Seminars in Pediatric Neurology最新文献_第4页

Pediatric neuroinflammatory diseases in the intensive care unit 重症监护室中的儿科神经炎疾病

IF 2.7 4区医学

Seminars in Pediatric Neurology Pub Date : 2024-04-01 DOI: 10.1016/j.spen.2024.101118

Kristen S. Fisher , Anna Illner , Varun Kannan

引用次数: 0

Building a pediatric neurocritical care program: The role of the clinical pharmacist practitioner on clinical practice and education. A curriculum for neuropharmacology training 建立儿科神经重症监护计划：临床药剂师在临床实践和教育中的作用。神经药理学培训课程

IF 2.7 4区医学

Seminars in Pediatric Neurology Pub Date : 2024-04-01 DOI: 10.1016/j.spen.2024.101119

Jon A. Cokley , Steven M. Lazar

{"title":"Building a pediatric neurocritical care program: The role of the clinical pharmacist practitioner on clinical practice and education. A curriculum for neuropharmacology training","authors":"Jon A. Cokley , Steven M. Lazar","doi":"10.1016/j.spen.2024.101119","DOIUrl":"10.1016/j.spen.2024.101119","url":null,"abstract":"<div><p>Clinical pharmacists are a part of the integrated health care team and provide valuable input on medication management for patients with acute and chronic disease states. Using epilepsy as a model, pharmacist involvement in patient care has been associated with significant reductions in monthly seizure frequency. Given differences in etiology, pediatric patients with epilepsy are likely to have higher number of treatments, with additional pharmacodynamic and pharmacokinetic differences, adding to the importance of utilizing a pediatric clinical pharmacist practitioner with neuropharmacology expertise. There is an increasing exposure to critically ill patients with epilepsy and other neurological disorders in the pediatric intensive care unit (PICU). These patients are more medically complex, increasing the risk for medication errors and increased health care costs.</p><p>Emphasis on neurocritical care education is a vital component to improving patient outcomes. Inclusion of a clinical pharmacist practitioner in these settings yields a positive impact on major health outcomes. In 2018, the Neurocritical Care Society developed consensus recommendations on the standards for the development of adult neurocritical care units. A pharmacist-delivered pediatric critical care neuropharmacology rotation represents a novel approach to expanding physician education to improve patient outcomes.</p><p>While there are sparse publications highlighting the importance of adult critical care and NCC pharmacists, no such literature exists describing the benefits of pediatric neurocritical care (PNCC) pharmacists. To the best of our knowledge, this is the first manuscript describing the role of clinical pharmacist practitioners in the development of PNCC program and the benefits they provide to patient care and education.</p></div>","PeriodicalId":49284,"journal":{"name":"Seminars in Pediatric Neurology","volume":"49 ","pages":"Article 101119"},"PeriodicalIF":2.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139813870","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

Neurological injury in pediatric heart disease: A review of developmental and acquired risk factors and management considerations 小儿心脏病的神经损伤：发育和获得性风险因素及管理注意事项综述

IF 2.7 4区医学

Seminars in Pediatric Neurology Pub Date : 2024-04-01 DOI: 10.1016/j.spen.2024.101115

Molly E. McGetrick , James J. Riviello

引用次数: 0

Multimodal neuromonitoring in the pediatric intensive care unit 儿科重症监护室的多模态神经监测

IF 2.7 4区医学

Seminars in Pediatric Neurology Pub Date : 2024-04-01 DOI: 10.1016/j.spen.2024.101117

Brian Appavu , James J. Riviello Jr.

