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Article: Treatment of children with simple febrile seizures: the AAP practice parameter. American Academy of Pediatrics.

Baumann, R J / Duffner, P K

2000 Volume 23, Issue 1, Page(s) 11–17

Abstract: Febrile seizures are the most common seizure disorder in childhood, occurring in 2-5% of children. Despite their frequency, there has been little unanimity of opinion regarding the need for long-term antiepileptic therapy. As such, the American Academy ... ...

Abstract	Febrile seizures are the most common seizure disorder in childhood, occurring in 2-5% of children. Despite their frequency, there has been little unanimity of opinion regarding the need for long-term antiepileptic therapy. As such, the American Academy of Pediatrics formulated a subcommittee to study the subject. A Practice Parameter was developed that addressed the issue of whether continuous or intermittent antiepileptic therapy is necessary for children with simple febrile seizures. The committee determined that with the exception of a high rate of recurrence, no long-term adverse effects of simple febrile seizures have been identified. The risk of developing epilepsy is extremely low and, even in those patients who do, there is no evidence that recurrent simple febrile seizures produce structural central nervous system damage. Also, there is no evidence that recurrent simple febrile seizures cause either learning problems or premature death. The committee concluded that although there is the evidence that continuous antiepileptic therapy with phenobarbital or valproic acid and intermittent therapy with diazepam are effective in reducing the risk of recurrence, the potential toxicities associated with antiepileptic therapy outweigh the relatively minor risks associated with simple febrile seizures. As such, long-term treatment is not recommended.
MeSH term(s)	Adolescent ; Anticonvulsants/administration & dosage ; Anticonvulsants/adverse effects ; Child ; Child, Preschool ; Clinical Trials as Topic ; Drug Therapy, Combination ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Pediatrics/standards ; Phenobarbital/administration & dosage ; Phenobarbital/adverse effects ; Risk Assessment ; Secondary Prevention ; Seizures, Febrile/drug therapy ; Seizures, Febrile/prevention & control ; United States ; Valproic Acid/administration & dosage ; Valproic Acid/adverse effects
Chemical Substances	Anticonvulsants ; Valproic Acid (614OI1Z5WI) ; Phenobarbital (YQE403BP4D)
Language	English
Publishing date	2000-07
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	639164-3
ISSN	1873-5150 ; 0887-8994
ISSN (online)	1873-5150
ISSN	0887-8994
DOI	10.1016/s0887-8994(00)00148-x
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Article ; Online: A synopsis of the American Academy of Pediatrics' practice parameters on the evaluation and treatment of children with febrile seizures.

Duffner, P K / Baumann, R J

Pediatrics in review

1999 Volume 20, Issue 8, Page(s) 285–287

MeSH term(s)	Child ; Child, Preschool ; Electroencephalography ; Humans ; Infant ; Infant, Newborn ; Pediatrics/methods ; Practice Guidelines as Topic ; Recurrence ; Seizures, Febrile/blood ; Seizures, Febrile/diagnosis ; Seizures, Febrile/etiology ; Seizures, Febrile/therapy ; Spinal Puncture
Language	English
Publishing date	1999-04-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	774515-1
ISSN	1526-3347 ; 0191-9601
ISSN (online)	1526-3347
ISSN	0191-9601
DOI	10.1542/pir.20-8-285
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Article: Changes in the approach to central nervous system tumors in childhood.

Duffner, P K / Cohen, M E

Pediatric clinics of North America

1992 Volume 39, Issue 4, Page(s) 859–877

Abstract: Current approaches to children with brain tumors are in a state of evolution. Currently, 50% of children with all types of brain tumors may be expected to survive 5 years. Therefore, the goals of neuro-oncology have broadened to include improved survival ...

