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Judges meeting children: 'Being heard
Thirty years ago, 15-year-old ‘A’ was admitted to hospital with pallor and bruising, having been taken ill on a Saturday afternoon on the football terraces, thereafter diagnosed with leukaemia. Treatment was started, but the child and his family were devout Jehovah’s Witnesses and refused to consent to a transfusion of blood products. The hospital authority sought the permission of the court1 to transfuse the boy. Blood and platelets were becoming urgently needed: his haemoglobin 4.6 g/dL, white cells 1.5, platelets 37. Evidence was adduced that with a further fall in haemoglobin, the risk to A’s li...
Source: Archives of Disease in Childhood - April 19, 2023 Category: Pediatrics Authors: Wheeler, R. Tags: Clinical law for clinical practice Source Type: research

Respiratory Variations in Aortic Blood Flow to Predict Volume Responsiveness in Ventilated Children With Leukemia and Neutropenic Septic Shock*
Conclusions: Respiratory variation in velocity time integral of aortic blood flow and respiratory variation in peak velocity of aortic blood flow derived from transthoracic echocardiography showed only a fair reliability in predicting volume responsiveness in ventilated children with leukemia and neutropenic septic shock.
Source: Pediatric Critical Care Medicine - May 1, 2020 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Massive Recurrent Post-Tonsillectomy Bleedings Revealing a Transient Factor XIII deficiency in a 10-year-old boy. A case report.
Publication date: Available online 28 May 2019Source: International Journal of Pediatrics and Adolescent MedicineAuthor(s): M. Jankovic, M.L. Choucair, B. Hallak, E. Hernandez, M. Russo, J. Llor, S. Kayemba-Kay’sAbstractA previously healthy 10-year-old boy was hospitalized for a left cervical abscess associated with massive tonsillar hypertrophy. He underwent abscess drainage and bilateral tonsillectomy. At H36 post-surgery, he presented with tonsillar hemorrhage requiring surgical revision. Hemorrhage relapsed 2 days later, with a total of 7 episodes, 5 of which required surgical revisions. Laboratory investigations wer...
Source: International Journal of Pediatrics and Adolescent Medicine - May 28, 2019 Category: Pediatrics Source Type: research

Acute methotrexate-related neurotoxicity and pseudo-stroke syndrome.
We describe five episodes of transient acute leukoencephalopathy mimicking a stroke, reported in the literature as "pseudo-stroke syndrome". Neurologic symptoms occurred 3-10 days after IV or IT methotrexate and manifested as aphasia and alternating sensorimotor deficit. The fluctuating symptomatology regressed completely within a few days. Brain MRI, which is essential for diagnosis, demonstrated early white matter diffusion restriction in the affected cerebral area. These anomalies disappeared in one week, while hyperintense T2 FLAIR signals developed in the corresponding brain areas. The long-term progression of thes...
Source: Archives de Pediatrie - November 13, 2017 Category: Pediatrics Authors: Deneux V, Leboucq N, Saumet L, Haouy S, Akbaraly T, Sirvent N Tags: Arch Pediatr Source Type: research

Severe Cerebral Vasospasm and Childhood Arterial Ischemic Stroke After Intrathecal Cytarabine
We report on 2 patients who developed widespread cerebral vasospasm and arterial ischemic strokes (AIS) after application of intrathecal (IT) cytarabine. In a 3-year-old child with acute lymphoblastic leukemia (ALL), left leg weakness, hyperreflexia, and clonus were noted 4 days after her first dose of IT cytarabine during the induction phase of her chemotherapy. Cerebral MRI revealed multiple acute cerebral ischemic infarcts and widespread cerebral vasospasm. A 5-year-old girl complained of right arm and leg pain and began limping 11 days after IT cytarabine. Symptoms progressed to right dense hemiplegia, left gaze deviat...
Source: PEDIATRICS - February 1, 2016 Category: Pediatrics Authors: Tibussek, D., Natesirinilkul, R., Sun, L. R., Wasserman, B. A., Brandao, L. R., deVeber, G. Tags: Hematology/Oncology, Cancer/Neoplastic, Neurology, Neurologic Disorders Case Report Source Type: research

Question 1: Is ultrasound scanning as sensitive as CT in detecting skull fractures in children presenting following head injury?
Scenario An 11-month-old child is brought to the emergency department following a witnessed fall from a dining room chair. There was no loss of consciousness and only a single episode of vomiting immediately following the fall. Neurological examination is normal, however, there is a 5 cm bruised boggy swelling in the left parietal region and you suspect there may be a skull fracture. The child meets the criteria for neuroimaging with CT scanning according to NICE guidance.1 The parents express anxiety about radiation exposure (a young relative is currently being treated for leukaemia), in addition to concerns about th...
Source: Archives of Disease in Childhood - September 11, 2014 Category: Pediatrics Authors: Burke, K., Christian, W. Tags: ADC Archimedes, Oncology, Neurological injury, Stroke, Radiology, Other anaesthesia, Clinical diagnostic tests, Radiology (diagnostics), Trauma, Injury Source Type: research

Cerebrovascular risk factors seen in a university hospital.
CONCLUSIONS: The RF for ischemic stroke are multiple in the pediatric population, and some of them are associated with a specific age and type of stroke. The detection of these factors may help in the primary prevention of people at risk, an early diagnosis, and treatment and prevention of recurrences. PMID: 24361170 [PubMed - as supplied by publisher]
Source: Anales de Pediatria - December 19, 2013 Category: Pediatrics Authors: Hernández Chávez M, Samsó Zepeda C, López Espejo M, Escobar Henríquez R, Mesa Latorre T Tags: An Pediatr (Barc) Source Type: research

SickKids Handbook of Pediatric Thrombosis and Hemostasis
This article is protected by copyright. All rights reserved.
Source: Acta Paediatrica - October 4, 2013 Category: Pediatrics Authors: Ellen Ruud Tags: Book Review Source Type: research

Hemiparesis and facial palsy caused by methotrexate.
We describe two teenagers, who during the implementation of the M phase of the protocol, suffered hemiparesis, facial paresis and dysarthria which quickly reversed. Leukemia involvement of the central nervous system and stroke, were ruled out. We briefly review the pathophysiology of methotrexate neurotoxicity, the characteristics of the focal paresis presentation and magnetic resonance image findings. PMID: 23786802 [PubMed - as supplied by publisher]
Source: Anales de Pediatria - June 17, 2013 Category: Pediatrics Authors: Rueda Arenas E, García Corzo J, Franco Ospina L Tags: An Pediatr (Barc) Source Type: research