Predictors of activities and participation six months after mild traumatic brain injury in children and adolescents.

Objective: This study aimed to identify predictors of long-term consequences for activities and participation in children and adolescents with mild traumatic brain injury (mTBI).

Methods: A multicentre prospective longitudinal cohort study was conducted. The primary outcome measure was activities and participation measured with the Child and Adolescent Scale of Participation - CASP and completed by children (N = 156) and caregivers (N = 231) six months post-mTBI.

Right ventricular-pulmonary arterial uncoupling in mild-to-moderate systemic hypertension.

Background: Mild-to-moderate hypertension with preserved left ventricular (LV) function may be associated with right ventricular (RV) dysfunction and increased pulmonary vascular resistance (PVR).

Methods: The present study explored the adequacy of RV-pulmonary arterial (PA) coupling in 211 never-treated hypertensive patients (mean blood pressure, BP 112 ± 12 mmHg) and 246 controls (BP 93 ± 12 mmHg). They underwent a comprehensive transthoracic Doppler echocardiography, and RV-PA coupling was estimated by the tricuspid annular plane systolic excursion (TAPSE) to systolic pulmonary artery pressure (PASP) ratio (TAPSE/PASP).

Estimated Daily Urine Volume and Solute Excretion from Spot Urine Samples to Guide the Therapy of Hyponatremia in SIADH.

In hyponatremia, due to the inappropriate secretion of antidiuretic hormone (SIADH), a high versus low solute intake will affect the urine volume (UV) and, hence, the SNa level. The clinical implication of the fractional solute excretion is presented. : In 35 normal controls and 24 patients with SIADH and urine osmolality higher than serum osmolality, we compared exact solute intake obtained from 24 h urine collection, with the estimated value obtained on a urine morning spot sample by the formula: The exact UV was compared with the estimated value given by the formula: In 65 patients with chronic SIADH, from which a morning spot urine sample was available, we determined the estimated fluid and solute intake.

A clinical diagnostic algorithm for early onset cerebellar ataxia.

Early onset cerebellar Ataxia (EOAc) comprises a large group of rare heterogeneous disorders. Determination of the underlying etiology can be difficult given the broad differential diagnosis and the complexity of the genotype-phenotype relationships. This may change the diagnostic work-up into a time-consuming, costly and not always rewarding task.

Amikacin liposome inhalation suspension for chronic Pseudomonas aeruginosa infection in cystic fibrosis.

Background: Shortcomings of inhaled antibiotic treatments for Pseudomonas aeruginosa infection in patients with cystic fibrosis (CF) include poor drug penetration, inactivation by sputum, poor efficiency due to protective biofilm, and short residence in the lung.

Methods: Eligible patients with forced expiratory volume in 1 s (FEV) ≥25% of predicted value at screening and CF with chronic P. aeruginosa infection were randomly assigned to receive 3 treatment cycles (28 days on, 28 days off) of amikacin liposome inhalation suspension (ALIS, 590 mg QD) or tobramycin inhalation solution (TIS, 300 mg BID).

Decreased pulmonary vascular distensibility in adolescents conceived by in vitro fertilization.

Study Question: What is the functional relevance of decreased pulmonary vascular distensibility in adolescents conceived by IVF?

Summary Answer: Children born by IVF have a slight decrease in pulmonary vascular distensibility observed during normoxic exercise that is not associated with altered right ventricular function and aerobic exercise capacity.

What Is Known Already: General vascular dysfunction and increased hypoxic pulmonary hypertension have been reported in ART children as compared to controls. Pulmonary hypertension or decreased pulmonary vascular distensibility may affect right ventricular function and thereby possibly limit maximal cardiac output and aerobic exercise capacity.

Post-operative cerebellar mutism syndrome: rehabilitation issues.

Introduction: Tumors of the cerebellum are the most common brain tumors in children. Modern treatment and aggressive surgery have improved the overall survival. Consequently, growing numbers of survivors are at high risk for developing adverse and long-term neurological deficits including deficits of cognition, behavior, speech, and language.

Barriers to accrual and enrollment in brain tumor trials.

Many factors contribute to the poor survival of malignant brain tumor patients, some of which are not easily remedied. However, one contributor to the lack of progress that may be modifiable is poor clinical trial accrual. Surveys of brain tumor patients and neuro-oncology providers suggest that clinicians do a poor job of discussing clinical trials with patients and referring patients for clinical trials.

What Are the Characteristics of the Upper Airway in Patients With Craniofacial Microsomia?

Purpose: Obstructive sleep apnea (OSA) is a common problem in patients with craniofacial microsomia (CFM); however, the exact pathophysiology in patients with CFM remains unclear. The first aim of this study was to evaluate upper airway volume and morphology in patients with CFM. The second aim was to identify risk factors for the presence of OSA.

Intra- and Inter-Rater Agreement Describing Myometrial Lesions Using Morphologic Uterus Sonographic Assessment: A Pilot Study.

Objectives: To evaluate the intra- and inter-rater agreement for myometrial lesions using Morphologic Uterus Sonographic Assessment terminology.

Methods: Thirteen raters with high (n = 6) or medium experience (n = 7) assessed 30 3-dimensional ultrasound clips with (n = 20) and without (n = 10) benign myometrial lesions. Myometrial lesions were reported as poorly or well defined and then systematically evaluated for the presence of individual features.

Braided stents and their impact in intracranial aneurysm treatment for distal locations: from flow diverters to low profile stents.

