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[Epileptic syndromes in pediatrics. What's new?] [儿科癫痫综合征，有什么新进展？］
IF 0.6 4区 医学
Medicina-buenos Aires Pub Date : 2024-09-01
Jorge Vidaurre, John Mytinger
{"title":"[Epileptic syndromes in pediatrics. What's new?]","authors":"Jorge Vidaurre, John Mytinger","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The classification of epilepsy syndromes in pediatrics has undergone significant changes. In 2017, the International League Against Epilepsy Task Force on Nosology and Definitions proposed a new classification and definition and established mandatory, exclusionary, and alert criteria for the diagnosis of the different syndromes. The goal of this article is not to provide an extensive review of each syndrome, but to focus on syndromes that suffered important changes in terminology and/or when consensus or new methods to improve diagnosis and treatment have been designed.</p>","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Ethical considerations in the management of premature newborns with severe intraventricular hemorrhage]. [处理严重脑室内出血早产新生儿的伦理考虑]。
IF 0.6 4区 医学
Medicina-buenos Aires Pub Date : 2024-09-01
Alfredo Cerisola, Fernando Silvera
{"title":"[Ethical considerations in the management of premature newborns with severe intraventricular hemorrhage].","authors":"Alfredo Cerisola, Fernando Silvera","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Intracranial hemorrhage continues to be a prevalent pathology in preterm newborns, especially in those with lower gestational age and birth weight. It occurs more frequently in the first days of life, and the severity of bleeding is directly related to the degree of immaturity and other conditions of the patient. Intracranial hemorrhage is associated with a significant increased risk of mortality and, in those who survive, it is associated with an increased risk of neurodevelopmental disorders and long-term disability. Establishing an accurate prognosis is essential but frequently it is difficult to assay, dealing with uncertainty that healthcare team and the family must consider when they have to decide about the goals of care to provide to the newborn, including withholding or withdrawing life support treatments. Reflections regarding the best interest of the newborn, the complexity of quality-of-life, end-of-life shared decision-making process, uncovered biases, parental values, emotions, preferences and hopes, should be included in these challenging bioethical considerations and communications with the family.</p>","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[The impact of congenital heart disease on neurodevelopment].
IF 0.6 4区 医学
Medicina-buenos Aires Pub Date : 2024-09-01
Hugo A Arroyo, Mariel Foti
{"title":"[The impact of congenital heart disease on neurodevelopment].","authors":"Hugo A Arroyo, Mariel Foti","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>It is estimated that about 1 in 100 live births has a congenital heart disease (CHD). Cognitive deficit, academic difficulties, and behavioral abnormalities, in combination, represent the most common morbidity affecting quality of life in survivors with CHD. Developmental dysfunction results from a complex interaction between patient-specific factors such as genetic susceptibility, cardiac diagnosis, fetal development, and environmental factors such as preoperative events, supportive techniques during surgical repair, postoperative events, socioeconomic status. A comprehensive neurodevelopmental assessment in all children with CHD is critical to identify any need for intervention early and provide the support needed to optimize their long-term development.</p>","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Contribution of the Ibero-American Academy of Neuropediatrics to the knowledge of self-limited epilepsy in infants]. [伊比利亚-美洲神经儿科学会对婴儿自限性癫痫知识的贡献]。
IF 0.6 4区 医学
Medicina-buenos Aires Pub Date : 2024-09-01
Roberto H Caraballo
{"title":"[Contribution of the Ibero-American Academy of Neuropediatrics to the knowledge of self-limited epilepsy in infants].","authors":"Roberto H Caraballo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Since the first presentation at the IV Iberoamerican Academy of Neuropediatrics Congress in 1995, our group has studied self-limited infantile epilepsy (SeLIE), both familial and non-familial, corroborating that they belong to the same entity due to their clinical and electroencephalographic characteristics and excellent prognosis. Associations were found with paroxysmal dyskinesias and migraine, as well as with hemiplegic migraine, episodic ataxia and intellectual disability in atypical cases. Mutations in PRRT2 are the main cause of SeLIE, however, other genes, such as SCN2A, KCNQ2-3 and SCN8A, have been recognized. Drugs for focal seizures that act on sodium channels are indicated. In emergencies, during cluster seizures, the use of benzodiazepines is important. In this publication, we review our contribution in SeLIE from our first report to the present and review the existing literature on the subject.</p>","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Malformations of cortical development: what's new?]
