Self-limited epilepsy with autonomic seizures: A case report.

Self-limited epilepsy with autonomic seizures, formerly known as benign occipital epilepsy of childhood or Panayiotopoulos syndrome is a focal epilepsy that is part of the epileptic syndromes with onset during childhood. The objective of this report is to raise awareness about its importance and describe the clinical manifestations, timely diagnosis, and treatment. A pediatric patient admitted with gastrointestinal manifestations is presented. The autonomic manifestations must be considered as part of the clinical spectrum that includes this disease and the digestive and autonomic manifestations that mask the diagnosis, sometimes even in the absence of motor seizures themselves. Electroencephalographic confirmation was performed, avoiding cataloging it in other differential diagnoses.

Global synergistic actions to improve brain health for human development.

The global burden of neurological disorders is substantial and increasing, especially in low-resource settings. The current increased global interest in brain health and its impact on population wellbeing and economic growth, highlighted in the World Health Organization's new Intersectoral Global Action Plan on Epilepsy and other Neurological Disorders 2022-2031, presents an opportunity to rethink the delivery of neurological services. In this Perspective, we highlight the global burden of neurological disorders and propose pragmatic solutions to enhance neurological health, with an emphasis on building global synergies and fostering a 'neurological revolution' across four key pillars - surveillance, prevention, acute care and rehabilitation - termed the neurological quadrangle. Innovative strategies for achieving this transformation include the recognition and promotion of holistic, spiritual and planetary health. These strategies can be deployed through co-design and co-implementation to create equitable and inclusive access to services for the promotion, protection and recovery of neurological health in all human populations across the life course.

Carga laboral de profesionales de enfermería en Unidad de Cuidado Intensivo según Nursing Activities Score / Nurses' Workload in Intensive Care Unit according to the Nursing Activities Score / Carga de trabalho dos profissionais de enfermagem na Unidade de Cuidados Intensivos de acordo com a pontuação das Atividades de Enfermagem

Introducción: Nursing Activities Score ha sido utilizada como un instrumento principalmente en la Unidad de Cuidados Intensivos para medir las actividades de enfermería, siendo esta la unidad que maneja pacientes de mayor complejidad para el cuidado. Objetivo: establecer la carga de trabajo, evaluada por Nursing Activities Score, y factores relacionados a la misma en Unidades de Cuidado Intensivo. Metodología: Revisión cualitativa tipo scoping Review, utilizando el método PRISMA. Búsqueda en las bases de datos CINAHL, LILACS, SCOPUS, SCIENCE DIRECT, SCIELO y PUBMED. Resultados: La muestra final se compone de 87 textos, que van desde el año 2007 hasta 2021. Se clasificaron en cinco categorías: Carga de trabajo en UCI, comparación entre unidades, carga de trabajo relacionada al personal de enfermería, carga de trabajo relacionada a las características de los pacientes y consecuencias de la carga de trabajo. Discusión: La revisión revela una carga de trabajo mayor al 50% en la mayoría de los estudios, esto debido a diferentes factores: principalmente las características particulares de los pacientes, no se observó una diferencia significativa entre unidades generales y especializadas, las cargas de trabajo elevadas suponen un factor de riesgo para la ocurrencia de eventos adversos. Conclusiones: Los resultados de esta revisión permiten evidenciar que el personal de enfermería está expuesto constantemente a altas cargas de trabajo. Esta carga de trabajo puede verse influenciada o influenciar diversos factores, como lo son las características de los pacientes a quienes se brinda atención o puede afectar positiva o negativamente la calidad de la atención de enfermería.

Introduction: The Nursing Activities Score has been used mainly in Intensive Care Units as an instrument to measure nursing activities since this is the unit that receives the most complex patients. For this reason, this scoping review aims to establish the workload using the Nursing Activities Score and the factors related to it in Intensive Care Units. Methods: Qualitative scoping review using the PRISMA statement. Searches were conducted in CINAHL, LILACS, Scopus, Science Direct, SciELO, and PubMed databases. Results: The final sample consists of 87 texts published between 2007 and 2021. They were classified into five categories: ICU workload, inter-unit comparison, workload related to nursing staff, workload related to patient characteristics, and workload consequences. Discussion: The review reveals a workload greater than 50% in most of the studies due to different factors, but mainly to patients' particular characteristics. No significant difference was observed between general and specialized units; high workloads are a risk factor for adverse events. Conclusions: This review shows that nurses are constantly exposed to high workloads. It is possible for workloads to affect or be influenced by various factors, such as the characteristics of patients being cared for, or to impact the quality of nursing care positively or negatively.

