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bradycardia sepsis

Vidya Ramasamy, Harvey Teo, Victor Samuel Rajadurai, Suresh Chandran
A female preterm infant was born to a non-consanguineous couple at 35 weeks of gestation. On day 8 of life, while on full feeds, she developed prolonged apnoea and bradycardia, requiring respiratory support. Her abdomen was soft with unremarkable serial abdominal X-rays. Her septic screen was negative. Metabolic acidosis was worsening despite treatment. Echocardiography showed evidence of high pulmonary pressures. With further deterioration, an ultrasound scan of the abdomen was requested in view of the rising suspicion of abdominal pathology in the absence of sepsis and metabolic disorders...
2016: BMJ Case Reports
Louma Basma Rustam, Saadieh Masri, Nathalie Atallah, Hani Tamim, Lama Charafeddine
BACKGROUND: Previous research has shown that oral stimulation improves feeding skills in preterm infants. However, it remains unclear whether other sensorimotor therapies have similar effect. OBJECTIVE: To investigate the effect of sensorimotor therapy on the time to reach full oral feeding (FOF) in infants <33weeks. METHODS: Retrospective review compared two time periods between 2009 and 2014, before (PRE TX) and after (POST TX) initiation of sensorimotor therapy to infants <33weeks...
August 2016: Early Human Development
Luiz Carlos Passos, Márcio Galvão Oliveira, Andre Rodrigues Duraes, Thiago Moreira Trindade, Andréa Cristina Costa Barbosa
Background Beta-blockers have been recommended for patients with heart failure and reduced ejection fraction for their long-term benefits. However, the tolerance to betablockers in patients hospitalized with acute heart failure should be evaluated. Objective To estimate the proportion of patients hospitalized with acute heart failure who can tolerate these agents in clinical practice and compare the clinical outcomes of patients who can and cannot tolerate treatment with beta-blockers. Setting Two reference hospitals in cardiology...
August 2016: International Journal of Clinical Pharmacy
George Panos, Dimitrios Velissaris, Vasilios Karamouzos, Charalampos Matzaroglou, Minos Tylianakis
BACKGROUND: We present the case of a septic patient with severe immunodeficiency, who developed QT interval prolongation followed by episodes of lethal cardiac arrhythmia. Cardiac events occurred after posaconazole administration, incriminating posaconazole use, alone or in combination with voriconazole, as the culpable agent. CASE REPORT: A 26-year-old female patient underwent orthopedic surgery to remove ectopic calcifications in her left hip joint. On the first post-operative day she became septic due to a surgical wound infection...
2016: American Journal of Case Reports
Zivanit Ergaz, Shmuel Benenson, Noa Ofek-Shlomai, Sinan Abu-Leil, Benjamin Bar-Oz
INTRODUCTION: Early prediction of late onset sepsis is imperative in order to improve survival and reduce long-term complications. Since clinical deterioration is detrimental, empiric antibiotic treatment is initiated once sepsis is suspected. Symptoms that may indicate invasive infection are non-specific. Previous risk scores offered to improve clinical decision-making but provided low predictive values. AIMS: To evaluate the quantitative early alert of software application compared to clinical judgment by the treating physician, and the "gold standard" of positive blood and/or positive cerebrospinal fluid...
January 2016: Harefuah
Rajendra Singh Chouhan, Ashish Bindra, Nitasha Mishra, Neha Hasija, Sumit Sinha
Abdominal compartment syndrome is a rare entity that can be life-threatening if not diagnosed and correctly managed in time. We report a case of abdominal compartment syndrome following an apparently uneventful excision and repair of myelomeningocele (MMC). Though MMC is the most complex congenital spinal cord malformation compatible with life and early surgery is recommended to decrease the risk of meningitis and sepsis but generally surgery is safe without major perioperative turbulence. The majority of the skin defects following excision of MMC are repaired by primary skin closure, but large defects may require secondary closure by skin grafts or rotational flaps...
October 2015: Journal of Pediatric Neurosciences
Leena Bhattacharya Mithal, Ram Yogev, Hannah Palac, Ilan Gur, Karen K Mestan
AIM: Current clinical and laboratory diagnostics for neonatal infection are inadequate. An infant's systemic inflammatory response may be identified earlier than clinical suspicion by a computerized algorithm (RALIS) incorporating multiple vital signs (VS). We tested the ability of RALIS to detect late onset infection (LOI) earlier than clinically suspected. METHODS: We conducted a retrospective review of infants enrolled in a birth cohort study at Prentice Women's Hospital...
