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pediatric hypokalemia

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...
August 16, 2016: Jornal de Pediatria
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
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
Shreya Sharma, Ramachandran Rameshkumar, Subramanian Mahadevan
Cleistanthus collinus, also known as Oduvanthalai in Tamil, is the most commonly encountered plant poison in southern India. The leaves are used for poisoning humans (suicide or homicide) and animals (cattle and fish) and as an abortifacient, especially in rural south India. Although this poisoning is commonly reported in adults, data regarding the use of N-acetylcysteine in pediatric poisoning is lacking. We report two previously healthy male siblings of pediatric age group who ingested the liquid extracted from crushed leaves of this plant given to them by their mother as a means of deliberate harm...
May 29, 2016: Journal of Tropical Pediatrics
Michal Cohen, Noa Leibovitz, Smadar Shilo, Nehama Zuckerman-Levin, Itai Shavit, Naim Shehadeh
BACKGROUND: Diabetic ketoacidosis (DKA) treatment protocols vary, however low-dose intravenous administration of regular insulin is the standard care for replacing insulin in most centers. Few studies, the majority in adults, demonstrated subcutaneous injection of rapid-acting insulin every 1-2 hours to be a valid alternative. OBJECTIVE: To evaluate the efficacy and safety of subcutaneous regular insulin administered every 4 hours in pediatric DKA in a clinical setting...
March 23, 2016: Pediatric Diabetes
Abraham M Kaslow, Anne Riquier-Brison, Janos Peti-Peterdi, Nick Shillingford, Josephine HaDuong, Rajkumar Venkatramani, Christopher P Gayer
A previously healthy 7-year-old male presented with hypertensive emergency, hypokalemia, and elevated plasma renin activity and aldosterone levels. There was no evidence of virilization or cushingoid features. MRI of the abdomen revealed a large (5 × 5 × 3 cm) peripherally enhancing, heterogeneous mass arising from the left adrenal gland. The patient was treated for a suspected pheochromocytoma. However, his blood pressure was not responsive to alpha-blockade. Blood pressure was controlled with a calcium channel blocker and an angiotensin-converting enzyme (ACE) inhibitor...
March 2016: Physiological Reports
Taís Daiene Russo Hortencio, Roberto José Negrao Nogueira, Fernando Augusto de Lima Marson, Antonio Fernando Ribeiro
BACKGROUND: Hypophosphatemia, hypomagnesemia, and hypokalemia occur in patients receiving parenteral nutrition (PN), mainly when the body's stores are depleted due to fasting or inflammation. Although these disorders are potentially fatal, few studies have reported the incidence in the pediatric population. METHODS: This study evaluated, in a historical cohort of pediatric patients, the prevalence of hypophosphatemia, hypokalemia, and hypomagnesaemia until 48 hours before initiation of PN infusion (P1) and from days 1-4 (P2) and days 5-7 (P3) of PN infusion and investigated if malnutrition, calories, and protein infusion were correlated to these disorders...
April 2016: Nutrition in Clinical Practice
Benjamin Sahn, Mei Lin Chen-Lim, Denise Ciavardone, Lisa Farace, Frances Jannelli, Megan Nieberle, Elizabeth Ely, Xuemei Zhang, Judith Kelsen, Anita Puma, Petar Mamula
OBJECTIVES: Electrolyte-free polyethylene glycol powder (PEG-3350) has been widely used for colonoscopy preparation (prep); however, limited safety data on electrolyte changes exists with 1-day prep regimens. The primary aim of this study was to determine the proportion of patients with significant serum chemistry abnormalities before and at the time of colonoscopy. Secondary aims included evaluation of prep tolerance and bowel cleansing efficacy. METHODS: We performed a prospective descriptive observational study of pediatric patients scheduled for outpatient colonoscopy who received our standard 1-day, weight-based 4 g/kg PEG-3350 prep with a single stimulant laxative dose and had serum chemistry testing within 60 days before and at the time of colonoscopy...
