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Pediatric life-sustaining treatment

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https://www.readbyqxmd.com/read/29707152/advance-care-planning-and-outcome-in-pediatric-palliative-home-care
#1
Jessica I Hoell, Hannah L Weber, Stefan Balzer, Mareike Danneberg, Gabriele Gagnon, Laura Trocan, Arndt Borkhardt, Gisela Janßen, Michaela Kuhlen
Pediatric advance care planning seeks to ensure end-of-life care conforming to the patients/their families' preferences. To expand our knowledge of advance care planning and "medical orders for life-sustaining treatment" (MOLST) in pediatric palliative home care, we determined the number of patients with MOLST, compared MOLST between the four "Together for Short Lives" (TfSL) groups and analyzed, whether there was a relationship between the content of the MOLST and the patients' places of death...
April 3, 2018: Oncotarget
https://www.readbyqxmd.com/read/29677032/landiolol-hydrochloride-rapidly-controls-junctional-ectopic-tachycardia-after-pediatric-heart-surgery
#2
Fumiya Yoneyama, Chiho Tokunaga, Hideyuki Kato, Tomomi Nakajima, Bryan J Mathis, Hiroaki Sakamoto, Yuji Hiramatsu
OBJECTIVES: Junctional ectopic tachycardia is a supraventricular tachyarrhythmia with atrioventricular dissociation that causes life-threatening postsurgical conditions in pediatric heart patients. This study evaluates the efficacy of landiolol hydrochloride for managing junctional ectopic tachycardia. DESIGN: A single-center retrospective study. SETTING: PICU at the university hospital. PATIENTS: Of 561 pediatric patients who underwent open-heart surgery between 2006 and 2017, 10 patients developed sustained junctional ectopic tachycardia and were selected for landiolol treatment...
April 19, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29546924/-limitation-of-vital-support-in-a-chilean-pediatric-intensive-care-unit-2004-2014
#3
Bettina von Dessauer, Carmen Benavente, Emilia Monje, Jazmina Bongain, Nadia Ordenes
OBJECTIVE: Describe the frequency and characteristics of PICU patients who undergo a process of withholding or withdrawing life-sustaining treatment (LTSV), between 2004 y 2014. PATIENTS AND METHOD: A retrospective, observational descriptive study, using two documents for quality assessment in the PICU of Hospital Roberto del Río: 1) daily individual patient tracking log and 2) daily record of quality indicators, including LTSV, both updated daily at the morning visit...
December 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/29514842/enhanced-intratumoral-delivery-of-sn38-as-a-tocopherol-oxyacetate-prodrug-using-nanoparticles-in-a-neuroblastoma-xenograft-model
#4
Ferro Nguyen, Ivan Alferiev, Peng Guan, David T Guerrero, Venkatadri Kolla, Ganesh S Moorthy, Michael Chorny, Garrett M Brodeur
Purpose: Currently, <50% of high-risk pediatric solid tumors like neuroblastoma can be cured, and many survivors experience serious or life-threatening toxicities, so more effective, less toxic therapy is needed. One approach is to target drugs to tumors using nanoparticles, which take advantage of the enhanced permeability of tumor vasculature. Experimental Design: SN38, the active metabolite of irinotecan (CPT-11), is a potent therapeutic agent that is readily encapsulated in polymeric nanoparticles. Tocopherol oxyacetate (TOA) is a hydrophobic mitocan that was linked to SN38 to significantly increase hydrophobicity and enhance nanoparticle retention...
March 7, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/29464831/intensive-remote-monitoring-versus-conventional-care-in-type-1-diabetes-a-randomized-controlled-trial
#5
Laura Gandrud, Aylin Altan, Paul Buzinec, Jesse Hemphill, Jayne Chatterton, Tina Kelley, Deneen Vojta
OBJECTIVE: While frequent contact with diabetes care providers may improve glycemic control among patients with type 1 diabetes (T1D), in-person visits are labor-intensive and costly. This study was conducted to assess the impact of an intensive remote therapy (IRT) intervention for pediatric patients with T1D. METHODS: Pediatric patients with T1D were randomized to IRT or conventional care (CC) for 6 months. Both cohorts continued routine quarterly clinic visits and uploaded device data; for the IRT cohort, data were reviewed and patients were contacted if regimen adjustments were indicated...
