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https://www.readbyqxmd.com/read/27914127/impact-of-initial-vancomycin-trough-concentration-on-clinical-and-microbiological-outcomes-of-methicillin-resistant-staphylococcus-aureus-bacteremia-in-children
#1
Ree Nar Yoo, Seo Hee Kim, Jina Lee
It is important to use vancomycin in a proper manner to ensure optimal drug exposure. Despite extensive use of vancomycin in children, studies on its optimal trough concentration (Ctrough) in the pediatric population remained rare. This retrospective study included children < 18 years old with culture-confirmed methicillin-resistant Staphylococcus aureus (MRSA) bacteremia who were hospitalized in our institute from January 2010 to April 2014. Clinical characteristics, initial vancomycin dose, Ctrough and clinical/microbiological outcomes were retrospectively collected from medical records...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27913986/establishing-clinical-meaning-and-defining-important-differences-for-patient-reported-outcomes-measurement-information-system-promis-%C3%A2-measures-in-juvenile-idiopathic-arthritis-using-standard-setting-with-patients-parents-and-providers
#2
Esi M Morgan, Constance A Mara, Bin Huang, Kimberly Barnett, Adam C Carle, Jennifer E Farrell, Karon F Cook
BACKGROUND: Patient-Reported Outcomes Measurement Information System (PROMIS) measures are used increasingly in clinical care. However, for juvenile idiopathic arthritis (JIA), scores lack a framework for interpretation of clinical severity, and minimally important differences (MID) have not been established, which are necessary to evaluate the importance of change. METHODS: We identified clinical severity thresholds for pediatric PROMIS measures of mobility, upper extremity function (UE), fatigue, and pain interference working with adolescents with JIA, parents of JIA patients, and clinicians, using a standard setting methodology modified from educational testing...
December 2, 2016: Quality of Life Research
https://www.readbyqxmd.com/read/27913773/pediatric-nutrition-assessment-anthropometrics-to-zinc
#3
Kelly Green Corkins, Erin E Teague
Pediatric patients with chronic illnesses or diseases or who require long-term nutrition support are most vulnerable to nutrition-related issues. Malnutrition in a pediatric patient may negatively affect long-term growth and development. Children also become malnourished much more quickly than adults. A comprehensive nutrition assessment that includes food and nutrition-related history, anthropometric measurements, biochemical data, medical tests and procedures, nutrition-focused physical findings, and patient history should be completed on these patients as no one parameter is a comprehensive indicator of nutrition status...
December 2, 2016: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/27913710/lessons-learned-from-35-cases-of-laryngeal-foreign-bodies-undergoing-misdiagnosis-in-pediatric-population
#4
Qingguo Chen, Hanqi Chu, Yanling Tao, Hongyan Huang, Liyan Peng
OBJECTIVES: To present 35 cases of laryngeal foreign bodies (FBs) in pediatric population undergoing misdiagnosis so as to draw on our lessons to improve early diagnosis. METHODS: A retrospective analysis over 15 years was conducted of 35 cases of laryngeal FBs undergoing misdiagnosis in children. Meanwhile, a control group, including 42 cases of laryngeal FBs without misdiagnosis in children, was set. These patients' clinical data were collected and analyzed to identify the risk factors for misdiagnosis...
December 2, 2016: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/27913607/autoimmune-comorbidities-in-hashimoto-s-thyroiditis-different-patterns-of-association-in-adulthood-and-childhood-adolescence
#5
R M Ruggeri, F Trimarchi, G Giuffrida, R Certo, E Cama, A Campennì, A Alibrandi, F De Luca, M Wasniewska
OBJECTIVE: Hashimoto's thyroiditis (HT), the most common autoimmune thyroid disease at any age, is often associated with other autoimmune diseases. The present study was aimed to describe the type and frequency of non-thyroidal autoimmune diseases (NTADs) in HT patients and to delineate the clinical pattern of diseases clustering in pediatric/adolescent and adult age. DESIGN: Cross-sectional study. METHODS: 1053 newly diagnosed HT patients (500 adults (467 F, mean age 40...
February 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/27913067/the-financial-impact-of-clinic-no-show-rates-in-an-academic-pediatric-otolaryngology-practice
#6
Zhen Huang, Mariam Ashraf, Heather Gordish-Dressman, Pamela Mudd
PURPOSE: To investigate determinants of no-show rates in an academic pediatric otolaryngology practice including appointment time, age, sex, new patient status, payer mix, and median household income by zip code. MATERIALS AND METHODS: Retrospective chart review of clinic no-show rates and patient demographics in a free standing children's hospital and affiliated outpatient clinics across eight providers in a one-year period. RESULTS: Analysis shows that the overall no-show rate across all providers was 15% with the highest rate of 19% in the zip code with the lowest median income...
