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Pediatric life-sustaining treatment

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https://www.readbyqxmd.com/read/28206733/end-of-life-decisions-in-34-slovene-intensive-care-units-a-nationwide-prospective-clinical-study
#1
Miha Orazem, Urh Groselj, Manca Stojan, Neza Majdic, Gaj Vidmar, Stefan Grosek
BACKGROUND: To determine how end-of-life decisions (EOLD) on limitations of life- sustaining treatment (LST) are made in three different types of intensive care units (ICUs) in Slovenia. METHODS: A national multicenter prospective study among 31 adult and three pediatric/neonatal ICUs (PICUs). The questionnaire form on EOLD was designed to assess the clinical practice. Data were collected between January 1, 2013, and March 31, 2013. For statistical analysis we used IBM® SPSS® Statistics 20 software package...
February 15, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28131553/-end-of-life-in-specialized-medical-pediatrics-department-a-french-national-survey
#2
Alice Ravanello, Isabelle Desguerre, Sandra Frache, Philippe Hubert, Daniel Orbach, Régis Aubry
AIMS: In France, most of children die in the hospital. This national survey aimed to achieve better understanding of end-of life care in specialized medical pediatrics departments for children facing the end-of-life, identify the available resources, put forward the difficulties encountered by professionals and describe end-of-life paths of children who died in these departments. MATERIAL AND METHODS: This study is based on a nationwide survey conducted among all existing specialized medical pediatrics departments (onco-haematology, neurology, reanimation) in France in 2015...
January 25, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28063864/the-end-of-life-experience-of-pediatric-heart-transplant-recipients
#3
Seth A Hollander, John Dykes, Sharon Chen, Lynsey Barkoff, Barbara Sourkes, Harvey Cohen, David N Rosenthal, Daniel Bernstein, Beth D Kaufman
CONTEXT: Despite advances in therapies, many pediatric heart transplant (Htx) recipients will die prematurely. We characterized the circumstances surrounding death in this cohort, including location of death and interventions performed in the final 24 hours. METHODS: We reviewed all patients who underwent Htx at Lucile Packard Children's Hospital, Stanford, survived hospital discharge, and subsequently died between 7/19/2007-9/13/2015. The primary outcome studied was location of death, characterized as inpatient, outpatient, or emergency department (ED)...
January 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28007511/-neonatal-palliative-care-at-home-contribution-of-the-regional-pediatric-palliative-care-team
#4
N Cojean, C Strub, P Kuhn, L Calvel
The "patients' rights and end-of-life care" act, known as the Leonetti law, has allowed implementation of palliative care in neonatology as an alternative to unreasonable therapeutic interventions. A palliative care project can be offered to newborns suffering from intractable diseases. It must be focused on the newborn's quality of life and comfort and on family support. Palliative care for newborns can be provided in the delivery room, in the neonatal unit, and also at home. Going home is possible but requires medical support...
February 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27940784/parental-refusal-of-surgery-in-an-infant-with-tricuspid-atresia
#5
Alexander A Kon, Angira Patel, Steven Leuthner, John D Lantos
We present a case of a fetal diagnosis of tricuspid atresia (TA). The pregnant woman and her husband requested that the baby be treated with only palliative care. The cardiologist did not think it would be appropriate to withhold life-prolonging surgery once the infant was born. The neonatologist argued that outcomes for TA are similar to those for hypoplastic left heart syndrome, and the standard practice at the institution was to allow parents to choose surgery or end-of-life care for those infants. The team requested an ethics consultation to assist in determining whether forgoing life-prolonging interventions in this case would be ethically supportable...
November 2016: Pediatrics
https://www.readbyqxmd.com/read/27919346/disease-control-via-intensified-lipoprotein-apheresis-in-three-siblings-with-familial-hypercholesterolemia
#6
Christina Taylan, Andrea Schlune, Thomas Meissner, Karolis Ažukaitis, Floris E A Udink Ten Cate, Lutz T Weber
BACKGROUND: Familial hypercholesterolemia (FH), the prevalent monogenic form of hypercholesterolemia, carries the risk of premature coronary heart disease. Lipoprotein-apheresis is established in children with severe dyslipidemia. We present 3 siblings with a negative/negative residual low-density lipoprotein (LDL) receptor mutation (p.Trp577Arg), unresponsive to drug treatment. OBJECTIVE: Intensified lipoprotein-apheresis is well tolerated and results in permanently low lipid values without harming the health-related quality of life in children...
November 2016: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/27894764/thoracoscopic-bilateral-t3-sympathectomy-for-primary-focal-hyperhidrosis-in-children
#7
Pablo Laje, Kali Rhodes, Leanne Magee, Mary Kate Klarich
AIM OF THE STUDY: Present our experience in the surgical treatment of primary focal hyperhidrosis of the hands by thoracoscopic bilateral T3 sympathectomy in pediatric patients. METHODS: Retrospective chart review of all patients operated between 2013 and 2015. RESULTS: We operated and included in the study 28 patients, 22 females and 6 males. Mean age was 14 (6-21) years. All patients had previously tried at least one form of medical therapy with no success...
