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Pediatric arrest

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https://www.readbyqxmd.com/read/29147440/rare-presentation-of-adrenocortical-carcinoma-in-a-4-month-old-boy
#1
Sonali Malhotra, Apoorva R Waikar, Prabhsimranjot Singh, Ludovico Guarini, Elka Jacobson-Dickman, Roja Motaghedi, Irina Kazachkova
Adrenocortical carcinoma (ACC) is a rare malignancy and even rarer in infancy. Most of these tumors in pediatric age group are hormonally active and predominantly present with virilization. Cortisol hypersecretion presenting as Cushing syndrome is extremely rare and seen in older age groups. We report a 4-month-old infant who presented with linear growth arrest and excessive weight gain in early infancy, consequently diagnosed with ACC. On long-term follow-up for 7 years, he remained metastasis free following surgical resection and was not treated with chemotherapy...
June 2017: World Journal of Oncology
https://www.readbyqxmd.com/read/29140968/end-tidal-carbon-dioxide-use-for-tracheal-intubation-analysis-from-the-national-emergency-airway-registry-for-children-near4kids-registry
#2
Melissa L Langhan, Beth L Emerson, Sholeen Nett, Matthew Pinto, Ilana Harwayne-Gidansky, Kyle J Rehder, Conrad Krawiec, Keith Meyer, John S Giuliano, Erin B Owen, Keiko M Tarquinio, Ron C Sanders, Michael Shepherd, Gokul Kris Bysani, Asha N Shenoi, Natalie Napolitano, Sandeep Gangadharan, Simon J Parsons, Dennis W Simon, Vinay M Nadkarni, Akira Nishisaki
OBJECTIVE: Waveform capnography use has been incorporated into guidelines for the confirmation of tracheal intubation. We aim to describe the trend in waveform capnography use in emergency departments and PICUs and assess the association between waveform capnography use and adverse tracheal intubation-associated events. DESIGN: A multicenter retrospective cohort study. SETTING: Thirty-four hospitals (34 ICUs and nine emergency departments) in the National Emergency Airway Registry for Children quality improvement initiative...
November 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29135805/failure-of-invasive-airway-placement-on-the-first-attempt-is-associated-with-progression-to-cardiac-arrest-in-pediatric-acute-respiratory-compromise
#3
Hannah R Stinson, Vijay Srinivasan, Alexis A Topjian, Robert M Sutton, Vinay M Nadkarni, Robert A Berg, Tia T Raymond
OBJECTIVES: The aim of this study was to describe the proportion of acute respiratory compromise events in hospitalized pediatric patients progressing to cardiopulmonary arrest, and the clinical factors associated with progression of acute respiratory compromise to cardiopulmonary arrest. We hypothesized that failure of invasive airway placement on the first attempt (defined as multiple attempts at tracheal intubation, and/or laryngeal mask airway placement, and/or the creation of a new tracheostomy or cricothyrotomy) is independently associated with progression of acute respiratory compromise to cardiopulmonary arrest...
November 10, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29123910/management-of-pediatric-cannot-intubate-cannot-oxygenate
#4
Yohei Okada, Wataru Ishii, Norio Sato, Hirokazu Kotani, Ryoji Iiduka
Case: "Cannot intubate, cannot oxygenate" (CICO) is a rare, life-threatening situation. We describe a pediatric case of CICO and highlight some educational points.A 3-year-old boy who collapsed in the bathtub came to our emergency department. On admission, he went into cardiac arrest probably because of an airway obstruction. We judged his condition as CICO and carried out an emergent tracheostomy after several attempts to perform a cricothyroidotomy failed. We continued resuscitation; however, circulation did not return spontaneously...
October 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29117093/death-of-a-simulated-pediatric-patient-toward-a-more-robust-theoretical-framework
#5
Mary E McBride, Dana Aronson Schinasi, Michael Alice Moga, Shreepada Tripathy, Aaron Calhoun
INTRODUCTION: A theoretical framework was recently proposed that encapsulates learner responses to simulated death due to action or inaction in the pediatric context. This framework, however, was developed at an institution that allows simulated death and thus does not address the experience of those centers at which this technique is not used. To address this, we performed a parallel qualitative study with the intent of augmenting the initial framework. METHODS: We conducted focus groups, using a constructivist grounded theory approach, using physicians and nurses who have experienced a simulated cardiac arrest...
