Abstract:
BACKGROUND:Severe traumatic brain injury (TBI) is a leading cause of mortality in children, but the accurate prediction of outcomes at the point of admission remains very challenging. Admission laboratory results are a promising potential source of prognostic data, but have not been widely explored in paediatric cohorts. Herein, we use machine-learning methods to analyse 14 different serum parameters together and develop a prognostic model to predict 6-month outcomes in children with severe TBI. METHODS:A retrospective review of patients admitted to Cambridge University Hospital's Paediatric Intensive Care Unit between 2009 and 2013 with a TBI. The data for 14 admission serum parameters were recorded. Logistic regression and a support vector machine (SVM) were trained with these data against dichotimised outcomes from the recorded 6-month Glasgow Outcome Scale. RESULTS:Ninety-four patients were identified. Admission levels of lactate, H+, and glucose were identified as being the most informative of 6-month outcomes. Four different models were produced. The SVM using just the three most informative parameters was the best able to predict favourable outcomes at 6 months (sensitivity = 80%, specificity = 99%). CONCLUSIONS:Our results demonstrate the potential for highly accurate outcome prediction after severe paediatric TBI using admission laboratory data.
journal_name
Pediatr Resjournal_title
Pediatric researchauthors
Kayhanian S,Young AMH,Mangla C,Jalloh I,Fernandes HM,Garnett MR,Hutchinson PJ,Agrawal Sdoi
10.1038/s41390-019-0510-9subject
Has Abstractpub_date
2019-11-01 00:00:00pages
641-645issue
5eissn
0031-3998issn
1530-0447pii
10.1038/s41390-019-0510-9journal_volume
86pub_type
杂志文章abstract::Cerebral concentrations of phenylalanine (PHE) were measured by means of quantitative in vivo 1H MR spectroscopy in 8 adult patients treated early for phenylketonuria type I. A 1.5-Tesla routine magnetic resonance scanner, localization sequence with short echo time (20 ms), and a fully automated data processing scheme...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199511000-00005
更新日期:1995-11-01 00:00:00
abstract::Staphylococcus aureus has been isolated at an increasing rate from infants' stools during the last decades, but it is not known whether this species can colonize and persist in the intestinal microflora. To investigate this, 49 Swedish infants were followed prospectively from birth until 12 months of age. S. aureus wa...
journal_title:Pediatric research
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doi:10.1203/00006450-200012000-00007
更新日期:2000-12-01 00:00:00
abstract::Data are scant regarding the development of cerebrovascular autoregulation in intrauterine growth-restricted (IUGR) newborns. We tested the hypothesis that IUGR improves the ability of neonates to withstand critical periods of gradual hemorrhagic hypotension by optimizing cerebrovascular autoregulation. Studies were c...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/01.PDR.0000139425.94975.77
更新日期:2004-10-01 00:00:00
abstract::Carnitine palmitoyltransferase (CPT) consists of two activities located in the outer (CPT I) and the inner (CPT II) mitochondrial membranes. CPT II deficiency in the adult as well as in the infantile form of the disease has been shown to result from mutations in the CPT II cDNA. Nothing is known regarding the genetic ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199610000-00005
更新日期:1996-10-01 00:00:00
abstract::A rabbit model of group B Streptococcal (GBS) shock was used to determine if myocardial dysfunction contributes to GBS shock and, if so, to ascertain if prostaglandins modulate this dysfunction. The infusion of heat-killed GBS (group I) produced a dramatic decrease in the first derivative of left ventricular pressure ...
journal_title:Pediatric research
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doi:10.1203/00006450-198506000-00001
更新日期:1985-06-01 00:00:00
abstract:BACKGROUND:Cardiovascular (CV) complications are the most significant cause of mortality in adults with Cushing disease (CD); little is known about CV risk factors in children with CD. Measurement of lipoprotein particles by nuclear magnetic resonance (NMR) spectroscopy is a novel technology to assess CV risk. The obje...
