Are pediatric patients with PHACE association at high risk for anesthetic complications?

2020 ◽  
Author(s):  
Brett S. Escarza ◽  
Susana Cruz‐Beltran ◽  
Greg Lessans ◽  
Thomas M. Austin ◽  
Humphrey V. Lam
Keyword(s):  
High Risk ◽  
Pediatric Patients ◽  
Anesthetic Complications

Excellent Outcome for Pediatric Patients with High Risk Hodgkin Lymphoma with Brentuximab Vedotin and Risk Adapted Residual Node Radiation

2020 ◽  
Author(s):  
Monika Metzger ◽  
Michael P. Link ◽  
Amy L. Billett ◽  
Jamie Flerlage ◽  
John T. Lucas Jr. ◽  
...  
Keyword(s):  
High Risk ◽  
Hodgkin Lymphoma ◽  
Pediatric Patients ◽  
Brentuximab Vedotin ◽  
Excellent Outcome

scholarly journals Are children with SARS‐CoV‐2 infection at high risk for thrombosis? Viscoelastic testing and coagulation profiles in a case series of pediatric patients

2020 ◽  
Vol 67 (12) ◽  
Author(s):  
Maha Al‐Ghafry ◽  
Banu Aygun ◽  
Abena Appiah‐Kubi ◽  
Adrianna Vlachos ◽  
Gholamabbas Ostovar ◽  
...  
Keyword(s):  
High Risk ◽  
Pediatric Patients ◽  
Case Series ◽  
Risk For Thrombosis

scholarly journals 688 Pediatric Obstructive Sleep Apnea (OSA) and COVID-19-Related Adverse Clinical Outcomes

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A269-A269
Author(s):  
Vaishal Shah ◽  
Nancy Foldvary-Schaefer ◽  
Lu Wang ◽  
Lara Jehi ◽  
Cynthia Pena Obrea ◽  
...  
Keyword(s):  
High Risk ◽  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Pediatric Patients ◽  
Control Design ◽  
Supplemental Oxygen ◽  
Case Control ◽  
World Health ◽  
Invasive Ventilation ◽  
High Flow Oxygen

Abstract Introduction The relationship of OSA and human coronavirus (COVID-19) in the pediatric population is unknown. We postulate that OSA is associated with SARS-CoV-2 positivity and with adverse COVID-19 outcomes in children. Methods A retrospective review of 120 consecutive patients (<18 years) with prior polysomnogram (PSG) and COVID-19 testing from the Cleveland Clinic COVID-19 registry was conducted. Using a case control design of SARS-CoV-2 positive and negative pediatric patients, we examined COVID-19 and pre-existing OSA (dichotomized AHI≥1) using logistic (OR,95%CI) regression and as continuous measures: AHI, oxygen(SpO2) nadir, %time SpO2<90%) using linear regression(beta+/-SE). In those positive for SARS-CoV-2(cases only), we assessed the association of OSA and World Health Organization(WHO) COVID-19 clinical outcome composite score (hospitalization, requiring supplemental oxygen, non-invasive ventilation/high-flow oxygen, invasive ventilation/ECMO or death) using Wilcoxon rank sum test for ordinal data. Results Cases (n=36) were 11.8±4.4 years, 61% male, 27.8% black and 88.9% with OSA, while 85.7% of controls (n=84) had OSA. OSA was not associated with increased SARS-CoV-2 positivity: OR=1.33(0.40, 4.45,p=0.64). No significant difference between cases and controls for mean AHI 3.7(1.5,6.0) vs 3.5(1.5,7.1),p=0.91,SpO2 nadir 88.6±5.4 vs 89.1±4.4,p=0.58,%time SpO2<90% 0.05[0.00,1.00) vs 0.10 (0.00,1.00, p=0.65) respectively was noted. WHO-7 COVID-19 clinical outcome did not meet statistical significance in relation to OSA due to the low event frequency (p=0.49). Of note, those with OSA vs without OSA had a higher WHO-7 outcome score of 2 vs 0 and prevalence of hospitalization: 12.5 vs 0% respectively. Of hospitalized patients, the following was observed: 23% had moderate/severe OSA vs 4.3% mild OSA, 50% required supplemental oxygen and 25% required intubation/invasive ventilation. No deaths or readmissions were reported. High risk conditions included: 75% obesity, 50% asthma, 25% sickle cell disease and 25% hypoplastic left heart. Conclusion In this first report of which we are aware focused on COVID-19 in pediatric OSA, we use a case control design leveraging COVID-19 and sleep laboratory registries. Albeit not statistically significant, pediatric patients with OSA had a higher percentage of worse clinical outcomes. Larger network studies are needed to clarify whether poorer COVID-19 outcomes may be attributable to OSA or modulated via high risk health conditions. Support (if any):

Investigation of High-Risk ST131 Clone in Extended Spectrum β-Lactamase–Producing Escherichia coli Isolates in Children

2021 ◽  
Author(s):  
Mehmet E. Bulut ◽  
Gülen Hürkal ◽  
Nazan Dalgıç
Keyword(s):  
Escherichia Coli ◽  
High Risk ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Maldi Tof Ms ◽  
E Coli ◽  
Maldi Tof ◽  
Extended Spectrum ◽  
St131 Clone ◽  
Tof Ms

