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  1. Article ; Online: Anaphyl-Crisis: Rising Rates of Pediatric Anaphylaxis.

    Patek, Paul M / Owda, Dalia / Menoch, Margaret J A

    Pediatric emergency care

    2022  Volume 38, Issue 9, Page(s) e1529–e1532

    Abstract: Objectives: Anaphylaxis is a serious allergic reaction that has the potential to be life-threatening if not recognized and managed rapidly. Several regional studies have shown increased incidence of anaphylaxis over the past decade. The objectives of ... ...

    Abstract Objectives: Anaphylaxis is a serious allergic reaction that has the potential to be life-threatening if not recognized and managed rapidly. Several regional studies have shown increased incidence of anaphylaxis over the past decade. The objectives of this study were to determine rates of pediatric anaphylaxis in southeast Michigan between January 1, 2010, and December 31, 2019, and to describe the epidemiology of pediatric patients presenting to emergency centers in southeast Michigan with anaphylaxis.
    Methods: We performed a retrospective chart review of all pediatric patients aged 0 to 17 years presenting to 2 large emergency centers from 2010 to 2019 with a diagnosis of anaphylaxis using International Classification of Diseases , Ninth and Tenth Revision , Clinical Modification codes. Epidemiological and visit data, including length of stay, use of intravenous medication, and emergency severity index, were extracted and analyzed. Pediatric anaphylaxis rates were calculated based on detected anaphylaxis cases divided by total pediatric emergency department visits to the 2 emergency centers. A Poisson regression model was used to predict rates of anaphylaxis per 100,000 emergency department visits.
    Results: One thousand three hundred ninety-one pediatric visits for anaphylaxis were identified during a period between January 1, 2010, and December 31, 2019. There was a significant rate of increase in pediatric anaphylaxis cases over the 10-year study period at both suburban emergency centers, with an annual increase of 21% and 13%. There was no significant change in trends in demographic factors. Most anaphylaxis cases were young, White males with private insurance. Most children did not receive intravenous medications (77%). The median length of stay increased by 1.5 hours over the study period and 92% of patients were discharged home.
    Conclusions: Pediatric emergency center visits and length of stay for anaphylaxis in southeast Michigan have markedly increased over the past 10 years.
    MeSH term(s) Anaphylaxis/diagnosis ; Child ; Emergency Service, Hospital ; Epinephrine/therapeutic use ; Humans ; International Classification of Diseases ; Male ; Patient Discharge ; Retrospective Studies
    Chemical Substances Epinephrine (YKH834O4BH)
    Language English
    Publishing date 2022-05-31
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632588-9
    ISSN 1535-1815 ; 0749-5161
    ISSN (online) 1535-1815
    ISSN 0749-5161
    DOI 10.1097/PEC.0000000000002771
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: SARS-CoV-2 Infection in a 2-Week-Old Male With Neutropenia.

    Patek, Paul / Corcoran, John / Adams, Lauren / Khandhar, Paras

    Clinical pediatrics

    2020  Volume 59, Issue 9-10, Page(s) 918–920

    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/complications ; Coronavirus Infections/drug therapy ; Humans ; Infant, Newborn ; Male ; Neutropenia/complications ; Neutropenia/drug therapy ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/drug therapy ; SARS-CoV-2 ; Treatment Outcome
    Chemical Substances Anti-Bacterial Agents
    Keywords covid19
    Language English
    Publishing date 2020-04-15
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 207678-0
    ISSN 1938-2707 ; 0009-9228
    ISSN (online) 1938-2707
    ISSN 0009-9228
    DOI 10.1177/0009922820920014
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Coronavirus-19 Multisystem Inflammatory Syndrome in Children (MIS-C): A Pediatric Simulation Case for Residents, Fellows, and Advanced Practice Providers.

    Gurkha, Dhritiman / Cashen, Katie / Patek, Paul / Lelak, Karima / Levasseur, Kelly

    MedEdPORTAL : the journal of teaching and learning resources

    2021  Volume 17, Page(s) 11180

    Abstract: Introduction: A rare but serious condition often requiring intensive care, multisystem inflammatory syndrome in children (MIS-C) is characterized by hyperinflammatory shock related to the SARS-CoV-2 pandemic. This resource teaches residents, pediatric ... ...

