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Thrombosis in children

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https://www.readbyqxmd.com/read/28721474/single-stick-tunneled-central-venous-access-using-the-jugular-veins-in-infants-weighing-less-than-5%C3%A2-kg
#1
Will S Lindquester, C Matthew Hawkins, Eric J Monroe, Anne E Gill, Giridhar M Shivaram, F Glen Seidel, Matthew P Lungren
BACKGROUND: Despite the demonstrated feasibility of the single-stick technique in the femoral vein, its use in neonates and infants for placing central lines in internal and external jugular veins has not been reported. OBJECTIVE: Describe and assess the safety and efficacy of tunneled jugular central venous catheter placement performed under ultrasound (US) and fluoroscopic guidance in neonates and infants weighing <5 kg using the single-stick technique at three tertiary pediatric hospitals...
July 18, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28712586/platelet-testing-to-guide-aspirin-dose-adjustment-in-pediatric-patients-after-cardiac-surgery
#2
Sirisha Emani, David Zurakowski, Michelle Mulone, James A DiNardo, Cameron C Trenor, Sitaram M Emani
OBJECTIVES: Thrombosis is associated with increased morbidity and mortality in pediatric patients undergoing cardiac surgery. Although aspirin commonly is used for thromboprophylaxis, the utility of laboratory-based tests that assess aspirin efficacy have not been evaluated. We sought to determine the relationship between platelet aggregation testing and aspirin dose adjustment on thrombosis rates in this population. METHODS: Pediatric patients undergoing cardiac surgery who received aspirin and underwent platelet testing were studied retrospectively...
June 20, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28710972/epidemiology-diagnosis-prevention-and-treatment-of-catheter-related-thrombosis-in-children-and-adults
#3
REVIEW
Lisa Baumann Kreuziger, Julie Jaffray, Marc Carrier
In this narrative review, the epidemiology, diagnosis, prevention strategies, and management of catheter-related thrombosis are outlined. Central venous catheters have significantly improved the quality of life of patients requiring chemotherapy, parenteral nutrition, and chronic transfusions. Catheter-related thrombosis (CRT) complicates between 1-5% of inserted catheters, with incidence varying between patient population, catheter type, and vein cannulated. Strategies to prevent CRT, including anticoagulation and locking solutions, have largely been ineffective...
July 4, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28704875/sonographic-and-doppler-sonographic-diagnosis-of%C3%A2-neonatal-ischemic-stroke
#4
Karl-Heinz Deeg
Children are particularly at risk for stroke in the neonatal period. 1/3 of all strokes in children occur during the perinatal period. The incidence of perinatal stroke is 1:4000. A differentiation is made between ischemic stroke and hemorrhagic stroke. Ischemic strokes are caused by arterial occlusion due to thrombosis or embolism. As a result of the nonspecific clinical symptoms in this age group, diagnosis is usually made too late. The only relatively specific symptom is focal cerebral seizure during the first week of life...
July 13, 2017: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/28694570/extrahepatic-portal-vein-obstruction-in-children-role-of-preoperative-imaging
#5
Shashidhar Achar, Hemonta Kumar Dutta, Rudra Kanta Gogoi
AIM: Extrahepatic portal vein obstruction (EHPVO) is characterized by features of recent thrombosis or portal hypertension with portal cavernoma as a sequel of portal vein obstruction. Imaging of spleno-portal axis is the mainstay for the diagnosis of EHPVO. The aim of this study is to analyze the role of imaging in the preoperative assessment of the portal venous system in children with EHPVO. MATERIALS AND METHODS: A hospital-based cross-sectional study was conducted on twenty children with EHPVO aged between 1 and 18 years over a period of 1 year...
