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https://www.readbyqxmd.com/read/29760372/a-review-of-induction-with-rabbit-antithymocyte-globulin-in-pediatric-heart-transplant-recipients
#1
Martin Schweiger, Andreas Zuckermann, Andres Beiras-Fernandez, Michael Berchtolld-Herz, Udo Boeken, Jens Garbade, Stephan Hirt, Manfred Richter, Arjang Ruhpawar, Jan Dieter Schmitto, Felix Schönrath, Rene Schramm, Uwe Schulz, Markus J Wilhelm, Markus J Barten
Pediatric heart transplantation (pHTx) represents only a small proportion of cardiac transplants. Due to these low numbers, clinical data relating to induction therapy in this special population are far less extensive than for adults. Induction is used more widely in pHTx than in adults, mainly because of early steroid withdrawal or complete steroid avoidance. Antithymocyte globulin (ATG) is the most frequent choice for induction in pHTx, and rabbit antithymocyte globulin (rATG, Thymoglobulin®) (Sanofi Genzyme) is the most widely-used ATG preparation...
May 15, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29749702/management-of-severe-chronic-pain-with-methadone-in-pediatric-patients-with-sickle-cell-disease
#2
Zachary LeBlanc, Chris Vance, Jason Payne, Jie Zhang, Lee Hilliard, Jeffrey D Lebensburger, Thomas H Howard
Vasocclusive pain crises are common among pediatric patients with sickle cell disease (SCD). Some patients with repeated pain crises develop chronic pain. We performed a retrospective cohort study of pediatric patients with SCD with chronic pain treated with methadone. We identified a significant reduction in pain hospitalizations following methadone treatment (0.35 ± 0.19 vs. 0.19 ± 0.17 hospitalizations/month, P = 0.016). In addition, we did not observe overt organ toxicity nor symptoms of opioid withdrawal during methadone wean...
May 11, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29716830/pediatric-donation-after-circulatory-determination-of-death-pdcd-a-narrative-review
#3
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/29697715/catatonia-in-the-medically-ill-etiology-diagnosis-and-treatment-the-academy-of-consultation-liaison-psychiatry-evidence-based-medicine-subcommittee-monograph
#4
Lex Denysenko, Nicole Sica, Thomas M Penders, Kemuel L Philbrick, Audrey Walker, Scott Shaffer, Paula Zimbrean, Oliver Freudenreich, Nicole Rex, Brendan T Carroll, Andrew Francis
BACKGROUND: Catatonia in medically ill patients is rare but often unrecognized. This monograph summarizes current knowledge on the diagnosis, epidemiology, etiology, and management of catatonia occurring in the medical setting. METHODS: PubMed searches were used to identify relevant articles from 1962 to present. RESULTS: More than 3,000 articles were obtained and reviewed for relevance, including references of articles identified by the initial search...
May 2018: Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists
https://www.readbyqxmd.com/read/29687342/predictors-of-preoperative-program-non-completion-in-adolescents-referred-for-bariatric-surgery
#5
Cassie Brode, Megan Ratcliff, Jennifer Reiter-Purtill, Sanita Hunsaker, Michael Helmrath, Meg Zeller
BACKGROUND: Factors contributing to adolescents' non-completion of bariatric surgery, defined as self-withdrawal during the preoperative phase of care, independent of program or insurance denial, are largely unknown. Recent adolescent and adult bariatric surgery literature indicate that psychological factors and treatment withdrawal play a role; however, for adolescents, additional age-salient (family/caregiver) variables might also influence progression to surgery. OBJECTIVES: The present study examined demographic, psychological, and family/caregiver variables as predictors of whether adolescents completed surgery ("completers") or withdrew from treatment ("non-completers")...
April 23, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29607497/low-dose-naltrexone-for-induction-of-remission-in-crohn-s-disease
#6
REVIEW
Claire E Parker, Tran M Nguyen, Dan Segal, John K MacDonald, Nilesh Chande
BACKGROUND: Crohn's disease is a transmural, relapsing inflammatory condition afflicting the digestive tract. Opioid signalling, long known to affect secretion and motility in the gut, has been implicated in the inflammatory cascade of Crohn's disease. Low dose naltrexone, an opioid antagonist, has garnered interest as a potential therapy. OBJECTIVES: The primary objective was to evaluate the efficacy and safety of low dose naltrexone for induction of remission in Crohn's disease...
April 1, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29607496/enteral-nutritional-therapy-for-induction-of-remission-in-crohn-s-disease
#7
REVIEW
Neeraj Narula, Amit Dhillon, Dongni Zhang, Mary E Sherlock, Melody Tondeur, Mary Zachos
BACKGROUND: Corticosteroids are often preferred over enteral nutrition (EN) as induction therapy for Crohn's disease (CD). Prior meta-analyses suggest that corticosteroids are superior to EN for induction of remission in CD. Treatment failures in EN trials are often due to poor compliance, with dropouts frequently due to poor acceptance of a nasogastric tube and unpalatable formulations. This systematic review is an update of a previously published Cochrane review. OBJECTIVES: To evaluate the effectiveness and safety of exclusive EN as primary therapy to induce remission in CD and to examine the importance of formula composition on effectiveness...
