Brain Damage In Children Research Articles

Parental stress in childhood epilepsy

Background. Epilepsy is a common and persistent neurological disorder that typically affects children. In addition to the obvious physical and emotional outcomes for a child, epilepsy, like other chronic conditions, can have a profound impact on the well-being of family members. In order to comprehensively address and manage parental stress, it is essential to have a thorough understanding of the various factors involved.Objective: to determine the influence of parental stress on the course of epilepsy in children.Material and methods. A search for publications devoted to the study of parental stress in pediatric epilepsy in scientific databases PubMed/MEDLINE, Google Scholar, ScienceDirect, eLibrary identified 2670 articles. After the selection, 39 publications were included in the review.Results. There are a number of questionnaires that allow determining the level of parental stress: PSI, PSI-SF, PIP, IPES. They have shown their accuracy and have been validated in studies devoted to parental stress in parents of children with chronic diseases, including epilepsy. The relationship between the level of parental stress and the prognosis of epilepsy course, psychological state of children and the quality of life of parents was shown. The need for additional psychological support for parents of children with epilepsy was indicated. The feasibility of using biomarkers of brain damage in children as an additional tool for assessing the severity of parental stress was presented.Conclusion. Children with chronic conditions, such as epilepsy, and their families often face a number of interrelated problems. These include parental stress, difficulties in following treatment plans and adjusting to school, social discrimination. Despite the relevance of this issue, there are no large-scale, longitudinal studies examining stress in parents of children with epilepsy, so the relationship between epilepsy and parental stress is not fully understood. A collaborative approach is necessary, in which both the child and parents take responsibility for the treatment of the disease.

Can Lesions in the Right Basal Ganglia Cause Aphasia? Crossed Aphasia in a Right-Handed Patient.

Aphasia is a common neurocognitive disorder caused by impaired speech and language, with stroke being the most frequent cause. The neuroanatomical mechanism underlying this condition is not yet fully understood. This case describes a 74-year-old Caucasian woman admitted with a clinical picture of right total anterior circulation infarct (TACI) and aphasia, scoring 17 on the National Institutes of Health Stroke Scale. Neuroimaging showed a large cortico-subcortical frontotemporoparietal and insular infarct involving the basal ganglia of the right hemisphere and bilateral focal atherosclerotic stenosis on the M1 segment of the middle cerebral artery. There was no left hemispheric lesion or abnormal electric activity on the electroencephalogram. A formal evaluation was compatible with transcortical motor aphasia. The aetiological study revealed atrial fibrillation, and the case was admitted as an ischaemic stroke of undetermined aetiology with two possible causes - intracranial atherosclerotic stenosis or atrial fibrillation. Our patient fulfilled all the formal criteria for crossed aphasia in dextral (CAD): aphasia, a lesion in the right hemisphere coupled with the structural integrity of the left hemisphere, an established preference for right-hand use without a familial history of left-handedness individuals, and an absence of brain damage in childhood. Our patient's case adds to the evidence that deep structures - alone or in combination with cortical structures - are primarily affected in CAD. The diagnostic criteria for crossed aphasia in dextral (CAD) are derived from clinical case studies and include aphasia, a lesion in the right hemisphere, a strong preference for using the right hand, the structural integrity of the left hemisphere and no history of brain damage during childhood.The right lentiform nucleus was found to be the most frequent anatomical substrate involved in CAD patients, consistent with our case description.Our patient experienced transcortical motor aphasia due to a stroke in the right hemisphere, adding to the evidence that in CAD patients, deep structures are primarily affected. In contrast, in left hemispheric lesions, cortical structures seem to be the main culprits.

Accuracy of acute hyperglycemia as a biomarker of severe brain damage in children with traumatic brain injury.

