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pediatric diabetic ketoacidosis

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https://www.readbyqxmd.com/read/27896145/interprofessional-multiple-step-simulation-course-improves-pediatric-resident-and-nursing-staff-management-of-pediatric-patients-with-diabetic-ketoacidosis
#1
Linnea M Larson-Williams, Amber Q Youngblood, Dawn Taylor Peterson, J Lynn Zinkan, Marjorie L White, Hussein Abdul-Latif, Leen Matalka, Stephen N Epps, Nancy M Tofil
AIM: To investigate the use of a multidisciplinary, longitudinal simulation to educate pediatric residents and nurses on management of pediatric diabetic ketoacidosis. METHODS: A multidisciplinary, multiple step simulation course was developed by faculty and staff using a modified Delphi method from the Pediatric Simulation Center and pediatric endocrinology department. Effectiveness of the simulation for the residents was measured with a pre- and post-test and a reference group not exposed to simulation...
November 4, 2016: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27822115/danish-registry-of-childhood-and-adolescent-diabetes
#2
REVIEW
Jannet Svensson, Charlotte Cerqueira, Per Kjærsgaard, Lene Lyngsøe, Niels Thomas Hertel, Mette Madsen, Henrik B Mortensen, Jesper Johannesen
AIM: The aims of the Danish Registry of Childhood and Adolescent Diabetes (DanDiabKids) are to monitor and improve the quality of care for children and adolescents with diabetes in Denmark and to follow the incidence and prevalence of diabetes. STUDY POPULATION: The study population consists of all children diagnosed with diabetes before the age of 15 years since 1996. Since 2015, every child followed up at a pediatric center (<18 years of age) will be included...
2016: Clinical Epidemiology
https://www.readbyqxmd.com/read/27807910/glargine-co-administration-with-intravenous-insulin-in-pediatric-diabetic-ketoacidosis-is-safe-and-facilitates-transition-to-a-subcutaneous-regimen
#3
V Sanoe Harrison, Stacy Rustico, Andrew A Palladino, Christine Ferrara, Colin Patrick Hawkes
BACKGROUND: Diabetes ketoacidosis (DKA) is a common presentation and complication of type 1 diabetes (T1D). While intravenous insulin is typically used to treat acute metabolic abnormalities, the transition from intravenous to subcutaneous treatment can present a challenge. We hypothesize that co-administration of glargine, a subcutaneous long-acting insulin analog, during insulin infusion may facilitate a flexible and safe transition from intravenous to subcutaneous therapy. OBJECTIVE: To determine if the practice of administering subcutaneous glargine during intravenous insulin is associated with an increased risk of hypoglycemia, hypokalemia, or other complications in children with DKA...
November 3, 2016: Pediatric Diabetes
https://www.readbyqxmd.com/read/27770618/diabetic-ketoacidosis-in-a-pediatric-intensive-care-unit
#4
Clarice L S Lopes, Paula Pitta Pinheiro, Luzia S Barberena, Guilherme U Eckert
OBJECTIVE: To describe the characteristics of children aged 0-14 years diagnosed with diabetic ketoacidosis and compare the following outcomes between children with prior diagnosis of type 1 diabetes mellitus (DM1) and children without prior diagnosis of DM1: length of hospital stay, severity on admission, insulin dosage, time of continuous insulin use, volume of fluids infused during treatment, and complications. METHODS: A retrospective descriptive study with review of medical records of patients admitted to the pediatric intensive care unit of a referral hospital from June 2013 to July 2015...
October 19, 2016: Jornal de Pediatria
https://www.readbyqxmd.com/read/27758023/clinical-outcomes-in-youth-beyond-the-first-year-of-type-1-diabetes-results-of-the-pediatric-diabetes-consortium-pdc-type-1-diabetes-new-onset-neon-study
#5
Eda Cengiz, Peiyao Cheng, Katrina J Ruedy, Craig Kollman, William V Tamborlane, Georgeanna J Klingensmith, Robin L Gal, Janet Silverstein, Joyce Lee, Maria J Redondo, Roy W Beck
OBJECTIVE: Current data are limited on the course of type 1 diabetes (T1D) in children and adolescents through the first few years of diabetes. The Pediatric Diabetes Consortium T1D new onset (NeOn) Study was undertaken to prospectively assess natural history and clinical outcomes in children treated at 7 US diabetes centers from the time of diagnosis. This paper describes clinical outcomes in the T1D NeOn cohort during the first 3 years postdiagnosis. RESULTS: A total of 1048 participants (mean age 9...
