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https://www.readbyqxmd.com/read/28989879/root-cause-analysis-of-diabetic-ketoacidosis-admissions-at-a-tertiary-referral-pediatric-emergency-department-in-north-india
#1
Muralidharan Jayashree, Rohit Sasidharan, Sunit Singhi, Karthi Nallasamy, Mullai Baalaaji
OBJECTIVES: To identify system-based factors contributing to Emergency Department (ED) admissions of children with diabetic ketoacidosis (DKA) and related complications with emphasis on parental and physician awareness and prereferral management. MATERIALS AND METHODS: A prospective observational root cause analysis study of all consecutive admissions of children with DKA to pediatric ED of a tertiary care referral hospital in northern India over a period of 1 year (July 2010-June 2011)...
September 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28983013/role-of-hiv-specific-cd8-t-cells-in-pediatric-hiv-cure-strategies-after-widespread-early-viral-escape
#2
Ellen M Leitman, Christina F Thobakgale, Emily Adland, M Azim Ansari, Jayna Raghwani, Andrew J Prendergast, Gareth Tudor-Williams, Photini Kiepiela, Joris Hemelaar, Jacqui Brener, Ming-Han Tsai, Masahiko Mori, Lynn Riddell, Graz Luzzi, Pieter Jooste, Thumbi Ndung'u, Bruce D Walker, Oliver G Pybus, Paul Kellam, Vivek Naranbhai, Philippa C Matthews, Astrid Gall, Philip J R Goulder
Recent studies have suggested greater HIV cure potential among infected children than adults. A major obstacle to HIV eradication in adults is that the viral reservoir is largely comprised of HIV-specific cytotoxic T lymphocyte (CTL) escape variants. We here evaluate the potential for CTL in HIV-infected slow-progressor children to play an effective role in "shock-and-kill" cure strategies. Two distinct subgroups of children were identified on the basis of viral load. Unexpectedly, in both groups, as in adults, HIV-specific CTL drove the selection of escape variants across a range of epitopes within the first weeks of infection...
October 5, 2017: Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28977299/saccharomyces-cerevisiae-fungemia-in-a-pediatric-patient-after-treatment-with-probiotics
#3
Mariá Ribas Romanio, Ligia Augusto Coraine, Vinicius Pignoti Maielo, Marcelo Luiz Abramczyc, Renato Lopes de Souza, Nilton Ferraro Oliveira
OBJECTIVE: To report the case of a one-year-old patient with a bloodstream infection associated with probiotics, and to discuss the indications and precautions concerning the therapeutic use of probiotics. CASE DESCRIPTION: A one-year-old male patient with Down syndrome in a late postoperative period of congenital cardiac disease correction. The patient was severely malnourished and had been hospitalized since he was two months old in the Pediatric Intensive Care Unit...
July 2017: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
https://www.readbyqxmd.com/read/28977099/fluid-overload-in-children-undergoing-mechanical-ventilation
#4
Clarice Laroque Sinott Lopes, Jefferson Pedro Piva
Patients admitted to an intensive care unit are prone to cumulated fluid overload and receive intravenous volumes through the aggressive resuscitation recommended for septic shock treatment, as well as other fluid sources related to medications and nutritional support. The liberal liquid supply strategy has been associated with higher morbidity and mortality. Although there are few prospective pediatric studies, new strategies are being proposed. This non-systematic review discusses the pathophysiology of fluid overload, its consequences, and the available therapeutic strategies...
September 28, 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28976467/fluid-resuscitation-in-pediatric-septic-shock-the-case-against-haste
#5
Teresa Kortz, Niranjan Kissoon
No abstract text is available yet for this article.
