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https://www.readbyqxmd.com/read/29161668/patterns-of-c-reactive-protein-ratio-response-to-antibiotics-in-pediatric-sepsis-a-prospective-cohort-study
#1
Vanessa Soares Lanziotti, Pedro Póvoa, Arnaldo Prata-Barbosa, Lucas Berbet Pulcheri, Ligia S C F Rabello, José Roberto Lapa E Silva, Marcio Soares, Jorge I F Salluh
PURPOSE: Evaluate sequential C-reactive protein (CRP) measurements and patterns of CRP-ratio response to antibiotic therapy during first 7days in Pediatric Intensive Care Unit (PICU) of septic children. METHODS: Prospective, cohort study of children (1month-12years) admitted at 3 PICUs, with diagnosis of sepsis with <72h course. CRP-ratio was calculated in relation to D0_CRP value. Children were classified according to an individual pattern of CRP-ratio response: fast - CRP_D4 of therapy was <0...
November 11, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29156378/effect-of-robotic-assisted-gait-rehabilitation-on-dynamic-equilibrium-control-in-the-gait-of-children-with-cerebral-palsy
#2
L Wallard, G Dietrich, Y Kerlirzin, J Bredin
Due to the intensity and repetition of movement, roboticassisted gait training therapy could have a beneficial effect on the recovery and improvement of postural and locomotor functions of the patient. This study sought to highlight the effects of robotic-assisted gait rehabilitation in gait of children with Cerebral Palsy (CP). We analyzed the different strategies before and after this rehabilitation which was used in order to generate forward motion while maintaining balance. Data were collected by a motion analysis system (Vicon® - Oxford Metrics, Oxford, UK)...
November 11, 2017: Gait & Posture
https://www.readbyqxmd.com/read/29143423/treatment-and-biology-of-pediatric-acute-lymphoblastic-leukemia
#3
REVIEW
Motohiro Kato, Atsushi Manabe
Acute lymphoblastic leukemia (ALL) is the most common pediatric malignancy. In the past ALL was intractable but now the survival probability is as high as 80-90%. Improved supportive care, treatment stratification based on relapse risk, biological features of leukemic cells, and optimization of treatment regimens by nationwide and international collaboration have contributed to this dramatic improvement. While including traditional risk factors (e.g., age and leukocyte count at diagnosis), the treatment has been modified based on biological characteristics (aneuploidy and translocation) and treatment response (assessed by minimal residual disease)...
November 16, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/29140934/response-of-symptomatic-persistent-chronic-disseminated-candidiasis-to-corticosteroid-therapy-in-immunosuppressed-pediatric-patients-case-study-and-review-of-the-literature
#4
Vered Shkalim-Zemer, Itzhak Levi, Salvador Fischer, Hannah Tamary, Joanne Yakobovich, Gali Avrahami, Gil Gilad, Sara Elitzur, Isaac Yaniv, Ronit Elhasid, Michal Manistersky, Itamar Shalit
BACKGROUND: Chronic disseminated candidiasis (CDC) is a severe invasive fungal infection principally observed during neutrophil recovery in patients with acute leukemia treated with intensive chemotherapy. Its pathophysiology remains unclear. We describe the management of six children with symptomatic CDC who did not respond to antifungal therapy. METHODS: The databases of the hematology-oncology departments of two tertiary pediatric medical centers were searched for all patients diagnosed with CDC from 2003 to 2015 who responded to corticosteroids after failing antifungal therapy...
November 14, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29139162/epidemiology-of-therapeutic-apheresis-with-a-multidisciplinary-approach-at-a-high-volume-pediatric-center
#5
Rachel M Sirignano, Matthew L Paden, Ross Fasano, Erin K Meyer
INTRODUCTION: Therapeutic apheresis (TA) is used inconsistently in pediatric populations. We seek to define our multidisciplinary institutional practice. METHODS: We conducted a retrospective chart review of patients receiving TA from January 1, 2012 through October 31, 2015. Data collected included demographics, American Society of Apheresis (ASFA) indication, complications, and mortality. RESULTS: Over 46 months, 1198 TA procedures were conducted on 289 patients ranging in age from 5 months to 21 years with weights ranging from 4...