April 1, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29569003/tacrolimus-and-mycophenolate-mofetil-as-second-line-therapies-for-pediatric-patients-with-autoimmune-hepatitis
#8
Cumali Efe, Haider Al Taii, Henriette Ytting, Niklas Aehling, Rahima A Bhanji, Hannes Hagström, Tugrul Purnak, Luigi Muratori, Mårten Werner, Paolo Muratori, Daniel Klintman, Thomas D Schiano, Aldo J Montano-Loza, Thomas Berg, Fin Stolze Larsen, Naim Alkhouri, Ersan Ozaslan, Michael A Heneghan, Eric M Yoshida, Staffan Wahlin
BACKGROUND: We studied the efficacy and safety of mycophenolate mofetil (MMF) and tacrolimus as second-line therapy in pediatric patients with autoimmune hepatitis (AIH) who were intolerant or non-responders to standard therapy (corticosteroid and azathioprine). PATIENTS AND METHODS: We performed a retrospective study of data from 13 centers in Europe, USA, and Canada. Thirty-eight patients (< 18 years old) who received second-line therapy (18 MMF and 20 tacrolimus), for a median of 72 months (range 8-182) were evaluated...
March 22, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29546924/-limitation-of-vital-support-in-a-chilean-pediatric-intensive-care-unit-2004-2014
#9
Bettina von Dessauer, Carmen Benavente, Emilia Monje, Jazmina Bongain, Nadia Ordenes
OBJECTIVE: Describe the frequency and characteristics of PICU patients who undergo a process of withholding or withdrawing life-sustaining treatment (LTSV), between 2004 y 2014. PATIENTS AND METHOD: A retrospective, observational descriptive study, using two documents for quality assessment in the PICU of Hospital Roberto del Río: 1) daily individual patient tracking log and 2) daily record of quality indicators, including LTSV, both updated daily at the morning visit...
December 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/29534693/severe-eye-complications-from-toxic-epidermal-necrolysis-following-initiation-of-nevirapine-based-haart-regimen-in-a-child-with-hiv-infection-a-case-from-cameroon
#10
Xavier Tchetnya, Calypse Asangbe Ngwasiri, Tiayah Munge, Leopold Ndemnge Aminde
BACKGROUND: Toxic epidermal necrolysis (TEN) is a rare life threatening dermatological disorder characterized by extensive epidermal detachment and erosion of mucous membranes. It is typically a side effect of some medications. Nevirapine, a nonnucleoside reverse transcriptase inhibitor (NNRTI) is one of the frequently used components of highly active antiretroviral therapy (HAART). Skin rash is its common adverse reaction, usually mild and rarely progressing to TEN. Ophthalmic involvement is common as well but rarely progresses to blindness especially in the pediatric population...
March 13, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29518638/thrombophilia-testing-in-children-what-and-when-should-be-tested
#11
REVIEW
Ulrike Nowak-Göttl, Heleen van Ommen, Gili Kenet
Venous thrombosis (VTE) in children is gaining increased awareness and apart from underlying medical conditions, recently reported systematic reviews on pediatric VTE (70% provoked) have shown significant associations between thrombosis and presence of inherited thrombophilic risk factors (IT), such as protein C-, protein S- and antithrombin deficiency, mutations of factor 5 (F5: rs6025) and factor 2 (F2: rs1799963), even more pronounced when combined IT were involved. Although we have learned more about the pathophysiology of VTE with the increased discovery of IT evidence is still lacking as to whether IT influence the clinical outcome in pediatric VTE...
April 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29508243/adjunctive-eslicarbazepine-acetate-in-pediatric-patients-with-focal-epilepsy-a-systematic-review-and-meta-analysis
#12
REVIEW
Simona Lattanzi, Francesco Brigo, Elisabetta Grillo, Claudia Cagnetti, Alberto Verrotti, Gaetano Zaccara, Mauro Silvestrini
BACKGROUND: In the treatment of pediatric epilepsy, there is a critical demand for effective and safe therapeutic options to address patients' unmet clinical needs. Eslicarbazepine acetate is a novel once-daily antiepileptic drug and a third-generation single enantiomer member of the dibenzazepine family. OBJECTIVE: The objective of this study was to evaluate the efficacy and safety of eslicarbazepine acetate as add-on treatment for focal-onset seizures in pediatric patients using meta-analytical techniques...
March 2018: CNS Drugs
https://www.readbyqxmd.com/read/29493583/anticipating-uncertainty-and-irrevocable-decisions-provider-perspectives-on-implementing-whole-genome-sequencing-in-critically-ill-children-with-heart-disease
#13
Danton S Char, Sandra Soo-Jin Lee, David Magnus, Mildred Cho
PurposeTo investigate the potential impacts of whole-genome sequencing (WGS) in the pediatric critical-care context, we examined how clinicians caring for critically ill children with congenital heart disease (CHD) anticipate and perceive the impact of WGS on their decision-making process and treatment recommendations.MethodsWe conducted semistructured in-person and telephone interviews of clinicians involved in the care of critically ill children with CHD at a high-volume pediatric heart center. We qualitatively analyzed the transcribed interviews...
