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Sepsis in children

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https://www.readbyqxmd.com/read/28437373/resuscitation-with-balanced-fluids-is-associated-with-improved-survival-in-pediatric-severe-sepsis
#1
Elizabeth T Emrath, James D Fortenberry, Curtis Travers, Courtney E McCracken, Kiran B Hebbar
OBJECTIVE: To evaluate outcomes in patients receiving balanced fluids for resuscitation in pediatric severe sepsis. DESIGN: Observational cohort review of prospectively collected data from a large administrative database. SETTING: PICUs from 43 children's hospitals. PATIENTS: PICU patients diagnosed with severe sepsis. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We reviewed data from the Pediatric Health Information System database from 2004 to 2012...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28430304/pre-ecmo-coagulopathy-does-not-increase-the-occurrence-of-hemorrhage-during-extracorporeal-support
#2
Pilar Anton-Martin, Lakshmi Raman, Nikhil Thatte, Jefferson Tweed, Vinai Modem, Janna Journeycake
INTRODUCTION AND METHODS: Observational retrospective cohort study to evaluate the association between precannulation coagulopathy and the occurrence of hemorrhage during extracorporeal membrane oxygenation (ECMO) in neonatal and pediatric patients at a tertiary children's hospital. RESULTS: Of 241 patients supported with ECMO between January 2009 and December 2014, 175 (72.6%) had precannulation coagulation laboratory data and were included in the study. Of the eligible patients, 84 (48%) were identified as coagulopathic and 91 (52%) were noncoagulopathic...
April 20, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28422977/defining-the-complex-phenotype-of-severe-systemic-loxoscelism-using-a-large-electronic-health-record-cohort
#3
Jamie R Robinson, Vanessa E Kennedy, Youssef Doss, Lisa Bastarache, Joshua Denny, Jeremy L Warner
OBJECTIVE: Systemic loxoscelism is a rare illness resulting from the bite of the recluse spider and, in its most severe form, can lead to widespread hemolysis, coagulopathy, and death. We aim to describe the clinical features and outcomes of the largest known cohort of individuals with moderate to severe loxoscelism. METHODS: We performed a retrospective, cross sectional study from January 1, 1995, to December 31, 2015, at a tertiary-care academic medical center, to determine individuals with clinical records consistent with moderate to severe loxoscelism...
2017: PloS One
https://www.readbyqxmd.com/read/28420570/herpesviradae-infections-in-severely-burned-children
#4
Paul Wurzer, Megan R Cole, Robert P Clayton, Gabriel Hundeshagen, Omar Nunez Lopez, Janos Cambiaso-Daniel, Raimund Winter, Ludwik K Branski, Hal K Hawkins, Celeste C Finnerty, David N Herndon, Jong O Lee
OBJECTIVE: Burn-related immunosuppression can promote human herpesviridae infections. However, the effect of these infections on morbidity and mortality after pediatric burn injuries is unclear. METHODS: We retrospectively analyzed pediatric patients with burns ≥10% of the total body surface area (TBSA) who were admitted between 2010 and 2015. On clinical suspicion of a viral infection, antiviral therapy was initiated. Viral infection was confirmed via Tzanck smear, viral culture, and/or PCR...
April 15, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28420264/the-rate-of-sepsis-in-a-national-pediatric-population-2006-to-2012
#5
Kristin A Schuller, Benson S Hsu, Allyson B Thompson
INTRODUCTION: The rate of pediatric severe sepsis is reported to be on the rise in the United States, increasing by approximately 6000 cases annually. The goal of this study was to determine the rate of pediatric sepsis per 100 000 inpatient discharges over time. METHODS: The 2006, 2009, and 2012 Agency for Healthcare Research and Quality Healthcare Cost Utilization Project Kid's Inpatient Databases were used to analyze the rate of sepsis in children over time...
