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Pediatric transport

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https://www.readbyqxmd.com/read/28218636/lobular-distribution-and-variability-in-hepatic-atp-binding-cassette-protein-b1-abcb1-p-gp-ontogenetic-differences-and-potential-for-toxicity
#1
Ngu Njei Abanda, Zoe Riches, Abby C Collier
The ATP Binding Cassette B1 (ABCB1) transporter has critical roles in endo- and xenobiotic efficacy and toxicity. To understand population variability in hepatic transport we determined ABCB1 mRNA and protein levels in total liver lysates sampled from 8 pre-defined sites (n = 24, 18-69 years), and in S9 from randomly acquired samples (n = 87, 7 days-87 years). ABCB1 levels did not differ significantly throughout individual livers and showed 4.4-fold protein variation between subjects. Neither mRNA nor protein levels varied with sex, ethnicity, obesity or triglycerides in lysates or S9 (that showed the same relationships), but protein levels were lower in pediatric S9 (p < 0...
February 17, 2017: Pharmaceutics
https://www.readbyqxmd.com/read/28217595/impact-of-pre-hospital-care-on-the-outcome-of-children-arriving-with-agonal-breathing-to-a-pediatric-emergency-service-in-south-india
#2
Debasis Das Adhikari, Krishna Mahathi, Urmi Ghosh, Indira Agarwal, Anila Chacko, Ebor Jacob, Kala Ebenezer
BACKGROUND: Data on the prehospital interventions received by critically ill children at arrival to Paediatric Emergency Services (PES) is limited in developing countries. This study aims to describe the pre-hospital care scenario, transport and their impact on outcome in non-traumatic, acutely ill children presenting in PES with agonal breathing. METHODS: Prospective observational study done on children aged below 15 years arriving in PES with agonal breathing due to non-trauma related causes...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28213931/successful-resumption-of-peritoneal-dialysis-following-living-donor-liver-transplantation-in-children-with-end-stage-renal-disease
#3
Hiroyuki Kanazawa, Akinari Fukuda, Mai Sato, Shingo Ishimori, Kengo Sasaki, Hajime Uchida, Takanobu Shigeta, Vidyadhar Padmakar Mali, Seisuke Sakamoto, Kenji Ishikura, Mureo Kasahara
Children with ESRD in need of RRT are commonly managed by PD due to difficulty with vascular access for HD and the relatively large extracorporeal blood volume required. Major abdominal surgery may result in injury to the peritoneum and consequent adhesion, thereby resulting in a reduction in the anatomical capacity and transport capability across the peritoneal membrane. Here, we report successful resumption of PD after LDLT in two pediatric patients. The causes of ESRD were PH1 and juvenile nephronophthisis, respectively...
February 18, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28197051/benefits-of-and-untoward-events-during-intrahospital-transport-of-pediatric-intensive-care-unit-patients
#4
M M Harish, Suhail Sarwar Siddiqui, Natesh R Prabu, Harish K Chaudhari, Jigeeshu V Divatia, Atul Prabhakar Kulkarni
BACKGROUND AND AIMS: The transport of critically ill patients for procedures or imaging outside the Intensive Care Unit (ICU) is potentially hazardous; hence, the transport process must be organized and efficient. The literature about benefits of and untoward events (UEs) during intrahospital transport of pediatric critically ill patient is scarce. We, therefore, audited the UEs during and benefits of intrahospital transport of critically ill pediatric patients in our ICU. SUBJECTS AND METHODS: Eighty critically ill pediatric (<18 years) cancer patients, transported from the ICU for either diagnostic or therapeutic procedure over a period of 6 months, were included in the study...
January 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28192049/establishing-a-hospital-response-network-among-children-s-hospitals
#5
Michael T Bartenfeld, Stephanie E Griese, Steven E Krug, Joanne Andreadis, Georgina Peacock
A timely and effective response to public health threats requires a broad-reaching infrastructure. Children's hospitals are focused on evaluating and managing some of the most vulnerable patients and thus have unique preparedness and response planning needs. A virtual forum was established specifically for children's hospitals during the 2014-15 Ebola outbreak, and it demonstrated the importance and utility of connecting these specialty hospitals to discuss their shared concerns. Developing a successful children's hospital response network could build the national infrastructure for addressing children's needs in preparedness and response and for enhancing preparedness and response to high-consequence pathogens...
