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lactate elevation in pediatrics

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https://www.readbyqxmd.com/read/29703492/predictive-factors-of-fatal-bleeding-in-acute-promyelocytic-leukemia
#1
Simon Mantha, Martin S Tallman, Sean M Devlin, Gerald A Soff
Acute promyelocytic leukemia (APL) is associated with a profound coagulopathy. Based on retrospective assessments, several potential risk factors for hemorrhagic morbidity and mortality have emerged. Several studies have shown elevated white blood cell (WBC) count at presentation to be a robust predictor of bleeding events. Other clinical and laboratory parameters have been evaluated with variable association with hemorrhagic morbidity or mortality. These include ECOG performance status, age, morphological subtype, platelet count, peripheral blood blast count, ethnicity, body mass index, prothrombin time, activated partial thromboplastin time, lactate dehydrogenase, d-dimers, creatinine and fibrinogen levels...
April 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29695177/clinical-manifestation-of-patients-with-atypical-hemolytic-uremic-syndrome-with-the-c3-p-i1157t-variation-in-the-kinki-region-of-japan
#2
Takeshi Matsumoto, Hidemi Toyoda, Keishirou Amano, Masahiro Hirayama, Eiji Ishikawa, Mika Fujimoto, Masaaki Ito, Kohshi Ohishi, Naoyuki Katayama, Yoko Yoshida, Masanori Matsumoto, Naohisa Kawamura, Makoto Ikejiri, Keiki Kawakami, Toshiyuki Miyata, Hideo Wada
The gain-of-function variation p.I1157T in C3 was previously identified in 8 patients with atypical hemolytic uremic syndrome (aHUS) at Mie University Hospital. In the present study, we identified another 11 patients with aHUS with this variation, including 10 pediatric patients (onset age: 1-16 years). The variation seems to be geographically concentrated around Mie Prefecture in Japan. Fifteen of the 19 patients with aHUS experienced infection as probable triggering events. All 19 patients had renal dysfunction...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29652273/assessment-of-the-effect-of-two-regimens-of-milrinone-infusion-in-pediatric-patients-undergoing-fontan-procedure-a-randomized-study
#3
Rabie Soliman, Adel Ragheb
Objective: The aim of the study was to compare the effect of two different regimens of milrinone on hemodynamics and oxygen saturation in pediatric patients undergoing Fontan procedure. Design: This was a randomized study. Setting: Cardiac centers. Patients: This study included 116 patients undergoing Fontan procedure. Material and Methods: Group E: Milrinone was started as infusion 0.5 μg/kg/min without a loading dose at the beginning of cardiopulmonary bypass (CPB) followed by infusion 0...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29603246/elevated-free-hemoglobin-and-decreased-haptoglobin-levels-are-associated-with-adverse-clinical-outcomes-unfavorable-physiologic-measures-and-altered-inflammatory-markers-in-pediatric-cardiac-surgery-patients
#4
Jill M Cholette, Anthony P Pietropaoli, Kelly F Henrichs, George M Alfieris, Karen S Powers, Francisco Gensini, Jeffrey S Rubenstein, Dawn Sweeney, Richard Phipps, Sherry L Spinelli, Majed A Refaai, Michael P Eaton, Neil Blumberg
BACKGROUND: There are data suggesting that free hemoglobin (Hb), heme, and iron contribute to infection, thrombosis, multiorgan failure, and death in critically ill patients. These outcomes may be mitigated by haptoglobin. STUDY DESIGN AND METHODS: 164 consecutively treated children undergoing surgery for congenital heart disease were evaluated for associations between free Hb and haptoglobin and clinical outcomes, physiologic metrics, and biomarkers of inflammation RESULTS: Higher perioperative free Hb levels (and lower haptoglobin levels) were associated with mortality, nosocomial infection, thrombosis, hours of intubation and inotropes, increased interleukin-6, peak serum lactate levels, and lower nadir mean arterial pressures...
