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https://www.readbyqxmd.com/read/29034782/the-comparative-epidemiology-of-pediatric-severe-sepsis
#1
Mary E Hartman, Mohammed J Saeed, Kimberly N Powell, Margaret A Olsen
OBJECTIVE: To determine whether the coding strategies used to identify severe sepsis in administrative data sets could identify cases with comparable case mix, hospitalization characteristics, and outcomes as a cohort of children diagnosed with severe sepsis using strict clinical criteria. METHODS: We performed a retrospective cohort study using data from 2005 to 2011 from the New York and Florida State Inpatient Databases, available from the US Healthcare Cost and Utilization Project...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29029776/accelerated-idioventricular-rhythm-requiring-catheter-ablation-in-a-child-the-dark-side-of-a-benign-arrhythmia
#2
A Errahmouni, S-S Bun, D G Latcu, A Tazi-Mezalek, N Saoudi
A 12 year-old boy, with no history of cardiac disease, was referred to our department for evaluation of an incessant accelerated idioventricular rhythm (AIVR) complicated with severe left ventricular (LV) dysfunction and cardiogenic shock. Extensive diagnostic work-up failed to reveal any structural heart disease. During electrophysiological study, AIVR originated from the right ventricular endocardial anterior wall and was successfully ablated using remote magnetic navigation. LV function showed complete recovery four weeks after the procedure...
October 10, 2017: Annales de Cardiologie et D'angéiologie
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/28988226/severe-complications-after-initial-management-of-hyperglycemic-hyperosmolar-syndrome-and-diabetic-ketoacidosis-with-a-standard-diabetic-ketoacidosis-protocol
#4
Bimota Nambam, Emily Menefee, Neslihan Gungor, Robert Mcvie
Hyperglycemic hyperosmolar syndrome (HHS) is a clinical entity not identical to diabetic ketoacidosis (DKA), and with a markedly higher mortality. Children with HHS can also present with concomitant DKA. Patients with HHS (with or without DKA) are profoundly dehydrated but often receive inadequate fluid resuscitation as well as intravenous insulin therapy based on traditional DKA protocols, and this can lead to devastating consequences. In this article, we briefly review HHS along with a report of an adolescent who presented with HHS and DKA and was initially managed as DKA...
October 9, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28985704/extracorporeal-membrane-oxygenation-for-kawasaki-disease-two-case-reports-and-the-extracorporeal-life-support-organization-experience-1999-2015
#5
Derek Best, Johnny Millar, Igor Kornilov, Yury Sinelnikov, Roberto Chiletti, Peter Rycus, Warwick Butt
Kawasaki disease is usually a limited illness of early childhood. However, life-threatening cardiac manifestations can occur, either at acute presentation or as a consequence of coronary arterial involvement. We report the successful use of veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) for cardiac support in two children with Kawasaki disease: one with acute Kawasaki disease shock syndrome, the other with complications of coronary arteritis and subsequent surgery. We also reviewed the reported experience in the ELSO database and available literature...
October 2017: Perfusion
https://www.readbyqxmd.com/read/28983013/role-of-hiv-specific-cd8-t-cells-in-pediatric-hiv-cure-strategies-after-widespread-early-viral-escape
#6
Ellen M Leitman, Christina F Thobakgale, Emily Adland, M Azim Ansari, Jayna Raghwani, Andrew J Prendergast, Gareth Tudor-Williams, Photini Kiepiela, Joris Hemelaar, Jacqui Brener, Ming-Han Tsai, Masahiko Mori, Lynn Riddell, Graz Luzzi, Pieter Jooste, Thumbi Ndung'u, Bruce D Walker, Oliver G Pybus, Paul Kellam, Vivek Naranbhai, Philippa C Matthews, Astrid Gall, Philip J R Goulder
Recent studies have suggested greater HIV cure potential among infected children than adults. A major obstacle to HIV eradication in adults is that the viral reservoir is largely comprised of HIV-specific cytotoxic T lymphocyte (CTL) escape variants. We here evaluate the potential for CTL in HIV-infected slow-progressor children to play an effective role in "shock-and-kill" cure strategies. Two distinct subgroups of children were identified on the basis of viral load. Unexpectedly, in both groups, as in adults, HIV-specific CTL drove the selection of escape variants across a range of epitopes within the first weeks of infection...
October 5, 2017: Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28982610/the-prospective-evaluation-of-risk-factors-and-clinical-influence-of-carbapenem-resistance-in-children-with-gram-negative-bacteria-infection
#7
Zumrut Sahbudak Bal, Nur Bekmezci, Mehmet Soylu, Semra Sen, Gulhadiye Avcu, Sohret Aydemir, Fadil Vardar
BACKGROUND: Carbapenem-resistant gram-negative (CRGN) infections have been increasing in recent years and associated with significant morbidity, mortality, and health care costs. The aim of this study was to evaluate the epidemiologic and clinical risk characteristics, risk factors, and outcome of CRGN infections and to compare with carbapenem-sensitive gram-negative (CSGN) infections in children. METHODS: Newly diagnosed CRGN infections in hospitalized children younger than age 18 years were prospectively recorded and all patients infected with a CSGN pathogen in the same unit within 48 hours of diagnosis were included in a control group between April 1, 2014, and December 31, 2014...
