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https://www.readbyqxmd.com/read/28806579/access-to-emergency-care-services-a-transversal-ecological-study-about-brazilian-emergency-health-care-network
#1
T A H Rocha, N C da Silva, P V Amaral, A C Q Barbosa, J V M Rocha, V Alvares, D G de Almeida, E Thumé, E B A F Thomaz, R C de Sousa Queiroz, M R de Souza, A Lein, N Toomey, C A Staton, J R N Vissoci, L A Facchini
OBJECTIVES: Studies of health geography are important in the planning and allocation of emergency health services. The geographical distribution of health facilities is an important factor in timely and quality access to emergency services; therefore, the present study analyzed the emergency health care network in Brazil, focusing the analysis at the roles of small hospitals (SHs). STUDY DESIGN: Cross-sectional ecological study. METHODS: Data were collected from 9429 hospitals of which 3524 were SHs and 5905 were high-complexity centers (HCCs)...
August 11, 2017: Public Health
https://www.readbyqxmd.com/read/28806468/an-overview-of-hemophagocytic-lymphohistiocytosis
#2
Ysabella M Esteban, Jill L O de Jong, Melissa S Tesher
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening syndrome characterized by a dysregulated hyperinflammatory response associated with aberrant activation of lymphocytes and macrophages that results in hypercytokinemia. It is classically divided into two types: (1) primary or familial HLH and (2) secondary HLH. Familial HLH is generally an autosomal recessive condition, whereas secondary HLH is usually associated with infectious diseases, autoinflammatory and autoimmune diseases (where it is more commonly known as macrophage activation syndrome), malignancy, immunosuppression, hematopoietic stem cell transplantation, organ transplantation, HIV infection, and metabolic diseases...
August 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28806465/safe-infant-sleep-practices-parental-engagement-education-and-behavior-change
#3
Sunah S Hwang, Michael J Corwin
Although the incidence of sudden unexpected infant death declined by nearly 50% in the 1990s, there has been little improvement in the past 15 years. Significant disparities in infant sleep practices and sleep-associated death exist, particularly by maternal race/ethnicity. This article provides a brief overview of recent observational and intervention studies related to infant sleep practices to describe the context and motivation for the population-based Study of Attitudes and Factors Effecting Infant Care (SAFE)...
August 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28806464/beyond-back-to-sleep-ways-to-further-reduce-the-risk-of-sudden-infant-death-syndrome
#4
Fern R Hauck, Kawai O Tanabe
Sudden infant death syndrome (SIDS) remains the leading cause of postneonatal mortality in the United States, despite reduction in rates of more than 50% since the initiation of the "Back to Sleep" (now called "Safe to Sleep") campaign in 1994. In recent years, the rate of decline in SIDS deaths has plateaued, even with the ongoing educational efforts that promote safe sleep and other risk reduction measures. The 2016 American Academy of Pediatrics guidelines for reducing the risk of SIDS focus heavily on sleep practices, bedding, and location, but also include factors that often receive less attention (ie, prenatal care, maternal smoking, alcohol and drug use, and childhood vaccinations)...
August 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28806344/neuro-ophthalmic-manifestations-of-pediatric-neurodegenerative-disease
#5
Gena Heidary
The topic of pediatric neurodegenerative disease is broad and ever expanding. Children who suffer from neurodegenerative disease often have concomitant visual dysfunction. Neuro-ophthalmologists may become involved in clinical care to identify corroborating eye findings when a specific condition is suspected, to monitor for disease progression, and in some cases, to assess treatment efficacy. Ophthalmic findings also may be the harbinger of a neurodegenerative process so a keen awareness of the possible manifestations of these conditions is important...
