scholarly journals (A109) Systematic Literature Review on Pediatric Sleep Disturbance Management Post-Disaster: Implications of Post-Disaster Pediatric Clinical Management in Developing Countries

2011 ◽  
Vol 26 (S1) ◽  
pp. s38-s38
Author(s):  
E.Y.Y. Chan ◽  
S.D. Koo
Keyword(s):  
Developing Countries ◽  
Sleep Disturbance ◽  
Clinical Management ◽  
Sleep Disturbances ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Traumatic Events ◽  
Clinical Effectiveness ◽  
Post Disaster ◽  
Pediatric Sleep

IntroductionSleep disturbances are common symptoms during the immediate and long-term aftermath of exposure of traumatic events. While stress affects sleep in all age groups, due to differences in physiological, psychological, and socio-behavorial risk factors, the clinical management of pediatric patients with sleep disturbances post-disaster might be different. This study aims to systematically review scientific literature on the clinical management of pediatric sleep disturbances post-disaster and its clinical implication in developing countries. Methods: A keyword-based, systematic review was conducted for scientific publication in academic and disaster literature databases (Medline, PUBMED, Academic Search Premier, Google Scholar, ELDIS, PsycINFO, PILOTS and RELIEFWEB) until October 2010. Abstracts of all the hits were inspected to remove non-relevant articles, and all relevant articles were reviewed and scored by two reviewers to determine relevancy before being included in the final study database. Quality, relevance, and applicability of the reported literature were examined critically with the EBM level of evidence and EPPHPPQ (2003) assessment tool.Results and DiscussionThe literature disproportionally emphasized the clinical effects and psychological impacts of traumatic events on pediatric patients, and most reported studies were reported as a subset within PTSD study literature. Management of younger children, gender differences, clinical effectiveness of cross-disciplinary management modalities, and experiences in middle- and low-income countries were extremely limited. While principles of sleep hygiene and clinical guidelines for management of adult sleep disturbance are available, the application of clinical effectiveness and appropriateness of these guidelines in pediatric population must be examined further.Conclusion and ImplicationsCurrently, there is limited literature on the acute management of pediatric sleep disturbances post-disaster in developing countries. Evidence-based studies are needed to identify the appropriate clinical approaches to support the pediatric population with sleep disturbances post-disaster.

scholarly journals Methodological flaws on “manual therapy for the pediatric population: a systematic review” by Prevost et al. (2019)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hainan Yu ◽  
Heather Shearer ◽  
Anne Taylor-Vaisey ◽  
Silvano Mior ◽  
Leslie Verville ◽  
...  
Keyword(s):  
Systematic Review ◽  
Manual Therapy ◽  
Clinical Management ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Internal Validity ◽  
Clinical Conditions

AbstractPrevost et al. published a systematic review evaluating the use of manual therapy for clinical conditions in the pediatric population in 2019. However, several methodological flaws in the conduct of the review limit the internal validity of its conclusions. We caution readers about the validity of the recommendations and suggest that the review not be used to inform the clinical management of pediatric patients.

Pediatric Sleep–Wake Disorders

2020 ◽  
pp. 239-268
Author(s):  
Rebecca Marshall ◽  
Kyle P. Johnson ◽  
Anna Ivanenko
Keyword(s):  
Sleep Disorders ◽  
Psychiatric Disorders ◽  
Sleep Disturbances ◽  
Pediatric Population ◽  
Sleep Wake Disorders ◽  
Psychiatric Symptomatology ◽  
Academic Impairment ◽  
Evidence Based Treatments ◽  
Primary Sleep Disorder ◽  
Pediatric Sleep

This chapter reviews pediatric sleep–wake disorders, with a particular focus on evaluation and treatment of sleep disturbances comorbid with primary psychiatric disorders and commonly prevalent primary sleep disorders in the pediatric population. The sleep disturbances due to primary sleep disorders can often result in symptoms and behaviors suggestive of a psychiatric condition such as inattention, poor impulse control, academic impairment, mood changes, fatigue, and excessive daytime sleepiness. It is important that the pediatric clinician assesses the youth presenting with sleep and psychiatric symptomatology for presence of primary sleep disorders. Consultation with a sleep physician for further evaluation and treatment is recommended if a primary sleep disorder is suspected. More evidence-based treatments are needed for primary insomnia and sleep disturbances comorbid with primary psychiatric disorders in pediatric population.

