Abstract:
BACKGROUND:Early recognition of patients at risk for sepsis is paramount to improve clinical outcomes. We hypothesized that subtle signatures of illness are present in physiological and biochemical time series of pediatric-intensive care unit (PICU) patients in the early stages of sepsis. METHODS:We developed multivariate models in a retrospective observational cohort to predict the clinical diagnosis of sepsis in children. We focused on age as a predictor and asked whether random forest models, with their potential for multiple cut points, had better performance than logistic regression. RESULTS:One thousand seven hundred and eleven admissions for 1425 patients admitted to a mixed cardiac and medical/surgical PICU were included. We identified, through individual chart review, 187 sepsis diagnoses that were not within 14 days of a prior sepsis diagnosis. Multivariate models predicted sepsis in the next 24 h: cross-validated C-statistic for logistic regression and random forest were 0.74 (95% confidence interval (CI): 0.71-0.77) and 0.76 (95% CI: 0.73-0.79), respectively. CONCLUSIONS:Statistical models based on physiological and biochemical data already available in the PICU identify high-risk patients up to 24 h prior to the clinical diagnosis of sepsis. The random forest model was superior to logistic regression in capturing the context of age.
journal_name
Pediatr Resjournal_title
Pediatric researchauthors
Spaeder MC,Moorman JR,Tran CA,Keim-Malpass J,Zschaebitz JV,Lake DE,Clark MTdoi
10.1038/s41390-019-0518-1subject
Has Abstractpub_date
2019-11-01 00:00:00pages
655-661issue
5eissn
0031-3998issn
1530-0447pii
10.1038/s41390-019-0518-1journal_volume
86pub_type
杂志文章abstract::To understand scoliosis, related comorbidities, and phenotype-genotype correlations in individuals with Rett syndrome (RTT), the Rare Disease Clinical Research Network database for RTT was probed. Clinical evaluations included a detailed history and physical examination, comprehensive anthropometric measurements, and ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/PDR.0b013e3181d0187f
更新日期:2010-04-01 00:00:00
abstract::C3H/HeJ mice develop an increase in terminal air space area detectable by postnatal d 14 that persists into adulthood compared with strain-matched controls (C3H/SnJ, C3H/OuJ). Morphometric quantification revealed a 50% increase in terminal air space area by postnatal d 14 and a 2.3-fold increase by 2 mo of age in C3H/...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/01.pdr.0000246071.50268.51
更新日期:2006-12-01 00:00:00
abstract::Chondro-osseous tissue from five patients with diastropic dwarfism was studied by histologic, histochemical, and electron microscopic methods. The major abnormalities observed were: 1) irregular distribution of chondrocytes undergoing degeneration in the resting cartilage; 2) abnormal distribution of collagens in the ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-197908000-00007
更新日期:1979-08-01 00:00:00
abstract:BACKGROUND:Mevalonate kinase deficiency (MKD) is a rare genetic autoinflammatory disease caused by blocking of the enzyme mevalonate kinase in the pathway of cholesterol and isoprenoids. The pathogenic mechanism originating an immune response in MKD patients has not been clearly understood. METHODS:We investigated the...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/pr.2013.96
更新日期:2013-09-01 00:00:00
abstract::Despite effective antibiotic treatment, neuronal injury is frequent among children and adults with bacterial meningitis resulting in a high rate of death and neurologic sequelae. The hematopoietic cytokine erythropoietin (EPO) provides neuroprotection in models of acute and chronic neurologic diseases. We studied whet...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/PDR.0b013e318159af7a
更新日期:2007-12-01 00:00:00
abstract::In its normal circulatory environment, the fetal left ventricle can maximally increase output less than 2-fold, in contrast to the nearly 3-fold increase that occurs at birth. Several studies have attributed this finding to fetal myocardial "immaturity," and speculated that there is a rapid maturation of the myocardiu...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199105010-00011
更新日期:1991-05-01 00:00:00
abstract::Premature rabbits delivered by cesarean section at 28 d of gestation were each given intratracheally 75 mg/kg of radiolabeled preparation of either natural rabbit surfactant, natural calf surfactant, or surfactant-TA. Each newborn rabbit was ventilated for up to 6 h in a ventilator-plethysmograph with individual adjus...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198904000-00024
更新日期:1989-04-01 00:00:00
abstract::A strongly positive tuberculin skin reaction (> 1.5 cm2) was observed during the acute phase of the illness in 11 children with Kawasaki disease (KD), but not in control pediatric patients with other febrile infections (41 patients) or diseases similar to KD (9 patients). The cutaneous sensitivity to intermediate stre...