Biomarkers are substances measured at the systemic level to evaluate organic responses in certain situations, establishing diagnoses, disease staging, and prognosis. Blood glucose is a biomarker recognized as a predictor of prognosis in children victims of traumatic brain injury (TBI). The scope of this study was to identify the accuracy of blood glucose as a biomarker of severe brain injury. A retrospective analytical study was conducted through the consecutive review of medical records of children and teenage victims of TBI who underwent neurological surgery between 2016 and 2023 in a level 1 trauma center. Two groups were compared: children with Glasgow Coma Scale (GCS) score ≤ 8 and children with GCS > 8. We calculated the predictive values to define the accuracy of blood glucose as a biomarker of brain injury. Ninety-two medical records were included for analysis. Hyperglycemia predominated in cases with GCS ≤ 8 (48% vs 3%; p < 0.0001; OR, 30; 95% CI, 5.9902-150.2448). The glycemic measurement considering the cutoff point of 200 mg/dL or 11.1 mmol/L showed a specificity of 97%, a positive predictive value of 86%, an accuracy of 84%, and a likelihood ratio for a positive test of 16. Victims with GCS ≤ 8 are 16 times more likely to develop acute hyperglycemia after TBI when compared to those with GCS > 8. Blood glucose is a biomarker with an accuracy of 84% to predict severe brain injury, considering the cutoff point of 200 mg/dL or 11.1 mmol/L.

Effects of prenatal alcohol exposure on the olfactory system development.

Fetal Alcohol Spectrum Disorders (FASD), resulting from maternal alcohol consumption during pregnancy, are a prominent non-genetic cause of physical disabilities and brain damage in children. Alongside common symptoms like distinct facial features and neurocognitive deficits, sensory anomalies, including olfactory dysfunction, are frequently noted in FASD-afflicted children. However, the precise mechanisms underpinning the olfactory abnormalities induced by prenatal alcohol exposure (PAE) remain elusive. Utilizing rodents as a model organism with varying timing, duration, dosage, and administration routes of alcohol exposure, prior studies have documented impairments in olfactory system development caused by PAE. Many reported a reduction in the olfactory bulb (OB) volume accompanied by reduced OB neuron counts, suggesting the OB is a brain region vulnerable to PAE. In contrast, no significant olfactory system defects were observed in some studies, though subtle alterations might exist. These findings suggest that the timing, duration, and extent of fetal alcohol exposure can yield diverse effects on olfactory system development. To enhance comprehension of PAE-induced olfactory dysfunctions, this review summarizes key findings from previous research on the olfactory systems of offspring prenatally exposed to alcohol.

Specific convulsions and brain damage in children hospitalized for Omicron BA.5 infection: an observational study using two cohorts

BackgroundSARS-CoV-2 continues to mutate over time, and reports on children infected with Omicron BA.5 are limited. We aimed to analyze the specific symptoms of Omicron-infected children and to improve patient care.MethodsWe selected 315 consecutively hospitalized children with Omicron BA.5 and 16,744 non-Omicron-infected febrile children visiting the fever clinic at our hospital between December 8 and 30, 2022. Specific convulsions and body temperatures were compared between the two cohorts. We analyzed potential associations between convulsions and vaccination, and additionally evaluated the brain damage among severe Omicron-infected children.ResultsConvulsion rates (97.5% vs. 4.3%, P\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$P$$\\end{document} < 0.001) and frequencies (median: 2.0 vs. 1.6, P\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$P$$\\end{document} < 0.001) significantly differed between Omicron-infected and non-Omicron-infected febrile children. The body temperatures of Omicron-infected children were significantly higher during convulsions than when they were not convulsing and those of non-Omicron-infected febrile children during convulsions (median: 39.5 vs. 38.2 and 38.6 °C, both P\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$P$$\\end{document} < 0.001). In the three Omicron-subgroups, the temperature during convulsions was proportional to the percentage of patients and significantly differed (P\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$P$$\\end{document} < 0.001), while not in the three non-Omicron-subgroups (P\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$(P$$\\end{document} = 0.244). The convulsion frequency was lower in the 55 vaccinated children compared to the 260 non-vaccinated children (average: 1.8 vs. 2.1, P\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$P$$\\end{document} < 0.001). The vaccination dose and convulsion frequency in Omicron-infected children were significantly correlated (P\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$P$$\\end{document} < 0.001). Fifteen of the 112 severe Omicron cases had brain damage.ConclusionsOmicron-infected children experience higher body temperatures and frequencies during convulsions than those of non-Omicron-infected febrile children. We additionally found evidence of brain damage caused by infection with omicron BA.5. Vaccination and prompt fever reduction may relieve symptoms.Graphical abstract

