Publications by authors named "Omer Bar Yosef"

Objective: Cerebral air embolism during Cardio-Pulmonary Bypass is a severe complication with significant neurological risks. We present six pediatric cases, detailing their presentation, management, and outcomes. The discussion reviews existing literature and proposes management guidelines for suspected air emboli.

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An association between subtle changes in T2 white matter hyper-intense signals (WMHSs) detected in fetal brain magnetic resonance imaging (fbMRI) and congenital cytomegalovirus (CMV) infection has been established. The research aim of this study is to compare children with congenital CMV infection with neurodevelopment outcome and hearing deficit with and without WMHSs in a historic prospective case study cohort of 58 fbMRIs. Of these, in 37 cases, fbMRI was normal (normal group) and WMHSs were detected in 21 cases (WMHS group).

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Open-heart surgery with cardiopulmonary bypass often leads to complications including pain, systemic inflammation, and organ damage. Traditionally managed with opioids, these pain relief methods bring potential long-term risks, prompting the exploration of alternative treatments. The legalization of cannabis in various regions has reignited interest in cannabinoids, such as cannabidiol, known for their anti-inflammatory, analgesic, and neuroprotective properties.

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Purpose: Fetal intracranial hemorrhage is rarely identified in prenatal imaging. When identified, sparse data regarding neurodevelopmental outcomes worsens prenatal dilemmas. This MRI-based study aimed to assess prenatal characteristics and neurodevelopmental outcomes of fetal intracranial hemorrhage.

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Article Synopsis
  • Patients with single large-scale mitochondrial DNA (mtDNA) deletion syndromes (SLSMDs) often suffer from serious multisystemic diseases like Pearson syndrome in childhood or Kearns-Sayre syndrome later on, and there's currently no effective treatment available.
  • A new approach called mitochondrial augmentation therapy (MAT) was tested on six patients with SLSMDs, where their own hematopoietic cells were infused with healthy maternal mitochondria.
  • The treatment showed safety, decreased harmful mtDNA levels in four patients, and increased mtDNA content in all six, alongside some improvements in aerobic function and quality of life measured by caregivers, suggesting a need for further clinical trials.
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Protein phosphatase 2A (PP2A) is a heterotrimeric serine/threonine phosphatase that regulates numerous biological processes. PPP2R1A encodes the scaffolding "Aα" subunit of PP2A. To date, nearly 40 patients have been previously reported with 19 different pathogenic PPP2R1A variants, with phenotypes including intellectual disability, developmental delay, epilepsy, infant agenesis/dysgenesis of the corpus callosum, and dysmorphic features.

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Introduction: Concerns regarding felbamate adverse effects restrict its widespread use in children with drug-resistant epilepsy. We aimed to examine the efficacy and safety of felbamate in those children and identify the ones who may benefit most from its use.

Methods: We retrospectively reviewed the medical files of all patients who were treated with felbamate in a tertiary pediatric epilepsy clinic between 2009-2021.

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Background: Limping and/or refusal to walk is a common complaint in the setting of the pediatric department, with a widely diverse differential diagnosis. An unusual etiology, is that of a hereditary neuropathy. Hereditary neuropathy with liability to pressure palsies (HNPP) is a recurrent, episodic demyelinating neuropathy, most commonly caused by a 17p11.

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Background: Temporal lobe T2 hyperintensity has been described in association with prenatal cytomegalovirus (CMV) infection on fetal MRI. However, these findings are often perplexing with high inter-observer variability. Our objective was to evaluate temporal lobe T2 signal quantitatively in prenatal CMV infection.

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Exome sequencing (ES) is an important diagnostic tool for individuals with neurodevelopmental disorders (NDD) and/or multiple congenital anomalies (MCA). However, the cost of ES limits the test's accessibility for many patients. We evaluated the yield of publicly funded clinical ES, performed at a tertiary center in Israel, over a 3-year period (2018-2020).

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Article Synopsis
  • CACNA1C is a gene that encodes a crucial part of a calcium channel found in the heart and brain, and variants in it have been linked to Timothy syndrome and long QT syndrome, but this study focuses on its neurological effects.
  • The study examined 25 individuals from 22 families with heterozygous variants in CACNA1C, showing a range of neurological issues like developmental delays, autism, hypotonia, ataxia, and epilepsy.
  • Results indicate that these variants can lead to different functional changes in the calcium channel, expanding the understanding of CACNA1C's role in neurodevelopmental disorders beyond previously known syndromes.
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Objectives: To assess the added value of third trimester fetal brain MRI, performed in one tertiary referral center, in cases of isolated ventriculomegaly as established by a dedicated multiplanar neurosonography.

