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pediatric hypokalemia

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https://www.readbyqxmd.com/read/29126579/chest-pain-as-a-manifestation-of-hypokalemia-in-a-pediatric-patient
#1
Jonathan S Schiffman
Patients presenting to the emergency department with chest pain are common and a cause of significant concern to patients and families and physicians alike. The causes of chest pain are myriad. These causes span diverse categories including cardiovascular, respiratory, abdominal and gastrointestinal, musculoskeletal, psychiatric, hematologic and oncologic, and neurologic Thull-Freedman (2010) [1]. These diverse etiologies present a diagnostic and management challenge to the ER physician who is tasked to minimize unnecessary diagnostics while not missing any significant disease...
November 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29059403/incidence-of-hyperglycemia-and-diabetes-and-association-with-electrolyte-abnormalities-in-pediatric-solid-organ-transplant-recipients
#2
Rahul Chanchlani, Sang Joseph Kim, Esther D Kim, Tonny Banh, Karlota Borges, Jovanka Vasilevska-Ristovska, Yanhong Li, Vicky Ng, Anne I Dipchand, Melinda Solomon, Diane Hebert, Rulan S Parekh
Background: Posttransplant hyperglycemia is an important predictor of new-onset diabetes after transplantation, and both are associated with significant morbidity and mortality. Precise estimates of posttransplant hyperglycemia and diabetes in children are unknown. Low magnesium and potassium levels may also lead to diabetes after transplantation, with limited evidence in children. Methods: We conducted a cohort study of 451 pediatric solid organ transplant recipients to determine the incidence of hyperglycemia and diabetes, and the association of cations with both endpoints...
September 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28989879/root-cause-analysis-of-diabetic-ketoacidosis-admissions-at-a-tertiary-referral-pediatric-emergency-department-in-north-india
#3
Muralidharan Jayashree, Rohit Sasidharan, Sunit Singhi, Karthi Nallasamy, Mullai Baalaaji
OBJECTIVES: To identify system-based factors contributing to Emergency Department (ED) admissions of children with diabetic ketoacidosis (DKA) and related complications with emphasis on parental and physician awareness and prereferral management. MATERIALS AND METHODS: A prospective observational root cause analysis study of all consecutive admissions of children with DKA to pediatric ED of a tertiary care referral hospital in northern India over a period of 1 year (July 2010-June 2011)...
September 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28945677/analysis-of-hypokalemia-as-a-side-effect-of-liposomal-amphotericin-in-pediatric-patients
#4
Ryoji Kobayashi, Dai Keino, Daiki Hori, Hirozumi Sano, Daisuke Suzuki, Kenji Kishimoto, Kunihiko Kobayashi
BACKGROUND: Liposomal amphotericin (L-AMB) is a widely used broad-spectrum anti-fungal drug. Although L-AMB demonstrates better safety compared with amphotericin, renal dysfunction and hypokalemia are well-known adverse effects of L-AMB. METHOD: We analyzed 56 episodes in 40 children and adolescents who received L-AMB therapy to determine risk factors of hypokalemia. RESULTS: Hypokalemia (<3.0 mEq/L continuously for more than two episodes) was observed in 31 out of 56 episodes (55...
September 21, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28864157/basal-insulin-for-the-management-of-diabetic-ketoacidosis
#5
REVIEW
Leonid Barski, Evgenia Brandstaetter, Iftach Sagy, Alan Jotkowitz
Due to its pharmacokinetic properties, it has been suggested that long-acting insulin analogues may have a role in facilitating the transition from continuous intravenous insulin infusion to subcutaneous maintenance therapy in patients with DKA for prevention of rebound hyperglycemia, particularly if there are high insulin requirements. Concomitant administration of basal insulin analogues with regular insulin infusion accelerates ketoacidosis resolution and prevents rebound hyperglycemia. Several studies have investigated the use of basal insulin in the management of DKA...
August 30, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28816795/voriconazole-antifungal-prophylaxis-in-children-with-malignancies-a-nationwide-study
#6
Zoi Dorothea Pana, Maria Kourti, Katerina Vikelouda, Antonia Vlahou, Nikolaos Katzilakis, Maria Papageorgiou, Dimitrios Doganis, Loizos Petrikkos, Anna Paisiou, Dimitrios Koliouskas, Antonios Kattamis, Eftichia Stiakaki, Maria Chatzistilianou, Helen Vasilatou-Kosmidis, Sophia Polychronopoulou, Stelios Grafakos, Emmanuel Roilides
BACKGROUND: Antifungal prophylaxis (AFP) is recommended in at-risk hematology-oncology patients. We evaluated the safety of AFP with voriconazole (VRC) in pediatric hematology/oncology patients. MATERIALS AND METHODS: A retrospective study of VRC AFP in children with malignancies hospitalized in all 7 Greek pediatric hematology/oncology centers during 2008 to 2012 was conducted. Patients' demographics, outcome, and adverse event (AE) data were recorded. RESULTS: Four hundred twenty-nine VRC AFP courses in 249 patients (median age 6 y, 55% boys) were studied...
