Wound classification in pediatric general surgery: significant variation exists among providers.

Background: Risk-adjusted rates of surgical site infections (SSI) are used as a quality metric to facilitate improvement within a hospital system and allow comparison across institutions. The NSQIP-Pediatric, among others, uses surgical wound classification as a variable in models designed to predict risk-adjusted postoperative morbidity, including SSI rates. The purpose of this study was to measure the level of agreement in wound classification assignment among 3 providers: surgeons, operating room (OR) nurses, and NSQIP surgical clinical reviewers (SCR).

Role of a respiratory viral panel in the clinical management of pediatric inpatients.

Background: Respiratory viral panels (RVPs) able to detect multiple pathogens are increasingly used in the management of pediatric inpatients. Despite this, few studies have examined whether the results of these tests are associated with clinically significant changes in medical management.

Methods: In this retrospective cohort study, we identified pediatric inpatients between August 2009 and December 2010 for whom an RVP was ordered within 24 hours of admission to a large, tertiary-care children's hospital.

Calcium-dependent regulation of the voltage-gated sodium channel hH1: intrinsic and extrinsic sensors use a common molecular switch.

The function of the human cardiac voltage-gated sodium channel Na(V)1.5 (hH1) is regulated in part by binding of calcium to an EF hand in the C-terminal cytoplasmic domain. hH1 is also regulated via an extrinsic calcium-sensing pathway mediated by calmodulin (CaM) via binding to an IQ motif immediately adjacent to the EF-hand domain.

An EF-hand in the sodium channel couples intracellular calcium to cardiac excitability.

Sodium channels initiate the electrical cascade responsible for cardiac rhythm, and certain life-threatening arrhythmias arise from Na(+) channel dysfunction. We propose a novel mechanism for modulation of Na(+) channel function whereby calcium ions bind directly to the human cardiac Na(+) channel (hH1) via an EF-hand motif in the C-terminal domain. A functional role for Ca(2+) binding was identified electrophysiologically, by measuring Ca(2+)-induced modulation of hH1.