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Pediatric thromboembolism

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https://www.readbyqxmd.com/read/28090468/clinical-features-and-extraintestinal-manifestations-of-crohn-disease-in-children
#1
Young Ah Lee, Peter Chun, Eun Ha Hwang, Sang Wook Mun, Yeoun Joo Lee, Jae Hong Park
PURPOSE: The aim of this study was to investigate the clinical features and extraintestinal manifestations (EIMs) of Crohn disease (CD) in Korean pediatric patients. METHODS: The medical records of 73 children diagnosed with CD were retrospectively reviewed. Data regarding baseline demographic and clinical characteristics, including CD phenotype at diagnosis based on the Montreal classification, and clinical features and course of EIMs were investigated. RESULTS: Fifty-two (71...
December 2016: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28079740/venous-thromboembolism-among-pediatric-orthopedic-trauma-patients-a-database-analysis
#2
Daniel Guzman, Samir Sabharwal, Caixia Zhao, Sanjeev Sabharwal
Using the 2012 Kids Inpatient Database, we assessed records of pediatric patients (<21 years old) with fractures of the upper limb, lower limb, spine, pelvis, and multiple locations and calculated the overall prevalence of venous thromboembolism (VTE) and associated potential risk factors. 387 (0.68%) of 57 183 patients with one or more fractures were diagnosed with VTE. Children sustaining fractures of the axial skeleton and those with multiple fractures had a higher prevalence of VTE than those with isolated extremity fractures...
January 10, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28068786/topical-and-low-dose-intravenous-tranexamic-acid-in-cyanotic-cardiac-surgery
#3
Jigar Patel, Mrugesh Prajapati, Hardik Patel, Hemang Gandhi, Shilpa Deodhar, Himani Pandya
Background Coagulopathy is a major problem in surgery for cyanotic congenital heart disease. Tranexamic acid has been used both topically and systemically and plays a vital role in pediatric cardiac surgery by reducing blood loss and blood product requirement. We aimed to determine the anti-fibrinolytic effectiveness of low-dose systemic or topical tranexamic acid or a combination of both. Methods Seventy-five patients were divided in 3 groups of 25. Group A patients were given tranexamic acid 20 mg kg(-1) intravenously after sternotomy and 20 mg kg(-1) after heparin reversal...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28067012/venous-thromboembolism-in-pediatric-trauma-patients-ten-year-experience-and-long-term-follow-up-in-a-tertiary-care-center
#4
Christine M Leeper, Madhav Vissa, James D Cooper, Lynn M Malec, Barbara A Gaines
BACKGROUND: Pediatric trauma patients are at high risk for development of venous thromboembolism (VTE). Our objective is to describe incidence, risk factors, and timing of development of VTE, anticoagulation complications, and long-term VTE outcomes in a critically injured pediatric population. PROCEDURE: We did a retrospective review of pediatric (0-17 years) trauma admissions to intensive care unit from 2005 to 2014. Our center employs VTE screening and prevention protocols for high-risk patients based on hypercoagulable history, age, injuries, and medical interventions...
January 9, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28030503/prophylaxis-against-venous-thromboembolism-in-pediatric-trauma-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma-and-the-pediatric-trauma-society
#5
Arash Mahajerin, John K Petty, Sheila J Hanson, A Jill Thompson, Sarah H OʼBrien, Christian J Streck, Toni M Petrillo, E Vincent S Faustino
BACKGROUND: Despite the increasing incidence of venous thromboembolism (VTE) in hospitalized children, the risks and benefits of VTE prophylaxis, particularly for those hospitalized after trauma, are unclear. The Pediatric Trauma Society and the Eastern Association for the Surgery of Trauma convened a writing group to develop a practice management guideline on VTE prophylaxis for this cohort of children using the Grading of Recommendations Assessment, Development and Evaluation framework...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28027187/analysis-of-morbidity-readmission-and-reoperation-after-craniosynostosis-repair-in-children
#6
Kevin T Jubbal, Nikhil Agrawal, Larry H Hollier
The impact of specific patient comorbidities on outcomes in craniosynostosis surgical repair is not well defined. The aim of this retrospective review was to evaluate the short-term 30-day reoperation rate, unplanned readmission rate, and overall morbidity of craniosynostosis surgical repair using the 2012 through 2014 American College of Surgeons National Surgical Quality Improvement Program-Pediatrics (ACS NSQIP-Pediatric) database. Overall morbidity included pneumonia, wound occurrence, shock/sepsis, venous thromboembolism, cardiac complication, renal and urinary complications, or nerve injury...