Abstract Objective Antimicrobial resistance poses a serious threat to children's health. In recent years, high-risk Escherichia coli ST131 has become an important target for global surveillance studies. The E.coli ST131 clone is associated with extended spectrum β-lactamase (ESBL) production, as well as multidrug resistance and treatment failure. Studies on this clone in the pediatric age group are limited. We aim to investigate the rate of high-risk E. coli ST131 clone in ESBL-positive E. coli isolates obtained from pediatric patients. Methods A total of 292 ESBL-positive E. coli isolates from clinical samples of pediatric patients was included in the study. MALDI-TOF MS system was used for bacterial identification. Susceptibility tests were performed using BD Phoenix automated system. ST131 detection was done by MALDI-TOF-MS. Fisher's exact test was used to compare the groups (significance <0.05). Results A total of 292 isolates was analyzed. The high-risk ST131 clone was detected in 117 (40%) of the 292 ESBL-positive isolates. ST131 rates were found to be significantly higher in children under the age of 5 years compared with children over the age of 5 years (49.3 vs. 31.1%, p = 0.0019). Ciprofloxacin resistance was higher in ST131 isolates (45.6 vs. 31.7%; p < 0.05). Conclusion The rate of the ST131 clone was found to be high in the pediatric population. The significantly high rate of resistance to ciprofloxacin, which is not commonly used in the pediatric population, in ST131 isolates reveals the importance of the spread of high-risk clones for the development of resistance.

Improving the Quality of Life for High-Risk Infants

2008 ◽  
Vol 27 (6) ◽  
pp. 369-369
Author(s):  
Sharyn Gibbins
Keyword(s):  
Quality Of Life ◽  
Medical Education ◽  
High Risk ◽  
Scientific Knowledge ◽  
Essential Role ◽  
Pediatric Patients ◽  
Health Advocacy ◽  
Medical Speciality ◽  
High Risk Infants

NEONATOLOGY IS A RELATIVELY NEW MEDICAL SPECIALITY that arose from the recognition that neonates were different from adults and other pediatric patients. The recognition of these differences between patients led, in part, to the development of perinatology and neonatology programs across the globe. As scientific knowledge and medical education evolved, so too did the recognition that nurses played an essential role in the care of high-risk infants. No longer restricted to Florence Nightingale’s initial advocacy for a nurturing environment only, the profession of nursing extends into areas of practice, education, mentorship, health advocacy, and research.

Pediatric problems of stratification of the severity of stages, cardiovascular complications and renal forecast of chronic kidney disease by NKF-K / DOQI (2002) and KDIGO (2012) classifications

2021 ◽  
Vol 25 (3) ◽  
pp. 9-19
Author(s):  
N. D. Savenkova ◽  
O. P. Grigoreva
Keyword(s):  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
Pediatric Patients ◽  
Cardiovascular Complications ◽  
High Risk Group ◽  
Cardiovascular Pathology ◽  
Cardiovascular Prognosis ◽  
Renal Prognosis

Chronic kidney disease (CKD) in children is a global problem worldwide. The article discusses the problem of stratification of CKD severity according to the classifications of the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (NKF-K / DOQI) (2002) and Kidney Disease Improving Global Outcomes (KDIGO) (2012) in pediatric patients. There are limitations in assessing severity of CKD stages C1-5 according to NKF-K / DOQI (2002) and KDIGO (2012) in children under 2 years of age who have a low glomerular filtration rate in contrast to adults. The stratification of the severity of stages 1-5 of CKD, cardiovascular complications and renal prognosis in children and adolescents according to the classifications NKF-K / DOQI (2002) [3] and KDIGO (2012) [14] are discussed. In adult patients with CKD, there is a compelling case for identifying of C3a and C3b sub stages in 3 stages of CKD according to KDIGO (2012) was that renal and cardiovascular prognosis are different with GFR 45-59 ml/min/1.73 m 2and GFR 30-44 ml/min/1.73 m 2 . The prognosis of the risk of developing cardiovascular diseases and complications for stages C2-5 in accordance with the KDIGO classification (2012) in children and adults differ. As follows from the publications, children with CKD in the pre-dialysis stages C2-4 form a high-risk group, with C4-5 on dialysis a group of very high risk of complications associated with cardiovascular pathology. Cardiovascular complications account for more than 30 % of all deaths of pediatric patients with CKD C4-5 on dialysis. The arguments justifying the allocation of CKD stages C1-5 in children under 2 years of age in accordance with the classification of NKF-K/DOQI (2002) are presented.

Long-Term Central Venous Access in Pediatric Patients at High Risk: Conventional versus Antibiotic–Impregnated Catheters

2014 ◽  
Vol 25 (3) ◽  
pp. 411-418 ◽  
Author(s):  
Kevin M. Baskin ◽  
Christopher Hunnicutt ◽  
Megan E. Beck ◽  
Elan D. Cohen ◽  
John J. Crowley ◽  
...  
Keyword(s):  
High Risk ◽  
Pediatric Patients ◽  
Central Venous Access ◽  
Venous Access ◽  
Central Venous

scholarly journals Targetable kinase gene fusions in high-risk B-ALL: a study from the Children’s Oncology Group

Blood ◽  
2017 ◽  
Vol 129 (25) ◽  
pp. 3352-3361 ◽  
Author(s):  
Shalini C. Reshmi ◽  
Richard C. Harvey ◽  
Kathryn G. Roberts ◽  
Eileen Stonerock ◽  
Amy Smith ◽  
...  
Keyword(s):  
High Risk ◽  
Tyrosine Kinase ◽  
Effective Treatment ◽  
Pediatric Patients ◽  
Genetic Alterations ◽  
Gene Fusions ◽  
Oncology Group ◽  
Kinase Gene ◽  
Tyrosine Kinase Signaling ◽  
Key Points

Key Points Ph-like ALL is characterized by a diverse array of genetic alterations activating cytokine receptor and tyrosine kinase signaling. Pediatric patients with Ph-like ALL can be identified in real time for effective treatment stratification.

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