November 15, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/29116003/protocols-on-classification-monitoring-and-therapy-in-children-s-rheumatology-pro-kind-results-of-the-working-group-polyarticular-juvenile-idiopathic-arthritis
#6
REVIEW
Gerd Horneff, Ariane Klein, Gerd Ganser, Michaela Sailer-Höck, Annette Günther, Ivan Foeldvari, Frank Weller-Heinemann
OBJECTIVE: Several effective pharmacologic treatment options for polyarticual juvenile idiopathic arthritis (JIA) have emerged but initial treatment is heterogeneous in Germany. Therefore, the German Society of Pediatric Rheumatolgy has established a commission to develop consensus "Protocols on classification, monitoring and therapy in children's rheumatology (PRO-KIND)" to harmonize diagnostic and treatment approaches for new-onset JIA in Germany. METHODS: A set of definitions for in- and exclusion, diagnostic workup, parameters for the evaluation of disease activity criteria, therapeutic options, medication dosing, monitoring recommendations, targets, definitions of a therapy failure and four therapeutic algorithms developed by a working group were agreed by web based survey to which all members of the GKJR have been invited...
November 7, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/29107441/real-life-experience-with-hydroxyurea-in-sickle-cell-disease-a-multicenter-study-in-a-cohort-of-patients-with-heterogeneous-descent
#7
Paolo Rigano, Lucia De Franceschi, Laura Sainati, Antonio Piga, Frédéric B Piel, Maria Domenica Cappellini, Carmelo Fidone, Nicoletta Masera, Giovanni Palazzi, Barbara Gianesin, Gian Luca Forni
We conducted the first nation-wide cohort study of sickle cell disease (SCD) in Italy, a Southern European country exposed to intense recent flux migration from endemic areas for SCD. We evaluate the impact of hydroxyurea on a total of 652 pediatric and adult patients from 33 Reference Centers for SCD (mean age 24.5±15years, 51.4% males). Hydroxyurea median treatment duration was 7years (range: <1year to 29years) at a mean therapeutic dose of 18±4.7mg/kg/day. Hydroxyurea was associated with a significant increase in mean total and fetal hemoglobin and a significant decrease in mean hemoglobin S, white blood and platelet counts, and lactate dehydrogenase levels...
October 9, 2017: Blood Cells, Molecules & Diseases
https://www.readbyqxmd.com/read/29093183/therapeutic-targeting-of-pgbd5-induced-dna-repair-dependency-in-pediatric-solid-tumors
#8
Anton G Henssen, Casie Reed, Eileen Jiang, Heathcliff Dorado Garcia, Jennifer von Stebut, Ian C MacArthur, Patrick Hundsdoerfer, Jun Hyun Kim, Elisa de Stanchina, Yasumichi Kuwahara, Hajime Hosoi, Neil J Ganem, Filemon Dela Cruz, Andrew L Kung, Johannes H Schulte, John H Petrini, Alex Kentsis
Despite intense efforts, the cure rates of childhood and adult solid tumors are not satisfactory. Resistance to intensive chemotherapy is common, and targets for molecular therapies are largely undefined. We have found that the majority of childhood solid tumors, including rhabdoid tumors, neuroblastoma, medulloblastoma, and Ewing sarcoma, express an active DNA transposase, PGBD5, that can promote site-specific genomic rearrangements in human cells. Using functional genetic approaches, we discovered that mouse and human cells deficient in nonhomologous end joining (NHEJ) DNA repair cannot tolerate the expression of PGBD5...
November 1, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/29092664/the-perspective-of-the-intensivist-on-inotropes-and-postoperative-care-following-pediatric-heart-surgery-an-international-survey-and-systematic-review-of-the-literature
#9
Peter P Roeleveld, J C A de Klerk
INTRODUCTION: Inotropes are frequently being used in children undergoing heart surgery to prevent or treat low cardiac output syndrome (LCOS). There is only limited evidence that inotropes actually positively influence postoperative outcome. Our aim was to describe the current international practice variation in the use of inotropes following congenital heart surgery. METHODS: We developed an online survey regarding the postoperative use of inotropes. We sent an invitation to all 197 registered members of the Pediatric Cardiac Intensive Care Society (PCICS) to participate in the survey...