October 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28968807/chymase-is-a-predictive-biomarker-of-dengue-hemorrhagic-fever-in-pediatric-and-adult-patients
#6
Hasitha Tissera, Abhay P S Rathore, Wei Yee Leong, Brian L Pike, Tyler E Warkentien, Farouk S Farouk, Ayesa Syenina, Eng Eong Ooi, Duane J Gubler, Annelies Wilder-Smith, Ashley L St John
Background: Most dengue patients experience mild disease, dengue fever (DF), while few develop life-threatening severe disease, or dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS). No laboratory tests predict DHF/DSS. We evaluated whether serum chymase can predict DHF/DSS in adult and pediatric patients and the influence of pre-existing conditions (PECs) on chymase levels. Methods: Serum chymase levels were measured in patients presenting with undifferentiated fever to hospitals in Colombo District, Sri Lanka...
August 25, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28964286/the-expression-and-correlation-of-hsp-70-and-hsp-27-in-serous-middle-ear-effusion-fluids-of-pediatric-patients-a-preliminary-study
#7
Hyun Jin Min, Ji Won Choe, Moon Young Chang, Kyung Soo Kim, Sei Young Lee, Seog-Kyun Mun
OBJECTIVES: Several cytokines and innate immune-associated molecules are present in middle ear effusions, but damage-associated molecular patterns (DAMPs) in middle ear effusion have not been studied. Therefore, we evaluated the role of heat shock proteins (Hsps) in the development of otitis media with effusion (OME). METHODS: Serous middle ear effusions from 22 pediatric patients who were diagnosed with OME and underwent ventilation tube insertion from June 2015 to March 2017 were evaluated in our study...
October 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28941540/adjunctive-steroid-therapy-for-treatment-of-pediatric-septic-shock
#8
REVIEW
Jerry J Zimmerman
Septic shock remains the major cause of childhood morbidity and mortality worldwide. Although early sepsis recognition, fluid resuscitation, timely administration of antimicrobials, and vasoactive-inotropic drug infusions are all key to achieving good sepsis outcomes, therapy using various steroid drug classes remains an attractive adjunctive intervention to minimize the duration of septic shock and transition to multiple organ dysfunction syndrome. All steroid drug classes possess biological plausibility to affect a beneficial clinical effect among children with septic shock, but none has undergone rigorous, prospective assessment in a large, high-quality pediatric interventional trial...
October 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28940011/guidelines-for-the-diagnosis-and-management-of-critical-illness-related-corticosteroid-insufficiency-circi-in-critically-ill-patients-part-i-society-of-critical-care-medicine-sccm-and-european-society-of-intensive-care-medicine-esicm-2017
#9
Djillali Annane, Stephen M Pastores, Bram Rochwerg, Wiebke Arlt, Robert A Balk, Albertus Beishuizen, Josef Briegel, Joseph Carcillo, Mirjam Christ-Crain, Mark S Cooper, Paul E Marik, Gianfranco Umberto Meduri, Keith M Olsen, Sophia Rodgers, James A Russell, Greet Van den Berghe
OBJECTIVE: To update the 2008 consensus statements for the diagnosis and management of critical illness-related corticosteroid insufficiency (CIRCI) in adult and pediatric patients. PARTICIPANTS: A multispecialty task force of 16 international experts in Critical Care Medicine, endocrinology, and guideline methods, all of them members of the Society of Critical Care Medicine and/or the European Society of Intensive Care Medicine. DESIGN/METHODS: The recommendations were based on the summarized evidence from the 2008 document in addition to more recent findings from an updated systematic review of relevant studies from 2008 to 2017 and were formulated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology...
September 21, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28938253/guidelines-for-the-diagnosis-and-management-of-critical-illness-related-corticosteroid-insufficiency-circi-in-critically-ill-patients-part-i-society-of-critical-care-medicine-sccm-and-european-society-of-intensive-care-medicine-esicm-2017
#10
Djillali Annane, Stephen M Pastores, Bram Rochwerg, Wiebke Arlt, Robert A Balk, Albertus Beishuizen, Josef Briegel, Joseph Carcillo, Mirjam Christ-Crain, Mark S Cooper, Paul E Marik, Gianfranco Umberto Meduri, Keith M Olsen, Sophia C Rodgers, James A Russell, Greet Van den Berghe
OBJECTIVE: To update the 2008 consensus statements for the diagnosis and management of critical illness-related corticosteroid insufficiency (CIRCI) in adult and pediatric patients. PARTICIPANTS: A multispecialty task force of 16 international experts in critical care medicine, endocrinology, and guideline methods, all of them members of the Society of Critical Care Medicine and/or the European Society of Intensive Care Medicine. DESIGN/METHODS: The recommendations were based on the summarized evidence from the 2008 document in addition to more recent findings from an updated systematic review of relevant studies from 2008 to 2017 and were formulated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology...
