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Pediatric Intensive Care Therapy

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https://www.readbyqxmd.com/read/29218773/illness-and-end-of-life-experiences-of-children-with-cancer-who-receive-palliative-care
#1
Erica C Kaye, Courtney A Gushue, Samantha DeMarsh, Jonathan Jerkins, April Sykes, Zhaohua Lu, Jennifer M Snaman, Lindsay Blazin, Liza-Marie Johnson, Deena R Levine, R Ray Morrison, Justin N Baker
BACKGROUND: The field of pediatric palliative oncology is newly emerging. Little is known about the characteristics and illness experiences of children with cancer who receive palliative care (PC). METHODS: A retrospective cohort study of 321 pediatric oncology patients enrolled in PC who died between 2011 and 2015 was conducted at a large academic pediatric cancer center using a comprehensive standardized data extraction tool. RESULTS: The majority of pediatric palliative oncology patients received experimental therapy (79...
December 8, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29209510/milrinone-in-congenital-diaphragmatic-hernia-a-randomized-pilot-trial-study-protocol-review-of-literature-and-survey-of-current-practices
#2
REVIEW
Satyan Lakshminrusimha, Martin Keszler, Haresh Kirpalani, Krisa Van Meurs, Patricia Chess, Namasivayam Ambalavanan, Bradley Yoder, Maria V Fraga, Holly Hedrick, Kevin P Lally, Leif Nelin, Michael Cotten, Jonathan Klein, Stephanie Guilford, Ashley Williams, Aasma Chaudhary, Marie Gantz, Jenna Gabrio, Dhuly Chowdhury, Kristin Zaterka-Baxter, Abhik Das, Rosemary D Higgins
Background: Congenital diaphragmatic hernia (CDH) is commonly associated with pulmonary hypoplasia and pulmonary hypertension (PH). PH associated with CDH (CDH-PH) is frequently resistant to conventional pulmonary vasodilator therapy including inhaled nitric oxide (iNO) possibly due to right and left ventricular dysfunction. Milrinone is an intravenous inotrope and lusitrope with pulmonary vasodilator properties and has been shown anecdotally to improve oxygenation in PH. We developed this pilot study to determine if milrinone infusion would improve oxygenation in neonates ≥36 weeks postmenstrual age (PMA) with CDH...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/29204526/outcomes-and-patterns-of-care-in-a-nationwide-cohort-of-pediatric-medulloblastoma-factors-affecting-proton-therapy-utilization
#3
Andrew S Kopecky, Atif J Khan, Wilbur Pan, Richard Drachtman, Rahul R Parikh
Purpose: We examined national outcomes and patterns of care for pediatric patients with medulloblastoma (MB) in a large observational cohort. Methods and materials: Using the National Cancer Database, we evaluated the clinical features and survival outcomes of patients diagnosed with MB. The association between intervention, covariables, and outcome was assessed in a multivariable Cox analysis and through logistic regression analysis. Survival was estimated using the Kaplan-Meier method...
October 2017: Advances in Radiation Oncology
https://www.readbyqxmd.com/read/29190172/implementation-of-a-real-world-school-based-asthma-therapy-program-targeting-urban-children-with-poorly-controlled-asthma
#4
Elizabeth D Allen, Kimberly Arcoleo, Courtney Rowe, William W Long
OBJECTIVE: Describe implementation and clinical impact of a "real world" School-Based Asthma Therapy (SBAT) Program serving an urban, largely Medicaid population in a large midwestern city in the United States. METHODS: A retrospective, descriptive evaluation of SBAT was conducted. Students were referred by school nurses or providers, enrolled throughout the year, and could reenroll in subsequent years. A total of 286 students participated in the 2015-2016 school year...
