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Apparent Life-threatening Event (apparent + life-threatening_event)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Systematic review: the extra-oesophageal symptoms of gastro-oesophageal reflux disease in children

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 3 2009
V. TOLIA
Summary Background, Extra-oesophageal symptoms are thought to be common, atypical symptoms of gastro-oesophageal reflux disease (GERD) in children. Aim, To investigate the prevalence of GERD in children with extra-oesophageal symptoms or of extra-oesophageal symptoms in children with GERD, and the effect of GERD therapies on extra-oesophageal symptoms. Methods, A systematic review of articles in PubMed and EMBASE. Results, We identified 18 relevant articles. The pooled weighted average prevalence of GERD in asthmatic children was 23%, compared with 4% in healthy controls from the same five studies. The majority of studies evaluating the relationship between apparent life-threatening event (ALTE) and GERD did not suggest a causal relationship. Seven studies reported that respiratory symptoms, sinusitis and dental erosion were significantly more prevalent in children with GERD than in controls. Data from pharmacotherapeutic trials were inconclusive and provided no support for a causal relationship between GERD and extra-oesophageal symptoms. Conclusions, Possible associations exist between GERD and asthma, pneumonia, bronchiectasis, ALTE, laryngotracheitis, sinusitis and dental erosion, but causality or temporal association were not established. Moreover, the paucity of studies, small sample sizes and varying disease definitions did not allow firm conclusions to be drawn. Most trials of GERD therapies showed no improvement in extra-oesophageal symptoms in children. [source]

Thalamic infarct presenting as apparent life-threatening event in infants

ACTA PAEDIATRICA, Issue 12 2009
Sachin Gupta
Abstract Thalamic infarction with distinct manifestations is well-described in adults but less well-delineated in children. We report two infants who presented with an apparent life-threatening event (ALTE) with very early magnetic resonance imaging (MRI) demonstrating a unilateral thalamic infarction. Subsequent MRI demonstrated bilateral changes in the brain stem and basal ganglia, which were in keeping with profound hypoxic ischaemic injury. We propose the thalamic infarction to be the primary event precipitating a profound hypoxic ischaemic injury as an alternative explanation to the neuroimaging observation. Conclusion:, Thalamic infraction may have a causal role in ALTE. Early and appropriate neuroimaging is required to detect these changes. [source]

Cholinergic and oxidative stress mechanisms in sudden infant death syndrome

ACTA PAEDIATRICA, Issue 11 2009
Anne Dick
Abstract Aim:, To determine whether biochemical parameters of cholinergic and oxidative stress function including red cell acetylcholinesterase (AChE), serum/plasma thyroglobulin, selenium, iron, ferritin, vitamins C, E, and A affect risk in apparent life-threatening event (ALTE), sudden infant death syndrome (SIDS), and sudden unexpected death in infancy (SUDI). To assess these biochemical parameters as a function of age; and for influence of pharmacology and epidemiology, including infant health, care, and feeding practices. Methods:, A multicentre, case,control study with blood samples from 34 ALTE and 67 non-ALTE (control) infants matched for age, and 30 SIDS/SUDI and four non-SIDS/non-SUDI (post-mortem control) infants. Results:, Levels/activity of the biochemical parameters were not significantly different in ALTE vs. control infants, with the exception of higher vitamin C levels in the ALTE group (p = 0.009). In ALTE and control groups, AChE and thyroglobulin levels increased and decreased respectively from birth to attain normal adult levels from 6 months. Levels of iron and ferritin were higher in the first 6 month period for all infant groups studied, intersecting with vitamin C levels peaking around 4 months of age. Conclusion:, Lower AChE levels and higher combined levels of iron and vitamin C in the first 6 months of life may augment cholinergic and oxidative stress effect, particularly at the age when SIDS is most prevalent. This may contribute to risk of ALTE and SIDS/SUDI events during infancy. [source]

Abnormal heart rate response to hypercapnia in boys with an apparent life-threatening event