December 23, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28011674/rare-genetic-variants-in-smap1-b3gat2-and-rims1-contribute-to-pediatric-venous-thromboembolism
#7
Frank Rühle, Anika Witten, Andrei Barysenka, Andreas Huge, Astrid Arning, Christine Heller, Anne Krümpel, Rolf Mesters, Andre Franke, Wolfgang Lieb, Mona Riemenschneider, Milan Hiersche, Verena Limperger, Ulrike Nowak-Göttl, Monika Stoll
Recent genome-wide association studies (GWAS) have confirmed known risk mutations for venous thromboembolism (VTE) and identified a number of novel susceptibility loci in adults. Here we present a GWAS in 212 nuclear families with pediatric VTE followed by targeted next generation sequencing (NGS) to identify causative mutations contributing to the association. Three SNPs exceeded the threshold for genome-wide significance as determined by permutation testing using 100.000 bootstrap permutations (p<10(-5))...
December 23, 2016: Blood
https://www.readbyqxmd.com/read/28010922/risk-factors-for-symptomatic-venous-and-arterial-thromboembolism-in-newborns-children-and-adolescents-what-did-we-learn-within-the-last-20years
#8
Gili Kenet, Verena Limperger, Maria Shneyder, Ulrike Nowak-Göttl
Venous thrombosis (VTE) in children is increasingly diagnosed, as advanced medical care has increased treatment intensity of hospitalized pediatric patients. The aim of this review was to summarize the data available and to discuss the controversial issue of thrombophilia screening in the light of the pediatric data available. Follow-up data for VTE recurrence in children suggest a recurrence rate between 3% (neonates) and 21% in individuals with unprovoked VTE. Apart from underlying medical conditions, recently reported systematic reviews on pediatric VTE (70% provoked) have shown significant associations between thrombosis and presence of protein C-, protein S- and antithrombin deficiency, factor 5 (F5: rs6025), factor 2 (F2: rs1799963), even more pronounced when combined inherited thrombophilias [IT] were involved...
December 14, 2016: Blood Cells, Molecules & Diseases
https://www.readbyqxmd.com/read/27988092/safety-of-tranexamic-acid-in-pediatric-cardiac-surgery-a-nationwide-database-study
#9
Takuma Maeda, Yusuke Sasabuchi, Hiroki Matsui, Yoshihiko Ohnishi, Shigeki Miyata, Hideo Yasunaga
OBJECTIVES: The present study aimed to examine the association between tranexamic acid (TXA) use and adverse effects (seizures, thromboembolism, and renal dysfunction) in a pediatric cardiac surgery population using a national inpatient database in Japan. The authors also assessed the association between TXA use and other clinical outcomes (length of hospital stay and in-hospital mortality). DESIGN: A nationwide, retrospective cohort study using propensity score analyses...
October 4, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27978589/gene-variations-in-the-protein-c-and-fibrinolytic-pathway-relevance-for-severity-and-outcome-in-pediatric-sepsis
#10
Navin P Boeddha, Marieke Emonts, Marjon H Cnossen, Moniek P de Maat, Frank W Leebeek, Gertjan J Driessen, Jan A Hazelzet
The host response to infection involves complex interplays between inflammation, coagulation, and fibrinolysis. Deregulation of hemostasis and fibrinolysis are major causes of critical illness and important determinants of outcome in severe sepsis. The hemostatic responses to infection vary widely between individuals, and are in part explained by polymorphisms in genes responsible for the protein C and fibrinolytic pathway. This review gives an overview of genetic polymorphisms in the protein C and fibrinolytic pathway associated with susceptibility and severity of pediatric sepsis...