scholarly journals Interactions between sleep disturbances and Alzheimer’s disease on brain function: a preliminary study combining the static and dynamic functional MRI

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Kaicheng Li ◽  
Xiao Luo ◽  
Qingze Zeng ◽  
Yerfan Jiaerken ◽  
Shuyue Wang ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Risk Factor ◽  
Sleep Disturbance ◽  
Brain Function ◽  
Sleep Disturbances ◽  
Brain Activity ◽  
Vascular Risk Factor ◽  
Underlying Mechanism ◽  
Amyloid Pet

AbstractThough sleep disturbance constitutes the risk factor for Alzheimer’s disease (AD), the underlying mechanism is still unclear. This study aims to explore the interaction between sleep disturbances and AD on brain function. We included 192 normal controls, 111 mild cognitive impairment (MCI), and 30 AD patients, with either poor or normal sleep (PS, NS, respectively). To explore the strength and stability of brain activity, we used static amplitude of low-frequency fluctuation (sALFF) and dynamic ALFF (dALFF) variance. Further, we examined white matter hyperintensities (WMH) and amyloid PET deposition, representing the vascular risk factor and AD-related hallmark, respectively. We observed that sleep disturbance significantly interacted with disease severity, exposing distinct effects on sALFF and dALFF variance. Interestingly, PS groups showed the dALFF variance trajectory of initially increased, then decreased and finally increased along the AD spectrum, while showing the opposite trajectory of sALFF. Further correlation analysis showed that the WMH burden correlates with dALFF variance in PS groups. Conclusively, our study suggested that sleep disturbance interacts with AD severity, expressing as effects of compensatory in MCI and de-compensatory in AD, respectively. Further, vascular impairment might act as important pathogenesis underlying the interaction effect between sleep and AD.

scholarly journals Paranasal Mass in a Healthy Male Toddler

2021 ◽  
pp. 014556132110079
Author(s):  
Melonie Anne Phillips ◽  
Meredith Lind ◽  
Gerd McGwire ◽  
Diana Rodriguez ◽  
Suzanna Logan
Keyword(s):  
Differential Diagnosis ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Age Group ◽  
Significant Morbidity ◽  
Healthy Male ◽  
Neck Tumors ◽  
Complete Surgical Resection ◽  
Maxilla And Mandible ◽  
Benign Mass

Head and neck tumors are rare in pediatric patients but should be kept in the differential when a patient presents with a new swelling or mass. One of these tumors is a myxoma, which is an insidiously growing, benign mass originating from the mesenchyme. They most commonly arise in the myocardium but can also develop in facial structures, particularly in the maxilla and mandible. When arising in facial structures, ocular, respiratory, and digestive systems can be affected based on local invasion. Complete surgical resection is curative but can lead to significant morbidity as well. Here, we present a case of a 15-month-old toddler presenting with a paranasal mass, which was ultimately diagnosed as a maxillary myxoma. This tumor is very rare in the pediatric population, especially in the toddler age-group, reminding clinicians to broaden the differential diagnosis when a patient’s course is atypical.

scholarly journals 1346. Implementation of a Multidisciplinary 48 Hour Antibiotic Timeout in a Pediatric Population

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S684-S684
Author(s):  
Victoria Konold ◽  
Palak Bhagat ◽  
Jennifer Pisano ◽  
Natasha N Pettit ◽  
Anish Choksi ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Pediatric Population ◽  
Intervention Group ◽  
Post Intervention ◽  
Days Of Therapy ◽  
New Antibiotics ◽  
Core Elements ◽  
Quasi Experimental ◽  
Empirical Antibiotics ◽  
The Impact

