Journal of child neurology
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The aim of this study was to investigate developmental impairment in several domains that might be associated with developmental language delay. The records of 56 preschool children with developmental language delay and 31 nonimpaired children were reviewed. ⋯ Children with language delay were significantly more likely to have impairment than were nonimpaired children in gross motor, fine motor, comprehension-conceptual and personal-social (P = .01, P = .02, P = .01, P = .02, respectively) functional domains. Our findings indicate that preschool children with language delay have wide-ranging difficulties in development and function.
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A retrospective review identified 99 adolescents (79% female) referred to a tertiary care center to evaluate the relationship between symptoms of orthostatic intolerance and chronic pain. Regression analysis indicated that functional disability was strongly associated with pain intensity (P < .001) and depression (P = .024). The association between functional disability and number of symptoms of orthostatic intolerance trended toward significance (P = .057). ⋯ Separate regression analysis of female patients showed similar results to the full sample but with a stronger relationship between depression and functional disability and a weaker relationship between heart increment and functional disability. In this sample of adolescents with symptoms of orthostatic intolerance and chronic pain, pain intensity and depression were associated with functional status, but postural tachycardia was not. Further research is needed to clarify potential gender differences.
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It remains controversial as to whether neonatal seizures have additional direct effects on the developing brain separate from the severity of the underlying encephalopathy. Using data collected from infants diagnosed with hypoxic-ischemic encephalopathy, and who were enrolled in an National Institute of Child Health and Human Development trial of hypothermia, we analyzed associations between neonatal clinical seizures and outcomes at 18 months of age. ⋯ When adjustment was made for study treatment and severity of encephalopathy, seizures were not associated with death, or moderate or severe disability, or lower Bayley Mental Development Index scores at 18 months of life. Among infants diagnosed with hypoxic-ischemic encephalopathy, the mortality and morbidity often attributed to neonatal seizures can be better explained by the underlying severity of encephalopathy.
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Case Reports
Seizures temporally associated with nitrous oxide administration for pediatric procedural sedation.
Nitrous oxide is an inhaled agent commonly used by dental staff to provide anxiolysis and analgesia for dental procedures and by anesthesia personnel as an adjunct to more potent general anesthetic gases. More recently, nitrous oxide has been used to provide sedation/analgesia for a variety of medical procedures in children outside of the operating room, including lumbar puncture, laceration repair, fracture reduction, and urologic imaging. ⋯ Although temporally related, no causality is established. Review of the medical and dental literature confirm the rarity of these events.