52,365 results match your criteria pediatric critical


(Re)producing "Whiteness" in Health Care: A Spatial Analysis of the Critical Literature on the Integration of Internationally-Educated Health Care Professionals in the Canadian Workforce.

Acad Med 2021 Aug 3. Epub 2021 Aug 3.

T.O. Mickleborough is a postdoctoral fellow, The Wilson Centre, University of Toronto and University Network, Toronto, Ontario, Canada; ORCID: https://orcid.org/0000-0002-4796-0282. M.A. Martimianakis is associate professor, Department of Pediatrics, University of Toronto and Hospital for Sick Children, and scientist, The Wilson Centre, University of Toronto and University Health Network, Toronto, Ontario, Canada; ORCID: https://orcid.org/0000-0002-2531-3156.

Purpose: There is a gap in the literature to understand how professionalizing systems intersect with socioeconomic and political realities such as globalization to (re)produce social inequities between those trained locally and those trained abroad. In this critical review, the question of how systemic racism is reproduced in health care is addressed.

Method: Electronic databases and non-traditional avenues for searching literature such as reference chaining and discussions with experts were employed to build an archive of texts related to integration of internationally-educated health care professionals (IEHP) into the workforce. Read More

View Article and Full-Text PDF

Therapeutic effects of vitamin D and IL-22 on methotrexate-induced mucositis in mice.

Anticancer Drugs 2021 Aug 3. Epub 2021 Aug 3.

Division of Pediatric Hematology and Oncology, Department of Pediatrics, Erciyes University School of Medicine Molecular Biology and Genetics, Betül-Ziya Eren Genome and Stem Cell Center (GENKOK) Department of Medical Biology, Erciyes University, School of Medicine Department of Histology and Embryology, Erciyes University, School of Medicine Department of Pathology, Erciyes University, School of Medicine Department of Biology, Erciyes University, Faculty of Science Department of Chemistry and Chemical Processing Technologies, Kayseri University, Mustafa Çikrikçioğlu Vocational School Department of Biology, Faculty of Arts and Science, Yozgat Bozok University, Yozgat, Turkey.

Mucositis is a common side effect of cancer therapies and transplant conditioning regimens. Management of mucositis involves multiple approaches from oral hygiene, anti-inflammatory, anti-apoptotic, cytoprotective, and antioxidant agents, to cryo-therapy, physical therapy, and growth factors. There is room for novel, affordable treatment options, or improvement of currently available therapies. Read More

View Article and Full-Text PDF

The COVIDome Explorer researcher portal.

Cell Rep 2021 Jul 28:109527. Epub 2021 Jul 28.

Linda Crnic Institute for Down Syndrome, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; Department of Pharmacology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA. Electronic address:

COVID-19 pathology involves dysregulation of diverse molecular, cellular, and physiological processes. To expedite integrated and collaborative COVID-19 research, we completed multi-omics analysis of hospitalized COVID-19 patients, including matched analysis of the whole-blood transcriptome, plasma proteomics with two complementary platforms, cytokine profiling, plasma and red blood cell metabolomics, deep immune cell phenotyping by mass cytometry, and clinical data annotation. We refer to this multidimensional dataset as the COVIDome. Read More

View Article and Full-Text PDF

Identification of potential biomarkers in dengue via integrated bioinformatic analysis.

PLoS Negl Trop Dis 2021 Aug 4;15(8):e0009633. Epub 2021 Aug 4.

Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

Dengue fever virus (DENV) is a global health threat that is becoming increasingly critical. However, the pathogenesis of dengue has not yet been fully elucidated. In this study, we employed bioinformatics analysis to identify potential biomarkers related to dengue fever and clarify their underlying mechanisms. Read More

View Article and Full-Text PDF

North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Position Paper on the Diagnosis and Management of Pediatric Acute Liver Failure.

J Pediatr Gastroenterol Nutr 2021 Aug 3. Epub 2021 Aug 3.