August 14, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28730220/verner-morrison-syndrome-literature-review
#7
Oana Andreea Belei, Elena Rodica Heredea, Estera Boeriu, Tamara Marcela Marcovici, Simona Cerbu, Otilia Mărginean, Emil Radu Iacob, Daniela Iacob, Andrei Gheorghe Marius Motoc, Eugen Sorin Boia
Chronic diarrhea in infants is a common condition for addressability to pediatric gastroenterologists. The causes are multiple and the delay in reaching the final diagnosis can lead to complications in the general condition of the child. The purpose of this review is to present the bio-clinical and histogenetic particularities of a rare clinical entity, characterized by tumoral causes of chronic diarrhea. VIPomas are neuroendocrine tumors that autonomously secrete vasoactive intestinal peptide (VIP). Watery diarrhea, hypokalemia and achlorhydria (WDHA) syndrome caused by VIP-producing tumors only rarely occurs in adult patients with non-pancreatic disease...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28489146/acute-muscular-weakness-in-children
#8
REVIEW
Ricardo Pablo Javier Erazo Torricelli
Acute muscle weakness in children is a pediatric emergency. During the diagnostic approach, it is crucial to obtain a detailed case history, including: onset of weakness, history of associated febrile states, ingestion of toxic substances/toxins, immunizations, and family history. Neurological examination must be meticulous as well. In this review, we describe the most common diseases related to acute muscle weakness, grouped into the site of origin (from the upper motor neuron to the motor unit). Early detection of hyperCKemia may lead to a myositis diagnosis, and hypokalemia points to the diagnosis of periodic paralysis...
April 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/28409853/a-phase-1-study-of-the-cxcr4-antagonist-plerixafor-in-combination-with-high-dose-cytarabine-and-etoposide-in-children-with-relapsed-or-refractory-acute-leukemias-or-myelodysplastic-syndrome-a-pediatric-oncology-experimental-therapeutics-investigators-consortium
#9
Todd M Cooper, Edward Allan Racela Sison, Sharyn D Baker, Lie Li, Amina Ahmed, Tanya Trippett, Lia Gore, Margaret E Macy, Aru Narendran, Keith August, Michael J Absalon, Jessica Boklan, Jessica Pollard, Daniel Magoon, Patrick A Brown
BACKGROUND: Plerixafor, a reversible CXCR4 antagonist, inhibits interactions between leukemic blasts and the bone marrow stromal microenvironment and may enhance chemosensitivity. A phase 1 trial of plerixafor in combination with intensive chemotherapy in children and young adults with relapsed or refractory acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), and myelodysplastic syndrome (MDS) was performed to determine a tolerable and biologically active dose. PROCEDURE: Plerixafor was administered daily for 5 days at four dose levels (6, 9, 12, and 15 mg/m(2) /dose) followed 4 hr later by high-dose cytarabine (every 12 hr) and etoposide (daily)...
August 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28291262/effects-of-bumetanide-on-neurobehavioral-function-in-children-and-adolescents-with-autism-spectrum-disorders
#10
E Lemonnier, N Villeneuve, S Sonie, S Serret, A Rosier, M Roue, P Brosset, M Viellard, D Bernoux, S Rondeau, S Thummler, D Ravel, Y Ben-Ari
In animal models of autism spectrum disorder (ASD), the NKCC1 chloride-importer inhibitor bumetanide restores physiological (Cl(-))i levels, enhances GABAergic inhibition and attenuates electrical and behavioral symptoms of ASD. In an earlier phase 2 trial; bumetanide reduced the severity of ASD in children and adolescents (3-11 years old). Here we report the results of a multicenter phase 2B study primarily to assess dose/response and safety effects of bumetanide. Efficacy outcome measures included the Childhood Autism Rating Scale (CARS), the Social Responsive Scale (SRS) and the Clinical Global Impressions (CGI) Improvement scale (CGI-I)...