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doi:10.1038/s41390-019-0438-0
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abstract::Hypothalamic growth hormone releasing hormone (GHRH) stimulates pituitary growth hormone secretion, which is essential for normal postnatal growth. Reports of an immunoreactive and biologically active GHRH-like peptide in placenta led us to investigate placental expression of GHRH mRNA. Placentas from d 19 gestation f...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199105010-00019
更新日期:1991-05-01 00:00:00
abstract::Rats were fed a 50% galactose diet during pregnancy and nursing, and the testes were later examined and hormone levels determined in male offspring. Exposure to galactose for various periods during pregnancy, throughout the entire gestation, or postnatally to nursing mother until pups were 5 wk of age produced no sign...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198404000-00008
更新日期:1984-04-01 00:00:00
abstract::BackgroundLactoferrin (LTF) could play a beneficial role in insulin resistance and diabetes, but the association of its gene variants with cardio-metabolic disorders in children has not been investigated. This study aimed to examine the relationship between LTF variants, plasma LTF concentrations, and cardio-metabolic...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/pr.2017.72
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abstract::Insulin administration is the primary therapy for type 1 diabetes mellitus (T1DM). Current available insulin therapies do not successfully enable children with T1DM to reach glycemic goals without side effects such as hypoglycemia and weight gain. Pramlintide is a synthetic analog of human amylin that acts in conjunct...
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pub_type: 杂志文章,评审
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abstract::We have previously demonstrated that vagal phase-response curves (PRC), which characterize the effects of critically timed, brief vagal stimuli on sinus node automaticity, exhibit a fundamentally different shape in the canine newborn than in the adult. In this study we analyzed the changes in sinus cycle length in res...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199401000-00013
更新日期:1994-01-01 00:00:00
abstract::Hemophagocytic lymphohistiocytosis (HLH) and Langerhans cell histiocytosis (LCH) are members of a group of rare heterogenous disorders, the histiocytoses, characterized by uncontrolled accumulation of pleomorphic infiltrates of leukocytes. The etiology of these diseases is mainly unknown. CD45 is a hemopoietic cell sp...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/01.PDR.0000106803.15344.72
更新日期:2004-03-01 00:00:00
abstract::Recently a soybean oil emulsion (Intralipid) (IL) has been released in the United States for use as a parenteral nutrient. The study reported here was undertaken to determine the effect of ingestion of IL on the synthesis and secretion of the second (C2) and fourth (C4) components of complement by guinea pig peritonea...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-197903000-00012
更新日期:1979-03-01 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:BACKGROUND:To evaluate the apoptosis inhibitor of macrophage (AIM) deposition patterns on the kidneys of children with IgA nephropathy (IgAN) and Henoch-Schönlein purpura nephritis (HSPN) and to investigate the clinical usefulness of serum and/or urinary AIM levels as biomarkers for the disease activity. METHODS:Immun...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/s41390-020-0951-1
更新日期:2020-05-14 00:00:00
abstract::Previously, we have reported marked pulmonary inflammation in infants who develop chronic lung disease of prematurity. We revisited these infants who did not have clinical or laboratory evidence of infection and searched for Ureaplasma urealyticum, group B streptococci, and other microbes by reverse transcription-PCR ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/01.PDR.0000100757.38675.50
更新日期:2004-01-01 00:00:00
abstract::Insulin is a potent mitogen for many cell types in vitro. During tissue culture, supraphysiological concentrations of insulin are necessary to promote cell replication in connective or musculoskeletal tissues. Insulin promotes the growth of these cells by binding, with low affinity, to the type I insulin-like growth f...
journal_title:Pediatric research
pub_type: 杂志文章,评审
doi:10.1203/00006450-198509000-00001
更新日期:1985-09-01 00:00:00
abstract::We studied the hemodynamic responses of 29 anesthetized and mechanically ventilated piglets to acute hypoxia [reduction of Pao2 from 130 to 38 mm Hg induced by inhalation of 7% fraction of inspired oxygen (Fio2) for 7.5 min] before and during group B beta-hemolytic streptococci (GBS) sepsis. During hypoxia, nonseptic ...
