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Pediatric brain death

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https://www.readbyqxmd.com/read/28923612/deceased-organ-donation-from-pediatric-donors-does-the-literature-really-help-us-implication-for-more-powerful-guidelines
#1
M Mojtabaee, F Sadegh Beigee, F Ghorbani
BACKGROUND: Brain-dead pediatric donors have always been the focus of attention because of the higher quality, utility, and possibility of their organ donation. However, donors under the age of 5 years always necessitate making more challenging management efforts, which are not clearly implied in most parts of the guidelines. METHODS: The data obtained from 79 brain-dead pediatric donors of the Organ Procurement Unit of Masih Daneshvari Hospital, Tehran, Iran, were assessed...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28912153/comprehensive-genomic-profiling-of-282-pediatric-low-and-high-grade-gliomas-reveals-genomic-drivers-tumor-mutational-burden-and-hypermutation-signatures
#2
Adrienne Johnson, Eric Severson, Laurie Gay, Jo-Anne Vergilio, Julia Elvin, James Suh, Sugganth Daniel, Mandy Covert, Garrett M Frampton, Sigmund Hsu, Glenn J Lesser, Kimberly Stogner-Underwood, Ryan T Mott, Sarah Z Rush, Jennifer J Stanke, Sonika Dahiya, James Sun, Prasanth Reddy, Zachary R Chalmers, Rachel Erlich, Yakov Chudnovsky, David Fabrizio, Alexa B Schrock, Siraj Ali, Vincent Miller, Philip J Stephens, Jeffrey Ross, John R Crawford, Shakti H Ramkissoon
BACKGROUND: Pediatric brain tumors are the leading cause of death for children with cancer in the U.S. Incorporating next-generation sequencing data for both pediatric low-grade (pLGGs) and high-grade gliomas (pHGGs) can inform diagnostic, prognostic, and therapeutic decision-making. MATERIALS AND METHODS: We performed comprehensive genomic profiling on 282 pediatric gliomas (157 pHGGs, 125 pLGGs), sequencing 315 cancer-related genes and calculating the tumor mutational burden (TMB; mutations per megabase [Mb])...
September 14, 2017: Oncologist
https://www.readbyqxmd.com/read/28904266/clinical-impact-of-main-pulmonary-artery-dilatation-on-outcome-in-pediatric-idiopathic-and-heritable-pulmonary-arterial-hypertension
#3
Satoshi Ikehara, Shinichi Takatsuki, Tomotaka Nakayama, Kazuyuki Naoi, Hiroyuki Matsuura, Tsutomu Saji
BACKGROUND: Few studies have investigated the clinical impact of pulmonary artery (PA) dilatation on outcomes in pediatric pulmonary arterial hypertension (PAH).Methods and Results:This study investigated the clinical outcomes of idiopathic or heritable PAH in 66 children aged <18 years at diagnosis. Main PA/thorax (MPA/T) ratio was measured on chest radiography in PAH patients. Patients were divided into 2 groups based on MPA/T ratio, and compared with a control group of 166 age- and gender-matched healthy children...
September 13, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28900876/improving-diagnostic-and-therapeutic-outcomes-in-pediatric-brain-tumors
#4
REVIEW
Sydney T Grob, Jean M Mulcahy Levy
Pediatric brain tumors are the primary cause of cancer-related death during childhood. Unfortunately, the number of primary and metastatic brain tumors is steadily increasing while the mortality rates for many central nervous system (CNS) lesions have remained stagnant. Molecularly defined tumor classes have been added to the most recent 2016 World Health Organization (WHO) Classification System of Central Nervous System Brain Tumors, driving potential new treatments and identifying targets to improve survival for these patients...
September 12, 2017: Molecular Diagnosis & Therapy
https://www.readbyqxmd.com/read/28891980/sinomenine-hydrochloride-inhibits-human-glioblastoma-cell-growth-through-reactive-oxygen-species-generation-and-autophagy-lysosome-pathway-activation-an-in-vitro-and-in-vivo-study
#5
Yumao Jiang, Yue Jiao, Zhiguo Wang, Tao Li, Yang Liu, Yujuan Li, Xiaoliang Zhao, Danqiao Wang
Glioblastoma is the most common malignant primary brain tumor, and it is one of the causes of cancer fatality in both adult and pediatric populations. Patients with glioblastoma require chemotherapy after surgical resection and radiotherapy. Therefore, chemotherapy constitutes a viable approach for the eradication of glioblastoma cells. In this study, the anti-tumor activity of sinomenine hydrochloride (SH) was evaluated in U87 and SF767 cells in vitro and in vivo. The results showed that SH potently inhibited U87 and SF767 cell viability and did not cause caspase-dependent cell death, as demonstrated by the absence of significant early apoptosis and caspase-3 cleavage...