Abstract	Current approaches to children with brain tumors are in a state of evolution. Currently, 50% of children with all types of brain tumors may be expected to survive 5 years. Therefore, the goals of neuro-oncology have broadened to include improved survival and improved quality of life. This article reviews changes in therapy that have altered survival as well as changes in therapy as a consequence of increasing recognition of complications and toxicity of treatment.
MeSH term(s)	Brain/radiation effects ; Brain Diseases/etiology ; Brain Neoplasms/therapy ; Child ; Glioma/therapy ; Humans ; Medulloblastoma/therapy ; Methotrexate/adverse effects ; Radiation Injuries
Chemical Substances	Methotrexate (YL5FZ2Y5U1)
Language	English
Publishing date	1992-08
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	215711-1
ISSN	1557-8240 ; 0031-3955
ISSN (online)	1557-8240
ISSN	0031-3955
DOI	10.1016/s0031-3955(16)38378-x
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Article: Long-term consequences of CNS treatment for childhood cancer, Part I: Pathologic consequences and potential for oncogenesis.

Cohen, M E / Duffner, P K

Pediatric neurology

1991 Volume 7, Issue 3, Page(s) 157–163

Abstract: The pathologic changes associated with the treatment of cancer of the nervous system are reviewed. Computed tomographic, magnetic resonance imaging, and positron emission tomographic findings of these abnormalities are described, followed by discussion ... ...

Abstract	The pathologic changes associated with the treatment of cancer of the nervous system are reviewed. Computed tomographic, magnetic resonance imaging, and positron emission tomographic findings of these abnormalities are described, followed by discussion of the known histopathologic features. For the most part, pathologic effects are primary vascular and/or demyelinating. We review each of these effects at all levels of the neural axis. This review concludes with a discussion of the risk of developing second malignancies. Although this complication is infrequent, the likelihood that survivors of childhood cancer will develop a second malignancy is 10 times that of age-matched controls. This phenomenon in part relates to genetic predisposition, environmental factors, and host susceptibility. These qualifications not withstanding, most studies implicate central nervous system radiation with and without chemotherapy as the primary etiology for second malignancies.
MeSH term(s)	Antineoplastic Agents/adverse effects ; Antineoplastic Agents/therapeutic use ; Brain/drug effects ; Brain/radiation effects ; Brain Neoplasms/chemically induced ; Brain Neoplasms/pathology ; Child ; Combined Modality Therapy ; Cranial Irradiation ; Humans ; Neoplasms/therapy ; Neoplasms, Multiple Primary/chemically induced ; Neoplasms, Multiple Primary/pathology ; Neoplasms, Radiation-Induced/pathology ; Risk Factors ; Spinal Cord/drug effects ; Spinal Cord/radiation effects
Chemical Substances	Antineoplastic Agents
Language	English
Publishing date	1991-05
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	639164-3
ISSN	1873-5150 ; 0887-8994
ISSN (online)	1873-5150
ISSN	0887-8994
DOI	10.1016/0887-8994(91)90078-y
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Article: Long-term consequences of CNS treatment for childhood cancer, Part II: Clinical consequences.

Duffner, P K / Cohen, M E

Pediatric neurology

1991 Volume 7, Issue 4, Page(s) 237–242

Abstract: Survival of children with brain tumors has improved over the past 20 years due in part to advances in surgery, radiation, and most recently chemotherapy. The long-term adverse effects of radiation and chemotherapy on these children is the subject of this ...

Abstract	Survival of children with brain tumors has improved over the past 20 years due in part to advances in surgery, radiation, and most recently chemotherapy. The long-term adverse effects of radiation and chemotherapy on these children is the subject of this report. In Part I, we reviewed the pathologic consequences of radiation, including leukoencephalopathy, radiation necrosis, and radiation myelopathy as well as the oncogenic effects of both radiation and chemotherapy. Part II addresses the long-term consequences of radiation and chemotherapy on intellectual and endocrine function. Risk factors for the development of both endocrinopathies and intellectual dysfunction include age at the time of radiation, volume and dose of radiation, site of tumor, and use of adjuvant chemotherapy, in particular methotrexate. Early recognition of these complications and treatment, where indicated, will measurably improve the quality-of-life of children treated for brain tumors. The national cancer groups are currently attempting to limit these long-term adverse effects by taking risk factors into account when formulating new treatment regimens.
MeSH term(s)	Brain Neoplasms/drug therapy ; Brain Neoplasms/radiotherapy ; Child ; Endocrine System Diseases/etiology ; Humans ; Intelligence/radiation effects ; Time Factors
Language	English
Publishing date	1991-07
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	639164-3
ISSN	1873-5150 ; 0887-8994
ISSN (online)	1873-5150
ISSN	0887-8994
DOI	10.1016/0887-8994(91)90038-m
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Article: The long-term effects of central nervous system therapy on children with brain tumors.