Crossed Aphasia without Hemiparesis in a Dextral: A Case Report

Introduction:: Aphasia, also known as language impairment, is a condition that affects the ability to express and understand language, as well as the ability to communicate. Crossed Aphasia in Dextral (CAD) is defined as aphasia after a right hemispheric stroke. Usually, aphasia is caused by a left-sided stroke in right-handed individuals. The prevalence of crossed aphasia in right-handed individuals is 0.38% to 3%. CAD is diagnosed when the following factors are present: aphasia, right-handed patient, no family h/o left-handedness, the structural integrity of the left hemisphere, and absence of brain damage in childhood. Another entity, Global Aphasia Without Hemiparesis (GAWH), is a rare stroke syndrome presenting with global aphasia without any weakness and occurs in the lesion of the left-sided peri-sylvian region. Case Report:: A 56-year-old female with a known case of severe mitral stenosis with chronic AF on warfarin and not on regular medications was brought to our hospital as she had not communicated for the past day. On initial examination, the patient was conscious, globally aphasic, with left facial lag and no weakness of limbs. Her initial Computed Tomography (CT) brain scan was normal. She was not thrombolysed as she was out of the window. Brain Magnetic Resonance Imaging (MRI) showed right frontal, temporal, and parietal infarct in middle cerebral artery territory. She was treated conservatively with full-dose anticoagulation and, upon discharge, was started on oral anticoagulants. At the time of discharge, the patient was able to understand a few commands and was having echolalia with non-fluent speech. She was reviewed again at 3 months, and she had a full recovery of her speech. Discussion:: CAD is a rare stroke syndrome with low prevalence. Even though all subtypes of aphasic syndromes are seen in CAD, Broca's aphasia is the common subtype, and men are affected commonly. Most patients also present with apraxia and visuospatial neglect. Our patient had all the criteria for the diagnosis of CAD and also had GAWH and showed rapid recovery. The cause of the disease in this patient was considered to be two different lesions involving language areas due to an embolism in her heart. Conclusion:: This case has been presented for its rarity due to the occurrence of both CAD and GAWH in the same patient in a right-sided infarct.

SIRT3 enhances the protective effect of Xyloketal B on seizure-induced brain injury by regulating AMPK/mTOR signaling-mediated autophagy.

Brain damage in children due to seizures is irreversible and has been a major public health concern. The herbal monomer Xyloketal B (Xyl-B) can be used as a neuroprotective drug because of its antioxidant, antiapoptotic, and anti-inflammatory effects but with few adverse effects. In this article, we constructed a rat developmental convulsion model and a primary hippocampal neuronal cell convulsion model, through which we studied hippocampal neuronal morphology and neuronal apoptosis using H&E staining and TUNEL staining, respectively. Moreover, we measured TNF-α, IL-6, and IL-1β inflammatory factor levels using ELISA, MDA, and SOD kits. The expression of SIRT3 in hippocampal tissues was determined by qPCR and Western blotting. The expression of autophagy-related proteins such as LC3, p62, and Beclin-1 was evaluated by Western blotting or immunohistochemistry. The role of SIRT3 and autophagic activity with Xyl-B in convulsive seizure-induced brain injury was investigated by knocking down SIRT3 expression levels. Our results showed that Xyl-B plays a neuroprotective role in convulsive seizure-induced brain injury by increasing SIRT3 expression and activating the autophagy pathway. The regulatory role of SIRT3 in the autophagy pathway with Xyl-B treatment was explored by knocking down SIRT3 expression and inhibiting autophagy. Our results revealed that SIRT3 enhances the protective effect of Xyl-B against postconvulsive brain injury by regulating AMPK/mTOR signaling-mediated autophagy.