    Abstract Introduction: A rare but serious condition often requiring intensive care, multisystem inflammatory syndrome in children (MIS-C) is characterized by hyperinflammatory shock related to the SARS-CoV-2 pandemic. This resource teaches residents, pediatric emergency medicine fellows, and advanced practice providers who care for children to recognize and manage MIS-C and associated sequelae while applying the basic principles of pediatric resuscitation.
    Methods: The simulation case was based on a real patient who presented to the emergency department with fever, rash, and cardiogenic shock. We designed the scenario to be used with a high-fidelity school-age mannequin in an emergency center resuscitation room or simulation lab. The case took 25 minutes to run, followed by a 15- to 20-minute debrief session. Personnel required for the case included a simulation technician, case instructor, emergency department nurse, parent, and consultant. Learners had to recognize the syndrome and treat the resultant shock and arrhythmia with a combination of vasopressors, antiarrhythmics, and defibrillation. Afterward, learners participated in a formal debriefing session and completed a written evaluation.
    Results: Twenty-five learners (six pediatric emergency medicine fellows, 12 residents, and seven advanced practice providers) participated in the scenario over a 3-month period. The written evaluation was completed by 20 of the 25 participants; all 20 felt their confidence, comfort, and knowledge regarding the topic had increased, with an average score of 5 (
    Discussion: This simulation case offers an effective experience for learners to become comfortable and confident in recognizing and managing MIS-C.
    MeSH term(s) COVID-19 ; Child ; Humans ; Pediatric Emergency Medicine ; SARS-CoV-2 ; Systemic Inflammatory Response Syndrome
    Language English
    Publishing date 2021-08-16
    Publishing country United States
    Document type Journal Article
    ISSN 2374-8265
    ISSN (online) 2374-8265
    DOI 10.15766/mep_2374-8265.11180
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: SARS-CoV-2 Infection in a 2-Week-Old Male With Neutropenia

    Patek, Paul / Corcoran, John / Adams, Lauren / Khandhar, Paras

    Clinical Pediatrics

    2020  Volume 59, Issue 9-10, Page(s) 918–920

    Keywords Pediatrics, Perinatology, and Child Health ; covid19
    Language English
    Publisher SAGE Publications
    Publishing country us
    Document type Article ; Online
    ZDB-ID 207678-0
    ISSN 1938-2707 ; 0009-9228
    ISSN (online) 1938-2707
    ISSN 0009-9228
    DOI 10.1177/0009922820920014
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Coronavirus-19 Multisystem Inflammatory Syndrome in Children (MIS-C)

    Dhritiman Gurkha / Katie Cashen / Paul Patek / Karima Lelak / Kelly Levasseur

    MedEdPORTAL, Vol

    A Pediatric Simulation Case for Residents, Fellows, and Advanced Practice Providers

    2021  Volume 17

    Abstract: Introduction A rare but serious condition often requiring intensive care, multisystem inflammatory syndrome in children (MIS-C) is characterized by hyperinflammatory shock related to the SARS-CoV-2 pandemic. This resource teaches residents, pediatric ... ...

    Abstract Introduction A rare but serious condition often requiring intensive care, multisystem inflammatory syndrome in children (MIS-C) is characterized by hyperinflammatory shock related to the SARS-CoV-2 pandemic. This resource teaches residents, pediatric emergency medicine fellows, and advanced practice providers who care for children to recognize and manage MIS-C and associated sequelae while applying the basic principles of pediatric resuscitation. Methods The simulation case was based on a real patient who presented to the emergency department with fever, rash, and cardiogenic shock. We designed the scenario to be used with a high-fidelity school-age mannequin in an emergency center resuscitation room or simulation lab. The case took 25 minutes to run, followed by a 15- to 20-minute debrief session. Personnel required for the case included a simulation technician, case instructor, emergency department nurse, parent, and consultant. Learners had to recognize the syndrome and treat the resultant shock and arrhythmia with a combination of vasopressors, antiarrhythmics, and defibrillation. Afterward, learners participated in a formal debriefing session and completed a written evaluation. Results Twenty-five learners (six pediatric emergency medicine fellows, 12 residents, and seven advanced practice providers) participated in the scenario over a 3-month period. The written evaluation was completed by 20 of the 25 participants; all 20 felt their confidence, comfort, and knowledge regarding the topic had increased, with an average score of 5 (strongly agree) on a 5-point Likert scale. Discussion This simulation case offers an effective experience for learners to become comfortable and confident in recognizing and managing MIS-C.
    Keywords Pediatrics ; Pediatric Emergency Medicine ; COVID-19 ; Multisystem Inflammatory Syndrome in Children ; Shock ; Case-Based Learning ; Medicine (General) ; R5-920 ; Education ; L
    Subject code 710
    Language English
    Publishing date 2021-08-01T00:00:00Z
    Publisher Association of American Medical Colleges
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Identification of novel loci for multiple myeloma when comparing with its precursor condition monoclonal gammopathy of unknown significance.

