BACKGROUND Anti-contactin-associated protein-like 2(CASPR2)antibody encephalitis is an autoimmune disorder characterized by the presence of antibodies against the voltage-gated potassium channel.This leads to neurolog...BACKGROUND Anti-contactin-associated protein-like 2(CASPR2)antibody encephalitis is an autoimmune disorder characterized by the presence of antibodies against the voltage-gated potassium channel.This leads to neurological symptoms,such as seizures,cognitive decline,and neuropathic pain,primarily affecting the limbic system.The prognosis of this disorder varies among individuals.CASE SUMMARY The patient,a girl aged nine years and nine months,underwent treatment for 14 to 21 d.The main clinical manifestations were vomiting and unclear consciousness,positive pathological signs,normal cranial computed tomography and magnetic resonance imaging,and abnormal electroencephalogram.The child was discharged after receiving immunoglobulin and hormone treatment.Subsequent follow-up over a period of 15 months after discharge,conducted through telephone and outpatient visits,showed no recurrence of symptoms.CONCLUSION Anti-CASPR2 antibody autoimmune encephalitis in children is rare,mainly manifested as convulsions,mental abnormalities,cognitive impairment,and neuropathic pain,among others.Timely evaluation for autoimmune encephalitis antibodies is crucial,especially in cases of recurrent central nervous system involvement in children.展开更多
Objective:To explore and analyze the effectiveness of targeted nursing in children with severe viral encephalitis complicated with respiratory failure.Methods:From April 2021 to April 2023,74 children with severe vira...Objective:To explore and analyze the effectiveness of targeted nursing in children with severe viral encephalitis complicated with respiratory failure.Methods:From April 2021 to April 2023,74 children with severe viral encephalitis complicated with respiratory failure admitted to the Department of Pediatrics of our hospital were selected as the research objects and divided into the target group(n=37)and the reference group(n=37).Targeted nursing was given to the target group,while general nursing was given to the reference group.Physical rehabilitation,motor scores,and lung function were compared between the groups.Results:The recovery time of limb abnormalities,convulsions,abnormal consciousness,and cranial nerve disorders in the target group was significantly better than that in the reference group(P<0.05).The motor function,joint activity and pain,sensory function,and total score of the target group were significantly lower than those of the reference group(P<0.05).After the intervention,lung function indicators including VC(vital capacity),FVC(forced vital capacity),and MVV(maximum voluntary ventilation)of the target group were better than those of the reference group(P<0.05).Conclusion:Targeted nursing can shorten the recovery period of severe viral encephalitis complicated with respiratory failure in children,speed up the recovery of motor function,and improve lung function.This nursing model has a significant application effect in children with severe viral encephalitis complicated with respiratory failure.展开更多
Autoimmune encephalitis is a poorly understood condition that can present with a combination of neurological and psychiatric symptoms, either of which may predominate. There are many autoantibodies associated with a v...Autoimmune encephalitis is a poorly understood condition that can present with a combination of neurological and psychiatric symptoms, either of which may predominate. There are many autoantibodies associated with a variety of clinical syndromes-anti-N-Methyl-D-Aspartate receptor(NMDAR) is the commonest. Currently, the most widely used therapy is prompt plasmapheresis and steroid treatment(and tumour resection if indicated), followed by second line immunosuppression if this fails. Given the growing awareness of autoimmune encephalitis as an entity, it is increasingly important that we consider it as a potential diagnosis in order to provide timely, effective treatment. We discuss several previously published case reports and one new case. These reports examined the effects of electroconvulsive therapy(ECT) on patients with autoimmune encephalitis, particularly those in whom psychiatric symptoms are especially debilitating and refractory to standard treatment. We also discuss factors predicting good outcome and possible mechanisms by which ECT may be effective. Numerous cases, such as those presented by Wingfield, Tsutsui, Florance, Sansing, Braakman and Matsumoto, demonstrate effective use of ECT in anti-NMDAR encephalitis patients with severe psychiatric symptoms such as catatonia, psychosis, narcolepsy and stupor who had failed to respond to standard treatments alone. We also present a new case of a 71-year-old female who presented to a psychiatric unit initially with depression, which escalated to catatonia, delusions, nihilism and auditory hallucinations. After anti-NMDAR antibodies were isolated, she was treated by the neurology team with plasmapheresis and steroids, with a partial response. She received multiple sessions of ECT and her psychiatric symptoms completely resolved and she returned to her premorbid state. For this reason, we suggest that ECT should be considered, particularly in those patients who are non-responders to standard therapies.展开更多
BACKGROUND Sensory integration intervention is highly related to the child's effective interaction with the environment and the child's development.Currently,various sensory integration interventions are being...BACKGROUND Sensory integration intervention is highly related to the child's effective interaction with the environment and the child's development.Currently,various sensory integration interventions are being applied,but research methodological problems are arising due to unsystematic protocols.This study aims to present the optimal intervention protocol by presenting scientific standards for sensory integration intervention through meta-analysis.AIM To prove the effectiveness of sensory integration therapy,examine the latest trend of sensory integration studies in Korea,and provide clinical evidence for sensory integration therapies.METHODS The database of Korean search engines,including RISS,KISS,and DBpia,was used to search for related literature published from 2001 to October 2020.The keywords,“Children”,“Sensory integration”,“Integrated sensory”,“Sensorymotor”,and“Sensory stimulation”were used in this search.Then,a meta-analysis was conducted on 24 selected studiesRISS,KISS,and DBpia,was used to search for related literature published from 2001 to October 2020.The keywords,“Children”,“Sensory integration”,“Integrated sensory”,“Sensorymotor”,and“Sensory stimulation”were used in this search.Then,a meta-analysis was conducted on 24 selected studies.RESULTS Sensory integration intervention has been proven effective in children with cerebral palsy,autism spectrum disorder,attention deficit/hyperactivity disorder,developmental disorder,and intellectual disability in relation to the diagnosis of children.Regarding sensory integration therapies,1:1 individual treatment with a therapist or a therapy session lasting for 40 min was most effective.In terms of dependent variables,sensory integration therapy effectively promoted social skills,adaptive behavior,sensory processing,and gross motor and fine motor skills.CONCLUSION The results of this study may be used as therapeutic evidence for sensory integration intervention in the clinical field of occupational therapy for children,and can help to present standards for sensory integration intervention protocols.展开更多
Research motivation:Through the 12 weeks dance therapy intervention for children with autism,the purpose is to explore the intervention model of dance therapy for children with autism and the changes in motor ability,...Research motivation:Through the 12 weeks dance therapy intervention for children with autism,the purpose is to explore the intervention model of dance therapy for children with autism and the changes in motor ability,social ability,and communication ability of children with autism after dance therapy intervention.The results of the research are expected to expand the intervention mode of dance therapy in my country and provide practical reference for rehabilitation intervention of children with autism.Research methods:24 autistic boys aged 6 to 12 with mild to moderate symptoms were recruited and screened through the Internet as the subjects of this study.We randomly divided them into experimental group(N=12)and control group(N=12).All children with autism have an autism diagnosis certificate issued by Children’s Hospital or a tertiary hospital,excluding other mental diseases(such as epilepsy,major physical disability,mental illness,no history of drugs and other interventions,etc.).We used the paired sample t-test to compare the score difference between the dance treatment group and the control group before and after the two groups,and used the observation method to record the basic communication behavior and the number of active communication behaviors in the experimental group during the intervention process.All data analysis is used in SPSS 20.0.Research results:After 12 weeks of dance therapy intervention,there were statistically significant differences in the gross movement,balance,and coordination abilities of the children in the experimental group compared with those before the intervention(p<0.01).There was no significant difference between the children in the control group(p>0.05).After 12 weeks of dance therapy intervention,there were statistically significant differences in the scores of the social response scale for children with autism in the experimental group(p<0.05).There was no significant change in the scores of each item of the SRS scale before and after intervention in the control group and the dance treatment group(p>0.05).展开更多
