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Sedation children

Patricia O'Connell, Benjamin Gaston, Tracey Bonfield, Theresa Grabski, David Fletcher, Steven L Shein
BACKGROUND: Periostin is a protein that serves as a downstream marker of the T-helper type 2 (Th2) cell response. It may serve to identify drug-responsive inflammatory phenotypes, particularly in children with asthma and possibly bronchiolitis. There are no published levels of periostin in healthy children <2 years of age, limiting interpretation of periostin levels in disease. We sought to explore the range of periostin levels of children <2 years without significant confounding illnesses...
December 11, 2018: Pediatric Pulmonology
Francesco Sulla, Melania Lachimia, Lucrezia Barbieri, Antonella Gigantiello, Concetta Iraci, Giulia Virgili, Giovanna Artioli, Leopoldo Sarli
BACKGROUND AND AIM OF THE WORK: Numerous negative outcomes of inadequate pain management among children have been cited in the literature. Inadequate pain management may be particularly detrimental to children and adolescents facing life-threatening injury or illness on a Paediatric Intensive Care Unit (PICU). It is therefore absolutely necessary that professionals utilize effective and efficient tools in order to evaluate a person's sensations of pain in the most objective way possible...
December 7, 2018: Acta Bio-medica: Atenei Parmensis
Sedat Giray Kandemirli, Feyza Kabar, Guzin Cakir Kandemirli, Nadide Basak Gulleroglu, Zeynep Yazici
Clavicle duplication is a rare entity with limited number of cases reported. Congenital origin and trauma related mechanisms are the main hypotheses to explain this anatomical variation. In skeletally immature patient, trauma may cause physeal-metaphyseal injury in the distal clavicle rather than acromioclavicular strain. The distal epiphysis remains in continuity with acromion and has an intact periosteal sleeve. The periosteal sleeve is extremely osteogenic, and may lead to new bone formation between epiphysis and displaced metaphysis...
December 8, 2018: Surgical and Radiologic Anatomy: SRA
Sedigheh Mozafar, Majid Bargrizan, Mojtaba Vahid Golpayegani, Shahnaz Shayeghi, Rahil Ahmadi
Background: This study compared the safety and efficacy of nitrous oxide (N2 O)/midazolam and N2 O/promethazine for dental treatment of uncooperative children. Materials and Methods: In this randomized, cross-over, clinical trial investigation Eighteen healthy uncooperative children with a pair of similar teeth requiring the same treatment were included. Combination of N2 O/midazolam was given in one visit, where N2 O/promethazine was administrated in the other appointment for each patient in a cross-over manner...
November 2018: Dental Research Journal
James J Brown, James M Gray, Mark G Roback, Usha Sethuraman, Ahmad Farooqi, Nirupama Kannikeswaran
BACKGROUND AND OBJECTIVES: Children with autism spectrum disorder (ASD) present more frequently to the emergency department (ED) than children with normal development, and frequently have injuries requiring procedural sedation. Our objective was to describe sedation practice and outcomes in children with ASD in the ED. METHODS: We performed a retrospective chart review of children with ASD who underwent sedation at two tertiary care EDs between January 2009-December 2016...
October 16, 2018: American Journal of Emergency Medicine
Kaitlin M Best, Lisa A Asaro, Martha A Q Curley
OBJECTIVE: To compare current analgesia and sedation management practices between critically ill children with pre-existing cognitive impairment and critically ill neurotypical children, including possible indicators of therapeutic efficacy. STUDY DESIGN: This study used secondary analysis of prospective data from the RESTORE clinical trial, with 2449 children admitted to the pediatric intensive care unit and receiving mechanical ventilation for acute respiratory failure...
December 5, 2018: Journal of Pediatrics
Jorge A Whitley, Shruthie Gnaneswaran, Molly Thach, Amy C Taylor, Paul A Merguerian, Kathleen Kieran
BACKGROUND: Many families wish to have radiologic tests performed locally, especially when obtaining these tests in specialized pediatric centers would require long-distance travel with associated costs and inconveniences. The differential availability of specialized and common pediatric uroradiographic tests in rural and urban areas has not been described. We undertook this study to describe the availability of common radiographic tests ordered by pediatric urologists, and to identify disparities in the availability of radiographic tests between urban and rural locations...
