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https://www.readbyqxmd.com/read/28821891/an-audit-of-829-paediatric-epidurals-in-a-tertiary-singapore-hospital-complications-and-conundrums
#1
Jolin Wong, Serene St Lim
INTRODUCTION: The incidence of complications related to epidural analgesia remains less well defined in the paediatric population as compared to adults. A retrospective review of prospectively collected data was performed to review and quantify risks of both adverse events and complications related to epidural analgesia in our Singaporean paediatric population. MATERIALS AND METHODS: Data from the Acute Pain Service (APS) was prospectively collected over 19 years...
July 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28821516/a-retrospective-review-of-paediatric-head-injuries-in-asia-a-pan-asian-trauma-outcomes-study-patos-collaboration
#2
Shu-Ling Chong, Uzma Rahim Khan, Indumathy Santhanam, Jun Seok Seo, Quan Wang, Sabariah Faizah Jamaluddin, Quoc Ai Hoang Trong, Su Yah Chew, Marcus Eng Hock Ong
OBJECTIVE: We aim to examine the mechanisms of head-injured children presenting to participating centres in the Pan Asian Trauma Outcomes Study (PATOS) and to evaluate the association between mechanism of injury and severe outcomes. DESIGN AND SETTING: We performed a retrospective review of medical records among emergency departments (EDs) of eight PATOS centres, from September 2014 - August 2015. PARTICIPANTS: We included children <16 years old who presented within 24 hours of head injury and were admitted for observation or required a computed tomography (CT) of the brain from the ED...
August 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28821498/impact-of-child-death-on-paediatric-trainees
#3
Clare E Hollingsworth, Carla Wesley, Jaymie Huckridge, Gabrielle M Finn, Michael J Griksaitis
OBJECTIVE: To assess the prevalence of symptoms of acute stress reactions (ASR) and post-traumatic stress disorder (PTSD) in paediatric trainees following their involvement in child death. DESIGN: A survey designed to identify trainees' previous experiences of child death combined with questions to identify features of PTSD. Quantitative interpretation was used alongside a χ(2) test. A p value of <0.05 was considered significant. SETTING: 604 surveys were distributed across 13 UK health education deaneries...
August 18, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28817675/deaths-during-tuberculosis-treatment-among-paediatric-patients-in-a-large-tertiary-hospital-in-nigeria
#4
Aishatu L Adamu, Muktar H Aliyu, Najiba Aliyu Galadanci, Baba Maiyaki Musa, Muktar A Gadanya, Auwalu U Gajida, Taiwo G Amole, Imam W Bello, Safiya Gambo, Ibrahim Abubakar
BACKGROUND: Despite availability of effective cure, tuberculosis (TB) remains a leading cause of death in children. In many high-burden countries, childhood TB is underdiagnosed and underreported, and care is often accessed too late, resulting in adverse treatment outcomes. In this study, we examined the time to death and its associated factors among a cohort of children that commenced TB treatment in a large treatment centre in northern Nigeria. METHODS: This is a retrospective cohort study of children that started TB treatment between 2010 and 2014...
2017: PloS One
https://www.readbyqxmd.com/read/28814489/right-ventricular-outflow-tract-stent-versus-bt-shunt-palliation-in-tetralogy-of-fallot
#5
Daniel Quandt, Bharat Ramchandani, Gemma Penford, John Stickley, Vinay Bhole, Chetan Mehta, Timothy Jones, David James Barron, Oliver Stumper
OBJECTIVE: This study sets out to compare morbidity, mortality and reintervention rates after stenting of the right ventricular outflow tract (RVOT) versus modified Blalock-Taussig shunt (mBTS) for palliation in patients with tetralogy of Fallot (ToF)-type lesions. METHODS: Retrospective case review study evaluating 101 patients (64 males) with ToF lesions who underwent palliation with either mBTS (n=41) or RVOT stent (n=60) to augment pulmonary blood flow over a 10-year period...
August 16, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28807188/the-global-burden-of-tuberculosis-mortality-in-children-a-mathematical-modelling-study
#6
Peter J Dodd, Courtney M Yuen, Charalambos Sismanidis, James A Seddon, Helen E Jenkins
BACKGROUND: Tuberculosis in children is increasingly recognised as an important component of the global tuberculosis burden, with an estimated 1 million cases in 2015. Although younger children are vulnerable to severe forms of tuberculosis disease, no age-disaggregated estimates of paediatric tuberculosis mortality exist, and tuberculosis has never been included in official estimates of under-5 child mortality. We aimed to produce a global mortality burden estimate in children using a complementary approach not dependent on vital registration data...
