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https://www.readbyqxmd.com/read/29771758/opportunistic-fungal-infection-in-children-and-management
#1
Joseph M Lam
PURPOSE OF REVIEW: An opportunistic mycosis is a fungal agent of low pathogenicity that specifically infects immunocompromised hosts. Advances in transplantation, preterm care, immunosuppressive therapies and intensive care, have lead to the emergence of pediatric patients with serious immunodeficiency who are vulnerable to nonpathogenic fungi. RECENT FINDINGS: The advent of the use of biologic agents in pediatric disease as well as the advances in care of preterm and immunosuppressed patients opens up a new cohort of patients at risk of opportunistic mycotic infections...
May 15, 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29769263/how-i-treat-burkitt-lymphoma-in-children-adolescents-and-young-adults-in-sub-saharan-africa
#2
Satish Gopal, Thomas G Gross
Burkitt lymphoma (BL) is the most common pediatric cancer in sub-Saharan Africa (SSA), and also occurs frequently among adolescents and young adults (AYA), often associated with human immunodeficiency virus (HIV). Treating BL in SSA poses particular challenges. Although highly effective, high-intensity cytotoxic treatments used in resource-rich settings are usually not feasible, and lower-intensity continuous infusion approaches are impractical. In this paper, based on evidence from the region, we review management strategies for SSA focused on diagnosis, use of pre-phase, and definitive treatment...
May 16, 2018: Blood
https://www.readbyqxmd.com/read/29766326/the-change-in-management-of-bronchiolitis-in-the-intensive-care-unit-between-2000-and-2015
#3
Minna Mecklin, Paula Heikkilä, Matti Korppi
This case-control study evaluated interventions for bronchiolitis in relation to time in the pediatric intensive care unit (PICU) during a 16-year surveillance period. Together, 105 infants aged < 12 months were treated for bronchiolitis in the PICU, and for them, we selected 210 controls admitted for bronchiolitis closest to cases. We collected data on treatments in the PICU, at the ward and in the emergency department for three periods: years 2000-2005, 2006-2010, and 2011-2015. Median hospital length of stay for PICU patients were 7 days (interquartile range 5-12), 5 days (4-8) and 8 days (4-12...
May 15, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29765932/fluid-overload-and-renal-angina-index-at-admission-are-associated-with-worse-outcomes-in-critically-ill-children
#4
Sidharth K Sethi, Veena Raghunathan, Shilpi Shah, Maninder Dhaliwal, Pranaw Jha, Maneesh Kumar, Sravanthi Paluri, Shyam Bansal, Maroun J Mhanna, Rupesh Raina
Objectives: We investigated the association of fluid overload and oxygenation in critically sick children, and their correlation with various outcomes (duration of ventilation, ICU stay, and mortality). We also assessed whether renal angina index (RAI) at admission can predict mortality or acute kidney injury (AKI) on day 3 after admission. Design and setting: Prospective study, pediatric intensive care in a tertiary hospital. Duration: June 2013-June 2014. Patients: Patients were included if they needed invasive mechanical ventilation for >24 h and had an indwelling arterial catheter...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29765186/effect-of-the-frequency-of-therapy-on-the-performance-of-activities-of-daily-living-in-children-with-cerebral-palsy
#5
Eun-Young Park, Eun-Joo Kim
[Purpose] This study investigated the frequency effect of physical and occupational therapy on activities of daily living performance in children with cerebral palsy. [Subjects and Methods] A total of 162 children with cerebral palsy who attended a convalescent or rehabilitation center for disabled individuals or a special school for physical disabilities in South Korea participated in this study. The Pediatric Evaluation Disability Inventory was used to collect data on activities of daily living performance according to physical therapy frequency based on neurodevelopmental therapy for 1 year...
