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Shock in children

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https://www.readbyqxmd.com/read/28107412/nasal-carriage-of-staphylococcus-aureus-among-children-in-the-ashanti-region-of-ghana
#1
Daniel Eibach, Michael Nagel, Benedikt Hogan, Clinton Azuure, Ralf Krumkamp, Denise Dekker, Mike Gajdiss, Melanie Brunke, Nimako Sarpong, Ellis Owusu-Dabo, Jürgen May
BACKGROUND: Nasal carriage with Staphylococcus aureus is a common risk factor for invasive infections, indicating the necessity to monitor prevalent strains, particularly in the vulnerable paediatric population. This surveillance study aims to identify carriage rates, subtypes, antimicrobial susceptibilities and virulence markers of nasal S. aureus isolates collected from children living in the Ashanti region of Ghana. METHODS: Nasal swabs were obtained from children < 15 years of age on admission to the Agogo Presbyterian Hospital between April 2014 and January 2015...
2017: PloS One
https://www.readbyqxmd.com/read/28099641/sepsis-related-acute-respiratory-distress-syndrome-in-children-with-cancer-the-respiratory-dynamics-of-a-devastating-condition
#2
Rodrigo Genaro Arduini, Orlei Ribeiro de Araujo, Dafne Cardoso Bourguignon da Silva, Andreza Almeida Senerchia, Antonio Sergio Petrilli
Objective: To evaluate the clinical course and respiratory parameters of mechanically ventilated children with cancer suffering from sepsis-related acute respiratory distress syndrome. Methods: This 2-year prospective, longitudinal, observational cohort study enrolled 29 children and adolescents. Clinical data, measurements of blood gases and ventilation parameters were collected at four different time points. Fluctuations between measurements as well as differences in estimated means were analyzed by linear mixed models in which death within 28 days from the onset of acute respiratory distress syndrome was the primary endpoint...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28099233/primary-outcome-measures-in-pediatric-septic-shock-trials-a-systematic-review
#3
Kusum Menon, James Dayre McNally, Jerry J Zimmerman, Michael S D Agus, Katie O'Hearn, R Scott Watson, Hector R Wong, Mark Duffett, David Wypij, Karen Choong
OBJECTIVE: To evaluate all published pediatric randomized controlled trials of patients with septic shock from any cause to examine the outcome measures used, the strengths and limitations of these measurements and whether the trial outcomes met feasibility criteria. DATA SOURCES: We used a previously published database of pediatric critical care randomized controlled trials (PICUtrials.net) derived from searches of MEDLINE, EMBASE, LILACS, and CENTRAL. STUDY SELECTION: We included randomized controlled trials of interventions to children admitted to a PICU with septic or dengue hemorrhagic shock which were published in English...
January 17, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28098631/after-the-fall-the-tapestry-of-disturbance-and-recovery
#4
Nalini M Nadkarni
On July 3, 2015, Nalini Nadkarni, a world-renowned ecologist who had been studying the biologic processes of ecosystem disturbance and recovery, sustained a catastrophic 50-foot free-fall from the top of the rainforest canopy to the forest floor at her remote field research site. She lost consciousness in shock and sustained life-threatening injuries. Her accompanying students hiked out, radio-called 911, and the Harborview Medical Center (Seattle) Medivac team arrived 4 hours later to rescue her. Her prognosis was extremely grim; her family gathered in anticipation of her death as she underwent four operations during her 10 days in the ICU...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28088009/cardiac-output-and-systemic-vascular-resistance-clinical-assessment-compared-with-a-noninvasive-objective-measurement-in-children-with-shock
#5
Asma Razavi, Christopher J L Newth, Robinder G Khemani, Fernando Beltramo, Patrick A Ross
PURPOSE: To evaluate physician assessment of cardiac output and systemic vascular resistance in patients with shock compared with an ultrasonic cardiac output monitor (USCOM). To explore potential changes in therapy decisions if USCOM data were available using physician intervention answers. STUDY DESIGN: Double-blinded, prospective, observational study in a tertiary hospital pediatric intensive care unit. Forty children (<18years) admitted with shock, requiring ongoing volume resuscitation or inotropic support...
