Adolescent ; Child ; Female ; Humans ; Male ; Marfan Syndrome ; complications ; diagnostic imaging ; Radiography ; Scoliosis ; diagnostic imaging ; surgery

INTRODUCTION: Evidence supporting non-invasive ventilation (NIV) in paediatric acute respiratory distress syndrome (PARDS) remains sparse. We aimed to describe characteristics of patients with PARDS supported with NIV and risk factors for NIV failure. MATERIALS AND METHODS: This is a multicentre retrospective study. Only patients supported on NIV with PARDS were included. Data on epidemiology and clinical outcomes were collected. Primary outcome was NIV failure which was defined as escalation to invasive mechanical ventilation within the first 7 days of PARDS. Patients in the NIV success and failure groups were compared. RESULTS: There were 303 patients with PARDS; 53/303 (17.5%) patients were supported with NIV. The median age was 50.7 (interquartile range: 15.7-111.9) months. The Paediatric Logistic Organ Dysfunction score and oxygen saturation/fraction of inspired oxygen (SF) ratio were 2.0 (1.0-10.0) and 155.0 (119.4- 187.3), respectively. Indications for NIV use were increased work of breathing (26/53 [49.1%]) and hypoxia (22/53 [41.5%]). Overall NIV failure rate was 77.4% (41/53). All patients with sepsis who developed PARDS experienced NIV failure. NIV failure was associated with an increased median paediatric intensive care unit stay (15.0 [9.5-26.5] vs 4.5 [3.0-6.8] days; <0.001) and hospital length of stay (26.0 [17.0-39.0] days vs 10.5 [5.5-22.3] days; = 0.004). Overall mortality rate was 32.1% (17/53). CONCLUSION The use of NIV in children with PARDS was associated with high failure rate. As such, future studies should examine the optimal selection criteria for NIV use in these children.

ABSTRACT High viscous glass ionomer cement (HVGIC) was recently developed for atraumatic restorative treatment (ART). However, its moisture sensitivity remains a limitation thus protective coating application is recommended. This study investigated the effect of resin coating on the surface roughness and microhardness of two HVGICs (Riva Self Cure HVGIC [RV] and Equia® Forte Fil [EQ]) conditioned in food-simulating liquids (FSLs). Fifty standard disc-shaped samples were fabricated using customised stainless-steel mould (10 × 2 mm). Coating was applied on top surface of all samples and subsequently divided into five groups: air (control), distilled water, 0.02 N citric acid, heptane and 50% ethanol-water solution. The samples were conditioned in FSLs at 37°C for seven days. Subsequently, the surface roughness and microhardness of samples were measured using optical profilometry and microhardness tester, respectively. SEM analysis was done for qualitative observation of surface morphological changes. Data were analysed using one-way ANOVA, two-way ANOVA and posthoc Tukey’s test (α = 0.05). Interestingly, the results revealed that surface roughness was significantly influenced by FSLs immersion, presence of coating and the materials itself (p < 0.001). The lowest surface roughness was found on control coated samples: RV (50.98±4.25) nm and EQ (62.77±3.92) nm, while the highest values seen on uncoated surfaces in citric acid: RV (505.26±31.10) nm and EQ (350.33±15.36) nm. RV samples had the lowest microhardness of 54.97±2.48 Vickers hardness number (VHN) post-immersion in citric acid. In conclusion, with the exception of RV conditioned in heptane and ethanol, the uncoated HVGICs generally had higher surface roughness than the coated HVGICs. HVGICs conditioned in citric acid showed the most significant increase in surface roughness and reduction in microhardness.
Glass Ionomer Cements--adverse effects