Jordi Miatello, Valérie Faivre, Clémence Marais, Mégane Raineau, Didier Payen, Pierre Tissieres
BACKGROUND: Monocyte (m)HLA-DR expression appears to be a potent marker of immunosuppression in critically ill patients. The persistence of low mHLA-DR expression is associated with an increased risk of nosocomial infections and mortality. To adapt this measurement to pediatric requirements and provide extensive 24/7 access, we have developed a whole blood no-lyse no-wash micromethod (MM) and compared it with the standardized method (SM). METHODS: mHLA-DR was quantified by flow cytometry using Quantibrite™ Anti-HLA-DR PE/Monocyte PerCP-Cy™5...
September 13, 2023: Cytometry. Part B, Clinical Cytometry
Alanoud Aljarbou, Carlos Cuello, Ana Teresa Figueiredo Stochero Leslie
AIM: To evaluate the efficacy and harms of a short (7-10 days) compared with a standard (10-14 days) duration of antibiotics in culture-proven neonatal sepsis for reducing all-cause mortality, treatment failure and duration of hospitalisation. METHODS: Medline, EMBASE and Cochrane CENTRAL were searched for randomised trials. RESULTS: We included five studies, all conducted in India (447 infants with a gestational age greater than 32 weeks)...
September 13, 2023: Acta Paediatrica
Nirupama Kannikeswaran, Prashant Mahajan
Sepsis is one of the leading causes of morbidity and mortality in children. Timely recognition and management of sepsis with fluid resuscitation and antibiotic administration leads to better clinical outcomes. However, clinical recognition of sepsis in children is challenging given its rare occurrence, the overlap of clinical features with other common febrile illness, lack of specific diagnostic biomarkers, and the ability of children to compensate until the late stages of shock. Despite updating of pediatric sepsis definition and implementation of screening tools to facilitate early recognition, mortality from sepsis continues to be high...
September 11, 2023: Indian Pediatrics
Constanza García-López, Isabel Medina-Vera, Luz Orozco-Covarrubias, Marimar Saez-de-Ocariz
BACKGROUND: Ecthyma gangrenosum (EG) usually results from the hematogenous seeding of the skin in the setting of bacteremia, mostly by Pseudomonas aeruginosa, especially in immunocompromised patients. It presents as erythematous-violaceous macules, or plaques with surrounding erythema before rapidly progressing to bullae and necrotic-ulcerative eschars. METHODS: We performed a retrospective chart review of EG patients diagnosed at the National Institute of Pediatrics...
September 12, 2023: International Journal of Dermatology
Mulugeta Nigusu Wondimu, Alemayehu Teklu Toni, Teshome Geletaw Zamanuel
BACKGROUND: Neonatal meningitis continues to be a devastating infection with high mortality and morbidity worldwide. The prevalence of neonatal meningitis varies across countries. However, there is a paucity of studies on neonatal meningitis in most low-resource settings. Therefore, this study aimed to determine the magnitude, clinical presentations, and associated risk factors of meningitis among newborns with neonatal sepsis. METHOD: An institution-based, cross-sectional study was conducted among newborns with neonatal sepsis from May 1, 2021, to Oct 30, 2021...
2023: PloS One
Antonius Hocky Pudjiadi, Nina Dwi Putri, Stephanie Wijaya, Fatima Safira Alatas
AIM: This study aimed to explore the factors contributing to mortality and its management among pediatric sepsis patients at a single center in Indonesia. METHOD: We conducted a retrospective study of children admitted due to sepsis from January 2015 to December 2019 in an Indonesian tertiary hospital. RESULTS: The mortality rate of pediatric sepsis in our study was 76.1% among 176 records with outcome identified. Mortality was significantly associated with septic shock at triage, number of organ failure, intensive care unit admission, inotropic use, septic shock and severe sepsis during hospitalization...
September 7, 2023: Journal of Tropical Pediatrics
Ravi Manchikalapati, Jonathon Schening, Andrew J Farias, Keith Sacco
The pathophysiology of pediatric sepsis is characterized by increased innate immune activation earlier in life. Interleukin-1 is a pro-inflammatory cytokine implicated in the pathophysiology of sepsis and ferritin is a stable surrogate biomarker for elevated IL-1 levels. Data in adult sepsis has shown that use of anakinra, an anti-IL-1 receptor antagonist led to improved clinical outcomes in patients with features of macrophage activation and hyperferritinemia. However, data in pediatric sepsis is lack. Our narrative review sought to highlight the current understanding of using IL-1 inhibitors in pediatric sepsis...
September 5, 2023: Shock
Jamie O Yang, Matt S Zinter, Matteo Pellegrini, Man Yee Wong, Kinisha Gala, Daniela Markovic, Brian Nadel, Kerui Peng, Nguyen Do, Serghei Mangul, Vinay M Nadkarni, Aaron Karlsberg, Dhrithi Deshpande, Manish J Butte, Lisa Asaro, Michael Agus, Anil Sapru
Background Sepsis is a highly heterogeneous syndrome, that has hindered the development of effective therapies. This has prompted investigators to develop a precision medicine approach aimed at identifying biologically homogenous subgroups of patients with septic shock and critical illnesses. Transcriptomic analysis can identify subclasses derived from differences in underlying pathophysiological processes that may provide the basis for new targeted therapies. The goal of this study was to elucidate pathophysiological pathways and identify pediatric septic shock subclasses based on whole blood RNA expression profiles...