IF 0.6 4区 医学
Medicina-buenos Aires Pub Date : 2024-09-01
María Celeste Buompadre
{"title":"[Malformations of cortical development: what's new?]","authors":"María Celeste Buompadre","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Malformations of cortical development (MCDs) are structural abnormalities that disrupt the normal process of cortical development in utero. MCDs include microcephaly with simplified gyral pattern/microlyssencephaly, hemimegalencephaly, focal cortical dysplasia, lissencephaly, heterotopia, polymicrogyria, and schizencephaly. The debut of MCD can be with pharmacoresistant epilepsy, developmental delay, neurologic deficits, or cognitive impairment. The diagnostic pathway for MCDs is complex owing to wide variations in presentation and etiology. Although the definitive diagnosis of MCD depends on histopathology, neuroimages have an important role in this process. Furthermore, knowing the disturbance of the molecular pathway involved is important. Increased understanding of the molecular biology and recent advances in genetic testing have caused rapid growth in the knowledge of the genetic causes of MCDs, allowing for information on prognosis, recurrence risk, and prediction of treatment outcomes.</p>","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Epilepsy or functional neurological disorder. Diagnostic strategies]. [癫痫或功能性神经紊乱。 诊断策略]。
IF 0.6 4区 医学
Medicina-buenos Aires Pub Date : 2024-09-01
Jaume Campistol
{"title":"[Epilepsy or functional neurological disorder. Diagnostic strategies].","authors":"Jaume Campistol","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A seizure is the manifestation of symptoms or signs produced by excessive or synchronous neuronal activity in the brain. It usually presents as brief, self-limited episodes of involuntary movements that can affect a part or the entire body and that are sometimes accompanied by loss of consciousness and sphincter control. Epilepsy may be considered after a single unprovoked seizure in a patient with a high risk of recurrence. Paroxysmal non-epileptic disorders are defined as episodes of sudden onset and short duration that imitate an epileptic seizure, caused by a brain dysfunction of diverse origin that, unlike epilepsy, is not due to excessive neuronal discharge. Its incidence is much higher than epilepsy and it can appear at any age. It is important for diagnosis to analyze the triggering factors, the details of each episode, physical examination and only proceed to basic complementary tests such as video-electroencephalogram in case of doubt or for diagnostic confirmation. There is a tendency to overdiagnose epilepsy and excessive use of anticonvulsant drugs. Those that can most frequently be confused are syncope, \"daydreams\" and pseudoseizures.</p>","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Guide to neurological follow-up in premature newborns]. [早产新生儿神经系统随访指南]。
IF 0.6 4区 医学
Medicina-buenos Aires Pub Date : 2024-09-01
Taha F Khan, Amanda M Romeu, Mildred Franco-Liñán, Alcy R Torres
{"title":"[Guide to neurological follow-up in premature newborns].","authors":"Taha F Khan, Amanda M Romeu, Mildred Franco-Liñán, Alcy R Torres","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>One in ten babies are born preterm, as defined as being less than 37 weeks of gestational age. Premature births are associated with a high risk of poor neurodevelopmental outcomes, including hearing, visual, motor, and cognitive impairments. Currently, there is no specific standardization for neurological follow-up infants born premature. Most formal neonatal intensive care units, follow-up programs monitor children until early childhood. However, some deficits, such as mild cognitive impairment, may only become apparent in school years. This review outlines a neurological follow-up timeline, as well as the different standardized measures that can be used to monitor development to ensure that children born preterm receive timely and appropriate therapies and services.</p>","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[How to generate recommendations for venous thromboprophylaxis in health institutions?] [如何为医疗机构的静脉血栓预防提出建议？］
IF 0.8 4区 医学
Medicina-buenos Aires Pub Date : 2024-05-01
José M Ceresetto, Carla Giumelli, Federico Bottaro, Delfina Cirelli, Enrique M Baldessari, Aldo H Tabares, Patricia Casais, Fernando J Vázquez