Introdução: O Nursing Activities Score tem sido usado como um instrumento principalmente na Unidade de Tratamentos Intensivos para medir as atividades de enfermagem, sendo essa a unidade que lida com os pacientes mais complexos para o cuidado. Por esta razão, o objetivo desta scoping review é estabelecer a carga de trabalho, conforme avaliado pelo Nursing Activities Score, e fatores relacionados em Unidades de Cuidados Intensivos. Metodologia: Revisão quantitativa usando scoping Review, utilizando o método PRISMA. Pesquisa nos bancos de dados CINAHL, LILACS, SCOPUS, SCIENCE DIRECT, SCIELO e PUBMED. Resultados: A amostra final consistiu em 87 textos, variando de 2007 a 2021. Eles foram classificados em cinco categorias: carga de trabalho na UTI, comparação entre unidades, carga de trabalho relacionada ao pessoal de enfermagem, carga de trabalho relacionada às características dos pacientes e consequências da carga de trabalho. Discussão: A revisão revela uma carga de trabalho superior a 50% na maioria dos estudos, isto devido a diferentes fatores: principalmente as características particulares dos pacientes, nenhuma diferença significativa foi observada entre unidades gerais e especializadas, altas cargas de trabalho são um fator de risco para a ocorrência de eventos adversos. Conclusões: Os resultados desta revisão comprovam que o pessoal de enfermagem está constantemente exposto a altas cargas de trabalho. Esta carga de trabalho pode ser influenciada ou influenciada por vários fatores, tais como as características dos pacientes atendidos ou pode afetar positiva ou negativamente a qualidade dos cuidados de enfermagem.

Worldwide epidemiology of neuro-coronavirus disease in children: lessons for the next pandemic.

PURPOSE OF REVIEW: The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic has overwhelmed the global community, negatively impacting patient health and research efforts; associated neurological manifestations are a significant cause of morbidity. This review outlines the worldwide epidemiology of neurologic manifestations of different SARS-CoV-2 clinical pediatric phenotypes, including acute coronavirus disease 2019 (COVID-19), multisystem inflammatory syndrome in children (MIS-C) and postacute sequelae of COVID-19 (PASC). We discuss strategies to develop adaptive global research platforms for future investigation into emerging pediatric neurologic conditions. RECENT FINDINGS: Multicenter, multinational studies show that neurological manifestations of acute COVID-19, such as smell/taste disorders, headache, and stroke, are common in hospitalized adults (82%) and children (22%), associated with increased mortality in adults. Neurological manifestations of MIS-C are reported in up to 20% of children, including headache, irritability, and encephalopathy. Data on PASC are emerging and include fatigue, cognitive changes, and headache. Reports of neurological manifestations in each phenotype are limited by lack of pediatric-informed case definitions, common data elements, and resources. SUMMARY: Coordinated, well resourced, multinational investigation into SARS-CoV-2-related neurological manifestations in children is critical to rapid identification of global and region-specific risk factors, and developing treatment and mitigation strategies for the current pandemic and future health neurologic emergencies.

COVID-19 and the Pediatric Nervous System: Global Collaboration to Meet a Global Need.

The coronavirus disease 2019 (COVID-19) pandemic has affected mortality and morbidity across all ages, including children. It is now known that neurological manifestations of COVID-19, ranging from headaches to stroke, may involve the central and/or peripheral nervous system at any age. Neurologic involvement is also noted in the multisystem inflammatory syndrome in children, a pediatric condition that occurs weeks after infection with the causative virus of COVID-19, severe acute respiratory syndrome coronavirus 2. Knowledge about mechanisms of neurologic disease is scarce but rapidly growing. COVID-19 neurologic manifestations may have particularly adverse impacts on the developing brain. Emerging data suggest a cohort of patients with COVID-19 will have longitudinal illness affecting their cognitive, physical, and emotional health, but little is known about the long-term impact on affected children and their families. Pediatric collaboratives have begun to provide important initial information on neuroimaging manifestations and the incidence of ischemic stroke in children with COVID 19. The Global Consortium Study of Neurologic Dysfunction in COVID-19-Pediatrics, a multinational collaborative, is working to improve understanding of the epidemiology, mechanisms of neurological manifestations, and the long-term implications of COVID-19 in children and their families.

Neonato con malformación de la vena de Galeno con diagnóstico oportuno: reporte de caso / Timely diagnosis of a Newborn wth Vein of Galen aneurysmal malformation: a case report

RESUMEN La malformación de la vena de Galeno a pesar de ser una patología poco frecuente representa un desafío clínico, por lo que debe ser detectada de forma temprana y manejada por un grupo multidisciplinario, iniciando desde los médicos generales quienes son los encargados de realizar el reconocimiento durante los controles prenatales, y así continuar el manejo de la mano de perinatólogos, pediatras, neonatólogos y radiólogos intervencionistas, todos ellos encargados de supervisar la evolución del paciente y dar tratamiento oportuno para mejorar el pronóstico de vida. A continuación, se presenta un caso clínico cuyo diagnóstico prenatal y manejo medico logró disminuir las complicaciones y comorbilidades resultantes, y así garantizar su preparación para una intervención endovascular posterior.