Objective: To investigate the effect of VOJTA therapy on gross motor function in children with cerebral palsy. Methods: The 86 children with cerebral palsy were all from the First People’s Hospital of Jingzhou City f...Objective: To investigate the effect of VOJTA therapy on gross motor function in children with cerebral palsy. Methods: The 86 children with cerebral palsy were all from the First People’s Hospital of Jingzhou City from January 2023-December 2023, and were divided into the control group and the study group with 43 cases according to the principle of voluntariness. Results: In terms of total effective rate of treatment, the gross motor function scale-88 (GMFM-88) was used to evaluate the effective rate before and after treatment, and the effective rate of the study group was higher than that of the control group, and the difference was statistically significant, and the scores of gross motor items of GMFM-88 were better than those of the control group after treatment, and the difference was statistically significant (P 0.05). Conclusion: The application of VOJTA therapy in the treatment of children with cerebral palsy can not only promote the rehabilitation of gross motor function, but also help to improve the treatment effect, and the earlier the treatment, the better.展开更多
Objective: To evaluate the therapeutic efficacy of atomoxetine hydrochloride (ATX) combined with psychological-behavioral modification therapy for attention-deficit/hyperactivity disorder (ADHD) in children. Methods: ...Objective: To evaluate the therapeutic efficacy of atomoxetine hydrochloride (ATX) combined with psychological-behavioral modification therapy for attention-deficit/hyperactivity disorder (ADHD) in children. Methods: A total of 60 cases of ADHD children admitted to our hospital between November 2021 and November 2022 were selected and randomly grouped into Group I and Group II. There were 30 cases in Group I who were treated with ATX combined with psychological-behavioral modification therapy. There were 30 cases in Group II who were treated with ATX monotherapy, and the therapeutic effects were compared. Results: Before treatment, there was no difference in the behavioral problem scores and cognitive function indexes of the two groups (P>0.05). After treatment, the behavioral problem scores of Group I were lower than those of Group II, and the cognitive function indicators of Group I were lower than those of Group II (P < 0.05). The adverse reaction rate of Group I was lower than that of Group II, and the total effective rate was higher than that of Group II (P < 0.05). Conclusion: ATX combined with psychological-behavioral modification therapy improved the behavioral problems of ADHD children, enhanced their cognitive function, and reduced the adverse reactions to drug treatment.展开更多
BACKGROUND: Traditional subhibernation therapy may easily cause complications, such as respiratory depression and hyportension because of application of chlorpromazine hydrochloride and promethazine in a large dosage...BACKGROUND: Traditional subhibernation therapy may easily cause complications, such as respiratory depression and hyportension because of application of chlorpromazine hydrochloride and promethazine in a large dosage. OBJECTIVE: To observe therapeutic effect of modified subhibernation therapy (alterative application of five anticonvulsants according to the half life) on status epilepticus in children with severe viral encephalitis (VE). DESIGN: Contrast observation. SETTING: Department of Pediatrics, the First Hospital of Jilin University. PARTICIPANTS: The participants in present study were 96 patients with severe viral encephalitis including 52 boys and 44 girls who received treatment in the Department of Pediatrics, the First Hospital of Jilin University from February 2000 to March 2006. All children met the diagnostic criteria of Zhufutong Practice Pediatrics (the seventh edition). Two weeks ago, they ever got upper respiratory infection or enteronitis and so on before the onset, spirit abnormal, behavior disorder, limbs act disorder, vomit, headache, convulsion, nervous system masculine signs such as limbs act disord, autonomic nerve damage manifestation, brain nerve palsy, dysreflexia, meningeal irritation sign, cerebrospinal fluid and electroencephalography (EEG) abnormity. All parents provided the confirmed consent. The patients were randomly divided into control group (n =40) and experimental group (n =56). METHODS: Patients in the control group received anticonvulsion, ice compress and routine treatment. The convulsion was treated with five drugs: 0.5 mg/kg wintermin and phenergan, respectively, 100 g/L chlorpromazine hydrochloride (0.5 mL/kg), 5 mg/kg luminal, 0.3 mg/kg ansiolin. When convulsion attacked, those five drugs were given alternatively; however, those were not given if the convulsion did not attack. Children in the experimental group were treated with improved subhibernation therapy based on routine treatment. The dosages of anticonvulsants were as the same as those in the control group. Based on the half life, every drug was alternated every 4-6 hours. In addition, anticonvulsants administrated for 2 successive days whether tic attacked or not. Then the hypnotic was removed gradually. MAIN OUTCOME MEASURES: Therapeutic efficacy, time of disappeared clinical symptoms and physical sign, and security of administration. RESULTS: All the 96 patients were involved in the final analysis. ① Total effective rate and reliability: Total effective rate was higher in the treatment groups than the control group (χ2=5.871 7, P 〈 0.05). All patients did not have respiratory depression and side effects. ② Time of disappeared clinical symptoms and physical sign: Recovery time of convulsion, fever, headache and vomit was shorter in the treatment group than that in the control group, and there was significant difference (t =17.612 1-34.330 7, P 〈 0.05); in addition, symptoms of status epilepticus were relieved obviously. Meanwhile, recovery time of paralysis, coma and anepia was shorter in the treatment group than that in the control group, and there was significant difference (t =10.660 8-24.700 8, P 〈 0.05). CONCLUSION: Therapeutic effect of improved subhibernation therapy on status epilepticus induced by severe viral encephalitis is positively and safer.展开更多
Objective:To report the neurologic prognosis and autoimmune complications of 16 cases of childhood herpes simplex virus encephalitis.Methods:The study was conducted atŞanlıurfa Training and Research Hospital,Turkey fr...Objective:To report the neurologic prognosis and autoimmune complications of 16 cases of childhood herpes simplex virus encephalitis.Methods:The study was conducted atŞanlıurfa Training and Research Hospital,Turkey from June 2017 to August 2019.The study included 16 pediatric patients aged between 6 months and 17 years(median age 77.7 months)who were diagnosed with herpes simplex virus type 1 encephalitis by pediatric infectious disease and pediatric neurology clinics.Patients were followed using patient records,and interviews at the pediatric neurology clinic or via the telephone.Clinical and demographic data,received therapies,neurologic prognosis and complications were evaluated.Results:Patients with and without autoimmune encephalitis were compared in terms of age,sex,symptom duration before treatment,initial cerebrospinal fluid protein,glucose,red blood count and white blood count but no significant difference was found.Autoimmune complications were seen in four patients.N-methyl-D-aspartate encephalitis was observed in three patients and choreoathetosis was seen in one patient.The average follow-up period was 48.3 months.Twenty-five percent of the patients were receiving multiple antiepileptic drug(AED)treatment,43.8%were receiving single AED treatment and 31.3%were not receiving AED treatment at the end of the follow-up.Motor disability was observed in 12.5%and drug-resistant epilepsy was observed in 6.3%who had autoimmune complications.Conclusions:Seizures and movement disorders were controlled with immunotherapy and autoantibodies should be studied routinely.Treatment should be started early upon recognition of autoimmune complications through follow-up by measuring autoantibody levels and clinical examination results.Effective prevention and curative treatment modalities are needed to avoid herpes simplex virus encephalitis complications.展开更多
