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https://www.readbyqxmd.com/read/28340081/retroocular-and-subdural-hemorrhage-or-hemosiderin-deposits-in-pediatric-autopsies
#1
Marc R Del Bigio, Susan M Phillips
The presence of hemosiderin in the optic nerve sheath and/or retina is sometimes used to estimate the timing of injury in infants or children with suspected non-accidental head trauma. To determine the prevalence of hemosiderin in deaths not associated with trauma, we performed a prospective study of retroocular orbital tissue, cranial convexity, and cervical spinal cord dura mater in infants and children <2.5 years age. In 53 cases of non-traumatic death, approximately 70% had blood or hemosiderin within the orbital fat, ocular muscles, and parasagittal cranial and/or cervical spinal subdural compartment...
March 14, 2017: Journal of Neuropathology and Experimental Neurology
https://www.readbyqxmd.com/read/28338185/a-structured-blood-conservation-program-in-pediatric-cardiac-surgery
#2
A B Budak, K McCusker, S Gunaydin
OBJECTIVE: The limitation of alternative transfusion practices in infants increases the benefits of blood conservation. We analyzed the efficacy of a structured program to reduce transfusions and transfusion-associated complications in cardiac surgery PATIENTS AND METHODS: Our pediatric surgery database was reviewed retrospectively, comparing outcomes from two different time periods, after the implementation of an effective blood conservation program beginning in March 2014. A total of 214 infants (8...
March 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28337077/antithrombin-iii-doses-rounded-to-available-vial-sizes-in-critically-ill-pediatric-patients
#3
Winifred M Stockton, Eimeira Padilla-Tolentino, Carolyn E Ragsdale
OBJECTIVES: Children have decreased levels of antithrombin III (AT III) compared to adults. These levels may be further decreased during acute illness. Administration of exogenous AT III can increase anticoagulant efficacy. The objective of this study was to evaluate AT III doses rounded to available vial sizes compared to partial vial doses in critically ill pediatric patients, including patients receiving extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT)...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28332872/characterization-of-spontaneous-and-induced-puberty-in-girls-with-turner-syndrome
#4
Lisal J Folsom, James E Slaven, Zeina M Nabhan, Erica A Eugster
OBJECTIVE: To characterize puberty in girls with Turner syndrome, and determine whether specific patient characteristics are associated with the timing of menarche. We also sought to compare spontaneous vs. induced puberty in these patients. DESIGN/PATIENTS/MEASUREMENTS: Medical records of girls followed in our Pediatric Endocrine clinic for Turner syndrome from 2007 to 2015 were reviewed. RESULTS: Fifty-three girls were included, of whom 10 (19%) achieved menarche spontaneously and 43 (81%) received hormone replacement therapy (HRT)...
March 23, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28332238/outcome-measures-for-adult-and-pediatric-hemophilia-patients-with-inhibitors
#5
REVIEW
Cedric Hermans, Günter Auerswald, Gary Benson, Gerry Dolan, Anne Duffy, Victor Jiménez-Yuste, Rolf Ljung, Massimo Morfini, Thierry Lambert, Mehdi Osooli, Silva Zupančić Šalek
Recent advancements in almost all aspects of hemophilia treatment have vastly improved patient care and management, and new and emerging treatments hold the promise of further progress. However, there remains a scarcity of data on long-term outcomes in hemophilia, particularly among those patients with inhibitors, for whom no validated outcome assessment tools are currently available. At the 15(th) Zürich Haemophilia Forum, an expert panel reviewed the most important outcome measures in inhibitor patients and considered the challenges associated with assessing outcomes in this population...
