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https://www.readbyqxmd.com/read/29773497/indications-for-red-cell-transfusions-in-pediatric-patients
#1
REVIEW
Jill M Cholette, Suzie A Noronha, Jerard Seghatchian, Neil Blumberg
Red cell transfusions are amongst the most common therapeutic procedures in seriously ill children, particularly in the inpatient setting. This is despite the fact that there is no evidence base for most clinical settings, with the exception of patients with hemoglobinopathies, particularly thalassemia and sickle cell anemia. Obviously exsanguinating hemorrhage and life threatening anemia are urgent indications for which no other therapeutic approach is currently available. Most transfusions are, however, given prophylactically to prevent the complications of hypoxia or hemodynamic stability, based upon expert opinion and a faith in the oxygen carrying capacity and beneficial hemodynamic properties of transfused red cells...
May 10, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29767574/right-ventricular-stroke-work-correlates-with-outcomes-in-pediatric-pulmonary-arterial-hypertension
#2
Weiguang Yang, Alison L Marsden, Michelle T Ogawa, Charlotte Sakarovitch, Keeley K Hall, Marlene Rabinovitch, Jeffrey A Feinstein
No abstract text is available yet for this article.
January 1, 2018: Pulmonary Circulation
https://www.readbyqxmd.com/read/29762230/outcomes-after-infections-in-adolescents-and-young-adults-with-continuous-flow-left-ventricular-assist-devices
#3
Sharon Chen, Ryan S Cantor, Scott Auerbach, Kurt Schumacher, Christopher S Almond, Pirooz Eghtesady, Juan Alejos, Bibhuti B Das, Borah J Hong, Robert Jaquiss, James K Kirklin, Aamir Jeewa
Infections in adult ventricular assist device patients increase subsequent mortality and stroke risk. Less is known about outcomes after infections in younger patients, where diabetes and obesity, risk factors associated with poor outcomes, are less prevalent. The purpose of this study was to examine outcomes after infections in adolescents and young adults with continuous-flow left ventricular assist devices (VAD) bridged to transplant. From Pediatric Interagency Registry for Mechanically Assisted Circulatory Support and Interagency Registry for Mechanical Circulatory Support registries, we identified patients aged 12-29 years with continuous-flow VADs implanted as bridged to transplant from September 2012 to March 2016...
May 11, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29760852/altered-mental-status-current-evidence-based-recommendations-for-prehospital-care
#4
REVIEW
Ashley Sanello, Marianne Gausche-Hill, William Mulkerin, Karl A Sporer, John F Brown, Kristi L Koenig, Eric M Rudnick, Angelo A Salvucci, Gregory H Gilbert
Introduction: In the United States emergency medical services (EMS) protocols vary widely across jurisdictions. We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of a patient with an acute change in mental status and to compare these recommendations against the current protocols used by the 33 EMS agencies in the State of California. Methods: We performed a literature review of the current evidence in the prehospital treatment of a patient with altered mental status (AMS) and augmented this review with guidelines from various national and international societies to create our evidence-based recommendations...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29749594/-non-aneurysmal-subarachnoid-haemorrhage-secondary-to-panarteritis-nodosa-at-paediatric-age-a-case-report
#5
L Salgado-Lopez, C de Quintana-Schmidt, I Catala-Antunez, J Aibar-Duran, L San Roman-Manzanera, J Molet-Teixido
INTRODUCTION: Polyarteritis nodosa is a necrotizing vasculitis that mainly affects small and medium-sized arteries in skin and internal organs. Neurological involvement is reported in around 25% of cases: ischemic stroke is relatively common, but haemorrhagic lesions are extremely rare. Subarachnoid haemorrhage in polyarteritis nodosa is an uncommon expression of this disease, mostly associated with aneurism rupture. To the best of the authors' knowledge, there is just one published case in pediatric age with polyarteritis nodosa and subarachnoid haemorrhage with no underlying aneurismal disease...