December 28, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28072671/evaluation-of-the-association-of-early-elevated-lactate-with-outcomes-in-children-with-severe-sepsis-or-septic-shock
#6
Noelle Gorgis, Jeannette M Asselin, Cynthia Fontana, R Scott Heidersbach, Heidi R Flori, Shan L Ward
OBJECTIVE: The aim of the study was to assess the association of initial lactate (L0) with mortality in children with severe sepsis. METHODS: This prospective cohort study included 74 patients younger than 18 years with severe sepsis admitted to the pediatric intensive care unit (PICU) of a tertiary, academic children's hospital with lactate measured within 3 hours of meeting severe sepsis or septic shock. The primary outcome was in-hospital mortality. The secondary outcomes included PICU and hospital length of stay...
January 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28070668/what-happens-to-asymptomatic-lower-pole-kidney-stones-smaller-than-10%C3%A2-mm-in-children-during-watchful-waiting
#7
Onur Telli, Nurullah Hamidi, Uygar Bagci, Arif Demirbas, Ahmet Metin Hascicek, Tarkan Soygur, Berk Burgu
BACKGROUND: The optimal management of lower pole kidney (LPK) stones in children is controversial. The aim of this study was to determine the outcomes of children with asymptomatic isolated LPK stones smaller than 10 mm during follow-up. METHODS: A total of 242 patients with 284 stones presenting at our institution between June 2004 and December 2014 with an asymptomatic, single LPK stone with a diameter of <10 mm were enrolled in the study. All children were assigned to receive first-line therapy and then categorized according to the need for medical intervention...
January 9, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28068437/association-between-early-lactate-levels-and-30-day-mortality-in-clinically-suspected-sepsis-in-children
#8
Halden F Scott, Lina Brou, Sara J Deakyne, Allison Kempe, Diane L Fairclough, Lalit Bajaj
Importance: Improving emergency care of pediatric sepsis is a public health priority, but optimal early diagnostic approaches are unclear. Measurement of lactate levels is associated with improved outcomes in adult septic shock, but pediatric guidelines do not endorse its use, in part because the association between early lactate levels and mortality is unknown in pediatric sepsis. Objective: To determine whether the initial serum lactate level is associated with 30-day mortality in children with suspected sepsis...
January 9, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28067685/association-between-initial-emergency-department-lactate-and-use-of-vasoactive-medication-in-children-with-septic-shock
#9
Michael J Miescier, Roni D Lane, Xiaoming Sheng, Gitte Y Larsen
OBJECTIVES: Current guidelines emphasize early recognition of pediatric septic shock using clinical examination findings. Elevated serum lactate has been associated with increased mortality in adult patients with septic shock. Our objective was to determine the association between the initial serum lactate obtained in the pediatric emergency department (PED) from patients treated for septic shock and the use of vasoactive medication within 24 hours. METHODS: This was a retrospective study from 2008 through 2012 of PED patients at a tertiary care children's hospital...
January 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28067671/a-fatal-case-of-coin-battery-ingestion-in-an-18-month-old-child-case-report-and-literature-review
#10
Francesco Ventura, Sara Candosin, Rosario Barranco, Alessandro Bonsignore, Luisa Andrello, Luca Tajana, Antonio Osculati
The ingestion of extraneous substances is quite common in clinical practice; it usually befalls in the pediatric age, mostly between 6 months and 6 years. In most cases, complications do not emerge, and the prognosis is considered favorable. However, when a case of battery ingestion occurs, serious adverse events may develop. The ingestion of these components is a potential life-threatening event for children.In this article, we report the case of an 18-month-old child who died from hemorrhagic shock due to an aortoesophageal fistula caused by a 20 mm lithium button battery lodged in the esophagus...