September 11, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28828924/use-of-ancillary-tests-when-determining-brain-death-in-pediatric-patients-in-the-united-states
#6
Ariane Lewis, Nellie Adams, Arun Chopra, Matthew P Kirschen
Although pediatric brain death guidelines stipulate when ancillary testing should be used during brain death determination, little is known about the way these recommendations are implemented in clinical practice. We conducted a survey of pediatric intensivists and neurologists in the United States on the use of ancillary testing. Although most respondents noted they only performed an ancillary test if the clinical examination and apnea test could not be completed, 20% of 195 respondents performed an ancillary test for other reasons, including (1) to convince a family that objected to the brain death determination that a patient is truly dead (n = 21), (2) personal preference (n = 14), and (3) institutional requirement (n = 5)...
October 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28801937/in-situ-split-liver-splitting-under-extra-corporeal-membrane-oxygenation-in-brain-dead-donor
#7
Assalino Michela, Pietro Majno, Christian Toso, Thierry Berney, Raphaël Giraud, Philipp Dutkowski, Axel Andres, Barbara Wildhaber, Laure Elkrief
Hemodynamic instability is generally considered as a contraindication to liver splitting, in particular when using an in-situ technique. We describe the cases of two young donors with brain death in whom refractory cardiac arrest and hemodynamic instability were supported by veno-arterial extracorporeal membrane oxygenation (VA-ECMO), allowing uneventful in situ splitting. Two adult and two pediatric liver recipients were successfully transplanted with immediate graft function. Favorable outcomes were also observed for the other transplanted organs, including one heart, two lungs and four kidneys...
August 12, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28800318/mir-513c-suppresses-neuroblastoma-cell-migration-invasion-and-proliferation-through-direct-targeting-glutaminase-gls
#8
Hong-Liang Xia, Yao Lv, Chun-Wei Xu, Ming-Cui Fu, Ting Zhang, Xiang-Ming Yan, Shu Dai, Qian-Wei Xiong, Yun Zhou, Jian Wang, Xu Cao
Neuroblastoma is a brain malignancy of childhood and accounts for 7-10% of childhood cancers, leading to approximately 15% of pediatric cancer deaths. MicroRNAs (miRNAs) are a family of short (about 18-25 nucleotides), noncoding and single stranded endogenous RNAs, which complementarily bind to the 3' untranslated regions of their target genes. Recently, glutamine metabolism has been recognized as an important nutrition source for tumor cells, and hence targeting glutamine metabolism could benefit to development of anti-cancer agents...
July 2, 2017: Cancer Biomarkers: Section A of Disease Markers
https://www.readbyqxmd.com/read/28782587/prolonged-ketamine-exposure-induces-increased-activity-of-the-glun2b-containing-n-methyl-d-aspartate-receptor-in-the-anterior-cingulate-cortex-of-neonatal-rats
#9
Saurabh S Kokane, Kerui Gong, Jianhui Jin, Qing Lin
Ketamine is a commonly used anesthetic among pediatric patients due to its high efficacy. However, it has been demonstrated by several preclinical studies that, widespread accelerated programmed death of neurons (neuroapoptosis) occurs due to prolonged or repeated exposure to ketamine specifically in the neonatal brain. Therefore, an emphasis on understanding the molecular mechanisms underlying this selective vulnerability of the neonatal brain to ketamine-induced neuroapoptosis becomes important in order to identify potential therapeutic targets, which would help prevent or at least ameliorate this neuroapoptosis...
August 4, 2017: Neurotoxicology and Teratology
https://www.readbyqxmd.com/read/28780390/a-12-year-experience-with-tracheostomy-for-neonates-and-infants-in-northern-taiwan-indications-hospital-courses-and-long-term-outcomes
#10
Chia-Huei Chen, Jui-Hsing Chang, Chyong-Hsin Hsu, Nan-Chang Chiu, Chun-Chin Peng, Wai-Tim Jim, Hung-Yang Chang, Kuo-Sheng Lee
BACKGROUND: Tracheostomy is a valuable procedure in infants and neonates with chronic respiratory failure or severe airway obstruction. The aim of this study is to identify the indication, hospital course, and long-term outcome in a cohort of infants who required tracheostomy in a neonatal and pediatric tertiary care center in northern Taiwan. METHODS: Medical records of infants, who underwent tracheostomy between January 2002 and December 2013, were retrospectively reviewed...