<b>Background:</b> Seasonal influenza associated neurological complications had high mortality and morbidity rates in children. In this study, we aimed to investigate the clinical characteristics and morta...<b>Background:</b> Seasonal influenza associated neurological complications had high mortality and morbidity rates in children. In this study, we aimed to investigate the clinical characteristics and mortality risk factors in children with influenza-associated encephalopathy. <b>Methods:</b> Retrospectively analyze the clinical data, laboratory tests, and imaging examinations of 68 children diagnosed with influenza-associated encephalopathy from January 2016 to December 2019 at Guangzhou Women and Children’s Medical Center, and the cases were divided into survival and non-survival groups by disease outcome and analyzed between two groups. Chi-square test or Mann-Whitney rank sum test was used for comparison between groups, and multivariate Logistic regression analysis was used for the analysis of risk factors for death. <b>Results:</b> Among the 68 children with influenza-associated encephalopathy, 40 were male, and 28 were female, aged from 3 months to 13 years, of which 66.18% (45/68) were under 5 years old. Pathogenetic tests showed that influenza virus type A accounted for 63.24% (43/68), and influenza virus type B accounted for 36.76% (25/68). Typical brain MRI changes in childhood influenza-associated encephalopathy were bilateral symmetrical lesions of the thalamus, basal ganglia, brainstem, and cerebellum. 68 patients had a mortality rate of 20.59% (14/68), with a significantly higher proportion of fever peak > 39°C, Acute Disturbance of Consciousness (ADOC), and cardiac arrest in the non-survival group than in the survival group (P < 0.05). Laboratory tests showed significantly higher in Alanine Aminotransferase (ALT), Aspartate Transaminase (AST), Creatinine Kinase (CK), Lactate Dehydrogenase (LDH), lactate, and C-Reactive Protein (CRP). And CSF protein levels in the non-survival group compared with the survivor (P < 0.05), among them, elevated ALT, AST, LDH, and CSF protein were independent high-risk factors for death from influenza-associated encephalopathy. <b>Conclusions:</b> Children under 5 years of age with influenza are prone to combine neurological complications and have a higher mortality rate. Significant elevations in ALT, AST, LDH, and CSF proteins predict death from influenza-associated encephalopathy in children.展开更多
Viral encephalitis in children caused by multiple viral infections,as a common central nervous system disease in pediatrics,has a high incidence in China.Its clinical symptoms usually include infection,poisoning,intra...Viral encephalitis in children caused by multiple viral infections,as a common central nervous system disease in pediatrics,has a high incidence in China.Its clinical symptoms usually include infection,poisoning,intracranial hypertension,and disturbance of consciousness.In severe cases,it can even endanger the lives of patient children.At present,the clinical treatment of the viral encephalitis mainly uses traditional Chinese medicine preparations such as Reduning Injection.The efficacy is significant.It can not only relieve the uncomfortable symptoms in a short time,but also has low incidence of adverse reactions.In this study,the factors that cause viral encephalitis in children were analyzed,and the efficacy,pharmacological action and clinical application of Reduning Injection were comprehensively elaborated,to provide a reference for clinical doctors to rationally treat viral encephalitis in children.展开更多
OBJECTIVE: To identify global research trends in three therapies for children with cerebral palsy. DATA RETRIEVAL: We performed a bibliometric analysis of studies on therapies for children with cerebral palsy from 2...OBJECTIVE: To identify global research trends in three therapies for children with cerebral palsy. DATA RETRIEVAL: We performed a bibliometric analysis of studies on therapies for children with cerebral palsy from 2002 to 2011 retrieved from Web of Science. SELECTION CRITERIA: Inclusion criteria: (a) peer-reviewed published articles on botulinum toxin, constraint-induced movement therapy, or acupuncture for children with cerebral palsy indexed in Web of Science; (b) original research articles, reviews, meeting abstracts, proceedings papers, book chapters, editorial material, and news items; and (c) publication between 2002 and 2011. Exclusion criteria: (a) articles that required manual searching or telephone access; (b) documents that were not published in the public domain; and (c) a number of corrected papers from the total number of articles. MAIN OUTCOME MEASURES: (1) Number of publications on the three therapies; (2) annual publication output, distribution by journals, distribution by institution, and top-cited articles on botulinum toxin; (3) annual publication output, distribution by journal, distribution by institution, and top-cited articles on constraint-induced movement therapy; (4) annual publication, distribution by journal, distribution by institution, and top-cited articles on acupuncture. RESULTS: This analysis, based on Web of Science articles, identified several research trends in studies published over the past 10 years of three therapies for children with cerebral palsy. More articles on botulinum toxin for treating children with cerebral palsy were published than the articles regarding constraint-induced movement therapy or acupuncture. The numbers of publications increased over the 10-year study period. Most papers appeared in journals with a focus on neurology, such as Developmental Medicine and Child Neurology and Journal of Child Neurology.Research institutes publishing on botulinum toxin treatments for this population are mostly in the Netherlands, the United States of America, and Australia; those publishing on constraint-induced movement therapy are mostly in Australia and the United States of America; and those publishing on acupuncture are mostly in China, Sweden and the United States of America.CONCLUSION: Analysis of literature and research trends indicated that there was no one specific therapy to cure cerebral palsy. Further studies are still necessary.展开更多
BACKGROUND Asymptomatic cytomegalovirus(CMV)infection is common in children;in contrast,in children with a weakened immune system,invasive CMV can occur.This is the first case report of a severe manifestation of CMV e...BACKGROUND Asymptomatic cytomegalovirus(CMV)infection is common in children;in contrast,in children with a weakened immune system,invasive CMV can occur.This is the first case report of a severe manifestation of CMV esophagoenterocolitis in a girl diagnosed with anti-N-methyl-D-aspartate-receptor(antiNMDAR)encephalitis who received only a moderate dose of corticosteroid therapy.CASE SUMMARY A 12-year-old-Thai girl presented with acute behavioural change and headache for 6 d.Electroencephalogram and positivity for NMDAR autoantibodies were compatible with anti-NMDAR encephalitis.Hence,she received pulse methylprednisolone 10 mg/kg per day for 4 d and continued with prednisolone 1.2 mg/kg per day.On day 42 of corticosteroid therapy,she developed unremitting vomiting and diarrhoea.Endoscopy showed multiple ulcers and erythaematous mucosa along the gastrointestinal tract.Tissue CMV viral load and viral-infected cells confirmed CMV esophago-enterocolitis.Therefore,the patient received ganciclovir 5 mg/kg per dose every 12 h for 3 wk and then 5 mg/kg per dose once daily for 3 wk.Unremitting diarrhoea slowly improved from stool output 1-4 L per day to 1-2 L per day after 3 wk of treatment.Pulse methylprednisolone 20 mg/kg for 5 d was initiated and continued with prednisolone 1 mg/kg per day.After this repeated pulse methylprednisolone treatment,surprisingly,diarrhoea subsided.Immunologic work-up was performed to rule out underlying immune deficiency with unremarkable results.CONCLUSION Unremitting diarrhoea from CMV esophago-enterocolitis subsided with antiviral and methylprednisolone therapy,implying the immune and NMDAR dysregulation in anti-NMDAR encephalitis.展开更多
BACKGROUND The incidence of short stature in KBG syndrome is relatively high.Data on the therapeutic effects of growth hormone(GH)on children with KBG syndrome accompanied by short stature in the previous literature h...BACKGROUND The incidence of short stature in KBG syndrome is relatively high.Data on the therapeutic effects of growth hormone(GH)on children with KBG syndrome accompanied by short stature in the previous literature has not been summarized.CASE SUMMARY Here we studied a girl with KBG syndrome and collected the data of children with KBG syndrome accompanied by short stature from previous studies before and after GH therapy.The girl was referred to our department because of short stature.Physical examination revealed mild dysmorphic features.The peak GH responses to arginine and clonidine were 6.22 and 5.40 ng/mL,respectively.The level of insulin-like growth factor 1(IGF-1)was 42.0 ng/mL.Genetic analysis showed a c.2635 dupG(p.Glu879fs)mutation in the ANKRD11 gene.She received GH therapy.During the first year of GH therapy,her height increased by 0.92 standard deviation score(SDS).Her height increased from-1.95 SDS to-0.70 SDS after two years of GH therapy.There were ten children with KBG syndrome accompanied by short stature who received GH therapy in reported cases.Height SDS was improved in nine(9/10)of them.The mean height SDS in five children with KBG syndrome accompanied by short stature increased from-2.72±0.44 to-1.95±0.57 after the first year of GH therapy(P=0.001).There were no adverse reactions reported after GH treatment.CONCLUSION GH treatment is effective in our girl and most children with KBG syndrome accompanied by short stature during the first year of therapy.展开更多