January 2017: Health Security
https://www.readbyqxmd.com/read/28176223/transportation-of-patients-on-extracorporeal-membrane-oxygenation-a-tertiary-medical-center-experience-and-systematic-review-of-the-literature
#6
Pedro Vitale Mendes, Cesar de Albuquerque Gallo, Bruno Adler Maccagnan Pinheiro Besen, Adriana Sayuri Hirota, Raquel de Oliveira Nardi, Edzangela Vasconcelos Dos Santos, Ho Yeh Li, Daniel Joelsons, Eduardo Leite Vieira Costa, Flavia Krepel Foronda, Luciano Cesar Pontes Azevedo, Marcelo Park
BACKGROUND: Utilization of extracorporeal membrane oxygenation (ECMO) has increased worldwide, but its use remains restricted to severely ill patients, and few referral centers are properly structured to offer this support. Inter-hospital transfer of patients on ECMO support can be life-threatening. In this study, we report a single-center experience and a systematic review of the available published data on complications and mortality associated with ECMO transportation. METHODS: We reported single-center data regarding complications and mortality associated with the transportation of patients on ECMO support...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28169980/epidemiologic-characteristics-of-pediatric-trauma-patients-receiving-prehospital-care-in-kigali-rwanda
#7
Adam R Aluisio, Olivier Félix Umuhire, Gabin Mbanjumucyo, Naomi George, Alexis Kearney, Naz Karim, Jeanne DʼArc Nyinawankusi, Eric Uwitonze, Sam Enumah, John W Scott, Zeta Mutabazi, Georges Ntakiyiruta, Sudha Jayaraman, Robert Riviello, Jean Claude Byiringiro, Adam C Levine
BACKGROUND: Pediatric trauma is a significant public health problem in resource-constrained settings; however, the epidemiology of injuries is poorly defined in Rwanda. This study describes the characteristics of pediatric trauma patients transported to the emergency department (ED) of the Centre Hospitalier Universitaire de Kigali by emergency medical services in Kigali, Rwanda. METHODS: This cohort study was conducted at the Centre Hospitalier Universitaire de Kigali from December 2012 to February 2015...
February 4, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28166099/pediatric-cardiopulmonary-arrest-in-the-postanesthesia-care-unit-rare-but-preventable-analysis-of-data-from-wake-up-safe-the-pediatric-anesthesia-quality-improvement-initiative
#8
Robert E Christensen, Bishr Haydar, Terri D Voepel-Lewis
BACKGROUND: Nearly 20% of anesthesia-related pediatric cardiac arrests (CAs) occur during emergence or recovery. The aims of this case series were to use the Wake Up Safe database to describe the following: (1) the nature of pediatric postanesthesia care unit (PACU) CA and subsequent outcomes and (2) factors associated with harm after pediatric PACU CA. METHODS: Pediatric CAs in the PACU were identified from the Wake Up Safe Pediatric Anesthesia Quality Improvement Initiative, a multicenter registry of adverse events in pediatric anesthesia...
February 3, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28157838/purification-and-characterization-of-micrornas-within-middle-ear-fluid-exosomes-implication-in-otitis-media-pathophysiology
#9
Stéphanie Val, Stephanie Jeong, Marian Poley, Anna Krueger, Gustavo Nino, Kristy Brown, Diego Preciado
BACKGROUND: Otitis Media (OM) is characterized by acute infection progressing to chronic middle ear effusion (MEE). Extracellular secretion of microRNAs (miRNAs) in exosomes is a newly discovered mechanism for cells exerting distant cell genetic regulation. Whether MEE contains exosomes with specific miRNAs is unknown. This study aimed to purify and characterize the exosomal and miRNA content of MEE. METHOD: MEEs were subjected to Exoquick exosomal purification and EXOCET exosomal quantification...
February 3, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28121834/pao2-fio2-ratio-derived-from-the-spo2-fio2-ratio-to-improve-mortality-prediction-using-the-pediatric-index-of-mortality-3-score-in-transported-intensive-care-admissions
#10
Samiran Ray, Libby Rogers, Christina Pagel, Sainath Raman, Mark J Peters, Padmanabhan Ramnarayan
OBJECTIVES: To derive a relationship between the SpO2/FIO2 ratio and PaO2/FIO2 ratio across the entire range of SpO2 values (0-100%) and to evaluate whether mortality prediction using the Pediatric Index of Mortality-3 can be improved by the use of PaO2/FIO2 values derived from SpO2/FIO2. DESIGN: Retrospective analysis of prospectively collected data. SETTING: A regional PICU transport service. PATIENTS: Children transported to a PICU...