Duffner, P K / Cohen, M E

Neurologic clinics

1991 Volume 9, Issue 2, Page(s) 479–495

Abstract: Survivals of children with brain tumors have increased over the past 20 years owing to advances in surgery, radiation, and, most recently, chemotherapy. Unfortunately, central nervous system therapy, particularly radiation, may be associated with the ... ...

Abstract	Survivals of children with brain tumors have increased over the past 20 years owing to advances in surgery, radiation, and, most recently, chemotherapy. Unfortunately, central nervous system therapy, particularly radiation, may be associated with the development of dementia and learning disabilities, leukoencephalopathy, endocrinopathies, and oncogenesis. Recognition of these long-term effects of therapy is important as some are amenable to treatment and others may be prevented by modification of current treatment regimens.
MeSH term(s)	Brain/drug effects ; Brain/radiation effects ; Brain Damage, Chronic/chemically induced ; Brain Damage, Chronic/etiology ; Brain Neoplasms/drug therapy ; Brain Neoplasms/radiotherapy ; Child ; Cranial Irradiation/adverse effects ; Follow-Up Studies ; Humans ; Intelligence/drug effects ; Intelligence/radiation effects ; Neoplasms, Radiation-Induced/etiology ; Neoplasms, Second Primary/etiology ; Radiation Injuries/etiology
Language	English
Publishing date	1991-05
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1013148-6
ISSN	1557-9875 ; 0733-8619
ISSN (online)	1557-9875
ISSN	0733-8619
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Article: Optic pathway tumors.

Cohen, M E / Duffner, P K

Neurologic clinics

1991 Volume 9, Issue 2, Page(s) 467–477

Abstract: Overall, the majority of patients with optic pathway tumors will have stable disease regardless if they are radiated or receive chemotherapy. This is a very indolent tumor system and, for the most part, not a threat to life. Because of this, issues ... ...

Abstract	Overall, the majority of patients with optic pathway tumors will have stable disease regardless if they are radiated or receive chemotherapy. This is a very indolent tumor system and, for the most part, not a threat to life. Because of this, issues regarding appropriate therapeutic approaches have yet to be resolved. Most agree that in patients with progressive visual loss and tumor limited to the orbit, surgery can be associated with a cure. The downside is the loss of vision associated with surgical extirpation. Radiation rather than surgery has been the mainstay of treatment for intracranial tumors of the optic pathway. To eliminate side effects associated with radiotherapy in the young child, chemotherapy may be the more considered choice. However, on escape of control, i.e., conversion of stable disease to progressive disease, radiotherapy should be considered.
MeSH term(s)	Child ; Combined Modality Therapy ; Cranial Nerve Neoplasms/drug therapy ; Cranial Nerve Neoplasms/pathology ; Cranial Nerve Neoplasms/radiotherapy ; Cranial Nerve Neoplasms/surgery ; Humans ; Optic Nerve/pathology ; Optic Nerve Diseases/drug therapy ; Optic Nerve Diseases/pathology ; Optic Nerve Diseases/radiotherapy ; Optic Nerve Diseases/surgery ; Orbital Neoplasms/drug therapy ; Orbital Neoplasms/pathology ; Orbital Neoplasms/radiotherapy ; Orbital Neoplasms/surgery ; Prognosis
Language	English
Publishing date	1991-05
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1013148-6
ISSN	1557-9875 ; 0733-8619
ISSN (online)	1557-9875
ISSN	0733-8619
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: School refusal and emotional lability in a 6-year-old boy.