May 2018: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/29750655/metabolic-risk-factors-in-adolescent-girls-with-type-1-diabetes
#6
Cíntia Castro-Correia, Rita Santos-Silva, Marta Pinheiro, Carla Costa, Manuel Fontoura
BACKGROUND: The incidence of pediatric metabolic syndrome (MS) has progressively increased. The incidence of type 1 diabetes mellitus (T1DM) has also increased. Thus, some children and adolescents with T1DM exhibit MS parameters. The aim of the study was to evaluate the presence of MS parameters in female adolescents with T1DM based on their nutritional status. METHODS: We evaluated 44 adolescents with T1DM (consecutive non-randomized sample) aged between 14 and 18 years, who were on intensive therapy with insulin...
May 11, 2018: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/29742212/accidental-strangulation-in-children-by-the-automatic-closing-of-a-car-window
#7
Kailene Serena, Jefferson Pedro Piva, Cinara Andreolio, Paulo Roberto Antonacci Carvalho, Tais Sica da Rocha
Among the main causes of death in our country are car accidents, drowning and accidental burns. Strangulation is a potentially fatal injury and an important cause of homicide and suicide among adults and adolescents. In children, its occurrence is usually accidental. However, in recent years, several cases of accidental strangulation in children around the world have been reported. A 2-year-old male patient was strangled in a car window. The patient was admitted to the pediatric intensive care unit with a Glasgow Coma Scale score of 8 and presented with progressive worsening of respiratory dysfunction and torpor...
March 2018: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29728467/predictors-of-location-of-death-for-children-with-cancer-enrolled-on-a-palliative-care-service
#8
Erica C Kaye, Samantha DeMarsh, Courtney A Gushue, Jonathan Jerkins, April Sykes, Zhaohua Lu, Jennifer M Snaman, Lindsay J Blazin, Liza-Marie Johnson, Deena R Levine, R Ray Morrison, Justin N Baker
BACKGROUND: In the U.S., more children die from cancer than from any other disease, and more than one third die in the hospital setting. These data have been replicated even in subpopulations of children with cancer enrolled on a palliative care service. Children with cancer who die in high-acuity inpatient settings often experience suffering at the end of life, with increased psychosocial morbidities seen in their bereaved parents. Strategies to preemptively identify children with cancer who are more likely to die in high-acuity inpatient settings have not been explored...
May 4, 2018: Oncologist
https://www.readbyqxmd.com/read/29722656/patterns-of-involved-field-radiation-therapy-protocol-deviations-in-pediatric-versus-adolescent-and-young-adults-with-hodgkin-lymphoma-a-report-from-the-children-s-oncology-group-ahod0031
#9
Aaron Parzuchowski, Rizvan Bush, Qinglin Pei, Debra L Friedman, Thomas J FitzGerald, Suzanne L Wolden, Kavita V Dharmarajan, Louis S Constine, Fran Laurie, Sandy K Kessel, Burton Appel, Karen Fernandez, Angela Punnett, Cindy L Schwartz, Jacob Cox, Stephanie A Terezakis
PURPOSE: The presented protocol for pediatric intermediate-risk Hodgkin lymphoma evaluated the use of a dose-intensive chemotherapy regimen (ABVE-PC [doxorubicin, bleomycin, vincristine, etoposide, cyclophosphamide, prednisone]) with response-based therapy augmentation (addition of DECA [dexamethasone, etoposide, cisplatin, cytarabine]) or therapy reduction (elimination of radiation). METHODS AND MATERIALS: A central review of the radiation therapy data for quality assurance was performed, and the association between radiation protocol deviation (RPD) and relapse was assessed in the pediatric group (age <15 years) and adolescent and young adult (AYA) group (age ≥15-21 years)...
