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https://www.readbyqxmd.com/read/29351327/a-novel-risk-classification-system-for-30-day-mortality-in-children-undergoing-surgery
#1
Oguz Akbilgic, Max R Langham, Arianne I Walter, Tamekia L Jones, Eunice Y Huang, Robert L Davis
A simple, objective and accurate way of grouping children undergoing surgery into clinically relevant risk groups is needed. The purpose of this study, is to develop and validate a preoperative risk classification system for postsurgical 30-day mortality for children undergoing a wide variety of operations. The National Surgical Quality Improvement Project-Pediatric participant use file data for calendar years 2012-2014 was analyzed to determine preoperative variables most associated with death within 30 days of operation (D30)...
2018: PloS One
https://www.readbyqxmd.com/read/29346232/use-of-point-of-care-ultrasound-to-guide-pediatric-gastrostomy-tube-replacement-in-the-emergency-department
#2
Toby C Myatt, Anthony J Medak, Samuel H F Lam
The presentation of a pediatric patient to the emergency department for a malfunctioning or dislodged gastrostomy tube (G-tube) is not uncommon. As such, these tubes are often replaced at the bedside. Improper placement can result in a number of complications, including perforation, fistula tract formation, peritonitis, and sepsis. The current criterion standard method to confirm proper G-tube placement is contrast-enhanced radiography. However, point-of-care ultrasound may be an alternative method to guide and confirm pediatric G-tube replacement in the emergency department...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29346221/a-validation-argument-for-a-simulation-based-training-course-centered-on-assessment-recognition-and-early-management-of-pediatric-sepsis
#3
Gary L Geis, Derek S Wheeler, Amy Bunger, Laura G Militello, Regina G Taylor, Jerome P Bauer, Terri L Byczkowski, Benjamin T Kerrey, Mary D Patterson
INTRODUCTION: Early recognition of sepsis remains one of the greatest challenges in medicine. Novice clinicians are often responsible for the recognition of sepsis and the initiation of urgent management. The aim of this study was to create a validity argument for the use of a simulation-based training course centered on assessment, recognition, and early management of sepsis in a laboratory-based setting. METHODS: Five unique simulation scenarios were developed integrating critical sepsis cues identified through qualitative interviewing...
January 17, 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29344053/an-overview-of-exposure-to-ethanol-containing-substances-and-ethanol-intoxication-in-children-based-on-three-illustrated-cases
#4
REVIEW
Kam Lun Hon, Alexander Kc Leung, Eddie Cheung, Bryan Lee, Michelle Mc Tsang, Alcy R Torres
Alcohol addiction and intoxication are major health problems worldwide. Acute alcohol intoxication is well reported in adults and adolescents but less frequently reported in children of younger ages. We report three anonymized cases of pediatric ethanol exposure and illustrate the different mechanisms of intoxication. In all cases, a focused history is the key to prompt diagnosis and timely management. Physicians should be aware of this potential poison in children presented with acute confusional or encephalopathic state...
2018: Drugs in Context
https://www.readbyqxmd.com/read/29342997/-x-linked-inhibitor-of-apoptosis-deficiency-manifested-as-crohn-s-disease-a-case-report-and-literature-review
#5
L J Xu, Y Y Luo, J D Yu, J G Lou, Y H Fang, J Chen
Objective: To analyze the clinical characteristics of X-linked inhibitor of apoptosis (XIAP) deficient patients with clinical manifestation of Crohn's disease. Methods: Clinical manifestations, laboratory investigations, genetic testing and therapeutic interventions of one case of XIAP deficiency who was admitted to Department of Gastroenterology in Children's Hospital, Zhejiang University School of Medicine in May 2016 were summarized. PubMed and Chinese database for articles published from January 2016 to June 2017 were searched using the key words of'Crohn's disease'and'XIAP', and the relevant literature was reviewed...
January 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29340851/comparison-of-antibiotic-dosing-recommendations-for-neonatal-sepsis-from-established-reference-sources
#6
T B Y Liem, E M A Slob, J U M Termote, T F W Wolfs, A C G Egberts, C M A Rademaker
Background Incorrect dosing is the most frequent prescribing error in neonatology, with antibiotics being the most frequently prescribed medicines. Computer physician order entry and clinical decision support systems can create consistency contributing to a reduction of medication errors. Although evidence-based dosing recommendations should be included in such systems, the evidence is not always available and subsequently, dosing recommendations mentioned in guidelines and textbooks are often based on expert opinion...
January 16, 2018: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29337789/multicohort-analysis-of-whole-blood-gene-expression-data-does-not-form-a-robust-diagnostic-for-acute-respiratory-distress-syndrome
#7
Timothy E Sweeney, Neal J Thomas, Judie A Howrylak, Hector R Wong, Angela J Rogers, Purvesh Khatri
OBJECTIVES: To identify a novel, generalizable diagnostic for acute respiratory distress syndrome using whole-blood gene expression arrays from multiple acute respiratory distress syndrome cohorts of varying etiologies. DATA SOURCES: We performed a systematic search for human whole-blood gene expression arrays of acute respiratory distress syndrome in National Institutes of Health Gene Expression Omnibus and ArrayExpress. We also included the Glue Grant gene expression cohorts...
