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Pediatric SIRS

Florian Lamping, Thomas Jack, Nicole Rübsamen, Michael Sasse, Philipp Beerbaum, Rafael T Mikolajczyk, Martin Boehne, André Karch
BACKGROUND: Since early antimicrobial therapy is mandatory in septic patients, immediate diagnosis and distinction from non-infectious SIRS is essential but hampered by the similarity of symptoms between both entities. We aimed to develop a diagnostic model for differentiation of sepsis and non-infectious SIRS in critically ill children based on routinely available parameters (baseline characteristics, clinical/laboratory parameters, technical/medical support). METHODS: This is a secondary analysis of a randomized controlled trial conducted at a German tertiary-care pediatric intensive care unit (PICU)...
March 15, 2018: BMC Pediatrics
Marwan H Adly, Mohamed Sobhy, Mohamed A Rezk, Medhat Ishak, Mahmoud A Afifi, Ayman El Shafie, Mahmoud Ahmed Ali, Wael Zekri, Ahmad Samir Alfaar, Wafaa M Rashed
BACKGROUND: Thyroid carcinoma is a very rare tumor in the pediatric age group, accounting for only 1.5-3% of childhood carcinomas in the United States and Europe. We aimed to identify the risk of a second malignancy among pediatric thyroid cancer survivors. METHODS: The cohort analysis consisted of pediatric cancer patients aged less than 20 years, diagnosed with a primary thyroid cancer, identified by site code ICD-0-3: C739, and reported to the SEER 9 database between 1973 and 2013...
February 28, 2018: International Journal of Clinical Oncology
Cheryl P Z Foo, Jamie A Seabrook, Gurinder Sangha, Jennifer Ruth Foster
OBJECTIVE: The aim of this study was to examine the incidence and outcomes of patients presenting with systemic inflammatory response syndrome (SIRS) in the pediatric emergency department (PED). METHODS: This was a descriptive, retrospective cohort study of all patients from birth to 18 years presenting to the PED of a single center on 16 days distributed over 1 year. The presence of presumed SIRS (pSIRS, defined as noncore temperature measurement and cell count when clinically indicated) and sepsis was determined for all study patients...
February 12, 2018: Pediatric Emergency Care
Bikrant B Lal, Seema Alam, Vikrant Sood, Dinesh Rawat, Rajeev Khanna
BACKGROUND & AIMS: There are no studies on acute kidney injury in paediatric acute-on-chronic liver failure. This study was planned with aim to describe the clinical presentation and outcome of acute kidney injury among paediatric acute-on-chronic liver failure patients. METHODS: Data of all children 1-18 years of age presenting with acute chronic liver failure (Asia pacific association for the study of the liver definition) was reviewed. Acute kidney injury was defined as per Kidney Diseases-Improving Global Outcomes guidelines...
January 11, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
Don K Nakayama
Sir Denis John Wolko Browne (1892-1967), while not the first in the British Isles to devote his entire surgical practice to pediatric surgery, is accepted as "the father of pediatric surgery in the United Kingdom." He made contributions to operations as varied as tonsillectomy, pyloromyotomy, and hypospadias repair, and provided fundamental insights into the proper treatment of club foot, congenital dislocation of the hip, and cryptorchidism. He introduced the transverse laparotomy incision, primary repair of congenital intestinal obstruction, and the end-to-back anastomosis for intestinal atresia, techniques so commonly used that it is difficult to think of pediatric surgical operations done any differently...
October 26, 2017: Journal of Pediatric Surgery
Waleed Al-Mahdi, Mazen M Ibrahim, David A Spiegel, Alexandre Arkader, Michael Nance, Keith Baldwin
BACKGROUND: Systemic inflammatory response syndrome (SIRS) is a well-recognized phenomenon in adult trauma populations. The "initial hit" of the traumatic event is often coupled with a systemic immune response characterized by changes in vital signs and laboratory indicators. A "second hit" from surgery during this time frame often results in acute lung injury, along with deterioration of the patient's clinical condition. We hypothesized that children and adolescents would experience SIRS physiology, but would not experience adult respiratory distress syndrome (ARDS) or "second hit" related death to the extent seen in the adult populations...
October 9, 2017: Journal of Pediatric Orthopedics
Lisa Wilks-Gallo, Chaim Zev Aron, Catherine R Messina
The therapeutic alliance between pediatricians and parents begins at the initial encounter. The manner in which pediatricians greet family members influences this relationship. This study evaluated whether parents are addressed using generic titles and investigated perceptions of parents regarding how they are addressed by medical staff. Written surveys of 137 parents of pediatric inpatients collected opinions about greetings during medical encounters. Parents were asked if they have been addressed as Mom/Dad/Mommy/Daddy during past medical encounters and which generic titles they would prefer...