November 30, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29189615/multi-modal-treatment-of-rhinocerebral-mucormycosis-in-a-pediatric-patient-with-relapsed-pre-b-acute-lymphoblastic-leukemia
#5
Zephyr D Dworsky, John S Bradley, Matthew T Brigger, Alice L Pong, Dennis John Kuo
A 17-year-old female developed invasive rhinocerebral mucormycosis during intensive re-induction chemotherapy for relapsed pre-B acute lymphoblastic leukemia. Due to the high case fatality rate for invasive mucormycosis in profoundly immunosuppressed patients, an aggressive treatment regimen was pursued. In addition to the standard of care treatments with intravenous amphotericin and aggressive surgical debridements, she received intraventricular amphotericin to the brain via an Ommaya reservoir, hyperbaric oxygen treatments, filgrastim, intravenous immunoglobulin and anti-fungal in vitro synergy testing to allow for more targeted antifungal therapy with the addition of micafungin...
November 16, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29187107/the-burdens-of-offering-ethical-and-practical-considerations
#6
Roxanne E Kirsch, Jillian Coronado, Peter P Roeleveld, James Tweddell, Antonio M Mott, Stephen J Roth
We reflect upon highlights of a facilitated panel discussion from the 2016 Pediatric Cardiac Intensive Care Society Meeting. The session was designed to explore challenges, share practical clinical experiences, and review ethical underpinnings surrounding decisions to offer intensive, invasive therapies to patients who have a poor prognosis for survival or are likely to be burdened with multiple residual comorbidities if survival is achieved. The discussion panel was representative of a variety of disciplines including pediatric cardiology, cardiac intensive care, nursing, and cardiovascular surgery as well as different health-care delivery systems...
November 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29185601/adherence-to-central-venous-catheter-insertion-bundle-in-neonatal-and-pediatric-units
#7
Fernanda Lopes de Araújo, Bruna Figueiredo Manzo, Anna Caroline Leite Costa, Allana Dos Reis Corrêa, Juliana de Oliveira Marcatto, Delma Aurélia da Silva Simão
OBJECTIVE: To describe the observed behavior of professionals in two neonatal and pediatric intensive care units regarding the use of central venous catheter insertion bundle, and the clinical and birth profile of neonates and children who received the devices. METHOD: A quantitative descriptive exploratory study was conducted in two intensive care units of a public hospital in Belo Horizonte with neonates and children, between February and September 2016. RESULTS: The sample consisted of 59 observed implants of central venous catheter...
November 27, 2017: Revista da Escola de Enfermagem da U S P
https://www.readbyqxmd.com/read/29181500/perinatal-diagnosis-management-and-follow-up-of-cystic-renal-diseases-a-clinical-practice-recommendation-with-systematic-literature-reviews
#8
Charlotte Gimpel, Fred E Avni, Carsten Bergmann, Metin Cetiner, Sandra Habbig, Dieter Haffner, Jens König, Martin Konrad, Max C Liebau, Lars Pape, Georg Rellensmann, Andrea Titieni, Constantin von Kaisenberg, Stefanie Weber, Paul J D Winyard, Franz Schaefer
Importance: Prenatal and neonatal cystic kidney diseases are a group of rare disorders manifesting as single, multiple unilateral, or bilateral cysts or with increased echogenicity of the renal cortex without macroscopic cysts. They may be accompanied by grossly enlarged kidneys, renal oligohydramnios, pulmonary hypoplasia, extrarenal abnormalities, and neonatal kidney failure. The prognosis is extremely variable from trivial to very severe or even uniformly fatal, which poses significant challenges to prenatal counseling and management...
November 27, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/29163800/end-of-life-care-in-children-with-hematologic-malignancies
#9
Jessica I Hoell, Jens Warfsmann, Stefan Balzer, Arndt Borkhardt, Gisela Janssen, Michaela Kuhlen
Introduction: Hematologic malignancies (HM) represent the most common neoplasms in childhood. Despite improved overall survival rates, they are still a major contributor to cancer death in children. Aims: To determine the proportion of children with HM in pediatric palliative care (PPC) and to identify the clinical characteristics and symptoms in comparison to children with extracranial solid tumors (non HM patients). Patients and Methods: This study was conducted as a single-center retrospective cohort study of patients in the care of a large specialized PPC team...
