Abstract:
AIM:To give evidence-based recommendations on the application of ketogenic diet parenteral nutrition (KD-PN) in emergency situations. METHOD:An international group of experts (n=14) researched the literature and distributed a survey among 150 expert centers. International accepted guidelines (European Society for Clinical Nutrition and Metabolism/European Society for Paediatric Gastroenterology Hepatology and Nutrition and the American Society for Parenteral and Enteral Nutrition) and handbooks for parenteral nutrition were considered general standards of care. RESULTS:In the literature, we identified 35 reports of patients treated by KD-PN. International guidelines and handbooks provided some conflicting information. Twenty-four expert teams from nine countries responded to the survey, reflecting the limited clinical experience. INTERPRETATION:This paper highlights 23 consensus-based recommendations for safe and effective KD-PN (e.g. diet initiation, calculation, application, monitoring, and evaluation) based on the best evidence available and expert opinions. WHAT THIS PAPER ADDS:In acute settings, ketogenic diet therapy (KDT) can be administered parenterally. Parenteral administration of KDT should be started only at the intensive care unit. Initiate ketogenic parenteral nutrition stepwise to the highest ratio possible with the lowest level of complications. Evaluate the risk-benefit ratio of parenteral administration continuously. Restart enteral feeding as soon as appropriate. :MANEJO CLÍNICO ÓPTIMO DE LOS NIÑOS QUE RECIBEN NUTRICIÓN PARENTERAL CETOGÉNICA: UNA GUÍA DE PRÁCTICA CLÍNICA: OBJETIVO: Dar recomendaciones basadas en evidencia sobre la aplicación de dieta cetogénica en la nutrición parenteral (DC-NP) en situaciones de emergencia. MÉTODO: Un grupo de expertos (n=14) investigó la literatura y distribuyó una encuesta en 150 centros especializados. Considerando como estándares de manejo las guías aceptadas internacionalmente (Sociedad Europea para la Nutrición Clínica y Metabolismo/Sociedad Europea de Gastroenterología Pediátrica, Hepatología y Nutrición, y la Sociedad Americana para Nutrición Enteral y Parenteral) y los manuales para la nutrición parenteral. RESULTADOS: En la literatura se identificaron 35 informes de pacientes tratados por DC-NP. Las directrices y manuales internacionales proporcionaron alguna información contradictoria. Veinticuatro equipos de expertos de nueve países respondieron a la encuesta, reflejando la limitada experiencia clínica. INTERPRETACIÓN: Este documento destaca 23 recomendaciones basadas en consensos para una DC-NP segura y eficaz (por ejemplo; iniciación de la dieta, cálculo, aplicación, monitoreo y evaluación) basada en la mejor evidencia disponible y las opiniones de expertos. :MANEJO CLÍNICO ÓTIMO DE CRIANÇAS RECEBENDO NUTRIÇÃO CETOGÊNICA PARENTERAL: UM GUIA PARA A PRÁTICA CLÍNICA: OBJETIVO: Oferecer recomendações baseadas em evidências da aplicação de dieta cetogênica por nutrição parenteral (DC-NP) em situações de emergência. MÉTODO: Um grupo internacional de especialistas (n=14) pesquisou a literatura e distribuiu um questionário em 150 centros especializados. Diretrizes internacioansi aceitas (Sociedade Européia de Nutrição Clínica e Metabolismo/ Sociedade Européia de Gastroenterologia, Hepatologia e Nutrição Pediátrica, e a Sociedade Americana de Nutrição Enteral e Parenteral) e livros sobre nutrição parenteral foram considerados padrão geral de atenção. RESULTADOS: Na literatura, identificamos 35 relados de pacientes tratados por DC-NP. As diretrizes internacionais e os livros forneceram informações conflitantes. Vinte e quatro equips de especialistas de nove países responderam ao questionário, refletindo a experiência clínica limitada. INTERPRETAÇÃO: Este artigo destaca 23 recomendações baseadas em consenso para DC-NP segura e efetiva (ex: início da dieta, cálculo, aplicação, monitoramento e avaliação) com base na melhor evidência disponível e opiniões de especialistas.