    Buradagunta, Christopher Staffi / Arsang-Jang, Shahram / Massat, Ben / Thapa, Bicky / Patek, Victoria / D'Souza, Anita / Auer, Paul / Urrutia, Raul / Janz, Siegfried / Dhakal, Binod / Hari, Parameswaran / Dong, Jing

    Leukemia

    2023  Volume 38, Issue 2, Page(s) 383–385

    MeSH term(s) Humans ; Multiple Myeloma/genetics ; Paraproteinemias/genetics ; Monoclonal Gammopathy of Undetermined Significance/genetics
    Language English
    Publishing date 2023-11-02
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 807030-1
    ISSN 1476-5551 ; 0887-6924
    ISSN (online) 1476-5551
    ISSN 0887-6924
    DOI 10.1038/s41375-023-02078-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Book ; Audio / Video ; Thesis: Immunopathology of experimentally induced acute and chronic inflammation in mice

    Patek, Paul Q.

    1977  

    Language English
    Size 1 Mikrofilm (136 S.) ; 35 mm
    Publishing country United States
    Document type Book ; Audio / Video ; Thesis
    Thesis / German Habilitation thesis Houston, Tex., Univ. of Texas, Diss., 1977
    HBZ-ID HT002360552
    Database Catalogue ZB MED Medicine, Health

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  8. Article ; Online: The opinions and experiences of Irish obstetric and gynaecology trainee doctors in relation to abortion services in Ireland.

    Aitken, Kara / Patek, Paul / Murphy, Mark E

    Journal of medical ethics

    2017  Volume 43, Issue 11, Page(s) 778–783

    Abstract: Introduction: The provision of abortion services in the Republic of Ireland is legally restricted. Recent legislation that has been implemented allows for abortion if there is a real and substantial risk to the woman's life, but in general Irish women ... ...

    Abstract Introduction: The provision of abortion services in the Republic of Ireland is legally restricted. Recent legislation that has been implemented allows for abortion if there is a real and substantial risk to the woman's life, but in general Irish women must travel abroad for abortion services. The aims of this study were to investigate the clinical experiences of Irish obstetric non-consultant hospital doctors (NCHDs) that work in this environment and to assess their attitudes towards termination of pregnancy (ToP).
    Methods: We conducted an online cross-sectional descriptive survey of 184 Irish obstetric NCHDs. Quantitate and qualitative analysis was performed.
    Results: There was a 28% response rate. 88% of respondents thought that ToP should be permitted for fatal fetal abnormality if the parents choose, 96% if the woman's health is severely affected and 86% in cases of rape and incest. Over 90% of respondents believed a woman's health suffers because of the need to travel abroad to undergo a ToP. Physical, psychological and social reasons were explored. The research also highlights that obstetric trainees are actively involved in the provision of preabortion and postabortion care.
    Conclusions: The clinical experiences and opinions of the respondents suggest that the current legal availability of abortion in Ireland is insufficient to guide best clinical practice and does not represent the views of those that provide obstetric care.
    MeSH term(s) Abortion, Induced ; Abortion, Legal ; Adult ; Attitude of Health Personnel ; Cross-Sectional Studies ; Education, Medical, Graduate ; Female ; Gynecology ; Humans ; Ireland ; Male ; Obstetrics ; Physicians ; Pregnancy ; Reproductive Health Services ; Specialization ; Young Adult
    Language English
    Publishing date 2017-03-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 194927-5
    ISSN 1473-4257 ; 0306-6800
    ISSN (online) 1473-4257
    ISSN 0306-6800
    DOI 10.1136/medethics-2015-102866
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  9. Article ; Online: Fatal central nervous system co-infection with SARS-CoV-2 and tuberculosis in a healthy child.