May 16, 2018: Revista de Neurologia
https://www.readbyqxmd.com/read/29731013/hypertension-canada-s-2018-guidelines-for-diagnosis-risk-assessment-prevention-and-treatment-of-hypertension-in-adults-and-children
#6
Kara A Nerenberg, Kelly B Zarnke, Alexander A Leung, Kaberi Dasgupta, Sonia Butalia, Kerry McBrien, Kevin C Harris, Meranda Nakhla, Lyne Cloutier, Mark Gelfer, Maxime Lamarre-Cliche, Alain Milot, Peter Bolli, Guy Tremblay, Donna McLean, Raj S Padwal, Karen C Tran, Steven Grover, Simon W Rabkin, Gordon W Moe, Jonathan G Howlett, Patrice Lindsay, Michael D Hill, Mike Sharma, Thalia Field, Theodore H Wein, Ashkan Shoamanesh, George K Dresser, Pavel Hamet, Robert J Herman, Ellen Burgess, Steven E Gryn, Jean C Grégoire, Richard Lewanczuk, Luc Poirier, Tavis S Campbell, Ross D Feldman, Kim L Lavoie, Ross T Tsuyuki, George Honos, Ally P H Prebtani, Gregory Kline, Ernesto L Schiffrin, Andrew Don-Wauchope, Sheldon W Tobe, Richard E Gilbert, Lawrence A Leiter, Charlotte Jones, Vincent Woo, Robert A Hegele, Peter Selby, Andrew Pipe, Philip A McFarlane, Paul Oh, Milan Gupta, Simon L Bacon, Janusz Kaczorowski, Luc Trudeau, Norman R C Campbell, Swapnil Hiremath, Michael Roerecke, Joanne Arcand, Marcel Ruzicka, G V Ramesh Prasad, Michel Vallée, Cedric Edwards, Praveena Sivapalan, S Brian Penner, Anne Fournier, Geneviève Benoit, Janusz Feber, Janis Dionne, Laura A Magee, Alexander G Logan, Anne-Marie Côté, Evelyne Rey, Tabassum Firoz, Laura M Kuyper, Jonathan Y Gabor, Raymond R Townsend, Doreen M Rabi, Stella S Daskalopoulou
Hypertension Canada provides annually updated, evidence-based guidelines for the diagnosis, assessment, prevention, and treatment of hypertension in adults and children. This year, the adult and pediatric guidelines are combined in one document. The new 2018 pregnancy-specific hypertension guidelines are published separately. For 2018, 5 new guidelines are introduced, and 1 existing guideline on the blood pressure thresholds and targets in the setting of thrombolysis for acute ischemic stroke is revised. The use of validated wrist devices for the estimation of blood pressure in individuals with large arm circumference is now included...
May 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29730064/risk-of-radiation-vasculopathy-and-stroke-in-pediatric-patients-treated-with-proton-therapy-for-brain-and-skull-base-tumors
#7
Matthew D Hall, Julie A Bradley, Ronny L Rotondo, Ricardo Hanel, Chetan Shah, Christopher G Morris, Philipp R Aldana, Daniel J Indelicato
PURPOSE: To estimate the rate of and identify risk factors for vasculopathy after proton therapy in pediatric patients with central nervous system and skull base tumors. METHODS AND MATERIALS: Between 2006 and 2015, 644 pediatric patients with central nervous system and skull base tumors were treated with proton therapy at a single institution. The 3 most common histologies were craniopharyngioma (n = 135), ependymoma (n = 135), and low-grade glioma (n = 131)...
March 29, 2018: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29718002/vertebral-artery-dissection-masquerading-as-concussion-in-an-adolescent
#8
Gogi Kumar, Bryan Ludwig, Vipul V Patel
OBJECTIVE: Educate providers about the clinical presentation and consequences of delaying diagnosis of traumatic vertebral artery dissection with thromboembolic ischemic strokes in the pediatric population. Vertebral artery dissection is often difficult to diagnose and can be a potentially devastating cause of ischemic stroke. METHODS: Review of the chart, peer review/discussion, and imaging interpretation. RESULTS: A 16-year-old boy was admitted with confusion after a head and neck trauma was sustained while wrestling...
May 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29709427/abcc6-mutations-and-early-onset-stroke-two-cases-of-a-typical-pseudoxanthoma-elasticum
#9
Marta Bertamino, Mariasavina Severino, Alice Grossi, Marta Rusmini, Domenico Tortora, Carlo Gandolfo, Silvia Pederzoli, Clara Malattia, Paolo Picco, Pasquale Striano, Isabella Ceccherini, Maja Di Rocco
Pseudoxanthoma elasticum (PXE) is a rare genetic disorder characterized by fragmented and mineralized elastic fibers in the mid-dermis of the skin, eye, digestive tract and cardiovascular system. Clinical presentation includes typical skin lesions, ocular angioid streaks, and multisystem vasculopathy. The age of onset varies considerably from infancy to old age, but the diagnosis is usually made in young adults due to frequent absence of pathognomonic skin and ocular manifestations in early childhood. We report two children with PXE presenting with isolated multisystem vasculopathy and early-onset stroke...
