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Pediatric mechanical support

M Tortajada-Girbés, M Mesa Del Castillo, H Larramona, J M Lucas, M Álvaro, A I Tabar, M J Jerez, A Martínez-Cañavate
Allergic respiratory diseases are major health problems in paediatric population due their high level of prevalence and chronicity, and to their relevance in the costs and quality of life. One of the most important risk factors for the development of airway diseases in children and adolescents is atopy. The mainstays for the treatment of these diseases are avoiding allergens, controlling symptoms, and preventing them through sustained desensitization by allergen immunotherapy (AIT). AIT is a treatment option that consists in the administration of increasing amounts of allergens to modify the biological response to them, inducing long-term tolerance even after treatment has ended...
October 21, 2016: Allergologia et Immunopathologia
Matteo Di Nardo, Graeme MacLaren, Marco Marano, Corrado Cecchetti, Paola Bernaschi, Antonio Amodeo
Extracorporeal life support (ECLS) is an important device in the management of children with severe refractory cardiac and or pulmonary failure. Actually, two forms of ECLS are available for neonates and children: extracorporeal membrane oxygenation (ECMO) and use of a ventricular assist device (VAD). Both these techniques have their own advantages and disadvantages. The intra-aortic balloon pump is another ECLS device that has been successfully used in larger children, adolescents, and adults, but has found limited applicability in smaller children...
2016: Frontiers in Pediatrics
Christopher A Flessner, Yolanda E Murphy, Elle Brennan, Alexandra D'Auria
Developmental models of pediatric anxiety posit multiple, maladaptive parenting behaviors as potential risk factors. Despite this, a standardized means of assessing multiple of these practices (i.e., anxiogenic parenting) in a comprehensive and efficient manner are lacking. In Study 1531 parents of children 7-17 years old completed an online survey via Amazon Mechanical Turk. In Study 2, a separate community sample (N = 109; 9-17 years old) was recruited and completed a comprehensive assessment battery as part of a larger study...
October 21, 2016: Child Psychiatry and Human Development
Anuja Bandyopadhyay, A Ioana Cristea, Stephanie D Davis, Veda L Ackerman, James E Slaven, Hasnaa E Jalou, Deborah C Givan, Ameet Daftary
RATIONALE: There is a lack of evidence regarding factors associated with failure of tracheostomy decannulation. OBJECTIVES: We aimed to identify characteristics of pediatric patients who fail a tracheostomy decannulation challenge Methods: A retrospective review was performed on all patients who had a decannulation challenge at a tertiary care center from June 2006 to October 2013. Tracheostomy decannulation failure was defined as reinsertion of the tracheostomy tube within 6 months of the challenge...
October 21, 2016: Annals of the American Thoracic Society
Adrienne Wang, Jacob Mouser, Jason Pitt, Daniel Promislow, Matt Kaeberlein
Pediatric mitochondrial disorders are a devastating category of diseases caused by deficiencies in mitochondrial function. Leigh Syndrome (LS) is the most common of these diseases with symptoms typically appearing within the first year of birth and progressing rapidly until death, usually by 6-7 years of age. Our lab has recently shown that genetic inhibition of the mechanistic target of rapamycin (TOR) rescues the short lifespan of yeast mutants with defective mitochondrial function, and that pharmacological inhibition of TOR by administration of rapamycin significantly rescues the shortened lifespan, neurological symptoms, and neurodegeneration in a mouse model of LS...
October 11, 2016: Oncotarget
Luiz F Caneo, Marcelo B Jatene
No abstract text is available yet for this article.
October 2016: Artificial Organs
Hiroyuki Matsuura, Fukiko Ichida, Tsutomu Saji, Shunichi Ogawa, Kenji Waki, Masahide Kaneko, Masahiro Tahara, Takashi Soga, Yasuo Ono, Satoshi Yasukochi
BACKGROUND: The 1st nationwide survey by the Japanese Society of Pediatric Cardiology and Cardiac Surgery of acute or fulminant myocarditis (AMC/FMC) in children revealed that the survival rate of FMC was only 51.6%. The 2nd nationwide survey was performed to evaluate the recent outcomes of pediatric myocarditis.Methods and Results:Questionnaires regarding patients aged ≤18 years with AMC/FMC during the period from January 2006 to December 2011 were mailed. A total of 221 cases (age 6...
