Successful Endoscopic Management of Complete Tracheal Occlusion in a Child.

Prolonged mechanical ventilation following cardiopulmonary and neurological events oftentimes necessitates a tracheostomy and tracheal granulation is one of its most common late complications. The literature recommends that large granulation be managed through surgical excision or endoluminal techniques. A 6-year-old boy presented with high-grade tracheal stenosis secondary to endotracheal cuff-related injury and prolonged tracheostomy.

Procalcitonin Guided Antibiotic Stewardship in Pediatric Sepsis and Lower Respiratory Tract Infections.

Objectives: To determine the impact of procalcitonin-guided antibiotic stewardship protocol (PCT-ASP) in children admitted with sepsis and lower respiratory tract infection on the duration of antibiotic therapy and clinical outcome.

Methods: This was a single-center study involving children with infections treated with antibiotic therapy according to the PCT-ASP as the study group. The control group consisted of children with same age and diagnosis who were treated with antibiotics according to individual unit protocol before the implementation of PCT-ASP.

Understanding Childhood Constipation through the Prism of the Caretaker.

Aims: Childhood constipation is presenting with increasing frequency at pediatric surgical clinics. The caregiver's role in prevention and management is pivotal. This study aimed at determining mothers' knowledge, attitudes, and practices with regard to childhood constipation and the association of these with demographic variables.

Role of Nuclear Factor-Kappa B Activation and Inflammatory Biomarkers in Critically Ill Children.

Mortality prediction is important for cautious monitoring and optimal management of critically ill children. The serum cytokine levels are elevated early in critical illness before the physiological parameters are deranged. This cross-sectional descriptive study included the critically ill children admitted in intensive care unit.

Nuclear Mitochondrial Disorder Due to a Variant in NAXE in Two Unrelated Indian Children.

Progressive encephalopathy with brain edema and/or leukoencephalopathy type 1 (PEBEL1) is a nuclear mitochondrial disorder involving the NAD(P)HX repair mechanism due to a NAXE variation. PEBEL1 is characterized by rapid neurologic deterioration culminating in death following high-grade fever during infancy. Currently, 23 patients from 14 families are described in the literature, with only three survivors.

Sirtuin 6 inhibition protects against glucocorticoid-induced skeletal muscle atrophy by regulating IGF/PI3K/AKT signaling.

Chronic activation of stress hormones such as glucocorticoids leads to skeletal muscle wasting in mammals. However, the molecular events that mediate glucocorticoid-induced muscle wasting are not well understood. Here, we show that SIRT6, a chromatin-associated deacetylase indirectly regulates glucocorticoid-induced muscle wasting by modulating IGF/PI3K/AKT signaling.

Smokeless Tobacco Exposure and Fetal Iron Status: An Analytical Study.

Objectives: To compare the cord serum ferritin and fetal iron status in newborns with and without maternal occupational smokeless tobacco exposure and determine the influencing factors.

Methods: This cross-sectional study included mother-infant dyads with occupational tobacco exposure (exposed) and an unexposed group. Umbilical cord serum ferritin was compared in both groups.

The Young Heart Tears Easily Apart: A Case Report of Spontaneous Coronary Artery Dissection.

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS), seen mostly in young females. The rarity and limited knowledge of the disease make its management challenging. Prompt diagnosis of the condition is extremely important to decrease both long- and short-term complications.

Sedation Usage in COVID-19 Acute Respiratory Distress Syndrome: A Multicenter Study.

Background: Patients with COVID-19 acute respiratory distress syndrome (ARDS) have been shown to have high sedation requirements.

Objective: The purpose of this study was to compare sedative use between patients with COVID-19 ARDS and non-COVID-19 ARDS.

Methods: This was a retrospective study of patients with COVID-19 ARDS compared with historical controls of non-COVID-19 ARDS who were admitted to 2 hospitals from March 1, 2020, to April 30, 2020, and April 1, 2018, to December 31, 2019, respectively.

Lower socioeconomic factors are associated with higher mortality in patients with septic shock.

Background: Previous studies have explored the relationship between socioeconomic status and sepsis outcomes OBJECTIVES: The purpose of this investigation is to determine if race, ethnicity, economic stability, neighborhood environment, and access to health care are predictive of mortality in patients with septic shock.

Methods: Retrospective study of septic shock patients admitted to two medical centers.

Results: Caucasian patients had higher proportion of outpatient physician visits in the year prior to admission and were less likely to be Medicare or Medicaid beneficiaries.

Electrocardiometry for Hemodynamic Categorization and Assessment of Fluid Responsiveness in Pediatric Septic Shock: A Pilot Observational Study.

