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Kats DJ, Roche KJ, Skotko BG. Epileptic spasms in individuals with Down syndrome: A review of the current literature. Epilepsia Open 2020; 5:344-353. [PMID: 32913943 PMCID: PMC7469826 DOI: 10.1002/epi4.12412] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/27/2020] [Accepted: 06/03/2020] [Indexed: 02/06/2023] Open
Abstract
Epilepsy can occur in individuals with Down syndrome (DS), with epileptic spasms representing the most frequent seizure type in this population. Epileptic spasms can have devastating consequences on the development of individuals with the condition. This review sought to explore the lifetime prevalence and underlying mechanism of epileptic spasms in this population. We also aimed to review the response rate to various treatments, the relapse rate, and the development of subsequent epilepsy or autism in this population. A comprehensive literature search was conducted for articles discussing the lifetime prevalence, diagnosis, treatment, outcomes, or underlying etiology of epileptic spasms in animal models or individuals with DS. According to available literature, the global clinic-based lifetime prevalence of epilepsy in individuals with DS ranged from 1.6% to 23.1%, with epileptic spasms representing 6.7%-66.7% of these cases. Response rate to treatment with adrenocorticotropic hormone/corticosteroids was highest (81%) and has the most literature supporting its use, with other regimens, including vigabatrin and other antiepileptic drugs, having lower response rates. Epileptic spasms occur more frequently in children with DS than in the general population, though more studies are needed to determine the true lifetime prevalence of epileptic spasms in this population. Generally, children with DS and epileptic spasms tend to be more responsive to treatment and have better outcomes than children with epileptic spasms of unknown etiology (ie, without DS), in terms of response and relapse rates as well as the development of intractable epilepsy (eg, Lennox-Gastaut syndrome).
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Affiliation(s)
- Daniel J. Kats
- Case Western Reserve University School of MedicineClevelandOHUSA
- Down Syndrome ProgramDivision of Medical Genetics and MetabolismDepartment of PediatricsMassachusetts General HospitalBostonMAUSA
| | - Katherine J. Roche
- Department of PediatricsHarvard Medical SchoolBostonMAUSA
- Harvard‐MIT Division of Health Sciences and TechnologyCambridgeMAUSA
| | - Brian G. Skotko
- Down Syndrome ProgramDivision of Medical Genetics and MetabolismDepartment of PediatricsMassachusetts General HospitalBostonMAUSA
- Department of PediatricsHarvard Medical SchoolBostonMAUSA
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Roche KJ, LeBlanc JJ, Levin AR, O'Leary HM, Baczewski LM, Nelson CA. Electroencephalographic spectral power as a marker of cortical function and disease severity in girls with Rett syndrome. J Neurodev Disord 2019; 11:15. [PMID: 31362710 PMCID: PMC6668116 DOI: 10.1186/s11689-019-9275-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 07/10/2019] [Indexed: 11/17/2022] Open
Abstract
Background Rett syndrome is a neurodevelopmental disorder caused by a mutation in the X-linked MECP2 gene. Individuals with Rett syndrome typically develop normally until around 18 months of age before undergoing a developmental regression, and the disorder can lead to cognitive, motor, sensory, and autonomic dysfunction. Understanding the mechanism of developmental regression represents a unique challenge when viewed through a neuroscience lens. Are circuits that were previously established erased, and are new ones built to supplant old ones? One way to examine circuit-level changes is with the use of electroencephalography (EEG). Previous studies of the EEG in individuals with Rett syndrome have focused on morphological characteristics, but few have explored spectral power, including power as an index of brain function or disease severity. This study sought to determine if EEG power differs in girls with Rett syndrome and typically developing girls and among girls with Rett syndrome based on various clinical characteristics in order to better understand neural connectivity and cortical organization in individuals with this disorder. Methods Resting state EEG data were acquired from girls with Rett syndrome (n = 57) and typically developing children without Rett syndrome (n = 37). Clinical data were also collected for girls with Rett syndrome. EEG power across several brain regions in numerous frequency bands was then compared between girls with Rett syndrome and typically developing children and power in girls with Rett syndrome was compared based on these clinical measures. 1/ƒ slope was also compared between groups. Results Girls with Rett syndrome demonstrate significantly lower power in the middle frequency bands across multiple brain regions. Additionally, girls with Rett syndrome that are postregression demonstrate significantly higher power in the lower frequency delta and theta bands and a significantly more negative slope of the power spectrum. Increased power in these bands, as well as a more negative 1/ƒ slope, trended with lower cognitive assessment scores. Conclusions Increased power in lower frequency bands is consistent with previous studies demonstrating a “slowing” of the background EEG in Rett syndrome. This increase, particularly in the delta band, could represent abnormal cortical inhibition due to dysfunctional GABAergic signaling and could potentially be used as a marker of severity due to associations with more severe Rett syndrome phenotypes.