journal_title:Pediatric research
pub_type: 临床试验,杂志文章
doi:10.1203/00006450-199704000-00017
更新日期:1997-04-01 00:00:00
abstract:BACKGROUND:Phytosterols in soybean oil (SO) lipids likely contribute to parenteral nutrition-associated liver disease (PNALD) in infants. No characterization of phytosterol metabolism has been done in infants receiving SO lipids. METHODS:In a prospective cohort study, 45 neonates (36 SO lipid vs. 9 control) underwent ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/pr.2015.78
更新日期:2015-08-01 00:00:00
abstract::BackgroundTo investigate the association between electronic cigarette (e-cig) use and smoking cessation among smokers who called the Youth Quitline in Hong Kong.MethodsThis longitudinal study collected data on youth smokers' (N=189) use and perception of e-cigs, conventional cigarette smoking behavior, and sociodemogr...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/pr.2017.80
更新日期:2017-07-01 00:00:00
abstract::The lymphocytes of human breast milk have been previously shown to be immunologically competent while the monocytes have been described as actively motile in some reports but not in another. Cells were separated from milk samples collected by lactating women 2 to 9 days postpartum. Milk cell migration and production o...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198510000-00006
更新日期:1985-10-01 00:00:00
abstract::11-Beta hydroxysteroid dehydrogenase type 2 (HSD2) oxidizes the biologically active glucocorticoid (GC), cortisol, to inactive cortisone. We characterized HSD2 gene expression and activity in human adult and fetal lung tissues and in cultured fetal lung explants, and examined the potential regulation of HSD2 in the fe...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/PDR.0b013e3180676cf3
更新日期:2007-07-01 00:00:00
abstract::A series of in vivo experiments is described in which [1-13C]phytanic acid was given as an oral substrate to a healthy subject and two patients showing an impairment in phytanic acid degradation, one with Refsum's disease and one with chondrodysplasia punctata. After intake of the substrate by the control in a dose of...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199211000-00016
更新日期:1992-11-01 00:00:00
abstract:BACKGROUND:Prematurity may influence the levels of amino acids, enzymes, and endocrine markers obtained through newborn screening. Identifying which analytes are the most affected by degree of prematurity could provide insight into how prematurity impacts metabolism. METHODS:Analytes from blood spots assayed by Newbor...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/pr.2013.212
更新日期:2014-02-01 00:00:00
abstract::The newborn immune system differs quantitatively and functionally from that of adults. Development of the immune system has important implications for childhood diseases. The immaturity of the immune system in the first years of life may contribute to failure of tolerance induction and in the development of allergic d...
journal_title:Pediatric research
pub_type: 杂志文章,评审
doi:10.1203/00006450-199609000-00001
更新日期:1996-09-01 00:00:00
abstract::During the last few years, advances in the care of low-birth-weight and preterm neonates has stimulated research on the best dietetic program to improve survival and to reduce handicap incidence. At present, fortification of human milk with artificial formulas is the most usual dietetic solution. As yet, however, litt...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199905010-00008
更新日期:1999-05-01 00:00:00
abstract::The purpose of the study was to investigate the effect of low doses of dopamine in children. Fourteen cases were studied after open heart surgery. Cardiac output and renal parameters were determined under baseline conditions and under continuous infusion of dopamine 2.5 and 5 micrograms/kg/min. During the control peri...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198909000-00009
更新日期:1989-09-01 00:00:00
abstract:BACKGROUND:For the second aim of the Kellogg Foundation grant, this double-blind RCT investigated the impact of plasma vitamin D metabolite 25-hydroxyvitamin D (25(OH)D) on plasma immune-mediators during pregnancy. We hypothesized that higher 25(OH)D concentrations would associate with reduced pro-inflammatory and incr...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/s41390-020-0885-7
更新日期:2020-04-20 00:00:00
abstract::One of two slightly different influenza A/ts-1[E] recombinant candidate live vaccines was given intranasally to each of 23 young children. Twelve of 15 children who had no serum HI antibody but who did have serum ANAB at the time of administration became infected and 1 had mild rhinitis. All eight who lacked both type...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-197604000-00008