July 2017: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/28693359/coagulation-monitoring-correlation-with-heparin-dose-in-pediatric-extracorporeal-life-support
#6
Katie Moynihan, Kerry Johnson, Lahn Straney, Christian Stocker, Ben Anderson, Prem Venugopal, John Roy
OBJECTIVES: Extracorporeal Life Support (ECLS) risks thrombotic and hemorrhagic complications. Optimal anti-coagulation monitoring is controversial. We compared coagulation tests evaluating the heparin effect in pediatric ECLS. METHODS: A retrospective study of children (<18yrs) undergoing ECLS over 12 months in a tertiary pediatric intensive care unit (PICU). Variables included anti-Factor Xa activity (anti-Xa), activated partial thromboplastin time (aPTT), activated clotting time (ACT) and thromboelastogram (TEG(®)6s) parameters: ratio and delta reaction (R) times (the ratio and difference, respectively, between R times in kaolin assays with and without heparinase)...
July 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28692549/a-case-of-familial-hemophagocytic-lymphohistiocytosis-type-4-with-involvement-of-the-central-nervous-system-complicated-with-infarct
#7
Saliha Ciraci, Alper Ozcan, Mustafa M Ozdemir, Samuel C C Chiang, Bianca Tesi, Akif M Ozdemir, Musa Karakukcu, Turkan Patiroglu, Can Acipayam, Selim Doganay, Hakan Gumus, Ekrem Unal
BACKGROUND: Familial hemophagocytic lymphohistiocytosis (HLH) is a fatal disease affecting infants and very young children. Central nervous system involvement of HLH can cause catastrophic results. METHOD: We present a case with cranial involvement of familial HLH type 4 who showed diffuse infiltration of white matter complicated with intracranial thrombosis. A 5-year-old girl from a consanguineous couple presented with fever and pancytopenia, and was referred to our hematology unit...
July 7, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28692445/normal-cerebral-vascular-pulsations-in-humans-changes-with-age-and-implications-for-microvascular-disease
#8
Mi O Kim, Yan Li, Fangfei Wei, Jiguang Wang, Michael F O'Rourke, Audrey Adji, Alberto P Avolio
BACKGROUND: Cerebral syndromes in older humans, secondary stroke in younger persons following trauma, and sickle cell anaemia in children, are linked by unexplained microvascular damage and high cerebral pressure or flow pulsations. The aim of this study was to characterize age-related pressure and flow waveforms patterns entering the brain, to explain these in terms of disturbed physiological function, and to consider clinical implications. METHOD: Blood flow velocity waves were measured in four cerebral vascular territories by transcranial Doppler of 1020 apparently normal patients (497 men, 21-78 years)...
July 7, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28689155/combination-of-hemostatic-therapies-for-treatment-of-patients-with-hemophilia-a-and-inhibitors
#9
Tami Livnat, Ivan Budnik, Sarina Levy-Mendelovich, Einat Avishai, Mudi Misgav, Assaf Arie Barg, Aharon Lubetsky, Tami Brutman-Barazani, Gili Kenet
BACKGROUND: Therapy application and monitoring of patients with hemophilia A (HA) and inhibitors are challenging. In the current study, combined FVIII - bypass therapy was implemented for a cohort of severe HA patients with inhibitors. METHODS: Plasma of 15 HA patients with inhibitors was spiked ex vivo with FVIII, rFVIIa, FEIBA and their combinations and thrombin generation (TG) was studied. Some patients who experienced hemarthroses or required minor surgeries were treated by a combined concomitant administration of FVIII+FEIBA as IV bolus doses...
June 27, 2017: Blood Cells, Molecules & Diseases
https://www.readbyqxmd.com/read/28686155/paediatric-venous-thromboembolism-a-report-from-the-italian-registry-of-thrombosis-in-children-riti
#10
Paola Giordano, Massimo Grassi, Paola Saracco, Angelo C Molinari, Chiara Gentilomo, Agnese Suppiej, Giuseppe Indolfi, Donatella Lasagni, Matteo Luciani, Fiammetta Piersigilli, Maria C Putti, Lidia L Rota, Stefano Sartori, Paolo Simioni
BACKGROUND: The Italian Registry of Thrombosis in Children (RITI) was established by a multidisciplinary team with the aims of improving knowledge about neonatal and paediatric thrombotic events in Italy and providing a preliminary source of data for the future development of specific clinical trials and diagnostic-therapeutic protocols. MATERIALS AND METHODS: We analysed the subset of RITI data concerning paediatric systemic venous thromboembolic events that occurred between January 2007 and June 2013...
