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https://www.readbyqxmd.com/read/28727288/complications-preceding-early-deaths-in-black-and-white-children-with-acute-myeloid-leukemia
#1
Lena E Winestone, Kelly D Getz, Tamara P Miller, Yimei Li, Yuan-Shung Huang, Alix E Seif, Brian T Fisher, Richard Aplenc
Black patients have a twofold increased risk of induction mortality compared to White patients with acute myeloid leukemia (AML). We reviewed diagnosis and billing data from Pediatric Health Information System for 28 AML Induction I deaths to investigate conditions preceding death in White and Black patients. Half of deaths occurred within 10 days of initial diagnostic admission. Respiratory, cardiac, renal, and infectious complications were common prior to both White and Black deaths. Deaths in White patients were more commonly preceded by intracranial hemorrhage compared to deaths in Black patients...
July 20, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28720036/procalcitonin-to-detect-bacterial-infections-in-critically-ill-pediatric-patients
#2
David M Jacobs, Maya Holsen, Shirley Chen, Nicholas M Fusco, Amanda B Hassinger
The diagnostic power of procalcitonin (PCT) in the pediatric intensive care unit (PICU) is uncertain. This study aimed to determine the diagnostic ability of PCT to detect serious bacterial infections (SBI) in a heterogeneous PICU population. This was a retrospective cohort study of patients on whom a PCT level was obtained within 48 hours of admission to a PICU from 2013 to 2015. Discriminatory ability of PCT to predict SBI was examined by test and receiver operating characteristics (AUC [area under the curve]-ROC)...
August 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28719626/impact-of-respiratory-infections-outdoor-pollen-and-socioeconomic-status-on-associations-between-air-pollutants-and-pediatric-asthma-hospital-admissions
#3
Julie E Goodman, Christine T Loftus, Xiaobin Liu, Ke Zu
BACKGROUND: Epidemiology studies have shown that ambient concentrations of ozone and fine particulate matter (PM2.5) are associated with increased emergency department (ED) visits and hospital admissions (HAs) for asthma. OBJECTIVE: Evaluate the impact of outdoor pollen, respiratory infections, and socioeconomic status (SES) on the associations between ambient ozone and PM2.5 and asthma HAs in New York City. METHODS: Daily ozone, PM2.5, meteorological factors, pollen, and hospitalization records during 1999 to 2009 were obtained for New York City residents...
2017: PloS One
https://www.readbyqxmd.com/read/28716803/psychiatric-boarding-in-the-pediatric-inpatient-medical-setting-a-retrospective-analysis
#4
Katherine A S Gallagher, I Simona Bujoreanu, Priscilla Cheung, Christine Choi, Sara Golden, Kerry Brodziak, Gabriela Andrade, Patricia Ibeziako
BACKGROUND AND OBJECTIVES: Psychiatric concerns are a common presenting problem for pediatric providers across many settings, particularly on inpatient medical services. The volume of youth requiring intensive psychiatric treatment outnumbers the availability of psychiatric placements, and as a result many youth must board on pediatric medical units while awaiting placement. As the phenomenon of boarding in the inpatient pediatric setting increases, it is important to understand trends in boarding volume and characteristics of pediatric psychiatric boarders (PBs) and understand the supports they receive while boarding...
July 17, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28716517/lethal-suicide-attempt-with-a-mixed-drug-intoxication-of-metoprolol-and-propafenone-a-first-pediatric-case-report
#5
Ivana Kacirova, Milan Grundmann, Martin Kolek, Erika Vyskocilova-Hrudikova, Romana Urinovska, Petr Handlos
INTRODUCTION: The β1 adrenergic receptor blocker metoprolol is often prescribed together with the antiarrhythmic drug propafenone. Both are metabolized by cytochrome P450 2D6 and propafenone is also an inhibitor of this enzyme. We present a pediatric case showing metoprolol and propafenone intoxication in combination. CASE: A 14-year-old girl was admitted to a local emergency department after ingestion of metoprolol (probably 1g) and propafenone (probably 1.5-3g) in a suicide attempt...
June 29, 2017: Forensic Science International
https://www.readbyqxmd.com/read/28714831/improving-the-quality-of-nutrition-in-pediatric-trauma
#6
Alice Wang, Helena Pelletier, Diana Calligan, Angela Coates, Karen Allison Bailey
Purpose Nutrition plays a key role in the recovery of pediatric trauma patients. A catabolic state in trauma patients may hinder recovery and inadequate nutrition may increase morbidity, mortality and length of hospital stay. The purpose of this paper is to review the current nutrition support practices for pediatric trauma patients at McMaster Children's Hospital (MCH), describe patient demographics and identify areas to improve the quality of patient care. Design/methodology/approach A retrospective chart review was conducted on pediatric trauma patients (age<18 years) identified through the trauma registry of MCH...
