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Pediatric Thrombosis

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https://www.readbyqxmd.com/read/29678653/continued-ultrasound-surveillance-required-after-hand-ischemia-associated-with-trauma-in-children
#1
Melissa L Kirkwood, Khalil H Chamseddin, Brianne Hanson, Carlos H Timaran, Mujtaba Ali, Alexis D Jacob, John E Rectenwald
BACKGROUND: Hand ischemia following trauma in children is rare and the natural history after upper extremity arterial bypass in children is unknown. We hypothesize children with brachial artery repair are at long term risk of developing aneurysmal degeneration or Thrombosis thus necessitating annual duplex ultrasonography and physical examination. STUDY DESIGN: A retrospective review of children who had brachial artery repair (bypass or vein patch) for hand ischemia secondary to trauma at a level I trauma pediatric hospital was performed...
April 17, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29668539/myeloproliferative-neoplasms-in-children-and-adolescents-and-thrombosis-at-unusual-sites-the-role-of-driver-mutations
#2
Laith Tafesh, Kathryn Musgrave, Wing Roberts, Dianne Plews, Peter Carey, Tina Biss
Myeloproliferative neoplasms (MPNs) in childhood and adolescence are rare and seldom complicated by thrombosis. We describe 3 cases of thrombosis at unusual sites in young patients with MPNs. In the pediatric MPN population, unlike in adult MPNs, a clonal mutation is identifiable in only a minority of cases (22% to 26%). All 3 of these individuals had JAK2 mutations driving the disease process. A literature search identified 19 cases of MPN-associated thrombosis in children. Seventeen of the 19 children (89...
April 17, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29663585/perioperative-anticoagulation-practices-for-pediatric-liver-transplantation
#3
Stylianos Voulgarelis, Bernadette Vitola, Stacee M Lerret, Johnny C Hong, John P Scott
Despite continued advancements in perioperative care for pediatric liver transplant (LT), graft-threatening vascular occlusion events including hepatic artery thrombosis (HAT) and portal vein thrombosis (PVT) remain a source of significant morbidity and mortality. Perioperative anticoagulation is commonly used for the prevention of HAT and PVT, but evidence-based guidelines are lacking. The goals of this survey were to determine the frequency of use of an anticoagulation protocol and to describe variation in anticoagulation practices among pediatric LT centers...
April 16, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29661787/thromboembolism-in-acute-lymphoblastic-leukemia-results-of-nopho-all2008-protocol-treatment-in-patients-1-45-years
#4
Cecilie Utke Rank, Nina Toft, Ruta Tuckuviene, Kathrine Grell, Ove Juul Nielsen, Thomas Leth Frandsen, Hanne Vibeke Hansen Marquart, Birgitte Klug Albertsen, Ulf Tedgård, Helene Hallböök, Ellen Ruud, Kirsten Brunsvig Jarvis, Petter Quist-Paulsen, Pasi Huttunen, Ulla Wartiovaara-Kautto, Ólafur Gísli Jónsson, Sonata Saulyte Trakymiene, Laimonas Griškevičius, Kadri Saks, Mari Punab, Kjeld Schmiegelow
Thromboembolism frequently occurs during acute lymphoblastic leukemia (ALL) therapy. We prospectively registered thromboembolic events during treatment of 1772 consecutive Nordic/Baltic ALL patients 1-45years treated according to the Nordic Society of Pediatric Hematology and Oncology (NOPHO) ALL2008 protocol (7/2008-4/2017). The 2.5-year cumulative incidence of thromboembolism (N=137) was 7.9% (95% confidence interval (CI) 6.6-9.1); higher in patients ≥10years ( P <.0001). Adjusted hazard ratios (HRa) were associated with greater age (10...