August 28, 2023: Research Square
Ashish Agarwal, Deepankar Bansal, Karthi Nallasamy, Muralidharan Jayashree, Vijai William
The coronavirus disease (COVID-19) pandemic affected the management and follow-up of several chronic ailments, including pediatric type 1 diabetes mellitus (T1DM). Restricted access to healthcare and fear of contracting the virus during medical facility visits resulted in poor compliance, irregular follow-up visits, treatment, and delayed diagnosis of complications in pediatric diabetes such as diabetic ketoacidosis (DKA). As such, the incidence of complicated DKA in resource-limited settings is high due to delayed presentation, poor compliance with therapy, and associated comorbidities such as malnutrition and sepsis...
2023: Pediatric Health, Medicine and Therapeutics
Laura De Nardi, Mariavittoria Sala, Federico Turoldo, Davide Zanon, Alessandra Maestro, Egidio Barbi, Barbara Faganel Kotnik, Natalia Maximova
Gender-based medicine is attracting increasing interest every day, but studies on pediatric populations are still limited. In this setting, sex differences among patients undergoing total parenteral nutrition (TPN) have not been previously reported. This study investigated the presence of sex differences in parenteral nutrition composition and outcomes among a cohort of pediatric patients admitted at the Oncohematology and Bone Marrow Transplant Unit of the Institute for Maternal and Child Health "Burlo Garofolo" of Trieste, Italy...
August 31, 2023: Nutrients
Mohammed K Alshammari, Ahlam H Alsanad, Rawan J Alnusayri, Abdulmajeed S Alanazi, Fatmah Q Shamakhi, Khaled M Alshahrani, Abdullah M Alshahrani, Ghaliah Yahya, Abdulaziz A Alshahrani, Turki S Alshahrani, Hamad S Sultan, Fatimah M Alshahrani, Fouzyia A Alreshidi, Renad A Alnigaidan, Abdulaziz A Almazyad
BACKGROUND: Neonatal early onset sepsis (NEOS) is a serious and potentially life-threatening condition affecting newborns within the first few days of life. While the diagnosis of NEOS was based on clinical signs and symptoms in the past, recent years have seen growing interest in identifying specific diagnostic factors and optimizing therapy outcomes. This study aims to investigate the diagnostic and risk factors and therapy outcomes of neonatal EOS in ICU patients in Saudi Arabia, with the goal of improving the management of neonatal EOS in the country...
2023: Frontiers in Pediatrics
Matija Bakoš, Milivoj Novak, Dalibor Šarić, Dorotea Bartoniček, Dražen Belina, Željko Đurić, Darko Anić, Željko Čolak, Sanja Konosić, Marina Mihalec, Filip Rubić, Toni Matić, Goran Međimurec, Mislav Planinc
BACKGROUND: The prevalence of heart failure is constantly increasing in both children and adults. End-stage heart failure in children unresponsive to medical therapy has limited treatment options. Surgical options include heart transplantation or implantation of durable ventricular assist devices (VADs). To start the VAD program, it was necessary to train core team members, invite experienced proctors and adjust the organizational approach. METHODS: We present our first seven pediatric patients who underwent a VAD implantation with primary indication end-stage dilated cardiomyopathy...
August 9, 2023: Heart Surgery Forum
Paul Ehiabhi Ikhurionan, Nellie V T Bell, Gabriel Egberue Ofovwe
OBJECTIVE: This study sought to describe the prevalence and clinical outcome after emergency blood transfusion among children presenting with severe anemia in a tertiary children's hospital in Sierra Leone. METHOD: This was a retrospective study of 395 children who received emergency blood transfusion at the Ola During Children's Hospital in Freetown. Association between mortality and sociodemographic and clinical factors was assessed using χ2 test. Statistical significance was set at P < 0...
September 5, 2023: Pediatric Emergency Care
María Hernández-García, Elies Roldan-Berengue, Carmina Guitart, Mònica Girona-Alarcón, Guillermo Argüello, Rosa Pino, Mariona F de Sevilla, Juan José García-García, Iolanda Jordan
Differential diagnosis between Multisystem Inflammatory Syndrome in Children (MIS-C) and other causes of systemic inflammatory response such as sepsis is complex. The aims were to evaluate the differences between pediatric patients with MIS-C and sepsis and to develop a score to distinguish both entities. This was a retrospective study that compared demographic, clinical, diagnostic, and therapeutic data of pediatric patients with MIS-C (cohort 2020-2022) and sepsis (cohorts 2010-2014 and 2017-2018) admitted to a Pediatric Intensive Care Unit (PICU) of a tertiary care hospital...