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Affiliation(s)
- Katherine J Roche
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, 1 Autumn Street, Boston, MA, 02215, USA.,Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA, USA
| | - Jocelyn J LeBlanc
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, 1 Autumn Street, Boston, MA, 02215, USA.,F.M. Kirby Neurobiology Center, Neurology Department, Harvard Medical School, Boston, MA, USA
| | - April R Levin
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, 1 Autumn Street, Boston, MA, 02215, USA.,Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Heather M O'Leary
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Lauren M Baczewski
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, 1 Autumn Street, Boston, MA, 02215, USA
| | - Charles A Nelson
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, 1 Autumn Street, Boston, MA, 02215, USA. .,Graduate School of Education, Harvard University, Cambridge, MA, USA.
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O'Leary HM, Kaufmann WE, Barnes KV, Rakesh K, Kapur K, Tarquinio DC, Cantwell NG, Roche KJ, Rose SA, Walco AC, Bruck NM, Bazin GA, Holm IA, Alexander ME, Swanson LC, Baczewski LM, Poon C, Mayor Torres JM, Nelson CA, Sahin M. Placebo-controlled crossover assessment of mecasermin for the treatment of Rett syndrome. Ann Clin Transl Neurol 2018; 5:323-332. [PMID: 29560377 PMCID: PMC5846450 DOI: 10.1002/acn3.533] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 12/21/2017] [Accepted: 12/21/2017] [Indexed: 01/01/2023] Open
Abstract
Objective To measure the efficacy of mecasermin (recombinant human insulin-like growth factor 1, rhIGF-1), for treating symptoms of Rett syndrome (RTT) in a pediatric population using a double-blind crossover study design. Methods Thirty girls with classic RTT in postregression stage were randomly assigned to placebo or rhIGF-1 in treatment period 1 and crossed over to the opposite assignment for period 2 (both 20 weeks), separated by a 28-week washout period. The primary endpoints were as follows: Anxiety Depression and Mood Scale (ADAMS) Social Avoidance subscale, Rett Syndrome Behaviour Questionnaire (RSBQ) Fear/Anxiety subscale, Parent Target Symptom Visual Analog Scale (PTSVAS) top three concerns, Clinical Global Impression (CGI), Parent Global Impression (PGI), and the Kerr severity scale. Cardiorespiratory- and electroencephalography (EEG)-based biomarkers were also analyzed. Results There were no significant differences between randomization groups. The majority of AEs were mild to moderate, although 12 episodes of serious AEs occurred. The Kerr severity scale, ADAMS Depressed Mood subscale, Visual Analog Scale Hyperventilation, and delta average power change scores significantly increased, implying worsening of symptoms. Electroencephalography (EEG) parameters also deteriorated. A secondary analysis of subjects who were not involved in a placebo recall confirmed most of these findings. However, it also revealed improvements on a measure of stereotypic behavior and another of social communication. Interpretation As in the phase 1 trial, rhIGF-1 was safe; however, the drug did not reveal significant improvement, and some parameters worsened.