Introduction: Intracranial aneurysms in distal locations are sometimes difficult to treat due to their branching locations and the presence of blister-like or very wide-necked aneurysms. Braided intracranial stents, including flow diverters (FDs) and low-profile braided intracranial stents (LPBSs) may provide additional advantages, due to their flow-diverting properties.

Areas Covered: The use of FDs in off-label, distal intracranial locations has been increasing with promising outcomes and has given rise to the LPBS, which has less flow-diverting properties, allowing for easier use in distal branching sites through 0.

Curative endovascular treatment for low-grade Spetzler-Martin brain arteriovenous malformations: a single-center prospective study.

Background: The treatment of low grade Spetzler-Martin (SM) brain arteriovenous malformations (AVMs) has been debated in unruptured cases. Nevertheless, in clinical practice there are cases where treatment is preferred; in these cases a very low complication rate is mandatory. In ruptured cases, early and complete obliteration of the nidus is the preferred strategy.

The Neuromodulation Appropriateness Consensus Committee on Best Practices for Dorsal Root Ganglion Stimulation.

Introduction: The Neuromodulation Appropriateness Consensus Committee (NACC) is dedicated to improving the safety and efficacy of neuromodulation and thus improving the lives of patients undergoing neuromodulation therapies. With continued innovations in neuromodulation comes the need for evolving reviews of best practices. Dorsal root ganglion (DRG) stimulation has significantly improved the treatment of complex regional pain syndrome (CRPS), among other conditions.

Correction to: Relevance of neuroimaging for neurocognitive and behavioral outcome after pediatric traumatic brain injury.

JC Goslings is the correct name of the sixth author of this article.

The Brains Ahead! intervention for children and adolescents with mild traumatic brain injury and their caregivers: rationale and description of the treatment protocol.

Purpose:: Approximately 20% of the children and adolescents after mild traumatic brain injury will not fully recover. They suffer long-term postconcussive symptoms and may experience limitations in activities and participation. Research suggests that early psychoeducational interventions may prevent long-term postconcussive symptoms.

The Right Heart-Pulmonary Circulation Unit in Systemic Hypertension.

Systemic hypertension is a risk factor for left heart failure, mostly with preserved ejection fraction. Left heart failure is a cause of pulmonary hypertension and eventual right ventricular (RV) failure. There has been report of altered RV function in mild to moderate hypertension with preserved systolic as well as diastolic function of the left ventricle.

Cerebellar mutism syndrome.

Cerebellar mutism most commonly, but not exclusively, develops in children after surgery for midline cerebellar or intraventricular tumors in the posterior fossa, typically medulloblastoma. Cerebellar mutism syndrome (CMS) comprises a complex set of neurologic and neurocognitive signs and symptoms, the cardinal and central component of which is an initially profound but usually reversible speech disorder. As such, CMS is currently recognized as an extreme form of the so-called cerebellar cognitive affective syndrome (Schmahmann syndrome).

Evaluation of management and guideline adherence in children with mild traumatic brain injury.

Aim: To evaluate the management and guideline adherence in children with mild traumatic brain injury (MTBI) in emergency departments (ED) in the Netherlands.

Methods: A multicentre cohort study was conducted, including children younger than 18 years with MTBI who presented within 24 hours after trauma in the ED of hospitals in the southwest region of the Netherlands, in 2014. Primary outcome measures for management were percentages of performed computed tomography (CT) scans and hospital admissions.

A low-grade astrocytoma in a sixteen-year-old boy with a 7q11.22 deletion.

We report a patient with developmental delay due to germline AUTS2 mutation who developed a low-grade astrocytoma. While the contribution of this mutation to the pathogenesis of the tumor is not known at this time, a role of AUTS2 in deregulation of PRC1 can be a part in tumorigenesis of a brain tumor.

Intracranial 4D flow magnetic resonance imaging reveals altered haemodynamics in sickle cell disease.

Stroke risk in children with sickle cell disease (SCD) is currently assessed with routine transcranial Doppler ultrasound (TCD) measurements of blood velocity in the Circle of Willis (CoW). However, there is currently no biomarker with proven prognostic value in adult patients. Four-dimensional (4D) flow magnetic resonance imaging (MRI) may improve risk profiling based on intracranial haemodynamics.

The significance of circadian rhythms and dysrhythmias in critical illness.

Many physiological and cellular processes cycle with time, with the period between one peak and the next being roughly equal to 24 h. These circadian rhythms underlie 'permissive homeostasis', whereby anticipation of periods of increased energy demand or stress may enhance the function of individual cells, organ systems or whole organisms. Many physiological variables related to survival during critical illness have a circadian rhythm, including the sleep/wake cycle, haemodynamic and respiratory indices, immunity and coagulation, but their clinical significance remains underappreciated.

A National Survey on Peri-interventional Management of Percutaneous Transhepatic Biliary Drainage.

Purpose: The purpose of this study is to evaluate knowledge about management of percutaneous transhepatic biliary drainage (PTBD) catheters among nurses taking care of hepato-pancreato-biliary (HPB) patients.

Methods: Six HPB nurses from the Dutch national HPB association created a questionnaire that was complemented by 2 HPB surgeons, 3 HPB interventional radiologists, and a methodologist. Registered nurses working at the department of gastroenterology or gastrointestinal surgery and familiar with the care for HPB patients were invited to complete the questionnaire.