Methods: Fetal brain MRI scans performed in a single tertiary center during a 3-year period were assessed for possible inclusion. Only cases diagnosed with ventriculomegaly without additional findings in a neurosonography preceding the MRI were included.

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Brain injury is a major source of patient morbidity after cardiac surgery in children. New early accurate biomarkers are needed for the diagnosis of patients at risk for cerebral postoperative damage. Specific circulating miRNAs have been found as suitable biomarkers for many diseases.

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Objectives: Fetal brain non-dilated ventricular asymmetry (NDVA) is a common finding on prenatal ultrasound exams. However, the optimal prenatal management in these cases remains unknown. We aimed to evaluate the benefit of prenatal genetic and magnetic resonance imaging (MRI) exams performed in cases of fetal NDVA detected on ultrasound.

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Background And Purpose: The cavum septum pellucidum (CSP) is an important landmark in the evaluation of the fetal neural axis. A deviation from the ultrasonic normal values may be associated with unfavorable outcomes, and a normal CSP provides reassurance of normal central forebrain development. Today, there is biometric data regarding the normal values for the width of the CSP in fetal ultrasound, but there is no such data for fetal MRI.

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  • The study aimed to analyze biometric parameters in ultrasound and MRI of fetuses diagnosed with isolated mega cisterna magna (MCM) at a single medical center.
  • Out of 103 fetuses, 44 had isolated MCM, showing significantly larger measurements in biparietal diameter and head circumference compared to the control group with normal CNS.
  • Results suggest that isolated MCM is associated with larger fetal CNS metrics and may be influenced by the gender of the fetus, with a higher prevalence of males in the study group.
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Background: Fetal ventriculomegaly is one of the more common fetal anomalies detected during prenatal screening.

Objectives: To assess the rate of genetic aberrations as the cause for ventriculomegaly in these fetuses.

Methods: A historic cohort study was conducted on 164 fetuses with sonographic diagnosis of ventriculomegaly.

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Article Synopsis
  • - The study explored how cognitive functions in children with epilepsy influence the severity of psychosocial problems, revealing that emotional and behavioral issues may vary based on the environment and the informant (parents vs. teachers).
  • - Participants included 155 children aged 5-18, whose cognitive abilities were assessed alongside reports of emotional and behavioral problems from both parents and teachers, with teachers typically reporting more severe symptoms.
  • - Findings suggest that differences in perspectives between informants highlight the need to consider these nuances in educational and therapeutic interventions for children with epilepsy.
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Major perioperative cardiovascular events are important causes of morbidity in pediatric patients with congenital heart disease who undergo reparative surgery. Current preoperative clinical risk assessment strategies have poor accuracy for identifying patients who will sustain adverse events following heart surgery. There is an ongoing need to integrate clinical variables with novel technology and biomarkers to accurately predict outcome following pediatric heart surgery.

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Introduction: The new anticonvulsant brivaracetam is a levetiracetam analog which binds to the synaptic vesicle protein 2A, and inhibits excitatory neurotransmitters' release. Brivaracetam was Food and Drug Administration (FDA) and European Medicine Agency (EMA) approved in 2016 as adjunctive treatment for focal onset seizures in patients over 16 years of age, and in 2018 for children over four years of age. Our aim was to describe effectiveness and tolerability in real-life pediatric epilepsy clinic.

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AMPA receptors (AMPARs) are tetrameric ligand-gated channels made up of combinations of GluA1-4 subunits encoded by GRIA1-4 genes. GluA2 has an especially important role because, following post-transcriptional editing at the Q607 site, it renders heteromultimeric AMPARs Ca-impermeable, with a linear relationship between current and trans-membrane voltage. Here, we report heterozygous de novo GRIA2 mutations in 28 unrelated patients with intellectual disability (ID) and neurodevelopmental abnormalities including autism spectrum disorder (ASD), Rett syndrome-like features, and seizures or developmental epileptic encephalopathy (DEE).

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Objective: Data regarding the neurodevelopmental outcome of fetal short corpus callosum (CC) diagnosed according to standard reference charts is scarce. The purpose of this study was to assess whether the finding is related to neurodevelopmental delay, and to examine reclassification to normal fetal CC length using CC length/EFW ratio.

Method: Historical prospective cohort study including pregnant women who were referred for fetal neurosonogram due to abnormal CC.

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Article Synopsis
  • - The study aimed to characterize arachnoid cysts (AC), which are rare congenital brain lesions, and compare the neurodevelopmental outcomes of affected children with those without AC.
  • - Researchers conducted a retrospective analysis of 29 fetuses with AC and 59 control fetuses, focusing on both the anatomical location of the cysts and their impact on neurodevelopment.
  • - Results showed that 77.3% of children with AC had normal development, while 22.7% experienced abnormal outcomes, indicating a generally favorable prognosis for most affected cases.
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