February 2019: Journal of Surgical Research
Pedro Bichaff, Karina T Setani, Emiliana H G Motta, Artur F Delgado, Werther B Carvalho, Michele Luglio
OBJECTIVE: Opioid abstinence syndrome is common in the pediatric intensive care environment because sedation is often needed during the children's treatment. There is no specific guideline regarding the management of these patients; and lately, methadone is an important drug for the prevention of abstinence symptoms during the weaning of opioids. This study gathers the available research to establish the initial dose of methadone, the rate of taper and tools to recognize this syndrome and act promptly...
October 2018: Revista da Associação Médica Brasileira
Rubina Malik, Dhanya Mullassery, Maren Kleine-Brueggeney, Ayad Atra, Anami Gour, Robin Sunderland, Bruce Okoye
OBJECTIVE: The objective of this study was to report our multidisciplinary diagnostic approach for patients with anterior mediastinal masses (AMM). METHODS: A retrospective review of patients with AMM at a tertiary pediatric surgical oncology centre (January 2011-December 2016) was performed. We analyzed data on clinical presentation, mode of tissue diagnosis, anesthetic techniques, and complications. RESULTS: Of the 44 patients admitted with AMM (median age 11 years, 27 males and 17 females), 22 had respiratory symptoms...
November 6, 2018: Journal of Pediatric Surgery
Francis J Gilchrist, Richard Buka, Mary Jones, Sheng Ang Ho, Warren Lenney, William D Carroll
Objectives: Chest CT is increasingly used to monitor disease progression in children with cystic fibrosis (CF) but there is no national guideline regarding its use. Our objective was to assess the indications for undertaking chest CT and the protocols used to obtain scans. Design Setting and participants: An electronic questionnaire was developed to assess clinicians views on chest CT in children with CF. It included general questions on perceived benefits and specific questions about its role in five clinical scenarios...
2018: BMJ paediatrics open
Fei Yang, Yang Liu, Qing Yu, Shangyingying Li, Jin Zhang, Mang Sun, Lu Liu, Yao Lei, Qing Tian, Hui Liu, Shengfen Tu
BACKGROUND: Intranasal procedural sedation using dexmedetomidine is well described in the literature. The combination of intranasal dexmedetomidine and ketamine is a novel approach for which there are little data on the rate of successful sedation or adverse events. OBJECTIVES: The aim of this study is to evaluate the rate of successful sedation and adverse events of intranasal procedural sedation using a combination of dexmedetomidine and ketamine for diagnostic examination in children...
November 28, 2018: Paediatric Anaesthesia
Ana Cláudia Mota Bonisson, Magda Lourenço Fernandes, Guilherme Freitas Araújo, Fabrício Eduardo Vieira, Luíza Melo Noronha, Renato Santiago Gomez
BACKGROUND AND OBJECTIVES: The combination of clonidine with local anesthetic administered for epidural anesthesia via caudal route seems to improve the quality of postoperative analgesia, but with conflicting results. This study compared the postoperative analgesia of three different doses of clonidine combined with bupivacaine in caudal epidural anesthesia in children undergoing hypospadias repair. METHODS: Eighty children aged 1 to 10 years, candidates for surgical repair of hypospadias, were randomly divided into four groups of 20 patients to receive general anesthesia combined with caudal epidural anesthesia with bupivacaine 0...
October 25, 2018: Revista Brasileira de Anestesiologia
Leanne M Aitken, Tracey Bucknall, Bridie Kent, Marion Mitchell, Elizabeth Burmeister, Samantha J Keogh
BACKGROUND: The sedation needs of critically ill patients have been recognized as a core component of critical care that is vital to assist recovery and ensure humane treatment. Evidence suggests that sedation requirements are not always optimally managed. Suboptimal sedation, both under- and over-sedation, have been linked to short-term (e.g. length of stay) and long-term (e.g. psychological recovery) outcomes. Strategies to improve sedation assessment and management have been proposed...
November 12, 2018: Cochrane Database of Systematic Reviews
Jose Carlos Flores-González, Ana Estalella-Mendoza, Patricia Rodríguez-Campoy, Mónica Saldaña-Valderas, Alfonso M Lechuga-Sancho
BACKGROUND: Upper gastrointestinal endoscopies (UGEs) performed under ketamine sedation may increase the risk of respiratory adverse events (RAEs) due to pharyngeal stimulation. Topical lidocaine prevents general anesthesia-induced laryngospasm. OBJECTIVE: Our objective was to determine whether topical lidocaine may reduce the incidence of RAEs induced by pharyngeal stimulation in UGEs performed on children sedated with ketamine. METHODS: We conducted a single-center prospective study...
