Disease Control ◽

Immune Globulin ◽

Immune Status ◽

Clinical Symptoms ◽

Normal Children ◽

Therapeutic Modalities ◽

Immunosuppressive Medications ◽

Life Threatening ◽

High Risk Children

Varicella may be a life-threatening infection in children who have immunodeficiency diseases or who are taking immunosuppressive medications. It was previously demonstrated that zoster immune globulin (ZIG) can prevent varicella in normal children if given within 72 hours of exposure, and its possible efficacy has been reported in high-risk immunodeficient children as well. A program for the distribution of ZIG to high-risk susceptibles was established at the Center for Disease Control in 1971. In 1972, 56 high-risk children were treated with ZIG after exposure. Forty-nine recipients had no clinical symptoms of varicella; at least 34 of these 49 had undetectable CF antibody before treatment, though their immune status by other serologic techniques was unknown. In the seven recipients who developed varicella, the disease was not life-threatening. ZIG may be preferable to other available therapeutic modalities in the prevention or modification of varicella.

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Evaluation of the Diagnostic Criteria for Anti-NMDA Receptor Encephalitis in Japanese Children

Neurology ◽

10.1212/wnl.0000000000011789 ◽

2021 ◽

pp. 10.1212/WNL.0000000000011789

Author(s):

Hiroya NISHIDA ◽

Kuniko KOHYAMA ◽

Satoko KUMADA ◽

Jun-ichi TAKANASHI ◽

Akihisa OKUMURA ◽

...

Keyword(s):

Nmda Receptor ◽

Diagnostic Criteria ◽

Predictive Value ◽

False Positive ◽

Pediatric Population ◽

True Positive ◽

Positive Group ◽

Nmdar Encephalitis ◽

Clinical Diagnostic ◽

Clinical Diagnostic Criteria

OBJECTIVE:To evaluate the validity of the 2016 clinical diagnostic criteria proposed for probable anti-NMDA receptor (NMDAR) encephalitis in children, we tested the criteria in a Japanese pediatric cohort.METHODS:We retrospectively reviewed clinical information of patients with neurological symptoms whose CSF were analyzed for NMDAR antibodies (Abs) in our laboratory from January 1, 2015, to March 31, 2019.RESULTS:Overall, 137 cases were included. Of the 41 cases diagnosed as probable anti-NMDAR encephalitis (“criteria-positive”) according to the 2016 criteria, 13 were positive and 28 were negative for anti-NMDAR Abs. Of the 96 criteria-negative cases, three were positive and 93 were negative for anti-NMDAR Abs. The sensitivity of the criteria was 81.2%, specificity was 76.9%, positive predictive value (PPV) was 31.7%, and negative predictive value was 96.9%. Compared with the true-positive group, the false-positive group contained more male than female patients (male:female, 4:9 in the true-positive vs. 19:9 in the false-positive group, p = 0.0425). The majority of the cases with false-positive diagnoses were associated with neurological autoimmunity.CONCLUSION:The clinical diagnostic criteria are reliable for deciding to start immunomodulatory therapy in the criteria-positive cases. Low PPV may be caused by a lower prevalence of NMDAR encephalitis and/or lower level of suspicion for encephalitis in the pediatric population. Physicians should therefore continue differential diagnosis, focusing especially on other forms of encephalitis.Classification of Evidence:This study provides Class IV evidence that the proposed diagnostic criteria for anti-NMDAR encephalitis in children has a sensitivity of 81.2% and a specificity of 76.9%.

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Cholesterol, Children, and Heart Disease: An Analysis of Alternatives

PEDIATRICS ◽

10.1542/peds.68.5.721 ◽

1981 ◽

Vol 68 (5) ◽

pp. 721-730

Author(s):

Donald M. Berwick ◽

Shan Cretin ◽

Emmett Keeler

Keyword(s):

Screening Program ◽

Rank Order ◽

Improve Efficiency ◽

Control Programs ◽

Policy Choices ◽

Targeted Screening ◽

Analysis Of Alternatives ◽

Cholesterol Control ◽

The Cost ◽

High Risk Children

Cost-effectiveness analysis is used to compare proposed cholesterol control programs. The analysis employs estimates of such biologic variables as effect of diet on cholesterol level, stability of level, and change in morbidity with level. Sensitivity analysis identifies the biologic and behavioral uncertainties that most critically affect policy choices. At a discount rate of 5%, a cholesterol-screening program for all 10-year-old children would cost about $10,000 per year of life saved. Rescreening would not improve efficiency. Targeted screening of high-risk children could improve efficiency by 25%, but would benefit only one sixth as many people. Community-wide interventions without screening may be more efficient by a factor of 3. The cost per year of life saved is most affected by the rate of discount and the dollar cost of changing behavior, but is insensitive to stability of cholesterol rank order and to the cost of screening.

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Cardiovascular Disease Prediction Using Data Mining Techniques

Coronary and Cardiothoracic Critical Care ◽

10.4018/978-1-5225-8185-7.ch013 ◽

2019 ◽

pp. 246-264

Author(s):

Kalyani Kadam ◽

Pooja Vinayak Kamat ◽

Amita P. Malav

Keyword(s):

Data Mining ◽

Cardiovascular Disease ◽

Big Data ◽

Cardiovascular Diseases ◽

Primary Objective ◽

Disease Prediction ◽

Data Mining Techniques ◽

Data Architecture ◽

Life Threatening ◽

Using Data

Cardiovascular diseases (CVDs) have turned out to be one of the life-threatening diseases in recent times. The key to effectively managing this is to analyze a huge amount of datasets and effectively mine it to predict and further prevent heart-related diseases. The primary objective of this chapter is to understand and survey various information mining strategies to efficiently determine occurrence of CVDs and also propose a big data architecture for the same. The authors make use of Apache Spark for the implementation.

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Noninvasive Blood Pressure Monitoring and Electrocardiography

The Pediatric Procedural Sedation Handbook ◽

10.1093/med/9780190659110.003.0014 ◽

2018 ◽

pp. 92-97

Author(s):

Melissa Langhan ◽

Seth Wolf

Keyword(s):

Blood Pressure ◽

Blood Pressure Monitoring ◽

Pediatric Population ◽

Noninvasive Blood Pressure ◽

Procedural Sedation And Analgesia ◽

Medication Side Effects ◽

Medication Side ◽

Life Threatening ◽

Sedation And Analgesia

There is a lack of data about the benefits of cardiovascular monitoring with continuous 3-lead electrocardiography (ECG) and intermittent noninvasive cuff blood pressure (BP) during procedural sedation and analgesia (PSA) in the pediatric population. However, these two safe modalities are important for patients during higher levels of PSA because of the risk of rare life-threatening conditions and to help identify possible medication side effects and drug interactions of common sedative medications. These monitoring modalities can also aid in determining the adequacy of sedation. It is generally accepted that a baseline determination of heart rate and BP should be obtained prior to any sedative administration. With deeper levels of sedation and throughout recovery, continuous 3-lead ECG and intermittent BP monitoring are recommended, in addition to other modalities such as pulse oximetry and capnography, to monitor the safety of the patient.

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