July 1, 2016: Journal of Perinatal Medicine
Renata Lazari Sandoval, Carlos Moreno Zaconeta, Paulo Roberto Margotto, Maria Teresinha de Oliveira Cardoso, Evely Mirella Santos França, Cristina Touguinha Neves Medina, Talyta Matos Canó, Aline Saliba de Faria
OBJECTIVE: To report the case of a newborn with recurrent episodes of apnea, diagnosed with Congenital Central hypoventilation syndrome (CCHS) associated with Hirschsprung's disease (HD), configuring Haddad syndrome. CASE DESCRIPTION: Third child born at full-term to a non-consanguineous couple through normal delivery without complications, with appropriate weight and length for gestational age. Soon after birth he started to show bradypnea, bradycardia and cyanosis, being submitted to tracheal intubation and started empiric antibiotic therapy for suspected early neonatal sepsis...
September 2016: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
Vinay Rathore, Arun Bansal, Sunit C Singhi, Pratibha Singhi, Jayashree Muralidharan
BACKGROUND: Data on outcome of children undergoing in-hospital cardiopulmonary resuscitation (CPR) in low- and middle-income countries are scarce. AIMS: To describe the clinical profile and outcome of children undergoing in-hospital CPR. METHODS: This prospective observational study was undertaken in the Advanced Pediatric Center, PGIMER, Chandigarh. All patients aged 1 month to 12 years who underwent in-hospital CPR between July 2010 and March 2011 were included...
February 3, 2016: Paediatrics and International Child Health
Peter Magnusson, Fredrik Gadler, Per Liv, Stellan Mörner
AIMS: Implantable defibrillators (ICDs) successfully terminate ventricular arrhythmias in hypertrophic cardiomyopathy (HCM), protect against bradycardia, and monitor atrial arrhythmias. This may alter the natural history and causes of death. METHODS: This nationwide observational longitudinal retrospective study of all HCM patients implanted during 1995-2012 obtained data from the Swedish ICD Registry, the National Patient Register, the Cause of Death Register, and were validated by review of medical records...
July 2016: Journal of Cardiovascular Medicine
Vivek Verma, Amy B Beethe, Michelle LeRiger, Rajesh R Kulkarni, Mutian Zhang, Chi Lin
PURPOSE: Complications of anesthesia for pediatric radiation therapy are imperative for both radiation oncologists and anesthesiologists to clinically assess and manage. We performed the first systematic review to date addressing this important issue. METHODS: A systematic search of PubMed and EMBASE was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Searches were not restricted based on publication date. Nine original investigations were identified, analyzed, and collated for this report...
May 2016: Practical Radiation Oncology
Mohammad Mahdi Zamani, Mahsa Keshavarz-Fathi, Maryam Sadat Fakhri-Bafghi, Armin Hirbod-Mobarakeh, Nima Rezaei, Amir Bahrami, Nader D Nader
PURPOSE: The aim of this systematic review was to evaluate the effectiveness and safety of dexmedetomidine used for sedation of patients with sepsis. METHODS: We searched Medline, Scopus, TRIP and CENTRAL, DART, OpenGrey, and ProQuest without applying any language filter up to July 15, 2015. Two of the authors independently reviewed search results for irrelevant and duplicate studies and extracted data and assessed methodological quality of the studies. We used tabulation to synthesize the findings of the studies and transformed data into a common rubric and calculated a weighted treatment effect across studies using Review Manager...
April 2016: Journal of Critical Care
T Malla, S Singh, P Poudyal, B Sathian, G Bk, K K Malla
BACKGROUND: An exchange transfusion involves replacing patient's blood with donor blood in order to remove abnormal blood components and circulating toxins while maintaining adequate circulating blood volume. OBJECTIVE: To observe the incidence, causes of jaundice requiring Exchange and any adverse event of exchange transfusion in newborns with unconjugated hyperbilirubinemia. METHOD: Prospective study undertaken at Neonatal Intensive Care Unit (NICU) of Manipal Teaching Hospital, Pokhara, Nepal from March 2014 to April 2015...
April 2015: Kathmandu University Medical Journal (KUMJ)
Veronica Siljehav, Annika M Hofstetter, Kristin Leifsdottir, Eric Herlenius
OBJECTIVE: To determine whether infection, with associated eicosanoid release, is a main cause of respiratory disruption in neonates, by measuring levels of prostaglandin E2 (PGE2) and its metabolite (PGEM) in cerebrospinal fluid (CSF). STUDY DESIGN: Of 59 eligible infants, 25 preterm infants (mean gestational age, 28 ± 0.5 weeks) and 22 full-term infants (mean gestational age, 40 ± 0.5 weeks) from a level 3 neonatal intensive care unit and the general maternity neonatal ward were enrolled prospectively...