    Freij, Bishara J / Gebara, Bassam M / Tariq, Rabail / Wang, Ay-Ming / Gibson, John / El-Wiher, Nidal / Krasan, Graham / Patek, Paul M / Levasseur, Kelly A / Amin, Mitual / Fullmer, Joseph M

    BMC pediatrics

    2020  Volume 20, Issue 1, Page(s) 429

    Abstract: Background: Central and peripheral nervous system symptoms and complications are being increasingly recognized among individuals with pandemic SARS-CoV-2 infections, but actual detection of the virus or its RNA in the central nervous system has rarely ... ...

    Abstract Background: Central and peripheral nervous system symptoms and complications are being increasingly recognized among individuals with pandemic SARS-CoV-2 infections, but actual detection of the virus or its RNA in the central nervous system has rarely been sought or demonstrated. Severe or fatal illnesses are attributed to SARS-CoV-2, generally without attempting to evaluate for alternative causes or co-pathogens.
    Case presentation: A five-year-old girl with fever and headache was diagnosed with acute SARS-CoV-2-associated meningoencephalitis based on the detection of its RNA on a nasopharyngeal swab, cerebrospinal fluid analysis, and magnetic resonance imaging findings. Serial serologic tests for SARS-CoV-2 IgG and IgA showed seroconversion, consistent with an acute infection. Mental status and brain imaging findings gradually worsened despite antiviral therapy and intravenous dexamethasone. Decompressive suboccipital craniectomy for brain herniation with cerebellar biopsy on day 30 of illness, shortly before death, revealed SARS-CoV-2 RNA in cerebellar tissue using the Centers for Disease Control and Prevention 2019-nCoV Real-Time Reverse Transcriptase-PCR Diagnostic Panel. On histopathology, necrotizing granulomas with numerous acid-fast bacilli were visualized, and Mycobacterium tuberculosis complex DNA was detected by PCR. Ventricular cerebrospinal fluid that day was negative for mycobacterial DNA. Tracheal aspirate samples for mycobacterial DNA and culture from days 22 and 27 of illness were negative by PCR but grew Mycobacterium tuberculosis after 8 weeks, long after the child's passing. She had no known exposures to tuberculosis and no chest radiographic findings to suggest it. All 6 family members had normal chest radiographs and negative interferon-γ release assay results. The source of her tuberculous infection was not identified, and further investigations by the local health department were not possible because of the State of Michigan-mandated lockdown for control of SARS-CoV-2 spread.
    Conclusion: The detection of SARS-CoV-2 RNA in cerebellar tissue and the demonstration of seroconversion in IgG and IgA assays was consistent with acute SARS-CoV-2 infection of the central nervous infection. However, the cause of death was brain herniation from her rapidly progressive central nervous system tuberculosis. SARS-CoV-2 may mask or worsen occult tuberculous infection with severe or fatal consequences.
    MeSH term(s) Betacoronavirus/genetics ; COVID-19 ; Child, Preschool ; Coinfection/diagnosis ; Coinfection/microbiology ; Coronavirus Infections/diagnosis ; Coronavirus Infections/epidemiology ; Coronavirus Infections/virology ; DNA, Bacterial/analysis ; Fatal Outcome ; Female ; Humans ; Mycobacterium tuberculosis/genetics ; Mycobacterium tuberculosis/isolation & purification ; Pandemics ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/virology ; RNA, Viral/analysis ; SARS-CoV-2 ; Tuberculosis, Central Nervous System/diagnosis ; Tuberculosis, Central Nervous System/microbiology
    Chemical Substances DNA, Bacterial ; RNA, Viral
    Keywords covid19
    Language English
    Publishing date 2020-09-09
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 2041342-7
    ISSN 1471-2431 ; 1471-2431
    ISSN (online) 1471-2431
    ISSN 1471-2431
    DOI 10.1186/s12887-020-02308-1
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