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Risk Factors for Mortality in Refractory Pediatric Septic Shock Supported with Extracorporeal Life Support.

Jennifer K Workman, David K Bailly, Ron W Reeder, Heidi J Dalton, Robert A Berg, Thomas P Shanley, Christopher J L Newth, Murray M Pollack, David Wessel, Joseph Carcillo, Rick Harrison, J Michael Dean, Kathleen L Meert, ,

Risk factors for mortality in children with refractory pediatric septic shock who are supported with extracorporeal life support (ECLS) are largely unknown. Therefore, we performed univariable and multivariable analyses to determine risk factors for mortality among children (<19 years) who underwent an ECLS run between January 2012 and September 2014 ... Read more >>

ASAIO J. (ASAIO journal (American Society for Artificial Internal Organs : 1992))
[2020, :]

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Omeprazole inhibits IgE-mediated mast cell activation and allergic inflammation induced by ingested allergen in mice.

Cynthia Kanagaratham, Yasmeen S El Ansari, Benjamin F Sallis, Brianna-Marie A Hollister, Owen L Lewis, Samantha C Minnicozzi, Michiko K Oyoshi, Rachel Rosen, Samuel Nurko, Edda Fiebiger, Hans C Oettgen,

BACKGROUND:Patients with eosinophilic esophagitis have increased numbers of mucosal mast cells. Administration of the proton pump inhibitor omeprazole can reduce both esophageal mast cell and eosinophil numbers and attenuate type 2 inflammation in these subjects. OBJECTIVE:Given that maintenance of an acidic environment within granules is important for mast cell homeostasis, ... Read more >>

J. Allergy Clin. Immunol. (The Journal of allergy and clinical immunology)
[2020, :]

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Vascular Reactivity Index as an Effective Predictor of Mortality in Children With Refractory Septic Shock.

En-Pei Lee, Lu-Lu Zhao, Shao-Hsuan Hsia, Oi-Wa Chan, Chia-Ying Lin, Ya-Ting Su, Jainn-Jim Lin, Han-Ping Wu,

BACKGROUND:Vasoplegia is vascular hyporesponsiveness to vasopressors and is an important phenomenon in children with refractory septic shock. This study aimed to develop an objective formula correlated with vasoplegia and evaluate the predictive power for mortality in children with refractory septic shock. MATERIALS AND METHODS:We retrospectively analyzed children with refractory septic ... Read more >>

J Intensive Care Med (Journal of intensive care medicine)
[2020, :885066620914850]

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Refractory and Fatal Presentation of Severe Autoimmune Hemolytic Anemia in a Child With the DNASE1L3 Mutation Complicated With an Additional DOCK8 Variant.

Aysenur Paç Kisaarslan, Maximilam Witzel, Ekrem Unal, Meino Rohlfs, Başaknur Akyildiz, Muhammet E Dogan, Hakan Poyrazoglu, Christoph Klein, Turkan Patiroglu,

Various autoimmune diseases may be associated with primary immune deficiencies. We reported a case with a loss-of-function mutation in DNASE1L3, a gene described previously in families with systemic lupus erythematosus. In addition, the patient showed a novel homozygous missense variant in DOCK8, a gene known to be responsible for the ... Read more >>

J. Pediatr. Hematol. Oncol. (Journal of pediatric hematology/oncology)
[2020, :]

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Trajectory of Mortality and Health-Related Quality of Life Morbidity Following Community-Acquired Pediatric Septic Shock.

Jerry J Zimmerman, Russell Banks, Robert A Berg, Athena Zuppa, Christopher J Newth, David Wessel, Murray M Pollack, Kathleen L Meert, Mark W Hall, Michael Quasney, Anil Sapru, Joseph A Carcillo, Patrick S McQuillen, Peter M Mourani, Hector Wong, Ranjit S Chima, Richard Holubkov, Whitney Coleman, Samuel Sorenson, James W Varni, Julie McGalliard, Wren Haaland, Kathryn Whitlock, J Michael Dean, Ron W Reeder, ,

OBJECTIVES:In-hospital pediatric sepsis mortality has decreased substantially, but long-term mortality and morbidity among children initially surviving sepsis, is unknown. Accordingly, the Life After Pediatric Sepsis Evaluation investigation was conducted to describe the trajectory of mortality and health-related quality of life morbidity for children encountering community-acquired septic shock. DESIGN:Prospective, cohort-outcome study, ... Read more >>

Crit. Care Med. (Critical care medicine)
[2020, 48(3):329-337]

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Critical Illness Factors Associated With Long-Term Mortality and Health-Related Quality of Life Morbidity Following Community-Acquired Pediatric Septic Shock.

