Children (Basel, Switzerland)
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Thromboelastometry (ROTEM), as a point of care test, is an attractive tool for rapid evaluation of hemostasis. Currently, no reference ranges exist for all ROTEM assays in neonates, limiting its use in this vulnerable population. The aim of the present study was: (1) to establish reference ranges for standard extrinsically activated (EXTEM), intrinsically activated (INTEM), and fibrinogen polymerization (FIBTEM) ROTEM assays in whole blood samples of healthy term neonates; (2) to determine the impact of gender, delivery mode, and hematocrit on ROTEM parameters. ⋯ This study provides, for the first time, reference ranges for ROTEM EXTEM/INTEM/FIBTEM values simultaneously in healthy term neonates. The combined evaluation of ROTEM tests increases its diagnostic accuracy, contributing to the expansion of ROTEM use in the neonatal population.
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Anesthesiologists and other acute care physicians perform and interpret portable ultrasonography-point-of-care ultrasound (POCUS)-at a child's bedside, in the perioperative period. In addition to the established procedural use for central line and nerve block placement, POCUS is being used to guide critical clinical decisions in real-time. Diagnostic point-of-care applications most relevant to the pediatric anesthesiologist include lung ultrasound for assessment of endotracheal tube size and position, pneumothorax, pleural effusion, pneumonia, and atelectasis; cardiac ultrasound for global cardiac function and hydration status, and gastric ultrasound for aspiration risk stratification. This article reviews and discusses select literature regarding the use of various applications of point-of-care ultrasonography in the perioperative period.
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Wildfires have been affecting California greatly, and vulnerable patients in neonatal intensive care units (NICUs) are not exempt. Our aim was to learn how personnel working in NICUs of California hospitals handled issues of neonatal transfer during wildfire disasters in recent years, with an ultimate goal to share lessons learned with healthcare teams on disaster preparedness. We identified California fires through newspaper articles and the CalFire.gov list. ⋯ While describing disaster preparedness, equipment (such as bassinets and backpacks), ambulance access/transport and documentation/charting were noted as important and essential. Teamwork, willingness to do other tasks that are not part of typical job descriptions, and unconventional strategies contribute to the success of keeping NICU babies safe when California wildfire strikes. Healthcare teams developed ingenious and surprising ways to evacuate NICU babies.
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The ongoing worldwide pandemic of the novel human coronavirus SARS-CoV-2 and the ensuing disease, COVID-19, has presented enormous and unprecedented challenges for all medical specialists. However, to date, children, especially neonates, have been relatively spared from the devastating consequences of this infection. ⋯ Among neonates and children, COVID-19-associated neurological manifestations have been relatively rare, yet reports involving neurologic dysfunction in this age range are increasing. As discussed in this review, pediatric neurologists and other pediatric specialists should be alert to potential neurological involvement by this virus, which might have neuroinvasive capability and carry long-term neuropsychiatric and medical consequences.
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Parental and familial factors influence numerous aspects of adolescents' lives, including their physical activity level (PAL). The purpose of this study was to evaluate the changes in PAL which occurred during the COVID-19 pandemic, and to evaluate influence of sociodemographic and parental/familial factors on PAL levels before and during pandemic in adolescents from Bosnia and Herzegovina. The sample included 688 adolescents (15-18 years of age; 322 females) who were tested on two occasions: in January 2020 (baseline; before the COVID-19 pandemic) and in April 2020 (follow-up; during the COVID-19 pandemic lockdown). ⋯ Approximately 50% of adolescents underwent sufficient PAL at baseline, while only 24% of them were achieving sufficient PAL at the time of follow-up measurement. Paternal education was positively correlated (OR (95%CI): baseline: 6.63 (4.58-9.96), follow-up: 3.33 (1.19-7.01)), while familial conflict was negatively correlated (baseline: 0.72 (0.57-0.90), follow-up: 0.77 (0.60-0.99)) with PALs before and during the pandemic. This study highlights the importance of the parent-child relationship and parental/familiar support in promoting physical activity both during regular life and during crises and health challenging situations like the COVID-19 pandemic.