September 2017: Lancet Global Health
https://www.readbyqxmd.com/read/28799706/outcome-after-transcatheter-occlusion-of-patent-ductus-arteriosus-in-infants-less-than-6-kg-a-national-study-from-united-kingdom-and-ireland
#7
Sok-Leng Kang, Salim Jivanji, Chetan Mehta, Andrew J Tometzki, Graham Derrick, Robert Yates, Sachin Khambadkone, Joseph de Giovanni, Oliver Stumper, Rami Dhillon, Vinay Bhole, Zdenek Slavik, Michael Rigby, Patrick Noonan, Ben Smith, Brodie Knight, Trevor Richens, Neil Wilson, Kevin Walsh, Adam James, John Thomson, Jamie Bentham, Nicholas Hayes, Sajid Nazir, Satish Adwani, Arjamand Shauq, Ram Ramaraj, Christopher Duke, Demetris Taliotis, Vikram Kudumula, San-Fui Yong, Gareth Morgan, Eric Rosenthal, Thomas Krasemann, Shakeel Qureshi, David Crossland, Tony Hermuzi, Robin P Martin
OBJECTIVES: This study aimed to report our national experience with transcatheter patent ductus arteriosus (PDA) occlusion in infants weighing <6 kg. BACKGROUND: The technique of transcatheter PDA closure has evolved in the past two decades and is increasingly used in smaller patients but data on safety and efficacy are limited. METHODS: Patients weighing < 6 kg in whom transcatheter PDA occlusion was attempted in 13 tertiary paediatric cardiology units in the United Kingdom and Ireland were retrospectively analyzed to review the outcome and complications...
August 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28797888/the-weighty-issue-of-obesity-in-paediatric-respiratory-medicine
#8
REVIEW
Dominic A Fitzgerald
Some have observed that developed world is fat and getting fatter. This is even extending into the developing world, and it is important to appreciate that the consequences of childhood obesity last into adulthood and are associated with premature death. From the paediatric respiratory perspective, the deposition of excess adipose tissue in the thoraco-abdominal region begins early in life and is believed to alter diaphragm mobility and chest wall expansion, reduce lung compliance, and result in a rapid shallow breathing pattern with an increased work of breathing and reduction in maximum ventilatory capacity...
June 11, 2017: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/28794077/survival-in-adults-and-children-with-systemic-lupus-erythematosus-a-systematic-review-and-bayesian-meta-analysis-of-studies-from-1950-to-2016
#9
Maria G Tektonidou, Laura B Lewandowski, Jinxian Hu, Abhijit Dasgupta, Michael M Ward
OBJECTIVE: To determine trends in survival among adult and paediatric patients with systemic lupus erythematosus (SLE) from 1950 to the present. METHODS: We performed a systematic literature review to identify all published cohort studies on survival in patients with SLE. We used Bayesian methods to derive pooled survival estimates separately for adult and paediatric patients, as well as for studies from high-income countries and low/middle-income countries. We pooled contemporaneous studies to obtain trends in survival over time...
August 9, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28793184/survey-highlights-the-need-for-specific-interventions-to-reduce-frequent-conflicts-between-healthcare-professionals-providing-paediatric-end-of-life-care
#10
Marie-Anne Archambault-Grenier, Marie-Hélène Roy-Gagnon, France Gauvin, Hubert Doucet, Nago Humbert, Sanja Stojanovic, Antoine Payot, Sylvie Fortin, Annie Janvier, Michel Duval
AIMS: This study explored how paediatric healthcare professionals experienced and coped with end-of-life conflicts and identified how to improve coping strategies. METHODS: A questionnaire was distributed to all 2,300 professionals at a paediatric university hospital, covering the frequency of end-of-life conflicts, participants, contributing factors, resolution strategies, outcomes and the usefulness of specific institutional coping strategies. RESULTS: Of the 946 professionals (41%) who responded, 466 had witnessed or participated in paediatric end-of-life discussions: 73% said these had led to conflict, more frequently between professionals (58%) than between professionals and parents (33%)...