<b><span style="font-family:Verdana;">Background: </span></b></span><span><span><span style="font-family:""><span style="font-family:Ver...<b><span style="font-family:Verdana;">Background: </span></b></span><span><span><span style="font-family:""><span style="font-family:Verdana;">Scoliosis is among interventions with high postoperative com</span><span><span style="font-family:Verdana;">plication rates due to the characteristics of the surgery, where blood los</span><span style="font-family:Verdana;"></span><span style="font-family:Verdana;">s,</span></span><span style="font-family:Verdana;"> transfusion and fluid requirements can be increased. A monocentric retrospective observational study was undertaken earlier to determine predictors of intraoperative and postoperative outcomes in surgical patients. In this initial cohort, there were patients who underwent scoliosis surgery, and a secondary </span><span style="font-family:Verdana;">analysis to describe outcomes in these patients was realized and presented</span> <span><span style="font-family:Verdana;">here. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To describe intraoperative and postoperative outcomes in</span></span><span style="font-family:Verdana;"> patients under 18 years old in scoliosis surgery included in the initial study and </span><span style="font-family:Verdana;">to propose improvement </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">and </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">implementation measures. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> A sec</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ondary analysis of patients undergoing scoliosis surgery </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">from</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> 1 January 2014 to </span><span style="font-family:Verdana;">17 May 2017 was undertaken in our institution—Necker Enfants Malades</span> <span style="font-family:Verdana;">uni</span><span style="font-family:Verdana;">ver</span><span><span style="font-family:Verdana;">sity hospital. The study was approved by the Ethics Committee. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> There </span></span><span style="font-family:Verdana;">were 116 patients with a mean age of 147.5 ± 40.2 months. Twenty-eight pa</span><span style="font-family:Verdana;">tients </span><span style="font-family:Verdana;">(24.1%) presented intraoperative and/or postoperative complications. The most</span> <span style="font-family:Verdana;">common intraoperative complication was hemorrhagic shock in 3 patients </span><span style="font-family:Verdana;">(2.6%). The most common postoperative organ failure was neuro</span><span style="font-family:Verdana;">logic in seven patients (6%), respiratory in 3 patients (2.6%), car</span><span style="font-family:Verdana;">dio-circulatory in 2 patients (1.7%) and renal failure in </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">1</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> patient (0.9%). The most common postoperative infection was surgical wound sepsis in 8 patients (6.9%), urinary sepsis in </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">3</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> patients (2.6%), and abdominal sepsis and septicemia in </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">2</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> patients (1.7%). </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">12</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> patients (10.3%) had reoperations. Fif</span><span style="font-family:Verdana;">ty-six patients (48.3%) had </span><span><span style="font-family:Verdana;">intraoperative transfusion. There was no in-hospital mortality. </span><b><span style="font-family:Verdana;">Conclusion:</span></b></span><span style="font-family:Verdana;"> The </span><span style="font-family:Verdana;">portion of patients with intraoperative and or postoperative complications </span><span style="font-family:Verdana;">was 24.1%, integrating goal-directed therapies in this surgical setting could improve postoperative outcomes.展开更多
Play is a pleasurable physical or mental activity that enhances the child’s skills involving negotiation abilities,problem-solving,manual dexterity,sharing,decision-making,and working in a group.Play affects all the ...Play is a pleasurable physical or mental activity that enhances the child’s skills involving negotiation abilities,problem-solving,manual dexterity,sharing,decision-making,and working in a group.Play affects all the brain's areas,structures,and functions.Children with autism have adaptive behavior,adaptive response,and social interaction limitations.This review explores the different applications of play therapy in helping children with autism disorder.Play is usually significantly impaired in children with autism.Play therapy is mainly intended to help children to honor their unique mental abilities and developmental levels.The main aim of play therapy is to prevent or solve psychosocial difficulties and achieve optimal child-healthy growth and development.Play therapy helps children with autism to engage in play activities of their interest and choice to express themselves in the most comfortable ways.It changes their way of self-expression from unwanted behaviors to more non-injurious expressive behavior using toys or activities of their choice as their words.Play therapy also helps those children to experience feeling out various interaction styles.Every child with autism is unique and responds differently.Therefore,different types of intervention,like play therapy,could fit the differences in children with autism.Proper evaluation of the child is mandatory to evaluate which type fits the child more than the others.This narrative review revised the different types of play therapy that could fit children with autism in an evidence-based way.Despite weak evidence,play therapy still has potential benefits for patients and their families.展开更多
There are several different types of drug delivery interfaces available on the market.Using the right interface for aerosol drug delivery to children is essential for effective inhalation therapy.However,clinicians us...There are several different types of drug delivery interfaces available on the market.Using the right interface for aerosol drug delivery to children is essential for effective inhalation therapy.However,clinicians usually focus on selecting the right drug-device combination and often overlook the importance of interface selection that lead to suboptimal drug delivery and therapeutic response in neonates and pediatrics.Therefore,it is necessary to critically assess each interface and understand its advantage and disadvantages in aerosol drug delivery to this patient population.The purpose of this paper is to provide a critical assessment of drug delivery interfaces used for the treatment of children with pulmonary diseases by emphasizing advantages and problems associated with their use during inhalation therapy.展开更多
<span style="font-family:Verdana;"> <strong>Background: </strong></span><span><span><span style="font-family:;" "=""><span style=&qu...<span style="font-family:Verdana;"> <strong>Background: </strong></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">Femoral and pelvic osteotomies are potential hemorrhagic interventions where transfusion requirements can be necessary. </span><b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:Verdana;">We undertook a secondary analysis of patients who underwent femoral and pelvic osteotomy in the initial cohort. The objective of this secondary analysis was to describe intraoperative and postoperative outcomes and to describe intraoperative management in these patients in terms of blood product management and fluid and hemodynamic therapy with the aim of implementing optimization management protocols for postoperative outcome improvement. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> A secondary analysis of patients who underwent femoral and pelvic osteotomy surgery was included in the initial retrospective study. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">There were eighteen patients with a mean age of 104 ± 47.1 months. Four (22.2%) patients had intraoperative and/or postoperative complications. One patient (5.6%) had an intraoperative hemorrhagic shock, two patients (11.1%) had postoperative neurologic failure, and one patient (5.6%) had postoperative wound sepsis. The transfusion rate was 50% in nine patients. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Femoral and pelvic osteotomies are interventions where blood, transfusion and fluid requirements can be increased;thus, this implies the necessity of a global patient blood management protocol with point-of-care tests and fluid- and hemodynamic-guided protocols with validated tools in children for intraoperative and postoperative outcome optimization.</span></span></span></span>展开更多