February 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27776895/evidence-in-immunotherapy-for-paediatric-respiratory-allergy-advances-and-recommendations
#8
REVIEW
M Tortajada-Girbés, M Mesa Del Castillo, H Larramona, J M Lucas, M Álvaro, A I Tabar, M J Jerez, A Martínez-Cañavate
Allergic respiratory diseases are major health problems in paediatric population due their high level of prevalence and chronicity, and to their relevance in the costs and quality of life. One of the most important risk factors for the development of airway diseases in children and adolescents is atopy. The mainstays for the treatment of these diseases are avoiding allergens, controlling symptoms, and preventing them through sustained desensitization by allergen immunotherapy (AIT). AIT is a treatment option that consists in the administration of increasing amounts of allergens to modify the biological response to them, inducing long-term tolerance even after treatment has ended...
November 2016: Allergologia et Immunopathologia
https://www.readbyqxmd.com/read/27591003/description-and-contribution-of-brain-magnetic-resonance-imaging-in-nontraumatic-critically-ill-children
#9
Guillaume Mortamet, Manoelle Kossorotoff, Amandine Baptiste, Nathalie Boddaert, Martin Castelle, Philippe Hubert, Fabrice Lesage, Sylvain Renolleau, Mehdi Oualha
BACKGROUND: The authors aimed to collect all brain magnetic resonance imaging (MRI) performed in critically ill children in the authors' medical pediatric intensive care unit over a 2-year period (2012-2013) to (1) describe the findings and (2) assess its contribution on practical patient care. METHODS: This is a single-center and retrospective study. All children without traumatic brain injury who underwent a brain MRI during pediatric intensive care unit stays were included...
September 2, 2016: Journal of Child Neurology
https://www.readbyqxmd.com/read/27377920/hems-in-alpine-rescue-for-pediatric-emergencies
#10
Stefan Taubenböck, Wolfgang Lederer, Marc Kaufmann, Gunnar Kroesen
OBJECTIVE: The objective of this study was to describe the pediatric emergencies encountered by the Christophorus-1 helicopter emergency medical service (HEMS) during a period of 2 years. METHODS: Emergency treatment of pediatric casualties by HEMS was evaluated at a helicopter base. Children up to 14 years who were treated by HEMS emergency physicians from Christophorus-1 during primary missions in the alpine region were retrospectively enrolled. RESULTS: Of the 1314 HEMS operations conducted during a 2-year investigation period, pediatric emergencies accounted for 114 (8...
September 2016: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/27243414/postdischarge-care-of-pediatric-traumatic-brain-injury-in-argentina-a-multicenter-randomized-controlled-trial
#11
Nancy A Carney, Gustavo J Petroni, Silvia B Luján, Nicolás M Ballarini, Gabriela A Faguaga, Hugo E M du Coudray, Amy E Huddleston, Gloria M Baggio, Juan M Becerra, Leonardo O Busso, Sureyya S Dikmen, Roberto Falcone, Mirta E García, Osvaldo R González Carrillo, Paula L Medici, Marta B Quaglino, Carina A Randisi, Silvia S Sáenz, Nancy R Temkin, Elida E Vanella
OBJECTIVE: To develop, in partnership with families of children with traumatic brain injury, a postdischarge intervention that is effective, simple, and sustainable. DESIGN: Randomized Controlled Trial. SETTING: Seven Level 1 Pediatric Trauma Centers in Argentina. PATIENTS: Persons less than 19 years of age admitted to one of the study hospitals with a diagnosis of severe, moderate, or complicated mild traumatic brain injury and were discharged alive...
July 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27185745/tackling-causes-and-costs-of-ed-presentation-for-american-football-injuries-a-population-level-study
#12
Blair J Smart, R Sterling Haring, Anthony O Asemota, John W Scott, Joseph K Canner, Besma J Nejim, Benjamin P George, Hatim Alsulaim, Thomas D Kirsch, Eric B Schneider
BACKGROUND: American tackle football is the most popular high-energy impact sport in the United States, with approximately 9 million participants competing annually. Previous epidemiologic studies of football-related injuries have generally focused on specific geographic areas or pediatric age groups. Our study sought to examine patient characteristics and outcomes, including hospital charges, among athletes presenting for emergency department (ED) treatment of football-related injury across all age groups in a large nationally representative data set...
July 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27100448/receipt-of-life-sustaining-treatments-for-taiwanese-pediatric-patients-who-died-of-cancer-in-2001-to-2010-a-retrospective-cohort-study
#13
Yen-Ni Hung, Tsang-Wu Liu, Dong-Tsamn Lin, Yueh-Chih Chen, Jen-Shi Chen, Siew Tzuh Tang
Aggressive life-sustaining treatments have the potential to be continued beyond benefit, but have seldom been systematically/nationally explored in pediatric cancer patients. Furthermore, factors predisposing children dying of cancer to receive life-sustaining treatments at end of life (EOL) have never been investigated in a population-based study. This population-based study explored determinants of receiving life-sustaining treatments in pediatric cancer patients' last month of life. For this retrospective cohort study, we used administrative data on 1603 Taiwanese pediatric cancer patients who died in 2001 to 2010...