August 9, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28789718/cardiovascular-pre-participation-screening-in-young-athletes-recommendations-of-the-association-of-european-paediatric-cardiology
#11
Peter Fritsch, Robert Dalla Pozza, Doris Ehringer-Schetitska, Eero Jokinen, Vesna Herceg, Erzsebet Hidvegi, Renate Oberhoffer, Andreas Petropoulos
Sudden death in young competitive athletes can be avoided by implementation of pre-participation screening programmes. A screening programme should be performed only by trained physicians and should include the athlete's personal and family history, physical examination results, and the readings from a 12-lead-electrocardiogram. The athlete should undergo this screening programme every second year to detect progressive diseases. In addition, the programme should include detailed instructions to the athletes to pause training during infections in order to prevent sudden death due to myocarditis...
August 9, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28780496/fifteen-minute-consultation-a-structured-approach-to-the-management-of-chronic-cough-in-a-child
#12
Cherry Alviani, Gary Ruiz, Atul Gupta
Coughing is a primary pulmonary defence mechanism that enhances clearance of secretions and particles from the airways and protects against aspiration of foreign materials. Coughing may affect 30% of children at any given time (1). Many are healthy children but some may have serious underlying disease. Childhood cough accounts for a large number of consultations and 80% of families who are referred to a paediatric respiratory clinic for chronic cough have sought medical advice five times or more (2). The majority of childhood coughs are secondary to an acute respiratory tract infection and will improve once the infection resolves, usually within 1 to 3 weeks...
August 5, 2017: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/28770972/prophylactic-levosimendan-for-the-prevention-of-low-cardiac-output-syndrome-and-mortality-in-paediatric-patients-undergoing-surgery-for-congenital-heart-disease
#13
REVIEW
Johanna Hummel, Gerta Rücker, Brigitte Stiller
BACKGROUND: Low cardiac output syndrome remains a serious complication, and accounts for substantial morbidity and mortality in the postoperative course of paediatric patients undergoing surgery for congenital heart disease. Standard prophylactic and therapeutic strategies for low cardiac output syndrome are based mainly on catecholamines, which are effective drugs, but have considerable side effects. Levosimendan, a calcium sensitiser, enhances the myocardial function by generating more energy-efficient myocardial contractility than achieved via adrenergic stimulation with catecholamines...
August 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28766888/prevalence-of-multi-drug-resistant-organisms-in-stool-of-paediatric-patients-with-acute-leukaemia-and-correlation-with-blood-culture-positivity-a-single-institution-experience
#14
Krupa Shankar, Venkatraman Radhakrishnan, Varalakskmi Vijayakumar, Jaikumar Ramamoorthy, Prasanth Ganesan, Manikandan Dhanushkodi, T S Ganesan, T G Sagar
BACKGROUND: Multi-drug resistant (MDR) bacteria are associated with increased morbidity and mortality in children with acute leukaemia. The present study was conducted to assess the prevalence of MDR bacteria in stool cultures of patients with acute leukaemia at presentation to the hospital. The results were then correlated with blood cultures when patients developed septicaemia. PATIENTS AND METHODS: The study involved analysis of case records of patients with newly diagnosed acute leukaemia less than 18 years of age treated at our centre from January 2015 to December 2015...
August 2, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28753181/real-life-anti-tumour-necrosis-factor-experience-in-500-paediatric-united-kingdom-inflammatory-bowel-disease-patients
#15
Victoria M Merrick, Kajal Mortier, Linda J Williams, Rafeeq Muhammed, Marcus Kh Auth, Mamoun Elawad, John Me Fell, R Mark Beattie, Sabarinathan Loganathan, Franco Torrente, Mary-Anne Morris, Charles Charlton, Nick M Croft, Astor Rodrigues, Mark Furman, Babu Vadamalayan, Huw Jenkins, Veena Zamvar, Sally G Mitton, Sonny Chong, Mike Cosgrove, Anthony Akobeng, David C Wilson, Richard K Russell
OBJECTIVES: To measure the effectiveness, safety and use of anti-Tumour necrosis Factor (TNF) therapy in paediatric inflammatory bowel disease (PIBD) in the United Kingdom (UK). METHODS: Prospective UK audit of patients newly starting anti-TNF therapy. Disease severity was assessed using Physician Global Assessment (PGA) +/or the Paediatric Crohn's Disease Activity Index (PCDAI). RESULTS: 37 centres participated (23 of 25 specialist PIBD sites)...