Pain and hospitalization caused a crisis in the child’s life. At the pre-school children, the stress of the disease makes children become less able to cope with separation. As a result, many children show anxious beh...Pain and hospitalization caused a crisis in the child’s life. At the pre-school children, the stress of the disease makes children become less able to cope with separation. As a result, many children show anxious behavior though more vague than toddler age children. Various ways have been conducted by nurses to treat anxiety in children, but the most effective types of the intervention have not be found. Types of intervention that can be done are art therapy and play therapy. This study aims to compare the effects of art therapy and play therapy in reducing anxiety on children who experience hospitalization. A quasi-experimental research design with pre-post test two group design is used. The sample was 23 children pre-school age for art therapy group and 25 children for play therapy with sampling techniques performed purposive sampling. Intervention of art therapy and play therapy each performed for 3 days with duration about 30 minutes. Anxiety levels before and after the intervention were measured by using the facial affective scale. The results show that there is a difference in anxiety between before and after the action in the art therapy group (p = 0.00) and that there are differences in anxiety before and after the action in the play therapy group (0.00). But statistical tests using Man Whitney U indicate that there is no difference in anxiety levels in pre-school children who do art therapy and play therapy (p = 0.26). So, it is concluded that the art therapy and the play therapy can reduce the level of anxiety on pre-school school children that experience hospitalization. Based on these conclusions, it is recommended that the art therapy and the play therapy can be used by nurses and the choice of the intervention should be submitted to the child.展开更多
Electroencephalogram (EEG)-recorded rhythmicelectrophysiologic activity of brain is synchronoussynthesis of postsynaptic potentials of pyramidalcells and their parietal dendrites of the cerebralcortex.Abnormal changes...Electroencephalogram (EEG)-recorded rhythmicelectrophysiologic activity of brain is synchronoussynthesis of postsynaptic potentials of pyramidalcells and their parietal dendrites of the cerebralcortex.Abnormal changes in EEG and brainelectrical activity mapping (BEAM) appear prior tothat in computed tomography (CT) and nuclearmagnetic resonance (NMR) during the acute stage ofencephalitis,providing a scientific and展开更多
文摘BACKGROUND Anti-contactin-associated protein-like 2(CASPR2)antibody encephalitis is an autoimmune disorder characterized by the presence of antibodies against the voltage-gated potassium channel.This leads to neurological symptoms,such as seizures,cognitive decline,and neuropathic pain,primarily affecting the limbic system.The prognosis of this disorder varies among individuals.CASE SUMMARY The patient,a girl aged nine years and nine months,underwent treatment for 14 to 21 d.The main clinical manifestations were vomiting and unclear consciousness,positive pathological signs,normal cranial computed tomography and magnetic resonance imaging,and abnormal electroencephalogram.The child was discharged after receiving immunoglobulin and hormone treatment.Subsequent follow-up over a period of 15 months after discharge,conducted through telephone and outpatient visits,showed no recurrence of symptoms.CONCLUSION Anti-CASPR2 antibody autoimmune encephalitis in children is rare,mainly manifested as convulsions,mental abnormalities,cognitive impairment,and neuropathic pain,among others.Timely evaluation for autoimmune encephalitis antibodies is crucial,especially in cases of recurrent central nervous system involvement in children.
文摘Objective:To explore and analyze the effectiveness of targeted nursing in children with severe viral encephalitis complicated with respiratory failure.Methods:From April 2021 to April 2023,74 children with severe viral encephalitis complicated with respiratory failure admitted to the Department of Pediatrics of our hospital were selected as the research objects and divided into the target group(n=37)and the reference group(n=37).Targeted nursing was given to the target group,while general nursing was given to the reference group.Physical rehabilitation,motor scores,and lung function were compared between the groups.Results:The recovery time of limb abnormalities,convulsions,abnormal consciousness,and cranial nerve disorders in the target group was significantly better than that in the reference group(P<0.05).The motor function,joint activity and pain,sensory function,and total score of the target group were significantly lower than those of the reference group(P<0.05).After the intervention,lung function indicators including VC(vital capacity),FVC(forced vital capacity),and MVV(maximum voluntary ventilation)of the target group were better than those of the reference group(P<0.05).Conclusion:Targeted nursing can shorten the recovery period of severe viral encephalitis complicated with respiratory failure in children,speed up the recovery of motor function,and improve lung function.This nursing model has a significant application effect in children with severe viral encephalitis complicated with respiratory failure.
文摘Autoimmune encephalitis is a poorly understood condition that can present with a combination of neurological and psychiatric symptoms, either of which may predominate. There are many autoantibodies associated with a variety of clinical syndromes-anti-N-Methyl-D-Aspartate receptor(NMDAR) is the commonest. Currently, the most widely used therapy is prompt plasmapheresis and steroid treatment(and tumour resection if indicated), followed by second line immunosuppression if this fails. Given the growing awareness of autoimmune encephalitis as an entity, it is increasingly important that we consider it as a potential diagnosis in order to provide timely, effective treatment. We discuss several previously published case reports and one new case. These reports examined the effects of electroconvulsive therapy(ECT) on patients with autoimmune encephalitis, particularly those in whom psychiatric symptoms are especially debilitating and refractory to standard treatment. We also discuss factors predicting good outcome and possible mechanisms by which ECT may be effective. Numerous cases, such as those presented by Wingfield, Tsutsui, Florance, Sansing, Braakman and Matsumoto, demonstrate effective use of ECT in anti-NMDAR encephalitis patients with severe psychiatric symptoms such as catatonia, psychosis, narcolepsy and stupor who had failed to respond to standard treatments alone. We also present a new case of a 71-year-old female who presented to a psychiatric unit initially with depression, which escalated to catatonia, delusions, nihilism and auditory hallucinations. After anti-NMDAR antibodies were isolated, she was treated by the neurology team with plasmapheresis and steroids, with a partial response. She received multiple sessions of ECT and her psychiatric symptoms completely resolved and she returned to her premorbid state. For this reason, we suggest that ECT should be considered, particularly in those patients who are non-responders to standard therapies.
文摘BACKGROUND Sensory integration intervention is highly related to the child's effective interaction with the environment and the child's development.Currently,various sensory integration interventions are being applied,but research methodological problems are arising due to unsystematic protocols.This study aims to present the optimal intervention protocol by presenting scientific standards for sensory integration intervention through meta-analysis.AIM To prove the effectiveness of sensory integration therapy,examine the latest trend of sensory integration studies in Korea,and provide clinical evidence for sensory integration therapies.METHODS The database of Korean search engines,including RISS,KISS,and DBpia,was used to search for related literature published from 2001 to October 2020.The keywords,“Children”,“Sensory integration”,“Integrated sensory”,“Sensorymotor”,and“Sensory stimulation”were used in this search.Then,a meta-analysis was conducted on 24 selected studiesRISS,KISS,and DBpia,was used to search for related literature published from 2001 to October 2020.The keywords,“Children”,“Sensory integration”,“Integrated sensory”,“Sensorymotor”,and“Sensory stimulation”were used in this search.Then,a meta-analysis was conducted on 24 selected studies.RESULTS Sensory integration intervention has been proven effective in children with cerebral palsy,autism spectrum disorder,attention deficit/hyperactivity disorder,developmental disorder,and intellectual disability in relation to the diagnosis of children.Regarding sensory integration therapies,1:1 individual treatment with a therapist or a therapy session lasting for 40 min was most effective.In terms of dependent variables,sensory integration therapy effectively promoted social skills,adaptive behavior,sensory processing,and gross motor and fine motor skills.CONCLUSION The results of this study may be used as therapeutic evidence for sensory integration intervention in the clinical field of occupational therapy for children,and can help to present standards for sensory integration intervention protocols.
