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pediatric infectious

Osman Yeşilbaş, Hasan Serdar Kıhtır, Hamdi Murat Yıldırım, Nevin Hatipoğlu, Esra Şevketoğlu
BACKGROUND: Leptospirosis is a zoonotic infectious disease caused by pathogenic spirochetes of the genus Leptospira. Although it is usually asymptomatic and self-limited, severe potentially fatal illness accompanied by multi-organ failure may occur. CASE REPORT: Here we report an unusual case of severe leptospirosis successfully treated with continuous venovenous hemofiltration (CVVHF) and therapeutic plasma exchange (TPE). The patient presented with pericardial tamponade, renal failure and macrophage activation syndrome, and later suffered prolonged jaundice and sclerosing cholangitis during hospitalization in the pediatric intensive care unit (PICU)...
September 2016: Balkan Medical Journal
Lakshmi Ganapathi, Lara Danziger-Isakov, Camille Kotton, Deepali Kumar, Shirish Huprikar, Marian G Michaels, Janet A Englund
BACKGROUND: Pediatric transplant infectious diseases (PTID) is emerging as an area of expertise within pediatric infectious diseases. Although guidelines for training in PTID have been published, no prior national survey has been conducted to identify trainee-described needs for instruction in PTID. METHODS: A survey was designed through collaboration between the American Society of Transplantation and the Pediatric Infectious Diseases Society, to assess trainee exposure, self-knowledge, and self-competency in PTID...
October 19, 2016: Journal of the Pediatric Infectious Diseases Society
Laura L Bio, Brandon J Patterson, Sanchita Sen, Angela L Bingham, Jane F Bowen, Benjamin Ereshefsky, Laura A Siemianowski
Objective. To identify the temporal effect and factors associated with student pharmacist self-initiation of interventions during acute patient care advanced pharmacy practice experiences (APPE). Methods. During the APPE, student pharmacists at an academic medical center recorded their therapeutic interventions and who initiated the intervention throughout clinical rotations. At the end of the APPE student pharmacists completed a demographic survey. Results. Sixty-two student pharmacists were included. Factors associated with lower rates of self-initiated interventions were infectious diseases and pediatrics APPEs and an intention to pursue a postgraduate residency...
September 25, 2016: American Journal of Pharmaceutical Education
Suvajyoti Guha, Brady McCaffrey, Prasanna Hariharan, Matthew R Myers
Surgical respirators, surgical masks (SMs) and facemasks for pediatric use (FPUs) are routinely used in the US healthcare industry as personal protective equipment (PPE) against infectious diseases. While N95s including surgical respirators have been routinely studied, SMs and FPUs have not received as much attention, particularly in the context of aerosolized threats. This is because SMs and PFUs are not designed to protect against sub-micron aerosols. However, with the possibility of new or re-emerging airborne diseases or bio-aerosol weapons lingering, combined with the limited availability of respirators and logistical issues associated with fit-testing millions, the general adult and pediatric populations may elect to wear SMs and FPUs, respectively, in the case of a pandemic or a bio-terrorist attack...
October 18, 2016: Journal of Occupational and Environmental Hygiene
A Lemoine, F Baudin, R Vialle, E Grimprel
INTRODUCTION: The prognosis of osteoarticular infections has improved over the past 20 years but it still remains potentially severe. The treatment of these infections has been simplified and shortened. In 2008, the Pediatric Infectious Disease Group (GPIP) established new therapeutic guidelines in order to standardize treatment in France. The aim of this study is to analyze practices in a Parisian hospital and assess the efficacy of this treatment in short and medium terms. MATERIALS AND METHODS: This retrospective study focused on patients older than 3 months, without comorbidities, who were hospitalized for an acute osteoarticular infection in 2012 at Trousseau Hospital (Paris), with a follow-up of at least 4 weeks...
October 10, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Mansour Amin, Mozhgan Ghaderpanah, Tahereh Navidifar
Meningitis is a life-threatening infection associated with a high mortality and morbidity worldwide. Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae are the most prevalent infectious agents that cause bacterial meningitis (BM). The objective of this study was to determine the frequencies of these three bacteria using bacterial cultures and polymerase chain reaction (PCR). In our cross-sectional study, cerebrospinal fluid (CSF) specimens were obtained from 196 patients who were suspected of having BM and referred to the pediatric ward of Abuzar Hospital (Ahvaz, Iran)...
