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Thrombosis in children

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https://www.readbyqxmd.com/read/29779622/anticoagulation-during-ecmo-in-neonatal-and-paediatric-patients
#1
Rebecca Barton, Vera Ignjatovic, Paul Monagle
Extracorporeal Membrane Oxygenation (ECMO) is a form of Extracorporeal Life Support (ECLS) which is used frequently in the paediatric and neonatal setting to support either the pulmonary, or both the pulmonary and cardiac systems. Management of ECMO requires the use of systemic anticoagulation to prevent patient and circuit based thrombosis, which in turn increases the risk of haemorrhage. A number of coagulation tests, laboratory and point of care based, are used to monitor anticoagulation, however the evidence for correlation of the test results with level of anticoagulant and clinical outcomes in children remains poor...
May 8, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29778713/concluding-commentary-on-current-trends-to-enhance-the-clinical-safety-of-pediatric-transfusion-focusing-on-prevention-of-untoward-complications-of-hsc-transplantation-newer-strategies-for-improving-the-standards-of-safety-quality-of-stem-cells-expansion-for
#2
REVIEW
Irena Sniecinski, Jerard Seghatchian
Clinical practice and related diagnostic, development and research [DDR] strategies in pediatric transfusion and transplantation cover a broad range of multidisciplinary studies, performed by many professionals involved in this most challenging clinical field [1]. This commentary on the current position and future perspectives in pediatric transfusion field is aimed to highlight major unresolved transfusion complications in pediatric patients, namely red blood cell and platelet alloimmunisation, and new ones such as nosocomial infection, thrombosis and multi-organ failure...
May 16, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29756168/transsplenic-splenoportography-and-portal-venous-interventions-in-pediatric-patients
#3
Eric J Monroe, Ethan J Speir, C Matthew Hawkins, Giri Shivaram, Kevin S H Koo, Anne E Gill
BACKGROUND: Data regarding transsplenic portal venous access for diagnostic imaging and endovascular intervention in children are limited, possibly due to concerns regarding high bleeding risks and resultant underutilization. OBJECTIVE: To investigate the safety and utility of transsplenic splenoportography and portal venous interventions in children. MATERIALS AND METHODS: A retrospective review was performed of all pediatric patients undergoing percutaneous transsplenic portal venous access and intervention at two large tertiary pediatric institutions between January 2012 and April 2017 was performed...
May 13, 2018: Pediatric Radiology
https://www.readbyqxmd.com/read/29744657/transcatheter-intervention-of-coronary-obstructions-in-infants-children-and-young-adults
#4
Ryan Callahan, James E Lock, Pinak B Shah, Audrey C Marshall
This study assesses the characteristics of coronary obstructions that underwent transcatheter intervention in a pediatric catheterization laboratory, the procedural details, and patient outcomes. Acute cardiac failure due to coronary obstructions in children is rare. The role of catheter based intervention is largely unreported. Single center retrospective review between January 2000 and December 2016. Thirty-three patients (median age 2y/o [0-38], weighing 9.6 kg [2.2-91]) underwent 39 transcatheter interventions on 39 lesions, mainly left main coronary (16/39; 39%) and right coronary (9/39; 23%) arteries...
May 9, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29736556/-correct-positioning-of-central-venous-catheters-in-pediatrics-are-current-formulae-really-useful
#5
REVIEW
C Cleff, M Boensch, F Eifinger, J Hinkelbein
BACKGROUND: Correct positioning of a central venous catheter (CVC) tip in pediatric patients is very important. Malpositioning may lead to direct complications, such as arrhythmia and increase the risk of thrombosis, infections, valve failures or pericardial tamponade. OBJECTIVE: The aim of this review was to identify and summarize published formulae for the correct positioning of the CVC tip in children and to discuss the benefits of these formulae for the daily routine...
May 7, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29736261/choroidal-infarction-following-ophthalmic-artery-chemotherapy
#6
Kelley J Bohm, Y Pierre Gobin, Jasmine H Francis, Gabrielle McInerney, Anahita Dabo-Trubelja, Paul H Dalecki, Brian P Marr, David H Abramson
Background: Methylenetetrahydrofolate reductase (MTHFR) genetic mutations and intra-procedural inhaled nitrous oxide (N2 O) independently increase blood levels of homocysteine, a compound associated with thrombosis. Patients with MTHFR mutations who also receive N2 O during ophthalmic artery chemotherapy (OAC) for retinoblastoma may have a heightened thrombotic risk. Case presentations: Single-center retrospective review of pediatric patients with advanced retinoblastoma who received OAC and developed choroidal infarcts...
2018: International Journal of Retina and Vitreous
https://www.readbyqxmd.com/read/29726081/liver-transplantation-for-neonatal-onset-citrullinemia
#7
Roshni Vara, Anil Dhawan, Maesha Deheragoda, Stephanie Grünewald, Germaine Pierre, Nigel D Heaton, Hector Vilca-Melendez, Nedim Hadžić
Citrullinemia or ASS deficiency in its classical form presents in the neonatal period with poor feeding, hyperammonemia, encephalopathy, seizures, and if untreated can be fatal. Despite advances in medical therapy, neurocognitive outcomes remain suboptimal. LT has emerged as a potential management option. A retrospective single-center review identified 7 children with a median age of 1.1 years (range, 0.6-5.8) at referral. Five children presented clinically, and 2 were treated prospectively from birth due to positive family history...