引用次数: 0

Beyond the brain: General intensive care considerations in pediatric neurocritical care 超越大脑：儿科神经重症监护中的一般重症监护注意事项

IF 2.7 4区医学

Seminars in Pediatric Neurology Pub Date : 2024-04-01 DOI: 10.1016/j.spen.2024.101120

Thao L. Nguyen , Dennis W. Simon , Yi-Chen Lai

{"title":"Beyond the brain: General intensive care considerations in pediatric neurocritical care","authors":"Thao L. Nguyen , Dennis W. Simon , Yi-Chen Lai","doi":"10.1016/j.spen.2024.101120","DOIUrl":"10.1016/j.spen.2024.101120","url":null,"abstract":"<div><p>Managing children with critical neurological conditions requires a comprehensive understanding of several principles of critical care. Providing a holistic approach that addresses not only the acute interactions between the brain and different organ systems, but also critical illness-associated complications and recovery is essential for improving outcomes in these patients.</p><p>The brain reacts to an insult with autonomic responses designed to optimize cardiac output and perfusion, which can paradoxically be detrimental. Managing neuro-cardiac interactions therefore requires balancing adequate cerebral perfusion and minimizing complications. The need for intubation and airway protection in patients with acute encephalopathy should be individualized following careful risk/benefit deliberations. Ventilatory strategies can have profound impact on cerebral perfusion. Therefore, understanding neuro-pulmonary interactions is vital to optimize ventilation and oxygenation to support a healing brain. Gastrointestinal dysfunction is common and often complicates the care of patients with critical neurological conditions. Kidney function, along with fluid status and electrolyte derangements, should also be carefully managed in the acutely injured brain. While in the pediatric intensive care unit, prevention of critical illness-associated complications such as healthcare-associated infections and deep vein thrombosis is vital in improving outcomes. As the brain emerges from the acute injury, rehabilitation and management of delirium and paroxysmal sympathetic hyperactivity is paramount for optimal recovery. All these considerations provide a foundation for the care of pediatric patients with critical neurological conditions in the intensive care unit.</p></div>","PeriodicalId":49284,"journal":{"name":"Seminars in Pediatric Neurology","volume":"49 ","pages":"Article 101120"},"PeriodicalIF":2.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140198715","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

Idiopathic Hypersomnia and Kleine–Levin Syndrome: Primary Disorders of Hypersomnolence Beyond Narcolepsy 特发性嗜睡和Kleine-Levin综合征:嗜睡症以外的嗜睡原发疾病

IF 2.7 4区医学

Seminars in Pediatric Neurology Pub Date : 2023-12-01 DOI: 10.1016/j.spen.2023.101082

Thomas J. Dye

{"title":"Idiopathic Hypersomnia and Kleine–Levin Syndrome: Primary Disorders of Hypersomnolence Beyond Narcolepsy","authors":"Thomas J. Dye","doi":"10.1016/j.spen.2023.101082","DOIUrl":"10.1016/j.spen.2023.101082","url":null,"abstract":"<div><p><span>Daytime sleepiness is common amongst children and adolescents. Inadequate sleep duration, inappropriate school start times, and the delay in sleep phase of adolescence may all contribute. Nocturnal sleep disruption due to sleep disorders such as </span>obstructive sleep apnea<span><span> or restless legs syndrome/periodic limb movement disorder may also lead to daytime sleepiness. Profound sleepiness however, when occurring in the setting of adequate sleep duration, is rare amongst children and adolescents and may prompt consideration of a central disorder of hypersomnolence<span> (CDH). Narcolepsy is the archetypal and most studied form of CDH and a detailed review of the presentation, evaluation, </span></span>treatment<span><span><span> of narcolepsy is included separately in this edition of Seminars in Pediatric Neurology. In addition to narcolepsy, 2 other forms of primary CDH exist, </span>idiopathic hypersomnia (IH) and Kleine-Levin syndrome (KLS). Onset of IH and KLS occurs most frequently during the </span>pediatric age range and presentation may include signs of encephalopathy in addition to hypersomnolence. As such, they are of particular relevance to pediatric neurology and associated fields. Unfortunately, when compared to narcolepsy little is known about IH and KLS, at both the physiologic and clinical level. This review will focus on the presentation, evaluation, and management of idiopathic hypersomnia and Kleine-Levin syndrome in the pediatric population.</span></span></p></div>","PeriodicalId":49284,"journal":{"name":"Seminars in Pediatric Neurology","volume":"48 ","pages":"Article 101082"},"PeriodicalIF":2.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135889849","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: 1

Current Considerations in the Diagnosis and Treatment of Circadian Rhythm Sleep-Wake Disorders in Children 诊断和治疗儿童昼夜节律睡眠-觉醒障碍的当前考虑因素