January 1, 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29067879/expression-of-disialoganglioside-gd2-in-neuroblastic-tumors-a-prognostic-value-for-patients-treated-with-anti-gd2-immunotherapy
#10
Tatjana Terzic, Martine Cordeau, Sabine Herblot, Pierre Teira, Sonia Cournoyer, Mona Beaunoyer, Michel Peuchmaur, Michel Duval, Herve Sartelet
Neuroblastoma, a malignant neoplasm of the sympathetic nervous system, is one of the most aggressive pediatric cancers. Patients with stage IV high-risk neuroblastoma receive an intensive multimodal therapy ending with an immunotherapy based on a chimeric monoclonal antibody ch14.18. Although the use of ch14.18 monoclonal antibody has significantly increased the survival rate of high-risk neuroblastoma patients, about 33% of these patients still relapse and die from their disease. Ch14.18 targets the disialoganglioside, GD2, expressed on neuroblastic tumor (NT) cells...
January 1, 2017: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/29065267/the-prognostic-importance-of-tgf-%C3%AE-tgf-%C3%AE-receptor-and-fascin-in-childhood-solid-tumors
#11
Hikmet Gulsah Tanyildiz, Gulsah Kaygusuz, Emel Unal, Nurdan Tacyildiz, Handan Dincaslan, Gulsan Yavuz
Fascin plays a role in tumor metastasis under the influence of TGF-β, each potentiating the effect of the other. We retrospectively investigated whether there was a prognostic relationship between TGF-β and fascin, and disease stage, local recurrence, metastasis tendency, and response to treatment. Twelve neuroblastomas, 17 osteosarcomas, 14 Ewing's sarcomas, 15 rhabdomyosarcoma cases, and 8 rare solid tumors were included. Serum TGF-β levels were high at the time of diagnosis in all groups (p = .015) and decreased significantly during remission (p = ...
October 24, 2017: Pediatric Hematology and Oncology
https://www.readbyqxmd.com/read/29062249/a-retrospective-evaluation-of-blood-cultures-in-a-pediatric-intensive-care-unit-a-three-year-evaluation
#12
Ayşe Betül Ergül, Halit Işık, Yasemin Ay Altıntop, Yasemin Altuner Torun
AIM: In this study, it was aimed to retrospectively assess the frequency and antibiotic resistance of microorganisms isolated from blood cultures of patients in a pediatric intensive care unit. MATERIAL AND METHODS: The study was conducted on blood culture tests obtained from patients in a pediatric intensive care unit and sent to a microbiology laboratory between 2013 and 2016. The species and antibiotic susceptibilities were assessed in microorganisms isolated from the blood cultures...
September 2017: Türk Pediatri Arşivi
https://www.readbyqxmd.com/read/29058370/proton-therapy-for-pediatric-head-and-neck-malignancies
#13
Jennifer Vogel, Stefan Both, Maura Kirk, Hann-Hsiang Chao, Rochelle Bagatell, Yimei Li, Richard Womer, Naomi Balamuth, Anne Reilly, Goldie Kurtz, Robert Lustig, Zelig Tochner, Christine Hill-Kayser
PURPOSE: Pediatric head and neck malignancies are managed with intensive multimodality therapy. Proton beam therapy (PBT) may reduce toxicity by limiting exposure of normal tissue to radiation. In this study, we report acute toxicities and early outcomes following PBT for pediatric head and neck malignancies. MATERIALS AND METHODS: Between 2010 and 2016, pediatric patients with nonhematologic malignancies of the head and neck were treated with PBT. Clinical and dosimetric data were abstracted from the medical record and treatment planning system with institutional review board approval...
October 23, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29048520/pain-acceptance-as-a-predictor-of-medical-utilization-and-school-absenteeism-in-adolescents-with-chronic-pain
#14
Michelle A Clementi, Grace S Kao, Evelyn Monico
Objective: Identifying factors contributing to high medical utilization and productivity loss is important, given the high cost of pediatric chronic pain. The current study examined chronic pain acceptance as a predictor of medical utilization and school absenteeism in adolescents with chronic pain. Methods: In all, 122 adolescents (aged 12-21 years) with chronic pain and their parents/guardians completed questionnaires assessing medical visits (past 6 months), medication usage, and number of school absences (past month)...