May 3, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29724900/can-thrombophilia-predict-recurrent-catheter-related-deep-vein-thrombosis-in-children
#8
Maria L Avila, Nour Amiri, Sanja Stanojevic, Trang T Vu, Katherine Barron, Peter Krol, Natasha Yue, Suzan Williams, Leonardo R Brandão
The role of thrombophilia testing in predicting catheter-related deep vein thrombosis (DVT) after an incident (i.e., first) catheter-related DVT in children remains unclear. The present study investigated the association between thrombophilia and recurrent catheter-related DVT. Children with thrombophilia testing, performed according to the clinician's judgment and the family's preference, and a history of objectively confirmed catheter-related DVT were included in the study. Recurrent catheter-related DVT following placement of a new catheter was the main outcome...
May 3, 2018: Blood
https://www.readbyqxmd.com/read/29720096/celiac-crisis-a-rare-and-profound-presentation-of-celiac-disease-a-case-report
#9
Elizabeth Ann Forrest, Mark Wong, Srinivasa Nama, Siddharth Sharma
BACKGROUND: Celiac crisis is a life-threatening manifestation of celiac disease and is rare in adults, with only a handful of cases documented worldwide and mostly in children. CASE PRESENTATION: A profoundly emaciated 43-year-old female presented with profuse diarrhoea, shortness of breath, left leg swelling with ulceration and immobility (Body Mass Index (BMI) = 14.7 kg/m2 ). The patient had normal anion-gap metabolic acidosis (pH = 7.16) with persisting hypokalemia, hyponatremia, hypomagnesemia and hypophosphatemia...
May 2, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29709343/increased-risk-of-thrombosis-associated-with-peripherally-inserted-central-catheters-compared-with-conventional-central-venous-catheters-in-children-with-leukemia
#10
Pierre-Amaël Noailly Charny, Nathalie Bleyzac, Robin Ohannessian, Edouard Aubert, Yves Bertand, Cecile Renard
OBJECTIVE: To study the risk of catheter-associated thrombosis (CAT) between peripherally inserted central catheters (PICCs) and tunneled central venous catheters in children with leukemia. STUDY DESIGN: We analyzed all PICCs and conventional tunneled catheters placed in patients aged <18 years and admitted to our institute for leukemia treatment between February 2008 and April 2014. Cases of symptomatic CAT were confirmed by ultrasound and treated with low-molecular-weight heparin...
April 27, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29706493/intravenous-fish-oil-lipid-emulsion-prevents-catheter-related-thromboses-in-pediatric-patients-with-intestinal-failure
#11
Mohammad M Jami, Vrinda Bhardwaj, Russell J Merritt
A central venous catheter is a risk factor for deep vein thrombosis. We compared the incidence of deep vein thrombosis in children with intestinal failure patients receiving soy oil lipid emulsion (n = 35) vs fish oil lipid emulsion (n = 35). Ten deep vein thrombosis occurred in the soy oil lipid emulsion group, and none in the fish oil lipid emulsion group (P < .001).
April 26, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29706371/an-anticoagulation-protocol-for-use-after-congenital-cardiac-surgery
#12
Asha G Nair, Olubunmi O Oladunjoye, Cameron C Trenor, Meena LaRonde, Sarah J van den Bosch, Lynn A Sleeper, Christina VanderPluym, Sitaram M Emani, John N Kheir
BACKGROUND: Patients undergoing surgery for congenital heart disease are at high risk for bleeding as well as thrombosis in the postoperative period. The objective of the study was to describe the design and effects of implementing a standardized unfractionated heparin anticoagulation protocol for children after congenital heart surgery. METHODS: We created a tiered guideline for the postoperative management of bleeding and thrombosis. In patients treated with unfractionated heparin, anti-factor Xa activity level as well as activated partial thromboplastin time were used for dose titration...
April 7, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29703491/thrombosis-in-pediatric-patients-with-leukemia
#13
Sarina Levy-Mendelovich, Assaf Arie Barg, Gili Kenet
Acute lymphoblastic leukemia (ALL) is the most common type of cancer diagnosed in children. It is reportedly the most common malignancy associated with thromboembolism in the pediatric age group. Over the last 2 decades, venous thromboembolism (VTE) has been increasingly diagnosed among pediatric ALL patients with an estimated incidence ranging from about 5% (for symptomatic cases) to about 30-70% (following sequential imaging studies in asymptomatic children). The etiology is multifactorial and may stem from alterations of the hemostatic system following various chemotherapy protocols (including use of l-Asparaginase), the presence of central venous lines (CVL), as well as comorbidities, e...