March 1, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29492382/current-state-of-pediatric-cardiac-transplantation
#14
REVIEW
Anne I Dipchand
Pediatric heart transplantation is standard of care for children with end-stage heart failure. The diverse age range, diagnoses, and practice variations continue to challenge the development of evidence-based practices and new technologies. Outcomes in the most recent era are excellent, especially with the more widespread use of ventricular assist devices (VADs). Waitlist mortality remains high and knowledge of risk factors for death while waiting and following transplantation contributes to decision-making around transplant candidacy and timing of listing...
January 2018: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29491753/voriconazole-poor-oral-bioavailability-and-possible-renal-toxicity-in-an-infant-with-invasive-aspergillosis
#15
Jenny A Walldorf, Omayma A Kishk, James D Campbell, Allison B Lardieri
Voriconazole is the recommended agent of choice for treatment of invasive aspergillosis; however, achieving therapeutic serum concentrations while avoiding toxicity, both with intravenous and oral formulations, is challenging in infants. We report the case of an infant with confirmed invasive aspergillosis who developed renal toxicity possibly associated with IV voriconazole. Renal function improved upon withdrawal of the IV agent and switch to the oral formulation. The infant subsequently required large oral weight-based dosing to achieve therapeutic voriconazole serum concentrations...
January 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29446447/individualized-prediction-of-seizure-relapse-and-outcomes-following-antiepileptic-drug-withdrawal-after-pediatric-epilepsy-surgery
#16
Herm J Lamberink, Kim Boshuisen, Willem M Otte, Karin Geleijns, Kees P J Braun
The objective of this study was to create a clinically useful tool for individualized prediction of seizure outcomes following antiepileptic drug withdrawal after pediatric epilepsy surgery. We used data from the European retrospective TimeToStop study, which included 766 children from 15 centers, to perform a proportional hazard regression analysis. The 2 outcome measures were seizure recurrence and seizure freedom in the last year of follow-up. Prognostic factors were identified through systematic review of the literature...
March 2018: Epilepsia
https://www.readbyqxmd.com/read/29443114/causes-and-circumstances-of-death-in-a-neonatal-unit-over-20-years
#17
Marissa C Michel, Tarah T Colaizy, Jonathan M Klein, Jeffrey L Segar, Edward F Bell
BackgroundWe examined changes in the causes and circumstances of death in our neonatal intensive care unit (NICU) over 20 years.MethodsFor 551 infants who died between 1993 and 2013, the principal cause of death was recorded. Circumstances of death were assigned to one of the following four categories: death following cardiopulmonary resuscitation (CPR), death while being mechanically ventilated without CPR, death after withholding life-support interventions, and death after withdrawal of life support. Data were compared across four 5-year epochs...
April 2018: Pediatric Research
https://www.readbyqxmd.com/read/29416346/prediction-of-emergence-agitation-using-withdrawal-reaction-following-rocuronium-injection-in-preschool-aged-patients-undergoing-inguinal-herniorrhaphy-a-preliminary-exploratory-observational-trial
#18
Dae Hee Kim, Go Un Roh, Young Bok Lee, Chang Ik Choi, Jae Moon Lee, Yun Jeong Chae
Purpose: The development of emergence agitation (EA) is associated with several factors including age, preoperative anxiety, postoperative pain, anesthesia method, and surgery type. No studies have investigated whether the withdrawal reaction following rocuronium injection can predict the occurrence of EA. Therefore, we investigated this relationship in preschool-aged children undergoing inguinal herniorrhaphy, and which grade of withdrawal reaction is appropriate for identifying patients at risk of experiencing EA...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29395886/-drug-administration-to-pediatric-patients-evaluation-of-the-nurses-preparation-habits-in-pediatric-units
#19
S Ménétré, M Weber, M Socha, S Le Tacon, I May, C Schweitzer, B Demoré
In hospitals, the nursing staff is often confronted with the problem of the preparation and administration of drugs for their pediatric patients because of the lack of indication, pediatric dosage, and appropriate galenic form. The goal of this study was to give an overview of the nurses' preparation habits in pediatric units and highlight their daily problems. This single-center prospective study was conducted through an observation of the nursing staff during the drug preparation process in medicine, surgery and intensive care units...
April 2018: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29382518/-risk-factors-associated-with-complications-that-required-the-removal-of-peripherally-inserted-central-venous-catheters-in-a-tertiary-pediatric-hospital
#20
Miriam Flores Moreno, Karina Saray Pueblas Bedoy, Aurelia Ojeda Sánchez, Jessie Zurita-Cruz
BACKGROUND: In pediatrics, complications of the peripherally inserted central venous catheters (PICC) are reported in 30% to 40% of cases, with the most frequent risk factors being the age of the patient and the location of PICC. The aim of this study was to describe the characteristics of PICCs and to identify factors related to their withdrawal due to complications. METHODS: Prospective cohort study. Patients from 2 months to 18 years of age were included and followed-up until PICC was withdrawn...
July 2017: Boletín Médico del Hospital Infantil de México
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