Solidarity with children and people with disabilities? : An economic analysis of reconstructive hip interventions in pediatric orthopedics

Brain damage in childhood can be caused cerebral palsy (CP) or be due to other diseases. Disturbance of muscle tone results in consecutive development of hip subluxation. Hip reconstructive surgery can significantly improve the mobility and quality of care of children. However, the DRG for surgical care of these conditions has been increasingly devalued. In Germany, this has already led to areduction of pediatric orthopedics departments, accompanied by an important risk of insufficient treatment options for children and people with disabilities. The aim of this retrospective study was an economic analysis of pediatric orthopedic interventions using the example of neurogenic hip decentration. For this purpose, the revenue-cost situation in patients with CP or other causes of brain damage was evaluated at amaximum care hospital in the period of 2019-2021. The entire analysis period showed adeficit. The non-CP-group showed the most important deficit. In CP-patients, however, the plus decreased each year and resulted in adeficit in 2021. While the distinction between cerebral palsy and other forms of brain damage in children is usually not relevant for treatment, it is evident that the non-CP group is massively underfinanced. Overall, the negative economic balance of pediatric orthopedics in the field of neurogenic hip reconstruction is clearly revealed. In the current interpretation of the DRG system, children with disabilities cannot be offered cost-effective care at amaximum-care university center.

Goiter prevalence and iodine deficiency disorder among school-age children (6-12 years) in district Ganderbal of Kashmir valley.

Iodine deficiency is a major cause of brain damage in childhood which can be prevented. Dietary deficiency of iodine is mainly responsible for iodine deficiency. This study was done to determine the prevalence of goiter among school-aged group of 6-12 years in district Ganderbal. This was a cross-sectional study done among children of 6-12 years in district Ganderbal. Out of 2700 children examined, Grade 1 goiter was found in 90 (3.3%) children and Grade 2 goiter was found in 6 (0.3%) with a total goiter rate (sum of grade first and grade second) of 3.6%. On analyzing the urine samples, about 19.1% of the children had mild to moderate iodine deficiency. The study showed mild goiter prevalence in school-aged children of 6-12 years in the Ganderbal district of Kashmir valley. Continuous periodic surveys to assess the magnitude of the iodine deficiency disorders (IDD) should be undertaken to ensure that we achieve sustainable elimination of IDD in India.

The folate-centric concept of pathogenesis and GBINC personalized multidisciplinary approach to the clinical management of children with neuropsychiatric syndromes. Review