July 10, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28713509/mechanical-ventilation-practice-in-egyptian-pediatric-intensive-care-units
#7
Bassant Salah Meligy, Sally Kamal, Seham Awad El Sherbini
INTRODUCTION: Mechanical ventilation is one of the indispensable tools in pediatric intensive care units. Few studies addressed the epidemiology of pediatric patients on mechanical ventilation and the frequently used modes of ventilation. This is the first study to describe the practice of mechanical ventilation (MV) in Egyptian pediatric intensive care units (PICUs). METHODS: This prospective observational study was conducted from January 2014 to December 2014 in two pediatric intensive care units at Cairo University Pediatric Hospital...
May 2017: Electronic Physician
https://www.readbyqxmd.com/read/28708677/repeated-critical-illness-and-unplanned-readmissions-within-1-year-to-picus
#8
Jeffrey D Edwards, Adam R Lucas, W John Boscardin, R Adams Dudley
OBJECTIVES: To determine the occurrence rate of unplanned readmissions to PICUs within 1 year and examine risk factors associated with repeated readmission. DESIGN: Retrospective cohort analysis. SETTING: Seventy-six North American PICUs that participated in the Virtual Pediatric Systems, LLC (VPS, LLC, Los Angeles, CA). PATIENTS: Ninety-three thousand three hundred seventy-nine PICU patients discharged between 2009 and 2010...
August 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28708210/particle-image-velocimetry-tests-on-pediatric-45-cc-and-30-cc-ventricle-assist-devices-effects-of-heart-rate-on-vad-operation
#9
Dariusz Witkowski, Damian Obidowski, Piotr Reorowicz, Daniel Jodko, Krzysztof Jozwik
BACKGROUND: This study investigated flow analysis inside pediatric ventricle assist devices (VADs) designed and manufactured at the Foundation for Cardiac Surgery Development (FRK), Zabrze, Poland. The main goal of the experiment was to define the minimal heart rate admissible in clinical practice. METHODS: The flow was directed by mechanical, single-disc valves developed at the Lodz University of Technology, Institute of Turbomachinery in Lodz, Poland. VAD operation conditions under different heart rates were analyzed...
July 8, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28705913/interpretation-modalities-used-on-family-centered-rounds-perspectives-of-spanish-speaking-families
#10
Ashley Anttila, David I Rappaport, Johan Tijerino, Nusrat Zaman, Iman Sharif
BACKGROUND AND OBJECTIVES: Limited-English-proficient (LEP) patients and families are at risk for worse hospital outcomes due to impaired communication. Family-centered rounds (FCR) have become the preferred format for information sharing among providers and families at pediatric institutions. However, there are limited data on FCR among LEP families, particularly regarding interpretation type. We sought to examine the relationships between interpretation type and FCR satisfaction and efficacy among Spanish-speaking families, the fastest growing LEP population in pediatric hospitals...
July 13, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28705513/pediatric-all-terrain-vehicle-atv-injuries-an-epidemic-of-cost-and-grief
#11
Kent A Strohecker, Christian J Gaffney, Jove Graham, Kaan Irgit, Wade R Smith, Thomas R Bowen
OBJECTIVE: Evaluate cost of care of all-terrain vehicle (ATV) related injuries sustained by riders 16 years and younger in Pennsylvania. METHODS: Population-based retrospective cohort design reviewing costs of care of 78 patients (≤16 years), admitted (01/01/2007-12/31/2009) to our institution for injuries sustained during an ATV accident. RESULTS: Cost of care varied from $322 to $310,435. Mean and median costs for all patients were $25,760 and $8,066, respectively...
July 10, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28705427/invasive-disease-by-streptococcus-pyogenes-patients-hospitalized-for-6-years
#12
Vanessa Arias-Constantí, Victoria Trenchs-Sainz de la Maza, Nuria Elvira Sanz-Marcos, Carmina Guitart-Pardellans, Amadeu Gené-Giralt, Carles Luaces-Cubells
INTRODUCTION AND OBJECTIVE: The last years an increase of severe cases of invasive disease (ID) due to Streptococcus pyogenes or streptococcus b-hemolytic group A (SGA) had been detected. The aim of this study was to analyze the epidemiology and the clinical features of ID due to SGA in a tertiary Pediatric Hospital. MATERIAL AND METHODS: Retrospective study in a Pediatric hospital, of all in-patients with final diagnosis of ID due to SGA during 6 years (2009-2014)...
July 10, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28705022/evaluation-of-dose-and-outcomes-for-pediatric-vilazodone-ingestions
#13
Christopher E Gaw, Henry A Spiller, Jason L Russell, Thiphalak Chounthirath, Gary A Smith
BACKGROUND: Selective serotonin reuptake inhibitor (SSRI) exposures among children younger than 6 years of age are generally well tolerated. Vilazodone is an SSRI with partial agonism at the 5-HT1A receptor with demonstrated clinical efficacy for depression whose off-label usage is likely to increase. Recent evidence suggests that unintentional ingestion of vilazodone in children under 6 years old is associated with more severe clinical effects than other SSRIs. We chose to evaluate dose and outcomes for pediatric vilazodone ingestions...