April 16, 2018: Blood
https://www.readbyqxmd.com/read/29657465/do-demographic-and-perioperative-parameters-really-affect-the-final-outcomes-of-pediatric-femur-shaft-fractures-managed-by-elastic-nails-a-prospective-study
#5
Abhinandhan Reddy, Narendran Pushpasekaran, Jitendra Singh, Gokul Chand Verma, Sathyamurthy Palanisamy
Objective: Pediatric femoral shaft fractures are more commonly treated with intramedullary titanium elastic nail system (TENS). Adhering to the principles, most studies had supported excellent results with this instrumentation and attributed the variation in age, weight, immobilization protocols, technical factors like fracture pattern, reduction and complications as reasons to poor outcomes in their individual studies. Hence, we wanted to identify the potential demographic and perioperative parameters that could affect the final outcomes in this cohort...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29656412/liver-doppler-findings-in-pediatric-patients-after-total-pancreatectomy-and-islet-autotransplantation
#6
Tara L Holm, Michael A Murati, Eric Hoggard, Lei Zhang, Kelly R Dietz
OBJECTIVES: This study was intended to establish normal values for velocities in the hepatic artery and portal veins in pediatric patients after total pancreatectomy and islet autotransplantation (TPIAT). METHODS: A retrospective review was performed of liver Doppler studies in pediatric patients after TPIAT over 6 years at an academic children's hospital. Doppler velocities in the liver vasculature and the hepatic artery resistive index were recorded. RESULTS: Sixty-five pediatric patients were evaluated...
April 15, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29650343/safety-efficacy-and-management-of-subcutaneous-treprostinil-infusions-in-the-treatment-of-severe-pediatric-pulmonary-hypertension
#7
Marilyne Levy, Maria-Jesus Del Cerro, Sophie Nadaud, Karunakar Vadlamudi, Elizabeth Colgazier, Jeff Fineman, Damien Bonnet, Ian Adatia
BACKGROUND: Continuous intravenous epoprostenol was the first treatment approved for pulmonary arterial hypertension (PAH) but administration through a central venous line carries risks of thrombosis and sepsis, particularly in children. We sought to evaluate the safety, efficacy and management of subcutaneous (SC) treprostinil in children with PAH. METHODS: Fifty-six children (median age 65, range 1-200 months) were treated with SC treprostinil. Clinical status, echocardiography, NT-proBNP, and site pain and infection were evaluated...
March 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29649341/how-does-your-piccompare-a-pilot-randomized-controlled-trial-comparing-various-picc-materials-in-pediatrics
#8
Tricia Kleidon, Amanda J Ullman, Li Zhang, Gabor Mihala, Brett Chaseling, Jason Schoutrop, Claire M Rickard
BACKGROUND: Despite the popularity of peripherally inserted central catheters (PICCs), recent literature highlights their potential injurious complications. Innovative PICC materials have been developed to prevent thrombosis and infection formation (Endexo®) and antireflux valves to prevent occlusion (pressure-activated safety valve®). No large randomized controlled trial has assessed these technologies. Our primary aim was to evaluate the feasibility of a large randomized controlled efficacy trial of PICC materials and design to reduce PICC complication in pediatrics...
February 8, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29628414/catheter-related-venous-thrombosis-in-hospitalized-pediatric-patients-with-inflammatory-bowel-disease-incidence-characteristics-and-role-of-anticoagulant-thromboprophylaxis-with-enoxaparin
#9
Carrie E Diamond, Carole Hennessey, Jennifer Meldau, Christine J Guelcher, Michael F Guerrera, Laurie S Conklin, Karun V Sharma, Yaser A Diab
OBJECTIVE: To describe the incidence and characteristics of central venous catheter (CVC)-related thrombosis in hospitalized pediatric patients with active inflammatory bowel disease (IBD) and report the potential usefulness of anticoagulant thromboprophylaxis (AT). STUDY DESIGN: We conducted a retrospective study of patients who were admitted to our children's hospital in the last 2 years with active IBD and required a CVC and identified all patients with an objectively confirmed symptomatic CVC-related thrombosis...