October 27, 2017: Oncotarget
https://www.readbyqxmd.com/read/29161668/patterns-of-c-reactive-protein-ratio-response-to-antibiotics-in-pediatric-sepsis-a-prospective-cohort-study
#10
Vanessa Soares Lanziotti, Pedro Póvoa, Arnaldo Prata-Barbosa, Lucas Berbet Pulcheri, Ligia S C F Rabello, José Roberto Lapa E Silva, Marcio Soares, Jorge I F Salluh
PURPOSE: Evaluate sequential C-reactive protein (CRP) measurements and patterns of CRP-ratio response to antibiotic therapy during first 7days in Pediatric Intensive Care Unit (PICU) of septic children. METHODS: Prospective, cohort study of children (1month-12years) admitted at 3 PICUs, with diagnosis of sepsis with <72h course. CRP-ratio was calculated in relation to D0_CRP value. Children were classified according to an individual pattern of CRP-ratio response: fast - CRP_D4 of therapy was <0...
November 11, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29143423/treatment-and-biology-of-pediatric-acute-lymphoblastic-leukemia
#11
REVIEW
Motohiro Kato, Atsushi Manabe
Acute lymphoblastic leukemia (ALL) is the most common pediatric malignancy. In the past ALL was intractable but now the survival probability is as high as 80-90%. Improved supportive care, treatment stratification based on relapse risk, biological features of leukemic cells, and optimization of treatment regimens by nationwide and international collaboration have contributed to this dramatic improvement. While including traditional risk factors (e.g., age and leukocyte count at diagnosis), the treatment has been modified based on biological characteristics (aneuploidy and translocation) and treatment response (assessed by minimal residual disease)...
November 16, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/29139162/epidemiology-of-therapeutic-apheresis-with-a-multidisciplinary-approach-at-a-high-volume-pediatric-center
#12
Rachel M Sirignano, Matthew L Paden, Ross Fasano, Erin K Meyer
INTRODUCTION: Therapeutic apheresis (TA) is used inconsistently in pediatric populations. We seek to define our multidisciplinary institutional practice. METHODS: We conducted a retrospective chart review of patients receiving TA from January 1, 2012 through October 31, 2015. Data collected included demographics, American Society of Apheresis (ASFA) indication, complications, and mortality. RESULTS: Over 46 months, 1198 TA procedures were conducted on 289 patients ranging in age from 5 months to 21 years with weights ranging from 4...
November 15, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/29092664/the-perspective-of-the-intensivist-on-inotropes-and-postoperative-care-following-pediatric-heart-surgery-an-international-survey-and-systematic-review-of-the-literature
#13
Peter P Roeleveld, J C A de Klerk
INTRODUCTION: Inotropes are frequently being used in children undergoing heart surgery to prevent or treat low cardiac output syndrome (LCOS). There is only limited evidence that inotropes actually positively influence postoperative outcome. Our aim was to describe the current international practice variation in the use of inotropes following congenital heart surgery. METHODS: We developed an online survey regarding the postoperative use of inotropes. We sent an invitation to all 197 registered members of the Pediatric Cardiac Intensive Care Society (PCICS) to participate in the survey...
January 1, 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29062249/a-retrospective-evaluation-of-blood-cultures-in-a-pediatric-intensive-care-unit-a-three-year-evaluation
#14
Ayşe Betül Ergül, Halit Işık, Yasemin Ay Altıntop, Yasemin Altuner Torun
AIM: In this study, it was aimed to retrospectively assess the frequency and antibiotic resistance of microorganisms isolated from blood cultures of patients in a pediatric intensive care unit. MATERIAL AND METHODS: The study was conducted on blood culture tests obtained from patients in a pediatric intensive care unit and sent to a microbiology laboratory between 2013 and 2016. The species and antibiotic susceptibilities were assessed in microorganisms isolated from the blood cultures...