Division of Gastroenterology, Hepatology and Nutrition, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA Department Pediatric Hepatology, Ann and Robert H Lurie Children's Hospital, Chicago, Illinois, USA Department of Pediatrics, Division of Pediatric Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN Division of Pediatric Gastroenterology, Nutrition and Liver Diseases, Hasbro Children's Hospital, Providence, RI Division of Pediatric Gastroenterology, Hepatology and Nutrition, Children Hospital of Eastern Ontario, Ottawa, Ontario, Canada Department of Pediatrics, Vagelos College of Physician and Surgeons, Columbia University, New York, NY.

Abstract: Pediatric acute liver failure (PALF) is a rare, rapidly progressive clinical syndrome with significant morbidity and mortality. The phenotype of PALF manifests as abrupt onset liver dysfunction, which can be brought via disparate etiology. Management is reliant upon intensive clinical care and support, often provided by the collaborative efforts of hepatologists, critical care specialists, and liver transplant surgeons. Read More

View Article and Full-Text PDF

Creation and Validation of a Shorthand Magnetic Resonance Imaging Bone Age Assessment Tool of the Knee as an Alternative Skeletal Maturity Assessment.

Am J Sports Med 2021 Aug 4:3635465211032986. Epub 2021 Aug 4.

Rady Children's Hospital, San Diego, California, USA.

Background: In managing pediatric knee conditions, an accurate bone age assessment is often critical for diagnostic, prognostic, and treatment purposes. Historically, the Greulich and Pyle atlas (hand atlas) has been the gold standard bone age assessment tool. In 2013, a shorthand bone age assessment tool based on this atlas (hand shorthand) was devised as a simpler and more efficient alternative. Read More

View Article and Full-Text PDF

Impact of COVID-19 on Acute Viral Bronchiolitis Hospitalization Among Infants in North India.

Indian J Pediatr 2021 Aug 4. Epub 2021 Aug 4.

Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.

View Article and Full-Text PDF

Obesity-related IL-18 Impairs Treg Function and Promotes Lung Ischemia-reperfusion Injury.

Am J Respir Crit Care Med 2021 Aug 4. Epub 2021 Aug 4.

University of Pennsylvania, 6572, Division of Transplant Immunology, Department of Pathology and Laboratory Medicine, Philadelphia, Pennsylvania, United States.

Rationale: Primary graft dysfunction (PGD) is a severe form of acute lung injury, leading to increased early morbidity and mortality after lung transplantation. Obesity is a major health problem, and recipient obesity is one of the most significant risk factors for developing PGD.

Objectives: We hypothesized that T-regulatory (Treg) cells are able to dampen early ischemia/reperfusion events and thereby decrease risk of PGD, whereas that action is impaired in obese recipients. Read More

View Article and Full-Text PDF

Canine-to-Human Transmission of Mycoplasma canis in the Central Nervous System.

J Pediatric Infect Dis Soc 2021 Aug 4. Epub 2021 Aug 4.

Division of Infectious Diseases, Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Dog bites remain a common occurrence in our society, particularly in toddlers and small children under the age of 2. Injuries to the head and face, more common in younger children, can often lead to significant morbidity. Additionally, there continues to be considerable clinical equipoise for standardized post-dog bite injury management. Read More

View Article and Full-Text PDF

Systematic evaluation of transcriptomics-based deconvolution methods and references using thousands of clinical samples.

Brief Bioinform 2021 Aug 3. Epub 2021 Aug 3.

Department of Clinical Pharmacy, School of Pharmacy, University of Southern California, 1540 Alcazar Street, Los Angeles, CA 90033, USA.

Estimating cell type composition of blood and tissue samples is a biological challenge relevant in both laboratory studies and clinical care. In recent years, a number of computational tools have been developed to estimate cell type abundance using gene expression data. Although these tools use a variety of approaches, they all leverage expression profiles from purified cell types to evaluate the cell type composition within samples. Read More

View Article and Full-Text PDF

Expanding the KIF4A-associated phenotype.

Am J Med Genet A 2021 Aug 3. Epub 2021 Aug 3.

Medical Genetics, Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland.

Kinesin super family (KIF) genes encode motor kinesins, a family of evolutionary conserved proteins, involved in intracellular trafficking of various cargoes. These proteins are critical for various physiological processes including neuron function and survival, ciliary function and ciliogenesis, and cell-cycle progression. Recent evidence suggests that alterations in motor kinesin genes can lead to a variety of human diseases, including monogenic disorders. Read More

View Article and Full-Text PDF

Interleukin-7 Reverses Lymphopenia and Improves T-Cell Function in Coronavirus Disease 2019 Patient With Inborn Error of Toll-Like Receptor 3: A Case Report.