October 2, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28977099/fluid-overload-in-children-undergoing-mechanical-ventilation
#8
Clarice Laroque Sinott Lopes, Jefferson Pedro Piva
Patients admitted to an intensive care unit are prone to cumulated fluid overload and receive intravenous volumes through the aggressive resuscitation recommended for septic shock treatment, as well as other fluid sources related to medications and nutritional support. The liberal liquid supply strategy has been associated with higher morbidity and mortality. Although there are few prospective pediatric studies, new strategies are being proposed. This non-systematic review discusses the pathophysiology of fluid overload, its consequences, and the available therapeutic strategies...
September 28, 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28974139/severe-vitamin-d-deficiency-at-admission-and-shock-reversal-in-children-with-septic-shock
#9
Suresh Kumar Angurana, Vishal Guglani
No abstract text is available yet for this article.
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28972153/pharmacochaperoning-in-a-drosophila-model-system-rescues-human-dopamine-transporter-variants-associated-with-infantile-juvenile-parkinsonism
#10
H M Mazhar Asjad, Ameya Kasture, Ali El-Kasaby, Michael Sackel, Thomas Hummel, Michael Freissmuth, Sonja Sucic
Point mutations in the gene encoding the human dopamine transporter (hDAT, SLC6A3) cause a syndrome of infantile/juvenile dystonia and parkinsonism. To unravel the molecular mechanism underlying these disorders and investigate possible pharmacological therapies, here we examined 13 disease-causing DAT mutants that were retained in the endoplasmic reticulum (ER) when heterologously expressed in HEK293 cells. In three of these mutants - i.e. hDAT-V158F, hDAT-G327R and hDAT-L368Q- the folding deficit was remedied with the pharmacochaperonenoribogaineor the heat shock protein 70 (HSP70)-inhibitor pifithrin-μ such that ER export of and radioligand binding and substrate uptake by these DAT mutants were restored...
September 29, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28966921/echocardiographic-evaluation-of-hemodynamics-in-neonates-and-children
#11
REVIEW
Yogen Singh
Hemodynamic instability and inadequate cardiac performance are common in critically ill children. The clinical assessment of hemodynamic status is reliant upon physical examination supported by the clinical signs such as heart rate, blood pressure, capillary refill time, and measurement of the urine output and serum lactate. Unfortunately, all of these parameters are surrogate markers of cardiovascular well-being and they provide limited direct information regarding the adequacy of blood flow and tissue perfusion...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28944301/intravenous-rehydration-of-malnourished-children-with-acute-gastroenteritis-and-severe-dehydration-a-systematic-review
#12
Kirsty A Houston, Jack G Gibb, Kathryn Maitland
Background: Rehydration strategies in children with severe acute malnutrition (SAM) and severe dehydration are extremely cautious. The World Health Organization (WHO) SAM guidelines advise strongly against intravenous fluids unless the child is shocked or severely dehydrated and unable to tolerate oral fluids. Otherwise, guidelines recommend oral or nasogastric rehydration using low sodium oral rehydration solutions. There is limited evidence to support these recommendations. Methods: We conducted a systematic review of randomised controlled trials (RCTs) and observational studies on 15 (th) June 2017 comparing different strategies of rehydration therapy in children with acute gastroenteritis and severe dehydration, specifically relating to intravenous rehydration, using standard search terms...
2017: Wellcome Open Research
https://www.readbyqxmd.com/read/28941540/adjunctive-steroid-therapy-for-treatment-of-pediatric-septic-shock
#13
REVIEW
Jerry J Zimmerman
Septic shock remains the major cause of childhood morbidity and mortality worldwide. Although early sepsis recognition, fluid resuscitation, timely administration of antimicrobials, and vasoactive-inotropic drug infusions are all key to achieving good sepsis outcomes, therapy using various steroid drug classes remains an attractive adjunctive intervention to minimize the duration of septic shock and transition to multiple organ dysfunction syndrome. All steroid drug classes possess biological plausibility to affect a beneficial clinical effect among children with septic shock, but none has undergone rigorous, prospective assessment in a large, high-quality pediatric interventional trial...
October 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28940060/psychosocial-implications-of-living-with-catecholaminergic-polymorphic-ventricular-tachycardia-in-adulthood
#14
Ebony Richardson, Catherine Spinks, Andrew Davis, Christian Turner, John Atherton, Julie McGaughran, Christopher Semsarian, Jodie Ingles
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare inherited arrhythmogenic disease with a high risk of sudden cardiac death. The impact on health-related quality of life (HR-QoL) and psychosocial outcomes is not known. We sought to provide the first description of HR-QoL and psychosocial wellbeing of adults with CPVT, parents of affected children and at-risk relatives. Participants were recruited through the Australian Genetic Heart Disease Registry and invited to complete a cross-sectional survey comprising a number of validated scales and open-ended questions...
