Archives of disease in childhood
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We treated 13 children aged 0.2 years to 15.7 years (median 7.1 years) with flecainide acetate for refractory symptomatic supraventricular tachycardia. Six children had direct atrioventricular accessory pathways, of whom four had overt Wolff-Parkinson-White syndrome on the 12 lead electrocardiogram, while in the other two the accessory pathway was concealed. Three children had nodal atrioventricular re-entrant tachycardia, two had a re-entrant tachycardia, the exact mechanism of which was not known, one child had ectopic atrial tachycardia, and one had atrial flutter associated with an atrial septal defect. ⋯ Side effects occurred in two children during intravenous administration, but there were no side effects with oral treatment. This experience indicates that flecainide, which has not been used extensively in children, is an effective and safe antiarrhythmic agent, capable of terminating and controlling supraventricular tachycardia in children. Furthermore, flecainide may be successful where conventional agents fail.
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Case Reports Clinical Trial
Non-convulsive status epilepticus resistant to benzodiazepines.
We describe the failure of an intravenous benzodiazepine to control non-convulsive status epilepticus occurring in six patients with the Lennox-Gastaut syndrome. In one patient the benzodiazepine induced a paradoxical response with clinical and electroencephalographic seizures.
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One hundred and two cases of neonatal cancers, representing 2% of all paediatric malignancies, were seen during a 60 year period at The Hospital for Sick Children, Toronto, Canada. The neonatal cancers included neuroblastoma (47%), retinoblastoma (17%), soft tissue sarcoma (12%), central nervous system tumours (9%), leukaemia (8%), and a few cases of Wilms' tumour, liver tumour, and miscellaneous tumours. The overall mortality from disease was 41%. ⋯ There was one instance of second malignancy of the thyroid gland induced by radiation. We conclude that although neonatal cancers are difficult management problems, many patients can be cured. Physicians should discuss with parents the possible risks associated with treatment before treatment is begun.