Developmental disabilities research reviews
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The neurosurgical goal when treating children with spina bifida (predominantly myelomeningocele) is to maintain stable neurological functioning throughout the patient's life time. Unfortunately, few long-term outcome studies are available to help direct the neurosurgical care of a child born with myelomeningocele and often treatment relies more heavily upon the experience of senior practitioners. This article reviews the current literature regarding neurosurgical treatment strategies, with recommendations concerning including prenatal diagnosis, in utero treatment and delivery modes, and postnatal management. Given the overall declining prevalence of open neural tube defects world-wide, research collaboration amongst practitioners through multicenter trial are essential to improving the lives of people born with this most complex congenital anomaly.
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Dev Disabil Res Rev · Jan 2010
ReviewPreterm birth: An overview of risk factors and obstetrical management.
Preterm birth is the leading cause of neonatal mortality and a major public health concern. Risk factors for preterm birth include a history of preterm birth, short cervix, infection, short interpregnancy interval, smoking, and African-American race. ⋯ Tocolytics may not prevent preterm birth but have a role in prolonging pregnancy for administration of medications to benefit the preterm infant. These include antenatal steroids and, if indicated, magnesium sulfate for neuroprotection and intravenous antibiotics for Group B Streptococcus prophylaxis.
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Dev Disabil Res Rev · Jan 2010
ReviewPain management in intellectually disabled children: Assessment, treatment, and translational research.
The primary focus of pain research in intellectually disabled individuals is still on pain assessment. Several observational pain assessment scales are available, each with its own characteristics, its own target group and its own validated use. Observational studies report differences in the treatment of intra- and postoperative pain of intellectually disabled children and almost all children with intellectual disability have comorbidities that need to be addressed. ⋯ We should now focus on tailoring the pain treatment. To this aim we need to perform pharmacokinetic and pharmacodynamic studies of analgesics and obtain information about the genotype-phenotype relationships for pain. This can lead to the development of specific analgesic algorithms.
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In this review, we trace the origins and follow the development of mitochondrial medicine from the premolecular era (1962-1988) based on clinical clues, muscle morphology, and biochemistry into the molecular era that started in 1988 and is still advancing at a brisk pace. We have tried to stress conceptual advances, such as endosymbiosis, uniparental inheritance, intergenomic signaling and its defects, and mitochondrial dynamics. We hope that this historical review also provides an update on mitochondrial medicine, although we fully realize that the speed of progress in this area makes any such endeavor akin to writing on water.
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Dev Disabil Res Rev · Jan 2009
ReviewNeuroimaging in pediatric traumatic brain injury: current and future predictors of functional outcome.
Although neuroimaging has long played a role in the acute management of pediatric traumatic brain injury (TBI), until recently, its use as a tool for understanding and predicting long-term brain-behavior relationships after TBI has been limited by the relatively poor sensitivity of routine clinical imaging for detecting diffuse axonal injury (DAI). Newer magnetic resonance-based imaging techniques demonstrate improved sensitivity to DAI. ⋯ In addition, we summarize current research demonstrating their early success in establishing relationships between imaging measures and functional outcomes after TBI. With the ongoing research, these imaging techniques may allow earlier identification of possible chronic sequelae of tissue injury for each child with TBI, thereby facilitating efficacy and efficiency in delivering successful rehabilitation services.