Life Expectancy Of Children Research Articles

Micronucleus frequencies in peripheral blood lymphocytes of children with chronic kidney disease

One of the crucial adverse effects of chronic kidney disease (CKD) and its treatment is an elevated cancer risk. There are no data on cytogenetic effects in children with CKD or children undergoing dialysis or those who have received a transplant. In this study, cytogenetic effects in children with CKD in pre-dialysis (PreD) stage, on regular haemodialysis (HD) and transplanted (Tx) compared with a control group of healthy children has been investigated using the cytokinesis-blocked micronucleus (CBMN) assay and fluorescence in situ hybridisation (FISH) combined with CBMN (CBMN-FISH) in peripheral blood lymphocytes. The results revealed a significant increase (P < 0.001) in micronucleus (MN) frequencies [mean ± SD (n)] in the PreD, HD and Tx groups versus the control group [CBMN assay; 9.19 ± 2.61 (16), 9.07 ± 4.86 (15), 6.12 ± 5.33 (17) versus 1.60 ± 0.99 (20), respectively]. Moreover, centromere negative micronucleus (C- MN) and centromere positive micronucleus (C+ MN) frequencies were significantly higher in each subgroup children (PreD, HD and Tx) than in the control group (P < 0.01) although children in Tx group had lower C- MN frequencies than PreD and lower C+ MN frequencies than PreD and HD groups (P < 0.05). Additionally, MN frequencies in mononuclear cells, nucleoplasmic bridges and nuclear buds in binucleated cells were increased in children with CKD (P < 0.001, P < 0.001, P > 0.05, respectively). The nuclear division index significantly decreased in Tx group relative to the control, PreD and HD groups (P < 0.001). Associations between cytogenetic parameters and creatinine or blood urea nitrogen were found (P < 0.05). To provide longer and better life expectancy of children with CKD and treatment modes, further research is needed to better understand and avoid these effects.

Pulmonary Complications of Down Syndrome during Childhood

Down syndrome (DS), caused by trisomy-21, is the most common chromosomal abnormality, affecting one in every 600 to 800 live births. Although cardiac management is often the dominant focus during the neonatal period, life expectancy for children with DS with minor or repaired cardiac defects is approximately 60 years,1-3 and optimal medical care requires knowledge of the multisystem nature of this disorder. Published health supervision guidelines that highlight a wide array of medical problems for which routine screening and anticipatory guidance are recommended in children with DS4 emphasize the importance of screening for obstructive sleep apnea (OSA) during childhood and adolescence (Table).

Dystonia. The paediatric perspective

This review focuses on some paediatric dystonias such as transient dystonias, new primary paediatric-onset dystonias, dopamine biosynthesis defects and new paroxysmal disorders. It is designed to provide practical help for neurologists and neuropediatricians to make appropriate diagnoses and plan the management of these disorders. Literature searches were performed and original papers, meta-analyses and review papers were reviewed. Paediatric onset dystonia is an increasingly interesting group of conditions that provides an expanding area of neuroscientific knowledge. Given the long life expectancy of children, appropriate treatment at the correct moment will have an important, lasting effect on the personal, social and healthcare domains.

Children as receptors of living donors

The most important factor in life expectancy for children on renal replacement therapy (RRT) is to have a functioning graft when they reach adulthood (63 years&nbsp; on transplantation vs 37 years on dialysis). The pediatric recipient is very suitable for a living donor transplantation (LDT), with few contraindications. There are several reasons that make LDT the most recommended RRT in children: pre-emptive transplant avoiding dialysis, good renal mass, minimal cold ischemia time, better HLA-matching and the possibility to program the time of surgery. Long term graft survival in LDT is significantly better than in cadaveric donor transplantation (CDT) (81.3%&nbsp; LDT vs 60.8 % CDT at 10 years follow-up). Calculated half-life graft survival for recipients aged 2-5 years reaches 27.5 years in some series, making LDT the ideal option for these children. Adolescent recipients (12-17 years) have an excellent early graft survival, but the worst long term outcome compared with the rest of pediatric population. However, preemptive LDT has a 70% of graft survival at 10 years. Late rejections episodes associated with non-adherence factors are found in all series. Unrelated LDT in pediatric recipients outcome remain unclear.

Difficult intubation management in a child with I-cell disease

I-cell disease (mucolipidosis II) is a rare metabolic disorder resulting from the deficiency of a specific lysosomal enzyme, N-acetylglucosamine-1-phosphotransferease. Developmental delay and growth failure are common presentations of I-cell disease. Psychomotor deterioration is rapid and progressive. Some physical signs such as hip dislocations, inguinal hernia, hepatomegaly, joint limitation, and skin changes may be present at birth. Coarse facial features and skeletal abnormalities become more conspicuous with time. The life expectancy of children with this condition is poor, with death usually occurring around the fifth year. A case report of the anesthetic management of gingivectomy with multiple dental extractions in a 5-year-old Omani female with I-cell disease is presented. The problems faced and their management during anesthesia are described.

