scholarly journals Changes in Transfusion Practice in Children and Adolescents over Time

2020 ◽  
Vol 47 (5) ◽  
pp. 379-384
Author(s):  
Florian Piekarski ◽  
Andrea Steinbicker ◽  
Kai Zacharowski ◽  
Patrick Meybohm
Keyword(s):  
Children And Adolescents ◽  
Inpatient Care ◽  
Pediatric Patients ◽  
Transfusion Practice ◽  
Blood Products ◽  
National Data ◽  
Resource Saving ◽  
The Past ◽  
Federal Statistical ◽  
Procedure Codes

Introduction: In recent years, resource-saving handling of allogeneic blood products and a reduction of transfusion rates in adults has been observed. However, comparable published national data for transfusion practices in pediatric patients are currently not available. In this study, the transfusion rates for children and adolescents were analyzed based on data from the Federal Statistical Office of Germany during the past 2 decades. Methods: Data were queried via the database of the Federal Statistical Office (Destasis). The period covered was from 2005 to 2018, and those in the sample group were children and adolescents aged 0–17 years receiving inpatient care. Operation and procedure codes (OPS) for transfusions, procedures, or interventions with increased transfusion risk were queried and evaluated in detail. Results: In Germany, 0.9% of the children and adolescents treated in hospital received a transfusion in 2018. A reduction in transfusion rates from 1.02% (2005) to 0.9% (2018) was observed for the total collective of children and adolescents receiving inpatient care. Increases in transfusion rates were recorded for 1- to 4- (1.41–1.45%) and 5- to 10-year-olds (1.24–1.33%). Children under 1 year of age were most frequently transfused (in 2018, 40.2% of the children were cared for in hospital). Transfusion-associated procedures such as chemotherapy or machine ventilation and respiratory support for newborns and infants are on the rise. Conclusion: Transfusion rates are declining in children and adolescents, but the reasons for increases in transfusion rates in other groups are unclear. Prospective studies to evaluate transfusion rates and triggers in children are urgently needed.

scholarly journals Endoscopic retrograde cholangiopancreatography in infants and children

2021 ◽  
Vol 09 (03) ◽  
pp. E292-E296
Author(s):  
Tone Lise Åvitsland ◽  
Lars Aabakken
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Medical Records ◽  
Pediatric Patients ◽  
Biliary Stricture ◽  
Infants And Children ◽  
University Hospital ◽  
Older Children ◽  
Endoscopic Retrograde ◽  
Procedure Codes ◽  
In Infants And Children

Abstract Background and study aims Previous reports have suggested that endoscopic retrograde cholangiopancreatography (ERCP) in pediatric patients are safe. However, the total number of cases presented in the literature remains small. We present results regarding safety and outcomes in pediatric patients undergoing ERCP at Oslo University Hospital. Patients and methods Patients < 18 years who underwent ERCP between April 1999 and November 2017 were identified using procedure codes. Medical records were examined for age, gender, diagnosis, indications, type of sedation, findings, interventions, and complications. Results A total of 244 procedures were performed in 158 patients. Fifty-six of these were in 53 infants (age ≤ 1 year). Mean age was 8.8 years. The youngest patient was 8 days old. Mean weight was 5.0 kg in infants, the smallest weighing 2.9 kg. Cannulation failed in 19 (7.8 %). The main indication in infants was suspicion of biliary atresia (n = 38). Six of the procedures (10.7 %) were therapeutic. In children the main indications were biliary stricture (n = 64) and investigation of primary sclerosing cholangitis (PSC) (n = 45). 119 (63.2 %) of these procedures were therapeutic.Complications were uncommon in infants; only two episodes of infection were registered. In children (> 1 year) post-ERCP pancreatitis were seen in 10.4 %. Conclusions Our retrospective series of ERCP procedures includes 56 procedures in infants, which is one of the largest series presented. Complications in infants are rare and post-ERCP pancreatitis was not seen. In older children 10.4 % experienced post-ERCP pancreatitis. In expert hands, ERCP was shown to be acceptably feasible and safe in infants and children.

scholarly journals Prevalence of COVID-19 Among Children and Adolescents While Easing Lockdown Restrictions in Cologne, North Rhine-Westphalia, Germany

2021 ◽  
Author(s):  
Robert Walter Körner ◽  
Lutz Thorsten Weber
Keyword(s):  
Children And Adolescents ◽  
Medical History ◽  
Day Care ◽  
Pediatric Patients ◽  
Upper Respiratory Tract ◽  
Care Facilities ◽  
Physical Examinations ◽  
Oropharyngeal Swab ◽  
Tract Infections ◽  
Time Of Presentation

