79 results match your criteria: "Michigan Wayne State University[Affiliation]"

Introduction: Silver sulfadiazine 1 % cream had historically been the mainstay initial treatment for scald wounds at our institution. However, we transitioned to using closed dressings of only petrolatum-impregnated 3 % bismuth tribromophenate gauze (Xeroform) for all partial-thickness burns. Xeroform adheres to the wound while allowing the exudates to drain and acts as a scaffold for re-epithelialization, after which it falls off without traumatizing the wound bed, theoretically allowing viable tissue to declare itself while requiring less frequent dressing changes.

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The Severity-of-Illness Score for Toxic Epidermal Necrolysis (SCORTEN) is a system that predicts in-hospital mortality for Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN). The system is widely utilized in adults but not in pediatrics. We aim to determine the accuracy of the SCORTEN in pediatrics.

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Article Synopsis
  • The study aimed to assess how different international clinical sites manage therapeutic hypothermia (TH) for neonatal hypoxic-ischemic encephalopathy (HIE) and identify areas for standardization.
  • An electronic survey was conducted, gathering responses from 105 sites, primarily from high-income regions, revealing varying practices in eligibility criteria, use of electroencephalography, and sedation methods.
  • The findings indicated significant regional differences in TH management, suggesting that future guidelines should take into account the availability of resources globally.
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Objective: To assess cognitive, behavioral, and adaptive functions in children and young adults with hemophilia treated according to contemporary standards of care.

Study Design: Evolving Treatment of Hemophilia's Impact on Neurodevelopment, Intelligence, and Other Cognitive Functions (eTHINK) is a US-based, prospective, cross-sectional, observational study (September 2018 through October 2019). Males (aged 1-21 years) with hemophilia A or B of any severity, with or without inhibitors, were eligible.

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Background: Children with short bowel syndrome requiring parenteral nutrition are at high risk of recurrent central line-associated bloodstream infections requiring inpatient admission. Predicting responses to treatment at admission could help revise our current treatment algorithm and reduce the length of stay.

Methods: We conducted a retrospective study of all intestinal rehabilitation clinic patients admitted for central line-associated bloodstream infections at our academic hospital between January 2018 and June 2021.

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Background: The Center for Medicaid and Medicare Services predicts the length of stay for pediatric burn patients based on several variables. However, many patients exceed their anticipated length. This study looks to identify aspects of patient presentation, wound characteristics, treatment, and discharge that are associated with a longer-than-predicted length of stay to identify strategies to safely reduce it.

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Pediatric ocular burns carry a risk of permanent vision impairment. This study identifies risk factors that place these patients at high risk of permanent visual complications. A retrospective review was conducted in our academic urban pediatric burn center.

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Isolated ocular palsies are often associated with a benign process in the pediatric population but early diagnosis is critical to exclude any serious pathology. In this case, a six-year-old female with no significant past medical history presented with isolated right-eye medial deviation. The patient reported right-eye medial deviation for the past several weeks and associated double vision, but denied any pain with eye movements, other cranial nerve changes, or headaches.

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Blood Pressure Classification Status in Children With CKD Following Adoption of the 2017 American Academy of Pediatrics Guideline.

Am J Kidney Dis

May 2023

Division of Nephrology, Seattle Children's Hospital; Department of Pediatrics, School of Medicine, University of Washington, Seattle, Washington. Electronic address:

Rationale & Objective: Accurate detection of hypertension is crucial for clinical management of pediatric chronic kidney disease (CKD). The 2017 American Academy of Pediatrics (AAP) clinical practice guideline for childhood hypertension included new normative blood pressure (BP) values and revised definitions of BP categories. In this study, we examined the effect of applying the AAP guideline's normative data and definitions to the Chronic Kidney Disease in Children (CKiD) cohort compared with use of normative data and definitions from the 2004 Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents.

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Pediatric hand friction injuries caused by running treadmills are ever more prevalent due to the increasing presence of home exercise equipment. These and other related injuries have received recent attention in the media, leading to mass product recalls in some cases. These friction injuries are similar to deep thermal burns, and these patients are usually cared for in the pediatric burn unit at our institution.

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Article Synopsis
  • Silver-based topical treatments, particularly silver sulfadiazine, have been commonly used for burn management, but studies show that silver nanoparticles can hinder healing due to toxicity at high concentrations.
  • Zinc oxide has shown promise as an antimicrobial alternative in burn treatment, and a pediatric burn center is transitioning to a zinc oxide/dimethicone spray, which is easier to apply and remove than traditional creams.
  • This study compares the effectiveness of silver sulfadiazine and zinc oxide/dimethicone in treating superficial second-degree burns in children, analyzing patient data for healing time and infection rates.
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Lack of Association of Household Income and Acute Gastroenteritis Disease Severity in Young Children: A Cohort Study.

Acad Pediatr

May 2022

Divisions of Pediatric Emergency Medicine and Gastroenterology, Departments of Pediatrics and Emergency Medicine, Alberta Children's Hospital, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary (SB Freedman), Calgary, Alberta, Canada.. Electronic address:

Article Synopsis
  • The study aimed to investigate the relationship between low household income and the severity of acute gastroenteritis (AGE) in children after they were discharged from the emergency department (ED).
  • Data was collected from pediatric EDs across the US, focusing on children aged 3 to 48 months, and explored various income measures and health outcomes.
  • Results showed that lower income households did not experience more severe AGE or increased healthcare utilization compared to higher income groups, suggesting that economic disparities do not significantly affect the disease course of children with AGE.
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Current challenges for men and women with mild-to-moderate haemophilia.