Crit Care Explor 2021 Jul 14;3(7):e0500. Epub 2021 Jul 14.

Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO.

Background: Immunotherapy treatment for coronavirus disease 2019 combined with antiviral therapy and supportive care remains under intense investigation. However, the capacity to distinguish patients who would benefit from immunosuppressive or immune stimulatory therapies remains insufficient. Here, we present a patient with severe coronavirus disease 2019 with a defective immune response, treated successfully with interleukin-7 on compassionate basis with resultant improved adaptive immune function. Read More

View Article and Full-Text PDF

Establishing a multidisciplinary initiative for interoperable electronic health record innovations at an academic medical center.

JAMIA Open 2021 Jul 31;4(3):ooab041. Epub 2021 Jul 31.

Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA.

Objective: To establish an enterprise initiative for improving health and health care through interoperable electronic health record (EHR) innovations.

Materials And Methods: We developed a unifying mission and vision, established multidisciplinary governance, and formulated a strategic plan. Key elements of our strategy include establishing a world-class team; creating shared infrastructure to support individual innovations; developing and implementing innovations with high anticipated impact and a clear path to adoption; incorporating best practices such as the use of Fast Healthcare Interoperability Resources (FHIR) and related interoperability standards; and maximizing synergies across research and operations and with partner organizations. Read More

View Article and Full-Text PDF

A Quality Improvement Initiative to Improve Discharge Timeliness and Documentation.

Pediatr Qual Saf 2021 Jul-Aug;6(4):e440. Epub 2021 Jul 28.

Department of Pediatrics, Rady Children's Hospital, University of California San Diego, San Diego, Calif.

Introduction: Discharge communication is critical for the continuity of patient care. However, discharge summaries are often not available in time for follow-up visits, and the content is inconsistent. We aimed to decrease the average time to discharge summary completion by 25%, reduce deficiencies (information errors) by 50%, and increase discharge summary template use to >80% in 6 months. Read More

View Article and Full-Text PDF

Standardized Neurodevelopmental Surveillance of High-risk Infants Using Telehealth: Implementation Study during COVID-19.

Pediatr Qual Saf 2021 Jul-Aug;6(4):e439. Epub 2021 Jul 28.

Neonatal Network, Nationwide Children's Hospital, Columbus, Ohio.

Introduction: Neurodevelopmental surveillance is critical for high-risk infants following neonatal intensive care discharge and is traditionally performed in-person. COVID-19 interruption of regular surveillance necessitated a rapid development of telehealth models for effective and standardized care.

Methods: We used implementation science and lean methodologies to develop an effective telehealth neurodevelopmental surveillance program for high-risk infants. Read More

View Article and Full-Text PDF

A Quality Improvement Approach to Influence Value-based Mucolytic Use in the PICU.

Pediatr Qual Saf 2021 Jul-Aug;6(4):e438. Epub 2021 Jul 28.

Division of Pediatric Critical Care Medicine, Department of Pediatrics, The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus, Ohio.

Introduction: High-cost medication administration, despite lacking evidence for use, results in poor healthcare value. This work aimed to reduce dornase-alfa utilization in critically ill mechanically ventilated children.

Methods: The project employed an observational pre-post design to develop a value-based clinical pathway to guide provider choice in mucolytic utilization in a quaternary pediatric intensive care unit. Read More

View Article and Full-Text PDF

Quantifying Discharge Medication Reconciliation Errors at 2 Pediatric Hospitals.

Pediatr Qual Saf 2021 Jul-Aug;6(4):e436. Epub 2021 Jul 28.

Division of Pediatric Critical Care Medicine, Department of Pediatrics, Seattle Children's Hospital, Seattle, Wash.

Introduction: Medication reconciliation errors (MREs) are common and can lead to significant patient harm. Quality improvement efforts to identify and reduce these errors typically rely on resource-intensive chart reviews or adverse event reporting. Quantifying these errors hospital-wide is complicated and rarely done. Read More

View Article and Full-Text PDF

Simulation-based User-centered Design: An Approach to Device Development during COVID-19.