Jerry J Zimmerman, Russell Banks, Robert A Berg, Athena Zuppa, Christopher J Newth, David Wessel, Murray M Pollack, Kathleen L Meert, Mark W Hall, Michael Quasney, Anil Sapru, Joseph A Carcillo, Patrick S McQuillen, Peter M Mourani, Hector Wong, Ranjit S Chima, Richard Holubkov, Whitney Coleman, Samuel Sorenson, James W Varni, Julie McGalliard, Wren Haaland, Kathryn Whitlock, J Michael Dean, Ron W Reeder, ,

OBJECTIVES:A companion article reports the trajectory of long-term mortality and significant health-related quality of life disability among children encountering septic shock. In this article, the investigators examine critical illness factors associated with these adverse outcomes. DESIGN:Prospective, cohort-outcome study, conducted 2013-2017. SETTING:Twelve United States academic PICUs. PATIENTS:Critically ill children, 1 month ... Read more >>

Crit. Care Med. (Critical care medicine)
[2020, 48(3):319-328]

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Implementation and evaluation of a self-directed learning activity for first-year medical students.

Molly Hill, Megan Peters, Michelle Salvaggio, Jay Vinnedge, Alix Darden,

Background: It is critical that medical students develop self-directed, life-long learning skills to navigate medical school successfully and to become competent healthcare professionals. Moreover, the Liaison Committee on Medical Education (LCME), the USA medical school accrediting body, requires activities designed to help students develop self-directed learning (SDL) skills in the ... Read more >>

Med Educ Online (Medical education online)
[2020, 25(1):1717780]

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Tripterine is a potential anti-allergic compound.

Bao-Jun Zhu, Ze-Quan Qian, Hui-Run Yang, Ru-Xia Li,

BACKGROUND:Tripterine (TRI), an active monomer in Tripterygium wilfordii, has significant pharmacological activities, such as anti-inflammatory, immunosuppressive and anti-tumor activities. TRI may be used to treat allergic diseases because of its characteristics of immunosuppression. OBJECTIVE:This study aims to explore the anti-allergic effect of TRI. METHODS:It was tested in vivo and in ... Read more >>

Curr Pharm Biotechnol (Current pharmaceutical biotechnology)
[2020, :]

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Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: experts’ consensus statement.

Kunling Shen, Yonghong Yang, Tianyou Wang, Dongchi Zhao, Yi Jiang, Runming Jin, Yuejie Zheng, Baoping Xu, Zhengde Xie, Likai Lin, Yunxiao Shang, Xiaoxia Lu, Sainan Shu, Yan Bai, Jikui Deng, Min Lu, Leping Ye, Xuefeng Wang, Yongyan Wang, Liwei Gao,

Since the outbreak of 2019 novel coronavirus infection (2019-nCoV) in Wuhan City, China, by January 30, 2020, a total of 9692 confirmed cases and 15,238 suspected cases have been reported around 31 provinces or cities in China. Among the confirmed cases, 1527 were severe cases, 171 had recovered and been ... Read more >>

World J Pediatr (World Journal of Pediatrics)
[0, :1-9]

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How 217 Pediatric Intensivists Manage Anemia at PICU Discharge: Online Responses to an International Survey.

Pierre Demaret, Oliver Karam, Julien Labreuche, Fabrizio Chiusolo, Juan Mayordomo Colunga, Simon Erickson, Marianne E Nellis, Marie-Hélène Perez, Samiran Ray, Marisa Tucci, Ariane Willems, Alain Duhamel, Frédéric Lebrun, Isabelle Loeckx, André Mulder, Stéphane Leteurtre, ,

OBJECTIVE:To describe the management of anemia at PICU discharge by pediatric intensivists. DESIGN:Self-administered, online, scenario-based survey. SETTING:PICUs in Australia/New Zealand, Europe, and North America. SUBJECTS:Pediatric intensivists. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:Respondents were asked to report their decisions regarding RBC transfusions, iron, and erythropoietin prescription to children ready to be discharged ... Read more >>

Pediatr Crit Care Med (Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies)
[2020, :]

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Comparison of Phenytoin, Valproate and Levetiracetam in Pediatric Convulsive Status Epilepticus: A Randomized Double-blind Controlled Clinical Trial.

Vinayagamoorthy Vignesh, Ramachandran Rameshkumar, Subramanian Mahadevan,

OBJECTIVE:To compare the efficacy of phenytoin, valproate, and levetiracetam in the management of pediatric convulsive status epilepticus. DESIGN:Randomized double-blind controlled clinical trial. SETTING:Pediatric critical care division in a tertiary care institute from June, 2016 to December, 2018. PARTICIPANTS:110 children aged three month to 12 year with convulsive status epilepticus. INTERVENTION:Patients ... Read more >>

Indian Pediatr (Indian pediatrics)
[2020, 57(3):222-227]

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Improving Influenza Vaccination in Hospitalized Children With Asthma.

