6289 research outputs found
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Pediatric Catatonia
No full textCME available for 1 year after presentation
CME Text Code: 97048
In order to claim CME credit, please complete an evaluation in CloudCME for each presentation.https://knowledgeconnection.mainehealth.org/pediatrics_gr/1088/thumbnail.jp
Enhancing Alzheimer\u27s Care: Impact of Staff Education on Behavioral Outcomes
No full textWould additional staff training and education in Alzheimer’s patient interactions compared to minimal/or no staff training and education in Alzheimer’s patient interactions lead to reduced behavioral events in bedside nursing?https://knowledgeconnection.mainehealth.org/nurseresidency/1149/thumbnail.jp
Activity of Cardiomyocyte Type 3 Deiodinase After Myocardial Infarction Influences Cardiac Recovery in Females
No full textThyroid hormone (TH) is essential for cardiovascular function, and women are disproportionately affected by TH disorders and experience worse outcomes following myocardial infarction (MI). However, the role of sex-specific TH regulation in post-MI cardiac recovery remains poorly understood. We investigated TH homeostasis and type 3 deiodinase (D3) activity, an enzyme that inactivates TH, in male and female C57BL/6 mice following MI. Using cardiomyocyte-specific D3-deficient (Dio3ΔHeart) mice, we investigated how impaired TH inactivation influences cardiac function and mitochondrial respiration. We also examined DIO3 mRNA expression, which encodes the D3 enzyme, in left ventricular (LV) tissue from human donors with non-failing (NF) hearts or ischemic cardiomyopathy (ICM). Four weeks post-MI, wild-type female mice exhibited sustained cardiac D3 activity, which effectively limited triiodothyronine (T3) levels in the left ventricle. In contrast, Dio3ΔHeart females, lacking cardiomyocyte D3, showed impaired systolic recovery, elevated LV T4 and T3 levels, and reduced fatty acid-supported mitochondrial respiration, effects not observed in Dio3ΔHeart males. Similarly, DIO3 expression was selectively upregulated in LV tissue from women with ICM, but not in men. These findings identify DIO3 as a key protective mechanism in females that limits T3-induced metabolic stress and preserves mitochondrial function after MI, revealing a sex-dependent pathway with therapeutic relevance for cardiac recovery
Per- and polyfluoroalkyl substances and hand osteoarthritis: data from the Osteoarthritis Initiative
No full textOBJECTIVE: To explore whether biological levels of specific per- and polyfluoroalkyl substances (PFAS) and a mixture of PFAS - reflecting the overall effect and accounting for correlations among each PFAS - relate to incident hand osteoarthritis (HOA) and progression. METHODS: Among a case-cohort sample from the Osteoarthritis Initiative (n=1,878), we examined associations of 8 PFAS in serum with odds of developing over the subsequent 4 years (1) symptomatic HOA and (2) an increased number of joints with radiographic osteoarthritis (Kellgren-Lawrence≥2; yes/no). We used weighted logistic regression to assess single PFAS (continuous and quartiles) and quantile g-computation to assess the PFAS-mixture in relation to our primary outcomes. RESULTS: Participants were primarily female (58%) and on average 62 years of age and overweight (mean BMI=28.6 kg/m). Participants with higher perfluorodecanoic acid (PFDA) and perfluorononanoic acid (PFNA; continuous variables) had greater odds of incident symptomatic HOA [OR (95%CI) per interquartile-range increment: PFDA 1.12 (1.05-1.20); PFNA 1.07 (1.00-1.13)], but associations were not monotonic when these PFAS were represented in quartiles. Participants with higher perfluorohexane sulfonoic acid (PFHxS) had lower odds of incident HOA [e.g., OR (95%CI): 0.94 (0.88-1.00) per interquartile-range increment]. We observed no other consistent associations between PFAS and either outcome. CONCLUSION: We observed possible associations of PFDA and PFNA serum concentrations with symptomatic HOA incidence, but we otherwise found no consistent evidence that greater PFAS concentrations relate to a greater chance of developing HOA incidence or progression
Performance of transesophageal echocardiography probe at temperature monitoring during simulated hypothermia and rewarming
No full textOBJECTIVE: To determine whether a transesophageal echocardiography (TEE) probe can accurately measure temperature and be used to monitor temperature changes over time without overheating in an experimental model of hypothermia and rewarming. METHODS: A 6L water bath was heated with a sous vide immersion circulator to 24C, 28C, 32C and 36C to simulate severe hypothermia, moderate hypothermia, mild hypothermia, and normothermia. A TEE probe, esophageal temperature probe, and bladder temperature probe were used to measure temperature. Temperatures were recorded every 60 seconds for 15 minutes prior to raising temperature to the next predetermined temperature. RESULTS: The TEE probe reported temperatures with a mean difference of 0.60°C (95% CI, 0.51°C - 0.69°C) compared to the reported temperature of the sous vide immersion circulator. The esophageal probe and bladder probe reported temperatures with a mean difference of -0.19°C (95% CI, -0.23°C - -0.14°C) and - 0.20°C (95% CI, -0.26°C - -0.14°C) respectively. CONCLUSION: During this simulation, the TEE tip temperature did not increase apart from expected changes from water temperature changes. The probe temperature was less accurate than the esophageal and bladder temperature probes but demonstrated precision in monitoring temperature changes and stable hypothermia. Based on this study, TEE probes should not be relied upon for an accurate initial temperature but can likely be used to monitor changes in temperature over time
Rural School-Based Health Centers: Meeting Children Where They Are to Improve Asthma Outcomes
No full textData Collection Variability Across Neonatal Hypoxic-Ischemic Encephalopathy Registries
No full textOBJECTIVE: To assess variability among data elements collected among existing neonatal hypoxic-ischemic encephalopathy (HIE) data registries worldwide and to determine the need for future harmonization of standard common data elements. STUDY DESIGN: This was a cross-sectional study of data elements collected from current or recently employed HIE registry data forms. Registries were identified by literature search and email inquiries to investigators worldwide. Data elements were categorized by group consensus. RESULTS: A total of 1281 data elements were abstracted from 22 registries based in 14 countries, including 3 middle-income countries. Registries had a median of 106.5 distinct data elements per registry (range 59-458). The most commonly collected data were related to pregnancy, therapeutic hypothermia, and short-term hospital outcomes. The least consistently collected data were laboratory values other than acid/base status values. Only 4 variables were consistently collected in every registry. Five registries included neurodevelopmental follow-up fields and 5 others linked their data to a separate follow-up registry. CONCLUSION: Many HIE registries are collecting patient data around the world, but there is considerable variability in the number, type, and format of data collected. Future attempts to develop standard common data elements to harmonize data collection globally will be crucial to facilitate worldwide collaboration and to optimize management and outcome of neonatal HIE
Pediatric Interfacility Transfers
No full textDate of Presentation: January 23rd, 2025
Presented by: Bailey O\u27Donnell, MD PGY-4 Medicine-Pediatric Resident MaineHealth Barbara Bush Children\u27s Hospital
CME available for 1 year after presentation
CME Text Code: 97003
In order to claim CME credit, please complete an evaluation in CloudCME for each presentation.https://knowledgeconnection.mainehealth.org/pediatrics_gr/1061/thumbnail.jp