September 2017: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/28806187/pain-is-an-underestimated-symptom-in-cystic-fibrosis
#6
Alexandra Masson, Maya Kirszembaum, Isabelle Sermet-Gaudelus
PURPOSE OF REVIEW: Life expectancy is increasing in cystic fibrosis and new aspects of the disease have to be taken into account in cystic fibrosis care. RECENT FINDINGS: Pain is encountered among 70% of adult and pediatric patients with cystic fibrosis. This symptom is underestimated by the multidisciplinary team. It has been reported as impacting quality of life and adherence to treatments. The location of pain is inconstant among the different studies but the major symptoms are headaches, gastrointestinal, and chest pain...
August 12, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28805507/the-medical-home-model-and-pediatric-asthma-symptom-severity-evidence-from-a-national-health-survey
#7
Sirikan Rojanasarot, Angeline M Carlson
The objective was to investigate the association between receiving care under the medical home model and parental assessment of the severity of asthma symptoms. It was hypothesized that parents of children who received care under the medical home model reported less severe asthma symptoms compared with their counterparts, whose care did not meet the medical home criteria. Secondary analyses were conducted using cross-sectional data from the 2011-2012 National Survey of Children's Health. Children with asthma aged 0-17 years were included and classified as receiving care from the medical home if their care contained 5 components: a personal doctor, a usual source of sick care, family-centered care, no problems getting referrals, and effective care coordination...
August 14, 2017: Population Health Management
https://www.readbyqxmd.com/read/28805113/hospitalized-adolescents-perception-of-dignity-a-qualitative-study
#8
Neda Jamalimoghadam, Shahrzad Yektatalab, Marzieh Momennasab, Abbas Ebadi, Najaf Zare
BACKGROUND: Adolescents can be vulnerable to diminished dignity in the hospital because young people have significantly different healthcare needs than children and adults. They like to cooperate with caregivers only when they get respectful and dignified care. Care without considering dignity can adversely influence the adolescents' recovery. However, many studies have been conducted on exploring the concept of the patients' dignity from the adult patients and fewer studies still have explored the dignity of young people...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28804708/pediatric-palliative-care-initiative-in-cambodia
#9
Mahmut Yaşar Çeliker, Yos Pagnarith, Kazumi Akao, Dim Sophearin, Sokchea Sorn
Cancer care with curative intent remains difficult to manage in many resource-limited settings such as Cambodia. Cambodia has a small workforce with limited financial and health-care resources resulting in delayed diagnoses and availability of limited therapeutic tools. Thus, palliative care becomes the primary form of care in most cases. Although palliative care is becoming an integral part of medical care in developed countries, this concept remains poorly understood and utilized in developing countries. Angkor Hospital for Children serves a relatively large pediatric population in northern Cambodia...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28803838/current-epidemiology-of-resistance-among-gram-negative-bacilli-in-pediatric-patients-in-turkey
#10
Kubra Aykac, Yasemin Ozsurekci, Sevgen Tanir Basaranoglu, Mustafa Senol Akin, Ali Bulent Cengiz, Asiye Bicakcigil, Banu Sancak, Ates Kara, Mehmet Ceyhan
BACKGROUND: The increasing incidence of infections caused by drug-resistant Gram-negative organisms has led to a reemergence in worldwide. This study attempted to investigate the changes in resistance of Gram-negative bacteria to different classes of antibiotics and treatment options in invasive infections. METHODS: We performed this study retrospectively between January 2012 and January 2017 in our tertiary care university hospital. A total of 302 patients with Gram-negative bacterial bacteremia and meningitis were defined...
August 10, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28803827/caring-for-the-caregiver-supporting-families-of-youth-with-special-health-care-needs
#11
Mariecel Pilapil, Daniel J Coletti, Cindy Rabey, David DeLaet
Caregivers of youth with special health care needs (YSHCN) are a critical part of the health care team. It is important for pediatric providers to be cognizant of the burden and strain caregiving can create. This article will discuss the health, psychological, social, and financial effects of caregiving, as well as strategies to screen for caregiver strain among families of YSHCN. Caregivers of YSHCN, for example, are more likely to report poor health status and demonstrate higher rates of depression and anxiety...
