Therapeutic Opportunities for Headaches and Migraines in Pediatric Populations: A Review

Headaches, migraine-like episodes, and other associated conditions are increasingly becoming the most frequent occurrence and a threat to the pediatric population in today’s world. It has become the most sought-after therapeutic opportunity in the clinical setting in a way that can help to treat, diagnose and minimize its ill effects or side effects in today’s world which has witnessed all severe forms of diseases and hopefully will witness more severe forms because of the everlasting unhealthy lifestyle and prevalent hypertension which can be maternal or paternal and can affect the newborn as well as all the pediatric age groups in today’s world. Severe forms of Headachin children or pediatric age groups can be a massive challenge for the clinician to identify, diagnose, and provide effective treatment that can be curable in most cases but can be fatal. In pediatric populations, headaches or migraines can result from underlying conditions, pathologies, or effects of maternal and paternal habits or lifestyles that need more attention than the symptom itself. The treatment spectrum ranges from pharmacological interventions to more unconventional options like acupuncture and alternative medicine. All these options are worth considering, as several studies show high efficacy and success rates with each of these conditions and etiology discussed above. In this review, the authors aim to discuss these different therapeutic options and weigh out their pros and cons, which can help in better and effective treatment to control or eliminate this disease.

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Covid-19 Incidence and Mortality by Age Strata and Comorbidities in Mexico City: A Focus in the Pediatric Population

Frontiers in Public Health ◽

10.3389/fpubh.2021.738423 ◽

2021 ◽

Vol 9 ◽

Author(s):

Nadia González-García ◽

María F. Castilla-Peón ◽

Fortino Solórzano Santos ◽

Rodolfo Norberto Jiménez-Juárez ◽

Maria Elena Martínez Bustamante ◽

...

Keyword(s):

Pediatric Population ◽

Age Groups ◽

Population Data ◽

Older Age ◽

Age Group ◽

Education Policies ◽

Infected People ◽

Risk Of Death ◽

Incidence And Mortality ◽

Pediatric Populations

Background: SARS-COV2 appears less frequently and less severely in the pediatric population than in the older age groups. There is a need to precisely estimate the specific risks for each age group to design health and education policies suitable for each population.Objective: This study aimed to describe the risk of death in SARS-COV2 infected subjects by age group and according to the presence of comorbidities.Methods: We analyzed data of confirmed SARS-COV2 infection cases where symptoms began between February 22th, 2020, and April 18th, 2021, as published by the General Epidemiology Direction (DGE) of the Mexican Ministry of Health. We calculated COVID-19 incidence and mortality by age group using population data from the Statistics and Population National Institute (INEGI), and estimated the association between risk of death and the presence of comorbidities.Results: Mortality in SARS-COV2 infected people varied considerably, between 7 and 155 deaths per million per year in the under-20 age groups compared to 441 to 15,929 in the older age groups. Mortality in pediatric populations is strongly associated with comorbidities (OR: 4.6-47.9) compared to the milder association for older age groups (OR: 3.16–1.23).Conclusion: The risk of death from SARS-COV2 infection in children is low and is strongly associated with comorbidities.

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Covid-19 Incidence And Mortality By Age Strata And Comorbidities In Mexico City: A Focus In The Pediatric Population

10.1101/2021.06.21.21259282 ◽

2021 ◽

Author(s):

MARIA FERNANDA CASTILLA PEON ◽

Nadia Gonzalez-Garcia ◽

Fortino Solorzano-Santos ◽

Rodolfo Jimenez Juarez ◽

Maria Elena Martinez Bustamante ◽

...

Keyword(s):

Pediatric Population ◽

Age Groups ◽

Population Data ◽

Older Age ◽

Age Group ◽

Infected People ◽

Risk Of Death ◽

Incidence And Mortality ◽

The Face ◽

Pediatric Populations

Introduction: SARS-COV2 appears less frequently and less severely in the pediatric population than in older age groups. In the face of the urgent need to reactivate activities suspended during the lockdown, mainly those essential for child development, this study aims to describe the risks of death of persons infected with SARS-COV2 by age group and according to the presence of comorbidities. Methodology: We analyzed data of confirmed SARS-COV2 infection cases where symptoms began between February 22th, 2020, and March 31, 2021, as published by the General Epidemiology Direction (DGE) of the Mexican Ministry of Health. We calculated COVID-19 incidence and mortality by age group with population data from the Statistics and Population National Institute (INEGI), estimating the correlation between risk of death and the presence of comorbidities. Results: Mortality in SARS-COV2 infected people varied considerably, between 7 to 155 deaths per million per year in the under-20 age groups compared to 441 to 15929 in the older age groups. Mortality in pediatric populations is strongly associated with comorbidities (OR: 4.6- 47.9) compared to the milder association for older age groups (OR: 3.16-1.23). Conclusions: The risk of death from SARS-COV2 infection in children is low and strongly associated with comorbidities.