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Affiliation(s)
- Heather M O'Leary
- Department of Neurology Boston Children's Hospital and Harvard Medical School Boston Massachusetts 02115
| | | | - Katherine V Barnes
- Department of Neurology Boston Children's Hospital and Harvard Medical School Boston Massachusetts 02115
| | - Kshitiz Rakesh
- Department of Neurology Boston Children's Hospital and Harvard Medical School Boston Massachusetts 02115
| | - Kush Kapur
- Department of Neurology Boston Children's Hospital and Harvard Medical School Boston Massachusetts 02115
| | | | - Nicole G Cantwell
- Department of Neurology Boston Children's Hospital and Harvard Medical School Boston Massachusetts 02115
| | - Katherine J Roche
- Division of Developmental Medicine Boston Children's Hospital and Harvard Medical School Boston Massachusetts 02115
| | - Suzanne A Rose
- Department of Neurology Boston Children's Hospital and Harvard Medical School Boston Massachusetts 02115
| | - Alexandra C Walco
- Department of Neurology Boston Children's Hospital and Harvard Medical School Boston Massachusetts 02115
| | - Natalie M Bruck
- Department of Neurology Boston Children's Hospital and Harvard Medical School Boston Massachusetts 02115
| | - Grace A Bazin
- Department of Neurology Boston Children's Hospital and Harvard Medical School Boston Massachusetts 02115
| | - Ingrid A Holm
- Department of Pediatrics Harvard Medical School Boston Massachusetts 02115.,Division of Genetics and Genomics and the Manton Center for Orphan Disease Research Boston Children's Hospital and Harvard Medical School Boston Massachusetts 02115
| | - Mark E Alexander
- Department of Pediatrics Harvard Medical School Boston Massachusetts 02115.,Department of Cardiology Boston Children's Hospital and Harvard Medical School Boston Massachusetts 02115
| | - Lindsay C Swanson
- Department of Neurology Boston Children's Hospital and Harvard Medical School Boston Massachusetts 02115
| | - Lauren M Baczewski
- Division of Developmental Medicine Boston Children's Hospital and Harvard Medical School Boston Massachusetts 02115
| | | | - Juan M Mayor Torres
- Department of Neurology Boston Children's Hospital and Harvard Medical School Boston Massachusetts 02115.,Department of Information Engineering and Computer Science University of Trento Trento Italy.,Department of Psychology Stony Brook University Stony Brook New York 11794
| | - Charles A Nelson
- Division of Developmental Medicine Boston Children's Hospital and Harvard Medical School Boston Massachusetts 02115
| | - Mustafa Sahin
- Department of Neurology Boston Children's Hospital and Harvard Medical School Boston Massachusetts 02115.,Translational Neuroscience Center Boston Children's Hospital and Harvard Medical School Boston Massachusetts 02115
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Stetcu I, Bertulani CA, Bulgac A, Magierski P, Roche KJ. Relativistic Coulomb excitation within the time dependent superfluid local density approximation. Phys Rev Lett 2015; 114:012701. [PMID: 25615463 DOI: 10.1103/physrevlett.114.012701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Indexed: 06/04/2023]
Abstract
Within the framework of the unrestricted time-dependent density functional theory, we present for the first time an analysis of the relativistic Coulomb excitation of the heavy deformed open shell nucleus (238)U. The approach is based on the superfluid local density approximation formulated on a spatial lattice that can take into account coupling to the continuum, enabling self-consistent studies of superfluid dynamics of any nuclear shape. We compute the energy deposited in the target nucleus as a function of the impact parameter, finding it to be significantly larger than the estimate using the Goldhaber-Teller model. The isovector giant dipole resonance, the dipole pygmy resonance, and giant quadrupole modes are excited during the process. The one-body dissipation of collective dipole modes is shown to lead a damping width Γ(↓)≈0.4 MeV and the number of preequilibrium neutrons emitted has been quantified.