March 22, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/28328243/factors-associated-with-bleeding-and-thrombosis-in-children-receiving-extracorporeal-membrane-oxygenation-ecmo
#6
Heidi J Dalton, Ron Reeder, Pamela Garcia-Filion, Richard Holubkov, Robert A Berg, Athena Zuppa, Frank W Moler, Thomas Shanley, Murray M Pollack, Christopher Newth, John Berger, David Wessel, Joseph Carcillo, Michael Bell, Sabrina Heidemann, Kathleen L Meert, Richard Harrison, Allan Doctor, Robert F Tamburro, J Michael Dean, Tammara Jenkins, Carol Nicholson
RATIONALE: Extracorporeal membrane oxygenation (ECMO) is employed for respiratory and cardiac failure in children but is complicated by bleeding and thrombosis. OBJECTIVES: (1) Measure the incidence of bleeding (blood loss requiring transfusion or intracranial hemorrhage) and thrombosis during ECMO support; (2) identify factors associated with these complications; and (3) determine the impact of these complications on patient outcome. METHODS: Prospective, observational cohort study in pediatric, cardiac, and neonatal intensive care units in eight hospitals from December 2012 to September 2014...
March 22, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28326849/long-term-efficacy-and-safety-of-prophylaxis-with-rfviii-in-chinese-pediatric-patients-with-hemophilia-a-a-multi-center-retrospective-non-interventional-phase-iv-recare-study
#7
Changgang Li, Xinsheng Zhang, Yongqiang Zhao, Runhui Wu, Qun Hu, Vicky Xu, Jing Sun, Renchi Yang, Xiaojing Li, Rongfu Zhou, Shinmei Lian, Jian Gu, Junde Wu, Qingsong Hou
BACKGROUND: The first recombinant factor VIII (rFVIII) product was launched in China in 2007. However, till date, no study has been conducted to describe the efficacy and safety of prophylaxis with rFVIII in Chinese pediatric patients with hemophilia A (HA). OBJECTIVE: To summarize the efficacy and safety data of prophylaxis with rFVIII in Chinese pediatric patients with HA. METHODS: ReCARE (Retrospective study in Chinese pediatric hemophilia A patients with rFVIII contained regular prophylaxis) was a retrospective study conducted in 12 hemophilia treatment centers (HTC's) across China...
March 22, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28321162/mortality-associated-with-gastrointestinal-bleeding-in-children-a-retrospective-cohort-study
#8
Thomas M Attard, Mikaela Miller, Chaitanya Pant, Ashwath Kumar, Mike Thomson
AIM: To determine the clinical characteristics of children with gastrointestinal bleeding (GIB) who died during the course of their admission. METHODS: We interrogated the Pediatric Hospital Information System database, including International Classification of Diseases, Current Procedural Terminology and Clinical Transaction Classification coding from 47 pediatric tertiary centers extracting the population of patients (1-21 years of age) admitted (inpatient or observation) with acute, upper or indeterminate GIB (1/2007-9/2015)...
March 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28319507/recombinant-factor-viia-is-associated-with-increased-thrombotic-complications-in-pediatric-cardiac-surgery-patients
#9
Laura Downey, Morgan L Brown, David Faraoni, David Zurakowski, James A DiNardo
BACKGROUND: Recombinant factor VIIa (rFVIIa) is routinely used as an off-label hemostatic agent in children undergoing cardiac surgery. Despite evidence that rFVIIa use is associated with an increased incidence of thrombotic complications in adult cardiac surgery, the safety of rFVIIa as a rescue hemostatic agent in the pediatric cardiac surgical population is less definitively delineated. In this retrospective study, we used propensity score matching to compare the incidence of thrombotic complications between children treated with rFVIIa and their matched controls...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28302281/the-art-and-science-of-pediatric-damage-control
#10
Anthony Tran, Brendan T Campbell
Damage control is a surgical strategy that has evolved and expanded considerably over the past 25 years. The approach was initially developed as a "bail out" procedure to control bleeding with severe abdominal injuries in the setting of unmitigated hemorrhagic shock. Damage control is now more broadly applied as a comprehensive management plan for the resuscitation and surgical treatment of injured patients with exhausted physiologic and metabolic reserve. This article reviews the most current concepts in damage control that are important and relevant to the practicing pediatric surgeon...
