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https://www.readbyqxmd.com/read/29343506/how-to-use%C3%A2-procalcitonin
#1
Philip Robinson, Surjo Kiran De
Diagnosing bacterial infection in the unwell or febrile child is a common challenge faced by all paediatricians. Despite the advent of novel molecular techniques, there is ongoing need for diagnostic assays with adequate performance and turnaround time to facilitate safe clinical decision-making when bacterial sepsis is suspected, such as whether to commence empirical treatment with antibiotics. Procalcitonin is an established marker of infection that has a potential role in the diagnosis and exclusion of serious or invasive bacterial infection in neonates and children...
January 17, 2018: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/29306854/successful-management-of-a-24-year-old-pregnant-woman-with-necrotising-fasciitis-of-the-forearm
#2
Sam Nahas, Anne McKirdy, Arjuna Imbuldeniya
A 24-year-old woman who was 24 weeks pregnant presented to the emergency department with septic shock and an elbow wound that had become infected. She sustained an injury to the tip of the right elbow on a light switch 4 days prior. In the space of 1 day, she developed a necrotising soft tissue infection, which was rapidly spread to the forearm with florid sepsis. Her initial serum C reactive protein was 392 mg/L, and white cell count was 32×109/L. The patient was treated promptly with aggressive surgical debridement and broad-spectrum antibiotics...
January 6, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29222137/benefits-of-probiotics-in-preterm-neonates-in-low-income-and-medium-income-countries-a-systematic-review-of-randomised-controlled-trials
#3
Girish Deshpande, Gayatri Jape, Shripada Rao, Sanjay Patole
OBJECTIVE: Although there is an overall reduction in underfive mortality rate, the progress in reducing neonatal mortality rate has been very slow. Over the last 20 years, preterm births have steadily increased in low-income and medium-income countries (LMICs) particularly in sub-Saharan Africa and South Asia. Preterm birth is associated with increased mortality and morbidity, particularly in LMICs. Based on systematic reviews of randomised controlled trials (RCTs), many neonatal units in high-income countries have adopted probiotics as standard of care for preterm neonates...
December 7, 2017: BMJ Open
https://www.readbyqxmd.com/read/29217093/risk-factors-for-the-appearance-of-secondary-foci-of-infection-in-children-with-community-acquired-staphylococcus-aureus-bacteraemia-cohort-study-2010-2016
#4
M Guadalupe Perez, Soledad Martiren, Florencia Escarra, Vanesa Reijtman, Alejandra Mastroianni, Ana Varela-Baino, Carola Cedillo, M Eva Garcia, Moira Taicz, Rosa Bologna
INTRODUCTION: Community-acquired Staphylococcus aureus (SA) bacteraemia is a common cause of hospitalisation in children. The occurrence of secondary foci (SF) of SA infection is associated with higher morbidity and mortality. OBJECTIVES: To identify risk factors for SF of infection in children with community-acquired SA bacteraemia. MATERIAL AND METHODS: Prospective cohort. All children aged from 30 days to 16 years admitted to a paediatric referral hospital between January 2010 and December 2016 for community-acquired infections, with SA isolated in blood cultures, were included...
December 4, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/29212494/epidemiology-and-outcomes-of-children-with-renal-failure-in-the-pediatric-ward-of-a-tertiary-hospital-in-cameroon
#5
Marie Patrice Halle, Carine Tsou Lapsap, Esther Barla, Hermine Fouda, Hilaire Djantio, Beatrice Kaptue Moudze, Christophe Adjahoung Akazong, Eugene Belley Priso
BACKGROUND: Pediatric nephrology is challenging in developing countries and data on the burden of kidney disease in children is difficult to estimate due to absence of renal registries. We aimed to describe the epidemiology and outcomes of children with renal failure in Cameroon. METHODS: We retrospectively reviewed 103 medical records of children from 0 to 17 years with renal failure admitted in the Pediatric ward of the Douala General Hospital from 2004 to 2013...