October 12, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/29048405/cooling-in-neonatal-hypoxic-ischemic-encephalopathy-practices-and-opinions-on-minimum-standards-in-the-state-of-california
#15
C J Wusthoff, C L Clark, H C Glass, T K Shimotake, J Schulman, S L Bonifacio
OBJECTIVE: Although hospitals increasingly offer therapeutic hypothermia (TH), there is variable implementation of related services. We assessed current practices and opinions regarding what services should be required of centers providing TH in California. STUDY DESIGN: We surveyed neonatal intensive care unit physicians statewide regarding practices and opinions about services related to TH. RESULTS: Of the 50 participating centers (47% response rate), 66% offer TH...
October 19, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29045268/early-nutrition-intervention-attenuates-weight-gain-for-pediatric-acute-lymphoblastic-leukemia-patients-in-maintenance-therapy
#16
Rachel Hill, Tyler Hamby, Lisa Bashore, Stefanie Rapisand, Kari Galipp, Kenneth Heym, W Paul Bowman
Obesity following treatment of pediatric acute lymphoblastic leukemia (ALL) has become a significant long-term concern. Excessive weight gain often occurs during treatment, particularly during induction and the first 6 months of maintenance therapy, and it may be potentially modifiable. This retrospective study aimed to evaluate the impact of an early, 3-visit nutrition intervention on weight gain during maintenance therapy in ALL patients. Medical records of the intervention group were compared with historical controls who were treated on the same ALL treatment protocols during an earlier time period...
October 17, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29044718/child-and-family-focused-cognitive-behavioral-therapy-for-pediatric-bipolar-disorder-applications-for-suicide-prevention
#17
Sally M Weinstein, Rick A Cruz, Ashley R Isaia, Amy T Peters, Amy E West
Despite high rates of suicide ideation (SI) and behavior in youth with pediatric bipolar disorder (PBD), little work has examined how psychosocial interventions impact suicidality among this high-risk group. The current study examined SI outcomes in a randomized clinical trial comparing Child- and Family-Focused Cognitive Behavioral Therapy (CFF-CBT) for PBD versus psychotherapy treatment-as-usual (TAU). Although not designed for suicide prevention, CFF-CBT addresses child and family factors related to suicide risk and thus was hypothesized to generalize to the treatment of suicidality...
October 16, 2017: Suicide & Life-threatening Behavior
https://www.readbyqxmd.com/read/29040243/toxic-shock-syndrome-still-a-timely-diagnosis
#18
Kira L Gossack-Keenan, April J Kam
BACKGROUND: Toxic shock syndrome (TSS) is an acute, severe, toxin-mediated disease, characterized by fever, hypotension, and multiorgan system involvement. Toxic shock syndrome has made headlines because of its high associated morbidity and mortality rate in previously healthy young females. Incidence peaked in the early 1980s owing to increased usage of ultra-absorbent tampons. After improved patient education and tampon labeling, the incidence of menstrual TSS has declined. CASE: A previously healthy 14-year-old girl presented to an urgent care center with a 2-day history of fever, erythematous maculopapular rash, vomiting, diarrhea, and malaise...
October 16, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29018400/including-a-lower-extremity-component-during-hand-arm-bimanual-intensive-training-does-not-attenuate-improvements-of-the-upper-extremities-a-retrospective-study-of-randomized-trials
#19
Geoffroy Saussez, Marina B Brandão, Andrew M Gordon, Yannick Bleyenheuft
Hand-Arm Bimanual Intensive Therapy (HABIT) promotes hand function using intensive practice of bimanual functional and play tasks. This intervention has shown to be efficacious to improve upper-extremity (UE) function in children with unilateral spastic cerebral palsy (USCP). In addition to UE function deficits, lower-extremity (LE) function and UE-LE coordination are also impaired in children with USCP. Recently, a new intervention has been introduced in which the LE is simultaneously engaged during HABIT (Hand-Arm Bimanual Intensive Therapy Including Lower Extremities; HABIT-ILE)...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29016313/case-report-fatal-pediatric-melioidosis-despite-optimal-intensive-care
#20
Alice Young, Catherine Tacon, Simon Smith, Ben Reeves, Greg Wiseman, Josh Hanson
With prompt administration of appropriate antimicrobial therapy and access to modern intensive care support, fatal pediatric melioidosis is very unusual. We describe cases of two children in whom the possibility of melioidosis was recognized relatively early, but who died of the disease, despite receiving optimal supportive care. We discuss the resulting implications for bacterial virulence factors in disease pathogenesis.
October 2, 2017: American Journal of Tropical Medicine and Hygiene
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