Haemophilia

January 2021

Hemophilia and Thrombosis Center, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA.

Current treatments in the field of haemophilia are changing the phenotype of many patients with severe haemophilia to that of mild haemophilia. Despite this improvement, those with mild-to-moderate haemophilia A and haemophilia B continue to experience unmet needs. Whereas some patients with mild-to-moderate haemophilia experience similar complications to those of patients with severe haemophilia, they possess several unique attributes.

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Risk factors for mortality in children with refractory pediatric septic shock who are supported with extracorporeal life support (ECLS) are largely unknown. Therefore, we performed univariable and multivariable analyses to determine risk factors for mortality among children (<19 years) who underwent an ECLS run between January 2012 and September 2014 at eight tertiary pediatric hospitals, and who had septic shock based on 2005 International Consensus Criteria. Of the 514 children treated with ECLS during the study period, 70 were identified with septic shock.

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Background: We aimed to conduct a multi-centre study characterising emergency department utilisation and critical readmissions experienced by children with Fontan circulation.

Methods: We conducted a retrospective review of children who underwent the Fontan operation at three institutions (i.e.

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Human Metapneumovirus Infection in Hospitalized Children.

Respir Care

May 2020

Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan.

Background: Most children are exposed to human metapneumovirus (HMPV) by the age of 5 y. This study aimed to describe the morbidity associated with HMPV infections in a cohort of children in the Midwest of the United States.

Methods: This was a retrospective 2-center cohort study including children (0-17 y old) hospitalized with HMPV infections at 2 tertiary care pediatric hospitals from 2009 to 2013.

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Reversible Cerebral Vasoconstriction Syndrome and Sickle Cell Disease: A Case Report.

J Pediatr Hematol Oncol

January 2021

Carman and Ann Adams Department of Pediatrics, Division of Hematology/Oncology.

Reversible cerebral vasoconstriction syndrome (RCVS), is rare in the pediatric population and is characterized by severe headaches and other neurologic symptoms. We present a case of RCVS occurring concomitantly with posterior reversible encephalopathy syndrome in an 8-year-old African American child with sickle cell disease (HbSS). Imaging studies including computed tomography, magnetic resonance imaging and cerebral angiography of the brain showed acute hemorrhagic stroke and a beaded appearance of peripheral cerebral vessels.

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Fetoplacental neuroblastoma metastasis has been postulated as a mechanism accounting for concordant cases where one twin develops a primary tumour and the second twin manifests the disease without an identifiable primary site. These tumours may originate and spread concomitantly due to the same genetic background shared by monozygotic twins. This study investigated the molecular profile of stage MS neuroblastoma presenting concomitantly in monozygotic twins.

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Almost all of what is known about neurologic and cognitive development in hemophilia derives from the Hemophilia Growth and Development Study, conducted during an era when treatment regimens and comorbidities differed significantly from the current environment. Results suggested hemophilia and human immunodeficiency virus had independent effects, and hemophilia negatively impacts academic achievement, attention, and behavior. The introduction of prophylaxis treatment in hemophilia has created the need for re-evaluation of the effects of hemophilia on neurodevelopment and cognition.

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Purpose: Recombinant activated factor VII (rFVIIa; NovoSeven RT; Novo Nordisk A/S, Bagsvaerd, Denmark) is approved in the United States for the treatment of bleeding and perioperative management in congenital hemophilia with inhibitors (CHwI), acquired hemophilia (AH), congenital factor VII (FVII) deficiency, and Glanzmann's thrombasthenia (GT) with refractoriness to platelets. The aim of the current analysis was to review clinical trials and registries pre- and post-licensure for each indication to establish the estimated rate of thrombosis and then to establish the association of all reported thrombotic events (TEs) with certain risk factors listed for many years in the prescribing information (PI).

Patients And Methods: A retrospective safety assessment of both clinical trials and registries used to support licensure and postmarketing surveillance was performed.

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Objective: To describe factors associated with platelet transfusion during pediatric extracorporeal membrane oxygenation and the relationships among platelet transfusion, complications, and mortality.

Design: Secondary analysis of data collected prospectively by the Collaborative Pediatric Critical Care Research Network between December 2012 and September 2014.

Setting: Eight Collaborative Pediatric Critical Care Research Network-affiliated hospitals.

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Objectives: To develop a novel device to predict systolic and diastolic blood pressure based on measured heart sound signals and evaluate its accuracy in comparison to intra-arterial blood pressure readings.

Study Design: Prospective, observational pilot study.

Setting: PICU.

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Objective: To determine in-hospital outcomes of neonates with hypoxic ischemic encephalopathy (HIE) requiring extracorporeal membrane oxygenation (ECMO).

Study Design: Single-center retrospective study from 2005 to 2016 of neonates ≥35 weeks gestation with moderate/severe HIE, requiring ECMO for persistent pulmonary hypertension of newborn (PPHN).

Results: Our cohort (n = 20) received therapeutic hypothermia for moderate (n = 12), severe (n = 5), or undocumented severity (n = 3) of HIE.

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