December 6, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#6
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29203305/infectious-complications-in-paediatric-patients-treated-with-extracorporeal-membrane-oxygenation
#7
Maria José Santiago-Lozano, Marta Lucía Barquín-Conde, Lucía Fuentes-Moreno, Roberto Manuel León-Vela, Lucas Madrid-Vázquez, Amelia Sánchez-Galindo, Jesús López-Herce Cid
INTRODUCTION: The aim of this study was to analyse the incidence, treatment and evolution of infections in children treated with ECMO. METHODS: A retrospective study based on a prospective database was performed. Children under the age of 18 years treated with ECMO from September 2006 to November 2015 were included. The patients' clinical characteristics were collected, together with ECMO technique, cultures and treatment of infection. RESULTS: One hundred patients with a median age of 11 months were analysed...
December 1, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/29201229/antimicrobial-resistance-and-prevalence-of-cvfb-sek-and-seq-genes-among-staphylococcus-aureus-isolates-from-paediatric-patients-with-bloodstream-infections
#8
Bing-Shao Liang, Yan-Mei Huang, Yin-Shuang Chen, Hui Dong, Jia-Liang Mai, Yong-Qiang Xie, Hua-Min Zhong, Qiu-Lian Deng, Yan Long, Yi-Yu Yang, Si-Tang Gong, Zhen-Wen Zhou
Staphylococcus aureus (S. aureus) is one of the most frequently isolated pathogens in neonatal cases of early and late-onset sepsis. Drug resistance profiles and carriage of toxin genes may affect the treatment and outcome of an infection. The present study aimed to determine the antimicrobial resistance patterns and frequencies of the toxin-associated genes conserved virulence factor B (CvfB), staphylococcal enterotoxin Q (SEQ) and staphylococcal enterotoxin K (SEK) among S. aureus isolates recovered from paediatric patients with bloodstream infections (BSIs) in Guangzhou (China)...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29175821/post-traumatic-stress-after-picu-and-corticosteroid-use
#9
Georgina Corbet Burcher, Maria D Picouto, Lorraine C Als, Mehrengise Cooper, Christine M Pierce, Simon Nadel, M Elena Garralda
AIM: To examine the association between corticosteroid use in paediatric intensive care units (PICU) and subsequent symptoms of post-traumatic stress disorder (PTSD). METHODS: The subjects were children aged 8-16 years admitted to PICU with sepsis, meningoencephalitis (ME) and other disorders. Illness information was extracted from case notes; 3-6 months post discharge children completed a PTSD symptom questionnaire (eight-item Impact of Events Scale (IES-8)) assessing intrusion and avoidance symptoms...
November 25, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29168220/number-needed-to-suffer-replying-to-comments-on-my-paper
#10
Per-Arne Lönnqvist
I would like to reply to the issues raised by the letter from Dr Barrington (1) on my Different View article on disability-free survival and number needed to suffer (2). However, first of all I would like to provide some important background on my interest in this area.First, I worked in NICU care for more than 10 years before focusing on paediatric anaesthesia and I am the proud father of premature triplets born at 31+4 weeks. As such, I have also been a parent who has witnessed NICU care three times for three months, including surfactant replacement, mechanical ventilation, surgical ductus ligation, sepsis and necrotising entercolitis treated by nil-by-mouth, total parenteral nutrition and antibiotics...
November 23, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29080366/an-epidemic-of-meningococcal-disease-in-children-in-north-norway-in-the-1970s-and-1980s-was-dominated-by-a-hypervirulent-group-b-strain
#11
Kine Nordheim, Ingunn Holmefoss Hovland, Bjørn Erik Kristiansen, Per Ivar Kaaresen, Trond Flaegstad
AIM: We examined children hospitalised for invasive meningococcal disease, a leading cause of paediatric sepsis, in Troms County, North Norway, from 1973 to 2016, including the epidemic in the 1970s and 1980s. METHODS: This study was a retrospective review of children under the age of 15 years who were hospitalised for meningococcal disease at the University Hospital of North Norway and Harstad Hospital. We studied hospital and bacteriological records to determine the incidence rates and phenotypes involved...
