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Pediatric arrest

Isabelle Bragard, Nesrine Farhat, Marie-Christine Seghaye, Oliver Karam, Arthur Neuschwander, Yasaman Shayan, Katharina Schumacher
OBJECTIVES: Pediatric cardiac arrest is a rare event. Its management requires technical (TSs) and nontechnical skills (NTSs). We assessed the effectiveness of a simulation-based training to improve these skills in managing life-threatening pediatric cardiac arrhythmias. METHODS: Four teams, each composed of 1 pediatric resident, 1 emergency medicine resident, and 2 pediatric nurses, were randomly assigned to the experimental group (EG) participating in 5 video-recorded simulation sessions with debriefing or to the control group (CG) assessed 2 times with video-recorded simulation sessions without debriefing at a 2-week interval...
October 18, 2016: Pediatric Emergency Care
Mark Driscoll, Carl-Éric Aubin, Alain Moreau, Yaroslav Wakula, Samira Amini, Stefan Parent
STUDY DESIGN: In vivo porcine model utilized to evaluate the influence of an intravertebral fusionless growth modulating device (hemi-staple) on intervertebral disks and growth plates. OBJECTIVE: To evaluate the radiographic and histologic changes in disks and growth plates with the purpose of measuring influence of the explored hemi-staple. SUMMARY OF BACKGROUND DATA: Fusionless growth modulation for the early treatment of scoliosis should insure the long-term viability of the intervertebral disk and successfully reduce or arrest local growth...
November 2016: Clinical Spine Surgery
Joseph A Carcillo, J Michael Dean, Richard Holubkov, John Berger, Kathleen L Meert, Kanwaljeet J S Anand, Jerry Zimmerman, Christopher J Newth, Rick Harrison, Jeri Burr, Douglas F Willson, Carol Nicholson, Michael J Bell, Robert A Berg, Thomas P Shanley, Sabrina M Heidemann, Heidi Dalton, Tammara L Jenkins, Allan Doctor, Angie Webster
BACKGROUND: Nosocomial infection remains an important health problem in long stay (>3 days) pediatric intensive care unit (PICU) patients. Admission risk factors related to the development of nosocomial infection in long stay immune competent patients in particular are not known. METHODS: Post-hoc analysis of the previously published Critical Illness Stress induced Immune Suppression (CRISIS) prevention trial database, to identify baseline risk factors for nosocomial infection...
November 2016: Pediatric Infectious Disease Journal
Maureen O'Sullivan
Since its foundation by remarkably talented and insightful individuals, prominently including Pepper Dehner, pediatric soft tissue tumor pathology has developed at an immense rate. The morphologic classification of tumoral entities has extensively been corroborated, but has also evolved with refinement or realignment of these classifications, through accruing molecular data, with many derivative ancillary diagnostic assays now already well-established. Tumors of unclear histogenesis, classically morphologically undifferentiated, are prominent amongst pediatric sarcomas, however, the classes of undifferentiated round- or spindle-cell-tumors-not-otherwise-specified are being dismantled gradually with the identification of their molecular underpinnings...
September 5, 2016: Seminars in Diagnostic Pathology
Laurence Ducharme-Crevier, Michele G Mills, Priya M Mehta, Craig M Smith, Mark S Wainwright
BACKGROUND: The primary objective of this study was to characterize changes in cerebral blood flow measured using transcranial Doppler in children with central nervous system infections. We hypothesized that children with central nervous system infections have abnormal cerebral blood flow, associated with a greater frequency of complications and poor neurological outcome. METHODS: We conducted a single-center, retrospective study of children admitted to the neonatal or pediatric intensive care unit with central nervous system infection and undergoing transcranial Doppler as part of routine care between March 2011 and July 2015...
September 4, 2016: Pediatric Neurology
Mohammed Absi, Susheel Tk Kumar, Hitesh Sandhu
Extracorporeal membrane oxygenation was instituted as an aid to in-hospital cardiopulmonary resuscitation (E-CPR) nearly 23 years ago, this led to remarkable improvement in survival considering the mortality rate associated with conventional cardiopulmonary resuscitation (CPR). Given this success, one begins to wonder whether the time has come for expanding the use of E-CPR to outside hospital cardiac arrests especially in the light of development of newer extracorporeal life support devices that are small, mobile, and easy to assemble...
October 6, 2016: Pediatric Emergency Care
Jennifer F Ha, Waseem Ostwani, Glenn Green
INTRODUCTION: With the advent of improved neonatal and pediatric intensive care management, tracheostomy is increasingly performed in children requiring prolonged ventilation. Even though tracheostomy is generally a safe procedure, there remains mortality and morbidity associated with it. OBJECTIVE: We report a rare complication of a tracheostomy tube resulting in extensive erosion and posterior tracheal false pouch secondary to a large tracheostomy tube and high positive end expiratory pressure in a 12-month-old infant...