April 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29697045/an-unexpected-case-of-post-operative-superior-caval-vein-syndrome
#14
Lynn Peng, Lisa Wise-Faberowski
Superior caval vein obstruction in children after congenital heart surgery has been more associated with thrombosis formation as result of single-ventricle palliation, infection, indwelling devices/catheters, or external compression. Many of these patients will present to the cardiac catheterisation laboratory for evaluation and possible intervention. We present an unusual case of superior caval vein obstruction in a patient after Tetralogy of Fallot repair.
April 26, 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29695022/catheter-related-arterial-thrombosis-in-neonates-and-children-a-systematic-review
#15
Mattia Rizzi, Neil Goldenberg, Mariana Bonduel, Shoshana Revel-Vilk, Ernest Amankwah, Manuela Albisetti
Catheter-related arterial thrombosis (CAT) is increasingly recognized in children. Available data are scarce and based on expert opinions. This systematic review aimed to identify knowledge on paediatric CAT. Among 3,484 publications, 22 met inclusion criteria. Fourteen reported on CAT due to umbilical arterial catheter (UAC), two to extremity indwelling catheter (EIC), one to both and five to cardiac catheter (CC). The overall cumulative incidence of CAT was 21% (95% confidence interval [CI], 13-31) with a relative incidence of 20% (95% CI, 10-33) for UAC and 11% (95% CI, 3-21) for CC-related CAT...
April 25, 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29690971/clinical-spectrum-and-outcome-of-cerebral-venous-sinus-thrombosis-in-children
#16
Iram Javed, Tipu Sultan, Zia Ur Rehman, Muhammad Rizwan Yaseen
OBJECTIVE: To determine clinical spectrum, neuroimaging finding and outcome of cerebral venous sinus thrombosis (CVST) in children. STUDY DESIGN: Descriptive and cross-sectional study. PLACE AND DURATION OF STUDY: Department of Paediatric Neurology, Children's Hospital and Institute of Child Health, Lahore, from 2015 to 2016. METHODOLOGY: Data was collected in a predesigned proforma by non-probability purposive sampling technique from all enrolled 32 patients fulfilling the inclusion criteria...
May 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29685556/pathophysiology-of-thrombosis-and-anticoagulation-post-fontan-surgery
#17
Chantal Attard, Joanna Huang, Paul Monagle, Vera Ignjatovic
The Fontan procedure has transformed the lives of children born with single-ventricle physiology, previously deemed inoperable. Worldwide, there are an increasing number of children with Fontan circulation, with the potential for survival into adulthood. Due to the abnormal circulation, Fontan patients have an increased risk of thromboembolic (TE) events, with up to 25% of events leading to death. Despite the importance of preventing TE events in this patient population, there is currently no clinical consensus on the optimal monitoring, thromboprophylaxis therapies, and treatment of these events...
April 14, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29678653/continued-ultrasound-surveillance-required-after-hand-ischemia-associated-with-trauma-in-children
#18
Melissa L Kirkwood, Khalil H Chamseddin, Brianne Hanson, Carlos H Timaran, Mujtaba Ali, Alexis D Jacob, John E Rectenwald
BACKGROUND: Hand ischemia following trauma in children is rare and the natural history after upper extremity arterial bypass in children is unknown. We hypothesize children with brachial artery repair are at long term risk of developing aneurysmal degeneration or Thrombosis thus necessitating annual duplex ultrasonography and physical examination. STUDY DESIGN: A retrospective review of children who had brachial artery repair (bypass or vein patch) for hand ischemia secondary to trauma at a level I trauma pediatric hospital was performed...
April 17, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29668568/transjugular-intrahepatic-portosystemic-shunt-insertion-for-the-management-of-portal-hypertension-in-children
#19
Lauren Johansen, Patrick McKiernan, Khalid Sharif, Simon McGuirk
OBJECTIVES: To describe our 20-year experience with transjugular intrahepatic portosystemic shunt (TIPSS) procedures for children with resistant portal hypertension (PHTN). METHODS: Retrospective review of all children that had a TIPSS performed at Birmingham Children's Hospital from 1 January 1995 - 1 January 2015. RESULTS: 40 children underwent 42 attempted TIPSS for resistant PHTN with recurrent variceal bleeding (n = 35), refractory ascites (n = 4), and hypersplenism (n = 1)...
April 17, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29668539/myeloproliferative-neoplasms-in-children-and-adolescents-and-thrombosis-at-unusual-sites-the-role-of-driver-mutations
#20
Laith Tafesh, Kathryn Musgrave, Wing Roberts, Dianne Plews, Peter Carey, Tina Biss
Myeloproliferative neoplasms (MPNs) in childhood and adolescence are rare and seldom complicated by thrombosis. We describe 3 cases of thrombosis at unusual sites in young patients with MPNs. In the pediatric MPN population, unlike in adult MPNs, a clonal mutation is identifiable in only a minority of cases (22% to 26%). All 3 of these individuals had JAK2 mutations driving the disease process. A literature search identified 19 cases of MPN-associated thrombosis in children. Seventeen of the 19 children (89...
April 17, 2018: Journal of Pediatric Hematology/oncology
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