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Affiliation(s)
- I Stetcu
- Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - C A Bertulani
- Department of Physics and Astronomy, Texas A & M University-Commerce, Commerce, Texas 75429, USA
| | - A Bulgac
- Department of Physics, University of Washington, Seattle, Washington 98195-1560, USA
| | - P Magierski
- Department of Physics, University of Washington, Seattle, Washington 98195-1560, USA and Faculty of Physics, Warsaw University of Technology, ulica Koszykowa 75, 00-662 Warsaw, Poland
| | - K J Roche
- Department of Physics, University of Washington, Seattle, Washington 98195-1560, USA and Pacific Northwest National Laboratory, Richland, Washington 99352, USA
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Wlazłowski G, Holt JW, Moroz S, Bulgac A, Roche KJ. Auxiliary-field quantum Monte Carlo simulations of neutron matter in chiral effective field theory. Phys Rev Lett 2014; 113:182503. [PMID: 25396365 DOI: 10.1103/physrevlett.113.182503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Indexed: 06/04/2023]
Abstract
We present variational Monte Carlo calculations of the neutron matter equation of state using chiral nuclear forces. The ground-state wave function of neutron matter, containing nonperturbative many-body correlations, is obtained from auxiliary-field quantum Monte Carlo simulations of up to about 340 neutrons interacting on a 10(3) discretized lattice. The evolution Hamiltonian is chosen to be attractive and spin independent in order to avoid the fermion sign problem and is constructed to best reproduce broad features of the chiral nuclear force. This is facilitated by choosing a lattice spacing of 1.5 fm, corresponding to a momentum-space cutoff of Λ=414 MeV/c, a resolution scale at which strongly repulsive features of nuclear two-body forces are suppressed. Differences between the evolution potential and the full chiral nuclear interaction (Entem and Machleidt Λ=414 MeV [L. Coraggio et al., Phys. Rev. C 87, 014322 (2013).
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Affiliation(s)
- G Wlazłowski
- Faculty of Physics, Warsaw University of Technology, Ulica Koszykowa 75, 00-662 Warsaw, Poland and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - J W Holt
- Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - S Moroz
- Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - A Bulgac
- Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - K J Roche
- Department of Physics, University of Washington, Seattle, Washington 98195, USA and Pacific Northwest National Laboratory, Richland, Washington 99352, USA
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Affiliation(s)
- K J Roche
- New York University Medical Center, NY 10016, USA
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Abstract
PURPOSE To determine the accuracy of a focused computed tomographic (CT) technique with oral and intravenous contrast materials for the diagnosis of appendicitis. MATERIALS AND METHODS Ninety-three abdominal-pelvic contrast material-enhanced CT scans obtained during 6 years in 54 girls and 39 boys (age range, 1-18 years) with right lower quadrant pain were retrospectively reviewed. The detected abnormal findings were recorded as being in the region above the upper pole of the right kidney, between the upper pole of the right kidney and the lower pole of the right kidney (RLP), or below the iliac crest. Sensitivity, specificity, and positive and negative predictive values were calculated. chi(2) analysis was performed to determine whether there were significant differences among patient groups according to region of detected disease. RESULTS Fifty-five scans were abnormal: 38 showed appendicitis; and 17, other diseases. No scans, except two that showed pneumonia, had key findings above the RLP. Nineteen scans showed key findings between the RLP and the iliac crest. Thirty-three scans had diagnostic findings only below the iliac crest. The sensitivity (97%), specificity (93%), positive predictive value (90%), and negative predictive value (98%) of interpretation with all images for the diagnosis of appendicitis were the same as those of interpretation with only the focused images. CONCLUSION CT performed to diagnose appendicitis can be limited to the region below the RLP.
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Affiliation(s)
- N R Fefferman
- Department of Radiology, Division of Pediatric Radiology, New York University Medical Center, 560 First Ave, New York, NY 10016, USA.