October 28, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28969235/super-refractory-status-epilepticus-a-therapeutic-challenge-in-paediatrics
#12
Shrikiran Aroor, Kanaparthi Shravan, Suneel C Mundkur, C Jayakrishnan, Sai Sripad Rao
A status epilepticus which persists for 24 hours or more after starting treatment with anaesthesia or has recurred inspite of general anaesthesia is known as Super-Refractory Status Epilepticus (SRSE). It includes cases where status epilepticus recurs on reduction or withdrawal of anaesthesia. SRSE, though infrequently seen, constitutes a medical emergency due to the associated high morbidity and mortality. No clear cut guidelines are available till date for the management of SRSE. Most of the published literature was case reports and expert opinion...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28965695/-evaluating-a-child-after-a-febrile-seizure-insights-on-three-important-issues
#13
S Auvin, M Antonios, G Benoist, M-A Dommergues, F Corrard, V Gajdos, C Gras Leguen, E Launay, A Salaün, L Titomanlio, L Vallée, M Milh
Febrile seizures (FS) are the most common seizures seen in the paediatric population in the out-of-hospital and emergency department settings, and they account for the majority of seizures seen in children younger than 5 years old. An FS is a seizure accompanied by fever, without central nervous system infection, occurring in children between 6 months and 5 years old. Five criteria have been used and taught to classify any FS as simple or complex FS. These factors do not bear the same significance for clinical practice, in particular, the decision to perform a lumbar puncture for cerebrospinal fluid analysis to rule out an intracranial infection...
November 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28963638/widening-access-developing-an-elearning-resource-for-health-and-social-care-professionals-caring-for-children-and-young-people-with-cancer
#14
Wendy McInally, Maria J Pouso Lista, Natalia McLaren, Diane S Willis
Cancer is a key priority worldwide, and caring for children and young people with cancer requires a range of specific knowledge, skills and experience in order to deliver the complex care regimes both within the hospital or community environment. The aim of this paper is to disseminate work undertaken to design and develop pedagogical practice and innovation through an eLearning resource for health care professionals caring for children and young people with cancer across the globe. The work undertaken evaluated an existing cancer course (which has been withdrawn) that was developed and delivered through the Paediatric Oncology Nurses Forum, Royal College Nursing (Nurse Educators) and Warwick University...
September 29, 2017: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/28955423/variations-in-injury-characteristics-among-paediatric-patients-following-trauma-a-retrospective-descriptive-analysis-comparing-pre-hospital-and-in-hospital-deaths-at-kamuzu-central-hospital-lilongwe-malawi
#15
Laura Purcell, Charles E Mabedi, Jared Gallaher, Steven Mjuweni, Sean McLean, Bruce Cairns, Anthony Charles
BACKGROUND: Trauma is a major cause of paediatric mortality in sub-Saharan Africa. In absence of pre-hospital care, the injury mechanism and cause of death is difficult to characterise. Injury characteristics of pre-hospital deaths (PHD) versus in-hospital deaths (IHD) were compared. METHODS: Using our trauma surveillance database, a retrospective, descriptive analysis of children (<18 years) presenting to Kamuzu Central Hospital in Lilongwe, Malawi from 2008 to 2013 was performed...