Solving the problem of children’s neuropsychiatric diseases is a priority task of modern medicine. The latest scientific achievements in the field of genetics, molecular biology and immunology, which demonstrate biochemical and immune‑dependent ways of formation of human neuropsychiatric disorders, shed light on the mechanisms of brain damage in children with ASD. These research give reason for optimism about overcoming this severe psychiatric pathology in the future thanks to the implementation of genetic, biochemical and immunodiagnostic approaches, as well as metabolic and immunotherapeutic interventions with neuroprotective effects. Currently, the folate‑centric concept of polygenic inheritance of predisposition to the development of neuropsychiatric syndromes in children with multisystem damage has been established. Biochemical and immune‑dependent (infectious, autoimmune, immunoinflammatory, and allergic) pathways of microbe‑induced autoimmune inflammatory encephalopathy with neuropsychiatric clinical manifestations are discussed in the context of the folate‑centric concept. Taking into account the new data, two personalized multidisciplinary approaches to the management of children with ASD and other neuropsychiatric syndromes are proposed. The first approach of J. J. Bradstreet et al. (2010) is based on the empirical analysis of a large group of laboratory biomarkers, the relevance of which has been demonstrated in clinical studies, and the targeted correction of abnormalities identified by biomarkers (so‑called biomarker‑guided interventions). In 2022, Frye R. developed a multidisciplinary personalized approach called BaS‑BiSTOR (collect Baseline data, search for Symptoms, measure Biomarkers, Select Treatment, Observe for Response), which systematizes and stratifies diagnostic and treatment interventions based on the assessment of biomarkers. In order to improve existing recommendations regarding specific subtypes of neuropsychiatric syndromes in children, this article proposes an improved personalized multidisciplinary approach to the clinical management of patients with autistic spectrum disorders and neuropsychiatric manifestations associated with genetic deficiency of the folate cycle, called GBINS (Genetic‑Biochemical‑Immunological‑Neurological‑Symptomatic evaluation). There are reasons to believe that the successful testing in clinical practice of evidence‑based personalized multidisciplinary diagnostic and treatment strategies will allow making a breakthrough in the clinical management of children with severe mental disorders in the near future, which will provide not only the possibility of recovery from a prognostically unfavorable and currently incurable neuropsychiatric disorder, but also and will contribute to stopping the large‑scale threatening epidemic of neuropsychiatric syndromes in the modern child population.&#x0D;

Prevalence of iodine deficiency and urinary iodine excretion among school-going children in a Southern District of Karnataka – A cross-sectional study

Background: Iodine deficiency is a major public health problem, which leads to impaired neurodevelopment, particularly in early life and is the single most preventable cause of mental retardation and brain damage in children and fortunately, it is preventable. Aims: To estimate the prevalence of goitre among school children in Kodagu District and to estimate the urine iodine excretion and salt iodine content in a subsample. Patients and Methods: A cross-sectional study was conducted among school children of 6-12 years in the Kodagu district. Sampling was done by population proportionate to size cluster sampling method with 2700 study participants, 540 salt samples and 270 urine samples. Results: Out of 2700 study participants, the prevalence of goitre was 15.50%. Students of Madikeri Taluk, rural area students, 11-year-old students, Consumption of Goitrogens among students show significant association with goitre after multivariate logistic regression analysis. Urinary iodine excretion test shows 0.36%, 1.80% and 12.99% of the participants had severe, moderate and mild iodine deficiency, respectively. Conclusion: The prevalence of goitre was high indicating that it is an endemic area. Activities such as periodic surveys, provision of iodised salt and intensified monitoring and further evaluation of the IDD programme is obligatory to reduce the goitre rate.

Insufficient Iodine Level in Urine among Children of a Secondary School: A Descriptive Cross-sectional Study.

Introduction: Iodine deficiency disorders are common endocrinopathies in Nepal. Children are at risk for iodine deficiency disorders. Irreversible mental retardation and brain damage in children are the devastating disorders lead by iodine deficiency. Therefore, the main objective of the study was to find out the prevalence of insufficient iodine level among the children of a secondary school. Methods: This descriptive cross-sectional study was conducted in urine from April 2019 to July 2019 after obtaining ethical approval from Nepal Health Research Council (Registration number: 802/2018). Forty-six urine samples were collected from school children for iodine estimation. Convenience sampling was done. Data were entered into Statistical Package for the Social Science version 21 and descriptive analyses were done. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Among the 46 students, majority 36 (78.30%) (95% Confidence Interval= 66.30-90.21) of the school children had insufficient urine iodine level. Among 36 salt samples collected from school children with low urine iodine level, 8 (22.2%) salt samples had iodine less than 15ppm. Conclusions: Iodine estimation revealed a very high percentage of urine samples containing insufficient levels of iodine is similar as compared to studies done in similar settings. Hence, the school children were at risk of iodine deficiency disorders. Iodine deficiency disorders prevention programs should be priority intervention based on available evidence.