Abstract Background In Germany, widespread full closures of schools and day care facilities were part of lockdown measures to control the spread of coronavirus disease 2019 (COVID-19). In the state of North Rhine-Westphalia closures took place on March 16, 2020 and were gradually eased from end of April 2020 until beginning of June 2020. Objective This study aims to evaluate the prevalence of COVID-19 among children and adolescents during the reopening period of schools and day care facilities in Cologne, North Rhine-Westphalia, Germany. It further depicts medical history and results of physical examinations of pediatric patients undergoing a test for severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2). Methods Testing for SARS-CoV-2 was carried out by a naso- and / or oropharyngeal swab by local pediatricians at the time of presentation. Samples were analyzed by real-time reverse transcription polymerase chain reaction (RT-PCR). Medical history and physical examination results were retrospectively analyzed. Results 525 children and adolescents presented mainly with mild upper respiratory tract infections. Three patients were diagnosed with COVID-19. Their medical history and examination results did not stand out from the other patients. Conclusion A precautious stepwise opening of schools and day care facilities was not associated with the occurrence of a relevant prevalence of COVID-19 among children and adolescents. However, a low general prevalence of COVID-19 at the end of the observation period has to be taken into account. Systematic testing might enable adjusted regulations in favor of full closures, especially in the light of increasing evidence for pediatric patients constituting a low-risk group for COVID-19.

Nonossifying fibroma. Four cases and review of the literature

1997 ◽  
Vol 87 (2) ◽  
pp. 66-69 ◽  
Author(s):  
A Glockenberg ◽  
E Sobel ◽  
JF Noël
Keyword(s):  
Young Children ◽  
Lower Extremity ◽  
Children And Adolescents ◽  
Lytic Lesion ◽  
Long Bones ◽  
Review Of The Literature ◽  
The Past ◽  
Nonossifying Fibroma ◽  
Metaphyseal Region

Nonossifying fibroma is a benign, lytic lesion that occurs in young children and adolescents. Radiographically, the lesion is multilocular and sharply demarcated. It often occurs at the metaphyseal region of long bones of the lower extremity and is usually eccentrically located. Four cases of nonossifying fibroma occurring during the past 7 years are presented with a review of the literature.

90 Lung ultrasound in pediatric asthma patients: A pilot study characterizing findings at baseline stat

2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e65-e66
Author(s):  
Noah Marzook ◽  
Alexander Dubrovsky
Keyword(s):  
Pediatric Patients ◽  
Lung Ultrasound ◽  
Demographic Data ◽  
Tertiary Care ◽  
Challenge Test ◽  
Primary Objective ◽  
Upper Respiratory Tract ◽  
The Past ◽  
Asthma Patients ◽  
B Lines

Abstract Primary Subject area Emergency Medicine - Paediatric Background Unlike the lung ultrasound (LU) findings of pneumonia, bronchiolitis, pleural effusions and pneumothorax, which have all been well described, the sonographic pattern of asthma remains unclear. Previous pediatric studies have shown that pediatric patients with acute asthma exacerbations had positive LU findings. It is also unclear whether these findings were the result of acute infections associated with the exacerbation or if the findings would be present at baseline, outside an exacerbation in an asthmatic patient. Objectives The primary objective of this study is to characterize lung ultrasound (LU) findings in stable asthma pediatric patients presenting in a tertiary care asthma or respiratory clinic. Design/Methods Eligible patients &gt;6 years of age, underwent a LU by the study sonographer between December 19, 2017 to June 25, 2019, during their regular follow up visit at the pulmonology clinic or scheduled pulmonary function test. Patients were defined as asthmatic if they had a positive methacholine challenge test (MCT) or spirometry at the day of the visit or in the past. Patients were excluded if they had an upper respiratory tract infection in the past 4 weeks, or had any other known pulmonary diseases. Baseline demographic and asthma severity (ISAAC score, ACQ-7) questionnaires were filled out by the patients, following which they underwent a LU by a novice sonographer using a 6-zone protocol. A blinded expert sonographer interpreted the images offline. A positive LU was defined as presence of more than 3 B-lines, consolidation (&lt;1cm or &gt;1cm), absent lung slide, and/or presence of pleural fluid. Results Fifty-two patients were enrolled in the study and 19.2% (CI 8.31-30.15) of the asthma patients had positive LU findings. The positive LU findings were diverse including B-lines (80%), small consolidation (80%), pleural line anomalies (10%). Positive LU findings were not correlated to any demographic value. Conclusion In our study, 19.2% of asthma patients at baseline have a positive LU. Lung consolidations larger than 1 cm were rarely seen. There were no significant differences between demographic data in asthmatic patients with positive compared to those with negative LUS. This positive LU scan rate is in keeping with a prior study on LU in pediatrics.