February 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29333818/community-acquired-methicillin-resistant-staphylococcus-aureus-infections-hospitalization-and-case-fatality-risk-in-10-pediatric-facilities-in-argentina
#8
Ángela Gentile, Julia Bakir, Gabriela Ensinck, Aldo Cancellara, Enrique V Casanueva, Verónica Firpo, Martín Caruso, María F Lución, Alejandro Santillán Iturres, Fabiana Molina, Héctor J Abate, Andrea Gajo Gane, Santiago López Papucci
INTRODUCTION: Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are prevalent both in Argentina and worldwide, and they may have a severe clinical course. OBJECTIVES: To estimate the hospitalization rate and case fatality risk factors of CA-MRSA infection. METHODS: Cross-sectional, analytical study. All patients < 15 years old with community-acquired Staphylococcus aureus (CA-SA) infections admitted to 10 pediatric facilities between January 2012 and December 2014 were included...
February 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29331260/multifaceted-behavior-of-meckel-s-diverticulum-in-children
#9
Qingjiang Chen, Zhigang Gao, Lifeng Zhang, Yuebin Zhang, Tao Pan, Duote Cai, Qixing Xiong, Qiang Shu, Yunzhong Qian
PURPOSE/BACKGROUND: Meckel's diverticulum (MD) is one of the most common congenital malformations of gastrointestinal tract in children. However, the nonspecific clinical manifestations of MD often cause a diagnostic as well as therapeutic challenge to pediatric surgeon. This study aimed to review our experience in managing this disease while evaluating the management strategies. METHODS: We retrospectively analyzed the clinical data of all patients diagnosed with MD admitted to our center between January 2010 and December 2015...
December 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29325220/profile-risk-factors-and-outcome-of-acute-kidney-injury-in-pediatric-acute-on-chronic-liver-failure
#10
Bikrant Bihari Lal, Seema Alam, Vikrant Sood, Dinesh Rawat, Rajeev Khanna
There are no studies on acute kidney injury (AKI) in pediatric acute-on-chronic liver failure (ACLF). This study was planned with aim to describe the clinical presentation and outcome of AKI among pediatric ACLF patients METHODS: Data of all children 1-18 years of age presenting with ACLF (APASL definition) was reviewed. AKI was defined as per KDIGO guidelines. Poor outcome was defined as death or need for liver transplant within 3 months of development of AKI RESULTS: A total of 84 children with ACLF presented to us in the study period...
January 11, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29313710/long-term-outcomes-after-protocolized-sedation-vs-usual-care-in-ventilated-pediatric-patients
#11
R Scott Watson, Lisa A Asaro, James H Hertzog, Lauren R Sorce, Alicia G Kachmar, Leslie A Dervan, Derek C Angus, David Wypij, Martha A Q Curley
RATIONALE: Whether a nurse-implemented goal-directed sedation protocol resulting in more awake yet calm intubated children affects post-discharge functional status, health-related quality of life, or risk for post-traumatic stress disorder is unknown. OBJECTIVES: To compare post-discharge outcomes in children with acute respiratory failure cluster randomized to a sedation protocol or usual care. METHODS: A stratified random sample of 1360 patients from 31 centers in the Randomized Evaluation of Sedation Titration for Respiratory Failure trial was assessed by mail, electronically, and/or telephone six months after intensive care unit discharge...
January 9, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29290230/antimicrobial-treatment-of-urinary-tract-infections-in-children
#12
R Cohen, J Raymond, E Launay, Y Gillet, P Minodier, F Dubos, E Grimprel
Urinary tract infections are the most frequent documented bacterial infections in children. The antibiotic choices proposed in this manuscript are based on the guidelines published by the Pediatric Infectious Disease Group (GPIP) and the French-Language Infectious Disease Society (SPILF). Dipstick positive for leukocytes and/or nitrites must precede in most circumstances (excluding the newborns, neutropenic patients and those with sepsis), urine culture and antibiotic prescription. The proportion of extended-spectrum β-lactamase (ESBL) Escherichia coli strains has increased steadily in recent years, and the situations in which oral antibiotic switch is frequently not available are increasing...
December 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29286559/high-incidence-of-acute-kidney-injury-during-chemotherapy-for-childhood-acute-myeloid-leukemia
#13
Liezl Du Plessis, Shahrad Rod Rassekh, Cherry Mammen
BACKGROUND/OBJECTIVES: Childhood acute myeloid leukemia (AML) is a rare and heterogeneous disease. Pediatric data on the epidemiology of acute kidney injury (AKI) in AML are limited. We report on the incidence of AKI in childhood AML and the risk factors associated with AKI episodes. METHODS: A retrospective cohort of 53 patients (≤18 years), with de novo AML, receiving chemotherapy over a 10-year period. All serum creatinine (SCr) levels during therapy-related hospitalizations were assessed to stage AKI episodes as per Kidney Disease: Improving Global Outcomes criteria...