January 7, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28057037/role-of-vasopressin-and-terlipressin-in-refractory-shock-compared-to-conventional-therapy-in-the-neonatal-and-pediatric-population-a-systematic-review-meta-analysis-and-trial-sequential-analysis
#11
Reem Masarwa, Gideon Paret, Amichai Perlman, Shimon Reif, Bruria Hirsh Raccah, Ilan Matok
BACKGROUND: Vasopressin (AVP) and terlipressin (TP) have been used as last-line therapy in refractory shock in children. However, the efficacy and safety profiles of AVP and TP have not been determined in pediatric refractory shock of different origins. We aimed to assess the efficacy and safety of the addition of AVP/TP therapy in pediatric refractory shock of all causes compared to conventional therapy with fluid resuscitation and vasopressor and inotropic therapy. METHODS: We conducted a systematic review, meta-analysis, and trial sequential analysis (TSA) comparing AVP and TP to conventional therapy...
January 5, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28045998/nutrition-smoothing-can-proximity-to-towns-and-cities-protect-rural-children-against-seasonal-variation-in-agroclimatic-conditions-at-birth
#12
Amelia F Darrouzet-Nardi, William A Masters
A large literature links early-life environmental shocks to later outcomes. This paper uses seasonal variation across the Democratic Republic of the Congo to test for nutrition smoothing, defined here as attaining similar height, weight and mortality outcomes despite different agroclimatic conditions at birth. We find that gaps between siblings and neighbors born at different times of year are larger in more remote rural areas, farther from the equator where there are greater seasonal differences in rainfall and temperature...
2017: PloS One
https://www.readbyqxmd.com/read/28042078/home-based-palliative-care-for-children-with-incurable-cancer-long-term-perspectives-of-and-impact-on-general-practitioners
#13
Ivana M M van der Geest, Patrick J E Bindels, Saskia M F Pluijm, Erna M C Michiels, Agnes van der Heide, Rob Pieters, Anne-Sophie E Darlington, Marry M van den Heuvel-Eibrink
CONTEXT: Although a large percentage of children with advanced-stage cancer die at home, remarkably little information is available regarding the experience of general practitioners (GPs) with respect to providing home-based palliative care to children with incurable cancer. OBJECTIVES: To explore the perspectives of GPs who care for children with advanced-stage cancer in a home-based setting. METHODS: In this cross-sectional study, 144 GPs who provided home-based palliative care to 150 children with incurable cancer from 2001 through 2010 were invited to complete a questionnaire addressing their perspectives regarding: 1) symptom management, 2) collaboration with other health care professionals, 3) the child's death and care after death and 4) impact of having provided palliative care, scored on distress thermometer (range 0-10)...
December 29, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28030495/resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-trauma-patients-in-youth
#14
Tatsuya Norii, Shin Miyata, Yusuke Terasaka, Sundeep Guliani, Stephen W Lu, Cameron Crandall
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) has received increasing attention for critically uncontrolled hemorrhagic shock. However, the efficacy of REBOA in patients in youth is unknown. OBJECTIVES: The aim of this study was to evaluate the mortality and characteristics of patients of age ≤ 18 years with severe traumatic injury who received REBOA. METHODS: We retrospectively analyzed observational cohort data from the Japan Trauma Data Bank (JTDB) from 2004 to 2015...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28027187/analysis-of-morbidity-readmission-and-reoperation-after-craniosynostosis-repair-in-children
#15
Kevin T Jubbal, Nikhil Agrawal, Larry H Hollier
The impact of specific patient comorbidities on outcomes in craniosynostosis surgical repair is not well defined. The aim of this retrospective review was to evaluate the short-term 30-day reoperation rate, unplanned readmission rate, and overall morbidity of craniosynostosis surgical repair using the 2012 through 2014 American College of Surgeons National Surgical Quality Improvement Program-Pediatrics (ACS NSQIP-Pediatric) database. Overall morbidity included pneumonia, wound occurrence, shock/sepsis, venous thromboembolism, cardiac complication, renal and urinary complications, or nerve injury...
