Journal of Pediatric Rehabilitation Medicine - Volume 12, issue 3

Authors: Bowman, Angeline | Ayyangar, Rita | Gonzales, Ian | Hornyak, Joseph

Article Type: Case Report

Abstract: A 9-year old male patient with a past medical history of congenital cytomegalovirus (CMV) infection and spastic quadriplegic cerebral palsy with an intrathecal baclofen pump was admitted to a tertiary care hospital with respiratory depression and unresponsiveness for approximately two days. He had a recent two-week hospital stay for respiratory failure due to pneumonia. After being prescribed antibiotics and being sent home, he had developed copious diarrhea. On readmission, he was found to be dehydrated and in acute renal failure. A physical exam revealed hypotonia throughout, in a patient who typically had spasticity with contractures. The Pediatric Rehabilitation Medicine service …was consulted for possible baclofen toxicity. Some signs and symptoms of baclofen toxicity include respiratory depression, seizures, CNS depression, hypotonia, hypotension, absent deep tendon reflexes, lethargy, ataxia, and cardiac arrhythmias. His intrathecal baclofen (ITB) dose was reduced, and signs/symptoms of ITB overdose began to resolve. As renal function improved, spasticity returned, necessitating increase in ITB dosing toward the premorbid dose. Show more

Keywords: Baclofen, intrathecal baclofen, toxicity, kidney injury, spasticity

DOI: 10.3233/PRM-180598

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 12, no. 3, pp. 313-315, 2019

Authors: Roden, Rosemary Claire | Oholendt, Kyle | Lange, Hannah | Noritz, Garey | Bonny, Andrea E.

Article Type: Research Article

Abstract: PURPOSE: Assessing provider adherence to preventative sexual and reproductive healthcare guidelines in adolescents and young adults (AYA) patients with physical and intellectual disabilities (PWD). METHODS: Records of PWD (N = 42) age 12–26 receiving health maintenance between 01/01/11–12/31/16 were reviewed for: (1) initiation and completion of human papilloma virus (HPV) vaccination series, (2) initiation and completion of meningococcal vaccination, (3) screening for human immunodeficiency virus (HIV), and documentation of (4) sexual, (5) menstrual, and (6) pregnancy histories. Unaffected age and gender-matched patients provided comparison data (Comparison Cohort, CC). RESULTS: …The mean age of both groups was 17.3 years ± 3.8 and 40.5% were female. There was no significant difference between groups regarding the completion of HPV or meningococcal vaccine series. Among those 15+ years of age, 7.1% of PWD and 28.6% of CC were screened for HIV (p = 0.04). Sexual history was documented in 19.0% of PWD versus 73.8% of CC (p < 0.001). Among females, menstrual regularity was recorded in 11.8% of PWD versus 47.1% of CC (p = 0.02) and pregnancy history in 0.0% of PWD versus 29.4% of CC (p = 0.04). CONCLUSIONS: Adherence to sexual health guidelines was suboptimal, and lower among PWD. Vaccination rates did not differ between the two groups. Show more

Keywords: Reproductive health, primary care, disability, sexual health, menstrual health, guidelines, adolescence, young adults, vaccination

DOI: 10.3233/PRM-180589

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 12, no. 3, pp. 317-324, 2019

Article Type: Other

DOI: 10.3233/PRM-190010

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 12, no. 3, pp. 325-333, 2019

Article Type: Other

DOI: 10.3233/PRM-190011

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 12, no. 3, pp. 335-, 2019