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Sepsis AND Pediatric

Jonathan A Harounian, Vijay A Patel, Michele M Carr
OBJECTIVE: To identify risk factors and determine perioperative morbidity of children under 2 years of age undergoing cervical abscess drainage. METHODS: Patients who underwent cervical abscess drainage 1-18 years of age were queried via the ACS-National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database (2012-2015). Analyzed outcomes include length of stay, operative time, readmission/reoperation rate, and postoperative complications. RESULTS: A total of 2181 children were identified, 858 were <2 (51...
January 2019: International Journal of Pediatric Otorhinolaryngology
Ben-Yi Fan, Lan Gu, Harripersaud Chand, Wen-Jun Liu, Jun-Bin Yuan
OBJECTIVES: To compare two different treatment strategies, one-stage and two-stage multi-tract mini-percutaneous nephrolithotomy (mt-mPCNL), for pediatric complex renal calculus disease. METHODS: Between the period of July 2016 and July 2018, a total of 36 children aged 15 years and younger, with complex renal calculi disease, who underwent total ultrasound-guided mt-mPCNL by a single experienced urologist were enrolled in our study. All patients were assigned either to Group 1 (n = 18) who received one-stage mt-mPCNL or Group 2 (n = 18) who received planned two-stage mt-mPCNL...
December 12, 2018: International Urology and Nephrology
Kang Cai, Yizhong Wang, Zhongqin Guo, Xiaonan Xu, Huajun Li, Qingli Zhang
Purpose: Streptococcus pneumoniae causes serious infections globally, including invasive pneumococcal disease (IPD). We analyze clinical features of pediatric IPD cases identified in China and antibiotic susceptibility of isolated pneumococcal strains. Methods: Confirmed pediatric IPD patients were prospectively recruited to the study. Symptoms at the time of hospitalization, laboratory tests, antimicrobial susceptibility of pneumococcal isolates, treatments, hospital stay, and residual findings at discharge were analyzed systematically...
2018: Infection and Drug Resistance
Jais Emmanuel, Adalberto Torres
Purpose To assess the impact of the automated surveillance of the electronic medical record process on clinical interventions among hospitalized children at a tertiary care pediatric center. Methods A retrospective chart review of the alerts triggered for central line-associated blood stream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), neonatal sepsis, or clinical deterioration through elevated pediatric early warning scores (PEWS) by automated electronic surveillance of the hospital electronic medical record (EMR) over a five-month period among hospitalized children...
October 1, 2018: Curēus
James D Fortenberry, Trung Nguyen, Jocelyn R Grunwell, Rajesh K Aneja, Derek Wheeler, Mark Hall, Geoffrey Fleming, Rod Tarrago, Sandra Buttram, Heidi Dalton, Yong Han, Kirk A Easley, Andrea Knezevic, Tian Dai, Matthew Paden, Joseph A Carcillo
OBJECTIVE: The objective was to compare the resolution of organ dysfunction, 28-day mortality, and biochemical markers in children with thrombocytopenia-associated multiple organ failure who received therapeutic plasma exchange versus no therapeutic plasma exchange. DESIGN: Observational longitudinal cohort study. SETTING: Nine U.S. PICUs. PATIENTS: Eighty-one children with sepsis-induced thrombocytopenia-associated multiple organ failure...
December 6, 2018: Critical Care Medicine
Idris V R Evans, Derek C Angus, Christopher W Seymour
No abstract text is available yet for this article.
December 4, 2018: JAMA: the Journal of the American Medical Association
Halden F Scott, Fran Balamuth, Raina M Paul
No abstract text is available yet for this article.
December 4, 2018: JAMA: the Journal of the American Medical Association
Feyza Hüsrevoğlu-Esen, Yasemin Altuner-Torun, Çiğdem Karakükçü, Seçil Köse, Ahmet Şehriyaroğlu, Dilek Kafadar, Aydın Esen, Mehmet Köse
Hüsrevoğlu-Esen F. Altuner-Torun Y, Karakükçü Ç, Köse S, Şehriyaroğlu A, Kafadar D, Esen A, Köse M. Gelsolin levels in patients with bronchiolitis. Turk J Pediatr 2018; 60: 286-289. Bronchiolitis is the leading cause of hospitalization in infants. Biomarkers can show severity of the disease and help in clinical management. In this study, the aim was to determine the clinical predictiveness of plasma gelsolin levels (pGSN) in acute bronchiolitis. From December 2013 to May 2014, 52 patients with bronchiolitis (aged < 24 months) were included in this study...