August 10, 2017: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/28803752/optimal-dose-timing-and-ratio-of-blood-products-in-massive-transfusion-results-from-a-systematic-review
#12
REVIEW
Zoe K McQuilten, Gemma Crighton, Susan Brunskill, Jessica K Morison, Tania H Richter, Neil Waters, Michael F Murphy, Erica M Wood
Optimal dose, timing and ratio to red blood cells (RBC) of blood component therapy (fresh frozen plasma [FFP], platelets, cryoprecipitate or fibrinogen concentrate) to reduce morbidity and mortality in critically bleeding patients requiring massive transfusion is unknown. We performed a systematic review for randomized controlled trials (RCT) in MEDLINE, The Cochrane Library, Embase, CINAHL, PubMed the Transfusion Evidence Library and using multiple clinical trials registries to 21 February 2017. Sixteen RCTs were identified: six completed (five in adult trauma patients, one pediatric burn patients) and ten ongoing trials...
July 6, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28803593/predictors-of-obtaining-follow-up-care-in-the-province-of-ontario-canada-following-a-new-diagnosis-of-atrial-fibrillation-heart-failure-and-hypertension-in-the-emergency-department
#13
Clare L Atzema, Bing Yu, Noah M Ivers, Paula A Rochon, Douglas S Lee, Michael J Schull, Peter C Austin
OBJECTIVE: Patients with cardiovascular diseases are common in the emergency department (ED), and continuity of care following that visit is needed to ensure that they receive evidence-based diagnostic tests and therapy. We examined the frequency of follow-up care after discharge from an ED with a new diagnosis of one of three cardiovascular diseases. METHODS: We performed a retrospective cohort study of patients with a new diagnosis of heart failure, atrial fibrillation, or hypertension, who were discharged from 157 non-pediatric EDs in Ontario, Canada, between April 2007 and March 2014...
August 14, 2017: CJEM
https://www.readbyqxmd.com/read/28803574/retrospective-evaluation-of-the-big-score-to-predict-mortality-in-pediatric-blunt-trauma
#14
Charlotte Grandjean-Blanchet, Guillaume Emeriaud, Marianne Beaudin, Jocelyn Gravel
OBJECTIVES: This study's objective was to measure the criterion validity of the BIG score (a new pediatric trauma score composed of the initial base deficit [BD], international normalized ratio [INR], and Glasgow Coma Scale [GCS]) to predict in-hospital mortality among children admitted to the emergency department with blunt trauma requiring an admission to the intensive care unit, knowing that a score <16 identifies children with a high probability of survival. METHODS: This was a retrospective cohort study performed in a single tertiary care pediatric hospital between 2008 and 2016...
August 14, 2017: CJEM
https://www.readbyqxmd.com/read/28803487/a-mechanism-based-approach-to-management-of-children-with-end-stage-liver-disease
#15
Allah B Haafiz
Due to parallel advances in surgical and acute care disciplines, liver transplantation (LT) has revolutionized the outlook for children with end-stage liver disease (ESLD). Contrary to advances in technical aspects of LT and the peri-operative care, pre-transplant management of ESLD remains quite a formidable challenge. Areas covered: This review provides mechanisms based management strategies to address common complications of ESLD including malnutrition, amended metabolic pathways, gastrointestinal dysfunction, and development of ascites...