February 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28299211/epistaxis-as-a-common-presenting-symptom-of-glanzmann-s-thrombasthenia-a-rare-qualitative-platelet-disorder-illustrative-case-examples
#11
Michael Recht, Meera Chitlur, Derek Lam, Syana Sarnaik, Madhvi Rajpurkar, David L Cooper, Sriya Gunawardena
Children often present to emergency departments (EDs) with uncontrollable nose bleeding. Although usually due to benign etiologies, epistaxis may be the presenting symptom of an inherited bleeding disorder. Whereas most bleeding disorders are detected through standard hematologic assessments, diagnosing rare platelet function disorders may be challenging. Here we present two case reports and review diagnostic and management challenges of platelet function disorders with a focus on Glanzmann's thrombasthenia (GT)...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28296755/inflammatory-bowel-diseases-a-burden-in-pediatrics-case-series-and-a-review-of-the-literature
#12
Cristina Oana Mărginean, Lorena Elena Meliţ, Simona Mocanu, Maria Oana Mărginean
INTRODUCTION: Inflammatory bowel disease is a chronic condition of the gastrointestinal tract, comprising mainly Crohn disease (CD) and ulcerative colitis (UC). Both of them are frequently encountered in children, being multifactorial conditions, with an unclear etiology. PATIENTS CONCERNS: We present 4 cases of inflammatory bowel disease (IBD) in children in order to underline the variable evolution depending on the patient's particularities. DIAGNOSIS, INTERVENTIONS AND OUTCOMES: The first case, a 13-year-old male patient, with a history of Henoch-Schonlein purpura, was admitted for rectal bleeding and weight loss, with normal laboratory parameters...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28296662/iv-versus-subcutaneous-enoxaparin-in-critically-ill-infants-and-children-comparison-of-dosing-anticoagulation-quality-efficacy-and-safety-outcomes
#13
Yaser A Diab, Karthik Ramakrishnan, Brandon Ferrell, Reginald Chounoune, Fahad A Alfares, Kendal M Endicott, Sara Rooney, Jason Corcoran, David Zurakowski, John T Berger, Venkat Shankar, Dilip S Nath
OBJECTIVE: Subcutaneous enoxaparin is the mainstay anticoagulant in critically ill pediatric patients although it poses several challenges in this patient population. Enoxaparin infused IV over 30 minutes represents an attractive alternative, but there is limited experience with this route of administration in children. In this study, we assess dosing, anticoagulation quality, safety, and clinical efficacy of IV enoxaparin compared to subcutaneous enoxaparin in critically ill infants and children...
March 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28295963/a-multicenter-study-of-the-impella-device-for-mechanical-support-of-the-systemic-circulation-in-pediatric-and-adolescent-patients
#14
V Vivian Dimas, Brian H Morray, Dennis W Kim, Christopher Sd Almond, Shabana Shahanavaz, Sebastian C Tume, Lynn F Peng, Doff B McElhinney, Henri Justino
OBJECTIVES: The objective was to review the use of Impella devices (Abiomed Inc, Danvers, MA) for temporary circulatory support in pediatric and adolescent patients (age ≤ 21 yrs). BACKGROUND: Options for minimally invasive circulatory support in children are limited, and published data are confined to case reports and small case series. METHODS: This was a retrospective, multicenter review of Impella implants in pediatric and adolescent patients from 2009-15, using standardized data collection and INTERMACS definitions...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28293079/pediatric-gastrointestinal-bleeding-perspectives-from-the-italian-society-of-pediatric-gastroenterology
#15
REVIEW
Claudio Romano, Salvatore Oliva, Stefano Martellossi, Erasmo Miele, Serena Arrigo, Maria Giovanna Graziani, Sabrina Cardile, Federica Gaiani, Gian Luigi de'Angelis, Filippo Torroni
There are many causes of gastrointestinal bleeding (GIB) in children, and this condition is not rare, having a reported incidence of 6.4%. Causes vary with age, but show considerable overlap; moreover, while many of the causes in the pediatric population are similar to those in adults, some lesions are unique to children. The diagnostic approach for pediatric GIB includes definition of the etiology, localization of the bleeding site and determination of the severity of bleeding; timely and accurate diagnosis is necessary to reduce morbidity and mortality...