2018: Turkish Journal of Pediatrics
Ali Güngör, Neşe Yaralı, Ali Fettah, İkbal Ok-Bozkaya, Namık Özbek, Abdurrahman Kara
Güngör A, Yaralı N, Fettah A, Ok-Bozkaya İ, Özbek N, Kara A. Hereditary spherocytosis: Retrospective evaluation of 65 children. Turk J Pediatr 2018; 60: 264-269. Hereditary spherocytosis (HS) is a common cause of congenital hemolytic anemia in Caucasians and it could be diagnosed at any age. The aim of this study is to examine the demographic characteristics, clinical features and laboratory findings of children with HS and their complications observed during follow up. Sixty-five patients, with hereditary spherocytosis between January 2008 and September 2013, were enrolled into this retrospective study...
2018: Turkish Journal of Pediatrics
Titilola M Afolabi, Kathleen A Fairman
BACKGROUND: To support families managing the complex requirements of home parenteral nutrition (HPN) in pediatric patients, health professionals need information about HPN indications and complications. Nationally representative information is limited. METHODS: A retrospective cohort analysis of the Truven Health Market Scan Commercial Claims and Encounters Database was performed and identified 683 patients aged ≤18 years receiving HPN during dates of service from January 2013 through September 2015...
December 3, 2018: Nutrition in Clinical Practice
Shan Zhang, Xiaoke Dai, Chunbao Guo
Intravenous fluid prescription plays an important role in sepsis management, which may be associated with patient prognosis. The objective of the present study was to determine if the administration of crystalloid fluids is associated with clinical outcome for patients with severe sepsis and septic shock.The medical records of 79 patients with severe sepsis or septic shock at an academic tertiary care hospital between 2011 and 2016 were reviewed retrospectively. The patients were dichotomized based on the median 3-day amount of corrected crystalloid fluids as low (<193 mL/kg) versus high (>193 mL/kg)...
November 2018: Medicine (Baltimore)
Vijay Kumar
Sepsis is a major health problem all over the world. Despite its existence since the time of Hippocrates (470 BC), sepsis is still a serious medical problem for physicians working in both pediatric and adult intensive care units. The most current US FDA-approved drug called recombinant human activated protein C or Drotrecogin-α is also failed in clinical trials and showed similar effects as placebo. The epidemiological data and studies have indicated sepsis as a major socioeconomic burden all over the world...
December 1, 2018: Inflammation
Jessica K Creedon, Sigella Vargas, Lisa A Asaro, David Wypij, Raina Paul, Elliot Melendez
OBJECTIVES: Antibiotic administration within 1 hour of hypotension has been shown to reduce mortality. It is unknown whether antibiotics before hypotension in children who eventually meet criteria for septic shock improves outcomes. This study assesses whether antibiotic timing from the time of meeting criteria for sepsis in children with septic shock impacts morbidity and mortality. METHODS: This is a retrospective study of children 18 years or younger presenting to a tertiary free-standing children's hospital emergency department with sepsis that subsequently progressed to septic shock and were admitted to an intensive care unit from 2008 to 2012...
November 26, 2018: Pediatric Emergency Care
Charlene M T Robertson, Karin T Bork, Gerda Tawfik, Gwen Y Bond, Leonora Hendson, Irina A Dinu, Elham Khodayari Moez, Ivan M Rebeyka, Gonzalo Garcia Guerra, Ari R Joffe
OBJECTIVE: To reduce bilateral delayed-onset progressive sensory permanent hearing loss using a systems-wide quality improvement project with adherence to best practice for the administration of furosemide. DESIGN: Prospective cohort study with regular audiologic follow-up assessment of survivors both before and after a 2007-2008 quality improvement practice change. SETTING: The referral center in Western Canada for complex cardiac surgery, with comprehensive multidisciplinary follow-up by the Complex Pediatric Therapies Follow-up Program...
