Characteristics and outcomes of physical activity interventions for individuals with mild traumatic brain injury: a scoping review protocol.

Introduction: Traumatic brain injury (TBI) is a major public health problem, and it is estimated that 85% of TBIs are diagnosed as mild and are commonly referred to as a concussion. In adults, symptoms are expected to resolve within 10-14 days after the injury, but up to 15% of individuals continue to have symptoms beyond this period. Recent clinical recommendations suggest the use of physical activity (PA) as a therapy to manage persisting symptoms.

Is a hybrid strategy a lower-risk alternative to stage 1 Norwood operation?

Background: For neonates with critical left ventricular outflow tract obstruction (LVOTO), hybrid procedures are an alternative to the Norwood stage 1 procedure. Despite perceived advantages, however, outcomes are not well defined. Therefore, we compared outcomes after stage 1 hybrid and Norwood procedures.

Clostridium difficile Infections in Children: Impact of the Diagnostic Method on Infection Rates.

BACKGROUND Polymerase chain reaction (PCR) assays based on the detection of the toxin B gene are replacing enzyme-linked immunosorbent assay (ELISA)-based toxin production detection or cell cytotoxicity assay in most laboratories. OBJECTIVE To determine the proportion of pediatric patients diagnosed with Clostridium difficile infection by PCR who would have also been diagnosed by ELISA and to compare the clinical characteristics of PCR+/ELISA+ vs PCR+/ELISA- patients. METHODS Using the microbiology laboratory information system, stool samples positive for C.

Increased morbidity associated with weekend paediatric road traffic injuries: 10-year analysis of trauma registry data.

Background: Road traffic injuries (RTIs) are a significant cause of paediatric morbidity and mortality worldwide, with a disproportionate number of these injuries occurring in low- and middle-income countries (LMICs). Adult data from LMICs suggest that weekends are particularly high-risk for RTIs, but whether children are at increased risk of RTI on weekends has not previously been investigated in any setting. This study sought to assess patterns in paediatric RTI presentations using hospital-based trauma surveillance data in Cape Town, South Africa.

National Survey on the Impact of Viral Testing for the ED and Inpatient Management of Febrile Young Infants.

Objective: Well-appearing febrile infants with viral illnesses cannot be distinguished from those with occult life-threatening infections. Infants with respiratory viruses are less likely to have serious bacterial infections; however, current risk-stratification criteria predate widespread viral testing and there are limited data to safely inform physician management with this now common diagnostic tool. This study sought to explore the possible impact of respiratory virus testing on clinical decision-making for the management of febrile young infants<6 weeks old.

Management of persistent postconcussion symptoms in youth: a randomised control trial protocol.

Introduction: Current management of concussion consists of early education, rest until symptom free, with gradual return to school and physical activity protocols. Although this management strategy is effective for most youth who sustain a concussion, it is not an appropriate strategy for youth with persistent postconcussion symptoms. Prolonged rest and periods of restricted activity may place youth at risk for secondary issues and contribute to the chronicity of postconcussion symptoms.

Association between ovarian stimulators with or without intrauterine insemination, and assisted reproductive technologies on multiple births.

Objective: We sought to quantify the risk of multiple births associated with the use of different modalities of medically assisted reproduction.

Study Design: We conducted a case-control study using a birth cohort from 2006 through 2009. This cohort was built with the linkage of data obtained by a self-administered questionnaire and medical, hospital, pharmaceutical, birth, and death databases in Quebec.

Developmental trajectories of infants and toddlers with good initial presentation following moderate or severe traumatic brain injury: a pilot clinical assessment project.

Objective: The purpose of this study was to review the feasibility and usefulness of instituting a clinical protocol of scheduled assessments for children after a moderate or severe traumatic brain injury (TBI) sustained before the age of 2 years and showing no immediate deficits at hospital discharge, as well as to explore the early developmental trajectories of these children.

Design: Exploratory analytical cohort study.

Setting: Pediatric Trauma Center Out-patient services.

Repair of atrioventricular canal with double-outlet right ventricle, transposition, or truncus arteriosus.