December 29, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29276875/drug-reaction-with-eosinophilia-and-systemic-symptoms-in-a-child-on-multiple-antiepileptics
#14
Jyotindra Narayan Goswami, Pankaj C Vaidya, Arushi Gahlot Saini, Dipankar De, Bishan Dass Radotra, Pratibha D Singhi
Goswami JN, Vaidya PC, Saini AG, De D, Radotra BD, Singhi PD. Drug reaction with eosinophilia and systemic symptoms in a child on multiple antiepileptics. Turk J Pediatr 2017; 59: 197-199. Drug reaction with eosinophilia and systemic symptoms (DRESS) is an adverse drug-reaction that may mimic systemic illnesses and have a fulminant presentation. We describe an 8-year-old girl with epilepsy and exposure to multiple anti-epileptics who presented with fever, extensive maculopapular rash, cervical lymphadenopathy, hepatomegaly, progressive anemia and transaminitis...
2017: Turkish Journal of Pediatrics
https://www.readbyqxmd.com/read/29273940/investigation-of-clostridium-difficile-ribotypes-in-symptomatic-patients-of-a-german-pediatric-oncology-center
#15
Arne Simon, Markus Mock, Norbert Graf, Lutz von Müller
In a German pediatric oncology unit, the attending physicians diagnosed 27 cases of Clostridium difficile-associated disease (CDI) from January 01, 2010 to October 31, 2013. This refers to a CDI incidence density of 2.0/1000 inpatient days. According to the hospital hygiene standard, symptomatic patients with CDI were kept in contact isolation. Most patients (median age 8.2 years) suffered from acute lymphoblastic leukemia; 88.9% were treated with broad-spectrum antibiotics during the preceding 4 weeks. 29...
December 22, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29237456/identification-of-potential-transcriptomic-markers-in-developing-pediatric-sepsis-a-weighted-gene-co-expression-network-analysis-and-a-case-control-validation-study
#16
Yiping Li, Yanhong Li, Zhenjiang Bai, Jian Pan, Jian Wang, Fang Fang
BACKGROUND: Sepsis represents a complex disease with the dysregulated inflammatory response and high mortality rate. The goal of this study was to identify potential transcriptomic markers in developing pediatric sepsis by a co-expression module analysis of the transcriptomic dataset. METHODS: Using the R software and Bioconductor packages, we performed a weighted gene co-expression network analysis to identify co-expression modules significantly associated with pediatric sepsis...
December 13, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/29232903/pediatric-thermal-burns-and-treatment-a-review-of-progress-and-future-prospects
#17
REVIEW
Elton Mathias, Madhu Srinivas Murthy
Burn injuries are a devastating critical care problem. In children, burns continue to be a major epidemiologic problem around the globe resulting in significant morbidity and death. Apparently, treating these burn injuries in children and adults remains similar, but there are significant physiological and psychological differences. The dermal layer of the skin is generally thinner in neonates, infants, and children than in adults. Enhanced evaporative loss and need for isotonic fluids increases the risk of hypothermia in the pediatric population...
December 11, 2017: Medicines (Basel, Switzerland)
https://www.readbyqxmd.com/read/29223416/cost-variation-across-centers-for-the-norwood-operation
#18
Kimberly E McHugh, Sara K Pasquali, Matthew A Hall, Mark A Scheurer
BACKGROUND: The Norwood operation is associated with high health care utilization, and prior studies reported substantial variability in Norwood costs across centers. However, specific factors driving this cost variation are unclear. We assessed center variability in Norwood costs and underlying mechanisms in a multicenter cohort. METHODS: Clinical data from the Pediatric Heart Network Single Ventricle Reconstruction trial were linked with cost data from the Children's Hospital Association Inpatient Essentials database...
December 6, 2017: Annals of Thoracic Surgery
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
#19
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/29212619/zinc-protoporphyrin-to-heme-ratio-and-ferritin-as-measures-of-iron-sufficiency-in-the-neonatal-intensive-care-unit
#20
Kendell German, Phuong T Vu, Kimberly N Grelli, Christopher Denton, Gina Lee, Sandra E Juul
OBJECTIVES: To evaluate ferritin and zinc protoporphyrin-to-heme (ZnPP/H) ratios as biomarkers of iron status in neonates, determine how specific clinical events affected these measures, and assess how iron status changed during hospitalization. STUDY DESIGN: We performed a retrospective study of all infants with paired ferritin and ZnPP/H measurements between October 2014 and May 2016. Concordance of these measurements, effects of sepsis, red blood cell transfusion, erythropoietin treatment, and iron supplementation were assessed...
December 4, 2017: Journal of Pediatrics
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