December 2015: Journal of Pediatrics
Peter Jones
Recent studies of atropine during critical care intubation (CCI) have revealed that neonates frequently experience bradycardia, are infrequently affected by ventricular arrhythmias and conduction disturbances and deaths have not been reported in a series of studies. The indiscriminate use of atropine is unlikely to alter the outcome during neonatal CCI other than reducing the frequency of sinus tachycardia. In contrast, older children experience a similar frequency of bradycardia to neonates and are more frequently affected by ventricular arrhythmias and conduction disturbances...
January 2016: Archives of Disease in Childhood
Stephen D DeMeo, Sudha R Raman, Christoph P Hornik, Catherine C Wilson, Reese Clark, P Brian Smith
IMPORTANCE: Immunization of extremely low-birth-weight (ELBW) infants in the neonatal intensive care unit (NICU) is associated with adverse events, including fever and apnea or bradycardia, in the immediate postimmunization period. These adverse events present a diagnostic dilemma for physicians, leading to the potential for immunization delay and sepsis evaluations. OBJECTIVE: To compare the incidence of sepsis evaluations, need for increased respiratory support, intubation, seizures, and death among immunized ELBW infants in the 3 days before and after immunization...
August 2015: JAMA Pediatrics
Vinay Rathore, Arun Bansal, Sunit C Singhi, Pratibha Singhi, Jayashree Muralidharan
BACKGROUND: Data on outcome of children undergoing in-hospital cardiopulmonary resuscitation (CPR) in low- and middle-income countries are scarce. AIMS: To describe the clinical profile and outcome of children undergoing in-hospital CPR. METHODS: This prospective observational study was undertaken in the Advanced Pediatric Center, PGIMER, Chandigarh. All patients aged 1 month to 12 years who underwent in-hospital CPR between July 2010 and March 2011 were included...
May 2016: Paediatrics and International Child Health
Evelien Hilde Verstraete, Koen Blot, Ludo Mahieu, Dirk Vogelaers, Stijn Blot
BACKGROUND AND OBJECTIVES: Blood culture is the gold standard to diagnose bloodstream infection but is usually time-consuming. Prediction models aim to facilitate early preliminary diagnosis and treatment. We systematically reviewed prediction models for health care-associated bloodstream infection (HABSI) in neonates, identified superior models, and pooled clinical predictors. DATA SOURCES: LibHub, PubMed, and Web of Science. METHODS: The studies included designed prediction models for laboratory-confirmed HABSI or sepsis...
April 2015: Pediatrics
Yi-Li Wang, Kwok-Keung Lam, Pao-Yun Cheng, Yen-Mei Lee
ETHNOPHARMACOLOGICAL RELEVANCE: Celastrol, a quinone methide extracted from the root of Tripterygium wilfordii Hook, possesses anti-oxidant and anti-inflammatory effects. Tripterygium wilfordii Hook is officially listed in the Chinese Pharmacopoeia and is used traditionally against rheumatoid arthritis, ankylosing spondylitis, and cancer. Furthermore, the circulatory protective effect of celastrol on an in vivo animal model of sepsis was investigated. AIM OF THE STUDY: Sepsis is a systemic inflammatory disorder that increases tissue oxidative stress and leads to multiple organ injury...
March 13, 2015: Journal of Ethnopharmacology
Hsin-Hsueh Shen, Kwok-Keung Lam, Pao-Yun Cheng, Ching-Wen Kung, Shu-Ying Chen, Pei-Chiang Lin, Ming-Ting Chung, Yen-Mei Lee
Alpha-lipoic acid (ALA), a naturally occurring disulfide derivative of octanoic acid, serves as a strong antioxidant and has been reported to possess anti-inflammatory effects. The aim of the present study is to investigate the preventive and therapeutic effects of ALA on multiple organ dysfunction syndrome (MODS) caused by endotoxemia in rats. Male Wistar rats were intravenously infused with lipopolysaccharide (LPS) (10 mg/kg) to induce endotoxemia. Alpha-lipoic acid 10, 20, or 40 mg/kg was administered intravenously 60 min before (pretreatment) LPS challenge, and ALA 40 mg/kg was administered intravenously 30 min after (posttreatment) LPS challenge...
April 2015: Shock
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