March 14, 2017: Translational Psychiatry
https://www.readbyqxmd.com/read/28018153/a-pediatric-diabetic-ketoacidosis-management-protocol-incorporating-a-two-bag-intravenous-fluid-system-decreases-duration-of-intravenous-insulin-therapy
#11
Megan Veverka, Kourtney Marsh, Susan Norman, Michael Alan Brock, Monica Peng, Jennifer Shenk, Jerome Gene Chen
OBJECTIVES: Diabetic ketoacidosis (DKA) is a leading cause of morbidity and mortality in children with type 1 diabetes. We implemented a standardized DKA management protocol by using a 2-bag intravenous (IV) fluid system. The purpose of the study was to examine if the protocol improved clinical outcomes and process efficiency. METHODS: This was a retrospective study of patients who did and did not undergo the protocol. Patients were included if they were 18 years of age or younger, were diagnosed with DKA, admitted to an intensive care unit or stepdown unit, and received continuous IV insulin...
November 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/27998223/phase-i-phase-ii-study-of-blinatumomab-in-pediatric-patients-with-relapsed-refractory-acute-lymphoblastic-leukemia
#12
COMPARATIVE STUDY
Arend von Stackelberg, Franco Locatelli, Gerhard Zugmaier, Rupert Handgretinger, Tanya M Trippett, Carmelo Rizzari, Peter Bader, Maureen M O'Brien, Benoît Brethon, Deepa Bhojwani, Paul Gerhardt Schlegel, Arndt Borkhardt, Susan R Rheingold, Todd Michael Cooper, Christian M Zwaan, Phillip Barnette, Chiara Messina, Gérard Michel, Steven G DuBois, Kuolung Hu, Min Zhu, James A Whitlock, Lia Gore
Purpose Blinatumomab is a bispecific T-cell engager antibody construct targeting CD19 on B-cell lymphoblasts. We evaluated the safety, pharmacokinetics, recommended dosage, and potential for efficacy of blinatumomab in children with relapsed/refractory B-cell precursor acute lymphoblastic leukemia (BCP-ALL). Methods This open-label study enrolled children < 18 years old with relapsed/refractory BCP-ALL in a phase I dosage-escalation part and a phase II part, using 6-week treatment cycles. Primary end points were maximum-tolerated dosage (phase I) and complete remission rate within the first two cycles (phase II)...
December 20, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27955984/lower-extremity-weakness-in-a-teenager-due-to-thyrotoxic-periodic-paralysis
#13
Matthew D Thornton
BACKGROUND: Thyrotoxic hypokalemic paralysis is the hallmark of thyrotoxic periodic paralysis (TPP). TPP is a potentially deadly complication of hyperthyroidism that occurs because of rapid and dramatic intracellular shift of potassium. This transference results in severe hypokalemia and clinically manifests itself as muscle weakness or paralysis. This condition predominantly affects males of Asian descent, and its presentation can range from mild to severe, as seen in our case. CASE REPORT: We present the case of a 15-year-old Asian-American male who presented to a tertiary-care pediatric emergency department complaining of generalized weakness and flaccid paralysis of his lower extremities...
April 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27888815/acute-diarrhoea-induced-by-rotavirus-in-children-hospitalysed-in-provincial-hospital-for-infectious-diseases-in-bydgoszcz-in-2014-year
#14
Beata Smok, Katarzyna Zieniewicz-Cieślik, Ewa Smukalska, Małgorzata Pawłowska
OBJECTIVE: The aim of the present study was to describe the epidemiology and course of rotavirus infection in children hospitalized at the T. Browicz Provincial Hospital for Infectious Diseases in Bydgoszcz, Poland in 2014 year. INTRODUCTION: Rotavirus infection is responsible for over 2 millions hospitalizations per year among children under 5 year old. Rotavirus gastroenterocolitis is one of the most common cause of severe dehydration, electrolyte disturbances and metabolic acidosis, leading to 400-600 thousand deaths per year in children younger than 5 years of age worldwide...
2016: Przegla̧d Epidemiologiczny
https://www.readbyqxmd.com/read/27855062/safety-tolerability-and-pharmacokinetics-of-liposomal-amphotericin-b-in-immunocompromised-pediatric-patients
#15
Nita L Seibel, Aziza T Shad, Ihor Bekersky, Andreas H Groll, Corina Gonzalez, Lauren V Wood, Paul Jarosinski, Donald Buell, William W Hope, Thomas J Walsh
The safety, tolerability, and pharmacokinetics of the liposomal formulation of amphotericin B (L-AMB) were evaluated in 40 immunocompromised children and adolescents. The protocol was an open-label, sequential-dose-escalation, multidose pharmacokinetic study with 10 to 13 patients in each of the four dosage cohorts. Each cohort received daily dosages of 2.5, 5.0, 7.5, or 10 mg of amphotericin B in the form of L-AMB per kg of body weight. Neutropenic patients between the ages of 1 and 17 years were enrolled to receive empirical antifungal therapy or treatment of documented invasive fungal infections...