October 4, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Muhammad Waseem, Audrey Paul, Gerald Schwartz, Denis Pauzé, Paul Eakin, Isabel Barata, Doug Holtzman, Lee S Benjamin, Joseph L Wright, Amanda B Nickerson, Madeline Joseph
BACKGROUND: Bullying is an important public health issue with broad implications. Although this issue has been studied extensively, there is limited emergency medicine literature addressing bullying. The emergency department (ED) physician has a unique opportunity to identify children and adolescents that are victims of bullying, and make a difference in their lives. OBJECTIVE: Our aim is to discuss the role of the emergency physician (EP) in identifying patients who have been victims of bullying and how to provide effective management as well as referral for further resources...
September 29, 2016: Journal of Emergency Medicine
Megan E Gornet, Michael P Kelly
Fractures of the second cervical vertebra (C2, axis) are common in adult spine surgery. Those fractures occurring in younger adult patients are often associated with high-energy mechanism trauma, resulting in a "Hangman's Fracture." Management of these fractures is often successful with nonoperative means, though surgery may be needed in those fractures with greater displacement and injury to the C2-C3 disc. Older patients are more likely to sustain fractures of the odontoid process. The evidence supporting surgical management of these fractures is evolving, as there may be a mortality benefit to surgery...
September 29, 2016: Current Reviews in Musculoskeletal Medicine
Glenn J R Whitman
Use of extracorporeal membrane oxygenation (ECMO), one of an increasing variety of mechanical circulatory support strategies, was first used close to 50 years ago. For decades, it was mostly applied to the pediatric population. However, during the past several years, its use has dramatically increased as therapy for pulmonary and cardiac failure in the adult. In particular, ECMO is being used more and more for postcardiotomy shock. Unfortunately, despite its increased application in this setting, improved outcomes have been hard to come by...
August 31, 2016: Journal of Thoracic and Cardiovascular Surgery
Hani Harb, Bilal Alashkar Alhamwe, Holger Garn, Harald Renz, Daniel P Potaczek
PURPOSE OF REVIEW: The goal of this review was to systematically analyze recent studies updating our knowledge on the role of epigenetic mechanisms in childhood asthma. RECENT FINDINGS: A systematic literature search was conducted that identified 23 fresh articles published within the last 5 years reporting the results of human studies on the relationships between epigenetic modifications and childhood asthma or its/related phenotypes. In almost all these studies, meaningful associations between levels of epigenetic marks (DNA methylation and/or histone modifications) and pediatric asthma or its/related phenotypes have been observed...
September 21, 2016: Current Opinion in Pediatrics
Susan M Hastings, Shriprasad Deshpande, Scott Wagoner, Kevin O Maher, David N Ku
Extracorporeal membrane oxygenation (ECMO) for cardiopulmonary support of critically ill patients is used frequently in the pediatric population. ECMO is burdened by complications, including thrombosis and hemorrhage. Here we demonstrate the focused location of clots, their histological composition, and the relationship of in situ thrombus to local hemodynamics in ECMO circuits.Pediatric ECMO circuits from Children's Healthcare of Atlanta, Emory University (Atlanta, GA) were obtained following removal from extracorporeal support over a 2...
September 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Roosevelt Bryant, Farhan Zafar, Chesney Castleberry, John L Jefferies, Angela Lorts, Clifford Chin, David L S Morales
The Berlin Heart EXCOR pediatric ventricular assist device is approved by the FDA for bridge to cardiac transplantation (BTT) in children. As the clinical outcomes of the EXCOR continue to be evaluated in the U.S., data on post transplant survival are needed. The UNOS database was used to identify patients < 18 years old undergoing orthotopic heart transplantation (OHT) from 6/2004 to 6/2014. Patients undergoing BTT with the EXCOR were identified. A matched cohort of (358) patients undergoing OHT without pre-transplant mechanical circulatory support (no-MCS) was also identified as controls...
September 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Apoorva Mulay, Khondoker Akram, Debbie Williams, Hannah Armes, Catherine Russell, Derek Hood, Stuart Armstrong, James P Stewart, Steve D M Brown, Lynne Bingle, Colin D Bingle
Otitis media (OM) or middle ear inflammation is the most common pediatric disease and leads to significant morbidity. Although understanding of underlying disease mechanisms is hampered by complex pathophysiology it is clear that epithelial abnormalities underpin the disease. There is currently a lack of a well characterised in vitro model of the middle ear (ME) epithelium that replicates the complex cellular composition of the middle ear. Here we report the development of a novel in vitro model of mouse middle ear epithelial cells (mMECs) at air liquid interface (ALI) that recapitulates the characteristics of the native murine ME epithelium...