Cardiopulmonary bypass strategy without donor blood components as a method for preventing brain damage in children

Aim. To establish the role of donor blood components which are used in the intraoperative period in children with septal congenital heart disease (CHD) who need surgical interventions with cardiopulmonary bypass (CPB) for the prevention of cerebral injury in the postoperative period.Methods. 40 children of 14 months old on average and 8.8 kg of weight were under the study. All patients underwent radical correction of the septal CHD with the use of CPB. The patients were divided into 2 groups according to the donated blood components used. Cerebral damage was assessed with the help of three specific markers: protein S-100-ß, neuron-specific enolase (NSE) and glial fibrillar acidic protein (GFAP). The severity of the systemic inflammatory response was defined by the level of the following markers: interleukin 1, 6 and 10 in serum before operations, after the completion of IC and 16 hours after surgery. The clinical analysis of cerebral injury was performed via the Cornell Assessment for Pediatric Delirium.Results. Statistically the concentration of all three markers of cerebral injury was significantly higher in the transfusion group after the end of CPB. Similar dynamics was observed in the concentrations of interleukins. In addition, the values for GFAP were higher in the transfusion group and 16 hours after surgery.Conclusion. The safety and effectiveness of the strategy on refusal of intraoperative transfusion in order to prevent cerebral injury in children during the correction of septal CHD has been demonstrated.

Shaken Baby Syndrome: literature review in the last 5 years

Background: The aim of this study was to perform a narrative review on what the literature about shaken baby syndrome brought us in the last five years. Methods: A search on PubMed and Scielo using the keywords ´´Shaken Baby Syndrome´´, ´´Abusive Head Trauma´´ and ´´Síndrome do Bebê Sacudido´´ found 842 articles. After apply the inclusion and exclusion criteria we defined the sample corpus in 54 articles. Results: In the last five years several medico-legal debates have taken place discussing the controversies in the pathophysiology and diagnosis of abusive head trauma. Despite this, it is still the most common cause of brain damage in child. Prevention methods were created and tested. Although some have been successful they need some adaptations to improve the effectiveness. Conclusion: The Shaken Baby Syndrome is a high incidence disease that involves several neurological, cognitive and motor impairments. Because of that new research needs to be done to improve our knowledge about this type of trauma and the effectiveness of the prevention methods.

A review on four different paths to respiratory arrest from brain injury in children; implications for child abuse

Child abuse was suspected in a case of out-of-hospital arrest with minor brain injuries. Confronted with continued disputes on pathophysiologic correlates even after autopsy, to assist the differentiation of potential causes of sudden cardiopulmonary arrest in children, we tried to identify the mechanism of cardiopulmonary arrest in brain injuries from different causes.Systematic review was carried out in two stages. First, major external causes of cardiopulmonary arrest among children and infants were identified from Pubmed and Google Scholar search, and then the exact sequence of cardiopulmonary arrest, and their pathophysiologic features were identified based on articles of animal models of brain injury.From the review, we have identified four major groups of external circumstances for rather sudden cardiopulmonary arrest from brain damage in children, after excluding congenital and other unrelated diseases; 1) impact brain apnea, 2) anoxic insults, 3) drug or other substance induced central nervous system depression, and 4) traumatic brain damage. Each group has different features in the course of cardiac and respiratory arrests. Based on this review of pathophysiologic features of cardio-respiratory responses from external causes, we have presented a suspected, but unlikely, child abuse case of respiratory arrest from brain injury.The social consequences of both unknowingly missing, and falsely incriminating the abuse can be grave, and the identification of the mechanisms of cardiopulmonary arrest from brain injury can be important for the differentiation of various potential causes.

