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Pediatric mechanical support

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https://www.readbyqxmd.com/read/28722341/proteomic-analysis-of-neuroblastoma-derived-exosomes-new-insights-into-a-metastatic-signature
#1
Marta Colletti, Andrea Petretto, Angela Galardi, Virginia Di Paolo, Luigi Tomao, Chiara Lavarello, Elvira Inglese, Maurizio Bruschi, Ana Amor Lopez, Luisa Pascucci, Birgit Geoerger, Hector Peinado, Locatelli Franco, Di Giannatale Angela
Neuroblastoma (NB) is the most common extracranial pediatric solid tumor. Around 70% of patients with metastatic disease at diagnosis present bone-marrow infiltration, which is considered a marker of poor outcome; however, the mechanism underlying this specific tropism has to be elucidated. Tumor-derived exosomes may support metastatic progression in several tumors by interacting with the microenvironment, and may serve as tumor biomarkers. The main objective of this study was to identify an exosomal signature associated with NB metastatic bone-marrow dissemination...
July 19, 2017: Proteomics
https://www.readbyqxmd.com/read/28722144/mechanisms-involved-in-hypersensitivity-reactions-to-polysulfone-hemodialysis-membranes
#2
Aranzazu Rodríguez-Sanz, Rafael Sánchez-Villanueva, Javier Domínguez-Ortega, Ana-María Fiandor, María-Paz Ruiz, Filomena Trocoli, Rafael Díaz-Tejeiro, Carlos Cadenillas, Elena González, Virginia Martínez, Margarita López-Trascasa, Santiago Quirce, Rafael Selgas, Teresa Bellón
Several cases of patients with anaphylactic or systemic hypersensitivity reactions to polysulfone (PS) hemodialysis (HD) membranes and tolerance to cellulose triacetate (CTA) membranes have recently been reported. To investigate the mechanisms involved in PS hypersensitivity, basophil, T cell, and complement activation were analyzed in acute-phase samples from two patients with systemic reactions to PS-based membranes. Basophil and T cell activation, as well as higher serum tryptase levels were detected in acute-phase samples compared with basal levels...
July 19, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28721140/serum-adipokines-and-vitamin-d-levels-in-patients-with-type-1-diabetes-mellitus
#3
Mohamed M Ismail, Tamer A Abdel Hamid, Alshaymaa A Ibrahim, Huda Marzouk
INTRODUCTION: Adiponectin, leptin and resistin are adipokines that play important roles in the regulation of lipid and carbohydrate metabolism in type 2 diabetes (T2DM). However, their influence in type 1 diabetes mellitus is still unknown. The aim of this study was to measure serum adiponectin, leptin and resistin levels and to investigate their relationships with vitamin D and other clinical and laboratory parameters in patients with type 1 diabetes. MATERIAL AND METHODS: Fifty subjects with type 1 diabetes and 50 healthy age- and sex-matched subjects were selected from the Endocrinology Outpatient Clinic of Cairo University Pediatrics Hospital...
June 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28720673/challenges-with-implementation-of-a-respiratory-therapist-driven-protocol-of-spontaneous-breathing-trials-in-the-pediatric-icu
#4
Conrad Krawiec, Dale Carl, Christy Stetter, Lan Kong, Gary D Ceneviva, Neal J Thomas
BACKGROUND: Timely ventilator liberation is crucial in the pediatric ICU. In many pediatric ICUs, the decision to initiate weaning is driven by the physician, which may lead to delays in ventilator liberation. The objectives of this quality improvement project were to develop and implement a respiratory therapist (RT)-led protocol for screening for spontaneous breathing trial (SBT) readiness, to test protocol feasibility, and to evaluate its impact on SBT timing. METHODS: A retrospective chart review was performed on all intubated patients in the pediatric ICU for 18 months prior to protocol institution...
July 18, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28720202/a-novel-surgical-approach-to-mechanical-circulatory-support-in-univentricular-infants
#5
Avihu Z Gazit, Orlando Petrucci, Peter Manning, Mark Shepard, Sirine Baltagi, Kathleen Simpson, Chesney Castleberry, Charles Canter, Pirooz Eghtesady
BACKGROUND: Historically, the options for mechanical circulatory support in infants, particularly those with single-ventricle physiology, have been limited and outcomes have generally been poor. We report a new approach implemented for long-term support in a series of such patients. METHODS: This study is a single-center case series of 7 patients with single-ventricle physiology after stage 1 palliation supported with mechanical circulatory support using a novel technique, between May 2014 and September 2015...