April 5, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29624817/fatal-hyperammonemia-associated-with-disseminated-serratia-marcescens-infection-in-a-pediatric-liver-transplant-recipient
#10
Stephen Mouat, Jonathan Bishop, Emma Glamuzina, Simon Chin, Emma J Best, Helen M Evans
Hyperammonemia is a rare and important complication post-liver transplantation. We review a case of a 5-month-old boy with biliary atresia who received a split liver transplant following a variceal bleed. The transplant was complicated by recurrent portal vein thrombosis. Colonized with Serratia marcescens pretransplant, he developed disseminated infection associated with very high levels of ammonia that led to his death. It is important to be aware of serum ammonia levels in patients with portal vein thrombosis, particularly in the setting of gastrointestinal bleeding and sepsis...
April 6, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29620617/pancreas-transplantation-from-pediatric-donors-a-single-center-experience
#11
Mario Spaggiari, Caterina Di Bella, Pierpaolo Di Cocco, Maya Campara, Kelly Galen, Federico Gheza, Jose Oberholzer, Enrico Benedetti, Ivo Tzvetanov
BACKGROUND: Pancreas allografts from pediatric donors are considered less suitable due to the increased risk of surgical complications and reduced islet cell mass that may compromise function. METHODS: All pancreatic transplants, procured from donors <18 years old, between January 2007 and March 2017, were included in the analysis. The grafts were subdivided into 3 groups by donor's weight: <30kg, 30-60kg, >60kg. Analysis of patient and graft survival was done between the groups, and subsequently between the pediatric cohort and the adult-donor control group...
April 3, 2018: Transplantation
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
#12
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/29589832/acute-traumatic-coagulopathy-the-value-of-histone-in-pediatric-trauma-patients
#13
Emel Ulusoy, Murat Duman, Aykut Çağlar, Tuncay Küme, Anıl Er, Fatma Akgül, Hale Çitlenbik, Durgül Yılmaz, Hale Ören
OBJECTIVE: Acute traumatic coagulopathy occurs after trauma with impairment of hemostasis and activation of fibrinolysis. Some endogenous substances may play role in this failure of the coagulation system. Extracellular histone is one such molecule that has recently attracted attention. This study investigated the association between plasma histone- complexed DNA (hcDNA) fragments and coagulation abnormalities in pediatric trauma patients. MATERIALS AND METHODS: This prospective case- control study was conducted in pediatric patients with trauma...
March 28, 2018: Turkish Journal of Haematology: Official Journal of Turkish Society of Haematology
https://www.readbyqxmd.com/read/29588143/vascular-thrombosis-in-pediatric-kidney-transplantation-graft-survival-is-possible-with-adequate-management
#14
REVIEW
Romy Gander, Marino Asensio, Gloria Fatou Royo, José Andrés Molino, Laura García, Alvaro Madrid, Gema Ariceta, Manuel Lopez
OBJECTIVE: Vascular thrombosis (VT) in pediatric kidney transplantation (KT) is a dreaded event that leads to graft loss in almost 100% of cases. In recent years, VT has become the most common cause of early graft loss. The aim of this study was to analyze our experience in diagnosis and treatment of VT and the impact of a new management protocol on patient outcome. METHODS: We conducted a retrospective study of 176 consecutive KT performed at our institution by the pediatric urology team between January 2000 and December 2015 and identified patients with VT...
March 20, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29579867/multicentric-study-of-the-andalusian-experience-in-polycystic-liver-disease-as-indication-for-liver-transplantation
#15
S Dios-Barbeito, M Domínguez-Bastante, A Moreno-Navas, F J León-Díaz, Y Fundora-Suárez, F J Briceño-Delgado, M Pitarch-Martínez, M Á Gómez-Bravo
BACKGROUND: The purpose of this study was to determine the morbidity and survival in patients with polycystic liver disease (PLD) undergoing liver transplantation (LT) in 4 Spanish hospitals. METHODS: A multicentric retrospective study using a prospective database was designed including 19 LTs after PLD diagnosis performed from January 1, 1990, to December 31, 2016. Pediatric patients were excluded from the analysis. RESULTS: Of the included patients, 63...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29577520/the-impact-of-thromboelastography-on-resuscitation-in-pediatric-liver-transplantation
#16
Joseph Sujka, Katherine W Gonzalez, Kayla L Curiel, James Daniel, Ryan T Fischer, Walter S Andrews, Brian M Wicklund, Richard J Hendrickson
Although TEG directs effective resuscitation in adult surgical patients, pediatric data are lacking. We performed a retrospective comparative review of the effect of TEG on blood product utilization and outcomes following pediatric liver transplantation in 38 patients between 2008 and 2014. Diagnoses, laboratory values, fluid and blood product use, and outcomes were examined. Nineteen patients underwent liver transplantation prior to the implementation of TEG, and 19 had perioperative TEG. The most common indications for transplant were BA (n = 14), HB (n = 7), and metabolic disorders (n = 7)...