Determination of indications for the treatment of temporary teeth in conditions of general anesthesia in preschool children by equipping the study of indicators of oxygen saturation of the brain using the method of cerebral oximetry

Annotation. A common problem at the dental appointment with different treatment methods (without general anesthesia and general anesthesia) is the risk of cognitive dysfunctions against the background of hypoxic brain damage in children: in the first case, against the background of stress, in the other, against the background of general anesthesia. The purpose of the study — to determine indications for the treatment of temporary teeth at the stages of growth and stabilization in conditions of general anesthesia in preschool children based on the study of oxygen saturation indicators of the brain using the cerebral oximetry method. Dental examination and dental procedures of varying severity were performed for 100 children under the age 3–7 years (545 teeth were treated) at the Dental Medical Center at the Bogomolets National Medical University. The method of cerebral oximetry was applied (the permissible reduction of cerebral oximetry was not more than 20%). The results of treatment of medium and deep caries showed a reliably low percentage of complications at different stages of tooth development that occur during rehabilitation of the oral cavity under general anesthesia (12.83% and 15%, respectively) than during rehabilitation of the oral cavity on an outpatient basis (23.5 % and 28.87%, respectively) (p≤0.01)). The results of the treatment of chronic fibrous pulpitis showed a reliably low percentage of complications that occur during oral rehabilitation in conditions of general anesthesia (15%) than during oral rehabilitation in outpatient settings (28.87%) (p&lt;0.01). In the treatment of chronic forms of periodontitis at the stage of root stabilization on an outpatient basis, 59% have complications that cause tooth extraction. Of these, 38% have complications in the form of an exacerbation of the process with a violation of the cortical plate, the rudiment of permanent teeth, 62% — pathological resorption of the roots of temporary teeth. In the treatment of chronic forms of periodontitis at the stage of root resorption on an outpatient basis, 73% have complications, including local enamel hypoplasia of permanent teeth. The treatment of this diagnosis involves several visits, which is technically impossible to perform under general anesthesia. Therefore, in order to preserve the rudiments of permanent teeth, teeth with chronic granulating periodontitis at the aggravation stage were subject to lengthening, at the stage of remission, at the stage of the formed root, instrumental and drug treatment of the channels and root canal filling with iodine paste (according to indications, removal) were performed, in the remission stage at the stage of root resorption, tooth extraction was performed. Dentistry with such a diagnosis involves several visits, which is technically impossible to perform under general anesthesia. The poem, in order to preserve the rudiments of permanent teeth, teeth with chronic granulating periodontitis at the exacerbation stage were subject to extension, at the stage of remission — at the stage of the formed root, instrumental and drug treatment of the channels and root canal filling with iodoform paste (according to indications - removal) were performed, in the remission stage at the stage of root resorption, tooth extraction was performed. Thus, in children aged 3–7 years: the choice of the method of dental treatment depends on the temperament and type of phobias, which determine the nature of the behavior at the dental appointment. Dispensary supervision of children ensures their habituation to the dental chair and, as a consequence, prevents the development of cryptogenic phobias in them.

Iodine supplementation of lactating women and assessment of infant visual information processing and maternal and infant thyroid function: A randomized trial.

Iodine deficiency is one of the major causes of brain damage in childhood. However, iodine supplementation during early pregnancy and lactation can prevent the ill effects of iodine deficiency. This study evaluated maternal and infant thyroid function and infant visual information processing (VIP) in the context of maternal iodine supplementation. A community-based, randomized, supplementation trial was conducted. Mother infant dyads (n = 106) were enrolled within the first 10 days after delivery to participate in this study. Mothers were randomly assigned either to receive a potassium iodide capsule (225 μg iodine) daily for 26 weeks or iodized salt weekly for 26 weeks. Maternal thyroxine (T4), triiodothyronine (T3), thyroid stimulating hormone (TSH), thyroglobulin (Tg), urinary iodine concentration (UIC), breast milk iodine concentration (BMIC) and infant T4, TSH, UIC and VIP were measured as outcome variables. At baseline, neither mothers nor infants in the two groups were significantly different in any of the biomarkers or anthropometric measurements. Maternal TSH and goiter prevalence significantly decreased following iodine supplementation. The percentage of infants who preferentially remembered the familiar face was 26% in the capsule and 51% in the I-salt groups. Infant sex, length for age Z score, BMIC, maternal education and household food security were strong predictors of novelty quotient. In conclusion supplementation daily for six months with an iodine capsule or the use of appropriately iodized salt for an equivalent time was sufficient to reduce goiter and TSH in lactating women. Higher BMIC and LAZ as well as better household food security, maternal education, and male sex predicted higher novelty quotient scores in the VIP paradigm.