September 22, 2016: Disease Models & Mechanisms
Victoria J Forster, Frederik W van Delft, Susan F Baird, Shona Mair, Roderick Skinner, Christina Halsey
PURPOSE: Methotrexate administration is associated with frequent adverse neurological events during treatment for childhood acute lymphoblastic leukemia. Here, we present evidence to support the role of common drug interactions and low vitamin B12 levels in potentiating methotrexate neurotoxicity. METHODS: We review the published evidence and highlight key potential drug interactions as well as present clinical evidence of severe methotrexate neurotoxicity in conjunction with nitrous oxide anesthesia and measurements of vitamin B12 levels among pediatric leukemia patients during therapy...
September 22, 2016: Cancer Chemotherapy and Pharmacology
Sophie Geoghegan, Kate Oulton, Catherine Bull, Joe Brierley, Mark Peters, Jo Wray
OBJECTIVE: Meeting the needs of parents of critically ill children is increasingly being recognized as an important factor in the child's clinical outcome as well as the implications it has for future parenting. Little is specifically known about the experience of parents who have a child in the ICU for a prolonged period. Our objective was to understand the experiences of this group to assist in the identification of mechanisms for providing support. DESIGN: Qualitative study based on semistructured interviews...
September 19, 2016: Pediatric Critical Care Medicine
James H Hertzog, Thomas E Pearson, Marc A Priest, Ellen Spurrier, Ryan R Davies
Ventricular assist devices (VADs) for the mechanical support of cardiac failure are being used more frequently in children of increasingly younger age. These children have significant and multiple medical comorbidities, and their length of hospital stay has been increasing. As this population of hospitalized VAD-supported children increases, so does the possibility of their need for interfacility transport for specialized diagnostic or therapeutic procedures. Reports on such transports are limited to 3 children who underwent scheduled elective transfers...
September 2016: Air Medical Journal
Edward Vincent S Faustino, Rainer Gedeit, Adam J Schwarz, Lisa A Asaro, David Wypij, Martha A Q Curley
OBJECTIVE: Identifying children ready for extubation is desirable to minimize morbidity and mortality associated with prolonged mechanical ventilation and extubation failure. We determined the accuracy of an extubation readiness test (Randomized Evaluation of Sedation Titration for Respiratory Failure extubation readiness test) in predicting successful extubation in children with acute respiratory failure from lower respiratory tract disease. DESIGN: Secondary analysis of data from the Randomized Evaluation of Sedation Titration for Respiratory Failure clinical trial, a pediatric multicenter cluster randomized trial of sedation...
September 14, 2016: Critical Care Medicine
Kevin M Valentine, Ajit A Sarnaik, Hitesh S Sandhu, Ashok P Sarnaik
OBJECTIVE: To describe the utility of high frequency jet ventilation (HFJV) as a rescue therapy in patients with respiratory failure secondary to respiratory syncytial virus (RSV) that was refractory to conventional mechanical ventilation (CMV). DESIGN: Descriptive study by retrospective review. SETTING: Pediatric intensive care unit at a tertiary care children's hospital. PATIENTS: Infants on mechanical ventilation for respiratory failure due to RSV...
2016: Frontiers in Pediatrics
Miguel Angel Palomero-Rodríguez, Héctor Chozas de Arteaga, Yolanda Laporta Báez, Jesús de Vicente Sánchez, Pascual Sanabria Carretero, Pilar Sánchez Conde, Antonio Pérez Ferrer
BACKGROUND: Over the last years, we have used a flow-inflating bag circuit with a nasotracheal or nasopharyngeal tube as an interface to deliver effective CPAP support in infants ("Mapleson D CPAP system"). The primary goal of this study was to assess the usefulness of the "Mapleson D CPAP system" for weaning of mechanical ventilation (MV) in infants who received MV over 24 h. MATERIALS AND METHODS: All infants who received MV for more than 24 h in the last year were enrolled in the study...
September 2016: Lung India: Official Organ of Indian Chest Society
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