September 1, 2017: Clinical Pediatrics
Sasha Bernatsky, Ann E Clarke, Omid Zahedi Niaki, Jeremy Labrecque, Laura E Schanberg, Earl D Silverman, Kristen Hayward, Lisa Imundo, Hermine I Brunner, Kathleen A Haines, Randy Q Cron, Kiem Oen, Linda Wagner-Weiner, Alan M Rosenberg, Kathleen M O'Neil, Ciarán M Duffy, Emily von Scheven, Lawrence Joseph, Jennifer L Lee, Rosalind Ramsey-Goldman
OBJECTIVE: To determine cancer incidence in a large pediatric-onset systemic lupus erythematosus (SLE) population. METHODS: Data were examined from 12 pediatric SLE registries in North America. Patients were linked to their regional cancer registries to detect cancers observed after cohort entry, defined as date first seen in the clinic. The expected number of malignancies was obtained by multiplying the person-years in the cohort (defined from cohort entry to end of followup) by the geographically matched age-, sex-, and calendar year-specific cancer rates...
October 2017: Journal of Rheumatology
G Tong, A Krauss, J Mochner, S Wollersheim, P Soltani, F Berger, K R L Schmitt
Deep hypothermia therapy (HT) is a standard method for neuroprotection during complex pediatric cardiac surgery involving extracorporeal circulation and deep hypothermic cardiac arrest. The procedure, however, can provoke systemic inflammatory response syndrome (SIRS), one of the most severe side effects associated with pediatric cardiac surgery. To date, the cellular inflammatory mechanisms induced by deep HT remain to be elucidated. Therefore, we investigated the effects of deep HT (17°C) and rewarming on the inflammatory response in lipopolysaccharide (LPS) stimulated BV-2 murine microglia...
September 1, 2017: Neuroscience
Hiie Soeorg, Tuuli Metsvaht, Imbi Eelmäe, Mirjam Merila, Sirli Treumuth, Kristi Huik, Marika Jürna-Ellam, Mari-Liis Ilmoja, Irja Lutsar
BackgroundWe aimed to determine the genetic relatedness between Staphylococcus epidermidis colonizing breast milk (BM) and BM-fed neonates during the first month of life.MethodsS. epidermidis was isolated from the stool and skin swabs of 20 healthy term and 49 preterm neonates hospitalized in the neonatal intensive care unit and from the BM of mothers once a week and typed by multilocus variable-number tandem-repeat analysis. Virulence-related genes were determined by PCR.ResultsThe gut (95%) and skin (100%) of term neonates were colonized with strains genetically similar to those in BM and carrying mecA and IS256 at low rate (both <6...
November 2017: Pediatric Research
Yun Gu, Beth L Nordstrom
BACKGROUND: Little published literature exists regarding malignancy risk in pediatric psoriasis patients. OBJECTIVE: To compare malignancy risk in biologic-naïve pediatric psoriasis patients with a matched pediatric population without psoriasis. METHODS: This retrospective cohort study used IMS LifeLink Health Plan Claims data covering 1998-2008. Cancer incidence was compared with the US Surveillance, Epidemiology, and End Results (SEER) data using standardized incidence ratios (SIR), and between cohorts using Cox models...
August 2017: Journal of the American Academy of Dermatology
Shireen Hayatghaibi, Daniel Ashton, Heather Cleveland, Kamlesh Kukreja
PURPOSE: We retrospectively studied whether a limited 2 h post-biopsy observation period after a percutaneous outpatient ultrasound-guided liver biopsy is a sufficient monitoring period for children. MATERIALS AND METHODS: This study is an IRB-approved retrospective cohort review of consecutive outpatient percutaneous ultrasound-guided liver biopsies from June 01, 2014, to June 30, 2016. A total of 198 biopsies in 192 patients (85 females and 113 males) underwent an outpatient ultrasound-guided liver biopsy between June 01, 2014, and June 30, 2016 (age range 3 weeks-18 years, mean 11...
June 8, 2017: Cardiovascular and Interventional Radiology
Elizabeth L Yanik, Jodi M Smith, Meredith S Shiels, Christina A Clarke, Charles F Lynch, Amy R Kahn, Lori Koch, Karen S Pawlish, Eric A Engels
BACKGROUND: The effects of pediatric solid organ transplantation on cancer risk may differ from those observed in adult recipients. We described cancers in pediatric recipients and compared incidence to the general population. METHODS: The US transplant registry was linked to 16 cancer registries to identify cancer diagnoses among recipients <18 years old at transplant. Standardized incidence ratios (SIRs) were estimated by dividing observed cancer counts among recipients by expected counts based on the general population rates...
May 2017: Pediatrics
Yang Yang, Liu Haihong, Zheng Jun, Chen Min, Li Ying, Hao Jinsheng, Liu Wei, Zhang Jie, Ni Xin
The purpose is to determine the value of preoperative evaluation on developmental levels using Gesell score in predicting the postoperative outcome in pediatric cochlear implantation (CI) recipients. 78 children who underwent CI were included in our study. Age at the time of CI ranged from 6 to 67 months. The Gesell score including adaptability, fine motor, gross motor, language, and social skill was used for evaluating the patients' developmental levels before the CI, and a developmental quotient (DQ) was calculated by the following formula: (developmental age/actual age) × 100...
