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https://www.readbyqxmd.com/read/29787942/thrombotic-and-hemorrhagic-complications-in-children-and-young-adult-recipients-of-hematopoietic-stem-cell-transplant-hsct
#1
Dominder Kaur, Aneel A Ashrani, Rajiv Pruthi, Shakila P Khan, Kent Bailey, Vilmarie Rodriguez
BACKGROUND: Overall incidence of hemostatic complications in pediatric recipients of Hematopoietic Stem Cell Transplant (HSCT) is scarcely studied. This retrospective review explored the incidence and underlying risk factors of bleeding and thrombotic complications in children. PROCEDURE: Clinical characteristics, hemorrhagic events (HE), thrombotic events (TE) and follow up data were abstracted from medical records on patients aged <21 years undergoing HSCT during January 2000-June 2015...
April 26, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29786813/prediction-of-mortality-in-pediatric-traumatic-brain-injury-implementations-from-a-tertiary-pediatric-intensive-care-facility
#2
Ebru Atike Ongun, Oğuz Dursun
BACKGROUND: To explore the mortality risk factors of traumatic brain injury in pediatric intensive care unit admissions. METHODS: Eighty-eight children (categorized using the Glasgow Coma Scale) between September 2014 and December 2016 were analyzed. Emergency department and intensive care course, treatment strategies, axonal injury, intubation and tracheostomy rates, length of intensive care and hospitalization, Rotterdam-CT scores, injury severity scores, and PRISM-III scores were recorded...
May 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29786658/melatonin-as-a-therapy-for-traumatic-brain-injury-a-review-of-published-evidence
#3
REVIEW
Nicole Osier, Emily McGreevy, Lan Pham, Ava Puccio, Dianxu Ren, Yvette P Conley, Sheila Alexander, C Edward Dixon
Melatonin (MEL) is a hormone that is produced in the brain and is known to bind to MEL-specific receptors on neuronal membranes in several brain regions. MEL's documented neuroprotective properties, low toxicity, and ability to cross the blood-brain-barrier have led to its evaluation for patients with traumatic brain injury (TBI), a condition for which there are currently no Food and Drug Administration (FDA)-approved therapies. The purpose of this manuscript is to summarize the evidence surrounding the use of melatonin after TBI, as well as identify existing gaps and future directions...
May 22, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29784284/routine-surveillance-imaging-following-mild-traumatic-brain-injury-with-intracranial-hemorrhage-may-not-be-necessary
#4
Smruti K Patel, Yair M Gozal, Bryan M Krueger, James C Bayley, Suzanne Moody, Norberto Andaluz, Richard A Falcone, Karin S Bierbrauer
BACKGROUND: Mild traumatic brain injury (mTBI) comprises the majority of pediatric traumatic brain injury. Children with mTBI even with traumatic intracranial hemorrhage (tICH) rarely experience a clinically significant neurologic decline (CSND). The utility of routine surveillance imaging in the pediatric population also remains controversial, especially owing to concerns about the risks of radiation exposure at a young age. This study aims to identify demographic or injury-related characteristics that may facilitate recognition of children at risk of progression with mTBI...
April 27, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29772353/cardiac-profile-of-chimeric-antigen-receptor-car-t-cell-therapy-in-children-a-single-institution-experience
#5
Danielle Burstein, Shannon Maude, Stephen Grupp, Heather Griffis, Joseph Rossano, Kimberly Lin
BACKGROUND: Immunotherapy with chimeric antigen receptor (CAR)-modified T-cells targeting CD19 for pediatric acute lymphoblastic leukemia (ALL) has demonstrated significant efficacy. The principle toxicity is cytokine release syndrome with resultant hypotension. However, the spectrum of cardiovascular effects associated with CAR T-cell therapy has not been systematically evaluated. METHODS: We reviewed all patients who received CD19-directed CAR T-cells at the Children's Hospital of Philadelphia between April 2012 and September 2016...