journal_name
Dev Med Child Neuroljournal_title
Developmental medicine and child neurologyauthors
van der Louw E,Aldaz V,Harvey J,Roan M,van den Hurk D,Cross JH,Auvin S,Review Group.doi
10.1111/dmcn.14306subject
Has Abstractpub_date
2020-01-01 00:00:00pages
48-56issue
1eissn
0012-1622issn
1469-8749journal_volume
62pub_type
杂志文章abstract::Bethanechol is a direct agonist of the acetylcholine receptor that was recently introduced in the therapy of gastro-oesophageal reflux. Acute dystonic reactions to bethanechol were observed in a 10-month-old infant who also demonstrated similar dystonic reactions to dopamine receptor blocking agents of two different c...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章
doi:10.1111/j.1469-8749.1986.tb03909.x
更新日期:1986-10-01 00:00:00
abstract::Following minor occipital head-trauma, a six-year-old boy developed bilateral internuclear ophthalmoplegia (INO) as the only neurological sign. After having excluded all other possible aetiological causes by careful examination, including magnetic resonance imaging, the symptoms eventually were attributed to the traum...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章
doi:10.1111/j.1469-8749.1993.tb11618.x
更新日期:1993-02-01 00:00:00
abstract::Fifty normal kindergarten and 50 first-grade children were examined three times at six-month intervals for synkineses to stress gaits and mirror movements to finger lifting, finger spreading, and timed motor maneuvers. Motor signs in the age-sensitive range showed substantial individual differences between children of...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章
doi:10.1111/j.1469-8749.1983.tb13786.x
更新日期:1983-08-01 00:00:00
abstract::Four infants developed dyskinesia after cardiopulmonary bypass surgery three to four days postoperatively. The dyskinesia was choreoathetotic, and involved mainly the mouth, tongue and face. It was absent during sleep. Three of these infants improved over periods of several weeks, but one infant remained dyskinetic on...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章
doi:10.1111/j.1469-8749.1993.tb11701.x
更新日期:1993-07-01 00:00:00
abstract::Aim To determine the levels of anxiety and depression in young people with spinal cord injuries (SCI) and their associated factors and outcomes. Method Children and adolescents aged 7 to 17 years at interview who had sustained SCI at least 1 year before the study were assessed using the Children's Depression Inventory...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章
doi:10.1111/j.1469-8749.2009.03268.x
更新日期:2009-10-01 00:00:00
abstract::Twenty-three Swedish children aged five to 18 years who fulfilled specific criteria for Asperger syndrome were examined and compared with an age- and IQ-matched group with infantile autism. The boy:girl ratio was 10:1. Less than 10 per cent were mentally retarded and 17 per cent were of above-average intelligence. Apa...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章,评审
doi:10.1111/j.1469-8749.1989.tb04031.x
更新日期:1989-08-01 00:00:00
abstract::This literature review addressed four questions. (1) In which populations other than cerebral palsy (CP) has the Gross Motor Function Classification System (GMFCS) been applied? (2) In what types of study, and why was it used? (3) How was it modified to facilitate these applications? (4) What justifications and eviden...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章,评审
doi:10.1111/dmcn.13602
更新日期:2018-02-01 00:00:00
abstract::The importance of the family environment for the development of children with neurodisabilities is undisputed. The objective of this study is to describe how family environment has been measured in research on families of children with neurodisabilities, in order to support researchers and clinicians to select appropr...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章,评审
doi:10.1111/dmcn.13287
更新日期:2017-03-01 00:00:00
abstract::Short-term test-retest reliability of the 10-metre fast walk test (10mFWT) and 6-minute walk test (6MWT) was evaluated in 31 ambulatory children with cerebral palsy (CP), with subgroup analyses in Gross Motor Function Classification System (GMFCS) Levels I (n=9), II (n=8), and III (n=14). Sixteen females and 15 males ...
