Statistical learning is characterized by detection of regularities in one's environment without an awareness or intention to learn, and it may play a critical role in language and social behavior. Accordingly, in this study we investigated the electrophysiological correlates of visual statistical learning in young children with autism spectrum disorder (ASD) using an event‐related potential shape learning paradigm, and we examined the relation between visual statistical learning and cognitive function. Compared to typically developing (TD) controls, the ASD group as a whole showed reduced evidence of learning as defined by N1 (early visual discrimination) and P300 (attention to novelty) components. Upon further analysis, in the ASD group there was a positive correlation between N1 amplitude difference and non‐verbal IQ, and a positive correlation between P300 amplitude difference and adaptive social function. Children with ASD and a high non‐verbal IQ and high adaptive social function demonstrated a distinctive pattern of learning. This is the first study to identify electrophysiological markers of visual statistical learning in children with ASD. Through this work we have demonstrated heterogeneity in statistical learning in ASD that maps onto non‐verbal cognition and adaptive social function.
Since the initial reports regarding the nationwide outbreak of e-cigarette or vaping product use-associated lung injury (EVALI) in August 2019 by the Centers for Disease Control and Prevention, a clear link has been established between EVALI and tetrahydrocannabinol (THC)-containing product use. We report a case of invasive pulmonary aspergillosis (IPA) as a complication of EVALI in an immunocompetent adolescent that resulted in a fatal outcome. We encourage physicians that are considering the diagnosis of EVALI be cognizant of the increased use of THC and other potential contaminants in vaping cartridges. IPA can be a fatal disease and early aggressive treatment is necessary.
Kawasaki disease is an acute multisystem vasculitis characterized by involvement of medium-sized vessels that mostly affects children under the age of 5 years. The presentation is typically preceded by five or more days of fever with additional clinical findings including rash, peripheral edema, mucositis, conjunctival changes, and unilateral cervical lymphadenopathy. The most feared complication of Kawasaki disease is development of coronary artery aneurysms. Common laboratory abnormalities include normocytic anemia, thrombocytosis, leukocytosis, and elevated inflammatory markers. Immune-mediated cytopenias such as autoimmune hemolytic anemia and thrombocytopenia are rarely seen at presentation in Kawasaki disease. We describe a unique case of a child presenting with autoimmune hemolytic anemia, who sequentially developed immune thrombocytopenia concerning for Evans’ syndrome and eventually diagnosed with Kawasaki Disease with coronary artery dilatation. Characteristic clinical findings including extremity edema, cracked lips, and rash developed later in the course. Our patient was treated with IVIG and steroids with significant clinical improvement and complete resolution of cytopenias and coronary aneurysms on long term follow up. Timely administration of IVIG prevents and minimizes the risk of long term cardiac consequences. Hence a high index of suspicion should be maintained for this relatively common pediatric illness, even in absence of more commonly seen laboratory findings.
Objective: Define the clinical characteristics, outcomes, and resource utilization patterns in pediatric patients with Multisystem Inflammatory Syndrome in Children (MIS-C) hospitalized at our center over the first year of the pandemic. Methods:Retrospective case series of patients < 22 years with a discharge diagnosis of MIS-C between 5/1/20 and 4/30/21.Demographic, clinical, and outcome data was collected and analyzed. We then performed an analysis comparing resource utilization in the first six months of the time period to the second six months in the time period. Results: Forty eight percent (38/81) of our population had a greater than 2g/dl drop in their hemoglobin during their hospitalization. 73% (59/81) had a 1g/dl or greater drop. Of the recommended labs, CRP (100%), D-dimer (98%), Ferritin (91%), ESR (87%) Procalcitonin (85%), Fibrinogen (85%) and BNP (85%) were most frequently abnormal. Triglycerides (17%), PT/PTT (50%) and LDH (59%) were least frequently abnormal. Between the two defined time periods, there was no statistically significant improvement in the number of lab draws obtained aside from lab draws for triglycerides (p = .049). Conclusions:Our clinical findings are consistent with those already published in the literature. Outcomes were also positive, with no deaths in our cohort and 83% had no cardiac abnormalities six weeks after admission. Laboratory resource utilization was substantial and did not improve over the first year of MIS-C cases at our organization. Our patients with MIS-C did frequently experience significant drops in their hemoglobin. There is likely opportunity to refine the available guidelines for the management of MIS-C.
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