April 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28419427/how-i-manage-children-with-neutropenia
#6
REVIEW
David C Dale
Neutropenia, usually defined as a blood neutrophil count <1·5 × 10(9) /l, is a common medical problem for children and adults. There are many causes for neutropenia, and at each stage in life the clinical pattern of causes and consequences differs significantly. I recommend utilizing the age of the child and clinical observations for the preliminary diagnosis and primary management. In premature infants, neutropenia is quite common and contributes to the risk of sepsis with necrotizing enterocolitis...
April 17, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28419265/validation-of-the-sepsis-metascore-for-diagnosis-of-neonatal-sepsis
#7
Timothy E Sweeney, James L Wynn, María Cernada, Eva Serna, Hector R Wong, Henry V Baker, Máximo Vento, Purvesh Khatri
What’s Known on This Subject.: Neonates are at increased risk for developing sepsis, but this population often exhibits ambiguous clinical signs that complicate the diagnosis of infection. No biomarker has yet shown enough diagnostic accuracy to rule out sepsis at the time of clinical suspicion. What This Study Adds.: We show that a gene-expression-based signature is an accurate objective measure of the risk of sepsis in a neonate or preterm infant, and it substantially improves diagnostic accuracy over that of commonly used laboratory-based testing...
April 13, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28410274/three-hypothetical-inflammation-pathobiology-phenotypes-and-pediatric-sepsis-induced-multiple-organ-failure-outcome
#8
Joseph A Carcillo, E Scott Halstead, Mark W Hall, Trung C Nguyen, Ron Reeder, Rajesh Aneja, Bita Shakoory, Dennis Simon
OBJECTIVES: We hypothesize that three inflammation pathobiology phenotypes are associated with increased inflammation, proclivity to develop features of macrophage activation syndrome, and multiple organ failure-related death in pediatric severe sepsis. DESIGN: Prospective cohort study comparing children with severe sepsis and any of three phenotypes: 1) immunoparalysis-associated multiple organ failure (whole blood ex vivo tumor necrosis factor response to endotoxin < 200 pg/mL), 2) thrombocytopenia-associated multiple organ failure (new onset thrombocytopenia with acute kidney injury and a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 activity < 57%), and/or 3) sequential multiple organ failure with hepatobiliary dysfunction (respiratory distress followed by liver dysfunction with soluble Fas ligand > 200 pg/mL), to those without any of these phenotypes...
April 13, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28399609/early-adverse-events-and-long-term-outcomes-of-endoscopic-sphincterotomy-in-a-pediatric-population-a-single-center-experience
#9
Jin Min Cho, In Sook Jeong, Hyun Jin Kim, Seak Hee Oh, Kyung Mo Kim
Background and aims: The use of endoscopic sphincterotomy (EST) in the management of pancreaticobiliary disease in children is increasing. However, studies of long-term outcomes are limited in pediatric patients. Therefore, this study evaluated the early adverse events and long-term outcomes following EST in pediatric patients. Patients and methods: We retrospectively analyzed data from 198 pediatric patients who underwent ESTs at Asan Medical Center Children's Hospital between 1994 and 2013. The median age was 8...
April 11, 2017: Endoscopy
https://www.readbyqxmd.com/read/28397655/-liver-failure-in-neonatal-children-is-a-diagnostic-challenge
#10
Heidi Smedegaard, Vibeke Brix Christensen, Morten Hanefeld Dziegiel, Marianne Hørby Jørgensen
This case report presents a newborn boy with hypoglycaemia, anaemia, jaundice and severe coagulopathy during the first day of his life, imitating sepsis and disseminated intravascular coagulation. One week after the birth he was diagnosed with acute liver failure due to gestational alloimmune liver disease (GALD). Despite the fact that GALD is rare, it must be suspected in all unexplained stillborn children and infants with severe liver disease. If diagnosed, it is possible to prevent death and severe liver failure in future newborns by treating the affected women with immunoglobulin during pregnancy...