May 14, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29772352/allogeneic-stem-cell-transplantation-from-hla-mismatched-donors-for-pediatric-patients-with-acute-lymphoblastic-leukemia-treated-according-to-the-2003-bfm-and-2007-international-bfm-studies-impact-of-disease-risk-on-outcomes
#6
Jean-Hugues Dalle, Adriana Balduzzi, Peter Bader, Arjan Lankester, Isaac Yaniv, Jacek Wachowiak, Anna Pieczonka, Marc Bierings, Akif Yesilipek, Petr Sedlacek, Marianne Ifversen, Sabina Sufliarska, Jacek Toporski, Evgenia Glogova, Ulrike Poetschger, Christina Peters
RATIONAL: Allogeneic HSCT is beneficial for pediatric patients with relapsed or (very) high-risk ALL in remission. A total of 1115 consecutive patients were included in the ALL SCT 2003 BFM study and the ALL SCT 2007-International study and were stratified according to relapse risk (Standard vs. High vs. Very High Risk of Relapse) and donor type (Matched Sibling vs. Matched Donor vs. Mismatched Donor). PATIENTS AND METHODS: A total of 148 patients (60% male, median age 8...
May 14, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29768294/a-pilot-study-to-reduce-computed-tomography-utilization-for-pediatric-mild-head-injury-in-the-emergency-department-using-a-clinical-decision-support-tool-and-a-structured-parent-discussion-tool
#7
Rakesh S Engineer, Seth R Podolsky, Baruch S Fertel, Purva Grover, Heather Jimenez, Erin L Simon, Courtney M Smalley
INTRODUCTION: The American College of Emergency Physicians embarked on the "Choosing Wisely" campaign to avoid computed tomographic (CT) scans in patients with minor head injury who are at low risk based on validated decision rules. We hypothesized that a Pediatric Mild Head Injury Care Path could be developed and implemented to reduce inappropriate CT utilization with support of a clinical decision support tool (CDST) and a structured parent discussion tool. METHODS: A quality improvement project was initiated for 9 weeks to reduce inappropriate CT utilization through 5 interventions: (1) engagement of leadership, (2) provider education, (3) incorporation of a parent discussion tool to guide discussion during the emergency department (ED) visit between the parent and the provider, (4) CDST embedded in the electronic medical record, and (5) importation of data into the note to drive compliance...
May 15, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29760839/severely-elevated-blood-pressure-and-early-mortality-in-children-with-traumatic-brain-injuries-the-neglected-end-of-the-spectrum
#8
M Austin Johnson, Matthew A Borgman, Jeremy W Cannon, Nathan Kuppermann, Lucas P Neff
Introduction: In adults with traumatic brain injuries (TBI), hypotension and hypertension at presentation are associated with mortality. The effect of age-adjusted blood pressure in children with TBI has been insufficiently studied. We sought to determine if age-adjusted hypertension in children with severe TBI is associated with mortality. Methods: This was a retrospective analysis of the Department of Defense Trauma Registry (DoDTR) between 2001 and 2013. We included for analysis patients <18 years with severe TBI defined as Abbreviated Injury Severity (AIS) scores of the head ≥3...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29757076/economic-evaluation-of-concussion-programs-in-the-state-of-idaho-the-collective-potential-of-prevention-and-clinical-care
#9
Susie Bergeron, Hilary Flint, Zeynep Hansen
Concussion, or mild traumatic brain injury, especially among young children, teenagers, and young adults, is a significant problem in Ada County, Idaho, and the United States. Although much has been learned about concussion, considerable controversy and gaps in knowledge still exist in many areas of research, leading to variation in concussion assessment, treatment, and management protocols. Health systems can positively impact concussion outcomes through community education and outreach, and provision of timely, coordinated, evidence-based clinical care...
May 14, 2018: Population Health Management
https://www.readbyqxmd.com/read/29756534/neurostimulant-prescribing-patterns-in-children-admitted-to-the-icu-after-traumatic-brain-injury
#10
Amanda Marie Morrison, Amy Houtrow, James Zullo, Patrick M Kochanek, Carol Vetterly, Ericka L Fink
Neurostimulant medications are commonly prescribed following traumatic brain injury (TBI) in adults; little is known about their use in children with TBI. Our objective was to analyze neurostimulant prescribing practices from 2005 to 2015 in children admitted to the intensive care unit (ICU) with TBI. We hypothesized that neurostimulant prescriptions have increased over time and are associated with older age and injury severity. A retrospective cohort study of patients aged 1 month to 18 years with an ICD-9-CM discharge diagnosis code for TBI admitted to the ICU between 2005 and 2015 in 37 pediatric hospitals included in the Pediatric Health Information System was conducted...