July 15, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28714856/use-of-human-aortic-extracellular-matrix-as-a-scaffold-for-construction-of-patient-specific-tissue-engineered-vascular-patch
#6
Liping Gao, Mingjun Du, Jingjing Lv, Sebastian Schmull, Ritai Huang, Jun Li
Abstract Synthetic or biologic materials are usually used to repair vascular malformation in congenital heart defects; however, non-autologous materials show both mismatch compliance and antigenicity, as well as a lack of recellularization on its surface. Here, we constructed a tissue-engineered vascular patch (TEVP) using decellularized extracellular matrix (ECM) scaffold obtained from excised human aorta during surgery, which was seeded with patient-derived bone marrow CD34-positive (CD34+) progenitor cells...
July 17, 2017: Biomedical Materials
https://www.readbyqxmd.com/read/28698205/an-fc-engineered-cd19-antibody-eradicates-mrd-in-patient-derived-mll-rearranged-acute-lymphoblastic-leukemia-xenografts
#7
Denis M Schewe, Ameera Alsadeq, Cornelia Sattler, Lennart Lenk, Fotini Vogiatzi, Gunnar Cario, Simon Vieth, Thomas Valerius, Sophia Rosskopf, Fabian Meyersieck, Julia Alten, Martin Schrappe, Martin Gramatzki, Matthias Peipp, Christian Kellner
Antibody therapy constitutes a major advance in the treatment of B-cell precursor acute lymphoblastic leukemia (BCP-ALL). To evaluate the efficacy and the mechanisms of action of CD19 monoclonal antibody therapy in pediatric BCP-ALL, an Fc engineered CD19 antibody carrying the S239D/I332E mutation for improved effector cell recruitment (CD19-DE) was tested. Patient derived xenografts (PDX) of pediatric MLL-rearranged ALL were established in NOD.Cg-Prkdc(scid) Il2rg(tm1Wjl)/SzJ (NSG) mice. Antibody CD19-DE was efficient in prolonging the survival of NSG mice in a minimal residual disease (MRD) model...
July 11, 2017: Blood
https://www.readbyqxmd.com/read/28697170/critically-ill-children-with-hemophagocytic-lymphohistiocytosis-a-case-series-of-14-patients
#8
Esther Huimin Leow, Shui Yen Soh, Ah Moy Tan, Yee Hui Mok, Mei Yoke Chan, Jan Hau Lee
Children with hemophagocytic lymphohistiocytosis (HLH) are at an increased risk of critical illness. In this study, we described the clinical characteristics of critically ill children with HLH and identify factors associated with poor clinical outcomes. Children who were diagnosed with HLH with emergent admission to Children's Intensive Care Unit (CICU) between January 1, 2000 and October 31, 2015 were included. The primary outcome was CICU mortality. Over the 15-year period, there were 14 critically ill patients with HLH with 23 CICU admissions...
July 10, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28686548/roles-of-vitamins-d-and-k-nutrition-and-lifestyle-in-low-energy-bone-fractures-in-children-and-young-adults
#9
Michał Karpiński, Janusz Popko, Katarzyna Maresz, Vladimir Badmaev, Sidney J Stohs
The research on skeletal system health in children and young adults, while recognizing the important role of calcium and vitamin D, goes beyond these nutritional standards. This review focuses on the role of vitamin K in combination with vitamin D and other factors in bone health. The current understanding is that maintaining bone health and prevention of low-energy fractures in any pediatric population includes nutritional factors combined with an active lifestyle. Calcium, vitamin D, and vitamin K supplementation contribute independently and collectively to bone health...
July 2017: Journal of the American College of Nutrition
https://www.readbyqxmd.com/read/28682718/the-ventricular-assist-device-in-the-life-of-the-child-a-phenomenological-pediatric-study
#10
Michael A van Manen
What is it like for a child to live with an artificial heart? The use of some medical therapies in children requires developmental considerations, is associated with psychosocial consequences, and calls for ethical sensitivities. A critical case is the ventricular assist device (VAD), a mechanical pump used to support the functioning of a failing heart. As a pediatric therapy, the device can be used as a temporary solution for poor heart function, a bridge to transplantation or recovery, or as a destination therapy...