July 24, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28741144/tobacco-use-and-smoke-exposure-in-children-new-trends-harm-and-strategies-to-improve-health-outcomes
#11
REVIEW
Luv D Makadia, P Jervey Roper, Jeannette O Andrews, Martha S Tingen
PURPOSE OF REVIEW: Every day in the USA, approximately 4000 adolescents begin smoking and the adolescent brain is particularly susceptible to nicotine addiction. We present current pediatric trends on tobacco use and exposures, various new products used by adolescents, the adverse biological and behavioral effects of tobacco use and exposures, and tobacco control strategies to eliminate tobacco-related illnesses and deaths in the pediatric population. RECENT FINDINGS: Twelve-20% of women continue to smoke during pregnancy...
August 2017: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/28723885/term-versus-preterm-cord-blood-cells-for-the-prevention-of-preterm-brain-injury
#12
Jingang Li, Tamara Yawno, Amy Sutherland, Jan Loose, Ilias Nitsos, Beth J Allison, Robert Bischof, Courtney A McDonald, Graham Jenkin, Suzanne L Miller
BACKGROUND: White matter brain injury in preterm infants can induce neurodevelopmental deficits. Umbilical cord blood (UCB) cells demonstrate neuroprotective properties, but it is unknown whether cells obtained from preterm versus term cord blood have similar efficacy. This study compared the ability of term cord blood (TCB) versus preterm cord blood (PCB) cells to reduce white matter injury in preterm fetal sheep. METHODS: Hypoxia-ischemia (HI) was induced in fetal sheep (0...
July 19, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28719478/a-review-of-nonfatal-drowning-in-the-pediatric-age-group-a-10-year-experience-at-a-university-hospital-in-saudi-arabia
#13
Faisal O Al-Qurashi, Abdullah A Yousef, Abdullah Aljoudi, Saleh M Alzahrani, Nasser Y Al-Jawder, Abdulrahman K Al-Ahmar, Mosab S Al-Majed, Hussam M Abouollo
OBJECTIVE: The aim of this study was to evaluate the nonfatal drowning experience, risk factors, intrahospital assessment and postincidental outcomes for children admitted to King Fahd Hospital of the University, AlKhobar, Saudi Arabia, over a 10-year period. METHODS: Children up to the age of 14 years who were admitted with the diagnosis of nonfatal drowning from July 2005 to June 2015 were included. Data regarding demographics, timing, season and location of drowning, presence of an assigned lifeguard, duration of submersion and transport to hospital, cardiopulmonary resuscitation, initial Glasgow Coma Scale, temperature, pH, blood sugar level, total hospital stay, and discharge status were extrapolated, and their effects on the patient's outcome analyzed...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28717727/childhood-cancer-mortality-in-india-direct-estimates-from-a-nationally-representative-survey-of-childhood-deaths
#14
Sumit Gupta, Shaun K Morris, Wilson Suraweera, Lukasz Aleksandrowicz, Rajesh Dikshit, Prabhat Jha
PURPOSE: Although most children with cancer live in low- and middle-income countries, measurements of childhood cancer burden in such countries have been restricted to incidence rates from a few subnational cancer registries and mortality rates from vital statistics. We aimed to provide alternative burden estimates by using nationally representative longitudinal survey-derived mortality rates. METHODS: We examined cancer deaths in childhood (1 month to 14 years of age) in the Million Death Study, a cohort of > 27,000 pediatric deaths in India on the basis of enhanced verbal autopsies...
December 2016: Journal of Global Oncology
https://www.readbyqxmd.com/read/28716517/lethal-suicide-attempt-with-a-mixed-drug-intoxication-of-metoprolol-and-propafenone-a-first-pediatric-case-report
#15
Ivana Kacirova, Milan Grundmann, Martin Kolek, Erika Vyskocilova-Hrudikova, Romana Urinovska, Petr Handlos
INTRODUCTION: The β1 adrenergic receptor blocker metoprolol is often prescribed together with the antiarrhythmic drug propafenone. Both are metabolized by cytochrome P450 2D6 and propafenone is also an inhibitor of this enzyme. We present a pediatric case showing metoprolol and propafenone intoxication in combination. CASE: A 14-year-old girl was admitted to a local emergency department after ingestion of metoprolol (probably 1g) and propafenone (probably 1.5-3g) in a suicide attempt...