April 1, 2018: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29720126/optimal-predictor-for-6-mercaptopurine-intolerance-in-chinese-children-with-acute-lymphoblastic-leukemia-nudt15-tpmt-or-itpa-genetic-variants
#10
Hong Zhou, Lei Li, Peng Yang, Lin Yang, Jin E Zheng, Ying Zhou, Yong Han
BACKGROUND: 6-mercaptopurine (6-MP) contributes substantially to remarkable improvement in the survival of childhood acute lymphoblastic leukemia (ALL) patients. However, 6-MP also has dose-limiting toxicities, particularly life-threatening myelosuppression, due to genetic polymorphisms in enzymes that metabolize 6-MP. Promising biomarkers for predicting 6-MP-induced leukopenia is still unclear in Chinese population. Here, we evaluated the associations of NUDT15, TPMT and ITPA genotypes with 6-MP intolerance in our cohort of childhood ALL patients...
May 2, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29716905/mobilization-therapy-in-the-pediatric-intensive-care-unit-a-multidisciplinary-quality-improvement-initiative
#11
Blair R L Colwell, Cydni N Williams, Serena P Kelly, Laura M Ibsen
BACKGROUND: Mobilization is safe and associated with improved outcomes in critically ill adults, but little is known about mobilization of critically ill children. OBJECTIVE: To implement a standardized mobilization therapy protocol in a pediatric intensive care unit and improve mobilization of patients. METHODS: A goal-directed mobilization protocol was instituted as a quality improvement project in a 20-bed cardiac and medical-surgical pediatric intensive care unit within an academic tertiary care center...
May 2018: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/29716830/pediatric-donation-after-circulatory-determination-of-death-pdcd-a-narrative-review
#12
REVIEW
Matthew J Weiss, Wendy Sherry, Laura Hornby
Pediatric donation after circulatory death (pDCD) is an established pathway for organ donation. It remains, however, a relatively rare event worldwide, and most clinicians outside of the pediatric intensive care unit (PICU) are unfamiliar with it. The goal of this review is to introduce the processes and concepts of pDCD. While most children die in circumstances that would not allow pDCD, many children that die after withdrawal of life sustaining therapy (WLST) may be eligible for donation of some organs. The potential benefits of this practice to patients on the wait list are well known, but donation can also be an opportunity to honor a patient's or family's desire to altruistically improve the lives of others...
April 14, 2018: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/29703037/fatal-malignant-pertussis-with-hyperleukocytosis-in-a-chinese-infant-a-case-report-and-literature-review
#13
Shu-Feng Tian, Hong-Mei Wang, Ji-Kui Deng
RATIONALE: Pertussis has re-emerged on a global scale and is an ongoing public health problem, even in countries with high rates of vaccination. Hyperleukocytosis [white blood cell (WBC) count >100 × 10/L] is a rare complication that strongly predicts mortality in cases of severe pertussis. PATIENT CONCERNS: We report a case of severe pertussis in an infant who initially presented with persistent cyanotic cough, tachypnea, and grunting. The infant's condition deteriorated rapidly, and she was transferred to the pediatric intensive care unit (PICU) during her third hour of hospitalization...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29701351/heart-transplantation-early-results-of-two-different-regimes-of-immnunosuppression
#14
Carlos Branco, David Prieto, André Antunes, Manuel Batista, Manuel J Antunes
INTRODUCTION: The management of induction and maintenance immunosuppression therapy after heart transplantation (HT) remains a controversial issue. The dosage and the timing has been a changing target. We aimed at evaluate the incidence of acute cellular rejection (ACR) [≥1R grade], major infection and survival in first year after HT in patients receiving two different induction immunosuppression regimes and with a reduction in intensity of triple maintenance immunosuppression dose...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29698337/cold-panniculitis-after-ice-therapy-for-supraventricular-tachycardia
#15
Laurie Malia, Alicia Wang, Laurie Scheiner, V Matt Laurich
A late preterm infant presenting with supraventricular tachycardia (SVT) was admitted to the pediatric intensive care unit because of poor systolic function seen on echocardiogram. The hospitalization was complicated by multiple breakthrough episodes of SVT requiring ice placed on the face during each repeat episode. The infant was later diagnosed as having cold panniculitis secondary to the application of ice to the face on multiple occasions. In children who are hemodynamically stable during SVT episodes, ice is used as first-line treatment...
