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Pediatric Respiratory Medicine

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https://www.readbyqxmd.com/read/28531789/do-picu-patients-meet-technical-criteria-for-performing-indirect-calorimetry
#1
Megan R Beggs, Gonzalo Garcia Guerra, Bodil M K Larsen
BACKGROUND & AIMS: Indirect calorimetry (IC) is considered gold standard for assessing energy needs of critically ill children as predictive equations and clinical status indicators are often unreliable. Accurate assessment of energy requirements in this vulnerable population is essential given the high risk of over or underfeeding and the consequences thereof. The proportion of patients and patient days in pediatric intensive care (PICU) for which energy expenditure (EE) can be measured using IC is currently unknown...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28525961/passive-and-active-immunization-against-respiratory-syncytial-virus-for-the-young-and-old
#2
Tonya Villafana, Judith Falloon, M Pamela Griffin, Qing Zhu, Mark T Esser
Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infections in infants worldwide and also causes significant disease in the elderly. Despite 60 years of RSV research and vaccine development, there is only one approved medicine to prevent RSV infections. Palivizumab, a monoclonal antibody (mAb) against the RSV fusion (F) protein, is indicated for preterm infants and children at high-risk for RSV infections. It is an active time in RSV vaccine and mAb development with 14 vaccines and 2 mAbs currently being tested in clinical trials as of 13 February 2017...
May 19, 2017: Expert Review of Vaccines
https://www.readbyqxmd.com/read/28471437/the-clinical-spectrum-and-natural-history-of-early-onset-diseases-due-to-dna-polymerase-gamma-mutations
#3
Omar Hikmat, Charalampos Tzoulis, Wui K Chong, Latifa Chentouf, Claus Klingenberg, Carl Fratter, Lucinda J Carr, Prab Prabhakar, Nandhini Kumaraguru, Paul Gissen, J Helen Cross, Thomas S Jacques, Jan-Willem Taanman, Laurence A Bindoff, Shamima Rahman
PurposeMutations in POLG, the most common single-gene cause of inherited mitochondrial disease, are diagnostically challenging owing to clinical heterogeneity and overlap between syndromes. We aimed to improve the clinical recognition of POLG-related disorders in the pediatric population.MethodsWe performed a multinational, phenotype: genotype study using patients from three centers, two Norwegian and one from the United Kingdom. Patients with age at onset <12 years and confirmed pathogenic biallelic POLG mutations were considered eligible...
May 4, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/28459618/an-american-thoracic-society-national-heart-lung-and-blood-institute-workshop-report-addressing-respiratory-health-equality-in-the-united-states
#4
Juan C Celedón, Esteban G Burchard, Dean Schraufnagel, Carlos Castillo-Salgado, Marc Schenker, John Balmes, Enid Neptune, Kristin J Cummings, Fernando Holguin, Kristin A Riekert, Juan P Wisnivesky, Joe G N Garcia, Jesse Roman, Rick Kittles, Victor E Ortega, Susan Redline, Rasika Mathias, Al Thomas, Jonathan Samet, Jean G Ford
Health disparities related to race, ethnicity, and socioeconomic status persist and are commonly encountered by practitioners of pediatric and adult pulmonary, critical care, and sleep medicine in the United States. To address such disparities and thus progress toward equality in respiratory health, the American Thoracic Society and the National Heart, Lung, and Blood Institute convened a workshop in May of 2015. The workshop participants addressed health disparities by focusing on six topics, each of which concluded with a panel discussion that proposed recommendations for research on racial, ethnic, and socioeconomic disparities in pulmonary, critical care, and sleep medicine...