November 8, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29117092/the-development-and-validation-of-a-concise-instrument-for-formative-assessment-of-team-leader-performance-during-simulated-pediatric-resuscitations
#6
Lindsay D Nadkarni, Cindy G Roskind, Marc A Auerbach, Aaron W Calhoun, Mark D Adler, David O Kessler
AIM: The aim of this study was to assess the validity of a formative feedback instrument for leaders of simulated resuscitations. METHODS: This is a prospective validation study with a fully crossed (person × scenario × rater) study design. The Concise Assessment of Leader Management (CALM) instrument was designed by pediatric emergency medicine and graduate medical education experts to be used off the shelf to evaluate and provide formative feedback to resuscitation leaders...
November 8, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29114009/2017-american-heart-association-focused-update-on-pediatric-basic-life-support-and-cardiopulmonary-resuscitation-quality-an-update-to-the-american-heart-association-guidelines-for-cardio-pulmonary-resuscitation-and-emergency-cardiovascular-care
#7
REVIEW
Dianne L Atkins, Allan R de Caen, Stuart Berger, Ricardo A Samson, Stephen M Schexnayder, Benny L Joyner, Blair L Bigham, Dana E Niles, Jonathan P Duff, Elizabeth A Hunt, Peter A Meaney
This focused update to the American Heart Association guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care follows the Pediatric Task Force of the International Liaison Committee on Resuscitation evidence review. It aligns with the International Liaison Committee on Resuscitation's continuous evidence review process, and updates are published when the International Liaison Committee on Resuscitation completes a literature review based on new science. This update provides the evidence review and treatment recommendation for chest compression-only CPR versus CPR using chest compressions with rescue breaths for children <18 years of age...
November 6, 2017: Circulation
https://www.readbyqxmd.com/read/29097609/recent-advances-of-cell-cycle-inhibitor-therapies-for-pediatric-cancer
#8
REVIEW
Christopher C Mills, E A Kolb, Valerie B Sampson
This review describes the pivotal roles of cell-cycle and checkpoint regulators and discusses development of specific cell-cycle inhibitors for therapeutic use for pediatric cancer. The mechanism of action as well as the safety and tolerability of drugs in pediatric patients, including compounds that target CDK4/CDK6 (palbociclib, ribociclib, and abemaciclib), aurora kinases (AT9283 and MLN8237), Wee1 kinase (MK-1775), KSP (ispinesib), and tubulin (taxanes, vinca alkaloids), are presented. The design of mechanism-based combinations that exploit the cross-talk of signals activated by cell-cycle arrest, as well as pediatric-focused drug development, are critical for the advancement of drugs for rare childhood diseases...
November 2, 2017: Cancer Research
https://www.readbyqxmd.com/read/29095938/challenges-to-code-status-discussions-for-pediatric-patients
#9
Katherine E Kruse, Jason Batten, Melissa L Constantine, Saraswati Kache, David Magnus
OBJECTIVES: In the context of serious or life-limiting illness, pediatric patients and their families are faced with difficult decisions surrounding appropriate resuscitation efforts in the event of a cardiopulmonary arrest. Code status orders are one way to inform end-of-life medical decision making. The objectives of this study are to evaluate the extent to which pediatric providers have knowledge of code status options and explore the association of provider role with (1) knowledge of code status options, (2) perception of timing of code status discussions, (3) perception of family receptivity to code status discussions, and (4) comfort carrying out code status discussions...
2017: PloS One
https://www.readbyqxmd.com/read/29076969/compatibility-of-zoll-defibrillators-in-simulation-based-training
#10
Jamie Leigh Shoemaker, Olivia T Duty, Kenneth J Martin, Gary L Geis
INTRODUCTION: In response to the need for high-quality cardiopulmonary resuscitation (CPR) during cardiac arrest, our institution recently purchased ZOLL R Series monitor/defibrillators. This defibrillator provides CPR quality metrics and displays a filtered rhythm through compressions. Purchase of this defibrillator resulted in a practice change and heavily impacted our simulation-based training courses by requiring providers to practice CPR and defibrillation in as close to the real environment as possible...