Are Children with Cerebral Palsy and Developmental Disability Living Longer?

A robust literature addresses life expectancy (LE) for children with cerebral palsy (CP) and developmental disability (DD). A Medline data search was completed using the terms CP, DD, LE, survival, as well as other pertinent terms. Further articles were gleaned from bibliographies of pertinent literature. Key disabilities accurately predict LE in children with CP and DD: (1) presence and severity of developmental disability, (2) inability to speak intelligible words, (3) inability to recognize voices, (4) inability to interact with peers, (4) severity of physical disability, (5) use of tube feeding, (6) incontinence, (7) cortical blindness, and (8) presence and severity of seizures. Children with CP and DD have a diminished LE, which can be accurately assessed based on simple clinical examination findings. Over the last 50 years there has been improvement in life expectancy based on comparison of newer and older studies. However in approximately the last 20 years, there has been only slight improvement in LE, and this has been found only in the most profoundly impaired children with CP and DD.

Self-concept and psychopatological risk in liver transplanted children

Aims. Increased recipients’ life expectancy in children undergoing orthotopic liver transplantation (OLT) has triggered several studies focussing not only on organic problems but also on neurological and psychological aspects.

Tumors of the Central Nervous System: Clinical Aspects, Molecular Mechanisms, Unanswered Questions, and Future Research Directions

Central nervous system tumors are the most common solid tumors in children. Many histological subtypes and biological variants exist. The 2007 Neurobiology of Disease in Children Symposium, held in conjunction with the 36th annual meeting of the Child Neurology Society, aimed to define current knowledge in the field and to develop specific aims for future clinical, translational, and fundamental science. Because of advances in structural and metabolic imaging, surgical technique, and combination therapies, the life expectancy of children with some of the most common tumors, such as cerebellar astrocytomas and medulloblastomas, has improved. Other common tumor types, including diffuse pontine gliomas and malignant embryonal tumors, still have a dismal prognosis. As novel therapies are identified for pediatric central nervous system tumors, long-term survival may be associated with considerable disability. A cooperative effort is crucial to early diagnosis and to translating basic research findings into safe, effective new treatments.

Problèmes cliniques émergents chez l’adulte drépanocytaire

Over the past 20 years, early medical treatment has significantly increased the life expectancy of children with sickle cell disease. More than 90% of patients now reach the age of 20, and the median life expectancy of sickle cell patients is at least 50 years in countries with advanced healthcare systems. The increase in the number of adults with homozygous sickle cell disease is accompanied by increasingly frequent chronic osteoarticular, renal, cardiorespiratory, ocular, cutaneous and cerebral complications. Pregnancy is a high-risk situation for the mother and child The efficacy and safety of hydroxyurea and long-term blood transfusions in adults with sickle cell disease are currently under investigation.

124 Terminal Care for Children with Life-Limiting Neurological Disorders at the Royal Hospital for Sick Children, Glasgow

It is well acknowledged that many paediatric neurological disorders can limit the life expectancy of children. However, these children do not always benefit from specialised, multidisciplinary palliative care during the terminal phase of their illness. Currently there are no specialised services available within the Royal Hospital for Sick Children in Glasgow. We have reviewed the care and its …

Too much, too little, too soon, too late? Transfusion and long‐term survival in children

Too much, too little, too soon, too late? Transfusion and long‐term survival in children

An exploratory study of parents' approaches to health promotion in families of adolescents with physical disabilities

The life expectancy of children with physical disabilities now extends into adulthood and has been accompanied by the transfer of rehabilitation services from institutions to the home. Thus, families must increasingly partner with health service providers to promote their child's health and prevent the development of secondary conditions that may contribute to heart disease, stroke, respiratory diseases, low endurance and emotional difficulties. To investigate within a family context the health promotion efforts of parents on behalf of a child with a physical disability. The Long Interview Method was used to interview 15 families (11 two-parent and 4 single-parent) having a child 11-16 years of age with a physical disability including cerebral palsy (7), spina bifida (3), muscular dystrophy (3) and other conditions (2). Parents' health promotion efforts were characterized by three main themes. First, parents emphasized traditional lifestyle health behaviours including nutrition, physical activity, tobacco, alcohol and drug use, and personal hygiene. Second, parents tried to foster their adolescent's social life and friendships. They expressed particular concern about how, and if, their child would develop a sense of purpose and have a productive future. Third, parents invested a great deal of effort into observing daily routines, making arrangements for their child's social inclusion and supporting their child in a way that balanced independence with safety and energy conservation. Parents recognize that their child with a physical disability faces greater obstacles, and work hard at health promotion. Healthcare workers need to work with parents to: (1) provide information about specific lifestyle health behaviours including nutrition, physical activity and sexuality; (2) advocate for resources to foster social inclusion; and (3) discuss family strategies that balance parental involvement with their child's need for independence and energy conservation for daily activities.