May 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28412073/pediatric-acute-flaccid-paralysis-enterovirus-d68-associated-anterior-myelitis
#5
James A Yoder, Michael Lloyd, Luke Zabrocki, Jonathan Auten
BACKGROUND: Enteroviral infections can cause acute flaccid paralysis secondary to anterior myelitis. Magnetic resonance imaging (MRI) is important in the diagnosis of this potentially devastating pediatric disease. Before the 2014 outbreak of Enterovirus D68 (EV-D68), the virus was considered a relatively benign disease. CASE REPORT: A fully immunized 8-year-old boy was brought to the emergency department complaining of a cough, headache, neck pain, and right arm pain and weakness...
April 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28398090/cardiopulmonary-exercise-testing-in-pediatrics
#6
Tim Takken, Bart C Bongers, Marco van Brussel, Eero A Haapala, Erik Hj Hulzebos
Aerobic fitness is an important determinant of overall health. Higher aerobic fitness has been associated with many health benefits. Because myocardial ischemia is rare in children, indications for exercise testing differ in children compared to adults. Pediatric exercise testing is imperative to unravel the physiological mechanisms of a reduced aerobic fitness and to evaluate intervention effects in children and adolescents with a chronic disease or disability. Cardiopulmonary exercise testing includes the measurement of respiratory gas exchange and is the gold standard for determining aerobic fitness, as well as for examining the integrated physiological responses to exercise in pediatric medicine...
April 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28390586/an-analysis-of-anaphylaxis-cases-at-a-single-pediatric-emergency-department-during-a-1-year-period
#7
Christopher D Wright, Mindy Longjohn, Phillip L Lieberman, Jay Adam Lieberman
BACKGROUND: Case series of anaphylaxis can vary regarding causes, treatments, and follow-up of patients. Unfortunately, case series that are specific to the pediatric population are few. OBJECTIVE: To describe confirmed cases of pediatric anaphylaxis in patients presenting to a pediatric hospital emergency department (ED). METHODS: We identified all ED visits with the International Classification of Diseases, Ninth Revision (ICD-9) codes 995...
April 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28328691/factors-associated-with-discharge-home-after-transfer-to-a-pediatric-emergency-department
#8
Erin R Peebles, Michael R Miller, Tim P Lynch, Janice A Tijssen
OBJECTIVES: The transfer of children from community emergency departments (EDs) to tertiary care pediatric EDs for investigations, interventions, or a second opinion is common. In order to improve health care system efficiency, we must have a better understanding of this population and identify areas for education and capacity building. METHODS: We conducted a retrospective chart review of all patients (aged 0-17 years) who were transferred from community ED to a pediatric ED from November 2013 to November 2014...
March 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28277413/community-primary-care-provider-preferences-for-emergency-department-follow-up-recommendations-a-regional-study
#9
Marissa A Hendrickson, Eta Obeya, Andrew R Wey, Philippe R Gaillard
BACKGROUND: Children who present to emergency departments (EDs) for care are frequently advised to follow up with their primary care providers (PCPs) after discharge; little is known about whether PCPs agree that follow-up advised by EDs is appropriate for their patients. OBJECTIVES: The aims of this study were to determine PCP preferences for follow-up recommendations given to their pediatric patients at the time of ED visits and to compare these preferences to reported emergency medicine provider (EMP) practice...
March 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28198756/utility-of-assessing-cytokine-levels-for-the-differential-diagnosis-of-pneumonia-in-a-pediatric-population
#10
Jian-Ming Zhou, Qing Ye
OBJECTIVES: Although pneumonia is easily diagnosed, determining the causative agent is difficult due to low pathogen detection rates. We performed a prospective observational study to evaluate the utility of measuring inflammatory cytokine levels to discriminate between pneumonia caused by typical bacteria, respiratory syncytial virus, or Mycoplasma pneumoniae in a pediatric population. DESIGN: Serum inflammatory cytokine levels at early stages of the disease were evaluated for pneumonia caused by the three different pathogenic microorganisms...