Abstract Background To meet the core elements required for antimicrobial stewardship programs, our institution implemented a pharmacy-led antibiotic timeout (ATO) process in 2017 and a multidisciplinary ATO process in 2019. An antibiotic timeout is a discussion and review of the need for ongoing empirical antibiotics 2-4 days after initiation. This study sought to evaluate both the multidisciplinary ATO and the pharmacy-led ATO in a pediatric population, compare the impact of each intervention on antibiotic days of therapy (DOT) to a pre-intervention group without an ATO, and to then compare the impact of the pharmacy-led ATO versus multidisciplinary ATO on antibiotic days of therapy (DOT). Methods This was a retrospective, pre-post, quasi-experimental study of pediatric patients comparing antibiotic DOT prior to ATO implementation (pre-ATO), during the pharmacy-led ATO (pharm-ATO), and during the multidisciplinary ATO (multi-ATO). The pre-ATO group was a patient sample from February-September 2016, prior to the initiation of a formal ATO. The pharmacy-led ATO was implemented from February-September 2018. This was followed by a multidisciplinary ATO led by pediatric residents and nurses from February-September 2019. Both the pharm-ATO and the multi-ATO were implemented as an active non-interruptive alert added to the electronic health record patient list. This alert triggered when new antibiotics had been administered to the patient for 48 hours, at which time, the responsible clinician would discuss the antibiotic and document their decision via the alert workspace. Pediatric patients receiving IV or PO antibiotics administered for at least 48 hours were included. The primary outcome was DOT. Secondary outcomes included length of stay (LOS) and mortality. Results 1284 unique antibiotic orders (n= 572 patients) were reviewed in the pre-ATO group, 868 (n= 323 patients) in the pharm-ATO and 949 (n= 305 patients) in the multi-ATO groups. Average DOT was not significantly different pre vs post intervention for either methodology (Table 1). Mortality was similar between groups, but LOS was longer for both intervention groups (Table 1). Impact of an ATO on DOT, Mortality and LOS Conclusion An ATO had no impact on average antibiotic DOT in a pediatric population, regardless of the ATO methodology. Disclosures All Authors: No reported disclosures

631 Sleep SMART in Adolescents with Neurodevelopmental Disorders

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A247-A248
Author(s):  
Alyson Hanish ◽  
Abbey Jo Klein ◽  
Therese Mathews ◽  
Ann Berger ◽  
Kevin Kupzyk ◽  
...  
Keyword(s):  
Sleep Disturbance ◽  
Neurodevelopmental Disorders ◽  
Sleep Disturbances ◽  
Immediate Release ◽  
Sleep Time ◽  
Normative Values ◽  
Exogenous Melatonin ◽  
Contingency Contracting ◽  
Sleep Questionnaires ◽  
The Impact

Abstract Introduction: Introduction Sleep disturbances are common in adolescents with neurodevelopmental disorders (NDDs). Inclusion of vulnerable populations such as adolescents with NDDs into sleep intervention efforts is essential as they are at high-risk for poor physical/mental health outcomes. The objective of this study is to pilot a sequential, multiple assignment, randomized trial (SMART) design to compare the impact of a sequence of sleep interventions, based on treatment response, to optimize sleep health in adolescents with NDDs. Methods: Methods Recruitment began June 2019 using convenience sampling. The SMART pilot feasibility study includes 1-week of baseline sleep data, and two 4-week periods of a sleep intervention (9-week total study enrollment). Interventions include exogenous melatonin, The Bedtime Bank, and their combination. Exogenous melatonin (liquid, immediate release, 3mg) is administered 30 minutes before bedtime. The Bedtime Bank, a behavioral sleep intervention, is based upon contingency contracting that relies on a credit- or debt-based system to hold adolescents accountable for maintaining a consistent bedtime. At baseline participants completed demographics, PROMIS pediatric sleep questionnaires, the Cleveland Adolescent Sleepiness Questionnaire (CASQ), salivary & urinary endogenous melatonin measurement, and one week of actigraphy. Upon enrollment, participants were randomly assigned to either melatonin or The Bedtime Bank. Participants who respond (nightly increase in total sleep time (TST) ≥18 minutes) remain on the assigned intervention; if non-responsive participants are re-randomized to a different sleep intervention or combination. Results: Results At baseline, participants (n=29, aged 10–18 years) had an average TST of 7 hours 11 minutes. PROMIS Sleep Disturbance (M=64.3, SE=2.5), PROMIS Sleep-Related Impairment scores (M=58.9, SE=2.2), and CASQ scores (M=40.0, SD= 10.5) were higher than reported normative values. Salivary DLMO & urinary 6-sulfatoyxmelatonin analysis is ongoing. For participants who completed the full 9-week trial, nearly 30% (n=7/24) were responsive (increased baseline TST ≥18 minutes) to one of the 4-week interventions. Conclusion: Conclusion Baseline data of the enrolled participants demonstrates poor indicators of TST, sleep disturbance, and sleep related impairment. Preliminary results of this SMART indicate some adolescents are responsive to sleep interventions aimed to improve their TST. Support (if any) Support: This clinical trial is funded by the National Institute of Nursing Research, National Institutes of Health (1K01NR017465-01A1).

