Visuoperceptual sequelae in children with hemophilia and intracranial hemorrhage.

BACKGROUND: The goal of this study was to examine the impact of focal brain injuries on the outcomes of visual perception and visuospatial abilities in Mexican children with hemophilia who have experienced intracranial hemorrhages. METHODS: We assessed ten boys who had hemophilia with intracranial hemorrhage (HIC), six boys who had hemophilia without intracranial hemorrhage (HH), and ten boys without hemophilia (CTL). The Verbal (VIQ), Performance IQs (PIQ), and Full Scale IQs (FSIQ) from the Wechsler Intelligence Scale for Children-Mexican Revision, Visual Perception, and Visuospatial Abilities domains, which are from a neuropsychological assessment battery for Spanish-speaking children (ENI), were employed for our analysis. RESULTS: The results showed that the HIC group performed in the low-average range on the PIQ and FSIQ, which was lower than the HH group. The HIC group showed low performance on visual perception tests, such as line orientation, fragmented objects, and overlapping figures, compared with their matched controls. CONCLUSIONS: The results suggest that it is not the ability to recognize objects that is impaired in the HIC group, but the ability to identify objects under less favorable conditions. Our findings may have therapeutic and rehabilitative implications for the management of children with hemophilia and early focal brain lesions.

Intellectual ability as a predictor of performance on the Wisconsin Card-Sorting Test.

The purpose of this study was to explore the relationship between intelligence and executive functioning in youth. More specifically, the authors hypothesized that there would be a positive correlation between scores on the Wechsler Intelligence Scale for Children-Fourth Edition General Ability Index (GAI) and understanding of sorting principles as measured by percent conceptual-level responses on the Wisconsin Card-Sorting Test (WCST). One hundred eighty-five children and adolescents completed neuropsychological evaluations. Results revealed a curvilinear regression with bright youth (GAI = 115-129) and gifted youth (GAI ≥130) performing better than average youth (GAI = 90-114) and no difference in performance between bright and gifted youth. Additionally, post-hoc analyses revealed intelligence in children 5 to 8 years of age and 12 to 16 years of age did not significantly predict percent conceptual-level responses, while intelligence predicted more than 19% of the variance in percent conceptual-level responses for children ages 9 to 11 years old. Findings revealed new evidence about the role of intellectual ability in executive functioning among different age ranges and have important implications for psychologists, caregivers, educators, and other professionals working with this population.

Is executive function intact after pediatric intracranial hemorrhage? A sample of Mexican children with hemophilia.

The goal of this study was to examine executive functioning outcomes in children with hemophilia who have suffered intracranial hemorrhage. We assessed 10 boys with hemophilia with intracranial hemorrhage; 6 boys with hemophilia without intracranial hemorrhage; and 10 healthy boys as controls. Intellectual functioning was assessed with subscales from the Wechsler Intelligence Scale for Children-Mexican Revision. Concept formation and reasoning, cognitive flexibility, and planning and organization domains from a neuropsychological assessment battery for Spanish-speaking children were employed for our analysis. Results indicated that children with intracranial hemorrhage demonstrated significant impairment on some measures of executive function compared with the control groups. All differences reflected poorer performance by the intracranial hemorrhage group. These results may reflect the impact of disruption to immature brain circuits and the deficiency of functional specificity within the immature brain. This is the only known study examining neuropsychological functioning in Mexican youth with hemophilia.

Labetalol-induced hyperkalemia in renal transplant recipients.

BACKGROUND: Labetalol is a commonly used agent for perioperative hypertension in renal transplant recipients. A previous report suggested that labetalol may cause life-threatening hyperkalemia after renal transplantation. METHODS: We performed a retrospective review of 103 consecutive renal transplants to determine whether labetalol was an independent predictor of hyperkalemia treatment. Thirty-eight patients (36.9%) received labetalol, and 65 patients (63.1%) had no labetalol medication. RESULTS: Of the 103 patients, 24 (23.3%) required treatment for hyperkalemia. Thirteen (34.2%) of the patients who had labetolol medication and 11 (16.9%) of the patients who did not receive labetalol were treated for hyperkalemia (p = 0.045). Factors considered for a logistic regression model included: the use of labetalol, cold ischemia time, diabetes, and dialysis method; intake of tacrolimus, beta blockers, angiotensin-converting enzyme inhibitors, or other antihypertensives prior to admission; the mannitol dose given intraoperatively, and the 24-hour urine output postoperatively. Intravenous labetalol (odds ratio OR = 4.52, confidence interval CI = 1.33-15.28; p = 0.02), 24- hour urine output (OR = 4.4, CI = 0.97-20.1: p = 0.47), increasing cold ischemia time (OR = 1.09, CI = 1.01-1.17; p = 0.02), and continuous ambulatory peritoneal dialysis (OR = 0.17, CI = 0.29-0.98; p = 0.036) were independent predictors. CONCLUSION: Labetalol appears to increase the risk of hyperkalemia in patients after renal transplantation.