Pediatr Qual Saf 2021 Jul-Aug;6(4):e427. Epub 2021 Jul 28.

Department of Pediatrics, Division of Pediatric Critical Care, Children's Healthcare of Atlanta, Atlanta, Ga.

Introduction: Since the onset of COVID-19, intubations have become very high risk for clinical teams. Barrier devices during endotracheal intubation protect clinicians from the aerosols generated. Simulation-based user-centered design (UCD) was an iterative design process used to develop a pediatric intubation aerosol containment system (IACS). Read More

View Article and Full-Text PDF

Crucial Role of Mammalian Glutaredoxin 3 in Cardiac Energy Metabolism in Diet-induced Obese Mice Revealed by Transcriptome Analysis.

Int J Biol Sci 2021 13;17(11):2871-2883. Epub 2021 Jul 13.

USDA/ARS Children Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas 77030, USA.

Obesity is often associated with metabolic dysregulation and oxidative stress with the latter serving as a possible unifying link between obesity and cardiovascular complications. Glutaredoxins (Grxs) comprise one of the major antioxidant systems in the heart. Although Grx3 has been shown to act as an endogenous negative regulator of cardiac hypertrophy and heart failure, its metabolic impact on cardiac function in diet-induced obese (DIO) mice remains largely unknown. Read More

View Article and Full-Text PDF

Japanese B Encephalitis.

Indian J Crit Care Med 2021 May;25(Suppl 2):S171-S174

Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

RNA viruses are not only reported for viral pandemics but also as important agents for emerging/re-emerging diseases. (JEV) is reported to cause epidemics of encephalitis in Southeast Asia, India, Korea, China, and Indonesia. In addition, several reports show that JEV has spread to new populations beyond these geographical regions. Read More

View Article and Full-Text PDF

Classification of psychiatric symptoms using deep interaction networks: the CASPIAN-IV study.

Sci Rep 2021 Aug 3;11(1):15706. Epub 2021 Aug 3.

Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.

Identifying the possible factors of psychiatric symptoms among children can reduce the risk of adverse psychosocial outcomes in adulthood. We designed a classification tool to examine the association between modifiable risk factors and psychiatric symptoms, defined based on the Persian version of the WHO-GSHS questionnaire in a developing country. Ten thousand three hundred fifty students, aged 6-18 years from all Iran provinces, participated in this study. Read More

View Article and Full-Text PDF

Pre-pregnancy BMI-associated miRNA and mRNA expression signatures in the placenta highlight a sexually-dimorphic response to maternal underweight status.

Sci Rep 2021 Aug 3;11(1):15743. Epub 2021 Aug 3.

Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Pre-pregnancy body mass index (BMI) is associated with adverse pregnancy and neonatal health outcomes, with differences in risk observed between sexes. Given that the placenta is a sexually dimorphic organ and critical regulator of development, examining differences in placental mRNA and miRNA expression in relation to pre-pregnancy BMI may provide insight into responses to maternal BMI in utero. Here, genome-wide mRNA and miRNA expression levels were assessed in the placentas of infants born extremely preterm. Read More

View Article and Full-Text PDF

Immunization with HMW1 and HMW2 adhesins protects against colonization by heterologous strains of nontypeable .

Proc Natl Acad Sci U S A 2021 Aug;118(32)

Department of Microbiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104;

Nontypeable (NTHi) is a common cause of localized respiratory tract disease and results in significant morbidity. The pathogenesis of NTHi disease begins with nasopharyngeal colonization, and therefore, the prevention of colonization represents a strategy to prevent disease. The NTHi HMW1 and HMW2 proteins are a family of conserved adhesins that are present in 75 to 80% of strains and have been demonstrated to play a critical role in colonization of the upper respiratory tract in rhesus macaques. Read More

View Article and Full-Text PDF

Risk factors and predictors that influence SARS-Cov-2 IgG positivity: A cross-sectional study of blood donors in Riyadh, Saudi Arabia.