April 25, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29688433/antimicrobial-stewardship-program-in-a-pediatric-intensive-care-unit
#16
Yuta Aizawa, Junichi Suwa, Hiroshi Higuchi, Kahoru Fukuoka, Mihoko Furuichi, Tetsuji Kaneko, Yoshihiko Morikawa, Kaoru Okazaki, Naoki Shimizu, Yuho Horikoshi
We conducted an antimicrobial stewardship program in a pediatric intensive care unit. An interrupted time-series analysis revealed a significant reduction in level and trend of days of therapy per 1000 patient-days for antipseudomonal agents. No increase in adverse patient outcomes was found.
April 23, 2018: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/29687529/lymphatic-imaging-and-intervention-in-a-pediatric-population-anesthetic-considerations
#17
David R Jobes, Lauren A Brown, Yoav Dori, Maxim Itkin, Susan C Nicolson
The recent adoption of an improved lymphatic access technique coupled with Dynamic Contrast-enhanced Magnetic Resonance Lymphangiography has introduced the ability to diagnose and treat severe lymphatic disorders unresponsive to other therapies. All pediatric patients presenting for lymphatic procedures require general anesthesia presenting challenges in managing highly morbid and comorbid conditions both from logistical as well as medical aspects. General anesthesia is used because of the procedural requirement for immobility to accurately place needles and catheters, treat pain secondary to contrast and glue injections, and to accommodate additional procedures...
April 23, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29683873/eltrombopag-induced-acute-liver-failure-in-a-pediatric-patient-a-pharmacokinetic-and-pharmacogenetic-analysis
#18
M Marano, J Serafinelli, S Cairoli, D Martinelli, M Pisani, G Palumbo, M G Cefalo, C Cecchetti, M Di Nardo, F S Falvella, B M Goffredo
Eltrombopag is an oral thrombopoietin-receptor-agonist (TPO-RA) approved for the treatment of patients with chronic idiopathic thrombocytopenic purpura (ITP), who are more than one year old, and show poor response to first-line therapy. ITP is a hematological disorder characterized by isolated thrombocytopenia in the absence of secondary causes or disorders. Eltrombopag is generally well tolerated in the pediatric population, therefore therapeutic drug monitoring (TDM) is not usually performed in clinical practice...
April 20, 2018: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/29668026/nicu-graduates-the-role-of-the-allied-health-team-in-follow-up
#19
Jane L Orton, Joy E Olsen, Katherine Ong, Rochelle Lester, Alicia J Spittle
Infants who graduate from the neonatal intensive care unit, including those infants born preterm and/or with brain injury, are at increased risk of long-term neurodevelopmental impairments. The developmental allied health team, consisting of physical therapy, occupational therapy, and speech pathology, is crucial in early evaluation of gross motor, fine motor, feeding, and language development. Surveillance of neurodevelopment in the first year of life is essential to ensure early detection of specific developmental delays and impairments, and to ensure timely referral for early intervention...
April 1, 2018: Pediatric Annals
https://www.readbyqxmd.com/read/29664502/hospital-acquired-hyponatremia-does-the-type-of-fluid-therapy-affect-children-admitted-to-intensive-care
#20
Pilar Velasco, Andrés J Alcaraz, Niki Oikonomopoulou, Marina Benito, Raquel Moya, Álvaro Sánchez
INTRODUCTION: The objective of this study was to evaluate the association between the type of initial fluid therapy used (isotonic or hypotonic solutions) and the development of hyponatremia, the plas ma chlorine values and the tolerance of venous access. PATIENTS AND METHOD: Retrospective cohort study in a Pediatric Intensive Care Unit (PICU) of a high complexity hospital. There were included children younger than 15 years old hospitalized during the first semester of 2010 and 2013 who recei ved intravenous maintenance fluid therapy, excluding patients undergoing cardiac surgery, kidney transplant and admissions that lasted less than 24 hours...
February 2018: Revista Chilena de Pediatría
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