May 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/28673108/melody-transcatheter-pulmonary-valve-placement-in-a-heartmate-ii-patient
#11
Tabitha G Moe, Linda Staley, Joseph N Graziano
Transcatheter pulmonary valve placement is emerging as a standard therapy for dysfunctional right ventricular outflow tract conduits. The Melody transcatheter pulmonary valve is indicated for use in the management of pediatric and adult patients with right ventricular outflow tract conduits measuring at least 16 mm in diameter. This is the first reported case of placement in a patient with a left ventricular assist device. We outline the preprocedural evaluation process, the procedural methods, and the outcomes of a successful implantation in a complex patient...
January 1, 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28668576/functional-outcomes-following-lesions-in-visual-cortex-implications-for-plasticity-of-high-level-vision
#12
Tina T Liu, Marlene Behrmann
Understanding the nature and extent of neural plasticity in humans remains a key challenge for neuroscience. Importantly, however, a precise characterization of plasticity and its underlying mechanism has the potential to enable new approaches for enhancing reorganization of cortical function. Investigations of the impairment and subsequent recovery of cognitive and perceptual functions following early-onset cortical lesions in humans provide a unique opportunity to elucidate how the brain changes, adapts, and reorganizes...
June 28, 2017: Neuropsychologia
https://www.readbyqxmd.com/read/28664670/population-pharmacokinetics-of-human-antithrombin-concentrate-in-pediatric-patients
#13
Brady S Moffett, Rosa Diaz, Marianne Galati, Donald Mahoney, Jun Teruya, Donald L Yee
AIMS: Antithrombin is increasingly used in pediatric patients, yet there are few age-specific pharmacokinetic data to guide dosing. We aim to describe the pharmacokinetic profile of human (plasma-derived) antithrombin concentrate in pediatric patients. METHODS: A retrospective review of 5 years of patients < 19 years of age admitted to our institution who received antithrombin concentrate, were not on mechanical circulatory support and had baseline (pre-dose) and post-dose plasma antithrombin activity levels available for analysis, was performed...
June 29, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28658462/isotretinoin-and-timing-of-procedural-interventions-a-systematic-review-with-consensus-recommendations
#14
Leah K Spring, Andrew C Krakowski, Murad Alam, Ashish Bhatia, Jeremy Brauer, Joel Cohen, James Q Del Rosso, Lucia Diaz, Jeffrey Dover, Lawrence F Eichenfield, Geoffrey C Gurtner, C William Hanke, Marla N Jahnke, Kristen M Kelly, Shilpi Khetarpal, Megan A Kinney, Moise L Levy, James Leyden, Michael T Longaker, Girish S Munavalli, David M Ozog, Heidi Prather, Peter R Shumaker, Elizabeth Tanzi, Abel Torres, Mara Weinstein Velez, Abigail B Waldman, Albert C Yan, Andrea L Zaenglein
Importance: The notion that systemic isotretinoin taken within 6 to 12 months of cutaneous surgery contributes to abnormal scarring or delayed wound healing is widely taught and practiced; however, it is based on 3 small case series from the mid-1980s. Objective: To evaluate the body of literature to provide evidence-based recommendations regarding the safety of procedural interventions performed either concurrently with, or immediately following the cessation of systemic isotretinoin therapy...
June 28, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28654569/maintaining-interrater-agreement-of-core-assessment-instruments-in-a-multisite-randomized-controlled-clinical-trial-the-randomized-evaluation-of-sedation-titration-for-respiratory-failure-restore-trial
#15
Ruth Lebet, Jennifer Hayakawa, Tracy B Chamblee, Joana A Tala, Nakul Singh, David Wypij, Martha A Q Curley
BACKGROUND: RESTORE (Randomized Evaluation of Sedation Titration for Respiratory Failure) was a cluster randomized clinical trial evaluating a sedation strategy in children 2 weeks to <18 years of age with acute respiratory failure supported on mechanical ventilation. A total of 31 U.S. pediatric intensive care units (PICUs) participated in the trial. Staff nurse rater agreement on measures used to assess a critical component of treatment fidelity was essential throughout the 4-year data collection period...