September 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28924559/fire-in-the-operating-room-during-hypospadias-repair
#11
Alessandro Boscarelli, Simone Frediani, Silvia Ceccanti, Alice Cervellone, Maria Vittoria Pesce, Denis A Cozzi
Fire in the operating room (OR) is a very distressful and shocking occurrence with potential dramatic consequences. Despite safety rules and rigorous recommendations, such unintentional events do occur every so often. Notably, the vast majority of cases have been reported in the adult population, with very few pediatric cases described to date. Herein, we report on a 16-month-old boy undergoing reconstructive surgery for penoscrotal hypospadias, who experienced an OR fire most likely related to the use of alcohol-based solution ignited by monopolar electrocautery...
November 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28917068/group-a-streptococcal-bacteraemia-experience-at-king-fahad-medical-city-in-riyadh-saudi-arabia
#12
Fawzyh J Al-Khadidi, Mohammed A AlSheheri, Tariq S AlFawaz, Mushira A Enani, Abdulaziz A AlAqeel, Dayel A AlShahrani
To identify clinical presentation, predisposing factors, and the outcome in patients with Group A Streptococcal bacteremia. Methods: This is a retrospective study of 33 pediatric and adult patients with Streptococcus pyogenes bacteremia, admitted at King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia from 2007 to 2015. Results: Thirty-three patient records, documenting bacteremia with group A beta-hemolytic streptococcus, were reviewed. Approximately 51.5% were pediatric and 48.5% were adult patients, with a male to female ratio of 2:1...
October 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28901013/how%C3%A2-active-are-young-cardiac-device-patients-objective-assessment-of-activity-in-children-with-cardiac-devices
#13
Caridad M de la Uz, Ashley E Burch, Bruce Gunderson, Jodi Koehler, Samuel F Sears
BACKGROUND: The daily activity of pediatric patients with implantable cardiac devices provides behavioral evidence of functional outcomes. Modern devices provide continuous accelerometer data that are sensitive to movement, but normative values have not been published for pediatric activity rates. This study provides the first normative accelerometer data on activity rates in a large sample of pediatric cardiac device patients. METHODS: Patients were between 3 and 18 years old (N = 1,905) and implanted with a cardiac device from a single device company, and enrolled in remote monitoring...
September 12, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28894374/predicting-and-managing-sepsis-in-burn-patients-current-perspectives
#14
Omar Nunez Lopez, Janos Cambiaso-Daniel, Ludwik K Branski, William B Norbury, David N Herndon
Modern burn care has led to unprecedented survival rates in burn patients whose injuries were fatal a few decades ago. Along with improved survival, new challenges have emerged in the management of burn patients. Infections top the list of the most common complication after burns, and sepsis is the leading cause of death in both adult and pediatric burn patients. The diagnosis and management of sepsis in burns is complex as a tremendous hypermetabolic response secondary to burn injury can be superimposed on systemic infection, leading to organ dysfunction...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28881515/-characteristics-of-epidemiology-and-antimicrobial-resistance-of-gram-negative-bacterial-bloodstream-infections-in-children
#15
L Dong, X Y Zhang, C C Li, Z Li, Y Q Xia
Objective: To study the epidemiology and antimicrobial resistance of Gram-negative bacterial bloodstream infections in children, and to guide the choice of antimicrobials and the control of nosocomial infection. Method: Clinical data, bacteriology and antimicrobial susceptibility test results were collected retrospectively in hospitalized children who were diagnosed with gram-negative bacterial bloodstream infections in Yuying Children's Hospital of Wenzhou Medical University from January, 2010 to December, 2015...