October 25, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29076774/2016-survey-about-temperature-management-during-extracorporeal-circulation-in-china
#11
Zhen Guo, Xin Li
OBJECTIVE: In order to assess the current status of temperature management during cardiopulmonary bypass (CPB) in China and, thereby, implement standardized management protocols, the authors carried out a national survey about institutions performing CPB. METHOD: The survey was carried out from September 2015 to February 2016 and was supported by the Chinese Society of ExtraCorporeal Circulation. A total of 114 institutions participated, accounting for 15.64% (114/729) of the total of germane Chinese institutions, whereby, 80...
October 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29070149/use-of-silver-diamine-fluoride-for-dental-caries-management-in-children-and-adolescents-including-those-with-special-health-care-needs
#12
Yasmi O Crystal, Abdullah A Marghalani, Steven D Ureles, John Timothy Wright, Rosalyn Sulyanto, Kimon Divaris, Margherita Fontana, Laurel Graham
BACKGROUND: This manuscript presents evidence-based guidance on the use of 38 percent silver diamine fluoride (SDF) for dental caries management in children and adolescents, including those with special health care needs. A guideline workgroup formed by the American Academy of Pediatric Dentistry developed guidance and an evidence-based recommendation regarding the application of 38 percent SDF to arrest cavitated caries lesions in primary teeth. TYPES OF STUDIES REVIEWED: The basis of the guideline's recommendation is evidence from an existing systematic review "Clinical trials of silver diamine fluoride in arresting caries among children: A systematic review...
September 15, 2017: Pediatric Dentistry
https://www.readbyqxmd.com/read/29066844/treatment-of-necrotic-teeth-by-apical-revascularization-meta-analysis
#13
Ling He, Juan Zhong, Qimei Gong, Sahng G Kim, Samuel J Zeichner, Lusai Xiang, Ling Ye, Xuedong Zhou, Jinxuan Zheng, Yongxing Liu, Chenyu Guan, Bin Cheng, Junqi Ling, Jeremy J Mao
Each year ~5.4 million children and adolescents in the United States suffer from dental infections, leading to pulp necrosis, arrested tooth-root development and tooth loss. Apical revascularization, adopted by the American Dental Association for its perceived ability to enable postoperative tooth-root growth, is being accepted worldwide. The objective of the present study is to perform a meta-analysis on apical revascularization. Literature search yielded 22 studies following PRISMA with pre-defined inclusion and exclusion criteria...
October 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29058248/ventilation-during-cardiopulmonary-resuscitation-in-children-a-survey-on-clinical-practice
#14
Rafael González, Lázaro Pascual, Alexandra Sava, Sara Tolón, Javier Urbano, Jesus López-Herce
BACKGROUND: This study aimed to investigate the ventilation practice during cardiopulmonary resuscitation (CPR) and after return of spontaneous circulation (ROSC) in children. METHODS: An online survey of CPR practices was designed and sent to healthcare professionals treating children. RESULTS: A total of 477 healthcare professionals from 46 countries responded to this survey; 92.7% were physicians and 64.2% worked in pediatric intensive care units...
December 2017: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/29023307/interrater-agreement-of-eeg-interpretation-after-pediatric-cardiac-arrest-using-standardized-critical-care-eeg-terminology
#15
Nicholas S Abend, Shavonne L Massey, Mark Fitzgerald, France Fung, Natalie J Atkin, Rui Xiao, Alexis A Topjian
PURPOSE: We evaluated interrater agreement of EEG interpretation in a cohort of critically ill children resuscitated after cardiac arrest using standardized EEG terminology. METHODS: Four pediatric electroencephalographers scored 10-minute EEG segments from 72 consecutive children obtained 24 hours after return of circulation using the American Clinical Neurophysiology Society's (ACNS) Standardized Critical Care EEG terminology. The percent of perfect agreement and the kappa coefficient were calculated for each of the standardized EEG variables and a predetermined composite EEG background category...