March 26, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29577004/staged-surgical-palliation-for-hlhs-in-a-girl-with-severe-factor-x-deficiency
#17
Ahmed F Elmahrouk, Mohamed F Ismail, Abdulbadee Bugis, Nashwa Badawy, Hesham Mohamed Aboelghar, Tamer Hamouda, Ahmed Jamjoom
Background  Factor X deficiency (also known as Stuart-Prower factor deficiency) is an autosomal recessive extremely rare hereditary hematologic disorder, affecting around 1:1,000,000 of the general population. Case Presentation  This case report describes a patient with hypoplastic left heart syndrome and severe factor X deficiency, who underwent staged surgical palliation. From stage 1 Norwood palliation, through superior cavopulmonary anastomosis and ending with total cavopulmonary connection with satisfactory hemostasis and no significant perioperative bleeding complication...
January 2018: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/29546772/peripherally-inserted-central-catheters-in-the-treatment-of-children-with-cancer-results-of-a-multicenter-study
#18
Maxim Yu Rykov, Sergei V Zaborovskij, Alexander N Shvecov, Vladimir V Shukin
PURPOSE: To review our experience with peripherally inserted central catheters in pediatric cancer patients. METHODS: The analysis included 353 patients (3 months up to 17 years, mean age 11.2 years) with a variety of cancers diseases, which in 2011-2016, 354 peripherally inserted central catheters were placed. All settings are carried out using ultrasound guidance. In 138 (39%) patients, external anatomical landmarks were used and in 216 (61%) intraoperative fluoroscopy...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29545104/long-term-outcome-of-portal-vein-stent-placement-in-pediatric-liver-transplant-recipients-a-comparison-with-balloon-angioplasty
#19
Dong Jae Shim, Gi-Young Ko, Kyu-Bo Sung, Dong Il Gwon, Heung Kyu Ko
PURPOSE: To evaluate the long-term efficacy of stent placement versus balloon angioplasty for portal vein (PV) stenosis in pediatric liver transplant (LT) recipients. MATERIALS AND METHODS: Fifty patients (<18 years old; median, 14 months) who underwent percutaneous transhepatic balloon angioplasty (n = 12), transhepatic stent placement (n = 18), or intraoperative transmesenteric stent placement (n = 20) between 1994 and 2015 were retrospectively analyzed...
March 13, 2018: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29537717/need-for-tissue-plasminogen-activator-for-central-venous-catheter-dysfunction-is-significantly-associated-with-thrombosis-in-pediatric-cancer-patients
#20
Jessica MacLean, Tamara MacDonald, Carol Digout, Nadine Smith, Krista Rigby, Ketan Kulkarni
BACKGROUND: Central venous catheter (CVC) dysfunction is a common complication among pediatric cancer patients. Tissue plasminogen activator (tPA) is administered to resolve CVC dysfunction. The present study was designed to determine risk factors associated with requirement of tPA for CVC dysfunction and to assess the clinical impact of CVC dysfunction in terms of CVC loss and venous thrombotic events (VTE). PROCEDURE: Case records of all pediatric patients with cancer from the Maritimes, Canada were reviewed following ethics approval...
March 14, 2018: Pediatric Blood & Cancer
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