es/iode’s Post

Clinical Presentation and Outcomes of Myocarditis Among the COVID-19 Pediatric Population: A Review of 100 Cases Abstract Background: COVID-19 has been associated with myocarditis in the pediatric population, leading to severe cardiac complications. Objective: To determine the clinical presentations and outcomes of myocarditis among the COVID-19-positive pediatric population. Materials and methods: This retrospective cross-sectional study included 100 cases from the Saidu Group of Teaching Hospitals, Swat. Inclusion criteria involved children of both genders, confirmed COVID-19 by PCR, and a myocarditis diagnosis. Exclusion criteria were other comorbid conditions, incomplete records, and age over five years. Data included age, gender, weight, clinical features, cardiac enzyme levels, ejection fraction, PCR results, immunoglobulin treatment, outcomes, and hospital stay duration. Statistical analysis was performed in SPSS employing descriptive statistics, chi-square tests, and Fisher's exact tests. Results: The mean age was 24.72±18.67 months, with 67 males and 33 females. Irritability was noted in 18 children, cyanosis in 27, and cough in 74. Tachycardia was observed in 91 children. Elevated cardiac enzymes and positive Troponin-I levels were found in 91 and 84 children, respectively. The mean ejection fraction was 36.29±9.12%. The average hospital stay was 7.11±2.49 days. Among 100 children, 26 died while 74 recovered. Immunoglobulin administration showed no significant difference between the expired and improved groups (p=0.6). Longer hospital stays were associated with mortality (p=0.002). Troponin-I levels were significantly higher in the expired group (p=0.01). Conclusion: Key factors associated with poor outcomes include low ejection fraction, elevated cardiac enzymes, positive Troponin-I levels, and shorter hospital stays. ***Click on image in banner below to access entire study results, its authors and their references. Posted by Larry Cole EXecutive Director of Covid Impact 360

T2 Biosystems has received FDA clearance to market its T2Candida Panel for paediatric patients, expanding the use of this rapid diagnostic test for detecting Candida species that cause sepsis. The T2Candida Panel is the only FDA-cleared test that can directly detect Candida species from blood samples in just 3-5 hours, without requiring a positive blood culture first. It runs on the T2Dx Instrument and can detect five Candida species that account for up to 95% of Candida bloodstream infections in the US. T2 Biosystems CEO John Sperzel stated: "This FDA clearance marks another important milestone in our commitment to expand the clinical utility of our sepsis test panels and allows our commercial team to immediately begin marketing and selling our test to over 200 children's hospitals in the US." Studies have shown significant advantages of the T2Candida Panel for paediatric patients: 🔹 A study at Bambino Gesù hospital in Rome found the T2Candida Panel provided results 121.8 hours faster than blood cultures and detected additional infections missed by blood culture. 🔹 A prospective study published in Clinical Infectious Diseases found the T2Candida Panel had the highest sensitivity and specificity among four pre-blood culture tests for detecting invasive candidiasis in paediatric patients. This expanded FDA clearance allows T2 Biosystems to market the T2Candida Panel to children's hospitals across the US, potentially improving outcomes for paediatric patients by enabling faster targeted antifungal treatment. https://lnkd.in/gseUxZiX Stay informed and ahead of the curve by following Practical Patient Care on LinkedIn for the latest industry news and insights! #PracticalPatientCare #T2Biosystems #FDAApproval #PediatricCare #SepsisDetection

Comparing the Prevalence and Characteristics of Chest Pain in Children and Adolescents Pre- and Post-COVID-19: A Retrospective Study Abstract Background: Chest pain is a common complaint among pediatric patients, often leading to visits to Emergency Departments or outpatient clinics. While most cases are benign, timely diagnosis is essential to prevent fatalities in those with serious conditions. The COVID-19 pandemic has shifted healthcare dynamics, necessitating an understanding of its impact on pediatric health, including potential complications such as chest pain, fever, cough, shortness of breath, sore throat, and headache. This study aims to explore the prevalence, characteristics, and potential association between COVID-19 and chest pain in children during two time periods: 2019 (before the COVID-19 pandemic) and 2021 (the full year during the pandemic). Methodology: Data were collected from medical records and telephone interviews with pediatric patients presenting with chest pain at the University of Jordan Hospital. The study included a sample size of 3294 patients with selection criteria based on presenting symptoms and COVID-19 status. Data collection occurred from 2019 and 2021, and demographic information (age, gender, weight), medical history (perinatal and family history), COVID-19 status (vaccination, infection history), and details about chest pain (frequency, onset) were documented. Statistical analyses were performed to evaluate differences between the two time periods using IBM SPSS Statistics for Windows, Version 28 (Released 2021; IBM Corp., Armonk, New York, United States). ***Click on logo in banner below to access the entire study, its authors and their references. Posted by Larry Cole Executive Director of Covid Impact 360