September 2017: Forensic Science International
https://www.readbyqxmd.com/read/28700540/clinical-and-radiological-presentations-and-management-of-blunt-splenic-trauma-a-single-tertiary-hospital-experience
#16
Gaby Jabbour, Ammar Al-Hassani, Ayman El-Menyar, Husham Abdelrahman, Ruben Peralta, Mohammed Ellabib, Hisham Al-Jogol, Mohammed Asim, Hassan Al-Thani
BACKGROUND Splenic injury is the leading cause of major bleeding after blunt abdominal trauma. We examined the clinical and radiological presentations, management, and outcome of blunt splenic injuries (BSI) in our institution. MATERIAL AND METHODS A retrospective study of BSI patients between 2011 and 2014 was conducted. We analyzed and compared management and outcome of different splenic injury grades in trauma patients. RESULTS A total of 191 BSI patients were identified with a mean (SD) age of 26.9 years (13...
July 12, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28699371/minocycline-attenuates-high-mobility-group-box-1-translocation-microglial-activation-and-thalamic-neurodegeneration-after-traumatic-brain-injury-in-postnatal-day-17-rats
#17
Dennis William Simon, Rajesh K Aneja, Henry Alexander, Michael J Bell, Hulya Bayir, Patrick M Kochanek, Robert S B Clark
In response to cell injury the danger signal high mobility group box-1 (HMGB) is released, activating macrophages by binding pattern recognition receptors. We investigated the role of the anti-inflammatory drug minocycline in attenuating HMGB1 translocation, microglial activation, and neuronal injury in a rat model of pediatric traumatic brain injury (TBI). Postnatal day 17 Sprague-Dawley rats were subjected to moderate-severe controlled cortical impact (CCI). Animals were randomized to treatment with minocycline (90 mg/kg, i...
July 12, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28667938/altered-stress-system-reactivity-after-pediatric-injury-relation-with-post-traumatic-stress-symptoms
#18
Linda Ewing-Cobbs, Mary R Prasad, Charles S Cox, Douglas A Granger, Gerardo Duque, Paul R Swank
Injury is the leading cause of death and disability in childhood. Injured children are at high risk for developing alterations in stress response systems and post-traumatic stress symptoms (PTSS) that may compromise long-term physical and psychological health. In a prospective, observational cohort study, we examined individual differences in, and correlates of, stress-reactivity of the hypothalamic-pituitary-adrenal axis (HPA; salivary cortisol) and autonomic nervous system (ANS; salivary alpha amylase, sAA) following pediatric injury...
October 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/28650356/trending-fibrinolytic-dysregulation-fibrinolysis-shutdown-in-the-days-after-injury-is-associated-with-poor-outcome-in-severely-injured-children
#19
Christine M Leeper, Matthew D Neal, Christine J McKenna, Barbara A Gaines
OBJECTIVE: To trend fibrinolysis after injury and determine the influence of traumatic brain injury (TBI) and massive transfusion on fibrinolysis status. BACKGROUND: Admission fibrinolytic derangement is common in injured children and adults, and is associated with poor outcome. No studies examine fibrinolysis days after injury. METHODS: Prospective study of severely injured children at a level 1 pediatric trauma center. Rapid thromboelastography was obtained on admission and daily for up to 7 days...
September 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28626255/underlying-cause-of-death-recorded-during-2013-to-2015-at-a-tertiary-general-hospital-in-vientiane-capital-lao-pdr
#20
Bounfeng Phoummalaysith, Viengsakhone Louangpradith, Tavanh Manivon, Bounxou Keohavong, Eiko Yamamoto, Nobuyuki Hamajima
In Lao People's Democratic Republic (Lao PDR), the cause of death is not registered in death reports. As a result, the government cannot produce official reports that show mortality according to cause of death. This study aimed to report the underlying cause of death in a tertiary general hospital (Mittaphab Hospital) in Vientiane capital. Mittaphab hospital is a governmental teaching hospital with 300 beds for inpatient services specialized in orthopedics, neurology, and hemodialysis. Since a children hospital exists beside Mittaphab Hospital, severe pediatric cases are referred to the child hospital...
February 2017: Nagoya Journal of Medical Science
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