March 30, 2018: Transfusion
https://www.readbyqxmd.com/read/29570701/infant-outcome-at-four-years-of-age-after-intrapartum-sampling-of-scalp-blood-lactate-for-fetal-assessment-a-cohort-study
#5
Nana Wiberg, Tobias Wirenfeldt Klausen, Tobias Tyrberg, Lennart Nordström, Eva Wiberg-Itzel
OBJECTIVE: To correlate the value of lactate in fetal scalp blood at delivery and the outcomes of the offspring at four years of age. METHODS: Cases where scalp blood lactate was taken within sixty minutes before delivery were identified from the randomized trial "Determination of pH or lactate in fetal scalp blood in management of intrapartum fetal distress". Data were grouped according to the generally accepted cutoffs for normality, pre-acidemia, acidemia and concentrations above mean +2 SD during the second stage...
2018: PloS One
https://www.readbyqxmd.com/read/29566695/cerebrospinal-fluid-plasmodium-falciparum-histidine-rich-protein-2-in-pediatric-cerebral-malaria
#6
Kiran T Thakur, Jimmy Vareta, Kathryn A Carson, Samuel Kampondeni, Michael J Potchen, Gretchen L Birbeck, Ian MacCormick, Terrie Taylor, David J Sullivan, Karl B Seydel
BACKGROUND: Cerebral malaria (CM) causes a rapidly developing coma, and remains a major contributor to morbidity and mortality in malaria-endemic regions. This study sought to determine the relationship between cerebrospinal fluid (CSF) Plasmodium falciparum histidine rich protein-2 (PfHRP-2) and clinical, laboratory and radiographic features in a cohort of children with retinopathy-positive CM. METHODS: Patients included in the study were admitted (2009-2013) to the Pediatric Research Ward (Queen Elizabeth Central Hospital, Blantyre, Malawi) meeting World Health Organization criteria for CM with findings of malarial retinopathy...
March 23, 2018: Malaria Journal
https://www.readbyqxmd.com/read/29552945/predictors-of-poor-outcomes-in-pediatric-venoarterial-extracorporeal-membrane-oxygenation
#7
Maanasi S Mistry, Sara M Trucco, Timothy Maul, Mahesh S Sharma, Li Wang, Shawn West
BACKGROUND: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) provides respiratory and hemodynamic support to pediatric patients in severe cardiac failure. We aim to identify risk factors associated with poorer outcomes in this population. METHODS: A retrospective chart review was conducted of pediatric patients requiring VA-ECMO support for cardiac indications at our institution from 2004 to 2015. Data were collected on demographics, indication, markers of cardiac output, ventricular assist device (VAD) insertion, heart transplantation, or left atrial (LA) decompression...
May 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29465563/non-hodgkin-lymphoma-diagnostic-and-prognostic-particularities-in-children-a-series-of-case-reports-and-a-review-of-the-literature-care-compliant
#8
REVIEW
Cristina Oana Mărginean, Lorena Elena Meliţ, Emoke Horvath, Horea Gozar, Mihaela Ioana Chinceşan
RATIONALE: Non-Hodgkin lymphoma remains an unpredictable condition in pediatric patients. PATIENT CONCERNS: Our first case describes an 8-year-old boy with a history of iron deficiency anemia, admitted in our clinic for recurrent abdominal pain, weight loss, loss of appetite, diarrheic stools, and fever. The second case also describes an 8-year-old boy admitted for abdominal pain and vomiting. The 3rd case refers to a 4 years and 10 months old boy admitted in our clinic with abdominal pain and loss of appetite, who was initially admitted in the Pediatrics Surgery Clinic with the suspicion of appendicitis...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29383210/analysis-of-clinical-manifestations-and-laboratory-findings-in-children-with-influenza-b-associated-myositis-a-single-center-study
#9
Jae Woong Yoon, Du Young Choi, Seung Hyun Lee, Sae Ron Sin, Seung Taek Yu
Background: Influenza-associated myositis (IAM) is a rare and poorly recognized complication of influenza infection in children, and is characterized by acute onset of severe pain in the lower extremities and a refusal to ambulate walk. We sought to understand the association between IAM and influenza B infection and to investigate its clinical and laboratory characteristics in affected children. Methods: Influenza B-associated myositis (IBAM) cases diagnosed in the pediatrics department of Wonkwang University Hospital from January 2010 and March 2016 were analyzed retrospectively...