Thrilled to share our latest publication: "Oral versus intravenous empirical antibiotics in children and adolescents with uncomplicated bone and joint infections: a nationwide, randomised, controlled, non-inferiority trial in Denmark." The study, conducted across 18 pediatric hospital departments, explores whether initial oral antibiotics are as effective as intravenous therapy for treating uncomplicated bone and joint infections (BJIs) in children and adolescents. 💡 Key Findings: Initial oral antibiotic treatment was non-inferior to intravenous antibiotics followed by oral therapy. None of the patients in either group experienced sequelae after 6 months. Similar rates of adverse events and surgeries were observed in both groups. No serious complications were reported. 🌟 Implications: Oral antibiotics can reduce healthcare costs, eliminate the need for intravenous catheters, and allow for home-based treatment. This aligns with antimicrobial stewardship principles and challenges the standard recommendation of initial intravenous treatment for BJIs. We believe these results are promising and could transform the approach to treating uncomplicated BJIs in children and adolescents. Read the full study here: https://lnkd.in/d-RPF8EQ #Pediatrics #InfectiousDiseases #Antibiotics #ClinicalResearch #HealthcareInnovation #AntimicrobialStewardship #BJIStudy #MedicalResearch #OralAntibiotics #IVAntibiotics #ChildHealth #HealthcareCosts #HomeTreatment #MedicalTrials #NonInferiorityTrial

Sobi has shared positive results from a late-stage study of Doptelet (avatrombopag) in paediatric patients with immune thrombocytopenia (ITP), a rare autoimmune disorder estimated to affect up to 100 people per million. The condition, characterised by low numbers of platelets that lead to bruising and an increased risk of bleeding, occurs in five out of 100,000 children per year. There is currently no cure available and patients usually relapse after various treatments, yet they still require treatment to reduce the risk of clinically significant bleeding. Sobi’s Doptelet, an orally administered thrombopoietin receptor agonist that works to increase platelet count, is already approved in the US and EU to treat certain adults with chronic ITP. It is hoped that data from the phase 3 AVA-PED-301 study, which has been evaluating Doptelet against placebo in eligible children and adolescents with ITP, will support global regulatory filings for the use of the therapy in this patient population. Lydia Abad-Franch, head of research, development and medical affairs, and chief medical officer at Sobi, said: “Considering the challenges in treatment administration, coupled with variable and transient responses, frequent relapses and associated toxicities from existing therapies, an unmet medical need currently exists in managing ITP among children and adolescents.” AVA-PED-301’s primary endpoint of durable platelet response was met in 28% of Doptelet-treated patients in comparison to 0% of those in the placebo cohort. The key secondary endpoint of two consecutive platelet counts was also met in 81.5% of patients receiving Doptelet, compared with 0% in the placebo arm. Additionally, a platelet response at day eight was observed in 56% of Doptelet-treated patients and 0% of those receiving placebo, while rescue therapy use occurred in 7% of the Doptelet group and 43% of the placebo group. Read more: https://lnkd.in/gDasUF5Q Stay in touch with all the leading stories, events and opportunities by subscribing to our LinkedIn Newsletter:https://bit.ly/3RbdKtc or joining some of the largest groups most relevant to you: https://bit.ly/4caKquL (A-Z list)