April 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28180024/ciliopathies-genetics-in-pediatric-medicine
#11
REVIEW
Machteld M Oud, Ideke J C Lamers, Heleen H Arts
Ciliary disorders, which are also referred to as ciliopathies, are a group of hereditary disorders that result from dysfunctional cilia. The latter are cellular organelles that stick up from the apical plasma membrane. Cilia have important roles in signal transduction and facilitate communications between cells and their surroundings. Ciliary disruption can result in a wide variety of clinically and genetically heterogeneous disorders with overlapping phenotypes. Because cilia occur widespread in our bodies many organs and sensory systems can be affected when they are dysfunctional...
March 2017: Journal of Pediatric Genetics
https://www.readbyqxmd.com/read/28163912/the-benefits-of-youth-are-lost-on-the-young-cardiac-arrest-patient
#12
REVIEW
Brian Griffith, Patrick Kochanek, Cameron Dezfulian
Children and young adults tend to have reduced mortality and disability after acquired brain injuries such as trauma or stroke and across other disease processes seen in critical care medicine. However, after out-of-hospital cardiac arrest (OHCA), outcomes are remarkably similar across age groups. The consistent lack of witnessed arrests and a high incidence of asphyxial or respiratory etiology arrests among pediatric and young adult patients with OHCA account for a substantial portion of the difference in outcomes...
2017: F1000Research
https://www.readbyqxmd.com/read/28124736/high-flow-nasal-cannula-hfnc-versus-nasal-continuous-positive-airway-pressure-ncpap-for-the-initial-respiratory-management-of-acute-viral-bronchiolitis-in-young-infants-a-multicenter-randomized-controlled-trial-tramontane-study
#13
Christophe Milési, Sandrine Essouri, Robin Pouyau, Jean-Michel Liet, Mickael Afanetti, Aurélie Portefaix, Julien Baleine, Sabine Durand, Clémentine Combes, Aymeric Douillard, Gilles Cambonie
PURPOSE: Nasal continuous positive airway pressure (nCPAP) is currently the gold standard for respiratory support for moderate to severe acute viral bronchiolitis (AVB). Although oxygen delivery via high flow nasal cannula (HFNC) is increasingly used, evidence of its efficacy and safety is lacking in infants. METHODS: A randomized controlled trial was performed in five pediatric intensive care units (PICUs) to compare 7 cmH2O nCPAP with 2 L/kg/min oxygen therapy administered with HFNC in infants up to 6 months old with moderate to severe AVB...
February 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28002689/design-and-implementation-of-a-telepediatric-primary-level-and-low-cost-system-to-reduce-unnecessary-patient-transfers
#14
Christian Cifuentes, Eduardo Romero, Javier Godoy
BACKGROUND: Most inhabitants in Latin America are concentrated in large urban foci with different access to facilities. Although the main hospitals offer specialized services, economically vulnerable populations cannot easily afford these services, the pediatric population being most affected. This article presents the design and implementation of a low cost telepediatric system, applied to primary care hospitals through a study in Bogotá, Colombia, mainly aimed to reduce the number of unnecessary transfers commonly sent to specialized medical services...
December 21, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/27955991/antibiotic-prescription-patterns-for-upper-respiratory-tract-infections-in-the-outpatient-qatari-population-in-the-private-sector
#15
Adeel Ajwad Butt, Cristina S Navasero, Bright Thomas, Salih Al Marri, Huda Al Katheeri, Asmaa Al Thani, Abdullatif Al Khal, Tasnim Khan, Abdul-Badi Abou-Samra
BACKGROUND: Antibiotics are often inappropriately prescribed for upper respiratory tract infections (URTIs) in developed countries. Data on the proportion of inappropriate prescriptions are lacking from the Middle East and other developing countries. METHODS: Health insurance claims for all antibiotics prescribed for URTIs in the private sector in the State of Qatar between May 2014 and December 2015 were retrieved. During the study period, health insurance was limited to Qatari nationals...