May 14, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29753521/emergency-department-implementation-of-the-centers-for-disease-control-and-prevention-pediatric-mild-traumatic-brain-injury-guideline-recommendations
#11
EDITORIAL
Angela Lumba-Brown, David W Wright, Kelly Sarmiento, Debra Houry
No abstract text is available yet for this article.
May 9, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29753157/treosulfan-fludarabine-and-low-dose-total-body-irradiation-for-children-and-young-adults-with-acute-myeloid-leukemia-or-myelodysplastic-syndrome-undergoing-allogeneic-hematopoietic-cell-transplantation-a-prospective-phase-ii-trial-of-the-pediatric-blood-and
#12
Eneida R Nemecek, Ralf A Hilger, Alexia Adams, Bronwen E Shaw, Deidre Kiefer, Jennifer Le-Rademacher, John E Levine, Gregory Yanik, Wing Leung, Julie-An Talano, Paul Haut, David Delgado, Neena Kapoor, Aleksandra Petrovic, Roberta Adams, Rabi Hanna, Hemalatha Rangarajan, Jignesh Dalal, Joseph Chewning, Michael R Verneris, Stacy Epstein, Lauri Burroughs, Evelio D Perez-Albuerne, Michael A Pulsipher, Colleen Delaney
This multicenter study evaluated a treosulfan-based regimen in children and young adults with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) undergoing allogeneic hematopoietic cell transplant (HCT). Forty patients with median age 11 years (1-19) underwent allogeneic HCT for AML in first (n=18), second (n=11), third or greater remission (n=3); or MDS (n=8) using bone marrow (n=25), peripheral blood stem cells (n=5) or cord blood (n=9). The regimen consisted of body surface area (BSA)-based treosulfan 10 g/m2 /day (BSA ≤ 0...
May 9, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29743771/cervical-myelopathy-in-a-child-a-rare-cause-of-hypoventilation-syndrome-presenting-with-type-2-respiratory-failure
#13
Alolika Mondal, Prabhas Prasun Giri
Hypoventilation syndrome leading to Type 2 respiratory failure is not a rare cause of Pediatric Intensive Care Unit admission and mechanical ventilation. Common causes in pediatric population are Guillain-Barre syndrome and various central nervous system disorders such as encephalitis, traumatic brain injury, and drugs. Any injury or disease in the cervical cord can also produce respiratory paralysis causing respiratory failure. Here, we present two cases of mixed cerebral palsy with cervical myelopathy due to compression effect of fractured segments of first and second cervical vertebrae...
April 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29743575/delayed-and-progressive-damages-to-juvenile-mice-after-moderate-traumatic-brain-injury
#14
Shu Zhao, Xiaoting Wang, Xiang Gao, Jinhui Chen
Symptoms are commonly more severe in pediatric traumatic brain injury (TBI) patients than in young adult TBI patients. To understand the mechanism, juvenile mice received a controlled cortical impact (CCI) injury at moderate level. Tissue lesion and cell death were measured and compared to our previous reports on brain injury in the young adult mice that received same level of impact using same injury device. Tissue lesion and cell death in the cortex was much less in the juvenile mouse brain in the first few hours after injury...
May 9, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29743395/-allogeneic-hematopoietic-stem-cell-transplantation-using-myeloablative-conditioning-including-total-body-irradiation-for-pediatric-acute-lymphoblastic-leukemia-a-single-center-retrospective-analysis
#15
Mamoru Honda, Yuki Arakawa, Ryota Kawakami, Toshikazu Itabashi, Masato Yanagi, Koji Sasaki, Kentaro Watanabe, Kiyotaka Isobe, Makiko Mori, Ryoji Hanada, Katsuyoshi Koh
This study aimed to investigate the clinical outcomes of hematopoietic stem cell transplantation (HSCT) with total body irradiation-based myeloablative conditioning (TBI-MAC) in pediatric patients with acute lymphoblastic leukemia (ALL). We retrospectively examined patients with ALL who underwent HSCT with TBI-MAC from January 2000 to August 2016 at our institute. We enrolled 67 patients with a median follow-up period of 8 years. The 5-year event-free survival (EFS) and overall survival (OS) were 51.2% and 59...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/29739276/corpus-callosum-vasculature-predicts-white-matter-microstructure-abnormalities-following-pediatric-mild-traumatic-brain-injury
#16
Kara M Wendel, Jeong Bin Lee, Bethann Affeldt, Mary Hamer, Indira S Harahap-Carrillo, Andrea C Pardo, Andre Obenaus
Emerging data suggest that pediatric traumatic brain injury (TBI) is associated with impaired developmental plasticity and poorer neuropsychological outcomes than adults with similar head injuries. Unlike adult mild TBI (mTBI), the effects of mTBI on white matter (WM) microstructure and vascular supply are not well-understood in the pediatric population. The cerebral vasculature plays an important role providing necessary nutrients and removing waste. To address this critical element, we examined the microstructure of the corpus callosum (CC) following pediatric mTBI using diffusion tensor imaging (DTI), and investigated myelin, oligodendrocytes, and vasculature of WM with immunohistochemistry...