December 23, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28026839/mj%C3%A3-ltsekvestrering-hos-barn-med-sicklecellanemi-akut-livshotande-komplikation-snabb-behandling-%C3%A3-r-avg%C3%A3-rande
#16
Fredrik Larsson, Anders Åhlin, Mats Marshall Heyman, Jonas Abrahamsson
Acute splenic sequestration in children with sickle cell disease - an overview Acute splenic sequestration (ASS) is a life-threatening complication of sickle cell disease (SCD). The condition is important to recognize due to the fact that it can occur with previously unknown disease. ASS is one of the most common causes of death in children with SCD and is the result of blood suddenly getting congested in the spleen, resulting in splenomegaly, acute anemia, and hypovolemic shock. Timely and appropriate treatment is essential in preventing death...
December 20, 2016: Läkartidningen
https://www.readbyqxmd.com/read/28007919/delivery-of-parasite-rna-transcripts-into-infected-epithelial-cells-during-cryptosporidium-infection-and-its-potential-impact-on-host-gene-transcription
#17
Yang Wang, Ai-Yu Gong, Shibin Ma, Xiqiang Chen, Yan Li, Chun-Jen Su, Dana Norall, Jing Chen, Juliane K Strauss-Soukup, Xian-Ming Chen
Cryptosporidium parvum is an important opportunistic parasite pathogen for immunocompromised individuals and a common cause of diarrhea in young children. Previous studies have identified a panel of RNA transcripts of very low protein-coding potential in C. parvum Using an in vitro model of human intestinal cryptosporidiosis, we report here that some of these C. parvum RNA transcripts were selectively delivered into the nuclei of host epithelial cells during C. parvum infection. Nuclear delivery of several such parasitic RNAs, including Cdg7_FLc_0990, involved heat-shock protein 70-mediated nuclear importing mechanism...
December 22, 2016: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28007393/fournier-s-gangrene-during-acth-therapy
#18
Shingo Numoto, Hirokazu Kurahashi, Yoshiteru Azuma, Atsushi Numaguchi, Kozaburo Nakahara, Takahisa Tainaka, Michihiko Takasu, Kiyoshi Yamakawa, Nozomi Nago, Taichiro Muto, Yoshiro Kitagawa, Akihisa Okumura
Fournier's gangrene is an infectious necrotizing fasciitis of the perineal, genital, or perianal regions and is uncommon in children. Adrenocorticotropic hormone (ACTH) is effective for the treatment of infantile spasms; however, suppression of immune function is one of the major adverse effects of this approach. We encountered a 2-month-old boy with infantile spasms that had been treated with ACTH and had developed complicating Fournier's gangrene. Strangulation of a right inguinal hernia was observed after ACTH treatment...
December 19, 2016: Brain & Development
https://www.readbyqxmd.com/read/28005910/melioidosis-in-malaysia-a-review-of-case-reports
#19
Paul Vijay Kingsley, Mark Leader, Nandika Suranjith Nagodawithana, Meghan Tipre, Nalini Sathiakumar
BACKGROUND: Melioidosis is a tropical infectious disease associated with significant mortality due to early onset of sepsis. OBJECTIVE: We sought to review case reports of melioidosis from Malaysia. METHODS: We conducted a computerized search of literature resources including PubMed, OVID, Scopus, MEDLINE and the COCHRANE database to identify published case reports from 1975 to 2015. We abstracted information on clinical characteristics, exposure history, comorbid conditions, management and outcome...
December 2016: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28005689/epidemiology-and-outcomes-of-hospitalized-children-with-necrotizing-soft-tissue-infections
#20
Balagangadhar R Totapally
OBJECTIVE: The purpose of this study was to evaluate the epidemiology and outcome of hospitalized children with a diagnosis of necrotizing soft tissue infections (NSTIs). METHODS: Demographic and outcome data of children 1 month to 18 years of age with a diagnosis of NSTI (ICD-9 diagnosis codes 728.86 and 729.4) were extracted from the Kids' Inpatient Database 2009 and 2012. Univariate and multivariate analyses were done to determine the factors affecting the mortality...
December 21, 2016: Pediatric Infectious Disease Journal
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