Development and usability test of ‘PROMIS Assessment’: a smartphone WeChat mini-program for children and adolescents with cancer (Preprint)

2021 ◽  
Author(s):  
Wen Zhang ◽  
Jennifer Stinson ◽  
Danyu Li ◽  
Qingmei Huang ◽  
Yueshi Huang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Children And Adolescents ◽  
Peer Relationships ◽  
Pediatric Patients ◽  
Qualitative Interviews ◽  
Usability Test ◽  
Usability Tests ◽  
Patient Reported ◽  
Intensity Functions

BACKGROUND The main goal for the healthcare of children and adolescents with cancer is to cure and better manage the distress caused by the multiple symptoms that may manifest during chemotherapy. Patient-reported outcomes (PROs) are considered to be the best way to obtain a subjective measure of symptoms. As such, it is crucial to select appropriate pediatric PROs tools, taking advantage of technologies to develop a suitable platform, and assess and manage symptoms over long-term cancer treatment. OBJECTIVE This study aimed to develop and test a smartphone application's usability, known as the WeChat mini-program. It enables children and adolescents with cancer aged 5 to 17 years old and their parent proxies to assess pediatric patients' quality of life-related symptoms using Pediatric Patient-reported Outcome Measurement Information System (PROMIS) profile-25. METHODS A focus group interview among researchers, clinical professionals, and software engineers, as well as personal qualitative interviews with pediatric patients and proxies, were conducted to form the development proposal. The iterative method was used to develop and assure the quality of the mini-program. The usability test was performed based on the standards of ISO 9241-11 among target users. Effectiveness and efficiency were based on usability tasks, satisfaction was measured with the Post-Study System Usability Questionnaire (PSSUQ), and additional qualitative interviews were conducted following all tests. Further modifications and tests would be performed to improve the mini-program based on feedback. RESULTS The WeChat mini-program 'PROMIS Assessment' included demographic and clinical information and the profile-25 questionnaire (which assesses and collects data on depressive symptoms, anxiety, fatigue, physical activity-mobility, peer relationships, pain interference, and pain intensity). Functions such as voice assistance, a reward system, data visualization, and reminders were added to improve accessibility and compliance. A total of 16 target users participated in the first round of usability tests. The completion rate of the three tasks ranged from 80.0% (for the proxy task of 'search and open') to 100.0%, and most users could complete tasks quickly. Satisfaction scores of the four dimensions of PSSUQ ranged from 6.2 to 6.8 (out of 7.0). In qualitative interviews, most participants thought the mini-program was convenient, easy to use, and helpful. Disadvantages were mainly problems with searching, expressions, and interaction with reality. The revised mini-program gained positive feedback during the second round of usability tests. CONCLUSIONS The 'PROMIS Assessment' and its administration website were developed and proved to have good usability. It can be used both inside and outside hospitals by children and adolescents with cancer and their proxies during treatment to assess their quality of life and offer significant patient-reported data to assist clinical decisions.

Response of weaned pigs to diets containing spray dried plasma protein and spray dried blood cells

1996 ◽  
Vol 1996 ◽  
pp. 139-139
Author(s):  
P.B. Lynch ◽  
E. Weaver ◽  
L. E. Russell
Keyword(s):  
Factorial Design ◽  
Plasma Protein ◽  
Blood Cells ◽  
Fish Meal ◽  
Blood Products ◽  
Weaned Pigs ◽  
Milk Products ◽  
The Past ◽  
The Us ◽  
Spray Dried

Spray dried plasma protein (SDPP) has been used as a replacement for expensive milk based ingredients in starter diets in the US over the past few years. The objective of this trial was to assess dried blood products as a replacement for dried milk products and fish meal in diets fed to pigs for four weeks after weaning.Thirty six mixed sex groups of 16 pigs, weaned at 22-28 days of age and weighing 7.6 (s.e. 0.1) kg, were used in this trial in a factorial design of two starter diets (control and 10% SDPP (AP920) - American Protein Corp., Ames, Iowa) for 14 days from weaning, followed by two link diets (control and 2.5% spray dried blood cells - SDBC (AP301)) for 12 days. Composition of diets is shown in Table 1. All pigs received a common weaner diet from day 26 to day 49 (34 kg liveweight approx).