IF 2.7 4区医学

Seminars in Pediatric Neurology Pub Date : 2023-12-01 DOI: 10.1016/j.spen.2023.101091

Rochelle M. Witt , Kelly C. Byars , Kristina Decker , Thomas J. Dye , Jessica M. Riley , Danielle Simmons , David F. Smith

{"title":"Current Considerations in the Diagnosis and Treatment of Circadian Rhythm Sleep-Wake Disorders in Children","authors":"Rochelle M. Witt , Kelly C. Byars , Kristina Decker , Thomas J. Dye , Jessica M. Riley , Danielle Simmons , David F. Smith","doi":"10.1016/j.spen.2023.101091","DOIUrl":"10.1016/j.spen.2023.101091","url":null,"abstract":"<div><p>Circadian Rhythm Sleep-Wake Disorders (CRSWDs) are important sleep disorders whose unifying feature is a mismatch between the preferred or required times for sleep and wakefulness and the endogenous circadian drives for these. Their etiology, presentation, and treatment can be different in pediatric patients as compared to adults. Evaluation of these disorders must be performed while viewed through the lens of a patient's comorbid conditions. Newer methods of assessment promise to provide greater diagnostic clarity and critical insights into how circadian physiology affects overall health and disease states. Effective clinical management of CRSWDs is multimodal, requiring an integrated approach across disciplines. Therapeutic success depends upon appropriately timed nonpharmacologic and pharmacologic interventions. A better understanding of the genetic predispositions for and causes of CRSWDs has led to novel clinical opportunities for diagnosis and improved therapeutics.</p></div>","PeriodicalId":49284,"journal":{"name":"Seminars in Pediatric Neurology","volume":"48 ","pages":"Article 101091"},"PeriodicalIF":2.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1071909123000608/pdfft?md5=dc8748def089af4e3fde204194c145ee&pid=1-s2.0-S1071909123000608-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136117802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Clinical Evaluation and Management of Narcolepsy in Children and Adolescents 儿童和青少年嗜睡症的临床评估和管理

IF 2.7 4区医学

Seminars in Pediatric Neurology Pub Date : 2023-12-01 DOI: 10.1016/j.spen.2023.101089

Thomas J. Dye

{"title":"Clinical Evaluation and Management of Narcolepsy in Children and Adolescents","authors":"Thomas J. Dye","doi":"10.1016/j.spen.2023.101089","DOIUrl":"10.1016/j.spen.2023.101089","url":null,"abstract":"<div><p><span><span>While sleepiness is common among children, and particularly adolescents, profound sleepiness in the setting of apparently adequate sleep should prompt consideration of a central disorder of </span>hypersomnolence<span>. These disorders, which include narcolepsy, </span></span>idiopathic hypersomnia<span><span><span>, Kleine-Levin syndrome, and others, are likely underrecognized in the pediatric population. Narcolepsy in particular should be of interest to child neurologists as the unique signs and symptoms of this disease often prompt evaluation in </span>pediatric neurology clinics. While sleepiness may appear to be a straightforward complaint, its evaluation requires a nuanced approach. </span>Cataplexy<span>, a hallmark of narcolepsy, can be confused for other neurologic conditions, though understanding its various manifestations makes it readily identifiable. Clinicians should be aware of these symptoms, as delay in diagnosis and misdiagnosis are common in childhood narcolepsy. While treatment options have been limited in the past, many new therapeutic options have become available and can result in significant improvement in symptoms. Given the age at presentation, paroxysmal and chronic features, diagnostic modalities, and available treatment options, the field of child neurology is well equipped to see patients with narcolepsy. In this review, I will focus on the presentation, evaluation, and management of pediatric patients with narcolepsy.</span></span></p></div>","PeriodicalId":49284,"journal":{"name":"Seminars in Pediatric Neurology","volume":"48 ","pages":"Article 101089"},"PeriodicalIF":2.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136117808","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: 1

Pediatric Intensive Care Unit related Sleep and Circadian Dysregulation: a focused review 儿科重症监护病房相关睡眠和昼夜节律失调:一项重点综述。