May 9, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29738554/repeated-mild-traumatic-brain-injury-can-cause-acute-neurologic-impairment-without-overt-structural-damage-in-juvenile-rats
#17
Alicia Meconi, Ryan C Wortman, David K Wright, Katie J Neale, Melissa Clarkson, Sandy R Shultz, Brian R Christie
Repeated concussion is becoming increasingly recognized as a serious public health concern around the world. Moreover, there is a greater awareness amongst health professionals of the potential for repeated pediatric concussions to detrimentally alter the structure and function of the developing brain. To better study this issue, we developed an awake closed head injury (ACHI) model that enabled repeated concussions to be performed reliably and reproducibly in juvenile rats. A neurological assessment protocol (NAP) score was generated immediately after each ACHI to help quantify the cumulative effects of repeated injury on level of consciousness, and basic motor and reflexive capacity...
2018: PloS One
https://www.readbyqxmd.com/read/29731964/total-body-irradiation-and-iron-chelation-treatment-are-associated-with-pancreatic-injury-following-pediatric-hematopoietic-stem-cell-transplantation
#18
Natalia Maximova, Massimo Gregori, Roberto Simeone, Aurelio Sonzogni, Davide Zanon, Giulia Boz, Lorenzo D'Antiga
Whereas many studies have addressed the risk of organ dysfunction following hematopoietic stem cell transplantation (HSCT), little is known about pancreatic susceptibility in this setting. We aimed to investigate the effect of iron overload (IO) and total body irradiation (TBI) on pancreatic function of children undergoing HSCT. We retrospectively evaluated children admitted between 2012-2016 fulfilling the following criteria: normal pancreatic iron concentration (PIC), regular pancreatic function before HSCT, availability of abdominal magnetic resonance imaging with gradient-recalled-echo sequences and a full set of biochemical markers of IO and pancreatic function performed before HSCT and at discharge...
April 13, 2018: Oncotarget
https://www.readbyqxmd.com/read/29725174/clinico-radiologic-profile-of-pediatric-traumatic-brain-injury-in-western-rajasthan
#19
Pawan Kumar Dara, Manish Parakh, Shyama Choudhary, Hemant Jangid, Priyanka Kumari, Satyendra Khichar
Objective: The aim of this study was to evaluate clinico-radiological profile and outcome of pediatric traumatic brain injury (TBI). Design: Prospective observational study. Setting: Intensive Care Unit, ward and OPD of Pediatrics, Dr. S. N. Medical College, Jodhpur (tertiary care hospital). Participants: A total of 188 children (1 month-18 years) were enrolled and 108 admitted. Intervention: TBI classified as mild, moderate, or severe TBI...
April 2018: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/29717626/the-moderating-effect-of-ankk1-on-the-association-of-family-environment-with-longitudinal-executive-function-following-traumatic-brain-injury-in-early-childhood-a-preliminary-study
#20
Julia Smith-Paine, Shari L Wade, Amery Treble-Barna, Nanhua Zhang, Huaiyu Zang, Lisa J Martin, Keith Owen Yeates, H Gerry Taylor, Brad G Kurowski
This study examined whether the ankyrin repeat and kinase domain containing 1 gene (ANKK1) C/T single-nucleotide polymorphism (SNP) rs1800497 moderated the association of family environment with long-term executive function (EF) following traumatic injury in early childhood. Caregivers of children with traumatic brain injury (TBI) and children with orthopedic injury (OI) completed the Behavior Rating Inventory of Executive Function (BRIEF) at post injury visits. DNA was collected to identify the rs1800497 genotype in the ANKK1 gene...
May 2, 2018: Journal of Neurotrauma
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