October 19, 2016: Pediatric Diabetes
https://www.readbyqxmd.com/read/27749721/pediatric-type-1-diabetes-reducing-admission-rates-for-diabetes-ketoacidosis
#6
Jeniece Trast Ilkowitz, Steven Choi, Michael L Rinke, Kathy Vandervoot, Rubina A Heptulla
BACKGROUND: Diabetes ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes mellitus (T1DM). Reducing DKA admissions in children with T1DM requires a coordinated, comprehensive management plan. We aimed to decrease DKA admissions, 30-day readmissions, and length of stay (LOS) for DKA admissions. METHODS: A multipronged intervention was designed in 2011 to reach all patients: (1) increase insulin pump use and basal-bolus regimen versus sliding scales, (2) transform educational program, (3) increased access to medical providers, and (4) support for patients and families...
October 2016: Quality Management in Health Care
https://www.readbyqxmd.com/read/27726271/pathways-to-reduce-diabetic-ketoacidosis-with-new-onset-type-1-diabetes-evidence-from-a-regional-pediatric-diabetes-center-auckland-new-zealand-2010-to-2014
#7
Eleanor R Gunn, Benjamin B Albert, Paul L Hofman, Wayne S Cutfield, Alistair J Gunn, Craig A Jefferies
BACKGROUND: There has been little change in the incidence of diabetic ketoacidosis (DKA) in newly diagnosed type 1 diabetes mellitus (T1DM) in children and adolescents in most developed countries. OBJECTIVES: To assess potentially modifiable antecedents of DKA in children <15 years of age with new onset T1DM. METHODS: Retrospective review of prospectively collected data from a complete regional cohort of children with T1DM in Auckland (New Zealand) from 2010 to 2014...
October 11, 2016: Pediatric Diabetes
https://www.readbyqxmd.com/read/27726268/a-survey-of-youth-with-new-onset-type-1-diabetes-opportunities-to-reduce-diabetic-ketoacidosis
#8
Luke Baldelli, Ben Flitter, Laura Pyle, David M Maahs, Georgeanna Klingensmith, Robert Slover, G Todd Alonso
OBJECTIVE: Pediatric patients in Colorado with new onset type 1 diabetes (T1D) presenting with diabetic ketoacidosis (DKA) increased from 29.9% to 46.2% from 1998 to 2012. The purpose of this study was to compare differences between patients with newly diagnosed T1D who presented in DKA with those who did not across three domains: sociodemographic factors, access to medical care, and medical provider factors, aiming to identify potential targets for intervention. METHODS: Sixty-one patients <17 years of age with T1D duration <6 months completed the questionnaire...
October 11, 2016: Pediatric Diabetes
https://www.readbyqxmd.com/read/27688429/medical-emergencies-in-pediatric-dentistry
#9
REVIEW
Dubravka Negovetić Vranić, Josipa Jurković, Jesenka Jeličić, Antonija Balenović, Gordana Stipančić, Ivana Čuković-Bagić
Medical emergencies that are life threatening can occur in dental practice. Complications may arise because of an underlying disease or a reaction to medication. Reactions to medications may be allergic and toxic. The most common reactions are toxic reactions to local anesthetics, whereas allergies occur mainly as a consequence of the application of antibiotics, usually penicillin. In response to stress, vasovagal syncope typically occurs. Other causes may be related to an underlying disease-specific pathology (such as acute asthma attack, diabetic ketoacidosis, hypoglycemia, or seizures) or accidents (aspiration of a foreign body causing obstruction of the respiratory system)...
March 2016: Acta Stomatologica Croatica
https://www.readbyqxmd.com/read/27547416/low-socioeconomic-status-is-associated-with-adverse-events-in-children-and-teens-on-insulin-pumps-under-a-universal-access-program-a-population-based-cohort-study
#10
Rayzel Shulman, Therese A Stukel, Fiona A Miller, Alice Newman, Denis Daneman, Jonathan D Wasserman, Astrid Guttmann
OBJECTIVE: To describe adverse events in pediatric insulin pump users since universal funding in Ontario and to explore the role of socioeconomic status and 24-hour support. RESEARCH DESIGN AND METHODS: Population-based cohort study of youth (<19 years) with type 1 diabetes (n=3193) under a universal access program in Ontario, Canada, from 2006 to 2013. We linked 2012 survey data from 33 pediatric diabetes centers to health administrative databases. The relationship between patient and center-level characteristics and time to first diabetic ketoacidosis (DKA) admission or death was tested using a Cox proportional hazards model and the rate of diabetes-related emergency department visits and hospitalizations with a Poisson model, both using generalized estimating equations...
