Intensive care management following defibrillation of an adolescent girl after recreational inhalant use: a case report and review of the literature.

We report the successful out-of-hospital defibrillation and intensive care management of a 14-year-old girl who developed ventricular fibrillation following the inhalation of two 150-mL butane cigarette lighter refill canisters. Following ambulance transport to the nearest tertiary pediatric health care facility, her acute clinical course consisted of sinus tachycardia, fluctuating consciousness, and severe cerebral agitation and combativeness. Over a period of 2 weeks, her neurological function significantly improved to the point she was able to be discharged back into the community, however, not without a number of formally identified neurological deficits. Inhalant gasses, through as yet unclear mechanisms, can cause the myocardium cell membrane to become unusually sensitive to catecholamines which in turn can sometimes lead to fatal arrhythmias. This case is reported for its rarity in terms of the patient being able to be discharged back into the community and to create awareness of the sudden and potentially devastating consequences of butane inhalant use for critical care physicians and prehospital health-care personnel.

Memory Problems in Parkinson's Disease Patients With and Without Mild Cognitive Impairment: Comparisons Between Caregiver and Self-report.

BACKGROUND: The purpose of this study was to examine differences in patient and caregiver ratings of memory function in a community sample of patients with Parkinson's disease (PD) diagnosed with and without mild cognitive impairment (PD-MCI). METHODS: One hundred sixty-five patient-caregiver pairings participated in the study. Patients with PD were administered a battery of neuropsychological tests assessing five of the key cognitive domains as indicated in the PD-MCI Movement Disorders Task Force criteria. Patients and caregivers also completed the Memory Assessment Clinics Self-Rating or Family Scale (MAC-S/MAC-F), and patients were divided into two groups, those with PD-MCI and those without. RESULTS: For patients diagnosed with PD-MCI, both patients and caregivers reported significantly more memory changes compared with patients without PD-MCI on the MAC-S and MAC-F. In contrast, for patients without PD-MCI, patients and caregivers differed significantly in their reporting of memory changes, with scores indicating that patients without PD-MCI felt their memory functioning was worse than what caregivers were reporting. CONCLUSIONS: Patients with PD without MCI might be more sensitive to memory changes than their caregivers. Whether the self-appraisal of memory problems is predictive of future cognitive difficulties, including progression to PD-MCI or PD dementia, should be the focus of future research.

Feasibility and consumer satisfaction ratings following an intervention for families who have a child with acquired brain injury.

OBJECTIVE: Our objective was to ascertain the feasibility and consumer satisfaction ratings of families who received an adapted pediatric acquired brain injury (ABI) 'Signposts for Building Better Behavior' program in either group- or telephone-support delivery formats. METHODS: Forty-eight families of children aged between 3 and 12 years with mild, moderate, and severe ABI completed Signposts in group (n=23) or telephone-support (n=25) format consisting of nine information booklets, a DVD, and Workbook. RESULTS: All parents approved of the skills taught and a majority felt the materials were helpful in both managing challenging behavior associated with brain injury, and teaching new skills to their brain injured child. All parents rated a high level of feasibility for all of the Signposts materials. CONCLUSION: The current research has provided preliminary evidence for the feasibility and satisfaction of a family-centered parent-based behavioral intervention program called Signposts to be used with a pediatric ABI population. It also provides evidence for a less costly option of intervention delivery via telephone-support.

Parental disciplinary practices following acquired brain injury in children.

PURPOSE: This study describes the disciplinary practices of parents following acquired brain injury (ABI) of their child and examines the relationship between disciplinary use, family-parental adversities and children's behavioural sequelae. METHOD: Participants were 48 parent respondents of children between 3-12 years with mild, moderate and severe ABI. Parents provided demographic information and completed questionnaires investigating disciplinary strategy use, parental-family functioning and child behaviour. RESULTS: Over-reactive and lax disciplinary strategies were endorsed most by parents. Dysfunctional levels of disciplinary use were associated with children who displayed more behaviour problems, parents with elevated distress and families experiencing more dysfunction and social adversity. CONCLUSION: Dysfunctional parenting practices, if not ameliorated, could exacerbate problematic child behaviour following ABI, as well as parent and family difficulties. Parental assessment may be useful as a method of screening for parental factors that put children at risk for ongoing behaviour problems and families for ongoing stress.