Objective: The objective of this study was to describe the clinical spectrum of patients presenting with shock or developing shock in a pediatric emergency department (ED) during an 8-year period.
Methods: An observational study of all pediatric ED patients with shock between September 1998 and September 2006 was performed. Trauma activations were excluded. A structured, explicit chart review using a standardized abstraction form and case definition was completed by 3 physicians board certified in pediatric emergency medicine. Interrater reliability was monitored.
Results: A total of 147 cases of shock were identified. Septic shock was the underlying physiology in 57% of cases. A pathogen was identified in 45% of these cases. Hypovolemic shock due to gastroenteritis, metabolic disease, surgical emergencies, or hemorrhage was the cause in 24% of cases. Distributive shock represented 14% of cases. Cardiogenic shock contributed to 5% of cases. Patients with septic shock received a mean of 58 mL/kg of crystalloid or colloid versus 50 mL/kg in patients with other causes. Intubation and vasopressor use was required in 41% and 21% of cases, respectively. Clinical signs of shock developed in the ED after initially presenting without clinical signs of shock in 14% of study subjects. Nearly half of these episodes occurred after the administration of antimicrobials or performance of a lumbar puncture. Mortality was 6% overall and 5% in septic shock patients.
Conclusions: Pediatric ED patients with shock represent a diverse population with substantial mortality. Of 147 patients, 21 presented without clinical signs of shock and deteriorated to a clinical condition meeting the definition of shock during the ED course.
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J Am Coll Cardiol
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Electrophysiology Laboratory and Arrhythmia Unit, Centro Integral de Enfermedades Cardiovasculares, Hospital Monteprincipe, Grupo HM Hospitales, Madrid, Spain. Electronic address:
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December 2024
Université de Lyon, UCBL1 Laboratoire Inter Universitaire de Biologie de la Motricité, EA 7424, 69100 Villeurbanne Cedex, France.
This study investigated muscle activation, shocks, and vibrations of the upper extremities during tennis serves between junior and adult tennis players. Thirty-five well-trained tennis players (15 juniors and 20 adults) performed 10 maximal successful tennis serves. Two triaxial accelerometers recorded the shock and vibration on the racket and the hand on the dominant side.
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December 2024
School of Sport and Physical Activity, College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield S10 2BP, UK.
RaceRunning is a sport for disabled people and successful performance depends on reducing the amount of time spent travelling a specific distance. Performance analysis in RaceRunning athletes is based on traditional methods such as recording race time, distances travelled and frequency (sets and reps) that are not sufficient for monitoring training loads. The aims of this study were to monitor training loads in typical training sessions and evaluate technical adaptations in RaceRunning performance by acquiring sensor metrics.
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December 2024
Department of Mechanical Engineering, Stanford University, Stanford, CA 93405, USA.
Distributed feedback lasers, which feature rapid wavelength tunability, are not presently available in the yellow and orange spectral regions, impeding spectroscopic studies of short-lived species that absorb light in this range. To meet this need, a rapidly tunable laser system was constructed, characterized, and demonstrated for measurements of the NH radical at 597.4 nm.
View Article and Find Full Text PDFPharmaceutics
December 2024
School of Pharmacy, Nantong University, Nantong 226001, China.
Porphyrin's excellent biocompatibility and modifiability make it a widely studied photoactive material. However, its large π-bond conjugated structure leads to aggregation and precipitation in physiological solutions, limiting the biomedical applications of porphyrin-based photoactive materials. It has been demonstrated through research that fabricating porphyrin molecules into nanoscale covalent organic frameworks (COFs) structures can circumvent issues such as poor dispersibility resulting from hydrophobicity, thereby significantly augmenting the photoactivity of porphyrin materials.
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