Developmental medicine and child neurology
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Dev Med Child Neurol · Jun 2008
The King's Outcome Scale for Childhood Head Injury and injury severity and outcome measures in children with traumatic brain injury.
The aim of this study was to relate discharge King's Outcome Scale for Childhood Head Injury (KOSCHI) category to injury severity and detailed outcome measures obtained in the first year post-traumatic brain injury (TBI). We used a prospective cohort study. Eighty-one children with TBI were studied: 29 had severe, 15 moderate, and 37 mild TBI. ⋯ KOSCHI did not correlate with behaviour or executive function. We conclude that the KOSCHI scored at hospital discharge correlates with severity of injury and some cognitive, health status, and HRQL outcomes early after TBI. It is not helpful at predicting later difficulties, or behavioural and emotional problems.
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Dev Med Child Neurol · Jun 2008
Chronic post-traumatic headache after head injury in children and adolescents.
This was a prospective, observational study of children aged 3 to 15 years admitted to hospital with head injury (HI). Demographic data and information on the nature of the HI, and history of premorbid headache were collected. A structured telephone questionnaire was used to interview parents and children 2 months after injury and at 4-monthly intervals for up to 3 years, if headache was reported. ⋯ These patients were excluded from the study. CPTH is common after minor and significant HI. It has the clinical features of tension-type headache and migraine and has a good prognosis.
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Dev Med Child Neurol · Jun 2008
Respiratory patterns and strategies during feeding in preterm infants.
Because patterns of integration of respiration into rhythmic suck-swallow efforts are highly variable, we examined the vagaries of respiratory efforts as they evolve from the first tentative attempts at integration through more complex rhythmic interactions, with a focus on several strategies in which breathing and suck-swallow are coordinated. Thirty-four preterm infants (18 males, 16 females) of 26 to 33 weeks gestational age, 32 to 40 weeks postmenstrual age (PMA), and 2 to 12 weeks postnatal age were studied weekly from initiation of bottle feeding (using breast milk or preterm formula, both fed from a bottle) until discharge, with simultaneous digital recordings of pharyngeal pressure, nasal thermistor airflow, and thoraco-abdominal strain-gauge readings. Exceptional patterns of feeding-adapted variations of respiration were noted, including breathing during swallow, alternating blocks of suck-swallow and respiration efforts, narial airflow without thoracic movement, modulation of respiratory phase relationship against swallow rhythm, and paired rhythms with swallow:breath ratios of more than 1:1. ⋯ In contrast, coordination and phase relationships of suck-swallow and breathing stabilized over time, as did the percentage of synchronized narial and thoracic respiratory efforts, which increased significantly after 36 weeks PMA compared with synchronization at 32 to 33.9 and 34 to 35.9 weeks PMA (p<0.05). There was also a significant positive correlation between percentage synchronization and PMA (r=0.58; p<0.001). The strategies and patterns noted here further clarify the developmentally regulated coordination of suck, swallow, and respiration into mature infant feeding, and may be predictive of those infants with short- and long-term feeding or developmental difficulties.
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Dev Med Child Neurol · Jun 2008
Letter Case ReportsEvaluation of swallowing function in Duchenne muscular dystrophy.