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Pediatric mechanical support

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https://www.readbyqxmd.com/read/29149393/challenges-in-minor-tbi-and-indications-for-head-ct-in-pediatric-tbi-an-update
#1
Navneet Singh, Ash Singhal
INTRODUCTION: Pediatric head trauma is one of the commonest presentations to emergency departments. Over 90% of such head injuries are considered mild, but still present risk acute clinical deterioration and longer term morbidity. Identifying which children are at risk of clinically important brain injuries remains challenging and much of the data on minor head injuries is based on the adult population. CHALLENGES IN PEDIATRICS: Children, however, are different, both anatomically and in terms of mechanism of injury, to adults and, even within the pediatric group, there are differences with age and stage of development...
October 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29129252/design-for-the-sacubitril-valsartan-lcz696-compared-with-enalapril-study-of-pediatric-patients-with-heart-failure-due-to-systemic-left-ventricle-systolic-dysfunction-panorama-hf-study
#2
Robert Shaddy, Charles Canter, Nancy Halnon, Lazaros Kochilas, Joseph Rossano, Damien Bonnet, Christopher Bush, Ziqiang Zhao, Paul Kantor, Michael Burch, Fabian Chen
BACKGROUND: Sacubitril/valsartan (LCZ696) is an angiotensin receptor neprilysin inhibitor approved for the treatment of adult heart failure (HF); however, the benefit of sacubitril/valsartan in pediatric HF patients is unknown. STUDY DESIGN: This global multi-center study will use an adaptive, seamless two-part design. Part 1 will assess the pharmacokinetics/pharmacodynamics of single ascending doses of sacubitril/valsartan in pediatric (1 month to <18 years) HF patients with systemic left ventricle and reduced left ventricular systolic function stratified into 3 age groups (Group 1: 6 to <18 years; Group 2: 1 to <6 years; Group 3: 1 month to <1 year)...
November 2017: American Heart Journal
https://www.readbyqxmd.com/read/29128319/a-proteomic-investigation-into-mechanisms-underpinning-corticosteroid-effects-on-neural-stem-cells
#3
Rawaa S Al-Mayyahi, Luke D Sterio, Joanne B Connolly, Christopher F Adams, Wa'il A Al-Tumah, Jon Sen, Richard D Emes, Sarah R Hart, Divya M Chari
Corticosteroids (CSs) are widely used clinically, for example in pediatric respiratory distress syndrome, and immunosuppression to prevent rejection of stem cell transplant populations in neural cell therapy. However, such treatment can be associated with adverse effects such as impaired neurogenesis and myelination, and increased risk of cerebral palsy. There is increasing evidence that CSs can adversely influence key biological properties of neural stem cells (NSCs) but the molecular mechanisms underpinning such effects are largely unknown...
November 8, 2017: Molecular and Cellular Neurosciences
https://www.readbyqxmd.com/read/29114700/invasive-candidiasis-in-pediatric-patients-at-king-fahad-medical-city-in-central-saudi-arabia-a-5-year-retrospective-study
#4
Zainab Almooosa, Gasmelseed Y Ahmed, Abeer Omran, Ayah AlSarheed, Afnan Alturki, Abdulaziz Alaqeel, Mohammed Alshehri, Tariq Alfawaz, Dayel AlShahrani
To identify predisposing factors, species distribution, antifungal susceptibility, and outcome. Methods: This study is a retrospective chart review that was conducted at a children's hospital at King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia. One hundred twenty-nine children with invasive candidiasis who were admitted between January 2010 and January 2015. Results: The statistical analysis results have revealed a group of risk factors; prematurity in 37 (28.7%) of patients, low birth weight in 42 (32...
November 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/29107545/infectious-complications-of-ventricular-assist-device-use-in-children-in-the-united-states-data-from-the-pediatric-interagency-registry-for-mechanical-circulatory-support-pedimacs
#5
Scott R Auerbach, Marc E Richmond, Kurt R Schumacher, Dalia Lopez-Colon, Max B Mitchell, Mark W Turrentine, Ryan S Cantor, Robert A Niebler, Pirooz Eghtesady
BACKGROUND: Infections are frequent in pediatric ventricular assist device (VAD) patients. In this study we aimed to describe infections in durable VAD patients reported to Pedimacs. METHODS: Durable VAD data from the Pedimacs registry (September 19, 2012 to December 31, 2015) were analyzed. Infections were described with standard descriptive statistics, Kaplan-Meier analysis and competing outcomes analysis. RESULTS: There were 248 implants in 222 patients, with a mean age and a median follow-up of 11 ± 6...