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Abstract
PURPOSE Our goal was to describe the use of gadolinium-enhanced 3D MR angiography (MRA) in the diagnosis of interrupted aortic arch (IAA). METHOD A review of our MR data base from a 1 year period yielded three patients (1 day, 8 days, and 16 years old) with IAA. All were referred for evaluation of aortic arch abnormalities, only one of whom had suspected IAA. Patients were imaged at 1.5 T with a 3D spoiled gradient echo pulse sequence (TR/TE 3.8-8/1.3-2.7 ms) following the administration of intravenous gadolinium chelates. Surgical correlation was available in all cases. RESULTS In the patient with clinically suspected IAA, a previously unsuspected aberrant right subclavian artery was identified that was not seen on preoperative echocardiography. In another patient with a history of previous mediastinal surgery, IAA was diagnosed without concomitant cardiac anomalies, suggesting surgical ligation. In the remaining patient, IAA was detected as well as a patent truncus arteriosus. CONCLUSION Gadolinium-enhanced 3D MRA may provide for a rapid diagnosis of IAA that may not be possible with other noninvasive modalities. The rapid acquisition time enables unstable pediatric patients to spend minimal time in the MR suite.
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Affiliation(s)
- K J Roche
- Department of Radiology/MRI, New York University Medical Center, NY 10016, USA
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Abstract
BACKGROUND Shone's complex is a series of four obstructive or potentially obstructive left-sided cardiac lesions (supravalvular mitral ring, parachute deformity of the mitral value, subaortic stenosis, and coarctation of the aorta). Both the complete form (all four lesions) and incomplete forms (less than four lesions) have been described. OBJECTIVE To determine which abnormalities of Shone's complex could be characterized by MR. MATERIALS AND METHODS MR examinations in three patients (one complete, two incomplete) were retrospectively reviewed. RESULTS A supravalvular mitral ring, found at surgery in one patient, was not identified. Regurgitant and stenotic flow across the mitral valve, abnormal motion of the valve leaflets and abnormalities of the papillary muscles were identified. Individual chordal attachments were difficult to resolve. Narrowing in the subaortic region and abnormal flow from the subaortic region through the valve plane were demonstrated. A discrete subaortic diaphragm in one patient was not resolved. Both focal and diffuse types of coarctation of the aorta were well characterized. CONCLUSION MR imaging is suited to evaluation of patients with Shone's complex. Individual chordal attachments and thin diaphragms of the mitral and aortic valves were difficult to resolve.
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Affiliation(s)
- K J Roche
- Department of Radiology, New York University Medical Center, Tisch Hospital, Rm. 236, 560 First Ave., New York, NY 10016, USA
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Abstract
Ruptured aneurysm of an aortic sinus of Valsalva is a rare cause of left-to-right shunting. We show how resonance imaging can be used to make the diagnosis. This technique can successfully characterize the shunt as well as determine the presence of associated anomalies, such as ventricular septation and aortic regurgitation. It may be the only study required prior to therapeutic intervention.
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Affiliation(s)
- K J Roche
- Department of Radiology, New York University Medical Center, NY 10016, USA.
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Abstract
OBJECTIVE To determine an injection protocol for pediatric hepatic CT and to investigate the use of power injection. MATERIALS AND METHODS Eighty-seven studies were prospectively performed using ioversol (320 mg iodine per cc) at 2 cc/kg. Three techniques were used: helical (1 s/slice); dynamic, non-breath-hold (5.5 s/slice); dynamic, breath-hold (10 s/slice) scans. The liver-scan time for each study was determined. Scan initiation ranged from 25 to 80 s. An injection duration (50-100 seconds) was selected. From the contrast volume (2 cc/kg x kg body wt) and injection duration, the injection rate (cc/s) was calculated for each patient. Each study was grouped by injection rate corrected for body weight (cc/kg/min) into: 1.2-1.5, 1.51-2.0, and 2.01-2.4. The aortic/liver attenuation curves were plotted for each group. RESULTS Liver-scan time for helical studies was a mean of 26 s, for dynamic, non-breath-hold studies 75 s, dynamic breath-hold scans were 154 s. Injection rates of 1.2-1.5 cc/kg/min produced a scanning interval of 165 s. Injection rates of 1.51-2.0 cc/kg/min produced a scanning interval of 120 s. Injection rates of 2.01-2.4 cc/kg/min produced a scanning interval of 90 s. There was no increase in hepatic attenuation for the injection rates 2.01-2.4 cc/kg/min compared with 1.51-2.0 cc/kg/min. There was one complication related to injection through a central line. CONCLUSIONS An injection protocol was determined for helical studies with injection rates of 1.7-2.0 cc/kg/min with initiation at 60 s; for dynamic, non-breath-hold studies with injection rates of 1.5-1.7 cc/kg/min with initiation at 50 s; and for dynamic breath-hold studies with injection rates of 1.2-1.5 cc/kg/min with initiation at 45 s. Power injection was used safely in our population.