August 14, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28803432/quality-of-life-in-home-ventilated-children-and-their-families
#16
Rafael González, Amaya Bustinza, Sarah N Fernandez, Miriam García, Silvia Rodriguez, Ma Ángeles García-Teresa, Mirella Gaboli, Silvia García, Olaia Sardón, Diego García, Antonio Salcedo, Antonio Rodríguez, Ma Carmen Luna, Arturo Hernández, Catalina González, Alberto Medina, Estela Pérez, Alicia Callejón, Juan D Toledo, Mercedes Herranz, Jesús López-Herce
HMV (home mechanical ventilation) in children has increased over the last years. The aim of the study was to assess perceived quality of life (QOL) of these children and their families as well as the problems they face in their daily life.We performed a multicentric cross-sectional study using a semi-structured interview about the impact of HMV on families and an evaluation questionnaire about perceived QOL by the patient and their families (pediatric quality of life questionnaire (PedsQL4.0)). We studied 41 subjects (mean age 8...
August 12, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28803331/impact-of-monitoring-health-related-quality-of%C3%A2-life-in-clinical-practice-in-children-with-type-1-diabetes-mellitus
#17
Marta Murillo, Joan Bel, Jacobo Pérez, Raquel Corripio, Gemma Carreras, Xavier Herrero, Josep-Maria Mengibar, Dolors Rodriguez-Arjona, Ulrike Ravens-Sieberer, Hein Raat, Luis Rajmil
PURPOSE: To test whether the systematic monitoring of health-related quality of life (HRQOL) in clinical practice in Spanish pediatric patients with T1DM helps improve their daily life in a multicenter longitudinal study. METHODS: One hundred thirty-six patients participated, recruited from five centers in Barcelona, Spain (72 girls, mean age 13.4 years). Complete data were collected for 119 patients (85%). Pediatricians were randomly assigned to the HRQOL intervention (n = 70), or control group (n = 49)...
August 12, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28802643/update-on-urinary-stones-in-children-current-and-future-concepts-in-surgical-treatment-and-shockwave-lithotripsy
#18
REVIEW
Mesrur Selcuk Silay, Jonathan S Ellison, Thomas Tailly, Paolo Caione
CONTEXT: Miniaturized instrumentation used for endoscopic treatment of urinary stone disease in children has been readily adopted in clinical practice. However, there is a need to optimize and individualize the surgical approach according to the patient's age, body habitus, and stone characteristics. Promising novel equipment and techniques will continue to advance the surgical care of these children. OBJECTIVE: To review the literature regarding surgical and shockwave lithotripsy (SWL) treatment of urinary stone disease in children and provide an overview on future treatment innovations...
August 9, 2017: European Urology Focus
https://www.readbyqxmd.com/read/28802385/comparison-of-home-sleep-apnea-testing-versus-laboratory-polysomnography-for-the-diagnosis-of-obstructive-sleep-apnea-in-children
#19
Nicholas Scalzitti, Shana Hansen, Stephen Maturo, Joshua Lospinoso, Peter O'Connor
INTRODUCTION: Obstructive sleep apnea (OSA) affects 1-5% of pediatric patients. Laboratory polysomnography is expensive, not always available, and is inconvenient for patients. Our study investigates the diagnostic ability of an unattended ambulatory monitor for the diagnosis of pediatric OSA. METHODS: A prospective study was conducted in children, ages 2-17. Subjects completed in-lab polysomnography simultaneously with ambulatory monitoring. Caregivers attempted home studies on two subsequent nights to compare the home monitor and the laboratory polysomnogram (PSG)...
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28802384/retrospective-study-of-intranasal-dexmedetomidine-as-a-prophylactic-against-emergence-delirium-in-pediatric-patients-undergoing-ear-tube-surgery
#20
Lisgelia Santana, Katherine Mills
OBJECTIVES: This study evaluated the effect of intranasal dexmedetomidine on emergence delirium (ED) in pediatric patients who underwent ear tube surgeries. Due to the brief nature of the surgery and low levels of pain experienced, an IV is rarely needed, limiting the medications available to anesthesiologists to manage postoperative delirium that may arise during recovery from inhalational anesthesia. Intravenous dexmedetomidine is an alpha-2 agonist anesthetic that is used in pediatric patients for the management of ED in various surgical procedures...
September 2017: International Journal of Pediatric Otorhinolaryngology
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