{"title":"[How to generate recommendations for venous thromboprophylaxis in health institutions?]","authors":"José M Ceresetto, Carla Giumelli, Federico Bottaro, Delfina Cirelli, Enrique M Baldessari, Aldo H Tabares, Patricia Casais, Fernando J Vázquez","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Venous thromboembolism disease (VTE) prevention strategy has to be constantly updated based on new evidence that is generated every year. Each institution must have a formal and active prevention policy against VTE and must develop guidelines or standards for thromboprophylaxis (TP) according to the local reality. During this process of adapting a guideline to the region and the generation of hospital recommendations, we must always consider the available local resources, the thromboembolic and hemorrhagic risk of the patients, even after discharge, and also their considerations and preferences. Adherence to local TP recommendations is one of the most important items evaluated by organizations that measure institutional quality. Individualized prophylaxis should consider personal and family history of VTE, the use of validated risk assessment models or RAMs for thrombosis and bleeding events, as well as the special characteristics of each patient. Ideally, each center's own statistics should be available for decision-making. Extrapolating guidelines from developed countries could have a negative impact, if we ignore our hospital's reality. In this document we will find practical tools for health institutions that will allow them to prepare recommendations or guidelines for adequate VTE prophylaxis.</p>","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141186530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pulmonary strain and end-expiratory lung volume during apnea test: a comparative analysis using electrical impedance tomography. 呼吸暂停测试时的肺应变和呼气末肺活量：使用电阻抗断层扫描进行比较分析。
IF 0.8 4区 医学
Medicina-buenos Aires Pub Date : 2024-01-01
Ignacio Fernández Ceballos, Joaquín Ems, Emilio Steinberg, Juan M Nuñez Silveira, Micaela B Hornos, Melany Berdiñas Anfuso, Carlos Videla, Nicolás M Ciarrocchi, Indalecio Carboni Bisso, Marcos Las Heras
{"title":"Pulmonary strain and end-expiratory lung volume during apnea test: a comparative analysis using electrical impedance tomography.","authors":"Ignacio Fernández Ceballos, Joaquín Ems, Emilio Steinberg, Juan M Nuñez Silveira, Micaela B Hornos, Melany Berdiñas Anfuso, Carlos Videla, Nicolás M Ciarrocchi, Indalecio Carboni Bisso, Marcos Las Heras","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The apnea test, employed for brain death assessment, aims to demonstrate the absence of respiratory drive due to hypercapnia. The tracheal oxygen insufflation apnea test mode (I-AT) involves disconnecting the patient from invasive mechanical ventilation (iMV) for approximately 8 minutes while maintaining oxygenation. This test supports the diagnosis of brain death based on a specified increase in PaCO2. Common complications include hypoxemia and hemodynamic instability, and lung collapse-induced reduction in end-expiratory lung volume (EELV). In our case series utilizing electrical impedance tomography (EIT), we observed that continuous positive airway pressure during the apnea test (CPAP-AT) effectively mitigated lung collapse. This resulted in improved pulmonary strain compared to the disconnection of iMV. These findings suggest the potential benefits of routine CPAP-AT, particularly for potential lung donors, emphasizing the relevance of our study in providing quantitative insights into EELV loss and its association with pulmonary strain and potential lung injury.</p>","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Ischemic stroke due to paradoxical embolism through pulmonary arteriovenous malformation in a young patient]. [年轻患者肺动静脉畸形引起的矛盾性栓塞导致缺血性中风]。
IF 0.8 4区 医学
Medicina-buenos Aires Pub Date : 2024-01-01
Matías J Alet, Hernán Bertoni, Sebastián F Ameriso
{"title":"[Ischemic stroke due to paradoxical embolism through pulmonary arteriovenous malformation in a young patient].","authors":"Matías J Alet, Hernán Bertoni, Sebastián F Ameriso","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Paradoxical embolism due to an isolated pulmonary arteriovenous malformation (PAVM) is a rare cause of ischemic stroke. PAVMs are abnormal high-flow connections between pulmonary arteries and veins, diverting deoxygenated blood into the systemic circulation and they represent a less common source of paradoxical embolisms, especially in young individuals. Endovascular embolization is the preferred treatment for clinically significant PAVMs. We present the case of a 34-year-old woman with a left thalamic ischemic stroke. Severe contrast passage was detected in cerebral arteries through transcranial Doppler. Intracardiac ultrasound did not reveal a patent foramen ovale, prompting further investigation with pulmonary CT angiography, confirming the presence of PAVM. The patient underwent successful endovascular treatment. It is essential to consider PAVM in the etiological diagnosis of ischemic stroke, especially in young patients with signs of abnormal right-to-left communication. Periodic follow-up imaging is recommended to assess potential recurrence or changes in PAVM, emphasizing the importance of appropriate management of these malformations.</p>","PeriodicalId":18419,"journal":{"name":"Medicina-buenos Aires","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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