July 2016: Journal of Pediatric Gastroenterology and Nutrition
Ronadip R Banerjee, Neyssa Marina, Laurence Katznelson, Brian J Feldman
Cushing's syndrome (CS) in the pediatric population is challenging to diagnose and treat. Although next-generation medical therapies are emerging for adults with CS, none are currently approved or used in children. Here we describe the first use of mifepristone, a glucocorticoid receptor antagonist, to treat CS in a pediatric subject. The patient, a 14-year-old girl with an 18-month history of metastatic neuroendocrine carcinoma, suffered from fatigue, profound myopathy, irritability, and depression. She was found to have hypertension, hypokalemia, and worsening control of her preexisting type 1 diabetes...
November 2015: Pediatrics
Ji Eun Kim, Se Jin Park, Ji Young Oh, Ji Hong Kim, Jae Seung Lee, Pyung Kil Kim, Jae Il Shin
PURPOSE: The aim of this study was to investigate noninfectious complications of peritoneal dialysis (PD), including mechanical and metabolic complications, at a single center in Korea. MATERIALS AND METHODS: We analyzed data from 60 PD patients aged ≤18 years (40 boys and 20 girls) during the period between 1986 and 2012. The collected data included gender, age, causes of PD, incidence of noninfectious complications, and treatment for the complications. RESULTS: The mean duration of PD therapy was 28...
September 2015: Yonsei Medical Journal
Larry W Buie, Joshua J Pecoraro, Troy Z Horvat, Ryan J Daley
OBJECTIVE: To review the clinical pharmacology, efficacy, and safety of blinatumomab for the treatment of pediatric and adult precursor B-cell acute lymphoblastic leukemia (B-ALL). DATA SOURCES: A literature search of EMBASE (1947 to April 2015), Medline (1946 to April 2015), PubMed (1996 to April 2015), the U.S. National Institutes of Health, the Food and Drug Administration, and relevant meeting abstracts was conducted using the terms blinatumomab, BiTE, bispecific T-cell engager, MT103, MEDI-538, and Blincyto...
September 2015: Annals of Pharmacotherapy
Emily Kay Boone, Arun Aggarwal
With the current prevalence of celiac disease, it is important to know the common signs and symptoms of this disease process and to also be aware of atypical presentations. This article describes a toddler who initially presented with recurrent diarrhea and weight loss with a significant secondary hypokalemia. His initial examination included screening for celiac disease, but the serology was negative. After persistent and worsening symptoms, further tests were pursued and a diagnosis of celiac disease was confirmed based on an upper endoscopy and histology...
May 2015: Pediatric Annals
Joowon Lee, Gi Beom Kim, Hye Won Kwon, Bo Sang Kwon, Eun Jung Bae, Chung Il Noh, Hong Gook Lim, Woong Han Kim, Jeong Ryul Lee, Yong Jin Kim
BACKGROUND AND OBJECTIVES: Milrinone is often used in children to treat acute heart failure and prevent low cardiac output syndrome after cardiac surgery. Due to the lack of studies on the long-term milrinone use in children, the objective of this study was to assess the safety and efficacy of the current patterns of milrinone use for ≥3 days in infants and children with heart diseases. SUBJECTS AND METHODS: We retrospectively reviewed the medical records of patients aged <13 years who received milrinone for ≥3 days from January 2005 to December 2012...
September 2014: Korean Circulation Journal
Karthi Nallasamy, Muralidharan Jayashree, Sunit Singhi, Arun Bansal
IMPORTANCE: The standard recommended dose (0.1 U/kg per hour) of insulin in diabetic ketoacidosis (DKA) guidelines is not backed by strong clinical evidence. Physiologic dose-effect studies have found that even lower doses could adequately normalize ketonemia and acidosis. Lowering the insulin dose may be advantageous in the initial hours of therapy when a gradual decrease in glucose, electrolytes, and resultant osmolality is desired. OBJECTIVE: To compare the efficacy and safety of low-dose insulin against the standard dose in children with DKA...