文摘Research motivation:Through the 12 weeks dance therapy intervention for children with autism,the purpose is to explore the intervention model of dance therapy for children with autism and the changes in motor ability,social ability,and communication ability of children with autism after dance therapy intervention.The results of the research are expected to expand the intervention mode of dance therapy in my country and provide practical reference for rehabilitation intervention of children with autism.Research methods:24 autistic boys aged 6 to 12 with mild to moderate symptoms were recruited and screened through the Internet as the subjects of this study.We randomly divided them into experimental group(N=12)and control group(N=12).All children with autism have an autism diagnosis certificate issued by Children’s Hospital or a tertiary hospital,excluding other mental diseases(such as epilepsy,major physical disability,mental illness,no history of drugs and other interventions,etc.).We used the paired sample t-test to compare the score difference between the dance treatment group and the control group before and after the two groups,and used the observation method to record the basic communication behavior and the number of active communication behaviors in the experimental group during the intervention process.All data analysis is used in SPSS 20.0.Research results:After 12 weeks of dance therapy intervention,there were statistically significant differences in the gross movement,balance,and coordination abilities of the children in the experimental group compared with those before the intervention(p<0.01).There was no significant difference between the children in the control group(p>0.05).After 12 weeks of dance therapy intervention,there were statistically significant differences in the scores of the social response scale for children with autism in the experimental group(p<0.05).There was no significant change in the scores of each item of the SRS scale before and after intervention in the control group and the dance treatment group(p>0.05).
文摘Objective: To investigate the effect of VOJTA therapy on gross motor function in children with cerebral palsy. Methods: The 86 children with cerebral palsy were all from the First People’s Hospital of Jingzhou City from January 2023-December 2023, and were divided into the control group and the study group with 43 cases according to the principle of voluntariness. Results: In terms of total effective rate of treatment, the gross motor function scale-88 (GMFM-88) was used to evaluate the effective rate before and after treatment, and the effective rate of the study group was higher than that of the control group, and the difference was statistically significant, and the scores of gross motor items of GMFM-88 were better than those of the control group after treatment, and the difference was statistically significant (P 0.05). Conclusion: The application of VOJTA therapy in the treatment of children with cerebral palsy can not only promote the rehabilitation of gross motor function, but also help to improve the treatment effect, and the earlier the treatment, the better.
文摘Objective: To evaluate the therapeutic efficacy of atomoxetine hydrochloride (ATX) combined with psychological-behavioral modification therapy for attention-deficit/hyperactivity disorder (ADHD) in children. Methods: A total of 60 cases of ADHD children admitted to our hospital between November 2021 and November 2022 were selected and randomly grouped into Group I and Group II. There were 30 cases in Group I who were treated with ATX combined with psychological-behavioral modification therapy. There were 30 cases in Group II who were treated with ATX monotherapy, and the therapeutic effects were compared. Results: Before treatment, there was no difference in the behavioral problem scores and cognitive function indexes of the two groups (P>0.05). After treatment, the behavioral problem scores of Group I were lower than those of Group II, and the cognitive function indicators of Group I were lower than those of Group II (P < 0.05). The adverse reaction rate of Group I was lower than that of Group II, and the total effective rate was higher than that of Group II (P < 0.05). Conclusion: ATX combined with psychological-behavioral modification therapy improved the behavioral problems of ADHD children, enhanced their cognitive function, and reduced the adverse reactions to drug treatment.
文摘BACKGROUND: Traditional subhibernation therapy may easily cause complications, such as respiratory depression and hyportension because of application of chlorpromazine hydrochloride and promethazine in a large dosage. OBJECTIVE: To observe therapeutic effect of modified subhibernation therapy (alterative application of five anticonvulsants according to the half life) on status epilepticus in children with severe viral encephalitis (VE). DESIGN: Contrast observation. SETTING: Department of Pediatrics, the First Hospital of Jilin University. PARTICIPANTS: The participants in present study were 96 patients with severe viral encephalitis including 52 boys and 44 girls who received treatment in the Department of Pediatrics, the First Hospital of Jilin University from February 2000 to March 2006. All children met the diagnostic criteria of Zhufutong Practice Pediatrics (the seventh edition). Two weeks ago, they ever got upper respiratory infection or enteronitis and so on before the onset, spirit abnormal, behavior disorder, limbs act disorder, vomit, headache, convulsion, nervous system masculine signs such as limbs act disord, autonomic nerve damage manifestation, brain nerve palsy, dysreflexia, meningeal irritation sign, cerebrospinal fluid and electroencephalography (EEG) abnormity. All parents provided the confirmed consent. The patients were randomly divided into control group (n =40) and experimental group (n =56). METHODS: Patients in the control group received anticonvulsion, ice compress and routine treatment. The convulsion was treated with five drugs: 0.5 mg/kg wintermin and phenergan, respectively, 100 g/L chlorpromazine hydrochloride (0.5 mL/kg), 5 mg/kg luminal, 0.3 mg/kg ansiolin. When convulsion attacked, those five drugs were given alternatively; however, those were not given if the convulsion did not attack. Children in the experimental group were treated with improved subhibernation therapy based on routine treatment. The dosages of anticonvulsants were as the same as those in the control group. Based on the half life, every drug was alternated every 4-6 hours. In addition, anticonvulsants administrated for 2 successive days whether tic attacked or not. Then the hypnotic was removed gradually. MAIN OUTCOME MEASURES: Therapeutic efficacy, time of disappeared clinical symptoms and physical sign, and security of administration. RESULTS: All the 96 patients were involved in the final analysis. ① Total effective rate and reliability: Total effective rate was higher in the treatment groups than the control group (χ2=5.871 7, P 〈 0.05). All patients did not have respiratory depression and side effects. ② Time of disappeared clinical symptoms and physical sign: Recovery time of convulsion, fever, headache and vomit was shorter in the treatment group than that in the control group, and there was significant difference (t =17.612 1-34.330 7, P 〈 0.05); in addition, symptoms of status epilepticus were relieved obviously. Meanwhile, recovery time of paralysis, coma and anepia was shorter in the treatment group than that in the control group, and there was significant difference (t =10.660 8-24.700 8, P 〈 0.05). CONCLUSION: Therapeutic effect of improved subhibernation therapy on status epilepticus induced by severe viral encephalitis is positively and safer.
文摘Objective:To report the neurologic prognosis and autoimmune complications of 16 cases of childhood herpes simplex virus encephalitis.Methods:The study was conducted atŞanlıurfa Training and Research Hospital,Turkey from June 2017 to August 2019.The study included 16 pediatric patients aged between 6 months and 17 years(median age 77.7 months)who were diagnosed with herpes simplex virus type 1 encephalitis by pediatric infectious disease and pediatric neurology clinics.Patients were followed using patient records,and interviews at the pediatric neurology clinic or via the telephone.Clinical and demographic data,received therapies,neurologic prognosis and complications were evaluated.Results:Patients with and without autoimmune encephalitis were compared in terms of age,sex,symptom duration before treatment,initial cerebrospinal fluid protein,glucose,red blood count and white blood count but no significant difference was found.Autoimmune complications were seen in four patients.N-methyl-D-aspartate encephalitis was observed in three patients and choreoathetosis was seen in one patient.The average follow-up period was 48.3 months.Twenty-five percent of the patients were receiving multiple antiepileptic drug(AED)treatment,43.8%were receiving single AED treatment and 31.3%were not receiving AED treatment at the end of the follow-up.Motor disability was observed in 12.5%and drug-resistant epilepsy was observed in 6.3%who had autoimmune complications.Conclusions:Seizures and movement disorders were controlled with immunotherapy and autoantibodies should be studied routinely.Treatment should be started early upon recognition of autoimmune complications through follow-up by measuring autoantibody levels and clinical examination results.Effective prevention and curative treatment modalities are needed to avoid herpes simplex virus encephalitis complications.