2016: BMJ Open Diabetes Research & Care
https://www.readbyqxmd.com/read/27531862/neuroimaging-findings-in-acute-pediatric-diabetic-ketoacidosis
#11
Alaysia Barrot, Thierry Agm Huisman, Andrea Poretti
Diabetic ketoacidosis (DKA) is a state of severe insulin deficiency and a serious complication in children with diabetes mellitus type 1. In a small number of children, DKA is complicated by injury of the central nervous system. These children have a significant mortality and high long-term neurological morbidity. Cerebral edema is the most common neuroimaging finding in children with DKA and may cause brain herniation. Ischemic or hemorrhagic stroke during the acute DKA episode is less common and accounts for approximately 10% of intracerebral complications of DKA...
October 2016: Neuroradiology Journal
https://www.readbyqxmd.com/read/27509361/challenging-the-one-dose-fits-all-model-for-insulin-in-the-acute-treatment-of-pediatric-diabetic-ketoacidosis-a-critical-appraisal-of-low-dose-versus-standard-dose-insulin-in-pediatric-diabetic-ketoacidosis-a-randomized-clinical-trial-by-nallasamy-et-al-jama
#12
Benjamin Edward Orwoll
OBJECTIVE: To review the findings and discuss the implications of the use of low-dose insulin infusions in pediatric diabetic ketoacidosis compared with standard-dose insulin. DATA SOURCES: A search of the electronic PubMed database was used to perform the clinical query as well as to search for additional relevant literature. STUDY SELECTION AND DATA EXTRACTION: The article by Nallasamy K et al "Low-Dose vs Standard-Dose Insulin in Pediatric Diabetic Ketoacidosis: A Randomized Clinical Trial...
October 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27493370/diabetic-ketoacidosis-in-children-admitted-to-pediatric-intensive-care-unit-of-king-fahad-hospital-al-baha-saudi-arabia-precipitating-factors-epidemiological-parameters-and-clinical-presentation
#13
Satti Abdulrahim Satti, Imad Yassin Saadeldin, Ali Saeed Dammas
Type I diabetes mellitus is the most common endocrine-metabolic disorder of childhood and adolescence and diabetic ketoacidosis (DKA) can be life-threatening. The study aims at identifying precipitating factors, states epidemiological features and describes clinical presentations in children with DKA admitted to Pediatric Intensive Care Unit (PICU), King Fahad Hospital, Al-Baha, Saudi Arabia. The hospital records of 80 children admitted to PICU with DKA between January 2000 and December 2004 were reviewed. Results were compared with published data from Saudi Arabia and other countries...
2013: Sudanese Journal of Paediatrics
https://www.readbyqxmd.com/read/27476639/serial-optic-nerve-sheath-diameter-ultrasonography-during-pediatric-diabetic-ketoacidosis-management-a-pilot-study
#14
Gregory Hansen, Jeff K Vallance, Darcy L Beer, Ian Clark, Elizabeth A C Sellers
OBJECTIVE: Intracranial hypertension is an infrequent but serious acute complication of pediatric diabetic ketoacidosis (DKA). Subclinical elevations of intracranial pressures however, may be more common, and can be indirectly evaluated with ultrasonography of the optic nerve sheath diameter (ONSD). In this pilot study, we report serial data on ONSD trajectories from five pediatric patients with DKA to generate hypotheses for future studies. METHODS: Five pediatric patients with type 1 diabetes presented to our emergency department with DKA and enrolled in our study <3h after initiation of treatment...
November 2016: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/27411426/a-rare-but-important-adverse-effect-of-tacrolimus-in-a-heart-transplant-recipient-diabetic-ketoacidosis
#15
Zeynelabidin Öztürk, E Nazlı Gönç, Leman Akcan, Selman Kesici, İlker Ertuğrul, Benan Bayrakçı
Heart transplantation indications in pediatric population include congenital heart diseases, cardiomyopathies and retransplants. Cardiomyopathy is the primary indication for 11 to 17 years of age. The surveillance after transplantation is a very important issue because of both the rejection risk and the adverse effects due to medications after transplantation. Immunosuppressive agents that are commonly used after heart transplantations have several toxicities. Here we present an adolescent patient diagnosed with dilated cardiomyopathy, performed heart transplantation, treated with tacrolimus and suffered from diabetic ketoacidosis due to tacrolimus...