ACTA PAEDIATRICA, Issue 12 2002
A Edner
Aim: To determine instantaneous cardiac variability responses to increased carbon dioxide (CO2) during quiet sleep in infants who may be at risk for the Sudden Infant Death syndrome (SIDS). Methods: The cardiac rate variability before, during and after a CO2 challenge was examined in 41 infants who had experienced an apparent life-threatening event (ALTE) and 41 gender- and age-matched control infants. Results: The ALTE infants responded to CO2 breathing with a significant increase in R-R intervals, i.e. decreases in heart rate, compared to the controls (45.1% increase in R-R intervals vs. 41.4%; p= 0.005). The differences between ALTE infants and controls depended primarily on the boys' responses. Conclusion: ALTE infants, particularly ALTE boys, have an autonomic dysfunction,lower sympathetic stimulation and/or inhibited vagal withdrawal when stressed with CO2. The outcome might provide clues to the mechanisms underlying the cardiovascular processes contributing to the terminal event in SIDS. [source]

Nonepileptic Disorders Imitating Generalized Idiopathic Epilepsies

EPILEPSIA, Issue 2005
Natalio Fejerman
Summary:, Differential diagnosis between epileptic and nonepileptic paroxysmal disorders is fundamental not only to allow correct management of patients but also to avoid the burden of unnecessary antiepileptic medication. The focus of this chapter is limited to imitators of idiopathic generalized epilepsies (IGE) which are expressed through myoclonic, tonic,clonic, tonic, atonic, and absence seizures. Apparent losses of consciousness and drop attacks also have to be considered. Benign myoclonus of early infancy is the main nonepileptic disorder in the differential diagnosis of infantile spasms, but is not dealt with here because West syndrome is not an IGE. Hyperekplexia, metabolic disorders, hypnagogic myoclonus, and disturbed responsiveness caused by the use of drugs are listed in Table 1. Other conditions that may imitate more focal epileptic seizures are omitted. Benign neonatal sleep myoclonus, apnea and apparent life-threatening events in infants, cyanotic and pallid breath-holding spells, syncope, staring spells, psychogenic seizures, hyperventilation syndrome, and narcolepsy have been selected based on frequency or difficulties in differential diagnosis with the intention to cover the most conspicuous imitators of IGE in different ages. Table 1. Nonepileptic disorders imitating idiopathic generalized epilepsies [source]

Laryngeal sensitivity in the neonatal period: From bench to bedside

PEDIATRIC PULMONOLOGY, Issue 8 2007
Philippe Reix MD
Abstract Laryngeal sensitivity in the newborn has been a subject of great interest for both researchers and clinicians for a number of years. From a clinical standpoint, laryngeal sensitivity is essential for both preventing foreign substances from entering into the lower airway and for finely tuning upper airway resistance. However, heightened reflexes originating from the laryngeal receptors in newborns and infants, due to neural immaturity, can lead to potentially dangerous cardiorespiratory events. The latter have been linked to apneas of prematurity, apparent life-threatening events, and sudden infant death syndrome (SIDS). From a physiological standpoint, many mechanisms pertaining to reflexes originating from laryngeal receptors are yet to be fully understood. This short review is an attempt to summarize current knowledge on laryngeal sensitivity and its potential consequences upon control of breathing abnormalities encountered within the first weeks of life. Pediatr Pulmonol. 2007; 42:674,682. © 2007 Wiley-Liss, Inc. [source]

Characteristics of respiratory syncytial virus-related apnoea in three infants

ACTA PAEDIATRICA, Issue 6 2004
M Rayyan
Apnoea is a common sign in respiratory syncytial virus (RSV) infections in young infants and can be the first presentation of an acquired RSV infection. We describe polysomnographic recordings of three infants revealing prolonged RSV-related apnoea before RSV infection was diagnosed. The apnoeas were of central origin. The caregivers had not noted any apparent life-threatening events (ALTE) prior to the polysomnography. Cardiorespiratory monitoring after the acute infection did not reveal any further apnoeas. Conclusion: Central, prolonged apnoea can be the first sign of an acquired RSV infection in young infants in the absence of other respiratory symptoms and without any previous observation of apnoea by the caregivers. [source]