December 15, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27965360/screening-guidelines-for-venous-thromboembolism-risk-in-hospitalized-children-have-low-sensitivity-for-central-venous-catheter-associated-thrombosis
#11
Asfawossen B Asfaw, Rowena C Punzalan, Ke Yan, Raymond G Hoffmann, Sheila J Hanson
OBJECTIVES: Local pediatric screening guidelines for venous thromboembolism (VTE) are developed from incomplete pediatric data and extrapolated from adult data in which immobility is a major risk factor. We hypothesized that screening guidelines centered on immobility are inadequate for identifying children at risk of central venous catheter (CVC)-associated VTE. METHODS: This retrospective case-control (4:1) study at an academic, quaternary-level, free-standing children's hospital applied screening guidelines for VTE risk to all cases of VTE from July 2012 to April 2014...
January 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/27957634/optimal-pediatric-dosing-of-anti-platelet-agents-for-pipeline-stent-embolization-a-case-report-and-review-of-the-literature
#12
Mary In-Ping Huang Cobb, Ali R Zomorodi, Erik F Hauck, Tony P Smith, L Fernando Gonzalez
BACKGROUND: Various strategies are emerging for dosing antiplatelet therapies in preparation for pipeline stent embolization in adults. Hyper-response is associated with hemorrhagic complications. Hypo-response is associated with thromboembolic events. Dosing of antiplatelet agents is highly variable, with little consensus among experts for adults-and even more so for children. To date, pipeline stents have been deployed in 11 pediatric patients, ages 4-15. A variety of clopidogrel and aspirin dosing regimens have been used, with response tested in only three patients, who were all therapeutic...
December 12, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27925425/preventing-acute-care-associated-venous-thromboembolism-in-adult-and-pediatric-patients-across-a-large-healthcare-system
#13
REVIEW
Timothy I Morgenthaler, Vilmarie Rodriguez
BACKGROUND: Although effective methods for venous thromboembolism prophylaxis (VTE-P) have been known for decades, reliable implementation has been challenging. OBJECTIVE: Develop reliable VTE-P systems for adult and for pediatric patients to reduce preventable venous thromboembolism (VTE). DESIGN: We used a discovery and diffusion system to first develop an effective system in 1 hospital location, and then spread the principle best practices across the entire 22-hospital system...
December 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/27909839/biventricular-support-using-a-centrifugal-pump-in-a-6%C3%A2-year-old-with-fulminant-myocarditis
#14
Hiromu Kehara, Tamaki Takano, Takamitsu Terasaki, Kenji Okada
We experienced a case of ventricular assist with both a pulsatile-flow and a continuous-flow pump in a pediatric patient, and herein report the clinical course and characteristics of the pumps. A 6-year-old female was diagnosed with fulminant myocarditis and transferred to our hospital for mechanical support. After 12 days of extracorporeal membrane oxygenation, we implanted a left ventricular assist device (LVAD) and a right ventricular assist device (RVAD) using centrifugal Gyro pumps with a membrane oxygenator in a paracorporeal fashion...
December 1, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/27884452/factors-associated-with-thrombotic-complications-in-pediatric-patients-with-vascular-malformations
#15
Pablo Sepúlveda, Alejandro Zavala, Pamela Zúñiga
BACKGROUND AND OBJECTIVES: Thrombosis is an uncommon disorder in children. Patients with slowflow vascular malformations have higher risk of developing localized intravascular coagulation, which is closely related to the presence of thrombotic events. These episodes cause pain, can be recurrent and determine a clear deterioration in the quality of life. Moreover, serious complications such as pulmonary thromboembolism and eventually death have been described. The aim of the present study is to identify clinical and laboratory risk factors associated with thrombotic events in pediatric patients with vascular malformations...
