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Does Whole-Body Vibration Treatment Make Children's Bones Stronger?
Swolin-Eide, D, Magnusson, P
Current osteoporosis reports. 2020;(5):471-479
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Abstract
PURPOSE OF REVIEW To summarize the last 10 years of literature regarding the effects of whole-body vibration (WBV) on bone in children, and if WBV results in increased bone acquisition. RECENT FINDINGS WBV intervention appears to be a safe intervention with beneficial effects on bone mass in some diseases and syndromes, but there is still low evidence for WBV in clinical practice. The positive effects on muscle strength, balance, and walking speed are more conclusive. One of the takeaways of this review is that well-trained individuals may not further improve bone mass with WBV; thus, interventions are more beneficial in pediatric individuals with Down syndrome or severe motor disabilities with low bone mass and reduced activity levels. WBV appears to be a safe non-pharmacological anabolic approach to increase bone mass in some pediatric populations; however, longer (> 6 months) and larger prospective studies are needed to elucidate the efficacy of WBV on bone health in young individuals.
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Respiratory morbidity in children with cerebral palsy: an overview.
Boel, L, Pernet, K, Toussaint, M, Ides, K, Leemans, G, Haan, J, Van Hoorenbeeck, K, Verhulst, S
Developmental medicine and child neurology. 2019;(6):646-653
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Abstract
Respiratory problems have a significant impact on morbidity and mortality in patients with cerebral palsy (CP). In particular, recurrent aspiration, impaired airway clearance, spinal and thoracic deformity, impaired lung function, poor nutritional status, and recurrent respiratory infections negatively affect respiratory status. Bronchopulmonary dysplasia may contribute to pulmonary problems, but asthma is not more common in CP than in the general population. We discuss treatment options for each of these factors. Multiple coexisting and interacting factors that influence the respiratory status of patients with CP should be recognized and effectively addressed to reduce respiratory morbidity and mortality. WHAT THIS PAPER ADDS Respiratory problems are a significant cause of morbidity in patients with cerebral palsy (CP). Respiratory status in patients with CP is influenced by recurrent aspiration and impaired airway clearance. Spinal and thoracic deformity, impaired lung function, poor nutrition, and respiratory infections also negatively affect respiratory status. These factors should all be addressed to reduce respiratory problems in patients with CP.
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Magnesium Sulfate and Novel Therapies to Promote Neuroprotection.
Jameson, RA, Bernstein, HB
Clinics in perinatology. 2019;(2):187-201
Abstract
Cerebral palsy occurs more often in preterm than in term deliveries and is one of the major neurologic injuries seen in preterm infants. Magnesium sulfate has been found to reduce the risk of cerebral palsy in patients at risk of delivery before 32 weeks' gestational age. Multiple large clinical trials have shown this effect. The authors recommend magnesium sulfate bolus followed by continuous dosing of magnesium sulfate in those at risk of delivery before 32 weeks' gestation until delivery occurs or is no longer imminent. This article also discusses novel and emerging therapies for the prevention of cerebral palsy.
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Necrotizing Enterocolitis and Neurodevelopmental Outcome.
Adams-Chapman, I
Clinics in perinatology. 2018;(3):453-466
Abstract
Necrotizing enterocolitis is a serious complication of prematurity that is associated with an increased risk for adverse neurodevelopmental outcome secondary to a complex relationship between various morbidities that increase the risk for central nervous system injury. Affected infants are exposed to a variety of circulating cytokines known to be associated with white matter injury. These infants also have an increased risk of secondary blood stream infections and nutritional compromise.
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Biological and Social Influences on the Neurodevelopmental Outcomes of Preterm Infants.
Burnett, AC, Cheong, JLY, Doyle, LW
Clinics in perinatology. 2018;(3):485-500
Abstract
Although very preterm birth and very low birthweight are recognized risk factors for longer term developmental difficulties, there is a wide spectrum of outcomes for children and adolescents born preterm. Biological and social variables have the potential to explain this variability. Although current understanding of these influences and how they interact is incomplete, perinatal factors are related to permanent neurosensory impairments such as cerebral palsy, blindness, and deafness. Cognitive and academic outcomes are variably associated with biological and social variables across development, and the most robust correlates of behavior and mental health difficulties include early behavioral problems and family influences.
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Missense mutation in the ITPR1 gene presenting with ataxic cerebral palsy: Description of an affected family and literature review.
Das, J, Lilleker, J, Shereef, H, Ealing, J
Neurologia i neurochirurgia polska. 2017;(6):497-500
Abstract
The inositol 1,4,5-triphosphate receptor type 1 (ITPR1) gene on chromosome 3 belongs to a family of genes encoding intracellular calcium channel proteins. Such channels are located primarily within the endoplasmic reticular membrane and release Ca2+, an intracellular messenger, which governs numerous intracellular and extracellular functions. We report a family with infantile-onset cerebellar ataxia with delayed motor development and intellectual disability caused by a heterozygous c.805C>T, p.Arg269Trp missense mutation in ITPR1. Both affected family members had postural tremor, hypotonia and dysarthria, but neither had pyramidal signs. Their neuroimaging revealed cerebellar atrophy. Several neurological conditions have been associated with ITPR1 mutations, such as spinocerebellar ataxia type 15 and Gillespie syndrome, and the phenotype may vary according to the location and type of mutations. Spinocerebellar ataxia type 15 is an autosomal dominant disorder, which causes late onset pure cerebellar ataxia. Gillespie syndrome is characterised by bilateral iris hypoplasia, congenital hypotonia, non-progressive ataxia and cerebellar atrophy. In this report, we provide a detailed phenotypic description of a family with a missense mutation in ITPR1. This mutation has only been reported once before. We also provide a literature review of the various phenotypes associated with ITPR1 gene.