Atrioventricular canal and conotruncal anomalies are a heterogeneous group of lesions presenting unique challenges for surgical repair. These are the establishment of unobstructed pathways from left ventricle (LV) to aorta and from right ventricle (RV) to pulmonary artery, closure of the inlet ventricular septal defect (VSD) and atrial septal defect (ASD) ostium primum, and the avoidance of significant left and right atrioventricular valve (AV) regurgitation. Repair of complete atrioventricular canal (CAVC) with tetralogy of Fallot (TOF) has been most commonly achieved, either using a single-patch or a 2-patch technique.

Lethal outcome after percutaneous aspiration of a presumed ovarian cyst in a neonate.

Most surgeons agree that complex neonatal ovarian cysts, regardless of size, warrant operative intervention. Management of simple cysts >4 cm is still controversial, although many favor intervention because of the increased risk of torsion. Whereas laparoscopic cyst resection is favored by some, others prefer less invasive percutaneous needle aspiration.

Intestinal venous congestion as a complication of elective silo placement for gastroschisis.

Use of a spring-loaded silastic silo has been advocated as a means of gentle reduction of the herniated bowel, while avoiding the possible complications of primary closure of gastroschisis. We recently encountered intestinal venous congestion during elective silo reduction of gastroschisis. Two babies with gastroschisis were treated postdelivery with a spring-loaded silo placed under the fascial defect and the eviscerated bowel suspended within the silo.

Attention to small details: big deal for gastrostomies.

Gastrostomy tubes are used in the pediatric population when long-term enteral feeding is needed. A common method of placement is percutaneously with endoscopy (PEG, percutaneous endoscopic gastrostomy). Although PEG placement is a straightforward procedure most of the time, it can be associated with a significant rate of minor complications and a smaller but significantly important rate of major complications.

Paediatric palliative care: challenges and emerging ideas.

Paediatric palliative care is an emerging subspecialty that focuses on achieving the best possible quality of life for children with life-threatening conditions and their families. To achieve this goal, the individuals working in this field need to: clearly define the population served; better understand the needs of children with life-threatening conditions and their families; develop an approach that will be appropriate across different communities; provide care that responds adequately to suffering; advance strategies that support caregivers and health-care providers; and promote needed change by cultivating educational programmes. Despite these challenges, advances in paediatric palliative care have been achieved in a short period of time; we expect far greater progress as the field becomes more formalised and research networks are established.

Fetal tracheal occlusion for the treatment of congenital diaphragmatic hernia.

Background: Congenital diaphragmatic hernia (CDH) continues to be associated with significant mortality and morbidity rates despite advances in neonatal care. Fetal intervention for CDH has been studied for 25 years. After initial difficulties encountered with open fetal repair, attention has turned to tracheal occlusion (TO) as a method to correct pulmonary hypoplasia before birth.

A surgical approach to adrenocortical tumors in children: the mainstay of treatment.

Background: Adrenocortical tumors (ACTs) are rare in the pediatric population. The pathogenesis, prognostic indicators, and management of these tumors are still unclear because of its infrequent occurrence. This case series presents the surgical experience of the authors' center over 29 years.

Central hypoventilation and diaphragmatic eventration: diagnosis and management.

Congenital central alveolar hypoventilation syndrome (CCAHS) is a disorder of ventilatory control that occurs without neuromuscular blockade or pulmonary disease. It is characterized by a lack of response to habitual respiratory stimulants, especially hypercapnia. In this article, the management of this syndrome by diaphragmatic pacing is discussed.

Parents' caregiving approaches: facing a new treatment alternative in severe intractable childhood epilepsy.

Parents of children with severe and intractable epilepsy face profound caregiving challenges, dealing with their child's frequent and intense seizures, accompanying physical, social and psychological problems, and ongoing quest for seizure control through a variety of medications, diet and surgery. With the advent of a new, surgical treatment for epilepsy, vagus nerve stimulation (VNS), these parents have been presented with a renewed possibility of seizure control for their children. While many studies have investigated the effects of VNS on seizure frequency and intensity, none have looked at parents' experiences in facing this potentially life changing treatment for their child.

The Benefits of Sound Field Amplification in Classrooms of Inuit Students of Nunavik: A Pilot Project.

Purpose: This pilot study investigated the potential benefits of sound field amplification for Inuit first and second language learners in a remote community of Nunavik, Northern Québec. Hearing screening results showed that 26% of students attending the local school had hearing loss due to otitis media. The study used speech intelligibility and attending behavior measures, as well as interviews, to examine the appropriateness of sound field amplification in the multilingual and multilevel instructional contexts found in the classrooms of Nunavik.