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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

🚨 Revolutionary Sepsis Protocol Saves Lives in Pediatric Oncology! 🚨 A groundbreaking sepsis management strategy in a pediatric hematology-oncology unit has achieved a remarkable milestone—zero sepsis-related deaths! This significant advancement highlights the critical importance of innovative healthcare solutions for vulnerable children battling severe illnesses. 🔍 Key Highlights: - Sepsis Algorithm Implementation: A comprehensive protocol that integrates continuous education for nurses, quality improvement techniques, and proactive prevention measures. - 📈 Impressive Results: - 10.7% increase in compliance with the algorithm. - 24.7% rise in timely antibiotic administration within the crucial one-hour window. This initiative underscores how structured education and timely interventions can drastically improve patient outcomes and safety. 🌟 The success of this protocol not only showcases the vital role of well-trained nursing staff but also serves as a scalable model that other pediatric units can adopt to combat sepsis effectively. Let's continue to prioritize child healthcare and explore innovative solutions! 👉 Click to learn more about this transformative achievement! #ClinicalResearches #HealthcareInnovation #NursingExcellence #PediatricHealth #SepsisAwareness #MarketAccess #MarketAccessToday

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)

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

This groundbreaking discovery of a genetic signature to predict neonatal sepsis could dramatically improve early diagnosis and treatment, especially in regions where resources are limited. Led by a research team from UBC, SFU, and the MRC Unit in The Gambia, the study identifies a set of four genes that together form a predictive signature, reliably indicating the risk of sepsis in newborns up to 90% of the time. Such early identification is crucial, as neonatal sepsis, affecting around 1.3 million babies annually and claiming 200,000 lives, can result in severe developmental and cognitive consequences if not treated promptly. The breakthrough could be transformative for neonatal care, particularly in regions where resources are limited. Identifying a genetic signature for sepsis is an incredible step forward—not just from a scientific perspective but in terms of real-world impact on public health. The possibility of integrating this into point-of-care devices is, frankly, revolutionary. Bringing sepsis diagnostics to the bedside could mean earlier intervention, fewer neonatal deaths, and a reduction in the long-term complications that often result from delayed treatment. This research has the potential to fundamentally change the way we care for our most vulnerable infants.

A Year in Review – The 2023 Critical Care and Resuscitation literature. 📚🩺 - The DEVICE Trial compared direct and video laryngoscopy in critically ill adults undergoing tracheal intubation. Video laryngoscopy had a higher first-pass success rate compared to direct laryngoscopy. Operator experience played a role in the success of video laryngoscopy. Location (ED or ICU) did not significantly impact the success of video laryngoscopy. Anticipated difficulty of intubation did not affect the success of video laryngoscopy. - The INCEPTION trial compared extracorporeal CPR (ECPR) to conventional CPR in patients with refractory out-of-hospital cardiac arrest. There was no significant difference in survival with a favorable neurologic outcome at 30 days between the two groups. - The TAME Trial compared targeted mild hypercapnia to targeted normocapnia in comatose adult patients with ROSC after out-of-hospital cardiac arrest. There was no improvement in neurologic outcomes at 6 months with targeted mild hypercapnia compared to targeted normocapnia. - The CT FIRST cohort study evaluated the diagnostic yield and safety of head-to-pelvis CT imaging in post-arrest care. The addition of a whole-body CT scan improved the diagnostic ability to identify the cause of OHCA compared to standard care alone. - The CLOVERS Trial compared a restrictive fluid strategy with early use of pressors to a liberal fluid strategy in patients with sepsis-induced hypotension. There was no significant difference in mortality before discharge home by day 90 between the two strategies. - The comparative effectiveness study of fludrocortisone and hydrocortisone versus hydrocortisone alone in patients with septic shock showed that the combination therapy reduced mortality, increased vasopressor and hospital-free days, and had no measurable impact on patient safety. - The CAPE COD Trial evaluated the administration of hydrocortisone in patients admitted to the ICU for severe community-acquired pneumonia. Hydrocortisone treatment reduced mortality at 28 days in these patients. - The van Baarle FLF et al. study evaluated the hypothesis that omitting prophylactic platelet transfusion before central venous catheter (CVC) placement in patients with platelet counts of 10,000-50,000 would not increase the risk of catheter-related bleeding. The study found that withholding prophylactic platelet transfusion before CVC placement in patients with severe thrombocytopenia resulted in more CVC-related bleeding compared to prophylactic platelet transfusion. #IntensiveCare #EmergencyMedicine #LiteratureReview #MedicalNews

Cardiopulmonary Arrest in Adults Evaluation , Differential Diagnosis , Prognosis , Complications , Deterrence and Patient Education Cardiopulmonary resuscitation should not be interrupted for doing blood or radiological investigation. However, point of care testing, like blood glucose or serum potassium may be done if it doesn't interfere with cardiopulmonary resuscitation efforts. Point of care ultrasound can also be used to evaluate the activity of the heart during cardiopulmonary resuscitation which has proved beneficial in many studies. Differential Diagnosis Patients with cardiopulmonary arrest will be pulseless and unresponsive. But there are certain conditions having clinical manifestations similar to cardiopulmonary arrest. It includes syncope, seizure, and overdose of certain medications like opioids. We should try to recognize and treat reversible causes of cardiopulmonary arrest commonly referred to as Hs and Ts. It includes- Hypovolemia Hypoxia Hypothermia Hypo/hyperkalemia Acidosis Tension pneumothorax Toxic overdose of drugs Thromboembolism/pulmonary embolism Thrombus/acute myocardial infarction Cardiac tamponade Prognosis Witnessed cardiopulmonary arrest along with immediate CPR and defibrillation have better patient survival and outcome. Healthy and young patients are more likely to obtain the return of spontaneous circulation as compared to elderly patients with known co-morbidities such as IHD. Complications Various complications can occur during cardiopulmonary resuscitation. AED failure is the most common complication. Other complications include the inability to obtain venous access, rib fracture, pneumothorax, pneumomediastinum, hemothorax, lung laceration, pulmonary hemorrhage, injury to the major vessel, and cardiac tamponade. Deterrence and Patient Education Most of the cardiopulmonary arrest occur outside hospitals. Immediate cardiopulmonary resuscitation and defibrillation are the two main intervention which has shown to improve patient outcomes. Hence, even laypersons with adequate CPR skills and training can save lives. But, sometimes even the trained person hesitate to start CPR because of a lack of confidence and cardiac arrest recognition. This points to the need for improving their skills and confidence by organizing regular training sessions and workshops.

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