September 2015: Turkish Journal of Pediatrics
https://www.readbyqxmd.com/read/27207491/outpatient-care-preceding-hospitalization-for-diabetic-ketoacidosis
#16
Stephanie S Crossen, Darrell M Wilson, Olga Saynina, Lee M Sanders
OBJECTIVE: To identify patterns of outpatient care associated with diabetic ketoacidosis (DKA) among pediatric patients with type 1 diabetes (T1D). METHODS: Retrospective cohort study using Medicaid claims data from 2009 to 2012 for children with T1D enrolled ≥365 consecutive days in California Children's Services, a Title V program for low-income children with chronic disease. Outcome was DKA hospitalization >30 days after enrollment. Outpatient visits to primary care, endocrinology, pharmacies, and emergency departments (EDs) were assessed during the 6 months before an index date: either date of first DKA hospitalization or end of enrollment for those without DKA...
June 2016: Pediatrics
https://www.readbyqxmd.com/read/27146235/right-ventricle-mass-removal-from-tricuspid-valve-apparatus-an-unusual-thromboembolic-complication-of-severe-ketoacidosis
#17
Ireneusz Haponiuk, Maciej Chojnicki, Konrad Paczkowski, Wojciech Kosiak, Radosław Jaworski, Mariusz Steffens, Aneta Szofer-Sendrowska, Katarzyna Gierat-Haponiuk, Marek Tomaszewski
The presence of a pathologic mass in the right ventricle (RV) may lead to hemodynamic consequences and to a life-threatening incident of pulmonary embolism. The diagnosis of an unstable thrombus in the right heart chamber usually necessitates intensive treatment to dissolve or remove the pathology. We present a report of an unusual complication of severe ketoacidosis: thrombus in the right ventricle, removed from the tricuspid valve (TV) apparatus. A four-year-old boy was diagnosed with diabetes mellitus (DM) type I de novo...
2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/27143290/medicaid-managed-care-reduces-readmissions-for-youths-with-type-1-diabetes
#18
Kathleen Healy-Collier, Walter J Jones, James E Shmerling, Kenneth R Robertson, Robert J Ferry
OBJECTIVES: To determine whether the likelihood of readmission (adjusted for severity on first admission) for pediatric type 1 diabetes (T1D) differs between Medicaid managed care and non-managed care. STUDY DESIGN: De-identified patients were retrospectively selected from the Pediatric Health Information Systems database of the Children's Hospital Association (CHA). The cohort of 42 hospitals across 25 states included discharges between 2008 and 2011 for patients who were receiving Medicaid at the time of service and had T1D as their diagnosis...
April 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27099736/testicular-failure-following-severe-diabetic-ketoacidosis-complicated-by-hypotensive-shock
#19
Waleed Janem, Lucy D Mastrandrea
The stalling or regression of pubertal development may be the first sign of hypergonadotropic hypogonadism in adolescent males. We report here a case of pediatric hypergonadotropic hypogonadism that likely developed secondary to ischemic injury during severe diabetic ketoacidosis (DKA). This case highlights the importance of performing genital exams during all evaluations of pediatric patients.
April 2016: Clinical Case Reports
https://www.readbyqxmd.com/read/27071071/elevated-leukocyte-azurophilic-enzymes-in-human-diabetic-ketoacidosis-plasma-degrade-cerebrovascular-endothelial-junctional-proteins
#20
Martin M H Woo, Eric K Patterson, Cheril Clarson, Gediminas Cepinskas, Mahmud Bani-Yaghoub, Danica B Stanimirovic, Douglas D Fraser
OBJECTIVE: Diabetic ketoacidosis in children is associated with vasogenic cerebral edema, possibly due to the release of destructive polymorphonuclear neutrophil azurophilic enzymes. Our objectives were to measure plasma azurophilic enzyme levels in children with diabetic ketoacidosis, to correlate plasma azurophilic enzyme levels with diabetic ketoacidosis severity, and to determine whether azurophilic enzymes disrupt the blood-brain barrier in vitro. DESIGN: Prospective clinical and laboratory study...
September 2016: Critical Care Medicine
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