Abstract P105: Associations of Childhood Obesity With Cardiometabolic Risk Factors by Era of Birth: The I3c Consortium

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Jessica G Woo ◽  
Lydia A Bazzano ◽  
Trudy L Burns ◽  
Stephen R Daniels ◽  
Terence Dwyer ◽  
...  
Keyword(s):  
Childhood Obesity ◽  
Children And Adolescents ◽  
High Glucose ◽  
Weight Status ◽  
Cardiometabolic Risk ◽  
Study Cohort ◽  
High Tc ◽  
The Past ◽  
Low Hdl ◽  
Logistic Regressions

Introduction: The prevalence of childhood obesity has increased dramatically over the past several decades, but it is unclear whether children and adolescents with obesity are experiencing more or fewer cardiometabolic risks from obesity now compared with several decades ago. This study leverages data from over 2600 children and adolescents with obesity born from 1951-1996 to determine whether relationships of obesity with cardiometabolic risk have changed over time. Methods: The first study visit, age 3-19, was used to classify individuals by era of birth (quartiles: 1951-1963, 1964-1969, 1970-1974, 1975-1996), weight status (obesity defined as BMI>CDC 95 th %ile and <120% of the 95 th %ile), high BP (SBP or DBP>95 th %ile), high total cholesterol (TC>170 mg/dl), high LDL-C (>110 mg/dl), high triglycerides (TG>100 mg/dl), high glucose (>100 mg/dl), and low HDL-C (<40 mg/dl males, <50 mg/dl females). Participants with obesity (excluding severe obesity) were included in this analysis. Logistic regressions were adjusted for age, sex, race and study cohort to calculate odds ratios relative to the most recent era of birth (1975-1996). Results: The prevalence of childhood obesity increased from 6.1% in the earliest birth era to 7.7% in the most recent (p<0.0001). The adjusted odds of children with obesity having high TC (p<0.0001), high TG (p<0.0001), and high BP (p=0.003) were half as likely among children born between 1964-69 or 1970-74, compared with the most recent birth era (Table). The odds of children with obesity having high LDL (p=0.59), low HDL (p=0.17) or high glucose (0.33) did not differ across birth eras. Conclusions: Childhood obesity in more recent decades has not only become more prevalent, but is associated with greater risks of high TC, high TG and high BP. However, the risks of high LDL, low HDL and high glucose have not significantly changed among children with obesity who were born between 1951 and 1996. Thus, comparisons of children or adolescents with obesity across eras should consider these differing risk profiles.

scholarly journals 2765. Pediatric Mumps during the 2015–2017 Mumps Resurgence in the United States

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S975-S975
Author(s):  
Mariel Marlow ◽  
John Zhang ◽  
Nakia S Clemmons ◽  
Mona Marin ◽  
Manisha Patel ◽  
...  
Keyword(s):  
United States ◽  
Children And Adolescents ◽  
Surveillance System ◽  
Pediatric Patients ◽  
Age Groups ◽  
Exposure Period ◽  
The United States ◽  
College Campuses ◽  
Control And Prevention ◽  
Low Rate

Abstract Background Numerous mumps outbreaks occurred in the United States over the last decade, with outbreaks affecting young adults on college campuses being among the largest and most widely publicized. However, at least half of mumps cases and outbreaks occurred in other age-groups and settings. We describe reported mumps cases among children and adolescents during 2015 through 2017. Methods The Centers for Disease Control and Prevention (CDC) analyzed reports of confirmed and probable mumps cases in persons aged ≤18 years (defined here as pediatric mumps) transmitted electronically through the Nationally Notifiable Diseases Surveillance System (NNDSS) by the 52 reporting jurisdictions. Results Between January 1, 2015 and December 31, 2017, 49 jurisdictions reported 4,886 pediatric mumps cases (35% of all US reported cases, 13,807); 8 jurisdictions reported >100 cases each, representing 82% of all pediatric cases. Overall, 29 (1%) cases were in infants <1 yr, 406 (8%) were in children aged 1–4 years, 1,408 (29%) in children aged 5–10 years, 1,365 (28%) in adolescents aged 11–14 years, and 1,678 (34%) in adolescents aged 15–18 years. Most (3,548, 73%) cases did not travel outside the state during their exposure period; only 37 (1%) traveled outside the country. Cases in patients aged 1–4 years were more frequently non-outbreak associated (38%) than those in patients <1 years and 5–18 years (24% and 9%, respectively). Among 3,309 (68%) patients with known number of MMR doses received, 81% of those 5–18 years had ≥2 MMR doses, while 67% of those 1–4 years had ≥1 dose. Median time since last MMR dose for patients with 2 doses was 8 years (IQR: 4, 11 years). Four patients had meningitis and 1 had encephalitis; all were ≥10 years old and previously received 2 MMR doses. Of male mumps patients older than 10 years of age (2,113), 46 (2%) reported having orchitis; of these, 33 (72%) had 2 MMR doses. Sixty-four patients were hospitalized and there were no deaths. Conclusion About one-third of cases reported during the recent US mumps resurgence were in children and adolescents. The low rate of mumps complications compared with previous studies suggests mumps complications may not be adequately captured in national surveillance or identified by providers. Providers should remain vigilant that mumps can still occur among fully vaccinated pediatric patients, even those recently vaccinated. Disclosures All authors: No reported disclosures.

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