scholarly journals The Specific Characteristics in Children with Obstructive Sleep Apnea and Cor Pulmonale

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Pi-Chang Lee ◽  
Betau Hwang ◽  
Wen-Jue Soong ◽  
C. C. Laura Meng
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Clinical Manifestations ◽  
Cor Pulmonale ◽  
Arousal Index ◽  
Obstructive Sleep ◽  
Hemodynamic Characteristics ◽  
Pulmonary Arterial

Background.The prevalence of obstructive sleep apnea (OSA) in the pediatric population is currently estimated at 1-2% of all children. The purpose of this study was to investigate the clinical and hemodynamic characteristics in pediatric patients with cor pulmonale and OSA.Methods.Thirty children with the diagnosis of OSA were included. These patients consisted of 26 male and 4 female children with a mean age of 7 ± 4 years old. Five of those children were found to be associated with cor pulmonale, and 25 had OSA but without cor pulmonale.Results.The arousal index was much higher in children with OSA and cor pulmonale. The children with OSA and cor pulmonale had much lower mean and minimal oxygen saturation and a higher incidence of bradycardia events. All 5 patients with OSA and cor pulmonale underwent an adenotonsillectomy, and the pulmonary arterial pressure dropped significantly after the surgery.Conclusion.This study demonstrated that the OSA pediatric patients with cor pulmonale had the different clinical manifestations and hemodynamic characteristics from those without cor pulmonale. The adenotonsillectomy had excellent results in both the OSA pediatric patients with and without cor pulmonale.

scholarly journals Treatment of an incarcerated inguinal hernia associated with abdominal tuberculosis in an adult patient

2018 ◽  
Vol 46 (8) ◽  
pp. 3474-3479
Author(s):  
Lin-bo Zhu ◽  
Yuan-yan Zhang ◽  
Jun-qiang Li ◽  
Peng-fei Li ◽  
Peng-bin Zhang ◽  
...  
Keyword(s):  
Developing Countries ◽  
Inguinal Hernia ◽  
English Language ◽  
Pediatric Patients ◽  
Extrapulmonary Tuberculosis ◽  
Abdominal Tuberculosis ◽  
Incarcerated Inguinal Hernia ◽  
Definitive Guideline ◽  
Unusual Finding ◽  
Language Literature

The incidence of tuberculosis is increasing worldwide, especially in developing countries. The prevalence of abdominal tuberculosis has been found to be as high as 12% in people with extrapulmonary tuberculosis. Peritoneal thickening and intestinal adhesions can occur in patients with abdominal tuberculosis. Inguinal hernias are extremely rare in people with abdominal tuberculosis; only 11 cases have been reported in the English-language literature, half of which involved pediatric patients. No definitive guideline on the management of such cases is available. In this report, we describe the unusual finding of an incarcerated inguinal hernia in an adult with abdominal tuberculosis and propose a therapy to treat this complicated disease based on our successful experience.

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