July 27, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28751535/how-to-use-tests-for-disorders-of-copper-metabolism
#16
Jane Armer, Christian De Goede
In paediatrics, one of our main aims in the diagnostic process is to identify any treatable conditions. The copper metabolism disorder Wilson's disease (WD) is one such condition that is caused by mutations in the ATP7B gene. Delay in treatment could result in irreversible disability or even death. Although liver disease is the most common presenting feature in children, some children may initially present with a subtle neurological presentation only. In patients presenting with dystonia, tremor, dysarthria or with a deterioration in school performance, there should be a high index of suspicion for WD...
July 27, 2017: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/28746800/the-changing-nature-of-relationships-between-parents-and-healthcare-providers-when-a-child-dies-in-the-paediatric-intensive-care-unit
#17
Ashleigh E Butler, Helen Hall, Beverley Copnell
AIM: To explore bereaved parents' interactions with healthcare providers when a child dies in a paediatric intensive care unit. BACKGROUND: Though most children admitted to a paediatric intensive care unit will survive, 2-5% will die during their stay. The parents of these children interact and form relationships with numerous healthcare staff during their child's illness and death. Though previous studies have explored the parental experience of child death in intensive care generally, the nature of their relationships with healthcare providers during this time remains unknown...
July 26, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28738258/open-label-multicentre-randomised-phase-ii-study-of-the-epssg-and-the-itcc-evaluating-the-addition-of-bevacizumab-to-chemotherapy-in-childhood-and-adolescent-patients-with-metastatic-soft-tissue-sarcoma-the-bernie-study
#18
Julia C Chisholm, Johannes H M Merks, Michela Casanova, Gianni Bisogno, Daniel Orbach, Jean-Claude Gentet, Anne-Sophie Thomassin-Defachelles, Pascal Chastagner, Stephen Lowis, Milind Ronghe, Kieran McHugh, Rick R van Rijn, Magalie Hilton, Jeanette Bachir, Sabine Fürst-Recktenwald, Birgit Geoerger, Odile Oberlin
PURPOSE: We evaluated the role of bevacizumab as part of the multi-modality treatment of children and adolescents with metastatic rhabdomyosarcoma (RMS) or non-rhabdomyosarcoma soft tissue sarcoma (NRSTS). PATIENTS AND METHODS: Eligible patients aged ≥6 months to <18 years were randomised to receive induction chemotherapy (four cycles of IVADo + five cycles of IVA, ±bevacizumab), surgery and/or radiotherapy, followed by maintenance chemotherapy (12 cycles of low-dose cyclophosphamide + vinorelbine, ±bevacizumab)...
July 21, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28737301/vaccine-preventable-admissions-to-an-irish-paediatric-intensive-care
#19
Y Doyle, M Healy, C McMahon, S Crowe
In the Republic of Ireland, the schedule of state-funded immunisation for children is comprehensive and includes diphtheria, pertussis, tetanus, pneumococcus, hepatitis B, meningococcus C, haemophilus B, polio, measles, rubella and mumps. Varicella and meningococcal B vaccines are commercially available but are not currently funded by the government. Each of the illnesses preventable by these vaccines can cause substantial morbidity, and rarely mortality, in infants and children. Our PICU continues to see serious illness due to avoidable infection...
May 10, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/28733186/easix-in-patients-with-acute-graft-versus-host-disease-a-retrospective-cohort-analysis
#20
Thomas Luft, Axel Benner, Sonata Jodele, Christopher E Dandoy, Rainer Storb, Ted Gooley, Brenda M Sandmaier, Natalia Becker, Aleksandar Radujkovic, Peter Dreger, Olaf Penack
BACKGROUND: Endothelial dysfunction links thrombotic microangiopathy to steroid-refractory graft-versus-host disease (GVHD) after allogeneic stem-cell transplantation. We aimed to assess if the simple formula-lactate dehydrogenase (U/L) × creatinine (mg/dL)/thrombocytes (10(9) cells per L)-termed the Endothelial Activation and Stress Index (EASIX), might be valuable for the prediction of death in patients with acute GVHD after allogeneic stem-cell transplantation. METHODS: For this retrospective analysis, we analysed a training cohort (in Germany) and three validation cohorts (in Germany and the USA) of patients with acute GVHD who had received consecutive allogeneic stem-cell transplantation...
July 18, 2017: Lancet Haematology
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