November 2014: JAMA Pediatrics
R C Brennan, W Furman, S Mao, J Wu, D C Turner, C F Stewart, V Santana, L M McGregor
PURPOSE: This phase I study endeavored to estimate the maximum tolerated dose and describe the dose-limiting toxicities (DLTs) of oral irinotecan with gefitinib in children with refractory solid tumors. METHODS: Oral irinotecan was administered on days 1-5 and 8-12 with oral gefitinib (fixed dose, 150 mg/m(2)/day) on days 1-12 of a 21-day course. The escalation with overdose control method guided irinotecan dose escalation (7 dose levels, range 5-40 mg/m(2)/day)...
December 2014: Cancer Chemotherapy and Pharmacology
Hiba Al-Zubeidi, Carla Demeterco, Kenneth Lee Jones
INTRODUCTION: Periodic paralysis associated with hyperthyroidism and hypokalemia is an uncommon disorder reported primarily in Asian males and rarely in children. We report three Hispanic adolescent males who were seen with Graves' disease (GD) and THPP. METHODS: The method used was chart review. RESULTS: Two of these boys presented with episodes of paralysis and were diagnosed with GD. The third was initially seen with hyperthyroidism and developed weakness and paralysis when his disease progressed because of therapeutic noncompliance...
January 2015: Journal of Pediatric Endocrinology & Metabolism: JPEM
Ildiko H Koves, Michael G Leu, Suzanne Spencer, Jean C Popalisky, Kate Drummond, Elaine Beardsley, Kristi Klee, Jerry J Zimmerman
OBJECTIVE: We sought to create and implement recommendations from an evidence-based pathway for hospital management of pediatric diabetic ketoacidosis (DKA) and to sustain improvement. We hypothesized that development and utilization of standard work for inpatient care of DKA would lead to reduction in hypokalemia and improvement in outcome measures. METHODS: Development involved systematic review of published literature by a multidisciplinary team. Implementation included multidisciplinary feedback, hospital-wide education, daily team huddles, and development of computer decision support and electronic order sets...
September 2014: Pediatrics
Justine Bacchetta, Odile Basmaison, Anne-Laure Leclerc, Aurélia Bertholet-Thomas, Pierre Cochat, Bruno Ranchin
BACKGROUND: The management of tubulopathies after renal transplantation (RTx) may require high doses of sodium and bicarbonate, reducing the quality of life and therapeutic compliance of the patient. Some studies on adult patients have highlighted the benefits of fludrocortisone (fludro) in the treatment of severe tubulopathies. METHODS: This study was a retrospective review of the medical charts of 15 children, aged 12.4 (range 3.6-17.4) years who received fludro after RTx...
October 2014: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Stanislaw R Burzynski, Tomasz J Janicki, Gregory S Burzynski, Ania Marszalek
BACKGROUND: Brainstem gliomas (BSG) are relatively rare tumors of which recurrent pediatric diffuse intrinsic pontine gliomas (RPDIPG) comprise a distinct group. Numerous trials have been conducted on RPDIPG, none of which have resulted in identifying any proven pharmacological treatment benefit. This study included 40 patients diagnosed with different types of BSG, but it was decided to describe first the encouraging results in the most challenging group of RPDIPG. MATERIALS AND METHODS: This single-arm phase II study evaluated the efficacy and safety of the combination of antineoplastons A10 and AS2-1 (ANP) in patients with RPDIPG...
December 2014: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Pierluigi Marzuillo, Alessandra Benettoni, Claudio Germani, Giovanna Ferrara, Biancamaria D'Agata, Egidio Barbi
Acquired long QT syndrome (LQTS) is a disorder of cardiac repolarization most often due to specific drugs, hypokalemia, or hypomagnesemia that may precipitate torsade de pointes and cause sudden cardiac death. Common presentations of the LQTS are palpitations, presyncope, syncope, cardiac arrest, and seizures. An abnormal 12-lead electrocardiogram obtained while the patient is at rest is the key to diagnosis. The occurrence of drug-induced LQTS is unpredictable in any given individual, but a common observation is that most patients have at least 1 identifiable risk factor in addition to drug exposure...
April 2014: Pediatric Emergency Care
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