September 23, 2017: Journal of Genetic Counseling
https://www.readbyqxmd.com/read/28916403/a-case-of-severe-acquired-hypertriglyceridemia-in-a-7-year-old-girl
#15
Jessica S Lilley, MacRae F Linton, Jennifer C Kelley, T Brent Graham, Sergio Fazio, Hagai Tavori
We report a case of severe type I hyperlipoproteinemia caused by autoimmunity against lipoprotein lipase (LPL) in the context of presymptomatic Sjögren's syndrome. A 7-year-old mixed race (Caucasian/African American) girl was admitted to the intensive care unit at Vanderbilt Children's Hospital with acute pancreatitis and shock. She was previously healthy aside from asthma and history of Hashimoto's thyroiditis. Admission triglycerides (TGs) were 2191 mg/dL but returned to normal during the hospital stay and in the absence of food intake...
August 12, 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/28905639/clinical-manifestations-of-kawasaki-disease-shock-syndrome
#16
Le Ma, Ya-Yuan Zhang, Hai-Guo Yu
A case-control study was performed to ascertain clinical features of children who had been diagnosed as Kawasaki disease shock syndrome (KDSS), a severe condition related to Kawasaki disease (KD). Hospitalized patients were selected in Nanjing Children's Hospital. Demographic characteristics, clinical presentation, laboratory data, cardiovascular findings, and therapies were analyzed. Compared with the control group, KDSS patients were older and had more serious skin rash. The proportions of leukocytosis, neutrophilia, and hypoalbuminemia was higher, as was the level of while blood cell count, C-reactive protein, brain natriuretic peptide, and ferroprotein...
September 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28905004/gastroenteritis-aggressive-versus-slow-treatment-for-rehydration-gastro-a-pilot-rehydration-study-for-severe-dehydration-who-plan-c-versus-slower-rehydration
#17
Kirsty A Houston, Jack G Gibb, Ayub Mpoya, Nchafatso Obonyo, Peter Olupot-Olupot, Margeret Nakuya, Jennifer A Evans, Elizabeth C George, Diana M Gibb, Kathryn Maitland
BACKGROUND: The World Health Organization (WHO) rehydration management guidelines (Plan C) for children with acute gastroenteritis (AGE) and severe dehydration are widely practiced in resource-poor settings, yet have never been formally evaluated in a clinical trial. A recent audit of outcome of AGE at Kilifi County Hospital, Kenya noted that 10% of children required high dependency care (20% mortality) and a number developed fluid-related complications. The fluid resuscitation trial, FEAST, conducted in African children with severe febrile illness, demonstrated higher mortality with fluid bolus therapy and raised concerns regarding the safety of rapid intravenous rehydration therapy...
2017: Wellcome Open Research
https://www.readbyqxmd.com/read/28901334/rainfall-shocks-are-not-necessarily-a-sensitive-early-indicator-of-changes-in-wasting-prevalence
#18
N A Ledlie, H Alderman, J L Leroy, L You
Evidence on the impact of weather shocks on child nutrition focuses on linear growth retardation (stunting) and thus, associates the effect of a short-term measure (weather events) on a cumulative measure (attained height). Relatively little is known on how weather shocks predict increases in wasting in a population. This study explores whether deviation in rainfall in Ethiopia, a drought prone country, is a sensitive indicator of future increases in wasting. Around 12% of children 0-23 months were wasted, but we found no consistent association between the rainfall shock variables and child weight-for-height Z-scores...
September 13, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28901013/how%C3%A2-active-are-young-cardiac-device-patients-objective-assessment-of-activity-in-children-with-cardiac-devices
#19
Caridad M de la Uz, Ashley E Burch, Bruce Gunderson, Jodi Koehler, Samuel F Sears
BACKGROUND: The daily activity of pediatric patients with implantable cardiac devices provides behavioral evidence of functional outcomes. Modern devices provide continuous accelerometer data that are sensitive to movement, but normative values have not been published for pediatric activity rates. This study provides the first normative accelerometer data on activity rates in a large sample of pediatric cardiac device patients. METHODS: Patients were between 3 and 18 years old (N = 1,905) and implanted with a cardiac device from a single device company, and enrolled in remote monitoring...
September 12, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28895096/palivizumab-prophylaxis-against-respiratory-syncytial-virus-infection-in-children-with-immunocompromised-conditions-or-down-syndrome-a-multicenter-post-marketing-surveillance-in-japan
#20
Tomoko Kashiwagi, Yukiko Okada, Ken Nomoto
OBJECTIVE: The aim of this study was to assess the safety and effectiveness of palivizumab for the prevention of lower respiratory tract infection (LRI) caused by respiratory syncytial virus (RSV) in children with immunocompromised conditions or Down syndrome. METHODS: In this multicenter, post-marketing surveillance study (December 2013 to December 2015), children aged ≤24 months with immunocompromised conditions or Down syndrome (without hemodynamically significant congenital heart disease) receiving palivizumab immunoprophylaxis during two RSV seasons were observed until 30 days after the final palivizumab injection...
September 11, 2017: Paediatric Drugs
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