February 21, 2018: Pediatric Diabetes
https://www.readbyqxmd.com/read/29436391/associations-between-pediatric-palliative-care-consultation-and-end-of-life-preparation-at-an-academic-medical-center-a-retrospective-ehr-analysis
#6
Matthew Stutz, Roy L Kao, Leanna Huard, Jonathan Grotts, Javier Sanz, Mindy K Ross
OBJECTIVES: Our aim in this study was to understand usage patterns of pediatric palliative care (PPC) consultation and associations with end-of-life preparation among pediatric patients who are deceased. METHODS: We reviewed 233 pediatric mortalities. Data extraction from the electronic health record included determination of PPC consultation by using Current Procedural Terminology codes. Diagnoses were identified by International Classification of Disease codes and were classified into categories of life-threatening complex chronic conditions (LT-CCCs)...
March 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29341962/withdrawal-of-life-sustaining-therapy
#7
Barbara G Jericho
PURPOSE OF REVIEW: The aim of this review is to examine literature relating to the withdrawal of life-sustaining therapy (WLST). RECENT FINDINGS: Discussions regarding end-of-life issues in adults and children are not occurring comprehensively. Discussions relating to the WLST in the pediatric population varies by institution and may vary by race, age, health insurance, diagnosis, and severity of illness. Completing advance directives prior to placement of life-sustaining treatments is not consistent practice...
January 15, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29321079/the-enactment-stage-of-end-of-life-decision-making-for-children
#8
Jane Elizabeth Sullivan, Lynn Heather Gillam, Paul Terence Monagle
OBJECTIVES: Typically pediatric end-of-life decision-making studies have examined the decision-making process, factors, and doctors' and parents' roles. Less attention has focussed on what happens after an end-of-life decision is made; that is, decision enactment and its outcome. This study explored the views and experiences of bereaved parents in end-of-life decision-making for their child. Findings reported relate to parents' experiences of acting on their decision. It is argued that this is one significant stage of the decision-making process...
January 11, 2018: Palliative & Supportive Care
https://www.readbyqxmd.com/read/29240626/first-report-of-biventricular-percutaneous-impella-ventricular-assist-device-use-in-pediatric-patients
#9
Javier J Lasa, Daniel A Castellanos, Susan W Denfield, William J Dreyer, Sebastian C Tume, Henri Justino, Athar M Qureshi
There is a growing interest in the use of percutaneously delivered ventricular assist devices (PVAD) in the pediatric patient population. A 16 year old female and 18 year old male both status post heart transplantation presented with evidence of graft rejection and acute severe global systolic and diastolic heart failure necessitating hemodynamic catheterization and inotropic support. Both underwent percutaneous Impella CP LVAD (Abiomed, Danvers, MA) placement with close monitoring of right ventricular function...
December 11, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29222827/responding-to-parental-requests-for-life-sustaining-treatment-relational-potential-revisited
#10
Aaron Wightman, Jennifer Cobelli Kett, Benjamin S Wilfond
No abstract text is available yet for this article.
December 8, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29179574/life-sustaining-treatment-status-at-the-time-of-death-in-a-japanese-pediatric-intensive-care-unit
#11
Fumiko Suzuki, Muneyuki Takeuchi, Kazuya Tachibana, Kanako Isaka, Yu Inata, Keiko Kinouchi
BACKGROUND: Substantial variability exists among countries regarding the modes of death in pediatric intensive care units (PICUs). However, there is limited information on end-of-life care in Japanese PICUs. Thus, this study aimed to elucidate the characteristics of end-of-life care practice for children in a Japanese PICU. METHODS: We examined life-sustaining treatment (LST) status at the time of death based on medical chart reviews from 2010 to 2014. All deaths were classified into 3 groups: limitation of LST (limitation group, death after withholding or withdrawal of LST or a do not attempt resuscitation order), no limitation of LST (no-limitation group, death following failed resuscitation attempts), or brain death (brain death group)...