February 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28289613/effect-of-perioperative-management-on-outcome-of-patients-after-craniosynostosis-surgery
#16
Abdoljalil Kalantar Hormozi, Nastaran Mahdavi, Mohammad Mehdi Foroozanfar, Seyed Sajad Razavi, Razavi Mohajerani, Ahmad Eghbali, Amir Ali Mafi, Haleh Hashemzadeh, Alireza Mahdavi
BACKGROUND: Craniosynostosis results from premature closure of one or more cranial sutures, leading to deformed calvaria and craniofacial skeleton at birth. Postoperative complications and outcome in intensive care unit (ICU) is related to surgical method and perioperative management. This study determined the perioperative risk factors, which affect outcome of patients after craniosynostosis surgery. METHODS: In a retrospective study, 178 patients with craniosynostosis who underwent primary cranial reconstruction were included...
January 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28281001/acute-complete-paraplegia-of-8-year-old-girl-caused-by-spinal-cord-infarction-following-minor-trauma-complicated-with-longitudinal-signal-change-of-spinal-cord
#17
Kosei Nagata, Yuji Tanaka, Hiroyuki Kanai, Yasushi Oshima
INTRODUCTION: Spinal cord infarction followed by minor trauma in pediatric patients is rare and causes serious paralysis. Fibrocartilaginous embolism (FCE) is a possible diagnosis and there have been no consecutive magnetic resonance imaging (MRI) reports. Here, we report a case of an acute complete paraplegia with spinal cord infarction and longitudinal spinal cord signal change following minor trauma in an 8-year-old girl. CASE DESCRIPTION: An 8-year-old girl presented to our hospital emergency services with total paraplegia 2 h after she hit her back and neck after doing a handstand and falling down...
March 9, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28265398/a-delayed-presentation-of-homozygous-protein-c-deficiency-in-a-series-of-children-a-report-on-two-molecular-defects
#18
Abdullah A Baothman, Enaam AlSobhi, Hassan A Khayat, Raed E Alsulami, Abdulaziz S Alkahtani, Abdelraheem A Al-Thobyani, Yousef I Marzouk, Mohammad A Abdelaal
Pediatric emergency visits with purpura fulminans should raise the suspicion of hereditary homozygous protein C deficiency even beyond the neonatal age. The absence of this classical finding does not role the diagnosis out as atypical presentation with isolated intraocular bleeding was observed. Premarital counseling should be offered when family history suggests.
March 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28262568/a-bleeding-assessment-tool-correlates-with-intraoperative-blood-loss-in-children-and-adolescents-undergoing-major-spinal-surgery
#19
Jennifer M Anadio, Peter F Sturm, Johan M Forslund, Sunil Agarwal, Adam Lane, Cristina Tarango, Joseph S Palumbo
Screening laboratory studies for bleeding disorders are of little predictive value for operative bleeding risk in adults. Predicting perioperative bleeding in pediatric patients is particularly difficult as younger patients often have not had significant hemostatic challenges. This issue is distinctly important for high bleeding risk surgeries, such as major spinal procedures. The aim of this study was to determine if the score of a detailed bleeding questionnaire (BQ) correlated with surgical bleeding in pediatric patients undergoing major spinal surgery...
February 24, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28257391/evaluation-of-guidelines-for-injured-children-at-high-risk-for-vte-a-prospective-observational-study
#20
Rachel M Landisch, Sheila J Hanson, Laura D Cassidy, Kristin Braun, Rowena C Punzalan, David M Gourlay
BACKGROUND: Pharmacologic prophylaxis for venous thromboembolism (VTE) is a widely accepted practice in adult trauma patients to prevent associated morbidity and mortality. However, VTE prophylaxis has not been standardized in injured pediatric patients. Our institution identified factors potentially associated with a high risk of VTE in critically injured children that led to prospective implementation of VTE prophylaxis guidelines. We hypothesize the guidelines are accurate in predicting children at risk for VTE...
March 2, 2017: Journal of Trauma and Acute Care Surgery
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