文摘<b>Background:</b> Seasonal influenza associated neurological complications had high mortality and morbidity rates in children. In this study, we aimed to investigate the clinical characteristics and mortality risk factors in children with influenza-associated encephalopathy. <b>Methods:</b> Retrospectively analyze the clinical data, laboratory tests, and imaging examinations of 68 children diagnosed with influenza-associated encephalopathy from January 2016 to December 2019 at Guangzhou Women and Children’s Medical Center, and the cases were divided into survival and non-survival groups by disease outcome and analyzed between two groups. Chi-square test or Mann-Whitney rank sum test was used for comparison between groups, and multivariate Logistic regression analysis was used for the analysis of risk factors for death. <b>Results:</b> Among the 68 children with influenza-associated encephalopathy, 40 were male, and 28 were female, aged from 3 months to 13 years, of which 66.18% (45/68) were under 5 years old. Pathogenetic tests showed that influenza virus type A accounted for 63.24% (43/68), and influenza virus type B accounted for 36.76% (25/68). Typical brain MRI changes in childhood influenza-associated encephalopathy were bilateral symmetrical lesions of the thalamus, basal ganglia, brainstem, and cerebellum. 68 patients had a mortality rate of 20.59% (14/68), with a significantly higher proportion of fever peak > 39°C, Acute Disturbance of Consciousness (ADOC), and cardiac arrest in the non-survival group than in the survival group (P < 0.05). Laboratory tests showed significantly higher in Alanine Aminotransferase (ALT), Aspartate Transaminase (AST), Creatinine Kinase (CK), Lactate Dehydrogenase (LDH), lactate, and C-Reactive Protein (CRP). And CSF protein levels in the non-survival group compared with the survivor (P < 0.05), among them, elevated ALT, AST, LDH, and CSF protein were independent high-risk factors for death from influenza-associated encephalopathy. <b>Conclusions:</b> Children under 5 years of age with influenza are prone to combine neurological complications and have a higher mortality rate. Significant elevations in ALT, AST, LDH, and CSF proteins predict death from influenza-associated encephalopathy in children.
基金National Natural Science Foundation of China(81873218)。
文摘Viral encephalitis in children caused by multiple viral infections,as a common central nervous system disease in pediatrics,has a high incidence in China.Its clinical symptoms usually include infection,poisoning,intracranial hypertension,and disturbance of consciousness.In severe cases,it can even endanger the lives of patient children.At present,the clinical treatment of the viral encephalitis mainly uses traditional Chinese medicine preparations such as Reduning Injection.The efficacy is significant.It can not only relieve the uncomfortable symptoms in a short time,but also has low incidence of adverse reactions.In this study,the factors that cause viral encephalitis in children were analyzed,and the efficacy,pharmacological action and clinical application of Reduning Injection were comprehensively elaborated,to provide a reference for clinical doctors to rationally treat viral encephalitis in children.
文摘OBJECTIVE: To identify global research trends in three therapies for children with cerebral palsy. DATA RETRIEVAL: We performed a bibliometric analysis of studies on therapies for children with cerebral palsy from 2002 to 2011 retrieved from Web of Science. SELECTION CRITERIA: Inclusion criteria: (a) peer-reviewed published articles on botulinum toxin, constraint-induced movement therapy, or acupuncture for children with cerebral palsy indexed in Web of Science; (b) original research articles, reviews, meeting abstracts, proceedings papers, book chapters, editorial material, and news items; and (c) publication between 2002 and 2011. Exclusion criteria: (a) articles that required manual searching or telephone access; (b) documents that were not published in the public domain; and (c) a number of corrected papers from the total number of articles. MAIN OUTCOME MEASURES: (1) Number of publications on the three therapies; (2) annual publication output, distribution by journals, distribution by institution, and top-cited articles on botulinum toxin; (3) annual publication output, distribution by journal, distribution by institution, and top-cited articles on constraint-induced movement therapy; (4) annual publication, distribution by journal, distribution by institution, and top-cited articles on acupuncture. RESULTS: This analysis, based on Web of Science articles, identified several research trends in studies published over the past 10 years of three therapies for children with cerebral palsy. More articles on botulinum toxin for treating children with cerebral palsy were published than the articles regarding constraint-induced movement therapy or acupuncture. The numbers of publications increased over the 10-year study period. Most papers appeared in journals with a focus on neurology, such as Developmental Medicine and Child Neurology and Journal of Child Neurology.Research institutes publishing on botulinum toxin treatments for this population are mostly in the Netherlands, the United States of America, and Australia; those publishing on constraint-induced movement therapy are mostly in Australia and the United States of America; and those publishing on acupuncture are mostly in China, Sweden and the United States of America.CONCLUSION: Analysis of literature and research trends indicated that there was no one specific therapy to cure cerebral palsy. Further studies are still necessary.
基金The Pediatric Gastroenterology and Hepatology Research Unit,ThailandGrants for Development of New Faculty Staff,Ratchadaphiseksomphot Endowment Fund,Thailand,No.RA63/012Thailand Research Fund Thailand Science Research and Innovation,Thailand,No.MRG6280190。
文摘BACKGROUND Asymptomatic cytomegalovirus(CMV)infection is common in children;in contrast,in children with a weakened immune system,invasive CMV can occur.This is the first case report of a severe manifestation of CMV esophagoenterocolitis in a girl diagnosed with anti-N-methyl-D-aspartate-receptor(antiNMDAR)encephalitis who received only a moderate dose of corticosteroid therapy.CASE SUMMARY A 12-year-old-Thai girl presented with acute behavioural change and headache for 6 d.Electroencephalogram and positivity for NMDAR autoantibodies were compatible with anti-NMDAR encephalitis.Hence,she received pulse methylprednisolone 10 mg/kg per day for 4 d and continued with prednisolone 1.2 mg/kg per day.On day 42 of corticosteroid therapy,she developed unremitting vomiting and diarrhoea.Endoscopy showed multiple ulcers and erythaematous mucosa along the gastrointestinal tract.Tissue CMV viral load and viral-infected cells confirmed CMV esophago-enterocolitis.Therefore,the patient received ganciclovir 5 mg/kg per dose every 12 h for 3 wk and then 5 mg/kg per dose once daily for 3 wk.Unremitting diarrhoea slowly improved from stool output 1-4 L per day to 1-2 L per day after 3 wk of treatment.Pulse methylprednisolone 20 mg/kg for 5 d was initiated and continued with prednisolone 1 mg/kg per day.After this repeated pulse methylprednisolone treatment,surprisingly,diarrhoea subsided.Immunologic work-up was performed to rule out underlying immune deficiency with unremarkable results.CONCLUSION Unremitting diarrhoea from CMV esophago-enterocolitis subsided with antiviral and methylprednisolone therapy,implying the immune and NMDAR dysregulation in anti-NMDAR encephalitis.
文摘BACKGROUND The incidence of short stature in KBG syndrome is relatively high.Data on the therapeutic effects of growth hormone(GH)on children with KBG syndrome accompanied by short stature in the previous literature has not been summarized.CASE SUMMARY Here we studied a girl with KBG syndrome and collected the data of children with KBG syndrome accompanied by short stature from previous studies before and after GH therapy.The girl was referred to our department because of short stature.Physical examination revealed mild dysmorphic features.The peak GH responses to arginine and clonidine were 6.22 and 5.40 ng/mL,respectively.The level of insulin-like growth factor 1(IGF-1)was 42.0 ng/mL.Genetic analysis showed a c.2635 dupG(p.Glu879fs)mutation in the ANKRD11 gene.She received GH therapy.During the first year of GH therapy,her height increased by 0.92 standard deviation score(SDS).Her height increased from-1.95 SDS to-0.70 SDS after two years of GH therapy.There were ten children with KBG syndrome accompanied by short stature who received GH therapy in reported cases.Height SDS was improved in nine(9/10)of them.The mean height SDS in five children with KBG syndrome accompanied by short stature increased from-2.72±0.44 to-1.95±0.57 after the first year of GH therapy(P=0.001).There were no adverse reactions reported after GH treatment.CONCLUSION GH treatment is effective in our girl and most children with KBG syndrome accompanied by short stature during the first year of therapy.