January 24, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28118153/dose-coefficients-for-icrp-reference-pediatric-phantoms-exposed-to-idealised-external-gamma-fields
#11
Lienard A Chang, Steven L Simon, Timothy J Jorgensen, David A Schauer, Choonsik Lee
Organ and effective dose coefficients have been calculated for the International Commission on Radiological Protection (ICRP) reference pediatric phantoms externally exposed to mono-energetic photon radiation (x- and gamma-rays) from 0.01 to 20 MeV. Calculations used Monte Carlo radiation transport techniques. Organ dose coefficients, i.e., organ absorbed dose per unit air kerma (Gy/Gy), were calculated for 28 organs and tissues including the active marrow (or red bone marrow) for 10 phantoms (newborn, 1 year, 5 year, 10 year, and 15 year old male and female)...
January 24, 2017: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
https://www.readbyqxmd.com/read/28118113/organ-doses-to-airline-passengers-screened-by-x-ray-backscatter-imaging-systems
#12
Elliott J Stepusin, Matthew R Maynard, Shannon E O'Reilly, Sadije Redzovic, Wesley E Bolch, David E Hintenlang, Thomas B Borak
Advanced imaging technologies (AIT) are being developed for passenger airline transportation. They are designed to provide enhanced security benefits by identifying objects on passengers that would not be detected by methodologies now used for routine surveillance. X-ray backscatter imaging is one AIT system being considered. Since this technology is based on scanning passengers with ionizing radiation, concern has been raised relating to the health risks associated with these exposures. Recommendations for standards of radiation safety have been proposed by the American National Standards Institute published in ANSI/HPS N43...
January 24, 2017: Radiation Research
https://www.readbyqxmd.com/read/28115033/development-of-an-evacuation-tool-to-facilitate-disaster-preparedness-use-in-a-planned-evacuation-to-support-a-hospital-move
#13
Ranna A Rozenfeld, Sally L Reynolds, Sherri Ewing, Mary Margaret Crulcich, Michelle Stephenson
OBJECTIVES: Our institution relocated to a new facility 3.5 miles from our original location in Chicago on June 9, 2012. We describe the tools we developed to prepare, execute, and manage our evacuation and relocation. METHODS: Tools developed for the planned evacuation included the following: level of acuity and team composition classification, patient departure checklist, evacuation handoff tool, and a patient tracking system within the electronic health record...
January 24, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28094679/a-retrospective-analysis-of-a-pediatric-tele-echocardiography-service-to-treat-triage-and-reduce-trans-pacific-transport
#14
Christopher A Rouse, Brandon T Woods, C Becket Mahnke
Introduction Tele-echocardiography can ensure prompt diagnosis and prevent the unnecessary transport of infants without critical congenital heart disease, particularly at isolated locations lacking access to tertiary care medical centers. Methods We retrospectively reviewed all infants who underwent tele-echocardiography at a remote 16-bed level IIIB NICU from June 2005 to March 2014. Tele-echocardiograms were completed by cardiac sonographers in Okinawa, Japan, and transmitted asynchronously for review by pediatric cardiologists in Hawaii...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28094348/weight-of-abcb1-and-por-genes-on-oral-tacrolimus-exposure-in-cyp3a5-nonexpressor-pediatric-patients-with-stable-kidney-transplant
#15
G N Almeida-Paulo, I Dapía García, R Lubomirov, A M Borobia, N L Alonso-Sánchez, L Espinosa, A J Carcas-Sansuán
Tacrolimus (TAC) is highly effective for the prevention of acute organ rejection. However, its clinical use may be challenging due to its large interindividual pharmacokinetic variability, which can be partially explained by genetic variations in TAC-metabolizing enzymes and transporters. The aim of this study was to evaluate the influence of genetic and clinical factors on TAC pharmacokinetic variability in 21 stable pediatric renal transplant patients. This study was nested in a previous Prograf to Advagraf conversion clinical trial...