May 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29124391/implementing-a-digital-real-time-hydrocephalus-and-shunt-registry-to-evaluate-contemporary-pattern-of-care-and-surgical-outcome-in-pediatric-hydrocephalus
#12
Hans Christoph Bock, Maximilian Kanzler, Ulrich-Wilhelm Thomale, Hans Christoph Ludwig
OBJECTIVE: Treatment monitoring and outcome evaluation in pediatric hydrocephalus require gapless documentation regarding surgical and clinical follow-up data beginning from day 1 of treatment in order to apply high quality of care. Endoscopic procedures, shunt insertion and revision surgeries, and individual modifications of valve hardware or pressure settings during follow-up as well as established outcome measurements are highly relevant for complete illustration of the patient's hydrocephalus histories...
March 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28993730/molecular-guided-therapy-provides-sustained-clinical-response-in-refractory-choroid-plexus-carcinoma
#13
Albert Cornelius, Jessica Foley, Jeffrey Bond, Abhinav B Nagulapally, Julie Steinbrecher, William P D Hendricks, Maria Rich, Sangeeta Yendrembam, Genevieve Bergendahl, Jeffrey M Trent, Giselle S Sholler
Choroid plexus carcinomas (CPCs) are rare, aggressive pediatric brain tumors with no established curative therapy for relapsed disease, and poor survival rates. TP53 Mutation or dysfunction correlates with poor or no survival outcome in CPCs. Here, we report the case of a 4 month-old female who presented with disseminated CPC. After initial response to tumor resection and adjuvant-chemotherapy, the tumor recurred and metastasized with no response to aggressive relapse therapy suggesting genetic predisposition...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28990396/physicians-perceptions-of-shared-decision-making-in-neonatal-and-pediatric-critical-care
#14
Claire A Richards, Helene Starks, M Rebecca O'Connor, Erica Bourget, Ross M Hays, Ardith Z Doorenbos
BACKGROUND: Most children die in neonatal and pediatric intensive care units after decisions are made to withhold or withdraw life-sustaining treatments. These decisions can be challenging when there are different views about the child's best interest and when there is a lack of clarity about how best to also consider the interests of the family. OBJECTIVE: To understand how neonatal and pediatric critical care physicians balance and integrate the interests of the child and family in decisions about life-sustaining treatments...
April 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28957984/health-related-quality-of-life-in-adolescent-patients-with-hepatitis-c-genotype-1-treated-with-sofosbuvir-and-ledipasvir
#15
Zobair M Younossi, Maria Stepanova, William Balistreri, Kathleen Schwarz, Karen F Murray, Philip Rosenthal, Sanjay Bansal, Sharon Hunt
OBJECTIVE: The aim of the study was to assess the effect of treatment with ledipasvir/sofosbuvir (LDV/SOF) on the health-related quality of life (HRQL) of pediatric patients with chronic hepatitis C virus (HCV) infection. METHODS: Adolescents (12-17 years) with HCV were treated with LDV/SOF (90/400 mg daily) for 12 weeks. HRQL was assessed using the PedsQLv4.0-SF15 completed by the children and caregivers before, during, and after treatment. RESULTS: We included 100 adolescents with HCV genotype 1 infection (14...