June 30, 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28685192/venous-thrombosis-and-stenosis-after-peripherally-inserted-central-catheter-placement-in-children
#11
H Stella Shin, Alexander J Towbin, Bin Zhang, Neil D Johnson, Stuart L Goldstein
BACKGROUND: Peripherally inserted central catheters (PICCs) can lead to development of venous thrombosis and/or stenosis. The presence of venous thrombosis and/or stenosis may preclude children with chronic medical conditions from receiving lifesaving therapies, from hemodialysis in end-stage renal disease to total parenteral nutrition in short bowel syndrome. Several adult studies have found an association between PICCs and venous thrombosis and/or stenosis, but none has evaluated for this association in children...
July 6, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28670838/incidence-and-risk-factors-of-early-surgical-complications-in-young-renal-transplant-recipients-a-persistent-challenge
#12
Nathan Rodricks, Rahul Chanchlani, Tonny Banh, Karlota Borges, Jovanka Vasilevska-Ristovska, Diane Hebert, Viral Patel, Armando J Lorenzo, Rulan S Parekh
There is a paucity of data on the rate of urological and vascular complications in very young children after kidney transplant. We conducted a study on the incidence and risk factors for early post-transplant surgical complications in young recipients (<5 years) over three decades. The primary outcome was any urological or vascular complication within 30 days of transplant, and the secondary outcome was incidence rate of graft failure reported as per 1000 person-years. Risk factors associated with surgical complications were analyzed by logistic regression...
July 3, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28669642/compound-posterior-cruciate-ligament-and-popliteal-artery-injury-due-to-dog-bite-a-case-report
#13
Yashwant Singh Tanwar, Atin Jaiswal, Hitesh Lal, Ashok Rajput
Injuries due to dog bites are a common occurrence and are mostly trivial. Severe dog bite injuries requiring hospitalization and complex reconstructive procedures are more common in children. We present the case of a five year old child with popliteal artery thrombosis and compound Posterior Cruciate ligament injury due to a dog bite. The child was managed by immediate thrombectomy, meticulous debridement and knee spanning external fixation followed by Skin Grafting. At one year post surgery range of motion was 10-110°, with no distal neurovascular deficit and no sign of instability...
June 29, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28660695/cerebral-sinus-venous-thrombosis-during-childhood-acute-lymphoblastic-leukemia-therapy-risk-factors-and-management
#14
Khaled M Ghanem, Raghida M Dhayni, Carol Al-Aridi, Nidale Tarek, Hani Tamim, Anthony K C Chan, Raya Saab, Miguel R Abboud, Hassan El-Solh, Samar A Muwakkit
BACKGROUND: Cerebral sinus venous thrombosis (CSVT) is a rare but serious complication of childhood acute lymphoblastic leukemia (ALL) therapy. No available consensus exists regarding its risk factors and appropriate management due to the rarity of cases. PROCEDURES: Out of 209 ALL patients aged 1-21 years treated at the Children's Cancer Center of Lebanon between May 2002 and May 2015, 13 developed CSVT during therapy. Patient characteristics, clinical management, and outcomes were studied...
June 29, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28656474/dissecting-kawasaki-disease-a-state-of-the-art-review
#15
REVIEW
S M Dietz, D van Stijn, D Burgner, M Levin, I M Kuipers, B A Hutten, T W Kuijpers
Kawasaki disease (KD) is a pediatric vasculitis with coronary artery aneurysms (CAA) as its main complication. The diagnosis is based on the presence of persistent fever and clinical features including exanthema, lymphadenopathy, conjunctival injection, and changes to the mucosae and extremities. Although the etiology remains unknown, the current consensus is that it is likely caused by an (infectious) trigger initiating an abnormal immune response in genetically predisposed children. Treatment consists of high dose intravenous immunoglobulin (IVIG) and is directed at preventing the development of CAA...
