Perspectives on the Management of Children in a Biocontainment Unit: Report of the NETEC Pediatric Workgroup.

During the outbreak of Ebola virus disease that struck West Africa during 2014-2016, a small handful of expatriate patients were evacuated to specialized high-level containment care units, or biocontainment units, in the United States and Western Europe. Given the lower mortality rate (18% versus 40% for those treated in Africa) among these patients, it is likely that high-level containment care will be used in the future with increasing frequency. It is also likely that children infected with Ebola and other highly hazardous communicable diseases will someday require such care.

Management of the Pediatric Patient Following Upper Extremity Replantation or Revascularization: A Suggested Protocol.

Background: Traumatic pediatric amputations of the hand and upper extremity can have long-term financial, psychological, developmental, and functional consequences that readily extend beyond the realm of that which is normally encountered in comparatively injured adults. These factors, along with a paucity of medical comorbidities, have guided a more liberal and aggressive approach to treating pediatric amputations in hopes of optimizing psychosocial, aesthetic, and developmental outcomes. Furthermore, advances in pharmacology and microsurgical replantation techniques have allowed what were otherwise exceedingly rare surgeries to become commonplace in hospitals all over the world.

Sustained hypoxia promotes the development of a pulmonary artery-specific chronic inflammatory microenvironment.

Recent studies demonstrate that sustained hypoxia induces the robust accumulation of leukocytes and mesenchymal progenitor cells in pulmonary arteries (PAs). Since the factors orchestrating hypoxia-induced vascular inflammation are not well-defined, the goal of this study was to identify mediators potentially responsible for recruitment to and retention and differentiation of circulating cells within the hypoxic PA. We analyzed mRNA expression of 44 different chemokine/chemokine receptor, cytokine, adhesion, and growth and differentiation genes in PAs obtained via laser capture microdissection in adjacent lung parenchyma and in systemic arteries by RT-PCR at several time points of hypoxic exposure (1, 7, and 28 days) in Wistar-Kyoto rats.

[Management of the acute respiratory distress syndrome].

Objective: To review the current support and treatment strategies of the acute respiratory distress syndrome.

Data Sources: Original data from our research laboratory and from representative scientific articles on acute respiratory distress syndrome and acute lung Injury searched through Medline.

Summary Of The Findings: Despite advances in the understanding of the pathogenesis of acute respiratory distress syndrome, this syndrome still results in significant morbidity and mortality.

[Treatment of intracranial hypertension].

Objectives: To review the current therapeutic approach of intracranial hypertension in pediatric patients admitted to intensive care unit.

Sources Of Data: Bibliographic review of the subject based on Medline.

Summary Of The Findings: The authors noticed that some measures to control intracranial hypertension are consensual, and others remain controversial.