October 3, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29105103/development-of-a-pediatric-cardiac-mechanical-support-program
#6
Abhishek Kashyap, Joseph W Turek, Samantha J Wagner, Laura Felderman, Elizabeth A Jaggers, Peter J Gruber, R Erik Edens
The development of a pediatric cardiac support program is a complex, multidisciplinary project. This study describes the University of Iowa Congenital Heart Program's experience from its inception to the present. In, we examine those specific factors that have led to substantial improvements in the program, additionally identifying where further gains can be made. We retrospectively reviewed all pediatric patients who received mechanical cardiac support at the University of Iowa from the inception of the program in 1991...
November 3, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29104480/heart-failure-and-mortality-of-adult-survivors-from-acute-myocarditis-requiring-intensive-care-treatment-a-nationwide-cohort-study
#7
Jung-Jung Chang, Ming-Shyan Lin, Tien-Hsing Chen, Dong-Yi Chen, Shao-Wei Chen, Jen-Te Hsu, Po-Chang Wang, Yu-Sheng Lin
Background The correlation between severity and long-term outcomes of pediatric myocarditis have been reported, however this correlation in adults has rarely been studied. Materials and Methods This nationwide population-based cohort study used data from the National Health Insurance Research Database in Taiwan. Patients aged < 75 and > 18 years admitted to an intensive care unit due to acute myocarditis were enrolled and divided into three groups according to mechanical circulatory support (MCS) after excluding major comorbidities...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/29102815/combining-genetic-and-epigenetic-parameters-of-the-serotonin-transporter-gene-in-obsessive-compulsive-disorder
#8
Edna Grünblatt, Zoya Marinova, Alexander Roth, Elena Gardini, Juliane Ball, Julia Geissler, Tomasz K Wojdacz, Marcel Romanos, Susanne Walitza
While genetic variants have been reported to be associated with obsessive-compulsive disorder (OCD), the small effect sizes suggest that epigenetic mechanisms such as DNA methylation may also be relevant. The serotonin transporter (SLC6A4) gene has been extensively investigated in relation to OCD, since serotonin reuptake inhibitors are the pharmacological treatment of choice for the disorder. The current study set three questions: Firstly, whether the high expressing loci of the SLC6A4 polymorphisms, 5-HTTLPR + rs25531, rs25532 and rs16965628 are associated with family-based (n = 164 trios) and case-control OCD (n = 186, 152, respectively)...
October 16, 2017: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/29101238/glucocorticoid-resistance-is-reverted-by-lck-inhibition-in-pediatric-t-cell-acute-lymphoblastic-leukemia
#9
Valentina Serafin, Giorgia Capuzzo, Gloria Milani, Sonia Anna Minuzzo, Marica Pinazza, Roberta Bortolozzi, Silvia Bresolin, Elena Porcù, Chiara Frasson, Stefano Indraccolo, Giuseppe Basso, Benedetta Accordi
Pediatric T-acute lymphoblastic leukemia (T-ALL) patients often display resistance to glucocorticoid (GC) treatment. These patients, classified as Prednisone Poor Responders (PPR), have poorer outcome compared to the other pediatric T-ALL patients receiving a high-risk adapted therapy. Since glucocorticoids are administered to ALL patients during all the different phases of therapy, GC resistance represents an important challenge to be addressed in order to improve the outcome for these patients. Mechanisms underlying resistance are not yet fully unraveled, thus our research focused on the identification of deregulated signaling pathways to point out new targeted approaches...