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Video Head Impulse Testing in a Pediatric Population: Normative Findings

Journal of the American Academy of Audiology ◽

10.3766/jaaa.17076 ◽

2018 ◽

Vol 29 (05) ◽

pp. 417-426 ◽

Cited By ~ 10

Author(s):

Katheryn Bachmann ◽

Kaitlin Sipos ◽

Violette Lavender ◽

Lisa L. Hunter

Keyword(s):

Pediatric Population ◽

Age Groups ◽

Reliability And Validity ◽

Semicircular Canals ◽

Head Impulse Test ◽

Test Time ◽

Pediatric Age ◽

Adult Group ◽

Cross Sectional ◽

Head Impulse

AbstractThe video head impulse test (vHIT) is a new tool being used in vestibular clinics to assess the function of all six semicircular canals (SCCs) by measuring the gain of the vestibulo-ocular reflex (VOR) in response to rapid head turns. Whereas vHIT has been validated in adults for all SCCs, there are few studies describing the normal response in children, particularly for stimulation of the vertical canals.The purpose of this study was to characterize the normal vHIT response for all six SCCs in children aged 4–12 years.A cross-sectional prospective descriptive study.Forty-one participants were categorized into one of four groups based on their age (4–6 years, 7–9 years, 10–12 years, and adults) with at least ten participants in each age group.The ICS Impulse system (GN Otometrics, Schaumburg, IL) was used to perform vHIT on each participant. Lateral, anterior, and posterior SCCs were stimulated by thrusting the head in the plane of the canal being evaluated and resulting VOR gain measures were calculated as eye velocity divided by head velocity. VOR gain of the pediatric age groups was compared with adults for all SCCs.There were no significant differences in mean VOR gain between the three pediatric age groups for any SCC measured; thus, the pediatric data were combined into one group of 30 children for comparison with the adult group. Results showed that the pediatric group had significantly higher mean VOR gain than the adult group during left lateral SCC testing. A significantly lower mean VOR gain, however, was observed for the children compared with the adult participants for left anterior and right posterior (LARP) impulses. There was a large amount of variability in the data during right anterior and left posterior (RALP) impulse testing for both the pediatric and the adult groups, which was at least partially attributed to large pupil diameter in the younger participants. Test time decreased with an increase in age for all impulse conditions (lateral, RALP, and LARP). Several modifications were necessary to obtain adequate data on the pediatric participants.vHIT can be used to successfully measure the function of the lateral SCC in children as young as 4 years of age. Our results provide normative gain values that can be used when testing children with lateral vHIT. Care must be taken to obtain the most accurate measures and reduce variability when testing children, particularly with LARP and RALP. Our data would suggest that lower gain cutoffs should be used for LARP and RALP testing in children than the cutoffs used for lateral vHIT. Further research is warranted to study LARP and RALP response reliability and validity in children because of the highly variable VOR gains found in this population. Pediatric modifications for successfully administering vHIT and obtaining reliable results are discussed.

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Prevalence of Unique Pediatric Pathologies Encountered by Paramedic Students Across Age Groups

Prehospital and Disaster Medicine ◽

10.1017/s1049023x1600056x ◽

2016 ◽

Vol 31 (4) ◽

pp. 386-391 ◽

Cited By ~ 2

Author(s):

Eric V. Ernest ◽

Tom B. Brazelton ◽

Elliot D. Carhart ◽

Jonathan R. Studnek ◽

Patricia L. Tritt ◽

...

Keyword(s):