Saudi Med J 2021 Aug;42(8):853-861

From the Department of Pediatrics (Alosaimi, Almazyad), College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia; from the College of Medicine Research Center (Alosaimi), King Saud University, Riyadh, Kingdom of Saudi Arabia; from the Department of Pathology and Laboratory Medicine (Alhetheel, Hasanato), King Saud University, Riyadh, Kingdom of Saudi Arabia.; from the College of Medicine (Aleisa, Altwerki, Alenezy, Almutairi), King Saud University, Riyadh, Kingdom of Saudi Arabia; from the Blood Bank (Khalid), King Saud University, Riyadh, Kingdom of Saudi Arabia; from the Department of Medicine (Alayed), College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia; from the Department of Family and Community Medicine (BinMoammar, Alshobaili); from the Division of Infectious Disease, Department of Internal Medicine (Al-Shahrani), King Saud University, Riyadh, Kingdom of Saudi Arabia; and from the Pediatric Infectious Diseases Unit, Department of Pediatrics, (Alsubaie), College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.

Objectives: To study the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after pandemic's peak and before the vaccine enrollment in Riyadh, Saudi Arabia and further explore predictors for SARS-CoV-2 positivity.

Methods: A cross-sectional study of 515 blood donors from November 22 to December 17, 2020 was conducted at King Saud University Medical City, Riyadh, Saudi Arabia to look at SARS-CoV-2 immunoglobulin G (IgG) positivity. The participants were asked questions about their demographic characteristics, past SARS-CoV-2 infection, SARS-CoV-2-related symptoms and exposures. Read More

View Article and Full-Text PDF

A 13-Year-Old With Fever and Chest Pain.

Pediatrics 2021 Aug 3. Epub 2021 Aug 3.

Cardiology.

A 13-year-old boy with a recent diagnosis of ulcerative colitis presented with fever and chest pain to the emergency department. The sharp pain had begun 2 days previous and radiated to his shoulders. It was constant, although it improved with sitting up and leaning forward. Read More

View Article and Full-Text PDF

Ensuring administration of first dose of antibiotics within the golden hour of management in neonates with sepsis.

BMJ Open Qual 2021 Jul;10(Suppl 1)

Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Administration of first dose of antibiotics within the golden hour in infants with sepsis is critical. Delays can increase mortality. During our observations as part of antibiotic stewardship programme in inborn neonatal unit, we found a significant delay in the administration of first dose of antibiotics from the decision time. Read More

View Article and Full-Text PDF

Clinical performance of posterior monolithic zirconia implant-supported fixed dental prostheses with angulated screw channels: A 3-year prospective cohort study.

J Prosthet Dent 2021 Jul 31. Epub 2021 Jul 31.

Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio.

Statement Of Problem: The choice of retention type of an implant-supported fixed dental prosthesis (FDP) becomes critical when the dental implant is not placed in a prosthetically ideal location. In recent years, computer-aided design and computer-aided manufacturing (CAD-CAM) technology has enabled the correction of the location of screw access hole depending on the clinical needs of the patient. However, how FPDs with angulated screw channels (ASCs) perform clinically is unclear. Read More

View Article and Full-Text PDF

Abnormal sleep physiology in children with 15q11.2-13.1 duplication (Dup15q) syndrome.

Mol Autism 2021 Aug 3;12(1):54. Epub 2021 Aug 3.

Children's Hospital Los Angeles, Los Angeles, CA, USA.

Background: Sleep disturbances in autism spectrum disorder (ASD) represent a common and vexing comorbidity. Clinical heterogeneity amongst these warrants studies of the mechanisms associated with specific genetic etiologies. Duplications of 15q11. Read More

View Article and Full-Text PDF

Thrombomodulin is associated with increased mortality and organ failure in mechanically ventilated children with acute respiratory failure: biomarker analysis from a multicenter randomized controlled trial.

Crit Care 2021 Aug 3;25(1):271. Epub 2021 Aug 3.

Division of Pediatric Critical Care, Department of Pediatrics, University of California, Los Angeles, Los Angeles, CA, USA.

Background: Acute respiratory failure (ARF) can progress to acute respiratory distress syndrome and death. Biomarkers may allow for risk stratification and prognostic enrichment in ARF. Thrombomodulin (TM) is a transmembrane antithrombotic mediator expressed in endothelial cells. Read More

View Article and Full-Text PDF