January 17, 2017: Pharmacogenomics Journal
https://www.readbyqxmd.com/read/28089059/management-of-hospitalized-asthmatic-children-before-transport
#16
Brande Mazzeo, Rami Bzeih, Robert Schultz, Melissa Tavolieri, Alicia Fraser, Sabrina M Heidemann
Asthmatic children are at risk for respiratory failure and should be appropriately treated before transport. The objectives were to find out if the Pediatric Advanced Life Support guidelines for asthma treatment were followed in the emergency department (ED); to determine if additional treatment during transport or within the first 2 hours of admission was needed; and to compare the management of intubated asthmatics by the ED, transport team, and the intensive care unit (ICU) physician. The records for children diagnosed with acute asthma over 7 years who were transported by the intensive care transport team were reviewed...
January 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28087478/renal-involvement-in-lysinuric-protein-intolerance-contribution-of-pathology-to-assessment-of-heterogeneity-of-renal-lesions
#17
Emmanuel Estève, Pauline Krug, Aurélie Hummel, Jean-Baptiste Arnoux, Olivia Boyer, Anais Brassier, Pascale de Lonlay, Vincent Vuiblet, Stéphanie Gobin, Rémi Salomon, Christine Piètrement, Jean-Paul Bonnefont, Aude Servais, Louise Galmiche
Lysinuric protein intolerance (LPI) is a rare autosomal recessive disease caused by mutations in the SLC7A7 gene encoding the light subunit of a cationic amino acid transporter. Symptoms mimic primary urea cycle defects but dysimmune symptoms are also described. Renal involvement in LPI was first described in the 1980's. In 2007, it appeared that it could concern as much as 75% of LPI patients and could lead to end stage renal disease. The most common feature is proximal tubular dysfunction and nephrocalcinosis but glomerular lesions are also reported...
January 10, 2017: Human Pathology
https://www.readbyqxmd.com/read/28086760/education-of-pediatric-subspecialty-fellows-in-transport-medicine-a-national-survey
#18
Geoffrey E Mickells, Denise M Goodman, Ranna A Rozenfeld
BACKGROUND: The transport of critically ill patients to children's hospitals is essential to current practice. The AAP Section on Transport Medicine has raised concerns about future leadership in the field as trainees receive less exposure to transport medicine. This study identifies the priorities of pediatric subspecialty fellows, fellowship directors and nursing directors in transport medicine education. METHODS: Internet based surveys were distributed to fellows, fellowship directors and nursing directors of transport teams affiliated with ACGME-approved fellowships in Neonatal-Perinatal Medicine (NPM), Pediatric Critical Care Medicine (PCCM), and Pediatric Emergency Medicine (PEM)...
January 13, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28072893/a-pediatric-application-of-the-strac-regional-hospital-trauma-registry-database-pediatric-trauma-deaths-in-south-central-texas-during-2004-2013
#19
Michelle Buehner, Jay Aden, Mathew Borgman, Preston Love, Brandi Wright, Mary Edwards
The purpose of this study was to define the demographics of pediatric traumatic injuries and to understand the predictive value of injury type, prehospital, and emergency department (ED) data regarding the mortality of pediatric trauma patients (<14 years of age) in South Central Texas. We report a retrospective review of pediatric trauma patients presenting to Trauma Service Area P in South Central Texas during 2004-2013. The primary outcome was mortality; secondary outcomes were ventilator days, hospital days, and intensive care unit stay...
January 1, 2017: Texas Medicine
https://www.readbyqxmd.com/read/28068001/in-vivo-and-in-vitro-ivacaftor-response-in-cystic-fibrosis-patients-with-residual-cftr-function-n-of-1-studies
#20
Meghan E McGarry, Beate Illek, Ngoc P Ly, Lorna Zlock, Sabrina Olshansky, Courtney Moreno, Walter E Finkbeiner, Dennis W Nielson
RATIONALE: Ivacaftor, a cystic fibrosis transmembrane conductance regulator (CFTR) potentiator, decreases sweat chloride concentration, and improves pulmonary function in 6% of cystic fibrosis (CF) patients with specific CFTR mutations. Ivacaftor increases chloride transport in many other CFTR mutations in non-human cells, if CFTR is in the epithelium. Some CF patients have CFTR in the epithelium with residual CFTR function. The effect of ivacaftor in these patients is unknown. METHODS: This was a series of randomized, crossover N-of-1 trials of ivacaftor and placebo in CF patients ≥8 years old with potential residual CFTR function (intermediate sweat chloride concentration, pancreatic sufficient, or mild bronchiectasis on chest CT)...
January 9, 2017: Pediatric Pulmonology
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