International Journal of Anesthesia and Critical Care

Low back pain (LBP) is one of the most prevalent conditions that will affect 70-85% of individuals at some point in their life [1]. LBP accounts for 2.3% of all visits to the physician, and is the most common area of the body to experience pain [2]. Exercise has been a mainstay for managing persons with chronic low back pain for almost 40

Leukemia is the most common childhood malignancy and cause of pediatric cancer death. Significant advances in the cure rates of B-cell acute lymphoblastic leukemia (B-ALL) and T-cell acute lymphoblastic leukemia (T-ALL) have been achieved; however, patients with refractory or relapsed B-ALL or T-ALL continue to have poor outcomes. Immunotherapy is a revolutionary treatment aimed to improve survival and reduce the toxicity of chemotherapy by harnessing the patient’s own immune system to target cancer cells.

The concept of immunotherapy has been traced as far back to third century BC Qin dynasty in China through the purposeful inoculation of Variola minor to prevent smallpox. 

The global scaling up of treatment and care for people living with Human Immunodeficiency Virus (PLHIV) has led to a 43% decline in new HIV pediatric infections since 2003, with 330,000 newly infected children in 2011.

Tracheostomy insertion is a common procedure used to support weaning from mechanical ventilation or following head and neck surgery. Resolution of the clinical need for tracheostomy is followed by a process of tracheostomy weaning and subsequent decannulation.

The World Health Organisation (WHO) defines anaemia as a haemoglobin (Hb) of less than 130 mg/mL in men and 120 mg/mL in non-pregnant women. Anaemia has a global prevalence of 25%. In patients presenting for surgery the prevalence can be as high as 40%. Anaemia can be acute or chronic; but becomes problematic when there are insufficient numbers of red blood cells to maintain physiological oxygen demand, the end result being compromised oxygen delivery.

Nonalcoholic fatty liver disease (NAFLD), a spectrum of pathologies ranging from simple steatosis to fibrosis and cirrhosis, is the most common cause of chronic liver disease, affecting over 80% of adults with obesity, one third of obese children ages 3-18 in North America [2] and ~10% of the general pediatric population.

Stroke at a young age is a rarely reported entity whether it is uncommon or overlooked. When it occurs, it can result in lifetime neurological deficits and disabilities for the child and an overwhelming emotional and mental challenge to caregivers. One of the reasons that can lead childhood stroke to be overlooked is an atypical presentation onset with a headache or acute symptomatic seizure. As time is brain, these differences in childhood stroke can lead to a delay in diagnosis and symptoms considered as a stroke mimic.

Junctophilin-2 (JP2) is a key structural protein of junctional membrane complexes (JMCs) that stabilize contacts between the sarcoplasmic reticulum and transverse tubules required for excitation-contraction (EC) coupling in cardiomyocytes. Under pathophysiological conditions, the intracellular cysteine protease Calpain activated by disturbed intracellular Ca2+ homeostasis cleaves JP2 and, hence, disturbs EC coupling.

Unapproved use of an approved drug is called “off-label” use. In line with European Medicine Agency’s pharmacovigilance directive, off-label use “relates to situations where a medicinal product is intentionally used for a medical purpose not in accordance with the authorised product information (SmPC).

Ptosis or the dropping of an eyelid can affect both the adult and pediatric populations and can be caused by various factors. Ptosis is not very common and in children, the common causes include orbital cellulitis, congenital ptosis, Cranial Nerve III palsy, and Horner’s syndrome.

Functional constipation (FC) has a pooled world prevalence of 9.5%, a clear definition by Rome IV Criteria, and the NAPGHAN/ESPGHAN guidelines recommendation for management. With well-defined parameters, this commentary discusses the paths followed by the literature to implement different therapeutic modalities over time. The text will prioritize information based on systematic reviews, meta-analyses, or reviews.

Objectives: Here, we review opioid-sparing or opioid-free anesthesia and pain management for urologic procedures and pathologies–urological pain syndromes, kidney stone pain management, development of post-surgical pain syndromes, and prevention. We explore acute management of perioperative pain during and after urologic procedures; additionally, we review the pathophysiology of various urologic pain syndromes along with a variety of interventions, including pharmacologic management, nerve blocks, neurolysis, and neuromodulatory therapies in hopes of educating providers who treat the urologic patient.

Objectives: To describe the predictors and associations of prolonged tracheostomy duration in pediatric cardiac surgical patients. Method: Prospective study. All pediatric patients below 10 years of age who underwent tracheostomy after cardiac surgery from January 2019 to December 2019, were subdivided into short and long groups according to the tracheostomy duration during the intrahospital stay if more than 21 days. Different variables were compared.

After establishing the new standard of care of isotonic fluids for maintenance therapy, there has not been a systematic follow-up to determine whether the goal of the switch has been achieved or whether there have been any unexpected complications with the change. This is a brief review of the history of maintenance intravenous fluids and potential complications of isotonic fluid therapy spurred by a case.

Asthma, as a comorbidity in the presence of cardiac disorder, can be a very annoying issue. In contrast to the patient's cardiac disease, it might not feel like a major problem, especially when considering some cyanotic heart conditions, but in reality, having a daily cough can be very concerning for families, affecting their kid’s quality of life, sleep, and daily activity.

Early childhood caries (ECC) is a pervasive and debilitating disease affecting millions of children worldwide. The traditional restorative approach, although effective, often requires invasive procedures, which can be traumatic for young children [1]. Furthermore, ECC can have far-reaching consequences, including pain, infection, and malocclusion, which can impact a child's quality of life and overall well-being. 

Observational, retrospective cohort single-center study in consecutive cases of children and adolescents, referred for initial evaluation of chronic abdominal pain at the Pediatric Gastroenterology Outpatient Clinic. Inclusion criteria: Age between 4 and 17 years; Diagnosis of AM defined from structured questionnaires according to three consensus criteria (Rome III, Rome IV criteria, and The International Classification of Headache Disorders).

Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus. Dupilumab, a treatment for EoE, requires an initial endoscopic evaluation no sooner than 12 weeks after initiation. As it is costly and pediatric patients often experience fear and pain associated with the injection, this could lead to non-adherence or premature cessation of therapy. Here, we report a case series, as part of a larger ongoing study, in which subjects demonstrated an earlier response to dupilumab.

Objective: This case series describes the presentation, clinical course, and functional outcomes of four pediatric patients with neuroinvasive Powassan virus infection who were admitted to inpatient rehabilitation with severe neurologic impairments. Design/Methods: Retrospective case series. Results: Inpatient rehabilitation treatment resulted in functional improvement across all patients with the most consistent gains noted in cognitive functions, including comprehension and social interaction.