IF 2.7 4区医学

Seminars in Pediatric Neurology Pub Date : 2023-12-01 DOI: 10.1016/j.spen.2023.101077

Amanda B. Hassinger , Syeda Afzal , Maya Rauth , Ryan K. Breuer

{"title":"Pediatric Intensive Care Unit related Sleep and Circadian Dysregulation: a focused review","authors":"Amanda B. Hassinger , Syeda Afzal , Maya Rauth , Ryan K. Breuer","doi":"10.1016/j.spen.2023.101077","DOIUrl":"10.1016/j.spen.2023.101077","url":null,"abstract":"<div><p>The pediatric intensive care unit<span> (PICU) is bright, loud, and disruptive to children. Strategies to improve the sleep of adults in the ICU have improved delirium and mortality rates. Children need more sleep than adults for active growth, healing, and development when well; this is likely true when they are critically ill. This review was performed to describe what we know in this area to date with the intent to identify future directions for research in this field. Since the 1990s, 16 articles on 14 observational trials have been published investigating the sleep on a total of 312 critically ill children and the melatonin<span><span> levels of an additional 144. Sleep measurements occurred in 9 studies through bedside observation (n = 2), actigraphy<span><span> (n = 2), electroencephalogram (n = 1) and polysomnography (n = 4), of which polysomnography is the most reliable. Children in the PICU sleep more during the day, have fragmented sleep and disturbed sleep architecture. Melatonin levels may be elevated and peak later in critically ill children. Early data suggest there are at-risk subgroups for sleep and circadian disruption in the PICU including those with sepsis, burns, </span>traumatic brain injury and after </span></span>cardiothoracic surgery. The available literature describing the sleep of critically ill children is limited to small single-center observational studies with varying measurements of sleep and inconsistent findings. Future studies should use validated measurements and standardized definitions to begin to harmonize this area of medicine to build toward pragmatic interventional trials that may shift the paradigm of care in the pediatric intensive care unit.</span></span></p></div>","PeriodicalId":49284,"journal":{"name":"Seminars in Pediatric Neurology","volume":"48 ","pages":"Article 101077"},"PeriodicalIF":2.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44605374","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

Sleep Disorders and Chronic Pain Syndromes in the Pediatric Population 儿科人群的睡眠障碍和慢性疼痛综合征

IF 2.7 4区医学

Seminars in Pediatric Neurology Pub Date : 2023-12-01 DOI: 10.1016/j.spen.2023.101085

Ann Oh MD , Angelina Koehler CPNP-PC , Marcy Yonker MD , Matthew Troester DO

{"title":"Sleep Disorders and Chronic Pain Syndromes in the Pediatric Population","authors":"Ann Oh MD , Angelina Koehler CPNP-PC , Marcy Yonker MD , Matthew Troester DO","doi":"10.1016/j.spen.2023.101085","DOIUrl":"10.1016/j.spen.2023.101085","url":null,"abstract":"<div><p>Sleep problems are widespread in children and adolescents suffering from chronic pain disorders. Sleep loss intensifies the experience of pain and is detrimental to the budding self-efficacy of a young individual with limitless horizons. Addressing sleep disorders may prevent the chronification of pain and prevent adverse health outcomes, such as functional impairment, psychiatric comorbidities and overall poor quality of life. This review will explore the cyclical nature between sleep, pain and mood, as well as the functional impact of this relationship on children and adolescents. There will be a discussion about sleep assessment and diagnostic testing, followed by a description of sleep disturbances found in specific pain conditions, ranging from headache, musculoskeletal/abdominal pain, to rheumatologic disorders. Finally, there will be a brief review of pharmacologic and behavioral interventions designed to improve sleep quality, and when possible, to alleviate pain.</p></div>","PeriodicalId":49284,"journal":{"name":"Seminars in Pediatric Neurology","volume":"48 ","pages":"Article 101085"},"PeriodicalIF":2.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1071909123000542/pdfft?md5=1c5ed75def801b6e2b131e7329d65a8e&pid=1-s2.0-S1071909123000542-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135889720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1