Stein, M T / Duffner, P K / Werry, J S / Trauner, D A

Journal of developmental and behavioral pediatrics : JDBP

2001 Volume 22, Issue 2 Suppl, Page(s) S29–32

MeSH term(s)	Affective Symptoms/diagnosis ; Affective Symptoms/psychology ; Brain Stem Neoplasms/diagnosis ; Brain Stem Neoplasms/psychology ; Child ; Child Reactive Disorders/diagnosis ; Child Reactive Disorders/psychology ; Diagnosis, Differential ; Glioma/diagnosis ; Glioma/psychology ; Humans ; Male ; Personality Assessment ; Phobic Disorders/diagnosis ; Phobic Disorders/psychology ; Pons ; Tomography, X-Ray Computed
Language	English
Publishing date	2001-04
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	603379-9
ISSN	0196-206X
ISSN	0196-206X
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Article: Treatment of CNS neoplasms in childhood by the Pediatric Oncology Group.

Cohen, M E / Duffner, P K

Brain & development

1989 Volume 11, Issue 6, Page(s) 360–367

Abstract: The incidence of brain tumors in children under 15 years of age in the United States is 2.4/100,000. Based upon a US population of approximately 60 million black and white children, there are only 1,200-1,500 newly diagnosed causes of CNS neoplasia ... ...

Abstract	The incidence of brain tumors in children under 15 years of age in the United States is 2.4/100,000. Based upon a US population of approximately 60 million black and white children, there are only 1,200-1,500 newly diagnosed causes of CNS neoplasia diagnosed in children each year in the US. These relatively small numbers, the large geographic dispersion, and the multitude of histologic types, make it unlikely that all but a few medical centers can develop a large experience with this diverse group of tumors. The Brain Tumor Committee (BTC) of the Pediatric Oncology Group was formed, in part, to address this problem. Each of the four goals of the BTC will be addressed separately. A justification for the rationale for each goal is given, following which there is a discussion of how each goal is being met.
MeSH term(s)	Antineoplastic Agents/therapeutic use ; Brain Neoplasms/drug therapy ; Brain Neoplasms/radiotherapy ; Brain Neoplasms/surgery ; Child ; Dose-Response Relationship, Drug ; Humans
Chemical Substances	Antineoplastic Agents
Language	English
Publishing date	1989
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	604822-5
ISSN	0387-7604
ISSN	0387-7604
DOI	10.1016/s0387-7604(89)80017-8
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Article: Isolated optic nerve gliomas in children with and without neurofibromatosis.

Duffner, P K / Cohen, M E

Neurofibromatosis

1988 Volume 1, Issue 4, Page(s) 201–211

Abstract: With the advent of noninvasive neuroimaging of the orbits and brain, many asymptomatic patients with intraorbital optic gliomas have been identified. These children, predominantly with neurofibromatosis, present a therapeutic quandary to the treating ... ...

Abstract	With the advent of noninvasive neuroimaging of the orbits and brain, many asymptomatic patients with intraorbital optic gliomas have been identified. These children, predominantly with neurofibromatosis, present a therapeutic quandary to the treating physician. There is no consensus regarding either the natural history of intraorbital optic gliomas or the approach treatment. This paper reviews the literature on the treatment of 227 children with intraorbital optic gliomas with surgery, radiation or 'watchful waiting'. Based on this review, an approach to the management of children with intraorbital optic gliomas with and without neurofibromatosis is suggested.
MeSH term(s)	Child ; Child, Preschool ; Cranial Nerve Diseases/complications ; Cranial Nerve Diseases/diagnosis ; Cranial Nerve Diseases/surgery ; Female ; Glioma/complications ; Glioma/diagnosis ; Glioma/surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Neurofibromatosis 1/complications ; Optic Nerve Diseases/complications ; Optic Nerve Diseases/diagnosis ; Optic Nerve Diseases/surgery ; Tomography, X-Ray Computed
Language	English
Publishing date	1988
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	639348-2
ISSN	1010-5662
ISSN	1010-5662
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