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Front Pain Res (Lausanne) 2022 17;3:859881. Epub 2022 May 17.

Departments of Psychiatry ad Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.

Post-traumatic headache (PTH) is a challenging clinical condition to identify and treat as it integrates multiple subjectively defined symptoms with underlying physiological processes. The precise mechanisms underlying PTH are unclear, and it remains to be understood how to integrate the patient experience with underlying biology when attempting to classify persons with PTH, particularly in the pediatric setting where patient self-report may be highly variable. The objective of this investigation was to evaluate the use of different machine learning (ML) classifiers to differentiate pediatric and young adult subjects with PTH from healthy controls using behavioral data from self-report questionnaires that reflect concussion symptoms, mental health, pain experience of the participants, and structural brain imaging from cortical and sub-cortical locations. Read More

J Pain 2022 May 25. Epub 2022 May 25.

Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States.

Psychedelic substances have played important roles in diverse cultures, and ingesting various plant preparations to evoke altered states of consciousness has been described throughout recorded history. Accounts of the subjective effects of psychedelics typically focus on spiritual and mystical-type experiences, including feelings of unity, sacredness, and transcendence. Over the past two decades, there has been increasing interest in psychedelics as treatments for various medical disorders, including chronic pain. Read More

J Child Neurol 2022 04 18;37(5):373-379. Epub 2022 Mar 18.

Department of Neurology, 2358University of Virginia, Charlottesville, VA, US.

Introduction: E-consults improve access to specialty expertise and increase satisfaction for patients and Primary Care Providers (PCPs). Pediatric neurology may be perceived as less amenable to e-consults compared to other specialties.

Methods: We performed a retrospective analysis of e-consults performed by pediatric neurologists at the University of Virginia. Read More

J Pain 2022 Mar 10. Epub 2022 Mar 10.

Center for Child Health, Behavior & Development, Seattle Children's Research Institute, Seattle, Washington; Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington.

Over 50% of adolescents with chronic pain report comorbid sleep disturbances (eg, difficulties with falling asleep), which is associated with increased pain-related disability and poorer quality of life. However, limited longitudinal data are available to understand how sleep disturbance may impact response to psychological treatment. Our primary hypothesis was that baseline sleep disturbances would significantly modify how adolescents responded to an internet-delivered psychological intervention for chronic pain in terms of outcome trajectories. Read More

PLoS One 2022 25;17(1):e0262923. Epub 2022 Jan 25.

Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy.

Objectives: We aimed to identify clinical, anamnestic, and sociodemographic characteristics associated with a positive swab for SARS-CoV2, and to provide a predictive score to identify at risk population in children aged 2-14 years attending school and tested for clinical symptoms of COVID-19.

Design: Cross sectional study.

Setting: Outpatient clinic of the IRCCS Burlo Garofolo, a maternal and child health tertiary care hospital and research centre in Italy. Read More

Sci Rep 2021 10 25;11(1):20972. Epub 2021 Oct 25.

Rare Diseases, Sanofi Genzyme, Thames Valley Park, Reading, UK.

Acid sphingomyelinase deficiency (ASMD), historically known as Niemann-Pick disease (NPD) types A, A/B, and B, is a rare, progressive, potentially fatal lysosomal storage disease with a spectrum of phenotypes. Little is known about how ASMD symptoms affect the lives of patients and their caregivers. In a cross-sectional qualitative study conducted in the US and UK, and in collaboration with the National Niemann-Pick Disease Foundation (US) and Niemann-Pick UK, we investigated the symptom experience of patients with ASMD types B and A/B and explored how the disease impacts their and their caregivers' lives. Read More

Headache 2021 07;61(7):985-987

Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.

Nat Rev Neurol 2021 07 26;17(7):449-458. Epub 2021 May 26.

Neurology and Pediatrics, University of California San Francisco, San Francisco, CA, USA.

Migraine is a complex genetic brain disorder with an intricate pathogenesis and polymorphous clinical presentations, particularly in children. In this Perspective, we describe the different phenotypes of migraine in children, including conditions that have been referred to in the International Classification of Headache Disorders as "syndromes that may be related to migraine''. Evidence is presented for the integration of abdominal migraine, cyclical vomiting syndrome, benign paroxysmal vertigo, benign paroxysmal torticollis and infantile colic into the unified diagnosis of 'childhood migraine syndrome' on the basis of clinical and epidemiological characteristics, and shared inheritance. Read More

Cureus 2020 Dec 21;12(12):e12200. Epub 2020 Dec 21.

Neurology, King Abdulaziz University, Jeddah, SAU.