June 27, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28650356/trending-fibrinolytic-dysregulation-fibrinolysis-shutdown-in-the-days-after-injury-is-associated-with-poor-outcome-in-severely-injured-children
#16
Christine M Leeper, Matthew D Neal, Christine J McKenna, Barbara A Gaines
OBJECTIVE: To trend fibrinolysis after injury and determine the influence of traumatic brain injury (TBI) and massive transfusion on fibrinolysis status. BACKGROUND: Admission fibrinolytic derangement is common in injured children and adults, and is associated with poor outcome. No studies examine fibrinolysis days after injury. METHODS: Prospective study of severely injured children at a level 1 pediatric trauma center. Rapid thromboelastography was obtained on admission and daily for up to 7 days...
July 22, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28643533/evaluation-of-variation-in-coagulation-among-children-with-mycoplasma-pneumoniae-pneumonia-a-case-control-study
#17
Tianhua Li, Haiying Yu, Weina Hou, Zhiyong Li, Chunfang Han, Lihong Wang
Objective Acute organ embolism in children with Mycoplasma pneumoniae pneumonia (MPP) has been reported, but changes in coagulation are unclear. This study aimed to investigate changes in coagulation in children with MPP. Methods A total of 185 children with MMP (cases) and 117 healthy children (controls) were recruited. We measured prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), and plasma fibrinogen (FIB) and D-dimer levels. Results Plasma FIB (3.39 ± 0.96 g/L vs 2...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28632503/the-catastrophic-antiphospholipid-syndrome-in-children
#18
Ellen J L Go, Kathleen M O'Neil
PURPOSE OF REVIEW: To review the difficult syndrome of catastrophic antiphospholipid syndrome, emphasizing new developments in the diagnosis, pathogenesis and treatment. RECENT FINDINGS: Few recent publications directly address pediatric catastrophic antiphospholipid syndrome (CAPS). Most articles are case reports or are data from adult and pediatric registries. The major factors contributing to most pediatric catastrophic antiphospholipid syndrome include infection and the presence of antiphospholipid antibodies, but complement activation also is important in creating diffuse thrombosis in the microcirculation...
June 16, 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28626543/cerebral-stroke-in-a-teenage-girl-with-paroxysmal-nocturnal-hemoglobinuria
#19
Francesco Gervasi, Lucia D'Amelio, Antonino Trizzino, Fabrizia Ferraro, Delia Russo, Giuseppe Santangelo, Francesca Cardella, Angela Trizzino, Floriana Di Marco, Piero Farruggia
We report a case of paroxysmal nocturnal hemoglobinuria (PNH) in a 14 year-old girl presenting a cerebral arterial thrombosis. The initial diagnosis was carential anemia due to menarche following identification of slight macrocytic anemia, leucopenia and mild thrombocytopenia at routine blood analysis. The child was eventually referred to a children's hospital after the onset of progressive fatigue, anorexia and paleness. Severe anemia (hemoglobin 6 g/dL) with negative Coombs test, mild leucopenia (white blood cells 4...
June 1, 2017: Hematology Reports
https://www.readbyqxmd.com/read/28620647/the-effect-and-safety-of-prostaglandin-administration-in-pediatric-liver-transplantation
#20
Céline Lironi, Valérie A McLin, Barbara E Wildhaber
BACKGROUND: Prostaglandins are often administered after liver transplantation (LT) to diminish ischemia-reperfusion injury (IRI), to favor liver recovery and to prevent vascular thrombosis. Possible beneficial effects in adult liver recipients are controversial, but the single existing pediatric small case series shows no significant impact of prostaglandin administration after LT. The purpose of this study was to analyze the effect of the prostaglandin dinoprostone in pediatric liver recipients...
June 2017: Transplantation Direct
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