SUMMARY The vein of Galen malformation is a clinical challenge despite its low frequency, this disease must be detected early during the prenatal age and managed by a multidisciplinary group, beginning with the general physician in the antenatal medical appointment and later receiving treatment with perinatologists, pediatricians, neonatologists and interventional radiologists; all of this in order to ensure a better outcome and neurologic and systemic consequences. This report shows a female patient with an early and accurate antenatal diagnosis of vein of Galen malformation; during the postnatal period multidisciplinary approach and rationale medical management lowered the risk and possible complications, allowing the preparation for a late endovascular intervention.

[The Moral Deliberation: The Clinical Ethics Method. Presentation of a Paediatric Case]. / La deliberación moral: el método de la ética clínica. A propósito de un caso de paciente pediátrico.

Decision-making is one of the most difficult tasks of medical judgment, especially when cases involve paediatric patients with different cultural characteristics. It is the obligation of clinical ethics, taking the interdisciplinary approach as a tool to comprehensively analyse the clinical, social, cultural and legal aspects, among other topics, when choosing the treatment options that will be more beneficial for the patient. A clinical case, should enable this process of analysis and teamwork to be understood in practical way in order to address difficult medical problems.

La deliberación moral: el método de la ética clínica. A propósito de un caso de paciente pediátrico / The Moral Deliberation: The Clinical Ethics Method. Presentation of a Paediatric Case

La toma de decisiones es una de las tareas más complejas del quehacer médico, y más cuando los casos afectan a pacientes pediátricos y con características socioculturales especiales. Es deber de la ética clínica, teniendo la interdisciplinaridad como herramienta, analizar de manera integral los aspectos clínicos, sociales, culturales y legales, entre otros, que se debe tener en cuenta a la hora de escoger la mejor opción terapéutica que beneficie al paciente. Un caso clínico permitirá entender de manera práctica este proceso de análisis y trabajo en equipo, para abordar problemas médicos difíciles.

Decision-making is one of the most difficult tasks of medical judgment, especially when cases involve paediatric patients with different cultural characteristics. It is the obligation of clinical ethics, taking the interdisciplinary approach as a tool to comprehensively analyse the clinical, social, cultural and legal aspects, among other topics, when choosing the treatment options that will be more beneficial for the patient. A clinical case, should enable this process of analysis and teamwork to be understood in practical way in order to address difficult medical problems.

Acute idiopathic pulmonary hemorrhage in infants. Report of two cases and literature review / Hemorragia pulmonar idiopática aguda en pediatría: reporte de 2 casos y revisión en la literatura

Acute idiopathic pulmonary hemorrhage is a rare life-threatening disease in children. The classic triad includes hemoptysis, anemia and respiratory distress. Since clinical presentation may vary, diagnosis can be difficult. Severe respiratory distress, and ventilatory failure requiring mechanical ventilation are often present. Chest X-rays usually show unilateral or bilateral infiltrates, therefore, other causes of pulmonary hemorrhage must be excluded, since most of them correspond to systemic diseases. Treatment often requires intravenous steroids to solve the respiratory failure in most cases. We present two cases involving infants treated at Hospital San José (a fourth level hospital in Bogotá, Colombia) with acute idiopathic pulmonary hemorrhage which required mechanical ventilation and responded to intravenous steroids. A literature review was conducted with special emphasis on clinical presentation, diagnosis and therapeutic approaches.

La hemorragia pulmonar idiopática aguda es una enfermedad poco común en pediatría que amenaza la vida de lactantes. La tríada clásica se caracteriza por hemoptisis, anemia y dificultad respiratoria, aunque su presentación clínica es variable, por lo que su diagnóstico presenta dificultades. Este cuadro de clínico se presenta junto a dificultad respiratoria severa y falla ventilatoria, que requiere una ventilación mecánica. En la radiografía se visualizan infiltrados unilaterales y/o bilaterales, por lo que deben excluirse otras causas de hemorragia pulmonar que en su mayoría son enfermedades sistémicas. El tratamiento requiere esteroides endovenosos que permitan resolver la falla respiratoria en la mayoría de los casos. Se presentan dos casos de lactantes menores atendidos en el Hospital de San José (hospital de cuarto nivel en Bogotá D.C.), con un cuadro agudo de hemorragia pulmonar idiopática con ventilación mecánica y que responden al tratamiento con esteroides endovenosos. Se realiza revisión de la literatura haciendo particular énfasis en la presentación clínica, el enfoque diagnóstico y terapéutico