November 3, 2017: Blood
https://www.readbyqxmd.com/read/29096807/eosinophilic-myocarditis-characteristics-treatment-and-outcomes
#10
Michela Brambatti, Maria Vittoria Matassini, Eric D Adler, Karin Klingel, Paolo G Camici, Enrico Ammirati
BACKGROUND: Eosinophilic myocarditis (EM) is an acute life-threatening inflammatory disease of the heart. Neither large case series nor clinical trials on this specific myocarditis have been reported. OBJECTIVES: Based on a systematic revision of all published histologically proven cases, this study aimed to describe the clinical presentation, treatment, and outcome of EM. METHODS: The study screened 443 manuscripts in MEDLINE and EMBASE on cases of EM published until June 2017...
November 7, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29077984/neurally-adjusted-ventilatory-assist-compared-to-other-forms-of-triggered-ventilation-for-neonatal-respiratory-support
#11
REVIEW
Thomas E Rossor, Katie A Hunt, Sandeep Shetty, Anne Greenough
BACKGROUND: Effective synchronisation of infant respiratory effort with mechanical ventilation may allow adequate gas exchange to occur at lower peak airway pressures, potentially reducing barotrauma and volutrauma and development of air leaks and bronchopulmonary dysplasia. During neurally adjusted ventilatory assist ventilation (NAVA), respiratory support is initiated upon detection of an electrical signal from the diaphragm muscle, and pressure is provided in proportion to and synchronous with electrical activity of the diaphragm (EADi)...
October 27, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29073953/temporary-circulatory-support-in-u-s-children-awaiting-heart-transplantation
#12
Vamsi V Yarlagadda, Katsuhide Maeda, Yulin Zhang, Sharon Chen, John C Dykes, Mary Alice Gowen, Paul Shuttleworth, Jenna M Murray, Andrew Y Shin, Olaf Reinhartz, David N Rosenthal, Doff B McElhinney, Christopher S Almond
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has long served as the standard of care for short-term mechanical circulatory support in pediatrics. It is unknown whether newer-generation temporary circulatory support (TCS) devices afford children a meaningful survival advantage over ECMO. OBJECTIVES: This study sought to determine whether bridge-to-heart transplant survival with a TCS device is superior to ECMO after adjusting for patient differences. METHODS: All children ≤21 years of age listed for heart transplant from 2011 to 2015 who received a TCS device or ECMO as a bridge to transplant were identified using Organ Procurement and Transplantation Network data...
October 31, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29066588/effect-of-high-flow-nasal-cannula-on-expiratory-pressure-and-ventilation-in-infant-pediatric-and-adult-models
#13
Katie R Nielsen, Laura E Ellington, Alan J Gray, Larissa I Stanberry, Lincoln S Smith, Robert M DiBlasi
BACKGROUND: Heated and humidified high-flow nasal cannula (HFNC) is a widely used form of respiratory support; however, data regarding optimal flows for a given patient size or disease state are lacking. A comprehensive study of the physiologic effects of HFNC is needed to better understand the mechanisms of action. The objective of the current study was to quantify the effect of HFNC settings in age-specific, anatomically correct nasal airways and spontaneously breathing lung models...
October 24, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29059075/extracorporeal-membrane-oxygenation-berlin-and-ventricular-assist-devices-a-primer-for-the-cardiologist
#14
Charlotte S Van Dorn, Devon O Aganga, Jonathan N Johnson
PURPOSE OF REVIEW: Mechanical circulatory support (MCS) has become an indispensable tool in the management of children with impending respiratory and cardiac failure. Though extracorporeal membrane oxygenation (ECMO) was classically the only form of support available to pediatric patients, considerable advances have allowed ventricular assist devices (VADs) to become increasingly utilized in children. This review provides an update of recent advances in ECMO and VAD management in children...
October 20, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29051925/opportunities-and-design-considerations-for-peer-support-in-a-hospital-setting
#15
Shefali Haldar, Sonali R Mishra, Maher Khelifi, Ari H Pollack, Wanda Pratt
Although research has demonstrated improved outcomes for outpatients who receive peer support-such as through online health communities, support groups, and mentoring systems-hospitalized patients have few mechanisms to receive such valuable support. To explore the opportunities for a hospital-based peer support system, we administered a survey to 146 pediatric patients and caregivers, and conducted semi-structured interviews with twelve patients and three caregivers in a children's hospital. Our analysis revealed that hospitalized individuals need peer support for five key purposes: (1) to ask about medical details-such as procedures, treatments, and medications; (2) to learn about healthcare providers; (3) to report and prevent medical errors; (4) to exchange emotional support; and (5) to manage their time in the hospital...