April 12, 2018: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/29695585/mortality-after-pediatric-arterial-ischemic-stroke
#10
Lauren A Beslow, Michael M Dowling, Sahar M A Hassanein, John K Lynch, Dimitrios Zafeiriou, Lisa R Sun, Ilona Kopyta, Luigi Titomanlio, Anneli Kolk, Anthony Chan, Jose Biller, Eric F Grabowski, Abdalla A Abdalla, Mark T Mackay, Gabrielle deVeber
OBJECTIVES: Cerebrovascular disease is among the top 10 causes of death in US children, but risk factors for mortality are poorly understood. Within an international registry, we identify predictors of in-hospital mortality after pediatric arterial ischemic stroke (AIS). METHODS: Neonates (0-28 days) and children (29 days-<19 years) with AIS were enrolled from January 2003 to July 2014 in a multinational stroke registry. Death during hospitalization and cause of death were ascertained from medical records...
April 25, 2018: Pediatrics
https://www.readbyqxmd.com/read/29690942/deterioration-of-functional-abilities-in-children-surviving-the-fontan-operation
#11
M Florencia Ricci, Billie-Jean Martin, Ari R Joffe, Irina A Dinu, Gwen Y Alton, Gonzalo G Guerra, Charlene M T Robertson
Functional abilities are needed for activities of daily living. In general, these skills expand with age. We hypothesised that, in contrast to what is normally expected, children surviving the Fontan may have deterioration of functional abilities, and that peri-Fontan stroke is associated with this deterioration. All children registered in the Western Canadian Complex Pediatric Therapies Follow-up Program who survived a Fontan operation in the period 1999-2016 were eligible for inclusion. At the age of 2 years (pre-Fontan) and 4...
April 25, 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29688023/passive-nocturnal-physiologic-monitoring-enables-early-detection-of-exacerbations-in-asthmatic-children-a-proof-of-concept-study
#12
Michelle F Huffaker, Michael Carchia, Bronwyn U Harris, William C Kethman, Todd E Murphy, Charlotte C D Sakarovitch, FeiFei Qin, David N Cornfield
RATIONALE: Asthma management depends on prompt identification of symptoms, which challenges both patients and providers. In asthma, a misapprehension of health between exacerbations can compromise compliance. Thus, there is a need for a tool that permits objective longitudinal monitoring without increasing the burden of patient compliance. OBJECTIVES: We sought to determine whether changes in nocturnal physiology are associated with asthma symptoms in pediatric patients...
April 24, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29687529/lymphatic-imaging-and-intervention-in-a-pediatric-population-anesthetic-considerations
#13
David R Jobes, Lauren A Brown, Yoav Dori, Maxim Itkin, Susan C Nicolson
The recent adoption of an improved lymphatic access technique coupled with Dynamic Contrast-enhanced Magnetic Resonance Lymphangiography has introduced the ability to diagnose and treat severe lymphatic disorders unresponsive to other therapies. All pediatric patients presenting for lymphatic procedures require general anesthesia presenting challenges in managing highly morbid and comorbid conditions both from logistical as well as medical aspects. General anesthesia is used because of the procedural requirement for immobility to accurately place needles and catheters, treat pain secondary to contrast and glue injections, and to accommodate additional procedures...
April 23, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29685887/cardiopulmonary-resuscitation-in-infants-and-children-with-cardiac-disease-a-scientific-statement-from-the-american-heart-association
#14
REVIEW
Bradley S Marino, Sarah Tabbutt, Graeme MacLaren, Mary Fran Hazinski, Ian Adatia, Dianne L Atkins, Paul A Checchia, Allan DeCaen, Ericka L Fink, George M Hoffman, John L Jefferies, Monica Kleinman, Catherine D Krawczeski, Daniel J Licht, Duncan Macrae, Chitra Ravishankar, Ricardo A Samson, Ravi R Thiagarajan, Rune Toms, James Tweddell, Peter C Laussen
Cardiac arrest occurs at a higher rate in children with heart disease than in healthy children. Pediatric basic life support and advanced life support guidelines focus on delivering high-quality resuscitation in children with normal hearts. The complexity and variability in pediatric heart disease pose unique challenges during resuscitation. A writing group appointed by the American Heart Association reviewed the literature addressing resuscitation in children with heart disease. MEDLINE and Google Scholar databases were searched from 1966 to 2015, cross-referencing pediatric heart disease with pertinent resuscitation search terms...
April 23, 2018: Circulation
https://www.readbyqxmd.com/read/29679441/feasibility-safety-and-outcome-of-recanalisation-treatment-in-childhood-stroke
#15
Sandra Bigi, Andrea Dulcey, Jan Gralla, Corrado Bernasconi, Amber Melliger, Alexandre N Datta, Marcel Arnold, Johannes Kaesmacher, Joel Fluss, Annette Hackenberg, Oliver Maier, Johannes Weber, Claudia Poloni, Urs Fischer, Maja Steinlin
Objective Intravenous thrombolysis and endovascular therapy (IVT/EVT) are evidence-based treatments for adults with arterial ischemic stroke (AIS). However, randomized controlled trials in pediatric patients are lacking. This study aimed to describe feasibility, safety, and outcome of IVT/EVT in children with AIS. Methods Retrospective study (01/2000-12/2015) of a multicenter, population-based consecutive cohort of patients aged 1 month - 16 years diagnosed with AIS presenting with a pedNIHSS ≥4. Clinical and radiological data of patients receiving IVT/EVT were compared to those receiving standard care (SC) using linear regression to adjust for potential confounders...