Pediatric Clinical Documentation Integrity (CDI) specialists ensure accurate and comprehensive documentation of pediatric patients' medical records. They review various diagnoses to ensure that documentation accurately reflects the severity of illness, complexity of care, and patient outcomes. Here are some common diagnoses that pediatric CDI specialists often review: 1. Respiratory Conditions: Asthma, Bronchiolitis, Pneumonia, Croup 2. Infectious Diseases: Upper respiratory infections (URIs), Otitis media, Urinary tract infections (UTIs), Skin and soft tissue infections (e.g., cellulitis) 3. Chronic Conditions: Diabetes mellitus (type 1 and type 2), Congenital heart defects, Cystic fibrosis, Juvenile idiopathic arthritis (JIA) 4. Neonatal Conditions: Neonatal jaundice, Prematurity-related complications Birth injuries, Respiratory distress syndrome (RDS), Necrotizing enterocolitis (NEC) 5. Growth and Development: Developmental delays, Growth disorders (e.g., short stature, obesity), Intellectual disabilities 6. Hematologic and Oncologic Conditions: Anemia, Leukemia, Hemophilia 7. Genetic and Congenital Disorders: Spina bifida, Cleft lip and palate, Trisomy 18 and 13, Turner syndrome 8. Injuries and Trauma: Fractures, Head injuries, Burns, Non-accidental trauma (child abuse), Sports-related injuries 9. Psychiatric and Behavioral Health Disorders: Anxiety disorders, Depression, Attention-deficit/hyperactivity disorder (ADHD), Autism spectrum disorder (ASD), Conduct disorders 10. Nutritional and Feeding Issues: Malnutrition, Feeding difficulties (e.g., dysphagia), Failure to thrive (FTT)

Pub alert 📣 Enoxaparin is a first-line anticoagulant used in the Neonatal ICU (NICU). With standard weight-based dosing, often multiple dose up-titrations are required to reach goal anti-Xa levels. In our retrospective cohort study, we employed Model-Informed Precision Dosing (MIPD), using individual infant clearance and volume estimates to customize a starting enoxaparin dose. When a PK model-guided dosing tool is employed, many infants have a recommendation for a starting dose that is HIGHER than our current standard of care. The data from this retrospective analysis was used to design dosing bounds for a prospective feasibility trial of using MIPD to individualize enoxaparin dose in neonates <44 weeks PMA. The trial will be Health Canada regulated and is possible through the support of MPRINT Hub. The Hospital for Sick Children Precision Child Health Link to paper: https://lnkd.in/gdaHTJSr

High Pediatric Hospital Mortality in LMICs: Urgent Call for Resource Allocation and Research The increasing rate of pediatric hospital deaths in low- and middle-income countries

Optimal Time to Antibiotics in Pediatric Sepsis?

A total of 146,003 HF patients were included for overall cost analysis with more patients with LVEF >40% (65.3%) compared to LVEF ≤40%. Patients with LVEF >40% were more likely to be older, female, White, and have higher systolic blood pressure and body mass index, lower natriuretic peptides, and higher costs attributed to non-HF and non-cardiovascular (CV) hospitalizations and skilled nursing facilities. Patients with LVEF ≤40% were more likely to have higher costs attributed to all-cause hospitalizations and HF or CV hospitalizations. The mean total health care costs through 1-year post-discharge were $40,557 and were similar across LVEF groups (p = 0.48) with the largest contributor to cost being all-cause hospitalization. This trial level meta-analysis of HF outcome trials demonstrated that SGLT2i significantly reduced the rate of all-cause hospitalizations (rate ratio [RR], 0.89; 95% confidence interval [CI], 0.84-0.93) and total HF hospitalizations (RR, 0.71; 95% CI, 0.66-0.76) with no evidence of heterogeneity across trials. A total of 133,914 SGLT2i-eligible patients were included for the cost-offset analysis. Applying the relative risk reduction of SGLT2i to all-cause hospitalization resulted in an anticipated mean hospitalization cost offset of $2,668 and $2,410 per patient with LVEF ≤40% and >40%, respectively. The projected mean hospitalization cost reduction for HF hospitalizations was $2,451 (LVEF ≤40%) compared to $1,439 (LVEF <40%) per patient. Using the annual US costs of SGLTi (range $2,892 to $7,428) resulted in a projected annual net cost ranging from cost excess of $5,018 to cost savings of $2,092, depending on LVEF and actual drug cost. Conclusions: This large cohort of older adults hospitalized for HF demonstrated different cause-specific costs of care between patients with LVEF ≤40% and >40%. SGLT2i significantly reduced the rate of HF and all-cause hospitalizations irrespective of LVEF in clinical trials, and optimal implementation of SGLT2i is projected to reduce costs by $1,439 to $2,668 per patient over 1-year post-discharge.