October 2016: Kaohsiung Journal of Medical Sciences
A Schnabel, U Range, G Hahn, T Siepmann, R Berner, C M Hedrich
Historically, osteomyelitis was considered an infectious disorder. More recently, inflammatory mechanisms were recognized causing a significant proportion of pediatric osteomyelitis. This study was to compare characteristics of children with chronic non-bacterial (CNO) and bacterial osteomyelitis (BOM). A chart review of osteomyelitis patients from the departments of pediatrics, pediatric surgery, orthopedic surgery, and oral and maxillofacial surgery was conducted in a tertiary referral center, covering the years 2004-2014...
October 11, 2016: Rheumatology International
María Belén Almejún, Bárbara Carolina Campos, Virginia Patiño, Miguel Galicchio, Marta Zelazko, Matías Oleastro, Pablo Oppezzo, Silvia Danielian
BACKGROUND: Common variable immunodeficiency is a heterogeneous syndrome characterized by impaired immunoglobulin production and usually presents with a normal quantity of peripheral B cells. Most attempts aiming to classify these patients have mainly been focused on T cell phenotypes or B cell phenotypes and their ability to produce protective antibodies, but it is still a major challenge to find a suitable classification that includes the clinical and immunological heterogeneity of these patients...
October 3, 2016: Journal of Allergy and Clinical Immunology
Thomas Kühne
Evidence-based medicine is growing in immune thrombocytopenia (ITP), but solid clinical data are still lacking in many areas. A majority of children has self-limited ITP, but chronic symptomatic ITP exists also in pediatrics. Management includes a watch-and-wait strategy for children with newly diagnosed ITP and no or mild bleeding, and immunoglobulins and corticosteroids, if more bleeding and mucous membrane involvement is present. Treatment endpoints differ in clinical research and in clinical practice. The requirement of platelet enhancing drugs needs to be better defined in guidelines...
October 4, 2016: Hämostaseologie
J Fluss, M Dinomais, M Kossotoroff, C Vuillerot, S Darteyre, S Chabrier
Over the last decade considerable advances have been made in the identification, understanding and management of pediatric arterial ischemic stroke. Such increasing knowledge has also brought new perspectives and interrogations in the current acute and rehabilitative care of these patients. Areas covered: In developed countries, focal cerebral arteriopathy is one of the most common causes of arterial ischemic stroke in childhood and imaging features are well characterized. However, there are ongoing debates regarding its underlying mechanisms, natural evolution and proper management...
October 12, 2016: Expert Review of Neurotherapeutics
Esin Aktas Cetin, Leyla Pur Ozyigit, Yusuf Metin Gelmez, Erkan Cakir, Ahmet Hakan Gedik, Gunnur Deniz
OBJECTIVES: Childhood tuberculosis (TB) comprises an important part of the world's TB burden. Monocytes set up the early phase of infection because of innate immune responses. Understanding the changes in monocyte subsets during multisystem infectious diseases may be important for the development of novel diagnostic and therapeutic strategies. The aim of this study was to evaluate the monocyte phenotype together with the cytokine secretion profiles of children with pulmonary tuberculosis...
September 29, 2016: Pediatric Pulmonology
Eva Hlavackova, Martin Liska, Hana Jicinska, Jiri Navratil, Jiri Litzman
The Fontan operation or total cavopulmonal connection (TCPC) is a palliative surgical correction of rare and complex inborn cardiac malformations that are characterized by univentricular circulation. Protein-losing enteropathy (PLE) develops in 4-13% of patients after the Fontan procedure. Fontan-related PLE leads to secondary combined immunodeficiency marked by hypogammaglobulinemia and predominantly CD4+ lymphocytopenia. Here, we present 3 case reports of patients with secondary immunodeficiency after the Fontan operation...
September 30, 2016: International Archives of Allergy and Immunology
Shahrzad Bakhtiar, Frank Ruemmele, Fabienne Charbit-Henrion, Eva Lévy, Frédéric Rieux-Laucat, Nadine Cerf-Bensussan, Peter Bader, Ulrich Paetow
Monogenic primary immunodeficiency syndromes can affect one or more endocrine organs by autoimmunity during childhood. Clinical manifestations include type 1 diabetes mellitus, hypothyroidism, adrenal insufficiency, and vitiligo. Lipopolysaccharide (LPS)-responsive beige-like anchor protein (LRBA) deficiency was described in 2012 as a novel primary immunodeficiency, predominantly causing immune dysregulation and early onset enteropathy. We describe the heterogeneous clinical course of LRBA deficiency in two siblings, mimicking an autoimmune polyendocrine disorder in one of them in presence of the same underlying genetic mutation...