September 2017: Türk Pediatri Arşivi
https://www.readbyqxmd.com/read/29048520/pain-acceptance-as-a-predictor-of-medical-utilization-and-school-absenteeism-in-adolescents-with-chronic-pain
#15
Michelle A Clementi, Grace S Kao, Evelyn Monico
Objective: Identifying factors contributing to high medical utilization and productivity loss is important, given the high cost of pediatric chronic pain. The current study examined chronic pain acceptance as a predictor of medical utilization and school absenteeism in adolescents with chronic pain. Methods: In all, 122 adolescents (aged 12-21 years) with chronic pain and their parents/guardians completed questionnaires assessing medical visits (past 6 months), medication usage, and number of school absences (past month)...
October 12, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/29048405/cooling-in-neonatal-hypoxic-ischemic-encephalopathy-practices-and-opinions-on-minimum-standards-in-the-state-of-california
#16
C J Wusthoff, C L Clark, H C Glass, T K Shimotake, J Schulman, S L Bonifacio
OBJECTIVE: Although hospitals increasingly offer therapeutic hypothermia (TH), there is variable implementation of related services. We assessed current practices and opinions regarding what services should be required of centers providing TH in California. STUDY DESIGN: We surveyed neonatal intensive care unit physicians statewide regarding practices and opinions about services related to TH. RESULTS: Of the 50 participating centers (47% response rate), 66% offer TH...
October 19, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29040243/toxic-shock-syndrome-still-a-timely-diagnosis
#17
Kira L Gossack-Keenan, April J Kam
BACKGROUND: Toxic shock syndrome (TSS) is an acute, severe, toxin-mediated disease, characterized by fever, hypotension, and multiorgan system involvement. Toxic shock syndrome has made headlines because of its high associated morbidity and mortality rate in previously healthy young females. Incidence peaked in the early 1980s owing to increased usage of ultra-absorbent tampons. After improved patient education and tampon labeling, the incidence of menstrual TSS has declined. CASE: A previously healthy 14-year-old girl presented to an urgent care center with a 2-day history of fever, erythematous maculopapular rash, vomiting, diarrhea, and malaise...
October 16, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29018400/including-a-lower-extremity-component-during-hand-arm-bimanual-intensive-training-does-not-attenuate-improvements-of-the-upper-extremities-a-retrospective-study-of-randomized-trials
#18
Geoffroy Saussez, Marina B Brandão, Andrew M Gordon, Yannick Bleyenheuft
Hand-Arm Bimanual Intensive Therapy (HABIT) promotes hand function using intensive practice of bimanual functional and play tasks. This intervention has shown to be efficacious to improve upper-extremity (UE) function in children with unilateral spastic cerebral palsy (USCP). In addition to UE function deficits, lower-extremity (LE) function and UE-LE coordination are also impaired in children with USCP. Recently, a new intervention has been introduced in which the LE is simultaneously engaged during HABIT (Hand-Arm Bimanual Intensive Therapy Including Lower Extremities; HABIT-ILE)...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29016313/case-report-fatal-pediatric-melioidosis-despite-optimal-intensive-care
#19
Alice Young, Catherine Tacon, Simon Smith, Ben Reeves, Greg Wiseman, Josh Hanson
With prompt administration of appropriate antimicrobial therapy and access to modern intensive care support, fatal pediatric melioidosis is very unusual. We describe cases of two children in whom the possibility of melioidosis was recognized relatively early, but who died of the disease, despite receiving optimal supportive care. We discuss the resulting implications for bacterial virulence factors in disease pathogenesis.
October 2, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28985201/-good-things-come-in-small-packages-application-of-exosome-based-therapeutics-in-neonatal-lung-injury
#20
REVIEW
Gareth R Willis, S Alex Mitsialis, Stella Kourembanas
Infants born at very low gestational age contribute disproportionately to neonatal morbidity and mortality. Advancements in antenatal steroid therapies and surfactant replacement have favored the survival of infants with ever-more immature lungs. Despite such advances in medical care, cardiopulmonary and neurological impairment prevail in constituting the major adverse outcomes for neonatal intensive care unit (NICU) survivors. With no single effective therapy for either the prevention or treatment of such neonatal disorders, the need for new tools to treat and reduce risk of further complications associated with extreme preterm birth is urgent...
October 6, 2017: Pediatric Research
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