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Affiliation(s)
- K J Roche
- Department of Radiology, New York University Medical Center/Bellevue Hospital, Room 236, 560 First Avenue, New York, NY 10016, USA
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Roche KJ, Genieser NB, Berger DK, Ambrosino MM. Traumatic abdominal pseudoaneurysm secondary to child abuse. Pediatr Radiol 1995; 25 Suppl 1:S247-8. [PMID: 8577545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Traumatic injury to the descending thoracic and abdominal aorta is uncommon in children and is usually secondary to recognized blunt trauma. Child abuse has not been previously reported as a cause. We report a 3-year-old boy who was kicked in the abdomen by his father. A resulting pseudoaneurysm was successfully resected.
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Affiliation(s)
- K J Roche
- New York University Medical Center/Bellevue Hospital, 560 First Avenue, New York, NY 10016, USA
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Abstract
The aim of this study was to evaluate the usefulness of thin-section low-dose computed tomography (TSCT) in the management of children with AIDS, as chest radiographs (CXR) often fail to adequately explain the patients' clinical status. We performed 54 noncontrast TSCTs on 32 children. The patients aged from 3 months to 14.6 years, were diagnosed as having bacterial pneumonia, lumphocytic interstitial pneumonitis (LIP), Pneumocystis carinii pneumonia (PCP), or Mycobacterium avium-intracellulare infection (MAI). The scans were correlated with the clinical diagnosis, T-lymphocyte-subset percentages, and p24-antigen levels. Subsegmental consolidations were seen in patients with LIP, PCP, and MAI, and as an isolated finding in those with only bacterial pneumonia. Ground-glass haziness was seen exclusively with acute PCP. Reticulonodular thickening was identified only in patients with LIP. Mosaic perfusion was seen with MAI, LIP, and pneumonia. The presence of adenopathy correlated with CD4+ T-cell subset percentages. The greatest value of CT in this study was in detecting new disease when chest films failed to correlate with a patient's clinical state, and in demonstrating acute/subacute disease in patients with severe baseline chest-film changes. Recurrent pneumonias may represent progression of "smoldering" disease, rather than true recurrent disease following complete clearing. Adenopathy with low CD4+ levels should suggest lymphoma or infection with MAI.
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Affiliation(s)
- M M Ambrosino
- Department of Radiology, New York University Medical Center, NY 10016, USA
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Abstract
Thin-section, high-resolution (1.0/1.5 mm thick slices), low-dose chest CT scans were performed in 55 infants and children. The studies were carried out with 1- and 2-s scan (data acquisition) times using a high-resolution (bone) algorithm. Although there was some motion artifact, the studies provided valuable information for evaluating diffuse parenchymal lung disease. The thin slices provided finer detail and more diagnostic information than images representing thicker sections. Most studies were performed using between 40 and 80 mAs. It is estimated that the patients' radiation exposure was 20% that of conventional high-resolution CT (HRCT) and 57% that of routine chest CT. Diagnostic HRCT scans can be obtained in infants and young children without the need for suspended respiration or specialized ultrafast CT scanners.
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Affiliation(s)
- M M Ambrosino
- Department of Radiology, New York University Medical Center, Bellevue Hospital Center, NY
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