January 2018: Korean Journal of Family Medicine
https://www.readbyqxmd.com/read/29183008/correlates-of-pulmonary-function-in-children-with-sickle-cell-disease-and-elevated-fetal-hemoglobin
#10
Adekunle D Adekile, Asmaa Azab, Abdullah Owayed, Mousa Khadadah
OBJECTIVE: The current study was carried out to compare pulmonary function tests (PFT) in pediatric Kuwaiti sickle cell disease (SCD) patients to age-matched normal controls and to investigate the association of PFTS to selected clinical and laboratory parameters. SUBJECTS AND METHODS: There were 38 patients with SCD and 36 controls in the study. The patients were recruited from the Pediatric Hematology Clinics of Mubarak Al-Kabeer and Al-Amiri Hospitals, Kuwait and were studied in steady state...
November 28, 2017: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
https://www.readbyqxmd.com/read/29112103/vasopressin-in-vasodilatory-shock-for-both-left-and-right-heart-anomalous-pediatric-patients-after-cardiac-surgery
#11
Zhongyuan Lu, Xu Wang, Juxian Yang, Shoujun Li, Jun Yan
Although the use of vasopressin has become common place in pediatric patients with vasodilatory shock after cardiac surgery, its efficacy and hemodynamic effects have not been systematically documented. Furthermore, previous studies were mainly limited patients with left heart anomalies. To date, the use of vasopressin in patients with right heart anomalies hasn't yet been reported. To clarify the hemodynamic effects of vasopressin on pediatric patients with vasodilatory shock after cardiopulmonary bypass, 70 consecutive patients, most of whom with right heart anomalies were retrospectively analyzed in Fuwai Hospital from October 2013 to September 2015...
November 3, 2017: Shock
https://www.readbyqxmd.com/read/29042839/a-retrospective-study-on-infusion-related-reactions-to-rituximab-in-a-heterogeneous-pediatric-population
#12
Clément Legeay, Henrique Bittencourt, Elie Haddad, Laurence Spiesser-Robelet, Valérie Thépot-Seegers, Roxane Therrien
OBJECTIVES: To assess risks and outcomes of infusion-related reactions to rituximab in a heterogeneous pediatric population. METHODS: All patients who received rituximab between July 2010 and July 2012 were retrieved from the pharmacy software and included for analysis. Data were collected according to 4 categories: demographic data, infusion data, infusion-related reactions, and biological data considered as risk factors (i.e., absolute lymphocyte count, lactate dehydrogenase levels)...
September 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29040243/toxic-shock-syndrome-still-a-timely-diagnosis
#13
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/29018323/cerebrospinal-fluid-amino-acid-profiling-of-pediatric-cases-with-tuberculous-meningitis
#14
Shayne Mason, Carolus J Reinecke, Regan Solomons
Background: In Africa, tuberculosis is generally regarded as persisting as one of the most devastating infectious diseases. The pediatric population is particularly vulnerable, with infection of the brain in the form of tuberculous meningitis (TBM) being the most severe manifestation. TBM is often difficult to diagnose in its early stages because of its non-specific clinical presentation. Of particular concern is that late diagnosis, and subsequent delayed treatment, leads to high risk of long-term neurological sequelae, and even death...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28963039/ketamine-induces-hippocampal-apoptosis-through-a-mechanism-associated-with-the-caspase-1-dependent-pyroptosis
#15
Zhi Ye, Qing Li, Qulian Guo, Yunchuan Xiong, Dong Guo, Hong Yang, Yan Shu
Ketamine, a pediatric anesthetic, is widely used in clinical practice. There was growing evidence showing that ketamine can promote neuronal death in developing brains of both humans and animals. In this study, we used in vivo neonatal and juvenile mouse models to induce ketamine-related neurotoxicity in the hippocampus. Active caspase-3 and -9 proteins, which are responsible for the release of cytochrome C, and the mitochondrial translocation of p53, which is associated with mitochondrial apoptosis, were found to be significantly up-regulated in the ketamine-induced hippocampal neurotoxicity...