November 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/29023218/out-of-hospital-pediatric-patient-safety-events-results-of-the-csi-chart-review
#16
Garth Meckler, Matthew Hansen, William Lambert, Kerth O'Brien, Caitlin Dickinson, Kathryn Dickinson, Joshua Van Otterloo, Jeanne-Marie Guise
OBJECTIVE: Studies of adult hospital patients have identified medical errors as a significant cause of morbidity and mortality. Little is known about the frequency and nature of pediatric patient safety events in the out-of-hospital setting. We sought to quantify pediatric patient safety events in EMS and identify patient, call, and care characteristics associated with potentially severe events. METHODS: As part of the Children's Safety Initiative -EMS, expert panels independently reviewed charts of pediatric critical ambulance transports in a metropolitan area over a three-year period...
October 12, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29019627/dry-drowning-myths-and-misconceptions
#17
M Denise Dowd
Drowning is a leading cause of death in children and is highly preventable. More than 10 people die of drowning in the United States each day, most of them adults. Rates of drowning are highest in children given their developmental vulnerabilities. Drowning incidents that result in cardiopulmonary arrest have a straightforward emergency clinical response, but the management approaches to the more common scenario of brief, nonfatal submersion is less clear. Clinicians must make clinical-care decisions based on evidence to provide safe and effective care in a timely manner and to help families avoid unnecessary anxiety...
October 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28991830/development-and-validation-of-an-empiric-tool-to-predict-favorable-neurologic-outcomes-among-picu-patients
#18
Punkaj Gupta, Mallikarjuna Rettiganti, Jeffrey M Gossett, Jennifer Daufeldt, Tom B Rice, Randall C Wetzel
OBJECTIVES: To create a novel tool to predict favorable neurologic outcomes during ICU stay among children with critical illness. DESIGN: Logistic regression models using adaptive lasso methodology were used to identify independent factors associated with favorable neurologic outcomes. A mixed effects logistic regression model was used to create the final prediction model including all predictors selected from the lasso model. Model validation was performed using a 10-fold internal cross-validation approach...
October 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28985969/modifiable-factors-associated-with-survival-after-out-of-hospital-cardiac-arrest-in-the-pan-asian-resuscitation-outcomes-study
#19
Hideharu Tanaka, Marcus E H Ong, Fahad J Siddiqui, Matthew H M Ma, Hiroshi Kaneko, Kyung Won Lee, Kentaro Kajino, Chih-Hao Lin, Han Nee Gan, Pairoj Khruekarnchana, Omer Alsakaf, Nik H Rahman, Nausheen E Doctor, Pryseley Assam, Sang Do Shin
STUDY OBJECTIVE: The study aims to identify modifiable factors associated with improved out-of-hospital cardiac arrest survival among communities in the Pan-Asian Resuscitation Outcomes Study (PAROS) Clinical Research Network: Japan, Singapore, South Korea, Malaysia, Taiwan, Thailand, and the United Arab Emirates (Dubai). METHODS: This was a prospective, international, multicenter cohort study of out-of-hospital cardiac arrest in the Asia-Pacific. Arrests caused by trauma, patients who were not transported by emergency medical services (EMS), and pediatric out-of-hospital cardiac arrest cases (<18 years) were excluded from the analysis...
October 3, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28984200/incorporating-genomic-transcriptomic-and-clinical-data-a-prognostic-and-stem-cell-like-myc-and-prc-imbalance-in-high-risk-neuroblastoma
#20
Xinan Holly Yang, Fangming Tang, Jisu Shin, John M Cunningham
BACKGROUND: Previous studies suggested that cancer cells possess traits reminiscent of the biological mechanisms ascribed to normal embryonic stem cells (ESCs) regulated by MYC and Polycomb repressive complex 2 (PRC2). Several poorly differentiated adult tumors showed preferentially high expression levels in targets of MYC, coincident with low expression levels in targets of PRC2. This paper will reveal this ESC-like cancer signature in high-risk neuroblastoma (HR-NB), the most common extracranial solid tumor in children...
October 3, 2017: BMC Systems Biology
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