Abdominal Pain ◽

Pediatric Patients ◽

Pediatric Population ◽

Saint Paul ◽

Age Groups ◽

Age Group ◽

Pediatric Age ◽

Provider Education ◽

Publication Type ◽

One Year

AbstractIntroductionTraditionally, Emergency Medical Services (EMS) educators have divided the pediatric population into age groups to assist in targeting their clinical and didactic curriculum. Currently, the accrediting body for paramedic training programs requires student exposure to pediatric patients based entirely on age without specifying exposure to specific pathologies within each age stratification. Identifying which pathologies are most common within the different pediatric age groups would allow educators to design curriculum targeting the most prevalent pathologies in each age group and incorporating the physiologic and psychological developmental milestones commonly seen at that age.HypothesisIt was hypothesized that there are unique clusterings of pathologies, represented by paramedic student primary impressions, that are found in different age groups which can be used to target provider education.MethodsThis is a retrospective review of prospectively collected data documented by paramedic students in the Fisdap (Field Internship Student Data Acquisition Project; Saint Paul, Minnesota USA) database over a one-year period. For the purposes of this study, pediatric patients were defined arbitrarily as those between the ages of 0-16 years. All paramedic student primary impressions recorded in Fisdap for patients aged 0-16 years were abstracted. Primary impression by age was calculated and graphed. The frequency of primary impression was then assessed for significance of trend by age with an alpha ≤.05 considered significant.ResultsThe following primary impressions showed clinically and statistically significant variability in prevalence among different pediatric age groups: respiratory distress, medical-other, abdominal pain, seizure, overdose/poisoning, behavioral, and cardiac. In patients less than 13 years old, respiratory and other-medical were the most common two primary impressions and both decreased with age. In patients 5-16 years old, the prevalence of abdominal pain and behavioral/psych increased. Bimodal distributions for overdose were seen with one spike in the toddler and another in the adolescent population. Seizures were most common in the age group associated with febrile seizure. Sepsis was seen most often in the youngest patients and its prevalence decreased with age.ConclusionThere are statistically significant variations in the frequency of paramedic student primary impressions as a function of age in the pediatric population. Emphasizing paramedic student exposure to the most common pathologies encountered in each age group, in the context of the psychological and physiological milestones of each age, may improve paramedic student pediatric practice.ErnestEV, BrazeltonTB, CarhartED, StudnekJR, TrittPL, PhilipGA, BurnettAM. Prevalence of unique pediatric pathologies encountered by paramedic students across age groups. Prehosp Disaster Med. 2016; 31(4):386–391.

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Intramedullary spinal cord cavernous malformations in the pediatric population

Surgical Neurology International ◽

10.25259/sni_494_2020 ◽

2020 ◽

Vol 11 ◽

pp. 275

Author(s):

Brian Fiani ◽

Taylor Reardon ◽

Ryne Jenkins ◽

Claudia Covarrubias ◽

Manraj Sekhon ◽

...

Keyword(s):

Spinal Cord ◽

Vascular Malformations ◽

Pediatric Population ◽

Age Groups ◽

Single Layer ◽

Neurological Status ◽

Outcome Data ◽

Pediatric Age ◽

Intramedullary Spinal Cord ◽

Cavernous Malformations

Background: Intramedullary spinal cavernous malformations (ISCM) account for just 1% of all intramedullary pediatric spinal cord lesions. Pathologically, they are well-circumscribed vascular malformations that typically appear dark blue or reddish-brown, often coming to the spinal cord surface. With regard to the histopathology findings, ISCMs are comprised sinusoidal vascular spaces lined by a single layer of endothelial cells within a loose connective tissue stroma. As these lesions are often misdiagnosed in the pediatric population, appropriate treatment may be unduly delayed. Methods: The authors performed an extensive review of the published literature (PubMed) focusing on ISCM in the pediatric age group. Results: The search yielded 17 articles exclusively pertaining to ISCM affecting the pediatric population. Conclusion: Here, we reviewed the clinical, radiographic, surgical, and outcome data for the treatment of ISCM in the pediatric age groups. Notably, over 50% of pediatric patients with ISCM experienced an improvement in their neurological status after a mean postoperative follow-up duration of 4 years. Future meta-analyses are needed to highlight the potential presence of ISCM and, thereby, decrease the rate of misdiagnosis of these lesions in the pediatric population presenting with recurrent intramedullary spinal cord hemorrhages.

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Foreign Body in the Esophagus-Comparison Between Adult and Pediatric Population

Nepal Journal of Medical Sciences ◽

10.3126/njms.v1i1.5797 ◽

1970 ◽

Vol 1 (1) ◽

pp. 42-44 ◽

Cited By ~ 1

Author(s):