November 2016: International Journal of Pediatric Otorhinolaryngology
Lars W Andersen, Tia T Raymond, Robert A Berg, Vinay M Nadkarni, Anne V Grossestreuer, Tobias Kurth, Michael W Donnino
Importance: Tracheal intubation is common during pediatric in-hospital cardiac arrest, although the relationship between intubation during cardiac arrest and outcomes is unknown. Objective: To determine if intubation during pediatric in-hospital cardiac arrest is associated with improved outcomes. Design, Setting, and Participants: Observational study of data from United States hospitals in the Get With the Guidelines-Resuscitation registry...
October 4, 2016: JAMA: the Journal of the American Medical Association
Lisa Rank, Sebastian Veith, Eva C Gwosch, Janine Demgenski, Magdalena Ganz, Marjolijn C Jongmans, Christopher Vogel, Arthur Fischbach, Stefanie Buerger, Jan M F Fischer, Tabea Zubel, Anna Stier, Christina Renner, Michael Schmalz, Sascha Beneke, Marcus Groettrup, Roland P Kuiper, Alexander Bürkle, Elisa Ferrando-May, Aswin Mangerich
Genotoxic stress activates PARP1, resulting in the post-translational modification of proteins with poly(ADP-ribose) (PAR). We genetically deleted PARP1 in one of the most widely used human cell systems, i.e. HeLa cells, via TALEN-mediated gene targeting. After comprehensive characterization of these cells during genotoxic stress, we analyzed structure-function relationships of PARP1 by reconstituting PARP1 KO cells with a series of PARP1 variants. Firstly, we verified that the PARP1\E988K mutant exhibits mono-ADP-ribosylation activity and we demonstrate that the PARP1\L713F mutant is constitutively active in cells...
September 29, 2016: Nucleic Acids Research
Franceso Zulian, Marta Balzarin, Carolina Birolo
Juvenile Systemic Sclerosis (JSSc) is one of the most severe multi-systemic connective tissue conditions encountered in pediatric rheumatology. Due to its high morbidity and mortality rate, early diagnosis, proper assessment and effective treatment are crucial. Areas covered: In this review, we will focus on the recent advances on the classification and general management of JSSc based on the literature search and on the Authors' experience. Expert Commentary: Classification criteria for the pediatric forms of systemic sclerosis, the new proposed assessment tools, such as the juvenile systemic sclerosis severity score, named J4S, and new techniques for the internal organs assessment, will facilitate both daily practice and research projects...
October 3, 2016: Expert Review of Clinical Immunology
Bana Agha Nasser, Julinar Idris, Abdu Rahman Mesned, Tageldein Mohamad, Mohamed S Kabbani, Ali Alakfash
BACKGROUND: Outcomes of cardiopulmonary resuscitation (CPR) in children with congenital heart disease have improved and many children have survived after an in-hospital cardiac arrest. AIM: The purpose of this study is to determine predictors of poor outcome after CPR in critical children undergoing cardiac surgery. METHODS: We conducted a retrospective chart review and data analysis of all CPR records and charts of all postoperative cardiac children who had a cardiac arrest and required resuscitation from 2011 until 2015...
October 2016: Journal of the Saudi Heart Association
Dubravka Negovetić Vranić, Josipa Jurković, Jesenka Jeličić, Antonija Balenović, Gordana Stipančić, Ivana Čuković-Bagić
Medical emergencies that are life threatening can occur in dental practice. Complications may arise because of an underlying disease or a reaction to medication. Reactions to medications may be allergic and toxic. The most common reactions are toxic reactions to local anesthetics, whereas allergies occur mainly as a consequence of the application of antibiotics, usually penicillin. In response to stress, vasovagal syncope typically occurs. Other causes may be related to an underlying disease-specific pathology (such as acute asthma attack, diabetic ketoacidosis, hypoglycemia, or seizures) or accidents (aspiration of a foreign body causing obstruction of the respiratory system)...
March 2016: Acta Stomatologica Croatica
Kaiying Shen, Haiqing Cai, Zhigang Wang, Yunlan Xu
Elastic stable intramedullary nailing (ESIN) has became a well-accepted method of osteosynthesis of diaphyseal fractures in the skeletally immature patient for many advantages, the purpose of this study is to evaluate the preliminary results of this minimally invasive treatment for severely displaced distal tibial diaphyseal metaphyseal junction (DTDMJ) fractures.This study was carried out over a 6-year period. Twenty-one severely displaced DTDMJ fractures treated using ESIN were evaluated clinically and radiographically...