journal_title:Developmental medicine and child neurology
pub_type: 临床试验,杂志文章
doi:10.1111/j.1469-8749.2008.02048.x
更新日期:2008-05-01 00:00:00
abstract::This study explored proximal-to-distal components during goal-directed reaching movements in children with mild or moderate hemiplegic cerebral palsy (HCP); [seven females, four males; mean age 8 y 6 mo; SD 27 mo], compared with age-matched, typically developing children (seven females, five males; mean age 8 y 3 mo [...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章
doi:10.1111/j.1469-8749.2008.03215.x
更新日期:2009-10-01 00:00:00
abstract::Homocystinuria due to 5,10-methylenetetrahydrofolate reductase deficiency may present with variable neurological manifestations. Radiological features include white matter changes (leukoencephalopathy). Clinical, biochemical, and radiological response to treatment may again be variable. Here we present a 12-year follo...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章
doi:10.1017/s0012162205000095
更新日期:2005-01-01 00:00:00
abstract::Following obstetrical brachial plexus injury, infants are unable to learn specific patterns of movement due to the disruption of neural pathways. Even with successful reinnervation (spontaneously or post surgical reconstruction), function can be suboptimal due to overactivity in antagonist muscles preventing movement ...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章
doi:10.1017/S0012162206000557
更新日期:2006-04-01 00:00:00
abstract::Impaired airway clearance leads to recurrent chest infections and respiratory deterioration in neuromuscular weakness. It is frequently the cause of death. Cough is the major mechanism of airway clearance. Cough has several components, and assessment tools are available to measure the different components of cough. Th...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章,评审
doi:10.1111/j.1469-8749.2008.03260.x
更新日期:2009-05-01 00:00:00
abstract::The use of statistics in medical diagnoses and biomedical research may affect whether an individual may live or die, whether their health is protected or jeopardized. Because society depends on sound statistical practice, all practitioners of statistics, whatever their training or occupation, have social obligations t...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章
doi:10.1111/j.1469-8749.2009.03553.x
更新日期:2010-03-01 00:00:00
abstract::Individuals with Down syndrome (DS), a disorder of known genetic etiology (trisomy of chromosome 21), exhibit several types of structural brain abnormalities that are detectable pathologically and by MRI. In addition, in middle age, individuals with DS develop histological and, in some cases, clinical features of Alzh...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章
doi:
更新日期:1998-05-01 00:00:00
abstract::Victimization by peers affects 10 to 20% of school children under the age of 12 years. Physical, verbal, and psychological victimization (being pushed, hit, called names, teased, being the target of rumours, theft, extortion) is associated with short- and long-term adjustment problems, such as peer rejection, social w...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章
doi:10.1017/s0012162204000854
更新日期:2004-08-01 00:00:00
abstract::The authors report an association between developmental language disorder and acquired aphasia in a 13-year-old right-handed boy. Acquired aphasia was caused by a right-frontal abscess (crossed aphasia). It was non-fluent, with a disorder of auditory comprehension, an unusual feature of prerolandic lesions. This case ...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章
doi:10.1111/j.1469-8749.1995.tb11934.x
更新日期:1995-01-01 00:00:00
abstract::Cerebral palsy (CP) can occur in term infants with or without preceding newborn encephalopathy. We compared the type and severity of CP and associated disability in these two groups. Participants from a population-based case-control study of term newborn encephalopathy were followed up for 6 years and linked to the We...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章
doi:10.1017/s0012162205000575
更新日期:2005-05-01 00:00:00
abstract::The extent to which children with either specific language impairment (SLI) or developmental coordination disorder (DCD) could be considered dyspraxic was examined using three tasks involving either familiar, or unfamiliar actions. SLI is diagnosed in children who fail to develop language in the normal fashion for no ...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章
doi:10.1111/j.1469-8749.1998.tb08214.x
更新日期:1998-06-01 00:00:00
