Angiopoietin Level Trajectories in Toddlers With Severe Sepsis and Septic Shock and Their Effect on Capillary Endothelium.

Objective: Angiopoietins are postulated diagnostic biomarkers in children and adults with severe sepsis and septic shock. The diagnostic value of angiopoietins in children less than 5 years old has not been established, nor has their effect on permeability in the capillary microvasculature. We aim to determine if levels of angiopoietin-1 or -2 (angpt-1, -2) are diagnostic for severe sepsis/shock in young children and whether they affect the permeability of cultured human dermal microvascular endothelial cells (HDMEC).

Evaluation of Electronic Medical Record Vital Sign Data Versus a Commercially Available Acuity Score in Predicting Need for Critical Intervention at a Tertiary Children's Hospital.

Objectives: Evaluate the ability of vital sign data versus a commercially available acuity score adapted for children (pediatric Rothman Index) to predict need for critical intervention in hospitalized pediatric patients to form the foundation for an automated early warning system.

Design: Retrospective review of electronic medical record data.

Setting: Academic children's hospital.

Thiamin Deficiency as a Cause of Persistent Hyperlactatemia in a Parenteral Nutrition-Dependent Patient.

Background: Despite the demonstrated dangers of inadequate supplies of injectable multivitamins, periodic shortages of these crucial pharmaceuticals continue to occur in the developed world. This case report provides a recent example of the potential danger of rationing parenteral multivitamins in chronically parenteral nutrition (PN)-dependent patients in the setting of national supply shortages.

Method And Results: Case report describing a chronically PN-dependent 21-year-old man who presented with signs and symptoms of septic shock to a pediatric intensive care unit at a university hospital.

Acute encephalitis.

Acute encephalitis remains one of the contemporary challenges of critical care medicine. The diagnosis is difficult and sometimes unconfirmed, and encephalitis remains without clear evidence-based therapies or even therapeutic goals for the prevention of high neurologic sequelae. This article provides a framework for pediatric intensivists to guide the diagnosis and management of patients with suspected encephalitis.

IL-21 induces differentiation of human naive and memory B cells into antibody-secreting plasma cells.

IL-21 is a type I cytokine that influences the function of T cells, NK cells, and B cells. In this study, we report that IL-21 plays a major role in stimulating the differentiation of human B cells. When human B cells were stimulated through the BCR, IL-21 induced minimal proliferation, IgD down-modulation, and small numbers of plasma cells.