January 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28866891/integration-of-hypnosis-into-pediatric-palliative-care
#16
Stefan J Friedrichsdorf, Daniel P Kohen
At least 8 million children would need specialized pediatric palliative care (PPC) services annually worldwide, and of the more than 42,000 children and teenagers dying annually in the United States, at least 15,000 children would require PPC. Unfortunately, even in resource-rich countries the majority of children dying from serious advanced illnesses are suffering from unrelieved, distressing symptoms such as pain, dyspnea, nausea, vomiting, and anxiety. State of the art treatment and prevention of those symptoms requires employing multi-modal therapies, commonly including pharmacology, rehabilitation, procedural intervention, psychology, and integrative modalities...
January 2018: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28652804/success-with-neurotropin-in-treating-pediatric-lower-extremity-pain-induced-by-spinal-cord-injury-after-epidural-anesthesia
#17
Mengye Zhu, Fuqing Zhou, Lingchao Li, Qin Yin, Mizhen Qiu, Yong Zhang
Spinal cord injury (SCI) complicated by epidural anesthesia, though rare, can result in neuropathic pain. However, the treatment for this kind of life-altering injury remains a challenge. A 7-year-old girl was referred with dyskinesia and severe pain in her right lower extremity due to an accidental SCI following lumbar puncture. After treatment with analgesics such as gabapentin, mecobalamin, and dexamethasone/methylprednisolone for 1 week, the myodynamia had improved, but progressive pain persisted. After treatment with neurotropin, a gradual decrease in visual analog scale score from 7 to 0 was observed...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28523117/evaluation-of-pediatric-residents-attitudes-toward-ethical-conflict-a-cross-sectional-study-in-tehran-iran
#18
Maliheh Kadivar, Marjan Mardani-Hamooleh, Shiva Shayestefar
Ethical conflicts are recognized as critical aspects in assessing competence in clinical communication. Moreover, pediatrics residents may face more problems, compared to other disciplines; due to the specific characteristics of the age group receiving services as well as the presence of their families. This study has been conducted with the aim of determining the attitude and perspective of pediatric residents toward ethical conflicts in the field of pediatrics. This descriptive, cross-sectional study was carried out on all residents of Tehran University of Medical Sciences (90 residents), selected through census method, in 2014...
2017: Journal of Medical Ethics and History of Medicine
https://www.readbyqxmd.com/read/28493614/accuracy-of-physical-examination-ankle-brachial-index-and-ultrasonography-in-the-diagnosis-of-arterial-injury-in-patients-with-penetrating-extremity-trauma-a-systematic-review-and-meta-analysis
#19
REVIEW
Ian S deSouza, Roshanak Benabbas, Sean McKee, Bardiya Zangbar, Ashika Jain, Lorenzo Paladino, Leon Boudourakis, Richard Sinert
BACKGROUND: Penetrating Extremity Trauma (PET) may result in arterial injury, a rare but limb- and life-threatening surgical emergency. Timely, accurate diagnosis is essential for potential intervention in order to prevent significant morbidity. OBJECTIVES: Using a systematic review/meta-analytic approach, we determined the utility of physical examination, Ankle-Brachial Index (ABI), and Ultrasonography (US) in the diagnosis of arterial injury in emergency department (ED) patients who have sustained PET...
August 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28455274/protocol-of-a-pilot-study-of-technology-enabled-coproduction-in-pediatric-chronic-illness-care
#20
Heather C Kaplan, Sunny Narendra Thakkar, Lisa Burns, Barbara Chini, Dana Mh Dykes, Gary L McPhail, Erin Moore, Shehzad Ahmed Saeed, Ian Eslick, Peter A Margolis, Lisa Opipari-Arrigan
BACKGROUND: Pediatric chronic illness care models are traditionally organized around acute episodes of care and may not meet the needs of patients and their families. Interventions that extend the patient-clinician interaction beyond the health care visit, allow for asynchronous and bidirectional feedback loops that span visits and daily life, and facilitate seamless sharing of information are needed to support a care delivery system that is more collaborative, continuous, and data-driven...
April 28, 2017: JMIR Research Protocols
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