K Koirala ◽

S Rai ◽

S Chhetri ◽

R Shah

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Pediatric Population ◽

Age Groups ◽

Rigid Bronchoscopy ◽

Medical Sciences ◽

Relative Ease ◽

Case File ◽

Rigid Esophagoscopy ◽

Pediatric Populations

Background: Foreign body (FB) impaction in the esophagus is a common emergency in all age groups. In the children coins are the commonest foreign bodies while bones have been found as the commonest in adults. Methods: This is a retrospective study comparing FB in the esophagus in adult and pediatric population between June 2007 and May 2010 in Manipal Teaching Hospital, Pokhara, Nepal. Most of the patients underwent rigid esophagoscopy and FB removal; few were removed under anesthesia by the anesthesiologists. Comparison was done in terms of pattern of FB, their site of impaction and relative ease of removal. Data were collected from the case file available from the medical record department and analysed using SPSS 11.6. Results: A total of 63 cases were included in this study. Out of which 28 (44.4%) patients were children and 35 (55.5%) were adults. Coin was the most common foreign body in the pediatric population (82.1%) whereas bones were the commonest ones (91.4%) in adults. In the pediatric population the commonest site of impaction was upper esophagus (92.8%) whereas mid esophagus was the commonest site (65.7%) in adults. Conclusion:There are differences in various aspects of impacted foreign bodies in esophagus in adult and pediatric populations. Coins being the commonest foreign bodies in children are relatively easier to remove due to their higher location and less chances of trauma. Contrary in the adults, bones being the commonest foreign body are difficult to remove due to the lower location and chances of trauma. Keywords: Foreign body; esophagus; rigid bronchoscopy DOI: http://dx.doi.org/10.3126/njms.v1i1.5797 Nepal Journal of Medical Sciences. 2012; 1(1): 42-44

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Antibiotic Resistance in Pediatric Infections: Global Emerging Threats, Predicting the Near Future

Antibiotics ◽

10.3390/antibiotics10040393 ◽

2021 ◽

Vol 10 (4) ◽

pp. 393

Author(s):

Alessandra Romandini ◽

Arianna Pani ◽

Paolo Andrea Schenardi ◽

Giulia Angela Carla Pattarino ◽

Costantino De Giacomo ◽

...

Keyword(s):

Antibiotic Resistance ◽

Pediatric Population ◽

Multidrug Resistant ◽

Resistant Bacteria ◽

Pediatric Age ◽

Carbapenem Resistant ◽

Pediatric Infections ◽

Surgical Treatments ◽

Developing System ◽

Near Future

Antibiotic resistance is a public health threat of the utmost importance, especially when it comes to children: according to WHO data, infections caused by multidrug resistant bacteria produce 700,000 deaths across all ages, of which around 200,000 are newborns. This surging issue has multipronged roots that are specific to the pediatric age. For instance, the problematic overuse and misuse of antibiotics (for wrong diagnoses and indications, or at wrong dosage) is also fueled by the lack of pediatric-specific data and trials. The ever-evolving nature of this age group also poses another issue: the partly age-dependent changes of a developing system of cytochromes determine a rather diverse population in terms of biochemical characteristics and pharmacokinetics profiles, hard to easily codify in an age- or weight-dependent dosage. The pediatric population is also penalized by the contraindications of tetracyclines and fluoroquinolones, and by congenital malformations which often require repeated hospitalizations and pharmacological and surgical treatments from a very young age. Emerging threats for the pediatric age are MRSA, VRSA, ESBL-producing Enterobacteriaceae, carbapenem-resistant Enterobacteriaceae and the alarming colistin resistance. Urgent actions need to be taken in order to step back from a now likely post-antibiotic era, where simple infections might cause infant death once again.

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Gynecologic Malignancies in Children and Adolescents: How Common is the Uncommon?

Journal of Clinical Medicine ◽

10.3390/jcm10040722 ◽

2021 ◽

Vol 10 (4) ◽

pp. 722

Author(s):

Christoph Wohlmuth ◽

Iris Wohlmuth-Wieser

Keyword(s):

Pediatric Population ◽

Age Groups ◽

Germ Cell Tumors ◽

Population Based ◽

Prognostic Indicators ◽

Gynecologic Malignancies ◽

Kaplan Meier ◽

Disease Stages ◽

Malignant Germ Cell Tumors ◽

Vaginal Neoplasms

The aim of this study is to assess the projected incidence and prognostic indicators of gynecologic malignancies in the pediatric population. In this population-based retrospective cohort study, girls ≤18 years with ovarian, uterine, cervical, vaginal and vulvar malignancies diagnosed between 2000 and 2016 were identified from the Surveillance, Epidemiology and End Results (SEER)-18 registry. The Kaplan–Meier method was used to analyze overall survival (OS). The age-adjusted annual incidence of gynecologic malignancies was 6.7 per 1,000,000 females, with neoplasms of the ovary accounting for 87.5%, vagina 4.5%, cervix 3.9%, uterus 2.5% and vulva 1.6% of all gynecologic malignancies. Malignant germ-cell tumors represented the most common ovarian neoplasm, with an increased incidence in children from 5–18 years. Although certain subtypes were associated with advanced disease stages, the 10-year OS rate was 96.0%. Sarcomas accounted for the majority of vaginal, cervical, uterine and vulvar malignancies. The majority of vaginal neoplasms were observed in girls between 0–4 years, and the 10-year OS rate was 86.1%. Overall, gynecologic malignancies accounted for 4.2% of all malignancies in girls aged 0–18 years and the histologic subtypes and prognosis differed significantly from patients in older age groups.