July 2017: Nursing Research
https://www.readbyqxmd.com/read/28653420/impact-of-endotracheal-tube-shortening-on-work-of-breathing-in-neonatal-and-pediatric-in-vitro-lung-models
#16
Rebecca Mohr, Jörg Thomas, Vincenzo Cannizzaro, Markus Weiss, Alexander R Schmidt
BACKGROUND: Work of breathing accounts for a significant proportion of total oxygen consumption in neonates and infants. Endotracheal tube inner diameter and length significantly affect airflow resistance and thus work of breathing. While endotracheal tube shortening reduces endotracheal tube resistance, the impact on work of breathing in mechanically ventilated neonates and infants remains unknown. AIM: The objective of this in vitro study was to quantify the effect of endotracheal tube shortening on work of breathing in simulated pediatric lung settings...
June 27, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28639944/clinical-impact-and-efficacy-of-bedside-echocardiography-on-patient-management-in-pediatric-intensive-care-units-picus-a-prospective-study
#17
Sanliay Şahin, Mutlu Uysal Yazıcı, Ganime Ayar, Tülin Köksal, İbrahim İlker Çetin, Filiz Ekici, Abdullah Kocabaş
OBJECTIVE: To determine the indication and necessity of echocardiographic assessment and therapeutic interventions in critically ill children. METHODS: A total of 140 children, including 75 mechanically ventilated (MV) and 65 spontaneously breathing (SB) children, who were admitted consecutively from March to August 2013 were evaluated prospectively. Data regarding the indication for echocardiography and therapeutic approaches used were documented. For evaluating disease severity, the Pediatric Risk of Mortality Score III (PRISM) was ascertained...
June 22, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28639081/clinical-impact-of-non-congenital-zika-virus-infection-in-infants-and-children
#18
REVIEW
Stefan H F Hagmann
PURPOSE OF REVIEW: While the Zika virus (ZIKV) has been noted for its distinct neurotropism and identified as a significant cause for a congenital infection syndrome, there has been increased recognition of the importance to better understand the clinical impact of non-congenital ZIKV infection in infants and children. This article reviews reports of perinatal and breast milk transmission of ZIKV and summarizes current clinical outcome data of pediatric non-congenital ZIKV infection. RECENT FINDINGS: Perinatal transmission and presence of infective ZIKV particles in breast milk have been reported...
June 21, 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28619306/management-of-viral-oral-ulcers-in-children-using-chinese-herbal-medicine-a-report-of-two-cases
#19
Yi-Chiao Lee, Ting-Hao Wang, Shih-Yu Chen, Hsiang-Ling Lin, Ming-Yen Tsai
OBJECTIVE: Viral oral ulcers are common presentations in pediatric clinics. Although self-limiting, painful ulcerative lesions and inflamed mucosa can decrease oral intake and lead to dehydration. Despite the widespread use of Chinese herbal medicine (CHM) for pediatric upper respiratory disease in Taiwan, there is little evidence for its effectiveness as an antipyretic or in aiding ulcer healing for children with viral oral ulcers. We report two cases of children who presented with viral oral ulcers to illustrate the potential efficacy of CHM treatment in recovery from herpangina (HA) and herpetic gingivostomatitis (HGS)...
June 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28614288/evaluation-of-the-tibial-tubercle-to-posterior-cruciate-ligament-distance-in-a-pediatric-patient-population
#20
Blake Clifton, Dustin L Richter, Dan Tandberg, Matthew Ferguson, Gehron Treme
BACKGROUND: Evaluation of distal extensor mechanism alignment continues to evolve in children with patella instability. Prior studies support the use of the tibial tubercle to trochlear groove (TT-TG) distance but limitations exist for this measurement including: changes in the TT-TG distance with knee flexion, difficulty with finding the deepest part of a dysplastic trochlea, and limitations regarding identification of the site of the anatomic abnormality. The tibial tubercle-posterior cruciate ligament (TT-PCL) distance has been introduced as an alternative measure to address the shortcomings in the TT-TG distance by quantifying the position of the TT independent of the trochlea and with respect to the tibia only...
June 13, 2017: Journal of Pediatric Orthopedics
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