July 2017: European Archives of Oto-rhino-laryngology
Henning Neubauer, Mengxia Li, Verena Rabea Müller, Thomas Pabst, Meinrad Beer
Purpose We explored the diagnostic value of diffusion-weighted MRI (DWI) for tumor characterization, differentiation and therapy monitoring in pediatric patients with extracranial neuroblastic tumors. Materials and Methods All 29 patients (14 girls, median age: 3 years) with neuroblastoma (NB, n = 19), ganglioneuroblastoma (GNB, n = 4) and ganglioneuroma (GN, n = 6) who had had at least one in-house DWI examination since 2005 were identified and retrospectively analyzed. Two independent blinded readers measured ADC values (unit: 10-3 mm(2)/s) and signal intensity ratios (SIRs) of the primary tumor and, if applicable, of the tumor after chemotherapy, metastases and tumor relapse...
July 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
Mehmet Akif Sarıca, Tahir Dalkıran, Mehmet Sait Menzilcioğlu, Mahmut Duymuş, Nursel Yurttutan
OBJECTIVES: Congenital hypothyroidism (CH) is most frequently encountered in newborns as an endocrine disorder characterized by thyroid hormone deficiency, and is one of the most common reasons for preventable mental retardation. This prospective study was designed to detect the pediatric occurrences of CH followed as euthyroid, with no anomalies detected via US on the gray scale, in comparison with a pediatric group with normal levels. METHODS: A total of 42 apparently healthy children with no thyroid disorder (Group 1) and 54 euthyroid CH (Group 2) using thyroid hormone were included in this study...
September 2016: Pediatric Endocrinology Reviews: PER
Raquel Gil-Gómez, Javier Blasco-Alonso, Pilar Sánchez-Yáñez, Vanessa Rosa-Camacho, Guillermo Milano Manso
INTRODUCTION: Neopterin and biopterin are sub-products of redox reactions, which act as cofactors of enzymes responsible for nitric oxide production. The hypothesis is presented that plasma neopterin and biopterin evolve differently during the first days in a critically ill child. METHODS: A single-centre prospective observational study was conducted on patients 7 days to 14 years admitted to our Paediatric Intensive Care Unit (PICU) and that met Systemic inflammatory response syndrome (SIRS) criteria...
December 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Maisam Abu-El-Haija, Soma Kumar, Flora Szabo, Steven Werlin, Darwin Conwell, Peter Banks, Veronique D Morinville
INTRODUCTION: Acute pancreatitis (AP) is an emerging problem in pediatrics, with most cases resolving spontaneously. Approximately 10% to 30%, however, are believed to develop "severe acute pancreatitis" (SAP). METHODS: This consensus statement on the classification of AP in pediatrics was developed through a working group that performed an evidence-based search for classification of AP in adult pancreatitis, definitions and criteria of systemic inflammatory response syndrome, and organ failure in pediatrics...
June 2017: Journal of Pediatric Gastroenterology and Nutrition
Claire S Kaufman, Charles A James, Roger K Harned, Bairbre L Connolly, Derek J Roebuck, Anne M Cahill, Josee Dubois, Frank P Morello, Robin K Morgan, Manrita K Sidhu
BACKGROUND: Pediatric interventional radiology is a distinct subspecialty differing from both pediatric diagnostic radiology and adult interventional radiology. We conducted a workforce survey in 2005 to evaluate the state of pediatric interventional radiology at that time. Since then there have been many advancements to the subspecialty, including the founding of the Society for Pediatric Interventional Radiology (SPIR). OBJECTIVE: To evaluate the current state of the pediatric interventional radiology workforce and compare findings with those of the initial 2005 workforce survey...
May 2017: Pediatric Radiology
Jeffrey S Hyams, Marla C Dubinsky, Robert N Baldassano, Richard B Colletti, Salvatore Cucchiara, Johanna Escher, William Faubion, John Fell, Benjamin D Gold, Anne Griffiths, Sibylle Koletzko, Subra Kugathasan, James Markowitz, Frank M Ruemmele, Gigi Veereman, Harland Winter, Nicholas Masel, Chu Ri Shin, Kezhen L Tang, Meena Thayu
BACKGROUND AND AIMS: Immunosuppressive therapy for inflammatory bowel disease (IBD) in pediatric patients is thought to increase the risk of malignancy and lymphoproliferative disorders, including hemophagocytic lymphohistiocytosis (HLH). We compared unadjusted incidence rates of malignancy and HLH in pediatric patients with IBD exposed to infliximab (IFX) with patients not exposed to biologics and calculated standardized incidence ratios (SIRs). METHODS: We collected and analyzed data from 5766 participants in a prospective study of long-term outcomes of pediatric patients with IBD (NCT00606346), from May 31, 2007 through June 30, 2016...
June 2017: Gastroenterology
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