December 9, 2016: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/27903293/personalized-medicine-approach-confirms-a-milder-case-of-abat-deficiency
#16
A Besse, A K Petersen, J V Hunter, V Appadurai, S R Lalani, P E Bonnen
ABAT deficiency (OMIM 613163) is a rare inborn error of metabolism caused by recessive variants in the gene 4-aminobutyric acid transaminase (ABAT), which is responsible for both the catalysis of GABA and maintenance of nucleoside pools in the mitochondria. To date, only a few patients have been reported worldwide. Their clinical presentation has been remarkably consistent with primary features of severe psychomotor retardation, encephalopathy, hypotonia, and infantile-onset refractory epilepsy. We report a new case of ABAT deficiency that marks an important departure from previous clinical findings...
December 1, 2016: Molecular Brain
https://www.readbyqxmd.com/read/27892444/mortality-patterns-among-hospital-deaths
#17
R K Karki
Background Death occurring in hospital is medically certified by attending physicians with cause of death. In developing countries such as Nepal, limited resources are available related to the pattern of deaths that occur in hospitals, so that the health priorities can be selected wisely. Objective The objective of this study was to determine the pattern, frequency and causes of inpatient mortality in hospital. Method This was a retrospective study of all deaths occurred at the Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel from 1st January 2012 to 31st December 2013...
January 2016: Kathmandu University Medical Journal (KUMJ)
https://www.readbyqxmd.com/read/27890390/world-association-of-sleep-medicine-wasm-2016-standards-for-recording-and-scoring-leg-movements-in-polysomnograms-developed-by-a-joint-task-force-from-the-international-and-the-european-restless-legs-syndrome-study-groups-irlssg-and-eurlssg
#18
R Ferri, S Fulda, R P Allen, M Zucconi, O Bruni, S Chokroverty, L Ferini-Strambi, B Frauscher, D Garcia-Borreguero, M Hirshkowitz, B Högl, Y Inoue, A Jahangir, M Manconi, C L Marcus, D L Picchietti, G Plazzi, J W Winkelman, R S Zak
This report presents the results of the work by a joint task force of the International and European Restless Legs Syndrome Study Groups and World Association of Sleep Medicine that revised and updated the current standards for recording and scoring leg movements (LM) in polysomnographic recordings (PSG). First, the background of the decisions made and the explanations of the new rules are reported and then specific standard rules are presented for recording, detecting, scoring and reporting LM activity in PSG...
October 2016: Sleep Medicine
https://www.readbyqxmd.com/read/27855739/validation-of-polyvinylidene-fluoride-impedance-sensor-for-respiratory-event-classification-during-polysomnography-in-children
#19
Anne G Griffiths, Pallavi P Patwari, Darius A Loghmanee, Matthew J Balog, Irina Trosman, Stephen H Sheldon
STUDY OBJECTIVES: Polysomnography is the gold standard for diagnosis and characterization of severity of sleep-disordered breathing. Accuracy and reliability of the technology used are critical to the integrity of the study's interpretation. Strict criteria for obstructive sleep apnea in children are lacking and diagnosis often requires consideration of frequency of respiratory events in addition to other measures. Current American Academy of Sleep Medicine recommendations for pediatric patients includes use of respiratory inductance plethysmography (RIP) belts, whereas polyvinylidene fluoride (PVDF) belts are currently only acceptable for use in adults...
February 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/27825176/-pulmonary-hypertension-cologne-consensus-conference-2016
#20
REVIEW
Stephan Rosenkranz, Hossein Ardeschir Ghofrani, Ekkehard Grünig, Hans Klose, Horst Olschewski, Christian Opitz, Marius Hoeper
Recently, the updated European Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension (PH) have been published. The practical implementation of the guidelines considering country-specific aspects, current data and individual features is essential for clinical patient care. In order to accomplish this, in June 2016 the 2(nd) Cologne Consensus Conference organized by the PH working groups of the German Society of Cardiology (DGK), the German Society of Respiratory Medicine (DGP) and the German Society of Pediatric Cardiology (DGPK) was held in Cologne, Germany...
November 2016: Deutsche Medizinische Wochenschrift
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