November 26, 2018: Pediatric Critical Care Medicine
Sunitha V Kaiser, Regina Lam, Gabby B Joseph, Charles McCulloch, Renee Y Hsia, Michael D Cabana, Naomi S Bardach
BACKGROUND: Adult hospital readmission rates can reliably identify meaningful variation in hospital performance; however, pediatric condition-specific readmission rates are limited by low patient volumes. OBJECTIVE: To determine if a National Quality Forum (NQF)-endorsed measure for pediatric lower respiratory illness (LRI) 30-day readmission rates can meaningfully identify high- and low-performing hospitals. DESIGN: Observational, retrospective cohort analysis...
November 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Martina Beckman, Matthew C Washam, Barbara DeBurger, David B Haslam, Joshua D Courter, Heidi Andersen, Joshua K Schaffzin, Michael J Tchou, Andrea Ankrum, Joel Mortensen
BACKGROUND: Targeted antimicrobial therapy can reduce morbidity in patients with sepsis. Molecular methodologies used in the clinical laboratory can provide information about infectious agents faster than traditional culture methods. Using molecular information to make clinical decisions more quickly has been shown to improve patient outcomes, and reduce length of stay and healthcare cost in adults. Its effect on pediatric care is less well described. METHODS: Blood cultures growing Gram-positive cocci or Gram-positive bacilli on Gram stain were evaluated by molecular and traditional methodologies...
October 14, 2018: Diagnostic Microbiology and Infectious Disease
Kevin J Downes, Julie C Fitzgerald, Emily Schriver, Craig L K Boge, Michael E Russo, Scott L Weiss, Fran Balamuth, Sherri E Kubis, Pam Tolomeo, Warren B Bilker, Jennifer H Han, Ebbing Lautenbach, Susan E Coffin, Jeffrey S Gerber
Background: Biomarkers can facilitate safe antibiotic discontinuation in critically ill patients without bacterial infection. Methods: We tested the ability of a biomarker-based algorithm to reduce excess antibiotic administration in patients with systemic inflammatory response syndrome (SIRS) without bacterial infections (uninfected) in our pediatric intensive care unit (PICU). The algorithm suggested that PICU clinicians stop antibiotics if (1) C-reactive protein <4 mg/dL and procalcitonin <1 ng/mL at SIRS onset and (2) no evidence of bacterial infection by exam/testing by 48 hours...
November 22, 2018: Journal of the Pediatric Infectious Diseases Society
Anselm Chi-Wai Lee
Macropolycytes are tetraploid neutrophils produced during accelerated myelopoiesis. They have been reported in adults with pernicious anemia, sepsis, and after cytotoxic chemotherapy. Two pediatric cases are reported, one after granulocyte colony-stimulating factor treatment and the other following Kawasaki disease, respectively.
November 20, 2018: Journal of Pediatric Hematology/oncology
Jack Garland, Winston Philcox, Kilak Kesha, Veronica Playle, Shanika Perera, Toni OʼRegan, Simon Stables, Rexson Tse
Diagnosing sepsis at postmortem is challenging. With respect to meningococcal sepsis, the postmortem microbiological identification of Neisseria meningitidis is nearly always due to true infection, including in cases of decomposition. Previous case series and case reports were able to isolate N. meningitidis in vitreous humor in adult deaths from meningococcal sepsis when blood and/or cerebrospinal fluid was unavailable. It was suggested that vitreous humor polymerase chain reaction (PCR) may be useful in the diagnosis of meningococcal sepsis...
November 20, 2018: American Journal of Forensic Medicine and Pathology
Thais Lira Cleto-Yamane, Conrado Lysandro Rodrigues Gomes, Jose Hermogenes Rocco Suassuna, Paulo Koch Nogueira
We performed a search in the MEDLINE database using the MeSH term: "Acute Kidney Injury", selecting the subtopic "Epidemiology", and applying age and year of publication filters. We also searched for the terms: "acute renal failure" and "epidemiology" "acute tubular necrosis" and "epidemiology" in the title and summary fields with the same filters. In a second search, we searched in the LILACS database, with the terms: "acute renal injury", or "acute renal failure" or "acute kidney injury" and the age filter...
November 14, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
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