Aim: To evaluate the utility of noninvasive electrocardiometry (ICON®) for hemodynamic categorization and assessment of fluid responsiveness in pediatric septic shock.

Materials And Methods: Pilot prospective observational study in a 12-bedded tertiary pediatric intensive care unit (PICU) in children aged between 2 months and 16 years with unresolved septic shock after a 20 mL/kg fluid bolus. Those with cardiac index (CI) <3.

Maternal Occupational Tobacco Exposure and Newborn Umbilical Cord Serum Leptin Concentration.

Objective: To assess the effect of maternal occupational tobacco handling (bidi rolling) on cord serum leptin levels.

Methods: We enrolled 64 neonates born to women who were bidi-rollers, and 64 small for gestational age (SGA) neonates and 57 term appropriate for gestational age (AGA) neonates born to mothers with no tobacco exposure. Cord blood leptin levels between the groups were compared.

A multicomponent oxygen delivery strategy for COVID-19 patients in a step-down intensive care unit: A case series.

Coronavirus disease 2019 (COVID-19) is the cause of the pandemic that has affected millions of people worldwide with pulmonary manifestations ranging from mild pneumonia to ARDS and characterized by hypoxia. This has led to questions regarding the most efficacious and least harmful oxygen delivery strategies that minimize exposure to health care workers. In this case series, we present the hospital course of 4 patients that were managed with a multi-component oxygen delivery method in a COVID-19 step down unit.

Damned If You Drain, Damned If You Don't: A Case of Pericardial Decompression Syndrome.

Pericardial decompression syndrome (PDS) is an unusual clinical scenario with a reported incidence of 5% in all surgical or percutaneously managed pericardial tamponade patients. It is defined as a paradoxical hemodynamic instability leading to left ventricular (LV), right ventricular (RV), or biventricular dysfunction. An 84-year-old female with a history of a chronic pericardial effusion presented with symptoms of tamponade.

A Rare Case of a Large, Deceitfully Quiet Brainstem Arteriovenous Malformation Presenting Only as Dizziness.

Dizziness is one of the most frequent complaints encountered in the medical practice affecting 15%-20% of adults yearly, and can be challenging to assess. Most patients use dizziness as a non-specific term, and thus suffer prejudice from the physicians' end and can be disregarded frequently. Dizziness can be a symptom of various diseases, some with sinister pathologies.

Et Tu, B12? Cobalamin Deficiency Masquerading As Pseudo-Thrombotic Microangiopathy.

Vitamin B12 deficiency is classically associated with megaloblastic anemia. Possible cobalamin deficiency is not investigated once hemolysis is seen. Around 2.

Toll-like receptor 2 deficiency hyperactivates the FoxO1 transcription factor and induces aging-associated cardiac dysfunction in mice.

Toll-like receptors (TLRs) are a family of pattern-recognition receptors involved in innate immunity. Previous studies have shown that TLR2 inhibition protects the heart from acute stress, including myocardial infarction and doxorubicin-induced cardiotoxicity in animal models. However, the role of TLR2 in the development of aging-associated heart failure is not known.

Knowledge, Attitude, and Practice of Yoga in Medical Students: Assessment of Anthropometry and Lifestyle Factors.

Medical students often experience significant stress during their undergraduate training. Evidence has shown short-term yoga to be effective in decreasing stress in students. This study aimed to assess knowledge about, attitude toward, and practice of (KAP) yoga among medical students.

SIRT2 deacetylase represses NFAT transcription factor to maintain cardiac homeostasis.

Heart failure is an aging-associated disease that is the leading cause of death worldwide. Sirtuin family members have been largely studied in the context of aging and aging-associated diseases. Sirtuin 2 (SIRT2) is a cytoplasmic protein in the family of sirtuins that are NAD-dependent class III histone deacetylases.

Focal Dermal Hypoplasia with a Mutation p.E300* of Gene in a Male Infant.

Focal dermal hypoplasia is a rare disorder inherited in an X-linked dominant pattern and is usually antenatally lethal in males. We report a surviving male with postzygotic mutation p.E300* in exon 10 of gene with mosaicism, earlier reported in a female of Thai origin.

Identification of SNAREs involved in synaptotagmin VII-regulated lysosomal exocytosis.

Ca2+-regulated exocytosis of lysosomes has been recognized recently as a ubiquitous process, important for the repair of plasma membrane wounds. Lysosomal exocytosis is regulated by synaptotagmin VII, a member of the synaptotagmin family of Ca2+-binding proteins localized on lysosomes. Here we show that Ca2+-dependent interaction of the synaptotagmin VII C(2)A domain with SNAP-23 is facilitated by syntaxin 4.