November 27, 2018: Paediatric Drugs
Heng Chen, Jia Wang, Lucina Q Uddin, Xiaomin Wang, Xiaonan Guo, Fengmei Lu, Xujun Duan, Lijie Wu, Huafu Chen
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by atypical functional integration of brain regions. The vast majority of neuroimaging studies of ASD have focused on older children, adolescents, and adults with the disorder. Very little work has explored whole-brain functional connectivity of young children with ASD. Here, we collected resting-state functional magnetic resonance imaging data from 58 young children (mean age 4.98 years; 29 with ASD; 29 matched healthy controls [HC])...
November 26, 2018: Autism Research: Official Journal of the International Society for Autism Research
Camille E van Hoorn, Sanne E Hoeks, H Essink, Dick Tibboel, Jurgen C de Graaff
BACKGROUND: Recent experimental studies suggest that currently used anesthetics have neurotoxic effects on young animals. Clinical studies are increasingly published about the effects of anesthesia on the long term outcome, providing contradictory results. The selective alpha-2 adrenergic receptor agonist dexmedetomidine has been suggested as an alternative non-toxic sedative agent. AIM: The aim of this systematic review is to assess the potential neuroprotective and neurobehavioral effects of dexmedetomidine in young animals and children...
November 26, 2018: Paediatric Anaesthesia
Kayla A Harvey, Andrea Kovalesky
PURPOSE: Parents' and nurses' expectations about pain control and comfort in children after heart surgery were explored to contribute to evidence-based family-centered interventions. DESIGN AND METHODS: 20 nurses and 23 parents from a tertiary pediatric center in the Pacific Northwest, were interviewed about their expectations of children's pain control and comfort experience in the hospital after heart surgery. In this descriptive study, data were collected from semi-structured recall interviews and analyzed using content analysis...
November 2018: Journal of Pediatric Nursing
Yong Chen, Meng-Hsiang Chen, Kristine R Baluyot, Taylor M Potts, Jordan Jimenez, Weili Lin
Quantitative assessments of normative brain development using MRI are of critical importance to gain insights into healthy neurodevelopment. However, quantitative MR imaging poses significant technical challenges and requires prohibitively long acquisition times, making it impractical for pediatric imaging. This is particularly relevant for healthy subjects, where imaging under sedation is not clinically indicated. MR Fingerprinting (MRF), a novel MR imaging framework, provides rapid, efficient, and simultaneous quantification of multiple tissue properties...
November 22, 2018: NeuroImage
Valvanera Vozmediano, John C Lukas, Esther Encinas, Stephan Schmidt, Ander Sologuren, Román Valiente, Luis Labeaga, Cristina Campo, Mónica Rodriguez
Bilastine is a non-sedating second-generation H1 antihistamine approved for treatment of allergic rhinoconjunctivitis (AR) and urticaria (U) in adults at the oral (p.o.) dose of 20 mg once daily (OD). Optimal attributes can be anticipated for its clinical use in pediatrics due to its favorable safety and tolerability and age-independent PD profile. The aim of this work was to characterize bilastine PK in children through population modeling of data from a limited sampling confirmatory clinical trial in children with AR or U...
November 20, 2018: European Journal of Pharmaceutical Sciences
Zhendong Yang, Guangmin Song, Weidong Hu, Xiujing Dang, Guo Haijuan, Jingui Yu
Dexmendetomidine hydrochloride (DEX) is a new common adrenergic receptor agonist, which not only keeps children calm but also has analgesic effect. Dexmedetomidine hydrochloride will enable children to maintain the natural non-REM sleep, which can be stimulated sedation or language arousal. The aim of this study is to observe the sedative effect and adverse drug reactions of dexmedetomidine hydrochloride injection and propofol injection in MRI examination. In this study, no children in the experimental group were required to add sedative drugs, and 2 cases in the control group were treated with sedative drugs...
September 2018: Pakistan Journal of Pharmaceutical Sciences
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