April 20, 2018: Annals of Neurology
https://www.readbyqxmd.com/read/29673614/lacunar-stroke-cavernous-angioma-and-fusiform-aneurysm-due-to-irradiation-for-pilocytic-astrocytoma-a-case-report
#16
Maruyama Kunitaka, Takuya Akai, Naoki Akioka, Takahiro Tomita, Shoichi Nagai, Satoshi Kuroda
Radiotherapy is a useful modality for the treatment of brain tumors, but may induce brain degeneration, tumor formation, and vasculopathy in the irradiated field. We describe a rare case of a pediatric patient who presented multiple different types of vascular events consecutively in the irradiated field including lacunar stroke because of occlusion of perforating artery, intraventricular hemorrhage from cavernoma, and subarachnoid hemorrhage because of the rupture of fusiform aneurysm, 6 years after radiotherapy against pilocytic astrocytoma...
April 16, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29673287/pediatric-stroke-rates-over-17-years-report-from-a-population-based-study
#17
Laura L Lehman, Jane C Khoury, J Michael Taylor, Samrat Yeramaneni, Heidi Sucharew, Kathleen Alwell, Charles J Moomaw, Katrina Peariso, Matthew Flaherty, Pooja Khatri, Joseph P Broderick, Brett M Kissela, Dawn O Kleindorfer
We previously published rates of pediatric stroke using our population-based Greater Cincinnati Northern Kentucky Stroke Study (GCNK) for periods July 1993-June 1994 and 1999. We report population-based rates from 2 additional study periods: 2005 and 2010. We identified all pediatric strokes for residents of the GCNK region that occurred in July 1, 1993-June 30, 1994, and calendar years 1999, 2005, and 2010. Stroke cases were ascertained by screening discharge ICD-9 codes, and verified by a physician. Pediatric stroke was defined as stroke in those <20 years of age...
January 1, 2018: Journal of Child Neurology
https://www.readbyqxmd.com/read/29669602/cerebral-vasculitis-and-lateral-rectus-palsy-two-rare-central-nervous-system-complications-of-dengue-fever-two-case-reports-and-review-of-the-literature
#18
H M M Herath, J S Hewavithana, C M De Silva, O A R Kularathna, N P Weerasinghe
BACKGROUND: Dengue fever is a common mosquito-borne viral illness with a clinical spectrum ranging from a simple febrile illness to potentially life-threatening complications such as dengue hemorrhagic fever and dengue shock syndrome. Dengue infection can affect many organs, including the central nervous system. The neurological manifestations reported in dengue infections are meningitis, encephalitis, stroke, acute disseminated encephalomyelitis, and Guillain-Barré syndrome. CASE PRESENTATION: We report the cases of two interesting patients with confirmed dengue infection who presented with complications of possible central nervous system vasculitis and cranial nerve palsy...
April 19, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29655630/is-varicella-vaccination-associated-with-pediatric-arterial-ischemic-stroke-a-population-based-cohort-study
#19
Shannon E MacDonald, Douglas C Dover, Michael D Hill, Adam Kirton, Kimberley A Simmonds, Lawrence W Svenson
BACKGROUND AND PURPOSE: Varicella disease is a risk factor for pediatric Arterial Ischemic Stroke (AIS). Isolated case reports have emerged suggesting that varicella vaccination may also pose a risk for AIS. METHODS: This retrospective population-based cohort study assessed the risk of AIS in children who received a varicella-containing vaccine, as compared to those who did not. The study cohort consisted of children born between January 1, 2006 and December 31, 2013, in the Canadian province of Alberta, where all routine childhood vaccinations are publicly-funded, and recorded in a central immunization repository...
April 11, 2018: Vaccine
https://www.readbyqxmd.com/read/29648667/epidemiology-risk-factors-and-characteristics-of-pediatric-stroke-a-nationwide-population-based-study
#20
Kuo-Liang Chiang, Chen-Yang Cheng
Background: Stroke, classically characterized as an acute acquired neurological deficit, is an important leading cause of death and chronic morbidity in children. Aims: This study reported the period prevalence, incidence, and risk factors of pediatric stroke in Taiwan. Methods and Procedures: All Taiwan inhabitants aged 1 month to 18 years registered in the National Health Insurance Research Database (NHIRD) between 2010 and 2011 were enrolled in this study...
April 10, 2018: QJM: Monthly Journal of the Association of Physicians
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