March 27, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28388526/sepsis-associated-in-hospital-cardiac-arrest-epidemiology-pathophysiology-and-potential-therapies
#11
REVIEW
Ryan W Morgan, Julie C Fitzgerald, Scott L Weiss, Vinay M Nadkarni, Robert M Sutton, Robert A Berg
Sepsis-associated cardiac arrest is a relatively common occurrence with especially poor outcomes. Of the greater than 200,000 in-hospital cardiac arrests that occur in the United States annually, between 30,000 and 60,000 occur in patients with underlying sepsis. These patients are less likely to survive than cardiac arrest victims without sepsis. In this review, we discuss the epidemiology of sepsis-associated in-hospital cardiac arrest in adults and children, the relevant physiology responsible for its pathogenesis and poor outcomes, and potential therapeutic interventions based on this pathophysiology...
March 31, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28382572/current-clinical-trials-on-the-use-of-ceftaroline-in-the-pediatric-population
#12
REVIEW
Adam Corey, Tsz-Yin So
The rate of antibiotic resistance in children continues to rise requiring the use of new antibiotics. Ceftaroline fosamil, a newer-generation cephalosporin, was recently approved for the treatment of acute bacterial skin and skin structure infections and community-acquired bacterial pneumonia in children aged >2 months. Ceftaroline provides coverage against staphylococcal and streptococcal infections, including methicillin-resistant Staphylococcus aureus and penicillin-resistant Streptococcus pneumoniae...
April 5, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28380279/causes-and-consequences-of-the-leishmania-infantum-burden-in-patients-with-kala-azar-ndash-a-study-of-625-patients
#13
Danielle A Zacarias, Nuno Rolão, Flaviane A de Pinho, Ingridi Sene, Jailthon C Silva, Teresinha C Pereira, Dorcas L Costa, Carlos H N Costa
BACKGROUND: An infected host's Leishmania infantum load in blood is considered to be an estimate of his or her total parasite burden. Therefore, the measurement of blood parasite burden is important in the identification of factors involved in parasite control. METHODS: Quantitative polymerase chain reaction was performed on blood samples from 625 patients with kala-azar consecutively admitted to a reference hospital in Teresina, Brazil. Primers were used to amplify a segment of kDNA using the TaqMan system...
April 5, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28377295/frequency-of-medical-emergency-team-activation-prior-to-pediatric-cardiopulmonary-resuscitation
#14
Natalie Jayaram, Maya L Chan, Fengming Tang, Christopher S Parshuram, Paul S Chan
BACKGROUND: Medical Emergency Teams (METs) are designed to respond to signs of clinical decline in order to prevent cardiopulmonary arrest and reduce mortality. The frequency of MET activation prior to pediatric cardiopulmonary resuscitation (CPR) is unknown. METHODS: Within the Get With The Guidelines-Resuscitation Registry (GWTG-R), we identified children with bradycardia or cardiac arrest requiring CPR on the general inpatient or telemetry floors from 2007 to 2013...
April 1, 2017: Resuscitation
https://www.readbyqxmd.com/read/28369502/severe-parechovirus-3-infections-in-young-infants-kansas-and-missouri-2014
#15
Claire M Midgley, Mary Anne Jackson, Rangaraj Selvarangan, Patrick Franklin, Elizabeth L Holzschuh, Jennifer Lloyd, Joseph Scaletta, Anne Straily, Sheri Tubach, Ashley Willingham, W Allan Nix, M Steven Oberste, Christopher J Harrison, Charles Hunt, George Turabelidze, Susan I Gerber, John T Watson
Background.: Infection with parechovirus type 3 (PeV3) can cause severe neurologic and sepsis-like illness in young infants; clinical and epidemiologic descriptions have been limited. We aimed to characterize PeV3 illness and explore risk factors for acquisition in a cluster of neonatal cases at Children's Mercy Hospital in Kansas City, Missouri. Methods.: Cerebrospinal fluid specimens were obtained from infants aged <180 days who were hospitalized with sepsis-like illness or meningitis between June 1 and November 1, 2014...