abstract:AIM:Dodd's Model for Differential Diagnosis is one of the available clinical diagnostic classification systems of childhood speech sound disorders. Yet we do not understand the validity of this system beyond clinical samples, precluding its application in epidemiological or population-based research. This study aimed t...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章
doi:10.1111/dmcn.13993
更新日期:2019-06-01 00:00:00
abstract::Nineteen sightless children and adolescents aged between 11 and 18 years were tested for physical condition and performance. Their residential school provided four adapted physical education lessons a week, lasting for 45 minutes. Their physical condition and performance was found to be comparable with that of normal ...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章
doi:10.1111/j.1469-8749.1985.tb03801.x
更新日期:1985-12-01 00:00:00
abstract::A prospective 14-year outcome study of two children meeting DSM-IV criteria for childhood disintegrative disorder is presented. Their ages at first evaluation were 4 years 7 months and 6 years 3 months. Both are now adults and continue to have a severe pervasive developmental disorder, mental retardation, seizure diso...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章
doi:10.1111/j.1469-8749.1998.tb12331.x
更新日期:1998-10-01 00:00:00
abstract::The diagnosis of Rett syndrome is currently determined by a series of criteria, the first three of which are concerned with the initial period of normality. Using the Australian Rett Syndrome Database, information about this early period was obtained by questionnaires to paediatricians and families. For girls born bet...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章
doi:
更新日期:1998-02-01 00:00:00
abstract::Five children (three males, two females; four right-, one left-handed; age range 6 to 14 years) who developed aphasia after gross-total excision of left predominantly thalamic tumors are reported. Three patients had Broca aphasia, one had mixed transcortical aphasia, and one patient had conduction aphasia. In the mont...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章
doi:10.1017/s0012162200001109
更新日期:2000-09-01 00:00:00
abstract:AIM:To compare neurophysiological parameters of central nervous system excitability in healthy children/adolescents with those of healthy adults. METHOD:Two experimental protocols were used in 19 healthy children/adolescents (10 males and 9 females, mean age 9y 11mo [SD 2y 9mo], range 5-15y) and 19 healthy adults (8 m...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章
doi:10.1111/dmcn.13072
更新日期:2016-08-01 00:00:00
abstract::This study investigated the effect of chronic exposure to lead on children's ability to maintain upright postural balance as a biological marker of lead-induced modifications of the neuromotor system. For this study, 162 six-year-old children, with a five-year geometric mean lead concentration in blood of 11.9 microgr...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章
doi:10.1111/j.1469-8749.1995.tb11939.x
更新日期:1995-10-01 00:00:00
abstract::Early epilepsy is known to worsen the developmental prognosis of young children with a congenital focal brain lesion, but its direct role is often very difficult to delineate from the other variables. This requires prolonged periods of follow-up with simultaneous serial electrophysiological and developmental assessmen...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章
doi:10.1111/j.1469-8749.2008.03162.x
更新日期:2008-11-01 00:00:00
abstract:AIM:Studies on the use of intrathecal baclofen (ITB) for ambulant adults with spasticity and/or dystonia of cerebral origin are scarce, and are even more limited for children and adolescents. This systematic review investigates the use of ITB to improve walking, transfer ability, and gross motor activities in ambulant ...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章,评审
doi:10.1111/j.1469-8749.2011.03992.x
更新日期:2011-10-01 00:00:00
abstract::Dynamic electromyography was used to examine the activity of muscles of 26 children with varus hindfoot deformities as a result of spastic cerebral palsy. Four different patterns of inappropriate muscle activity involving the tibialis anterior, tibialis posterior, gastrocnemius and soleus were seen during walking. Dyn...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章
doi:10.1111/j.1469-8749.1984.tb04411.x
更新日期:1984-02-01 00:00:00
abstract::Thrombotic and thromboembolic complications are the main causes of morbidity and mortality in patients with homocystinuria. However, it is unusual for thrombosis and infarction to be the presenting feature leading to investigation for homocystinuria and cerebrovascular lesions in the first year of life. We describe a ...
journal_title:Developmental medicine and child neurology
pub_type: 杂志文章
doi:10.1017/s0012162299000250
更新日期:1999-02-01 00:00:00