May 2017: Proceedings of the SIGCHI Conference on Human Factors in Computing Systems
https://www.readbyqxmd.com/read/29032583/third-generation-ventricular-assist-device-mid-term-outcomes-of-the-heartware-hvad-in-pediatric-patients
#16
Mustafa Pac, Sinan Sabit Kocabeyoglu, Umit Kervan, Dogan Emre Sert, Serhat Koca, Ibrahim Ece, Feyza Aysenur Pac
The HeartWare HVAD is a small, third generation continuous flow pump that is intracorporeally placed for support of a failing ventricle in adult patients. This device is small in size when compared to other left ventricular assist devices and can therefore be used in smaller sized pediatric patients. We present our initial experience using the HVAD as a bridge to heart transplantation in the pediatric population. We performed a retrospective, single center, nonrandomized review of 17 pediatric patients who underwent HVAD implantation between June 2013 and March 2016...
October 15, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29032316/fiber-reinforced-silicone-for-tracheobronchial-stents-an-experimental-study
#17
Samanta Bianchi Vearick, Kétner Bendo Demétrio, Rogério Gastal Xavier, Alexandre Heitor Moreschi, André Frotta Muller, Paulo Roberto Stefani Sanches, Luis Alberto Loureiro Dos Santos
A trachea is a tubular structure composed of smooth muscle that is reinforced with cartilage rings. Some diseases can cause sagging in smooth muscle and cartilaginous tissue. The end result is reduction (narrowing) of the trachea diameter. A solution to this problem is the use of tracheal stents, which are small tubular devices made of silicone. One is inserted into the trachea to prevent or correct its constriction. The purpose of tracheal stent use is to maintain cartilage support that would otherwise be lost in the airway...
October 9, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/29028076/intestinal-probiotics-in-relieving-clinical-symptoms-of-severe-hand-foot-and-mouth-disease-and-potential-mechanism-analysis
#18
F Zhu, Z Jiang, H-W Li
OBJECTIVE: In this prospective cohort study, the efficacy and action mechanism of an intestinal probiotic formulation, Golden Bifid, in severe hand, foot, and mouth disease (HFMD) were determined in 63 consecutively admitted patients successfully treated in the Pediatrics Emergency Department of our hospital. PATIENTS AND METHODS: All patients had a persistent fever; 43 patients had rashes on hands, feet, crissum, and hips; and 45 patients had neurological signs and symptoms...
September 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29018043/educational-added-value-unit-development-and-testing-of-a-measure-for-educational-activities
#19
Amy B Guiot, Eric S Kirkendall, Craig H Gosdin, Samir S Shah, Dominick J DeBlasio, Katie A Meier, Jennifer K O'Toole
OBJECTIVES: University-based hospitalists educate health care professionals as an expectation, often lacking time and support for these activities. The purpose of this study was to (1) develop a tracking tool to record educational activities, (2) demonstrate its applicability and ease of completion for faculty members in different divisions, and (3) compare educational efforts of individuals from different professional pathways and divisions by using the educational added value unit (EAVU)...
October 10, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28985202/3d-bioprinting-using-stem-cells
#20
REVIEW
Chin Siang Ong, Pooja Yesantharao, Chen Yu Huang, Gunnar Mattson, Joseph Boktor, Takuma Fukunishi, Huaitao Zhang, Narutoshi Hibino
Recent advances have allowed for three-dimensional (3D) printing technologies to be applied to biocompatible materials, cells and supporting components, creating a field of 3D bioprinting that holds great promise for artificial organ printing and regenerative medicine. At the same time, stem cells, such as human induced pluripotent stem cells, have driven a paradigm shift in tissue regeneration and the modeling of human disease, and represent an unlimited cell source for tissue regeneration and the study of human disease...
October 6, 2017: Pediatric Research
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