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Biomedical subjects

J Gordon Millichap

Publications and source records attributed to J Gordon Millichap.

7 recordsLinked to original sources
PubMed2006

Serum ferritin in children with attention-deficit hyperactivity disorder.

To further define a role for iron deficiency in attention-deficit hyperactivity disorder, serum ferritin was included in a battery of laboratory tests obtained in children attending a clinic for attention deficit disorders. In a total of 68 consecutive patients (ages 5-16 years; 54 male, 14 female), the range of serum ferritin levels was a low of 7.7 ng/mL and a high of 150 ng/mL. The mean (+/-S.D.) serum ferritin level in patients with attention-deficit hyperactivity disorder (39.9 +/- 40.6 ng/mL) was not different from that of control subjects. Seventy-four percent of patients had serum ferritin levels below 50 ng/mL; 44% were below 30 ng/mL; and 18% below 20 ng/mL. None had evidence of iron deficiency anemia. A comparison of the clinical characteristics of the 12 patients with the lowest serum ferritin levels (<20 ng/mL) and 12 with the highest levels (>60 ng/mL) disclosed no significant difference in severity or frequency of attention-deficit hyperactivity disorder and comorbid symptoms or response to medications. In this patient cohort, a causative role for low serum ferritin in attention-deficit hyperactivity disorder has not been confirmed.

Adolescent↗
PubMed2006

Role of viral infections in the etiology of febrile seizures.

The role of viral infection in the etiology of febrile seizures is a relatively neglected field of neurologic research. A National Institutes of Health Consensus Conference (1981) omitted reference to causes of infections and the role of fever in febrile seizures, and emphasized outcome and anticonvulsant treatment. In an earlier review of the world literature (1924-1964), except for roseola infantum, viral infections as a cause of febrile seizures were rarely diagnosed. The present review includes reports of viruses most commonly associated with febrile seizures in the last decade, especially human herpesvirus-6 and influenza. The specificity and neurotropic properties of some viruses in the febrile seizure mechanism, a possible encephalitic or encephalopathic pathology, and the essential role of fever and height of the body temperature as a measure of the febrile seizure threshold are discussed. Cytokine and immune response to infection, and a genetic susceptibility to febrile seizures are additional etiologic factors. Future research should emphasize early detection of causative viruses, the nature of viral neurotropism, and the role of cytokines in fever induction. Trials of antiviral agents and vaccines, with attention to safety concerns, and more effective antipyretics would address the febrile seizure mechanism more specifically than anticonvulsant therapies.

Herpesviridae Infections↗
PubMed2006

Electroencephalography hyperventilation and stroke in children with sickle cell disease.

A recent study and report in which hyperventilation was used during electroencephalography (EEG) in 6 children with sickle cell disease (SCD) and seizures, without serious complication, prompted a cautionary response regarding the potential risks attending the practice of EEG hyperventilation in SCD patients. Earlier reports of neurological impairment and stroke precipitated by the routine use of hyperventilation in children with SCD are reviewed, the mechanism and management of vascular infarction following hyperventilation are discussed, and readers are reminded of the AEEGS guidelines and contraindications to routine hyperventilation, which include SCD and trait and cerebrovascular disorders. The frequent nonobservance of these guideline recommendations among neurologists, and the need to more widely inform practitioners of the risks of hyperventilation in SCD are discussed.

Adolescent↗
PubMed2003

The diet factor in pediatric and adolescent migraine.

Diet can play an important role in the precipitation of headaches in children and adolescents with migraine. The diet factor in pediatric migraine is frequently neglected in favor of preventive drug therapy. The list of foods, beverages, and additives that trigger migraine includes cheese, chocolate, citrus fruits, hot dogs, monosodium glutamate, aspartame, fatty foods, ice cream, caffeine withdrawal, and alcoholic drinks, especially red wine and beer. Underage drinking is a significant potential cause of recurrent headache in today's adolescent patients. Tyramine, phenylethylamine, histamine, nitrites, and sulfites are involved in the mechanism of food intolerance headache. Immunoglobulin E-mediated food allergy is an infrequent cause. Dietary triggers affect phases of the migraine process by influencing release of serotonin and norepinephrine, causing vasoconstriction or vasodilatation, or by direct stimulation of trigeminal ganglia, brainstem, and cortical neuronal pathways. Treatment begins with a headache and diet diary and the selective avoidance of foods presumed to trigger attacks. A universal migraine diet with simultaneous elimination of all potential food triggers is generally not advised in practice. A well-balanced diet is encouraged, with avoidance of fasting or skipped meals. Long-term prophylactic drug therapy is appropriate only after exclusion of headache-precipitating trigger factors, including dietary factors.

Adolescent↗