Introduction COVID-19 has been a gravitating topic in the past months, yet much information about this new virus is to be unraveled. The uncertainties about the virus and its effects have affected a lot of daily life activities. One of these affected activities is emergency department (ED) visits and how this disease might have changed people's perspective on when to go to an emergency. Read More

Cureus 2020 Nov 23;12(11):e11652. Epub 2020 Nov 23.

Anaesthesiology, Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida, IND.

Background After a slow start due to an effective lockdown, the coronavirus disease 2019 (COVID-19) pandemic in India has been raging at a rapid pace, posing a formidable challenge to the healthcare system in the country. The personal protective equipment (PPE) undoubtedly provides a shield of protection for the healthcare workers (HCWs) fighting the disease as a valuable asset to the nation. However, there have been various problems associated with the PPE, ranging from its shortage to problems arising from heat, dehydration, etc while wearing them. Read More

Auris Nasus Larynx 2021 Jun 25;48(3):464-470. Epub 2020 Sep 25.

Division of Otorhinolaryngology, Department of Surgery, Dentistry, Gynecology, and Pediatrics, University of Verona, University Hospital of Verona, Borgo Trento, Piazzale Aristide Stefani, 1, 37126 Verona, Italy.

Objective: To report on the application of the 3D exoscopic system to microsurgery in a cohort of head and neck cancer patients; to analyse the performance of microvascular anastomoses, flap harvesting and insetting under exoscopic view and to evaluate the surgeon's feedback after procedures.

Methods: An observational study was performed on 10 consecutive patients undergoing exoscopic microsurgical free flap reconstruction. The VITOM 3D system was applied to all procedures for microsurgical anastomoses, flap harvesting and insetting. Read More

Diagn Interv Radiol 2020 11;26(6):596-602

Division of Neuroradiology, Department of Radiology and the Department of Neurology, Division of Pediatric Neurology, Minnesota University, Minneapolis, USA.

Purpose: Nusinersen is a drug approved in December 2016 for treatment of spinal muscular atrophy (SMA). We want to share our initial experience with image-guided, non-image-guided, and port-delivered nusinersen injections in a large single-center SMA patient cohort, treating both pediatric and adult patients with focus on technical considerations and other patient concerns from a combined perspective of patient, neurologist, and radiologist.

Methods: All nusinersen injections between February 2017 and September 2018 were retrospectively reviewed. Read More

J Cerebrovasc Endovasc Neurosurg 2019 Sep 30;21(3):163-168. Epub 2019 Sep 30.

Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Sinus pericranii (SP) is a rare vascular anomaly of the scalp that consists of an abnormal pericranial venous channel connected to adjacent dural venous sinuses. Most SP are asymptomatic and are found in the pediatric age group. We aim to report a case of symptomatic SP in adult and describe the clinical, radiological, and pathohistological findings to help understand and differentiate this lesion from other scalp lesions. Read More

J Health Psychol 2021 09 1;26(10):1637-1650. Epub 2019 Nov 1.

Boston Children's Hospital, USA.

This study examined parenting factors associated with children's self-regulation and physician-rated treatment adherence using a self-determination theory framework in pediatric chronic headache. Participants were 58 children and adolescents (aged 10-17 years), who underwent initial and follow-up multidisciplinary evaluation at a headache clinic, and their mothers. Regression analyses showed that higher maternal autonomy support and structure were significantly related to children's lower treatment-related reactance and higher adherence. Read More

Autoimmun Rev 2019 Oct 8;18(10):102363. Epub 2019 Aug 8.

Institute of Pediatrics, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy.

The contribution of autoimmune phenomena to dysfunction of hypophysis or hypothalamus is far to be unraveled and also the specific pathways of hypophysitis are poorly understood until now, mostly for the pediatric population. Primary hypophysitis is rare in children and often regarded as an autoimmune disorder, following the evidence of lymphoplasmacytic infiltration in the pituitary gland, detection of anti-pituitary antibodies (APA) and anti-hypotalamus antibodies (AHA) by indirect immunofluorescence on cryostatic sections of human or primate hypophysis and hypothalamus, and coexistence with other autoimmune disorders. The rarity of this condition and the lack of ad hoc studies make hard any assessment of the real incidence of hypophysitis in pediatric patients, and also the role of APA and AHA has been poorly investigated in children with idiopathic hypopituitarism. Read More

Psychooncology 2019 09 16;28(9):1901-1909. Epub 2019 Jul 16.

Patient Partner, Toronto, Ontario, Canada.

Objective: Today, more than 80% of children diagnosed with cancer are expected to survive. Despite the high prevalence of pain associated with the diagnosis and treatment of childhood cancer, there is a limited understanding of how having cancer shapes children's experience and meaning of pain after treatment has ended. This study addresses this gap by exploring childhood cancer survivors' (CCS') experiences of pain from their perspective and the perspective of their parents. Read More

Neurogastroenterol Motil 2019 06;31 Suppl 2:e13604

Division of Gastroenterology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.