February 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27807910/glargine-co-administration-with-intravenous-insulin-in-pediatric-diabetic-ketoacidosis-is-safe-and-facilitates-transition-to-a-subcutaneous-regimen
#16
V Sanoe Harrison, Stacy Rustico, Andrew A Palladino, Christine Ferrara, Colin Patrick Hawkes
BACKGROUND: Diabetes ketoacidosis (DKA) is a common presentation and complication of type 1 diabetes (T1D). While intravenous insulin is typically used to treat acute metabolic abnormalities, the transition from intravenous to subcutaneous treatment can present a challenge. We hypothesize that co-administration of glargine, a subcutaneous long-acting insulin analog, during insulin infusion may facilitate a flexible and safe transition from intravenous to subcutaneous therapy. OBJECTIVE: To determine if the practice of administering subcutaneous glargine during intravenous insulin is associated with an increased risk of hypoglycemia, hypokalemia, or other complications in children with DKA...
December 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/27770618/diabetic-ketoacidosis-in-a-pediatric-intensive-care-unit
#17
Clarice L S Lopes, Paula Pitta Pinheiro, Luzia S Barberena, Guilherme U Eckert
OBJECTIVE: To describe the characteristics of children aged 0-14 years diagnosed with diabetic ketoacidosis and compare the following outcomes between children with prior diagnosis of type 1 diabetes mellitus and children without prior diagnosis of type 1 diabetes mellitus length of hospital stay, severity on admission, insulin dosage, time of continuous insulin use, volume of fluids infused during treatment, and complications. METHODS: A retrospective descriptive study with review of medical records of patients admitted to the pediatric intensive care unit of a referral hospital from June 2013 to July 2015...
March 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/27542916/acute-kidney-injury-in-hiv-infected-children-comparison-of-patients-according-to-the-use-of-highly-active-antiretroviral-therapy
#18
Douglas de Sousa Soares, Malena Gadelha Cavalcante, Samille Maria Vasconcelos Ribeiro, Rayana Café Leitão, Ana Patrícia Freitas Vieira, Roberto da Justa Pires Neto, Geraldo Bezerra da Silva Junior, Elizabeth de Francesco Daher
OBJECTIVE: To assess clinical and laboratory data, and acute kidney injury (AKI) in HIV-infected children using and not using highly active antiretroviral therapy (HAART) prior to admission. METHODS: A retrospective study was conducted with HIV-infected pediatric patients (<16 years). Children who were using and not using HAART prior to admission were compared. RESULTS: Sixty-three patients were included. Mean age was 5.3±4.27 years; 55...
November 2016: Jornal de Pediatria
https://www.readbyqxmd.com/read/27362851/decreasing-iv-potassium-in-pediatric-cardiac-intensive-care-quality-improvement-project
#19
Leslie A Rhodes, Kevin M Wall, Staci L Abernathy, Ashley B Moellinger, Santiago Borasino, Jeffrey A Alten
OBJECTIVES: IV potassium supplementation is commonly used in the pediatric cardiovascular ICU. However, concentrated IV potassium chloride doses can lead to life-threatening complications. We report results of a quality improvement project aimed at decreasing concentrated IV potassium chloride exposure. DESIGN: Retrospective evaluation of a quality improvement project aimed at reducing IV potassium chloride exposure. SETTING: Pediatric cardiac ICU...
August 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27325428/liddle-syndrome-in-a-turkish-family-with-heterogeneous-phenotypes
#20
Bahar Büyükkaragöz, Aysun Caltik Yilmaz, Deniz Karcaaltincaba, Osman Ozdemir, Michael Ludwig
Liddle syndrome (LS) is a familial disease characterized by early onset hypertension (HT). Although regarded as rare, its incidence may be greater than expected because the classical findings of hypokalemic metabolic alkalosis with suppressed renin and aldosterone levels are not consistently present. Herein, we present the case of an adolescent boy and maternal relatives who were followed up with misdiagnosis of essential HT for a long duration. Clinical diagnosis of LS was confirmed on genetic analysis. Despite carrying the same mutation, the index patient and the family members manifested heterogeneous phenotypes of the disease including age at presentation, degree of HT, presence of hypokalemia and renal/cardiac complications...
August 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
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