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doi:10.1203/00006450-200004000-00017
更新日期:2000-04-01 00:00:00
abstract::Astrocyte end-feet ensheathe blood vessels in the brain and are believed to provide structural integrity to the cerebral vasculature. We sought to determine in developing infants whether the coverage of blood vessels by astrocyte end-feet is decreased in germinal matrix (GM) compared with cerebral cortex and white mat...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/01.pdr.0000214975.85311.9c
更新日期:2006-05-01 00:00:00
abstract::Thrombocytopenia in the first days of life, in association with evidence of reduced megakaryocytopoiesis and platelet production at birth, is common in sick preterm babies. Thrombopoietin (Tpo) is the major regulator of platelet production in adults. However, these babies have low Tpo levels at birth, suggesting that ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199907000-00005
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abstract::This study examined the relationships between cerebral fractional oxygen extraction (FOE), mean arterial blood pressure (MABP), left ventricular output (LVO), blood gases, and other physiologic variables in 36 very-low-birth-weight preterm infants during the first 3 d after birth. There was a decrease in cerebral FOE ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/01.PDR.0000111288.87002.3A
更新日期:2004-03-01 00:00:00
abstract::The presence of high concentrations of sodium in the sweat of patients with cystic fibrosis is widely accepted by all investigators as one of the most important manifestations of the genetic defect. However, the simple means of sweat collection utilized for diagnostic purposes has been extended to the biochemical and ...
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doi:10.1203/00006450-198508000-00020
更新日期:1985-08-01 00:00:00
abstract::DNA segments that are separated from the promoter region of a gene by many thousands of bases may nonetheless regulate the transcriptional activity of that gene. This finding has led to the investigation of mechanisms underlying long-range chromatin interactions. In intermitotic cells, chromosomes decondense, filling ...
journal_title:Pediatric research
pub_type: 杂志文章,评审
doi:10.1203/pdr.0b013e31804575db
更新日期:2007-05-01 00:00:00
abstract::Television viewing (TVV) is considered a contributing factor to the development of childhood obesity yet it is unclear whether obesity results, in part, from increased energy intake during TVV. The objective of this study was to determine the effect of TVV on food intake (FI) of boys at a meal and its effect on calori...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/pdr.0b013e3180536591
更新日期:2007-06-01 00:00:00
abstract::Studies were designed to develop an animal model for the syndrome of hypochloremic, hypokalemic metabolic alkalosis (HMA), and failure to thrive in infants due to intake of chloride-deficient formula. Littermate canine puppies, 2 wk old, were fed soy formula containing normal chloride, 20 mEq/liter (NC, n = 5), or low...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198705000-00015
更新日期:1987-05-01 00:00:00
abstract:BACKGROUND:Necrotising enterocolitis (NEC) and late-onset sepsis (LOS) are the leading causes of death among preterm infants in the developed world. This study aimed to explore the serum proteome and metabolome longitudinally in preterm infants with NEC or LOS, matched to controls. METHODS:Nineteen patients (10 cases,...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/pr.2015.235
更新日期:2016-03-01 00:00:00
abstract::To determine the role of pili in mediating adherence of type b and nontypeable Haemophilus influenzae to several respiratory cell types, piliated bacteria, nonpiliated phase variants, and nonpiliated mutants possessing insertionally inactivated pilin genes were tested. Both piliated and nonpiliated strains adhered to ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199602000-00025
更新日期:1996-02-01 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::Human Bifidobacterium sp strain bifidum (B. bifidum) was administered to BALB/c lactating mice (n = 58) and their litters (n = 327 pups) to evaluate the ingested strain's adherent properties and ability to inhibit murine rotavirus (MRV) infection. ELISA and anaerobic bacteriologic techniques were used to measure MRV s...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199406000-00014
更新日期:1994-06-01 00:00:00
abstract::Sleep organization of infants may be influenced by differences in nutrient intakes from human milk and formula. Because sleep/awake and sleep stage patterns affect energy expenditure, we hypothesized that differences in sleep organization between breast-fed and formula-fed infants might account in part for differences...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199211000-00003
更新日期:1992-11-01 00:00:00