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The Accuracy of Broselow Tape Weight Estimate among Pediatric Population

BioMed Research International ◽

10.1155/2016/7042947 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 8

Author(s):

Turki M. AlHarbi ◽

Abdullaziz AlGarni ◽

Fasial AlGamdi ◽

Mona Jawish ◽

Tariq Ahmad Wani ◽

...

Keyword(s):

Body Weight ◽

Pediatric Population ◽

Body Height ◽

Age Groups ◽

Cross Sectional Study ◽

The Body ◽

Accurate Estimation ◽

Cross Sectional ◽

Actual Weight ◽

Medical City

Objective.To determine the accuracy of the Broselow Tape (BT) versions 2007 and 2011 in estimating weight among pediatric population.Methods.A cross-sectional study was conducted at King Fahad Medical City and six schools across Riyadh province on 1–143-month-old children. BT 2007 and 2011 estimated weights were recorded. Both tapes via the child’s height produce an estimated weight, which was compared with the actual weight.Results.A total of 3537 children were recruited. The height (cm) of the subjects was97.7±24.1and the actual weight (kg) was16.07±8.9, whereas the estimated weight determined by BT 2007 was15.87±7.56and by BT 2011 was16.38±7.95. Across all the five age groups, correlation between actual weight and BT 2007 ranged between 0.702 and 0.788, while correlation between actual weight and BT 2011 ranged between 0.698 and 0.788. Correlation between BT 2007 and BT 2011 across all the five age groups ranged from 0.979 to 0.989. Accuracy of both the tape versions was adversely affected when age was >95 months and body weight was >26 kilograms.Conclusions.Our study showed that BT 2007 and 2011 provided accurate estimation of the body weight based on measured body height. However, 2011 version provided more precise estimate for weight.

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The Safety and Efficacy Evaluation of Dexmedetomidine for Procedural Sedation and Postoperative Behaviors in Pediatric Populations: A Systematic Review and Meta-analysis

Annals of Pharmacotherapy ◽

10.1177/10600280211009845 ◽

2021 ◽

pp. 106002802110098

Author(s):

Linguang Gan ◽

Xiaohong Zhao ◽

Xiangjian Chen

Keyword(s):

Pediatric Population ◽

Meta Analysis ◽

Procedural Sedation ◽

Cochrane Library ◽

Control Group ◽

High Dose ◽

Efficacy Evaluation ◽

Safety And Efficacy ◽

Ovid Medline ◽

Pediatric Populations

Background: This study systematically evaluated the safety and efficacy of dexmedetomidine for procedural sedation and postoperative behaviors in a pediatric population as well as whether the results met the information required to draw conclusions. Objective: To evaluate the safety and efficacy evaluation of dexmedetomidine for procedural sedation and postoperative behaviors in a pediatric population. Methods: PubMed, Cochrane library, Web of Science and Ovid MEDLINE were searched to obtain randomized controlled trials (RCTs) comparing dexmedetomidine with control medicine and comparing different doses of dexmedetomidine. Results: There were a total of 16 RCTs for a total of 3240 patients. Dexmedetomidine slowed down the heart rate (HR; mean difference: −13.27; 95% CI: −16.41 to 10.14; P < 0.001) and reduced postoperative delirium (risk ratio [RR]: 0.31; 95% CI: 0.20-0.50; P < 0.001), the number of pain patients (RR: 0.48; 95% CI: 0.30-0.75; P = 0.002), and desaturation (RR: 0.34; 95% CI: 0.13-0.89; P = 0.03) compared with the control group. The limitation was that it was difficult to determine the range of low- and high-dose dexmedetomidine. Conclusion and Relevance: Dexmedetomidine slowed down intraoperative HR within the normal range, which might reduce myocardial oxygen consumption. It reduced postoperative pain and postoperative complications: delirium and desaturation. Dexmedetomidine showed no dose-dependent increase in the procedural sedation time of pediatric patients. Clinically, dexmedetomidine can improve pediatric procedural sedation and postoperative behavior, and it can be considered as a related medicine for safety in pediatric surgery.

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