The increasing recognition of cyclic vomiting syndrome (CVS) in adults prompted the development of these evidence-based guidelines on the management of CVS in adults, which was sponsored by the American Neurogastroenterology and Motility Society (ANMS) and the Cyclic Vomiting Syndrome Association (CVSA). GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) framework was used and a professional librarian performed the literature search. The expert committee included the President of the CVSA who brought a patient perspective into the deliberations. Read More

Urol Int 2019 22;103(2):202-210. Epub 2019 May 22.

Department Urology-Pediatric Urology, UZ Leuven, Leuven, Belgium,

Purpose: A low-pressure bladder in children with neuropathic bladder dysfunction can be achieved using anticholinergic medication. Due to the significant side effects of oral oxybutynin, our patients are treated with daily intravesical oxybutynin instillations. Newer oral anticholinergic medication, such as fesoterodine, claim to have fewer side effects in a once daily formulation. Read More

Front Neurol 2019 12;10:364. Epub 2019 Apr 12.

Dipartimento di Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro", University of Palermo, Palermo, Italy.

Pediatric migraine remains still a challenge for the headache specialists as concerns both diagnostic and therapeutic aspects. The less ability of children to describe the exact features of their migraines and the lack of reliable biomarker for migraine contribute to complicate the diagnostic process. Therefore, there's need for new effective tools for supporting diagnostic and therapeutic approach in children with migraine. Read More

Pain Rep 2018 Sep 11;3(Suppl 1):e680. Epub 2018 Sep 11.

Department of Clinical Child and Adolescent Psychology and Psychotherapy, University of Trier, Trier, Germany.

Introduction: Fear of pain seems to be a key factor in the development and maintenance of chronic pain and pain-related disability. Interoceptive fear conditioning is assumed to constitute an important mechanism in the origins and maintenance of fear of pain. If conditioned stimuli such as internal bodily sensations are repeatedly paired with pain (unconditioned stimulus), they in turn elicit a conditioned fear response, including defence mobilization such as startle modulation and changes in heart rate and electrodermal activity. Read More

Headache 2018 Apr 22;58(4):512-524. Epub 2018 Jan 22.

Montefiore Medical Center, Bronx, NY, USA.

Objective: To assess the impact of parental migraine on adolescents (aged 13-21 years) living within the parental home from the adolescent's perspective.

Background: Family members are affected by their parent's migraine. We surveyed adolescents on the social, academic, and emotional effects of their parent's migraine. Read More

Pediatr Emerg Care 2020 Jun;36(6):e310-e317

From the Children's Hospital of Eastern Ontario.

Objective: The aim of this study was to explore the perspectives of families regarding their expectations and experience of visiting the emergency department (ED) for migraine.

Methods: This was a qualitative study involving the families of 25 patients aged 10 to 18 years receiving ED care for acute migraine. Following their visit, independent semistructured telephone interviews were conducted with both the patient and parent or guardian. Read More

Case Rep Radiol 2017 31;2017:2467085. Epub 2017 Jan 31.

French Medical Institute for Children (FMIC), Kabul, Afghanistan.

A 10-year-old boy with the history of headache, anorexia, and vomiting was referred to our department to undergo a brain CT scan. CT images demonstrated a well-defined, rounded, hyperdense lesion at the level of the foramen of Monro causing moderate dilatation of the lateral ventricles. An 11-year-old girl with a long history of a headache was also referred to undergoing a brain MRI. Read More

J Pain 2017 06 18;18(6):637-644. Epub 2017 Jan 18.

Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Headache Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. Electronic address:

We compared headache frequency trajectories between clinical trial participants who received cognitive-behavioral therapy (CBT) and amitriptyline (CBT+A) or headache education (HE) and amitriptyline (HE+A) to determine if there was a differential time course of treatment response between the groups. One hundred thirty-five patients (age 10-17 years) diagnosed with chronic migraine participated, attending 8 one-hour one-on-one CBT or HE sessions with a trained psychologist for 8 weekly sessions, 2 sessions at weeks 12 and 16, and a post-treatment visit at week 20. Participants kept daily headache diaries and completed take-home assignments between visits. Read More

J Pain 2017 04 3;18(4):366-375. Epub 2016 Dec 3.

Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Barcelona, Catalonia, Spain; Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues, Barcelona, Catalonia, Spain. Electronic address:

Migraine with aura is a subtype of migraine characterized by transient neurological disturbances that usually precede headache. Cortical spreading depression (CSD) is the likely pathophysiological correlate of the aura phase of migraine, found in common and rare forms of migraine, such as familial hemiplegic migraine. CSD is a depolarization wave that propagates across the cerebral gray matter transiently suppressing neuronal activity. Read More

Acad Med 2016 11;91(11):1509-1515

R.E. Hawkins is vice president, Medical Education Outcomes, American Medical Association, Chicago, Illinois. M.B. Irons is senior vice president, Academic Affairs, American Board of Medical Specialties, Chicago, Illinois. C.M. Welcher is senior policy analyst, Medical Education Outcomes, American Medical Association, Chicago, Illinois. M.V. Pouwels is director, Medical Education Collaborations, American Medical Association, Chicago, Illinois. E.S. Holmboe is senior vice president, Milestone Development and Evaluation, Accreditation Council for Graduate Medical Education, Chicago, Illinois. E.J. Reisdorff is executive director, American Board of Emergency Medicine, East Lansing, Michigan. J.M. Cohen is director, Education, Department of Neurology, Mount Sinai Continuum; Headache Fellowship program director, Headache Institute and Adolescent Headache Center, Mount Sinai Roosevelt Hospital; and assistant professor of neurology, Icahn School of Medicine at Mount Sinai, New York, New York. S. Dentzer is senior policy adviser, Robert Wood Johnson Foundation, Washington, DC. D.G. Nichols is president and chief executive officer, American Board of Pediatrics, Chapel Hill, North Carolina. C.A. Lien is professor and vice chair for academic affairs, Department of Anesthesiology, Weill Cornell Medical Center, New York, New York. T.D. Horn is executive director, American Board of Dermatology, Newton, Massachusetts. R.B. Noone is executive director, American Board of Plastic Surgery, Philadelphia, Pennsylvania. R.S. Lipner is senior vice president, Evaluation, Research and Development, American Board of Internal Medicine, Philadelphia, Pennsylvania. K.W. Eva is associate director and senior scientist, Centre for Health Education Scholarship, and professor and director of education research and scholarship, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. J.J. Norcini is president and chief executive officer, Foundation for Advancement of International Medical Education and Research, Philadelphia, Pennsylvania. L.M. Nora is president and chief executive officer, American Board of Medical Specialties, Chicago, Illinois. J.P. Gold is chancellor, University of Nebraska Medical Center, Omaha, Nebraska.

This article describes the presentations and discussions at a conference co-convened by the Council on Medical Education of the American Medical Association (AMA) and by the American Board of Medical Specialties (ABMS). The conference focused on the ABMS Maintenance of Certification (MOC) Part III Examination. This article, reflecting the conference agenda, covers the value of and evidence supporting the examination, as well as concerns about the cost of the examination, and-given the current format-its relevance. Read More

J Pain 2016 08 19;17(8):855-873.e8. Epub 2016 Apr 19.

IWK Health Centre, Halifax, Nova Scotia, Canada.

Unlabelled: Little is known about childhood and adolescent risk and prognostic factors for recurrent headaches. This systematic review 1) examined longitudinal evidence about factors associated with onset and course of recurrent headaches in childhood or adolescence, using meta-analysis where possible, and 2) evaluated the quality of this evidence using a modified Grading of Recommendations Assessment, Development and Evaluation framework. Through searching electronic databases, reference lists of included studies, and an electronic mail list we identified and included 23 articles reporting 19 cohorts. Read More

J Pain 2016 06 10;17(6):694-706. Epub 2016 Mar 10.

MEG Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio.

Unlabelled: To investigate the spatial heterogeneity of cortical excitability in adolescents with migraine, magnetoencephalography (MEG) recordings at a sampling rate of 6,000 Hz were obtained from 35 adolescents with an acute migraine and 35 age- and sex-matched healthy control participants during an auditory-motor task. Neuromagnetic activation from low- to high-frequency ranges (5-1,000 Hz) was measured at sensor and source levels. The heterogeneity of cortical excitability was quantified within each functional modality (auditory vs motor) and hemispherical lateralization. Read More

Acta Neurochir (Wien) 2015 Sep 30;157(9):1587-93. Epub 2015 Jul 30.

Department of Neurosurgery, Hacettepe University School of Medicine, Ankara, Turkey,

Purpose: Chordoma is a rare neoplasm that arises from embryonic notochordal remnants along the axial skeleton (i.e., clivus, sacrum) and the vertebral bodies. Read More

J Headache Pain 2014 Mar 18;15:15. Epub 2014 Mar 18.

Headache Center, C, Mondino National Institute of Neurology Foundation, IRCCS, University of Pavia, Pavia, Italy.

Headache is one of the most common disorders in childhood, with an estimated 75% of children reporting significant headache by the age of 15 years. Pediatric migraine is the most frequent recurrent headache disorder, occurring in up to 28% of older teenagers. Headaches rank third among the illness-related causes of school absenteeism and result in substantial psychosocial impairment among pediatric patients. Read More