Juareztran8087

With the growing number of ICU survivors experiencing cognitive deficits, it is essential to develop and test interventions that restore cognitive function in this understudied population.

Post-extubation upper airway obstruction is the most common cause of extubation failure in children, but there are few data regarding long-term morbidity. We aim to describe the frequency of long-term airway sequelae in intubated children and determine the association with post-extubation upper airway obstruction.

Retrospective, post hoc analysis of previously identified prospective cohort of children in the pediatric/cardiothoracic ICU at Children's Hospital Los Angeles from July 2012 to April 2015. A single provider blinded to the upper airway obstruction classification reviewed the electronic medical records of all patients in the parent study, before and after the index extubation (extubation during parent study), to identify pre-index and post-index upper airway disease. Primary outcomes were prevalence of newly diagnosed airway anomalies following index extubation.

Single center, tertiary, 391-bed children's hospital.

From the parent study, 327 children younger than 18 years (intubated for at lents may represent an at-risk population that should be monitored closely after leaving the ICU.

Post-extubation subglottic upper airway obstruction is associated with a three-fold greater odds of long-term airway morbidity. These patients may represent an at-risk population that should be monitored closely after leaving the ICU.

Laryngeal ultrasound is a nonirradiating, noninvasive method for assessing the upper airway in children. This systematic review and meta-analysis examine available evidence for accuracy of laryngeal ultrasound in diagnosing vocal cord immobility in infants and children after surgery and trauma affecting the vocal cords.

Medical subject heading terms were used to search MEDLINE, Embase, Google Scholar, Web of Science, and the Cochrane Library for relevant citations. Publications from January 1, 2000, to June 30, 2020 were included in the search strategy. Study inclusion criteria consisted of randomized control trials and nonrandomized retrospective or prospective observational studies where vocal cord motion was evaluated by laryngeal ultrasound and compared with a reference test. Studies were excluded if there was insufficient data to compute a sensitivity/specificity table. AT406 clinical trial Case reports, case series less than 10, and manuscripts not published in English were also excluded.

Studies which included subjectrates high sensitivity and specificity for detecting vocal cord motion in children in a wide range of clinical settings. Laryngeal ultrasound offers a low-risk imaging option for assessing vocal cord function in children compared with the current gold standard of laryngoscopy.

To summarize the literature on prevalence, impact, and contributing factors related to diagnostic error in the PICU.

Search of PubMed, EMBASE, and the Cochrane Library up to December 2019.

Studies on diagnostic error and the diagnostic process in pediatric critical care were included. Non-English studies with no translation, case reports/series, studies providing no information on diagnostic error, studies focused on non-PICU populations, and studies focused on a single condition/disease or a single diagnostic test/tool were excluded.

Data on research design, objectives, study sample, and results pertaining to the prevalence, impact, and factors associated with diagnostic error were abstracted from each study.

Using independent tiered review, 396 abstracts were screened, and 17 studies (14 full-text, 3 abstracts) were ultimately included. Fifteen of 17 studies (88%) had an observational research design. Autopsy studies (autopsy rates were 20-47%) showed a 10-23% rate of missed major diagnoses; 5-16%uld involve a balanced focus between studying the diagnosis of individual diseases and uncovering common system- and process-related determinants of diagnostic error.

A 23-year-old man working on a prawn trawler off the Northern Australian coast was bitten on the right hand by a black-banded sea snake (Laticauda colubrina), resulting in the rapid onset of ptosis, blurred vision, and respiratory difficulties with convulsions, loss of consciousness, and death. Resuscitation was unsuccessful. No antivenom was available because of the remote location. At autopsy, a small puncture wound was identified on the middle interphalangeal joint of the right little finger. No other significant abnormalities were detected. Elevations in creatine kinase (1558 μ/L) and myoglobin (24,800 μg/L) levels were found. Death was caused by respiratory failure after sea snake envenomation. This case demonstrates potential difficulties in establishing the diagnosis of lethal sea snake envenomation, including the inconspicuous nature of the bite marks with no local reaction and the underlying neurotoxic nature of the lethal mechanisms, which leaves very nonspecific pathological findings. Myonecrosisenvenomation, including the inconspicuous nature of the bite marks with no local reaction and the underlying neurotoxic nature of the lethal mechanisms, which leaves very nonspecific pathological findings. Myonecrosis may occur but is variable. Unless reliably witnessed, sea snake envenomation may not be suspected. Failing vision or unexplained paresis in fishermen or individuals who have been in the sea may point to the diagnosis.

We assess the utility of a Centers for Disease Control and Prevention (CDC) guidelines-based coronavirus disease 2019 (COVID-19) screening checklist for postmortem severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) surveillance, detailing the relationship between the histologic findings at autopsy and attribution of death to COVID-19.SARS-CoV-2 nasopharyngeal swabs were collected at the time of autopsy in all "checklist-positive" decedents. Additional "checklist-negative" decedents were randomly tested daily. Lung slides were blindly reviewed by 3 pathologists, assessing for the presence of diffuse alveolar damage (DAD) and other findings. Sixteen decedents had positive postmortem SARS-CoV-2 nasopharyngeal swabs and underwent complete autopsies. Seven decedents had positive screening checklists. Of these, 4 had DAD and 1 had COVID-19-associated thromboembolic disease. Of the 9 decedents with negative screening checklists, 2 had DAD, but only 1 was attributed to COVID-19; the other was likely drug related.