March 29, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28367192/correlation-between-maternal-and-childhood-vitb12-folic-acid-and-ferritin-levels
#16
Fatima Zeeshan, Attia Bari, Saima Farhan, Uzma Jabeen, Ahsan Waheed Rathore
OBJECTIVE: To determine the correlation between serum folic acid, vitamin B12 and ferritin of mother and child and to study various neonatal risk factors as a cause of anemia in children. METHODS: One hundred eighty children two months to two years of age admitted in the department of Pediatric Medicine of The Children's Hospital and The Institute of Child Health Lahore from January 2013 to January 2015 with common medical conditions having anemia were included...
January 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28365283/-epidemiological-and-clinical-characteristics-of-infants-admitted-to-hospital-due-to-human-parechovirus-infections-a-prospective-study-in-spain
#17
Fernando Martín Del Valle, Cristina Calvo, Inés Martinez-Rienda, Amaia Cilla, María P Romero, Ana Isabel Menasalvas, Leticia Reis-Iglesias, Diana Roda, María J Pena, Nuria Rabella, María Del Mar Portugués de la Red, Gregoria Megías, Antonio Moreno-Docón, Almudena Otero, María Cabrerizo
INTRODUCTION: Human parechovirus (HPeV) is one of the recently described picornaviridae viruses that have been associated with fever of unknown origin (FUO), clinical sepsis, gastroenteritis, meningitis, or encephalitis in very young infants. The aim of this study is to describe the epidemiology and clinical features of these viruses. PATIENTS AND METHODS: A prospective multicentre 3-year study was conducted in 12 hospitals in Spain. Out of 850 specimens examined, 47 were positive (5...
March 29, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28358790/prognostic-value-of-high-sensitivity-c-reactive-protein-procalcitonin-and-pancreatic-stone-protein-in-pediatric-sepsis
#18
Qiong Wu, Jun Nie, Fu-Xia Wu, Xiu-Lan Zou, Feng-Yi Chen
BACKGROUND To investigate the prognostic value of procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP), and pancreatic stone protein (PSP) in children with sepsis. MATERIAL AND METHODS A total of 214 patients with sepsis during hospitalization were enrolled. Serum levels of PCT, hs-CRP, and PSP were measured on day 1 of hospitalization and the survival rates of children were recorded after a follow-up of 28 days. Pearson's correlation analysis was conducted to test the association of PCT, hs-CRP, and PSP with pediatric critical illness score (PCIS)...
March 30, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28342565/mini-review-new-pathogen-profiles-elizabethkingia-anophelis
#19
REVIEW
J Michael Janda, Denise L Lopez
Within a little more than 5 years since its taxonomic description in 2011, from the midgut of mosquitoes, Elizabethkingia anophelis has emerged as an important causes of sepsis in adults and children and in cases of neonatal meningitis. At least 3 moderate- to large-scale outbreaks of disease have been caused by this bacterium, the largest 2 occurring in the Midwest United States in 2015-2016. Several studies suggest that E. anophelis, and not E. meningoseptica, is the predominant human pathogen of this genus; identification to species is difficult...
March 16, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28340493/conservative-treatment-with-octreotide-to-provide-early-recovery-of-children-with-esophageal-perforation
#20
Ramazan Karabulut, Zafer Turkyilmaz, Kaan Sonmez, Abdullah Can Basaklar
Background The effectiveness of nonoperative treatment of esophageal perforation (EP) in children with octreotide is highlighted. Methods Records of nine patients (seven boys and two girls with an average age of 5.83 ± 5.35 years) with EP were reviewed. Results EP developed in six patients during dilation of esophageal stenosis (five of six caused by caustic burns). In the other three patients, EP developed after nasogastric placement, after endotracheal intubation, and during endoscopy for foreign body...
March 24, 2017: Thoracic and Cardiovascular Surgeon
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