April 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27056572/physical-activity-and-health-related-quality-of-life-in-pediatric-cancer-patients-following-a-4-week-inpatient-rehabilitation-program
#14
Carsten Müller, Konstantin A Krauth, Joachim Gerß, Dieter Rosenbaum
PURPOSE: Chronic health conditions and impaired quality of life are commonly experienced in childhood cancer survivors. While rehabilitation clinics support patients in coping with the disease, studies evaluating an inpatient rehabilitation program on promoting physical activity (PA) and health-related quality of life (HRQoL) are missing. METHODS: A 4-week inpatient rehabilitation program was prospectively evaluated. One hundred fifty patients with leukemia or lymphoma (N = 86), brain tumors (N = 38), and sarcomas (N = 26) were enrolled on average 17 months after cessation of acute medical treatment...
September 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/26927938/modes-of-death-in-a-pediatric-cardiac-icu
#15
Angelo Polito, Cristiana Garisto, Chiara Pezzella, Claudia Iacoella, Paola E Cogo
OBJECTIVE: To determine epidemiology and proximate causes of death in a pediatric cardiac ICU in Southern Europe. DESIGN: Retrospective chart review. SETTING: Single-center institution. PATIENTS: We concurrently identified 57 consecutive patients who died prior to discharge from the cardiac ICU. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Over the study period, there were 57 deaths for a combined mortality rate of 2...
May 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/26849737/o-020%C3%A2-pmn-cd64-therapeutic-target-for-sustained-remission-during-infliximab-maintenance
#16
Phillip Minar, Kimberly Jackson, Yi-Ting Tsai, Lee Denson
BACKGROUND: The treatment goal in Crohn's disease (CD) is to rapidly induce clinical remission to quickly improve health-related quality of life and reduce disease related complications. For many, the relapsing and remitting course is exceedingly turbulent as the lack of clinical symptoms may falsely reassure clinicians as silent intestinal inflammation further brews. Treat-to-Target is a novel therapeutic strategy rapidly gaining momentum to prevent disease-related complications by proactively, routinely and noninvasively monitoring biological activity (intestinal injury) during maintenance therapy...
March 2016: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/26847523/medical-indication-regarding-life-sustaining-treatment-for-children-focus-groups-with-clinicians
#17
Julia Desiree Lotz, Ralf J Jox, Christine Meurer, Gian Domenico Borasio, Monika Führer
BACKGROUND: Decisions about medical indication are a relevant problem in pediatrics. Difficulties arise from the high prognostic uncertainty, the decisional incapacity of many children, the importance of the family, and conflicts with parents. The objectivity of judgments about medical indication has been questioned. Yet, little is known about the factors pediatricians actually include in their decisions. AIM: Our aims were to investigate which factors pediatricians apply in deciding about medical indication, and how they manage conflicts with parents...
December 2016: Palliative Medicine
https://www.readbyqxmd.com/read/26786497/white-coat-hypertension-in-pediatrics
#18
REVIEW
Alexander Jurko, Milan Minarik, Tomas Jurko, Ingrid Tonhajzerova
The article summarizes current information on blood pressure changes in children during clinic visit. White coat as a general dressing of physicians and health care personnel has been widely accepted at the end of the 19th century. Two problems can be associated with the use of white coat: white coat phenomenon and white coat hypertension. Children often attribute pain and other unpleasant experience to the white coat and refuse afterwards cooperation with examinations. Definition of white coat hypertension in the literature is not uniform...
January 15, 2016: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/26332004/oral-immunotherapy-for-peanut-allergy
#19
REVIEW
Katherine Anagnostou, Andrew Clark
Peanut allergy is a common disease and the cause of severe, life-threatening allergic reactions and death. It is rarely outgrown; most pediatric patients carry the disease into adulthood. Peanut allergy poses a significant burden on the quality of life of sufferers and their families, which results mainly from the fear of accidental peanut ingestion but is also due to dietary and social restrictions. Current standard management involves avoidance advice, patient education, and provision of emergency rescue medication...
2016: Annual Review of Medicine
https://www.readbyqxmd.com/read/26291959/hematopoietic-stem-cell-transplantation-for-cd40-ligand-deficiency-single-institution-experience
#20
Heather Allewelt, Paul L Martin, Paul Szabolcs, Nelson Chao, Rebecca Buckley, Suhag Parikh
BACKGROUND: X-linked hyper-IgM syndrome (X-HIGM) due to mutations in the gene encoding CD40 ligand results in failure of Ig class switching and an increased propensity for recurrent sinopulmonary and other infections, and thus decreased life expectancy. Allogeneic hematopoietic stem cell transplantation (HSCT) is curative, but long-term follow-up data are limited. PROCEDURES: We conducted a retrospective analysis of seven patients who have undergone allogeneic HSCT for HIGM syndrome at Duke University Medical Center...
December 2015: Pediatric Blood & Cancer
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