SPECIFICS OF PSYCHOMOTOR DEVELOPMENT IN CHILDREN WITH DIFFERENT OUTCOMES OF PERINATAL HYPOXIC BRAIN INJURY

Aim. To analyse the psychomotor development of children with different outcomes of perinatal hypoxic brain injury and to assess the effectiveness of nootropic therapy in terms of formation of speech skills and cognitive activity. Materials and methods. The study included 136 children having suffered from asphyxia during labour and/or intrauterine hypoxia. The analysis of the neurological pathology and psychomotor development in the children was carried out during the first two years of their life. Neurological deficit was formed in 55 (40.4%) children; the remaining children exhibited functional disorders of the nervous system. The evaluation of the children’s psychomotor development was carried out using the Clinical Adaptive Test/Clinical Linguistic and Auditory Milestone Scale (CAT/ CLAMS). The level of motor development in the children with cerebral palsy was determined using the System for Assessing Global Motor Functions. Results. Functional disorders of the nervous system were manifested in the hyperactivity syndrome, tempo-retarded development and dissociation of speech, cognitive and motor functions. The global nature of hypoxic brain damage in children with neurological deficit determined the predominance of severe disorders in motor functions, cognitive activity and speech development. According to the study, neurological deficit was more often formed in premature babies, but severe impairments in motor functions due to pronounced destructive changes in the brain prevailed in mature babies. The study showed the effectiveness of nootropic drugs in children with functional disorders of the nervous system, as well as in children with neurological deficit without pronounced structural changes in the brain. Conclusion. An analysis of psychomotor development and assessment of the effectiveness of nootropic therapy in young children with perinatal hypoxic brain damage allows the adequacy of the rehabilitation for correction of the revealed violations to be determined.

Brain damage in children

No abstract available.

Pengaruh Pemberian “Contrash Bathing” Terhadap Penurunan Spatisitas Otot Lengan Dan Tungkai Pada Anak Dengan Cerebral Palsy

Abstract: Muscle spasticity, Contrash bathing, Cerebral palsy, Ashworth Scale. CP or cerebral palsy is a condition brain damage in childhood where there is a motor limitations caused by static lesions, non-progressive brain. CP showed abnormalities in muscle tone, causing a disturbance in the form of uncontrolled muscle tension or spasticity so that children are not able to perform functional movements. The aim of this study was to determine the influence of granting contrash bathing or showering in contrast with the water cold temperature (18 degrees Celsius) and the water warm temperatures (38 degrees Celsius) alternately with the duration of a specified time so that the muscles will experience the relaxation or muscle relaxation in the hope of limbs in children can be moved easily. There is the effect of bathing contrash therapy to decrease muscle spasticity in children with cerebral palsy. This study is a quasiexperimental study with two group pre and post test design. The subjects were all patients with CP in Yogyakarta WKCP that meets the criteria of inclusion, exclusion and drop out. The study was conducted for 8 weeks. Data collected were analyzed using SPSS 16.0. The different test within groups measured with Wilcoxon test, and for between groups measured with Mann Whitney test. The significance level was set on 0,05. The Results is the contras bath can reduce spasticity muscles in your arms and legs to cerebral palsy (p = 0.011 and p = 0.025.