2016: Frontiers in Pediatrics
Michelle Ribeiro Viana Taveira, Luciana Santana Lima, Cláudia Corrêa de Araújo, Maria Júlia Gonçalves de Mello
BACKGROUND: Totally implantable venous access ports (TIVAPs) are used for prolonged central venous access, allowing the infusion of chemotherapy and other fluids and improving the quality of life of children with cancer. TIVAPs were developed to reduce the infection rates associated with central venous catheters; however, infectious events remain common and have not been fully investigated in pediatric oncology patients. PROCEDURE: A retrospective cohort was formed to investigate risk factors for central line-associated bloodstream infection (CLABSI) in pediatric cancer patients...
September 26, 2016: Pediatric Blood & Cancer
Heather VanderMeulen, Jeffrey M Pernica, Madan Roy, April J Kam
Objective To assess the promptness and appropriateness of management in pediatric cases of necrotizing fasciitis (NF). Methods A retrospective chart review examined cases of pediatric NF treated at a pediatric tertiary care center over a 10-year period. Results Twelve patients were identified over the 10-year period. The median (25th to 75th centile) times to appropriate antibiotic administration, infectious disease consults, surgical consults and debridement surgeries were 2.6 (2.1-3.2), 7.7 (3.4-24.4), 4...
September 23, 2016: Clinical Pediatrics
M Larquey, E Mahé
Postinfectious erythema multiforme is an uncommon skin disease in childhood that can have a strong impact, especially in infants if there is involvement of the mucous membranes. The lesion is targeted (central bullous lesions with three concentric circles). Its diagnosis is typically made clinically. Atypical forms are the highly inflammatory, mainly bullous type, with exclusive involvement of the mucous membrane, or recurrent erythema multiforme. The diagnosis of erythema multiforme is frequently suspected in children with urticaria multiforme...
September 20, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Shannon M Sullivan, Kate Tsiplova, Wendy J Ungar
Economic evaluations conducted in children have unique features compared to adults. Important developments in pediatric economic evaluation in recent years include new options for valuing health states for cost-utility analysis (CUA) and shifting child health priorities. The Pediatric Economic Database Evaluation (PEDE) project includes a comprehensive database of pediatric health economic evaluations published since 1980. The objective of this scoping review was to identify trends over time in the use of CUA and other analytic techniques, and the therapeutic areas chosen for study...
October 2016: Expert Review of Pharmacoeconomics & Outcomes Research
Bhavika J Patel, Lillian Lai, Gary Goldfield, Renee Sananes, Patricia E Longmuir
Psychosocial health issues are common among children with cardiac diagnoses. Understanding parent and child perceptions is important because parents are the primary health information source. Significant discrepancies have been documented between parent/child quality-of-life data but have not been examined among psychosocial diagnostic instruments. This study examined agreement and discrepancies between parent and child reports of psychosocial health and quality of life in the paediatric cardiology population...
September 20, 2016: Cardiology in the Young
Amit Wolfovitz, Noam Yehudai, Michal Luntz
OBJECTIVES/HYPOTHESIS: To identify and analyze factors influencing the outcome of facial nerve palsy (FNP) in a pediatric population. STUDY DESIGN: Retrospective study. METHODS: Sixty-seven pediatric patients (72 consecutive cases) diagnosed with and treated for FNP were divided into two severity subgroups. Associations between recovery in these groups and categorical variables were assessed using the Fisher exact test and for age using the t test...
September 19, 2016: Laryngoscope
David Schnell, Elie Azoulay, Dominique Benoit, Benjamin Clouzeau, Pierre Demaret, Stéphane Ducassou, Pierre Frange, Matthieu Lafaurie, Matthieu Legrand, Anne-Pascale Meert, Djamel Mokart, Jérôme Naudin, Frédéric Pene, Antoine Rabbat, Emmanuel Raffoux, Patricia Ribaud, Jean-Christophe Richard, François Vincent, Jean-Ralph Zahar, Michael Darmon
Neutropenia is defined by either an absolute or functional defect (acute myeloid leukemia or myelodysplastic syndrome) of polymorphonuclear neutrophils and is associated with high risk of specific complications that may require intensive care unit (ICU) admission. Specificities in the management of critically ill neutropenic patients prompted the establishment of guidelines dedicated to intensivists. These recommendations were drawn up by a panel of experts brought together by the French Intensive Care Society in collaboration with the French Group for Pediatric Intensive Care Emergencies, the French Society of Anesthesia and Intensive Care, the French Society of Hematology, the French Society for Hospital Hygiene, and the French Infectious Diseases Society...
December 2016: Annals of Intensive Care
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