January 2018: Neuropharmacology
https://www.readbyqxmd.com/read/28869492/the-lactate-albumin-ratio-a-valuable-tool-for-risk-stratification-in-septic-patients-admitted-to-icu
#16
Michael Lichtenauer, Bernhard Wernly, Bernhard Ohnewein, Marcus Franz, Bjoern Kabisch, Johanna Muessig, Maryna Masyuk, Alexander Lauten, Paul Christian Schulze, Uta C Hoppe, Malte Kelm, Christian Jung
The lactate/albumin ratio has been reported to be associated with mortality in pediatric patients with sepsis. We aimed to evaluate the lactate/albumin ratio for its prognostic relevance in a larger collective of critically ill (adult) patients admitted to an intensive care unit (ICU). A total of 348 medical patients admitted to a German ICU for sepsis between 2004 and 2009 were included. Follow-up of patients was performed retrospectively between May 2013 and November 2013. The association of the lactate/albumin ratio (cut-off 0...
September 2, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28774273/thrombotic-microangiopathy-associated-with-valproic-acid-toxicity
#17
Sean A Hebert, Timothy P Bohan, Christian L Erikson, Rita D Swinford
BACKGROUND: Thrombotic microangiopathy (TMA) is a serious, sometimes life-threatening disorder marked by the presence of endothelial injury and microvascular thrombi. Drug-induced thrombotic microangiopathy (DI-TMA) is one specific TMA syndrome that occurs following drug exposure via drug-dependent antibodies or direct tissue toxicity. Common examples include calcineurin inhibitors Tacrolimus and Cyclosporine and antineoplastics Gemcitabine and Mitomycin. Valproic acid has not been implicated in DI-TMA...
August 3, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28719513/dihydrofolate-reductase-genetic-polymorphisms-affect-methotrexate-dose-requirements-in-pediatric-patients-with-acute-lymphoblastic-leukemia-on-maintenance-therapy
#18
Guillermo Gervasini, Silvia G de Murillo, Mercedes Jiménez, María D de la Maya, Jose M Vagace
We have aimed to determine the effect of polymorphisms in regulatory regions of the DHFR gene in relation to methotrexate (MTX) dose adjustments and drug-induced toxicity in children on maintenance therapy for acute lymphoblastic leukemia (ALL). In total, 41 children diagnosed with ALL were screened for 3 tag-single nucleotide polymorphisms in the DHFR promoter (C-1610G, C-680G/T, A-317G) and an intronic 19-bp insertion/deletion. Genotypes were analyzed in relation to dose requirements and toxicity. The percentage of MTX dose administered (with respect to protocol-recommended values) was affected by DHFR polymorphisms...
November 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28698729/neurological-and-vascular-manifestations-of-ethylmalonic-encephalopathy
#19
Ali Reza Tavasoli, Parastoo Rostami, Mahmoud Reza Ashrafi, Parvaneh Karimzadeh
Objective Ethylmalonic encephalopathy (EE) is a severe mitochondrial disease of early infancy clinically characterized by a combination of developmental delay, progressive pyramidal signs, and vascular lesions including petechial purpura, orthostatic acrocyanosis, and chronic hemorrhagic diarrhea. Biochemical hallmarks of the disease are persistently high level of lactate, and C4-C5-acylcarnitines in blood, markedly elevated urinary excretion of methylsuccinic and ethylmalonic (EMA) acids. Here we report two patients with EE as a 16-months-old male infant and a 2-yr-old boy referred to Pediatric Neurology Clinic in Children's Medical Center, Tehran-Iran that in one patient genetic analysis revealed a homozygous mutation of the ETHE1 gene in favor of ethylmalonic acidemia...
2017: Iranian Journal of Child Neurology
https://www.readbyqxmd.com/read/28622280/elevated-central-venous-to-arterial-co2-difference-is-not-associated-with-poor-clinical-outcomes-after-cardiac-surgery-with-cardiopulmonary-bypass-in-children
#20
Takaaki Akamatsu, Yu Inata, Kazuya Tachibana, Takeshi Hatachi, Muneyuki Takeuchi
OBJECTIVE: To investigate whether elevated central venous to arterial CO2 difference is associated with delayed extubation and prolonged ICU stay in children after cardiac surgery with cardiopulmonary bypass. DESIGN: Retrospective review of medical records. SETTING: PICU in a tertiary children's hospital. PATIENTS: Pediatric patients younger than 18 years old who underwent cardiac surgery with cardiopulmonary bypass between January 2014 and December 2014...
September 2017: Pediatric Critical Care Medicine
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