September 2016: Medicine (Baltimore)
Erich M Gauger, Lauren L Casnovsky, Erica J Gauger, Deborah C Bohn, Ann E Van Heest
This study reviewed the clinical history and management of acquired growth arrest in the upper extremity in pediatric patients. The records of all patients presenting from 1996 to 2012 with radiographically proven acquired growth arrest were reviewed. Records were examined to determine the etiology and site of growth arrest, management, and complications. Patients with tumors or hereditary etiology were excluded. A total of 44 patients (24 boys and 20 girls) with 51 physeal arrests who presented at a mean age of 10...
September 29, 2016: Orthopedics
Kathleen L Meert, Russell Telford, Richard Holubkov, Beth S Slomine, James R Christensen, J Michael Dean, Frank W Moler
OBJECTIVE: To investigate relationships between cardiac arrest characteristics and survival and neurobehavioral outcome among children recruited to the Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital trial. DESIGN: Secondary analysis of Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital trial data. SETTING: Thirty-six PICUs in the United States and Canada. PATIENTS: All children (n = 295) had chest compressions for greater than or equal to 2 minutes, were comatose, and required mechanical ventilation after return of circulation...
September 27, 2016: Pediatric Critical Care Medicine
Paul T Engels, Mete Erdogan, Sandy L Widder, Michael B Butler, Nelofar Kureshi, Kate Martin, Robert S Green
BACKGROUND: Although used primarily in the pediatric population for decades, the use of intraosseous (IO) devices in the resuscitation of severely injured adult trauma patients has recently become more commonplace. The objective of this study was to determine the experience level, beliefs and attitudes of trauma practitioners in Canada, Australia and New Zealand regarding the use of IO devices in adult trauma patients. METHODS: We administered a web-based survey to all members of 4 national trauma and emergency medicine organizations in Canada, Australia and New Zealand...
October 1, 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Aykut Çağlar, Adnan Ayvaz, Ahmet Güzeçiçek, Ali Yildirim, Utku Karaarslan, Aslan Babayiğit, Murat Duman
OBJECTIVE: An electrical injury (EI) is an emergency that causes high morbidity and mortality each year. The aim of this study was to define the epidemiological, clinical, and laboratory factors that might predict severe patients and cardiac arrest in pediatric EI cases. METHODS: All of the patients' medical files were reviewed retrospectively through a 2-year period for the demographic, clinical, and laboratory findings. The patients were classified into the severe injury group or the mild injury group...
September 23, 2016: Pediatric Emergency Care
Peter Faunø, Lone Rømer, Torsten Nielsen, Martin Lind
BACKGROUND: Anterior cruciate ligament reconstruction (ACLR) in skeletally immature patients can result in growth plate injury, which can cause growth disturbances. PURPOSE: To evaluate radiological tibial and femoral length and axis growth disturbances as well as clinical outcomes in skeletally immature ACLR patients treated with a transphyseal drilling technique. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A total of 39 pediatric patients with ACL injury and open physes at time of surgery, as diagnosed clinically and with magnetic resonance imaging (MRI), were treated using transphyseal ACLR using hamstring graft...
September 2016: Orthopaedic Journal of Sports Medicine
Lesley M Foley, Robert S B Clark, Alberto L Vazquez, T Kevin Hitchens, Henry Alexander, Chien Ho, Patrick M Kochanek, Mioara D Manole
BackgroundDisturbances in cerebral blood flow (CBF) and brain oxygenation (PbO2) are present early after pediatric cardiac arrest (CA). CBF-targeted therapies improved neurological outcome in our CA model. To assess the therapeutic window for CBF- and PbO2-targeted therapies, we propose to determine if CBF and PbO2 disturbances persist at 24 h after experimental pediatric CA.MethodsRegional CBF and PbO2 were measured at 24 h after asphyxial CA in immature rats (n=26, 6-8/group) using arterial spin label MRI and tissue electrodes, respectively...
September 16, 2016: Pediatric Research
Jorge López, Sarah N Fernández, Rafael González, María J Solana, Javier Urbano, Jesús López-Herce
AIMS: Actual resuscitation guidelines recommend 10 respirations per minute (rpm) for advanced pediatric life support. This respiratory rate (RR) is much lower than what is physiological for children. The aim of this study is to compare changes in ventilation, oxygenation, haemodynamics and return of spontaneous circulation (ROSC) rates with three RR. METHODS: An experimental model of asphyxial cardiac arrest (CA) in 46 piglets (around 9.5 kg) was performed. Resuscitation with three different RR (10, 20 and 30 rpm) was carried out...
2016: PloS One
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