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Nutritional assessment and intervention in children with cerebral palsy: a practical approach.
Scarpato, E, Staiano, A, Molteni, M, Terrone, G, Mazzocchi, A, Agostoni, C
International journal of food sciences and nutrition. 2017;(6):763-770
Abstract
Cerebral palsy (CP) is associated with the presence of feeding disorders in almost 60% of the affected children with subsequent undernutrition reported in up to 46% of the subjects. Since undernutrition may have a detrimental impact on physical and cognitive development, the introduction of an adequate nutritional support should always be considered in children with neurological impairment. The aim of the present review is to provide a practical guide to the assessment of nutritional status in children with CP, in order to identify individuals at risk for malnutrition that need the introduction of an adequate and personalized nutritional support. This review summarizes the methods for the evaluation of oral-motor function, anthropometric parameters, body composition and energy balance in children with CP. Moreover, we reviewed the indications for the introduction of nutritional support, and the suggested modalities of intervention.
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Preterm labor: approach to decreasing complications of prematurity.
Locatelli, A, Consonni, S, Ghidini, A
Obstetrics and gynecology clinics of North America. 2015;(2):255-74
Abstract
Obstetricians play a relevant role in minimizing neonatal morbidity and mortality for women in preterm labor. Tocolytic agents can delay preterm birth for at least 2 days, thus allowing the administration of antenatal corticosteroid and in-utero transfer to appropriate neonatal health care settings, interventions that reduce neonatal mortality and morbidity. Antibiotics besides group B streptococcus prophylaxis are not indicated. The benefit/risk ratio of amniocentesis has not been assessed yet. Magnesium sulfate significantly reduces the risk of cerebral palsy. Cesarean delivery benefits fetuses in breech presentation and those severely growth restricted at <34 weeks. In preterm infants delayed clamping is associated with significant benefits.
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Care of Adults With Intellectual and Developmental Disabilities: Cerebral Palsy.
Jones, KB, Wilson, B, Weedon, D, Bilder, D
FP essentials. 2015;:26-30
Abstract
Cerebral palsy (CP) is a group of disorders that primarily affect motor function. This developmental disability is becoming more common in adults as life expectancy increases for individuals with CP. Many physical, medical, mental, and behavioral health conditions are associated with CP, and assistance should be provided to patients with CP to optimize function, when available. These comorbidities include intellectual disabilities, seizures, muscle contractures, abnormal gait, osteoporosis, communication disorders, malnutrition, sleep disorders, and mental health disorders, such as depression and anxiety. The physician should be familiar with screening for and assisting patients with these issues. Optimizing quality of life requires individualized care plans that may include physical therapy, muscle relaxants, surgery, and nutritional support. Other issues to be addressed include methods to facilitate employment; sexual concerns; and support through local and national organizations for patients, families, and caregivers.
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10.
The use of intravenous magnesium in non-preeclamptic pregnant women: fetal/neonatal neuroprotection.
Jacquemyn, Y, Zecic, A, Van Laere, D, Roelens, K
Archives of gynecology and obstetrics. 2015;(5):969-75
Abstract
PURPOSE To review the effect of intravenous magnesium in obstetrics on fetal/neonatal neuroprotection. METHODS A systematic review of published studies. RESULTS Five randomized trials and 4 meta-analyses have shown a significant 32% reduction of cerebral palsy when administering magnesium sulfate in case of preterm delivery. The pathophysiologic mechanism is not fully unraveled: modulation of the inflammatory process, both in the mother and the fetus, and downregulation of neuronal stimulation seem to be involved. After long-term high-dose intravenous administration of magnesium, maternal and neonatal adverse effects such as maternal and neonatal hypotonia and osteoporosis and specific fetal/neonatal cerebral lesions have been described. In case of administration for less than 48 h at 1 g/h and a loading dose of 4 g, these toxic amounts are not achieved. American, Canadian and Australian guidelines recommend the use of intravenous magnesium in any threatening delivery at less than 32 weeks. The "number needed to treat" to avoid 1 cerebral palsy is between 15 and 35. CONCLUSIONS Intravenous magnesium significantly reduces the risk for cerebral palsy in preterm birth. Open questions remain the optimal dosing schedule, whether or not repeating when delivery has been successfully postponed and a new episode of preterm labor occurs. Some concern has been raised on a too optimistic value for random error which might have led to over-optimistic conclusions in classic meta-analysis. Randomized trials comparing different doses and individual patient data meta-analysis might resolve these issues.