July 14, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28702686/disparities-in-epilepsy-surgery-in-the-united-states-of-america
#14
Iván Sánchez Fernández, Christopher Stephen, Tobias Loddenkemper
The aim is to describe the epidemiology of epilepsy surgery in children and adults in the United States. We performed a descriptive study of the National Inpatient Sample (NIS) for the year 2012 and the Kids' Inpatient Database (KID) for the period 2010-2012, the largest all-payer databases on inpatient data in the USA. These databases estimate 97% of all inpatient hospital discharges in the USA. In the KID, 12,899 (0.2%) of admission records had brain surgery and 600 of the 4900 (12.2%) admissions with focal refractory epilepsy underwent epilepsy surgery...
July 12, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28699942/hospital-level-factors-associated-with-pediatric-emergency-department-return-visits
#15
Zachary Pittsenbarger, Cary Thurm, Mark Neuman, Sandra Spencer, Harold Simon, Craig Gosdin, Samir Shah, Richard McClead, Anne Stack, Elizabeth Alpern
BACKGROUND: Return visits (RVs) and RVs with admission (RVAs) are commonly used emergency department quality measures. Visit- and patient-level factors, including several social determinants of health, have been associated with RV rates, but hospital-specific factors have not been studied. OBJECTIVE: To identify what hospital-level factors correspond with high RV and RVA rates. SETTING: Multicenter mixed-methods study of hospital characteristics associated with RV and RVA rates...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28699603/infants-with-extrahepatic-biliary-atresia-effect-of-follow-up-on-the-survival-rate-at-ege-university-medical-school-transplantation-center
#16
Miray Karakoyun, Maşallah Baran, Caner Turan, Murat Kılıç, Orkan Ergun, Sema Aydoğdu
BACKGROUND/AIMS: Biliary atresia (BA) is the main cause of neonatal cholestasis and the primary reason for infant liver transplants worldwide. It is an obliterative cholangiopathy observed only in children and caused by progressive inflammation and fibrosis of the bile duct. We collaborated with a liver transplantation center to investigate the effects of follow-up in patients with BA. MATERIALS AND METHODS: Medical records of 99 patients who were diagnosed with BA and monitored at our center from 1990 to 2002 (27 patients) and from 2003 to 2015 (72 patients) were analyzed retrospectively...
July 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28699564/detecting-clinically-relevant-new-information-in-clinical-notes-across-specialties-and-settings
#17
Rui Zhang, Serguei V S Pakhomov, Elliot G Arsoniadis, Janet T Lee, Yan Wang, Genevieve B Melton
BACKGROUND: Automated methods for identifying clinically relevant new versus redundant information in electronic health record (EHR) clinical notes is useful for clinicians and researchers involved in patient care and clinical research, respectively. We evaluated methods to automatically identify clinically relevant new information in clinical notes, and compared the quantity of redundant information across specialties and clinical settings. METHODS: Statistical language models augmented with semantic similarity measures were evaluated as a means to detect and quantify clinically relevant new and redundant information over longitudinal clinical notes for a given patient...
July 5, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28697268/the-cost-of-hospital-admission-brief-resolved-unexplained-events
#18
Justin Triemstra
The modern health care system continues to expand at a meteoric rate with ever-increasing technological advancements. However, with these advancements come unsustainably rising costs and occasionally unintended, avoidable harm. In this article, we use a brief resolved unexplained event (BRUE) to illustrate how recent guidelines can help physicians practice value in this modern health care system. A BRUE is a common pediatric problem that is seen in ambulatory and emergency department settings. Infants presenting with a BRUE can be separated into low- and high-risk groups per recent guidelines...
July 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28697267/back-to-the-basics-community-acquired-pneumonia-in-children
#19
Kathleen Boyd
Community-acquired pneumonia (CAP) is a common childhood infection and often a reason for inpatient admission, especially when a child is hypoxic or in respiratory distress. Despite advances in technology and diagnostics, it remains difficult to accurately differentiate bacterial CAP from a viral process. Most of the laboratory tests routinely done in inpatient medicine, such as complete blood counts and acute phase reactants, do little to differentiate a viral pneumonia from a bacterial pneumonia. Clinicians must rely heavily on the clinical presentation and decide whether to treat empirically with antibiotics...
July 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28697170/critically-ill-children-with-hemophagocytic-lymphohistiocytosis-a-case-series-of-14-patients
#20
Esther Huimin Leow, Shui Yen Soh, Ah Moy Tan, Yee Hui Mok, Mei Yoke Chan, Jan Hau Lee
Children with hemophagocytic lymphohistiocytosis (HLH) are at an increased risk of critical illness. In this study, we described the clinical characteristics of critically ill children with HLH and identify factors associated with poor clinical outcomes. Children who were diagnosed with HLH with emergent admission to Children's Intensive Care Unit (CICU) between January 1, 2000 and October 31, 2015 were included. The primary outcome was CICU mortality. Over the 15-year period, there were 14 critically ill patients with HLH with 23 CICU admissions...
July 10, 2017: Journal of Pediatric Hematology/oncology
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