文摘<b><span style="font-family:Verdana;">Background: </span></b></span><span><span><span style="font-family:""><span style="font-family:Verdana;">Scoliosis is among interventions with high postoperative com</span><span><span style="font-family:Verdana;">plication rates due to the characteristics of the surgery, where blood los</span><span style="font-family:Verdana;"></span><span style="font-family:Verdana;">s,</span></span><span style="font-family:Verdana;"> transfusion and fluid requirements can be increased. A monocentric retrospective observational study was undertaken earlier to determine predictors of intraoperative and postoperative outcomes in surgical patients. In this initial cohort, there were patients who underwent scoliosis surgery, and a secondary </span><span style="font-family:Verdana;">analysis to describe outcomes in these patients was realized and presented</span> <span><span style="font-family:Verdana;">here. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To describe intraoperative and postoperative outcomes in</span></span><span style="font-family:Verdana;"> patients under 18 years old in scoliosis surgery included in the initial study and </span><span style="font-family:Verdana;">to propose improvement </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">and </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">implementation measures. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> A sec</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ondary analysis of patients undergoing scoliosis surgery </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">from</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> 1 January 2014 to </span><span style="font-family:Verdana;">17 May 2017 was undertaken in our institution—Necker Enfants Malades</span> <span style="font-family:Verdana;">uni</span><span style="font-family:Verdana;">ver</span><span><span style="font-family:Verdana;">sity hospital. The study was approved by the Ethics Committee. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> There </span></span><span style="font-family:Verdana;">were 116 patients with a mean age of 147.5 ± 40.2 months. Twenty-eight pa</span><span style="font-family:Verdana;">tients </span><span style="font-family:Verdana;">(24.1%) presented intraoperative and/or postoperative complications. The most</span> <span style="font-family:Verdana;">common intraoperative complication was hemorrhagic shock in 3 patients </span><span style="font-family:Verdana;">(2.6%). The most common postoperative organ failure was neuro</span><span style="font-family:Verdana;">logic in seven patients (6%), respiratory in 3 patients (2.6%), car</span><span style="font-family:Verdana;">dio-circulatory in 2 patients (1.7%) and renal failure in </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">1</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> patient (0.9%). The most common postoperative infection was surgical wound sepsis in 8 patients (6.9%), urinary sepsis in </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">3</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> patients (2.6%), and abdominal sepsis and septicemia in </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">2</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> patients (1.7%). </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">12</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> patients (10.3%) had reoperations. Fif</span><span style="font-family:Verdana;">ty-six patients (48.3%) had </span><span><span style="font-family:Verdana;">intraoperative transfusion. There was no in-hospital mortality. </span><b><span style="font-family:Verdana;">Conclusion:</span></b></span><span style="font-family:Verdana;"> The </span><span style="font-family:Verdana;">portion of patients with intraoperative and or postoperative complications </span><span style="font-family:Verdana;">was 24.1%, integrating goal-directed therapies in this surgical setting could improve postoperative outcomes.
文摘Play is a pleasurable physical or mental activity that enhances the child’s skills involving negotiation abilities,problem-solving,manual dexterity,sharing,decision-making,and working in a group.Play affects all the brain's areas,structures,and functions.Children with autism have adaptive behavior,adaptive response,and social interaction limitations.This review explores the different applications of play therapy in helping children with autism disorder.Play is usually significantly impaired in children with autism.Play therapy is mainly intended to help children to honor their unique mental abilities and developmental levels.The main aim of play therapy is to prevent or solve psychosocial difficulties and achieve optimal child-healthy growth and development.Play therapy helps children with autism to engage in play activities of their interest and choice to express themselves in the most comfortable ways.It changes their way of self-expression from unwanted behaviors to more non-injurious expressive behavior using toys or activities of their choice as their words.Play therapy also helps those children to experience feeling out various interaction styles.Every child with autism is unique and responds differently.Therefore,different types of intervention,like play therapy,could fit the differences in children with autism.Proper evaluation of the child is mandatory to evaluate which type fits the child more than the others.This narrative review revised the different types of play therapy that could fit children with autism in an evidence-based way.Despite weak evidence,play therapy still has potential benefits for patients and their families.
文摘There are several different types of drug delivery interfaces available on the market.Using the right interface for aerosol drug delivery to children is essential for effective inhalation therapy.However,clinicians usually focus on selecting the right drug-device combination and often overlook the importance of interface selection that lead to suboptimal drug delivery and therapeutic response in neonates and pediatrics.Therefore,it is necessary to critically assess each interface and understand its advantage and disadvantages in aerosol drug delivery to this patient population.The purpose of this paper is to provide a critical assessment of drug delivery interfaces used for the treatment of children with pulmonary diseases by emphasizing advantages and problems associated with their use during inhalation therapy.
文摘<span style="font-family:Verdana;"> <strong>Background: </strong></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">Femoral and pelvic osteotomies are potential hemorrhagic interventions where transfusion requirements can be necessary. </span><b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:Verdana;">We undertook a secondary analysis of patients who underwent femoral and pelvic osteotomy in the initial cohort. The objective of this secondary analysis was to describe intraoperative and postoperative outcomes and to describe intraoperative management in these patients in terms of blood product management and fluid and hemodynamic therapy with the aim of implementing optimization management protocols for postoperative outcome improvement. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> A secondary analysis of patients who underwent femoral and pelvic osteotomy surgery was included in the initial retrospective study. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">There were eighteen patients with a mean age of 104 ± 47.1 months. Four (22.2%) patients had intraoperative and/or postoperative complications. One patient (5.6%) had an intraoperative hemorrhagic shock, two patients (11.1%) had postoperative neurologic failure, and one patient (5.6%) had postoperative wound sepsis. The transfusion rate was 50% in nine patients. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Femoral and pelvic osteotomies are interventions where blood, transfusion and fluid requirements can be increased;thus, this implies the necessity of a global patient blood management protocol with point-of-care tests and fluid- and hemodynamic-guided protocols with validated tools in children for intraoperative and postoperative outcome optimization.</span></span></span></span>
文摘Pain and hospitalization caused a crisis in the child’s life. At the pre-school children, the stress of the disease makes children become less able to cope with separation. As a result, many children show anxious behavior though more vague than toddler age children. Various ways have been conducted by nurses to treat anxiety in children, but the most effective types of the intervention have not be found. Types of intervention that can be done are art therapy and play therapy. This study aims to compare the effects of art therapy and play therapy in reducing anxiety on children who experience hospitalization. A quasi-experimental research design with pre-post test two group design is used. The sample was 23 children pre-school age for art therapy group and 25 children for play therapy with sampling techniques performed purposive sampling. Intervention of art therapy and play therapy each performed for 3 days with duration about 30 minutes. Anxiety levels before and after the intervention were measured by using the facial affective scale. The results show that there is a difference in anxiety between before and after the action in the art therapy group (p = 0.00) and that there are differences in anxiety before and after the action in the play therapy group (0.00). But statistical tests using Man Whitney U indicate that there is no difference in anxiety levels in pre-school children who do art therapy and play therapy (p = 0.26). So, it is concluded that the art therapy and the play therapy can reduce the level of anxiety on pre-school school children that experience hospitalization. Based on these conclusions, it is recommended that the art therapy and the play therapy can be used by nurses and the choice of the intervention should be submitted to the child.
文摘Electroencephalogram (EEG)-recorded rhythmicelectrophysiologic activity of brain is synchronoussynthesis of postsynaptic potentials of pyramidalcells and their parietal dendrites of the cerebralcortex.Abnormal changes in EEG and brainelectrical activity mapping (BEAM) appear prior tothat in computed tomography (CT) and nuclearmagnetic resonance (NMR) during the acute stage ofencephalitis,providing a scientific and