更新日期:1976-04-01 00:00:00
abstract::Increased fetal lung expansion profoundly inhibits surfactant protein gene expression and stimulates cellular proliferation in the fetal lung. Our aim was to determine whether increased expansion of the lung after birth, by the application of a continuous positive airway pressure (CPAP) for 12 h, inhibits surfactant p...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-200112000-00015
更新日期:2001-12-01 00:00:00
abstract::Respiratory parameters of skeletal muscle were determined in permeabilized muscle fibers by adapting a technique described by Veksler et al. for cardiac fibers (Biochim Biophys Acta, 892:191-196, 1987). This method consists of the permeabilization of muscle fibers by saponin by allowing respiratory substrates and inhi...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199207000-00004
更新日期:1992-07-01 00:00:00
abstract::In the small bowel of patients with cystic fibrosis, primary defects involving both chloride transport and mucus secretion have been demonstrated, but there is no general consensus about the morphologic counterpart of functional and biochemical abnormalities. We have studied the intestinal mucosa in a group of patient...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199802000-00013
更新日期:1998-02-01 00:00:00
abstract::BackgroundHyperoxic lung injury is characterized by cellular damage from high oxygen concentrations that lead to an inflammatory response and it disrupts normal alveolarization in the developing newborn lung. Adenosine is a signaling molecule that is generated extracellularly by ecto-5'-nucleotidase (CD73) in response...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/pr.2017.176
更新日期:2017-08-23 00:00:00
abstract::Neonatal PMN (polymorphonuclear neutrophils) exhibit altered inflammatory responsiveness and greater longevity compared with adult PMN; however, the involved mechanisms are incompletely defined. Receptors containing immunoreceptor tyrosine-based inhibitory motif (ITIM) domains promote apoptosis by activating inhibitor...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/PDR.0b013e3181b1bc19
更新日期:2009-09-01 00:00:00
abstract::Oxygen is critical for multicellular existence. Its reduction to water by the mitochondrial electron transport chain helps supply the metabolic demands of human life. The incompletely reduced, reactive oxygen byproducts of this reaction, however, can be quite toxic. In this review, we explore the mechanisms responsibl...
journal_title:Pediatric research
pub_type: 杂志文章,评审
doi:10.1203/PDR.0b013e31818fc83f
更新日期:2009-03-01 00:00:00
abstract::The syndrome of hypoxemia-related myocardial dysfunction in the newborn is generally associated with severe intrapartum asphyxia. We investigated the changes in total and regional distribution of myocardial blood flow (MBF) that occur during asphyxia and the factors that regulate MBF, in the chronically prepared, near...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198408000-00019
更新日期:1984-08-01 00:00:00
abstract::The aim of the present study was to determine the proportion of gamma/delta T-lymphocytes and CD16/CD56 (CD3- and CD3+) cells in the peripheral blood of children and adolescents with Graves' disease (GD; n = 27; mean age, 15.5 +/- 5.1 y) and nontoxic nodular goiter (NTNG; n = 25; mean age, 15.2 +/- 5.7 y), in comparis...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/01.PDR.0000076663.94850.44
更新日期:2003-09-01 00:00:00
abstract::Several neuropathologic findings in infants and children with human immunodeficiency virus type-1 (HIV-1) infection are different from those observed in adults, probably related to the fact that the retroviral infection occurs in the setting of neuro-development. This report describes the interaction and biologic acti...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199511000-00025
更新日期:1995-11-01 00:00:00
abstract::We compared sex-specific growth attainment of a population-based cohort of 147/166 (89%) extremely low birthweight (ELBW < 1000 g) and 131/145 (90%) sociodemographically comparable normal birthweight (NBW) cohort at young adulthood, and examined the pattern of growth trajectories and correlates of growth at ages 1, 2,...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/01.pdr.0000246201.93662.8e
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:There is a strong need for continuous cerebral circulation monitoring in neonatal care, since suboptimal cerebral blood flow may lead to brain injuries in preterm infants and other critically ill neonates. NeoDoppler is a novel ultrasound system, which can be gently fixed to the anterior fontanel and measure...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/s41390-019-0535-0
更新日期:2020-01-01 00:00:00