September 7, 2023: European Journal of Pediatrics
Catarina Gouveia, Maria Paula Bajanca-Lavado, Rafael Mamede, Ana Araújo Carvalho, Fernanda Rodrigues, José Melo-Cristino, Mario Ramirez, Ana Friães
Since autumn 2022, observed numbers of paediatric invasive group A Streptococcus infections in Portugal (n = 89) were higher than in pre-COVID-19 seasons. Between September 2022 and May 2023, the dominant diagnoses were pneumonia (25/79), mostly with empyema (20/25), and sepsis (22/79). A number of cases required admission to intensive care (27/79) and surgery (35/79), and the case fatality rate was 5.1% (4/79). Genomic sequencing (n = 55) revealed multiple genetic lineages, dominated by the M1UK sublineage (26/55) and more diverse emm 12 isolates (12/55)...
September 2023: Euro Surveillance
Zhenziang Fan, Kate F Kernan, Yidi Qin, Scott Canna, Robert A Berg, David Wessel, Murray M Pollack, Kathleen Meert, Mark Hall, Christopher Newth, John C Lin, Allan Doctor, Tom Shanley, Tim Cornell, Rick E Harrison, Athena F Zuppa, Katherine Sward, J Michael Dean, H J Park, Joseph A Carcillo
BACKGROUND: One of five global deaths are attributable to sepsis. Hyperferritinemic sepsis (> 500 ng/mL) is associated with increased mortality in single-center studies. Our pediatric research network's objective was to obtain rationale for designing anti-inflammatory clinical trials targeting hyperferritinemic sepsis. METHODS: We assessed differences in 32 cytokines, immune depression (low whole blood ex vivo TNF response to endotoxin) and thrombotic microangiopathy (low ADAMTS13 activity) biomarkers, seven viral DNAemias, and macrophage activation syndrome (MAS) defined by combined hepatobiliary dysfunction and disseminated intravascular coagulation, and mortality in 117 children with hyperferritinemic sepsis (ferritin level > 500 ng/mL) compared to 280 children with sepsis without hyperferritinemia...
September 6, 2023: Critical Care: the Official Journal of the Critical Care Forum
Rita Pissarra, Bárbara Pereira-Neto, Pedro Miragaia, Sara Almeida, Filipa Flor-DE-Lima, Paulo Soares
BACKGROUND: Despite recent improvements, premature infants remain at high risk for long-term morbidity and poorer neurodevelopment, particularly very preterm (VP) and very low birth weight (VLBW). The aim of this study was to describe neurodevelopmental outcomes at two years and identify potential predictors of worse performance. METHODS: In a retrospective cohort, a two-years' neurodevelopmental evaluation was analyzed. Multivariable regressions were used to study the association of perinatal history with neurodevelopmental outcomes...
September 6, 2023: Minerva pediatrics
Colin J Sallee, Joseph A Hippensteel, Kristen R Miller, Kaori Oshima, Andrew T Pham, Robert P Richter, John Belperio, Yamila L Sierra, Andreas Schwingshackl, Peter M Mourani, Eric P Schmidt, Anil Sapru, Aline B Maddux
BACKGROUND: Sepsis-associated destruction of the pulmonary microvascular endothelial glycocalyx (EGCX) creates a vulnerable endothelial surface, contributing to the development of acute respiratory distress syndrome (ARDS). Constituents of the EGCX shed into circulation, glycosaminoglycans and proteoglycans, may serve as biomarkers of endothelial dysfunction. We sought to define the patterns of plasma EGCX degradation products in children with sepsis-associated pediatric ARDS (PARDS), and test their association with clinical outcomes...
September 6, 2023: Journal of Intensive Care Medicine
Gultac Evren, Neslihan Zengin
Continuous renal replacement therapy (CRRT) is a commonly used therapeutic modality in the pediatric intensive care unit (PICU) for the treatment of severe acute kidney injury, as well as for addressing metabolic abnormalities, fluid-electrolyte imbalances, and acid-base disorders. According to reports, therapeutic hypothermia treatment has demonstrated the ability to decrease cellular metabolism, oxygen consumption, formation of free radicals, cell death, and inflammatory signals. The study encompassed all individuals who underwent CRRT at both Manisa City Hospital and Manisa Celal Bayar University Hospital throughout the period from February 2021 to November 2022...
September 5, 2023: Therapeutic Hypothermia and Temperature Management
Yong Yang, Sui-Yu Yang, Zong-Bo Chen, Li Liu
OBJECTIVES: To investigate the association of single nucleotide polymorphisms (SNPs) of myeloid differentiation factor 88 ( MyD88 ) and Toll-like receptor adaptor molecule 1 ( TICAM1 ) and their interactions with community-acquired pneumonia (CAP) in children. METHODS: Improved multiple ligase detection reaction assay was used for detecting the polymorphisms of nine tagging SNPs of the MyD88 and TICAM1 genes in 375 children with CAP who attended the Department of Pediatrics of the Second Affiliated Hospital of Yan'an University Medical School from August 2015 to September 2017 and 306 healthy children who underwent physical examination...
August 15, 2023: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
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