June 2017: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/28876567/a-review-of-presentations-to-the-surgical-research-society-of-southern-africa-and-the-association-of-surgeons-of-south-africa-from-2010-to-2016
#16
S Burger, S van Straten, S Rayne
This paper looks at research done in South Africa from 2010 to 2016. We reviewed a total of 679 abstracts, posters and oral presentations submitted to the SAJS and the ASSA congresses during this time. During this time 21945 patients were investigated with an average of 577,5 patients per study. Each paper had on average 3,5 authors. The most popular topics are trauma (23%), gastrointestinal surgery (18%) and breast (11%). Upcoming topics include: reducing sepsis, global surgery, procedural discussion, infectious diseases (HIV/ TB), post-operative healing, ENT, neuro, plastic surgery, cardiothoracic and paediatric surgery...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28855237/predict-prioritisation-study-establishing-the-research-priorities-of-paediatric-emergency-medicine-physicians-in-australia-and-new-zealand
#17
Heather Carol Deane, Catherine L Wilson, Franz E Babl, Stuart R Dalziel, John Alexander Cheek, Simon S Craig, Ed Oakley, Meredith Borland, Nicholas G Cheng, Michael Zhang, Elizabeth Cotterell, Tibor Schuster, David Krieser
BACKGROUND: The Paediatric Research in Emergency Departments International Collaborative (PREDICT) performs multicentre research in Australia and New Zealand. Research priorities are difficult to determine, often relying on individual interests or prior work. OBJECTIVE: To identify the research priorities of paediatric emergency medicine (PEM) specialists working in Australia and New Zealand. METHODS: Online surveys were administered in a two-stage, modified Delphi study...
August 30, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28845129/sepsis-epidemiology-and-outcome-in-the-paediatric-intensive-care-unit-of-vilnius-university-children-s-hospital
#18
Odeta Bobelytė, Ieva Gailiūtė, Vytautas Zubka, Virginija Žilinskaitė
Research was carried out at the paediatric intensive care unit (paediatric ICU) of the Children's Hospital, affiliate of Vilnius University Hospital Santariškių klinikos. BACKGROUND: Being the most common cause of children's death, sepsis is a challenge for most physicians. In order to improve the outcomes, it is important to know the aetiology and peculiarities of sepsis in a particular region and hospital. The aim of this study was to analyse the outcomes of sepsis in a paediatric intensive care unit and their relation with patients' characteristics and causative microorganisms...
2017: Acta Medica Lituanica
https://www.readbyqxmd.com/read/28827252/safety-of-ceftriaxone-in-paediatrics-a-systematic-review-protocol
#19
Linan Zeng, Imti Choonara, Lingli Zhang, Song Xue, Zhe Chen, Miaomiao He
INTRODUCTION: Ceftriaxone is widely used in children in the treatment of sepsis. However, concerns have been raised about the safety of ceftriaxone, especially in young children. The aim of this review is to systematically evaluate the safety of ceftriaxone in children of all age groups. METHODS AND ANALYSIS: MEDLINE, PubMed, Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, International Pharmaceutical Abstracts and adverse drug reaction (ADR) monitoring systems will be systematically searched for randomised controlled trials (RCTs), cohort studies, case-control studies, cross-sectional studies, case series and case reports evaluating the safety of ceftriaxone in children...
August 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28818544/trends-in-antimicrobial-resistance-in-bloodstream-infection-isolates-at-a-large-urban-hospital-in-malawi-1998-2016-a-surveillance-study
#20
Patrick Musicha, Jennifer E Cornick, Naor Bar-Zeev, Neil French, Clemens Masesa, Brigitte Denis, Neil Kennedy, Jane Mallewa, Melita A Gordon, Chisomo L Msefula, Robert S Heyderman, Dean B Everett, Nicholas A Feasey
BACKGROUND: Bacterial bloodstream infection is a common cause of morbidity and mortality in sub-Saharan Africa, yet few facilities are able to maintain long-term surveillance. The Malawi-Liverpool-Wellcome Trust Clinical Research Programme has done sentinel surveillance of bacteraemia since 1998. We report long-term trends in bloodstream infection and antimicrobial resistance from this surveillance. METHODS: In this surveillance study, we analysed blood cultures that were routinely taken from adult and paediatric patients with fever or suspicion of sepsis admitted to Queen Elizabeth Central Hospital, Blantyre, Malawi from 1998 to 2016...
October 2017: Lancet Infectious Diseases
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