Articles: child.
-
Pediatr Crit Care Me · Jan 2025
Multicenter StudyProtocol for the Catheter-Related Early Thromboprophylaxis With Enoxaparin (CRETE) Studies.
In post hoc analyses of our previous phase 2b Bayesian randomized clinical trial (RCT), prophylaxis with enoxaparin reduced central venous catheter (CVC)-associated deep venous thrombosis (CADVT) in critically ill older children but not in infants. The goal of the Catheter-Related Early Thromboprophylaxis with Enoxaparin (CRETE) Studies is to investigate this newly identified age-dependent heterogeneity in the efficacy of prophylaxis with enoxaparin against CADVT in critically ill children. ⋯ Randomization is 2:1 to enoxaparin or usual care (no enoxaparin) for older children and 1:1:1 to either of 2 anti-Xa ranges of enoxaparin or usual care for infants. Ultrasonography will be performed after removal of CVC to assess for CADVT. Subjects will be monitored for bleeding. Platelet poor plasma will be analyzed for markers of thrombin generation. Samples from subjects with CADVT will be counter-matched 1:1 to subjects without CADVT from the opposite trial arm. Institutional Review Board approved the "CRETE Studies" on July 1, 2021. Enrollment is ongoing with planned completion in July 2025 for older children and July 2026 for infants.
-
Paediatric anaesthesia · Jan 2025
Evaluation of propofol-based procedural sedation in pediatric hemato-oncological patients provided by physician assistants in anesthesia.
Procedural sedation and analgesia are required for painful hemato-oncological procedures such as lumbar and bone marrow punctures. At our institution, sedation with propofol and alfentanil is usually provided by Physician Assistants in Anesthesia. We evaluated the adverse events during the PSA program for children, provided by Physician Assistants in Anesthesia. ⋯ Sedation and analgesia for short painful procedures in selected pediatric hemato-oncological units with a dedicated protocol may be safely provided by trained and certified Physician Assistants in Anesthesia.
-
To identify the association of mothers with a career in higher educati--on and their children's growth and development. ⋯ There is a strong correlation between the time spent with children and the child's growth and development. For working mothers in academia, creating a supportive family or childcare environment and creating dedicated, quality time for interaction with their children are essential. Working mothers are encouraged to manage their time effectively to balance professional and parenting responsibilities and to engage in activities that enhance their children's physical, mental, and emotional development.
-
A combination treatment of surgery, chemotherapy, and radiotherapy can improve the survivals of pediatric patients with Ewing sarcoma (ES). However, prognosis remains poor for patients with metastatic disease at diagnosis or recurrence. Other high-risk (HR) features include large tumor burden, tumors of the axial skeleton, and poor histologic response. Several studies have documented high-dose chemotherapy with autologous stem cell rescue (HDC-ASCR) to be effective in such patients. In this retrospective study, we present the results of HDC-ASCR for high-risk ES (HRES) in children and young adults in a single institute. ⋯ HDC-ASCR seems promising as an alternative treatment for HRES in improving OS in this retrospective study with a limited case number.
-
Despite nationally endorsed treatment guidelines and stewardship programs, variation and deviation from evidence-based antibiotic prescribing occur, contributing to inappropriate use and medication-related adverse events. Measures of antibiotic prescribing variability can aid in quantifying this problem but are not adequate. ⋯ We developed and applied a novel metric to quantify diversity in antibiotic prescribing that permits comparisons across hospitals and can be leveraged to identify high-priority areas for local and national stewardship interventions.