Surgical Correction of Developmental Scoliosis Following Cardiac Transplantation

Case report. To present a pediatric patient who underwent successful 2-stage anterior and posterior scoliosis surgery 20 months after cardiac transplantation. Cardiac transplantation has increased the life expectancy in children with end-stage cardiac failure caused by congenital heart disease or cardiomyopathy. Scoliosis is commonly associated with congenital cardiac disease. Previous reports have suggested that anterior scoliosis surgery is contraindicated after heart transplantation. We describe the case of a 13-year-old patient who underwent staged anterior and posterior spinal arthrodesis to correct a severe thoracic developmental scoliosis. The 2 procedures were performed 1 week apart. Following the first stage, pulmonary edema had developed, which required reintubation and administration of diuretics. Significant blood loss occurred during the posterior spinal fusion. The patient had a satisfactory correction of her scoliosis and made a good recovery. Three years after surgery, she had no complaints of her back and had a solid spinal fusion. Elective anterior and posterior spinal arthrodesis can be safely performed in cardiac transplant recipients with severe developmental scoliosis. This procedure can achieve optimum correction of the curvature and a successful outcome without long-term medical or technical complications.

Respite care for children, young people and families - are their needs addressed?

In recent years there has been an increasing demand for respite care in the community setting, as advances in medicine and technology have enhanced the life expectancy of children and young people with a life-limiting illness. However, the need for flexible respite provision in the home frequently presents a challenge for those health care professionals involved in caring for these children and their families. Following a review of literature this paper will demonstrate how a family-centred approach to respite provision and palliative care can enhance the quality of life for a child nearing the end of life and support the expressed needs of the child's family with accessible respite care.

Estimating life expectancy in children with neurological disabilities

Estimating life expectancy in children with neurological disabilities

Life expectancy for children with cerebral palsy and mental retardation: Implications for life care planning

Physicians may be asked by attorneys or other patient advocates to help plan for the long-term needs of children with cerebral palsy (CP) and developmental disability (DD). The first step in such planning is to thoroughly examine the literature dealing with life expectancy in these populations. This review paper comprehensively reviews the literature relating to survival in children with cerebral palsy and developmental disability. A Medline data search was completed using the terms cerebral palsy, life expectancy, survival, as well as other pertinent terms. Further articles were gleaned from bibliographies of pertinent literature. Certain key disabilities can be used to accurately predict life expectancy in children with cerebral palsy and mental retardation. These include: (1) presence and severity of mental retardation, (2) inability to speak intelligible words, (3) inability to recognize voices, (4) inability to interact with peers, (4) severity of physical disability, (5) use of tube feeding, (6) incontinence, and (7) presence and severity of seizures. Literature review definitively shows that children with CP and DD have a diminished life expectancy, which can be assessed based on simple clinical examination findings.

The life expectancy of children diagnosed with a pervasive developmental disorder.

The life expectancy of children diagnosed with a pervasive developmental disorder.

Life expectancy of children in vegetative and minimally conscious states

We determined estimates of survival in children, 3-15 years of age, in the vegetative state (VS) (n = 564), immobile minimally conscious state (MCS) (n = 705), and mobile MCS (n = 3,806). Data were extracted from the annual Client Development Evaluation Reports of the California Department of Developmental Services between 1988 and 1997 using the operational definitions for these three states on the basis of 15 descriptive behavioral categories. Patients were also categorized according to the following four etiologies: acquired (traumatic and nontraumatic) brain injury; perinatal/genetic; degenerative; and unknown/undetermined. The percentage of patients surviving 8 years was 63%, 65%, and 81%, for the VS, immobile MCS, and mobile MCS, respectively. Children in the VS and MCSs with acquired brain injury had lower mortality rates and those with degenerative diseases the highest mortality rates. We observed little difference in survival between patients in the VS and immobile MCS, suggesting that the presence of consciousness is not a critical variable in determining life expectancy. Furthermore, survival was much greater for patients in the mobile MCS than for those in the immobile MCS, suggesting that mobility is more important in predicting survival than the level of consciousness.

Pediatric inflammatory bowel disease.

Pediatric inflammatory bowel disease (IBD) becomes adult inflammatory bowel disease, but several considerations require particular attention when children develop the disease. The disease generally manifests with active inflammation in children, whereas obstruction from "burnt-out" disease may become more prevalent with age. Because children are still growing, avoiding the growth-suppressing affects of the disease (and of steroid pharmacotherapy) is important in pediatric patients, in contrast to adults. Finally, the longer life expectancy of children than adults mandates even more attention to long-term safety issues in young patients.

Life Expectancy of Children with Cerebral Palsy

Life Expectancy of Children with Cerebral Palsy