November 6, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27861210/symptomatic-venous-thromboembolism-after-adolescent-knee-arthroscopy
#16
Robert F Murphy, Benton Heyworth, Dennis Kramer, Manahil Naqvi, Patricia E Miller, Yi-Meng Yen, Mininder S Kocher, Benjamin J Shore
BACKGROUND: The frequency of knee arthroscopy procedures is increasing in pediatric and adolescent patients. In general, complications after these procedures in adolescents are uncommon. The purposes of this study are to report the incidence of venous thromboembolism (VTE) in adolescent patients after knee arthroscopy procedures, as well identify risk factors in this patient population. METHODS: Medical records were reviewed in all pediatric and adolescent patients (≤19 y) who underwent an arthroscopic knee procedure from 2010 to 2014 and were diagnosed with a symptomatic VTE in the postoperative period...
November 17, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27850788/1151-implementing-a-venous-thromboembolism-prevention-program-in-the-pediatric-intensive-care-unit
#17
Beth Wathen, Pamela Reiter, Bryce Clark, Brian Branchford
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27826712/subclinical-pulmonary-hypertension-in-childhood-systemic-lupus-erythematosus-associated-with-minor-disease-manifestations
#18
Pedro Anuardo, Monica Verdier, Natali W S Gormezano, Gabriela R V Ferreira, Gabriela N Leal, Alessandro Lianza, Juliana C O A Ferreira, Rosa M R Pereira, Nadia E Aikawa, Maria Teresa Terreri, Claudia S Magalhães, Simone Appenzeller, Maria Carolina Dos Santos, Silvana B Sachetti, Claudio A Len, Gecilmara S Pilleggi, Simone Lotufo, Eloisa Bonfá, Clovis A Silva
The aim of this study was to evaluate pulmonary hypertension (PH) in 852 childhood-onset systemic lupus erythematosus (cSLE) patients. This was a large multicenter study conducted in 10 Pediatric Rheumatology Services of São Paulo state, Brazil. PH was defined as systolic pulmonary artery pressure >35 mmHg and/or measurement of the mean pulmonary artery pressure >25 mmHg and/or diastolic pressure >15 mmHg by transthoracic echocardiogram. Demographic data, clinical manifestations, disease activity score (SLEDAI-2K), disease damage score (SLICC/ACR-DI) and treatments were also evaluated...
November 8, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27820879/heparin-for-the-treatment-of-thrombosis-in-neonates
#19
REVIEW
Olga Romantsik, Matteo Bruschettini, Simona Zappettini, Luca Antonio Ramenghi, Maria Grazia Calevo
BACKGROUND: Among pediatric patients, newborns are at highest risk of developing thromboembolism. Neonatal thromboembolic (TE) events may consist of both venous and arterial thromboses and often iatrogenic complications (eg, central catheterization). Treatment guidelines for pediatric patients with TE events most often are extrapolated from the literature regarding adults. Options for the management of neonatal TE events include expectant management; nitroglycerin ointment; thrombolytic therapy or anticoagulant therapy, or a combination of the two; and surgery...
7, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27779597/abnormalities-in-fibrinolysis-at-the-time-of-admission-are-associated-with-deep-vein-thrombosis-mortality-and-disability-in-a-pediatric-trauma-population
#20
Christine M Leeper, Matthew D Neal, Christine McKenna, Jason L Sperry, Barbara A Gaines
BACKGROUND: Abnormalities in fibrinolysis are common and associated with increased mortality in injured adults. While hyperfibrinolysis (HF) and fibrinolysis shutdown (SD) are potential prognostic indicators and treatment targets in adults, these derangements are not well described in a pediatric trauma cohort. METHODS: This was a prospective analysis of highest level trauma activations in subjects aged 0 to 18 years presenting to our academic center between June 1, 2015, and July 31, 2016, with admission rapid thrombelastograph...
January 2017: Journal of Trauma and Acute Care Surgery
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