September 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28881451/validation-of-a-pediatric-early-warning-system-for-hospitalized-pediatric-oncology-patients-in-a-resource-limited-setting
#16
Asya Agulnik, Alejandra Méndez Aceituno, Lupe Nataly Mora Robles, Peter W Forbes, Dora Judith Soberanis Vasquez, Ricardo Mack, Federico Antillon-Klussmann, Monica Kleinman, Carlos Rodriguez-Galindo
BACKGROUND: Pediatric oncology patients are at high risk of clinical deterioration, particularly in hospitals with resource limitations. The performance of pediatric early warning systems (PEWS) to identify deterioration has not been assessed in these settings. This study evaluates the validity of PEWS to predict the need for unplanned transfer to the pediatric intensive care unit (PICU) among pediatric oncology patients in a resource-limited hospital. METHODS: A retrospective case-control study comparing the highest documented and corrected PEWS score before unplanned PICU transfer in pediatric oncology patients (129 cases) with matched controls (those not requiring PICU care) was performed...
September 7, 2017: Cancer
https://www.readbyqxmd.com/read/28879205/pediatric-burn-resuscitation-past-present-and-future
#17
REVIEW
Kathleen S Romanowski, Tina L Palmieri
Burn injury is a leading cause of unintentional death and injury in children, with the majority being minor (less than 10%). However, a significant number of children sustain burns greater than 15% total body surface area (TBSA), leading to the initiation of the systemic inflammatory response syndrome. These patients require IV fluid resuscitation to prevent burn shock and death. Prompt resuscitation is critical in pediatric patients due to their small circulating blood volumes. Delays in resuscitation can result in increased complications and increased mortality...
2017: Burns and trauma
https://www.readbyqxmd.com/read/28876563/defining-predictors-of-mortality-in-pediatric-trauma-patients
#18
P Brysiewicz, D L Clarke, B Sartorius, J L Bruce, G L Laing
BACKGROUND: The aim of this study was to describe our cohort of pediatric trauma patients and to analyze their physiological data. The intention was to highlight the difficulty in using systolic blood pressure (SBP) readings in this population and to investigate the role of base excess (BE) in predicting clinical outcomes in pediatric trauma patien. METHOD: The Pietermaritzburg Metropolitan Trauma Service (PMTS) maintains a prospective digital trauma registry, and all pediatric trauma patients admitted to the service for the period January 2012 - July 2016 were included...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28873333/role-of-echocardiography-in-reducing-shock-reversal-time-in-pediatric-septic-shock-a-randomized-controlled-trial
#19
Ahmed A El-Nawawy, Aly M Abdelmohsen, Hadir M Hassouna
OBJECTIVE: To evaluate the role of echocardiography in reducing shock reversal time in pediatric septic shock. METHODS: A prospective study conducted in the pediatric intensive care unit of a tertiary care teaching hospital from September 2013 to May 2016. Ninety septic shock patients were randomized in a 1:1 ratio for comparing the serial echocardiography-guided therapy in the study group with the standard therapy in the control group regarding clinical course, timely treatment, and outcomes...
September 3, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28868586/the-correlation-between-inferior-vena-cava-diameter-measured-by-ultrasonography-and-central-venous-pressure
#20
Hans Vaish, Virendra Kumar, Rama Anand, Viswas Chhapola, Sandeep Kumar Kanwal
OBJECTIVE: To find a correlation between inferior vena cava (IVC) diameters, IVC compressibility index (CI) and central venous pressure (CVP). METHODS: Prospective observational study was done at pediatric intensive care unit (PICU) of Kalawati Saran Children's Hospital (KSCH). Fifty children aged 5-18 y, presenting with shock were enrolled for the study. IVC diameters, CI and relevant clinical data were noted at enrollment, 30 min, 1 h, 6 h, and 12 h. Central line was placed at the time of admission...
September 4, 2017: Indian Journal of Pediatrics
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