Dana M Foradori, Esther M Sampayo, S Aya Fanny, Meera K Namireddy, Anjali M Kumar, Huay-Ying Lo,

OBJECTIVES:Children with asthma are at increased risk of complications from influenza; hospitalization represents an important opportunity for vaccination. We aimed to increase the influenza vaccination rate among eligible hospitalized patients with asthma on the pediatric hospital medicine (PHM) service from 13% to 80% over a 4-year period. METHODS:Serial Plan-Do-Study-Act cycles ... Read more >>

Pediatrics (Pediatrics)
[2020, 145(3):]

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Physicians' Approach to Anaphylaxis in Childhood.

Tuba Tuncel, Ozlem Sancakli, Ozlem Bag, Hafize Selma Cetin, Emine Ece Özdoğru,

Anaphylaxis is a life-threatening, severe, generalized, or systemic hypersensitivity reaction. The incidence of anaphylaxis is increasing especially in pediatric age. Our aim in this study was to investigate the knowledge and attitudes of the physicians on the diagnosis and treatment of anaphylaxis. METHODS:A questionnaire form consisting of a total of ... Read more >>

Pediatr Emerg Care (Pediatric emergency care)
[2020, :]

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Antibiotic Timing in Pediatric Septic Shock.

Roni D Lane, Jared Olson, Ron Reeder, Benjamin Miller, Jennifer K Workman, Emily A Thorell, Gitte Y Larsen,

BACKGROUND AND OBJECTIVES:National guidelines advocate for the administration of antibiotics within 1 hour to children with septic shock, although there is variance in the pediatric evidence-based literature supporting this benchmark. Our objective for this study was to describe the association of target time to antibiotic administration (TTAA) with outcomes of ... Read more >>

Hosp Pediatr (Hospital pediatrics)
[2020, :]

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Early Use of Adjunctive Therapies for Pediatric Acute Respiratory Distress Syndrome: A PARDIE Study.

Courtney M Rowan, Margaret J Klein, Deyin Doreen Hsing, Mary K Dahmer, Philip C Spinella, Guillaume Emeriaud, Amanda B Hassinger, Byron E Piñeres-Olave, Heidi R Flori, Bereketeab Haileselassie, Yolanda M Lopez-Fernandez, Ranjit S Chima, Steven L Shein, Aline B Maddux, Jon Lillie, Martin C J Kneyber, Lincoln S Smith, Robinder G Khemani, Neal J Thomas, Nadir Yehya, ,

RATIONALE:Little data exist to guide early adjunctive therapy use in pediatric acute respiratory distress syndrome (PARDS). OBJECTIVE:To describe contemporary use of adjunctive therapies for early PARDS as a framework for future investigations. METHODS:Pre-planned, sub-study of a prospective, international, cross-sectional observational study of children with PARDS from 100 centers over 10 ... Read more >>

Am. J. Respir. Crit. Care Med. (American journal of respiratory and critical care medicine)
[2020, :]

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Characteristics and Treatment of Anaphylaxis in Children Visiting a Pediatric Emergency Department in Korea.

Won Seok Lee, Jaewoo An, Young-Ho Jung, Hye Mi Jee, Kyu-Young Chae, Young A Park, Man Yong Han, Kyung Suk Lee,

Anaphylaxis is a serious life-threatening allergic disease in children. This study is aimed at determining the characteristics of pediatric patients who experienced anaphylaxis along with treatments administered in order to determine the usefulness of tryptase level assessment as a marker of anaphylaxis in Korean children. A total of 107 patients ... Read more >>

Biomed Res Int (BioMed research international)
[2020, 2020:2014104]

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Qualitative analysis of perceived impacts on childhood food allergy on caregiver mental health and lifestyle.

Elissa M Abrams, Elinor Simons, Leslie Roos, Kim Hurst, Jennifer L P Protudjer,

BACKGROUND:Approximately 8% of children have food allergy. Yet, little is known about how parents cope with the burden of this disease. OBJECTIVE:This study aimed to describe the perceptions of food allergy-related mental health issues of parents of children with food allergy. METHODS:Parents of children with pediatric allergist-diagnosed food allergy were ... Read more >>

Ann. Allergy Asthma Immunol. (Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology)
[2020, :]

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Low vasopressin and progression of neonatal sepsis to septic shock: a prospective cohort study.

Abhishek S Aradhya, Venkataseshan Sundaram, Naresh Sachdeva, Sourabh Dutta, Shiv S Saini, Praveen Kumar,

The study objective was to analyze the association between low plasma vasopressin and progression of sepsis to septic shock in neonates < 34 weeks gestation. Septic neonates of < 34 weeks gestation were consecutively enrolled; moribund neonates and those with major malformations were excluded. Subjects were monitored for progression of sepsis to septic shock ... Read more >>

Eur. J. Pediatr. (European journal of pediatrics)
[2020, :]

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Making the GRADE in Anaphylaxis Management: Towards Recommendations Integrating Values, Preferences, Context, and Shared Decision-Making.

M S Shaker, J Oppenheimer, D V Wallace, D B K Golden, D M Lang, , E S Lang, J A Bernstein, R L Campbell, D Chu, C Dinakar, A K Ellis, M Greenhawt, C Horner, J A Lieberman, M A Rank, D R Stukus, J Wang,

OBJECTIVE:To review GRADE methodology and discuss the clinical application of conditional recommendations in clinical guidelines, specifically in the context of anaphylaxis. DATA SOURCES:Articles describing GRADE, evidence synthesis, evidence to recommendation frameworks, and shared decision making were used to discuss conditional recommendations of the 2020 Anaphylaxis GRADE guideline. STUDY SELECTIONS:A narrative ... Read more >>

Ann. Allergy Asthma Immunol. (Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology)
[2020, :]

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A case of bi-ventricular extensive calcification caused by multiple factors.

Xiaoyan Tu, Zhihui Hu, Kevin Yang, Zhuoqing Hu, Yi Jiang,

BACKGROUND:Extensive myocardial calcification has a low incidence rate, but when the patients do have extensive myocardial cases, the prognosis is usually poor. Several sepsis-related extensive myocardial calcification cases have been reported, but there are cases of biventricular calcifications that are caused by multiple cases besides bacteremia and the treatment for ... Read more >>

BMC Pediatr (BMC pediatrics)
[2020, 20(1):85]

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Update on penicillin allergy delabeling.

Marcus Shaker, Samuel McWilliams, Matthew Greenhawt,

PURPOSE OF REVIEW:To review phenotyping and risk classification of penicillin allergy and provide an update on penicillin allergy delabeling strategies for primary care. RECENT FINDINGS:Beta-lactams are considered the treatment of choice for a wide range of bacterial pathogens; however, many patients receive second-line agents due to being labeled as having ... Read more >>

Curr. Opin. Pediatr. (Current opinion in pediatrics)
[2020, 32(2):321-327]

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Stat5a promotes brown adipocyte differentiation and thermogenic program through binding and transactivating the Kdm6a promoter.

Weihua Liu, Yuqiang Ji, Beining Zhang, Haiping Chu, Chunyan Yin, Yanfeng Xiao,

Previous studies reported that Stat5 promotes adipogenesis and white adipocyte differentiation. However, the role of Stat5 in brown adipocyte development is poorly understood. We found Stat5a was higher expressed in brown adipocytes than in white adipocytes, and its level was increased during the process of brown adipocyte differentiation. In addition, ... Read more >>

Cell Cycle (Cell cycle (Georgetown, Tex.))
[2020, :1-11]

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Food Allergy Management at School.

Roxanne Dupuis, Eliza Whiteman Kinsey, Jonathan M Spergel, Terri Brown-Whitehorn, Amy Graves, Kate Samuelson, Caleb Epstein, Cynthia Mollen, Carolyn C Cannuscio,

BACKGROUND:Approximately 8% of schoolchildren in the United States experience potentially life-threatening food allergies. They must diligently avoid allergenic foods and have prompt access to epinephrine to treat anaphylaxis. These prevention strategies must be sustained without interruption, posing a range of challenges at school. METHODS:We conducted semi-structured interviews with 178 participants ... Read more >>

J Sch Health (The Journal of school health)
[2020, :]

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Are Children with a History of Asthma More Likely to Have Severe Anaphylactic Reactions? A Retrospective Cohort Study.

Timothy E Dribin, Kenneth A Michelson, Yin Zhang, David Schnadower, Mark I Neuman,

OBJECTIVE:To assess whether a history of asthma was associated with anaphylaxis severity in children hospitalized for anaphylaxis. STUDY DESIGN:Retrospective cohort study of children ≤21 years old hospitalized for anaphylaxis from 2009 to 2016. The primary outcome was severe anaphylactic reactions defined by examination findings (stridor, respiratory distress, or hypotension) or administered ... Read more >>

J. Pediatr. (The Journal of pediatrics)
[2020, :]

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Kawasaki Disease in Children Older Than 10 Years: A Clinical Experience From Northwest India.

Ankur Kumar Jindal, Rakesh Kumar Pilania, Sandesh Guleria, Pandiarajan Vignesh, Deepti Suri, Anju Gupta, Manphool Singhal, Amit Rawat, Surjit Singh,

Background: Kawasaki disease (KD) is predominantly seen in young children (<5 years). Diagnosis of KD is often delayed in older children and adolescents, leading to a higher risk of coronary artery abnormalities (CAAs). There is a paucity of literature on KD in older children. Methods: Data were collated from a ... Read more >>

Front Pediatr (Frontiers in pediatrics)
[2020, 8:24]

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