November 23, 2016: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/27911972/integrating-behavioral-health-into-pediatric-primary-care-implications-for-provider-time-and-cost
#7
Natasha Gouge, Jodi Polaha, Rachel Rogers, Amy Harden
OBJECTIVES: Integrating a behavioral health consultant (BHC) into primary care is associated with improved patient outcomes, fewer medical visits, and increased provider satisfaction; however, few studies have evaluated the feasibility of this model from an operations perspective. Specifically, time and cost have been identified as barriers to implementation. Our study aimed to examine time spent, patient volume, and revenue generated during days when the on-site BHC was available compared with days when the consultant was not...
December 2016: Southern Medical Journal
https://www.readbyqxmd.com/read/27911597/evidence-based-psychosocial-treatments-for-pediatric-elimination-disorders
#8
Jaclyn A Shepard, Joseph E Poler, Jesse H Grabman
Pediatric elimination disorders are common in childhood, yet psychosocial correlates are generally unclear. Given the physiological concomitants of both enuresis and encopresis, and the fact that many children with elimination disorders are initially brought to their primary care physician for treatment, medical evaluation and management are crucial and may serve as the first-line treatment approach. Scientific investigation on psychological and behavioral interventions has progressed over the past couple of decades, resulting in the identification of effective treatments for enuresis and encopresis...
December 2, 2016: Journal of Clinical Child and Adolescent Psychology
https://www.readbyqxmd.com/read/27910751/recent-advances-in-pharmacotherapeutic-paradigm-of-mild-to-recalcitrant-atopic-dermatitis
#9
Zahid Hussain, Shariza Sahudin, Hnin Ei Thu, Ahmad Nazrun Shuid, Syed Nasir Abbas Bukhari, Endang Kumolosasi
Atopic dermatitis (AD) is a common, chronic skin inflammatory disorder characterized by perivascular infiltration of immunoglobulin E (IgE), T lymphocytes, and mast cells. The key factors responsible for the pathophysiology of this disease are immunological disorders and defects in epidermal barrier properties. Pruritus, intense itching, psychological stress, deprived physical and mental performance, and sleep disturbance are the hallmark features of this dermatological disorder. Preventive interventions such as educational programs, avoidance of allergens, and exclusive care toward the skin could play a partial role in suppressing the symptoms...
2016: Critical Reviews in Therapeutic Drug Carrier Systems
https://www.readbyqxmd.com/read/27910175/postanesthesia-evaluation-of-emotional-and-psychological-satisfaction-in-a-hispanic-population
#10
Angela Zauner, Alvaro Pinilla, Daniel Benitez, Alejandra Tellez, David Romero, Ana Suarez, Vanessa López, Eduardo Hermida
BACKGROUND: Patient satisfaction has a positive impact on clinical care. Different strategies, such as questionnaires, have been developed to evaluate and improve patient satisfaction. A validated pediatric anesthesia questionnaire previously showed the importance of perioperative care built upon a relationship of trust between healthcare providers and children and parents, and a comfortable environment in which satisfactory answers are provided. However, the questionnaire was validated in English, and no research exists on the use of satisfaction questionnaires in Spanish...
December 2, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27909839/biventricular-support-using-a-centrifugal-pump-in-a-6%C3%A2-year-old-with-fulminant-myocarditis
#11
Hiromu Kehara, Tamaki Takano, Takamitsu Terasaki, Kenji Okada
We experienced a case of ventricular assist with both a pulsatile-flow and a continuous-flow pump in a pediatric patient, and herein report the clinical course and characteristics of the pumps. A 6-year-old female was diagnosed with fulminant myocarditis and transferred to our hospital for mechanical support. After 12 days of extracorporeal membrane oxygenation, we implanted a left ventricular assist device (LVAD) and a right ventricular assist device (RVAD) using centrifugal Gyro pumps with a membrane oxygenator in a paracorporeal fashion...
December 1, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/27909379/-it-is-an-eye-opener-that-there-is-a-relationship-between-rehabilitation-and-hiv-perspectives-of-physiotherapists-and-occupational-therapists-in-kenya-and-zambia-on-the-role-of-rehabilitation-with-adults-and-children-living-with-hiv
#12
Stephanie Nixon, Cathy Cameron, Margaret Mweshi, Esther Munalula Nkandu, Carlius Okidi, Stephen Tattle, Tammy Yates
Purpose: To present the perspectives of rehabilitation providers-physiotherapists and occupational therapists-in Kenya and Zambia on the role of rehabilitation in the care of adults and children living with HIV. Methods: This qualitative, interpretivist study was part of a broader project to adapt a Canadian e-module on HIV-related disability for rehabilitation providers in Sub-Saharan Africa (SSA). Focus groups, demographic questionnaires, and knowledge-attitude-belief surveys were conducted with rehabilitation providers in Kenya and Zambia...
2016: Physiotherapy Canada. Physiothérapie Canada
https://www.readbyqxmd.com/read/27908963/anomalous-mesenteric-vessel-a-rare-etiology-of-intermittent-partial-small-bowel-obstruction
#13
Natasha Hansraj, Shannon M Larabee, Kimberly M Lumpkins
We report a case of an 11-year with recurrent episodes of abdominal pain and vomiting. Diagnostic laparoscopy during a severe episode demonstrated an anomalous blood vessel incompletely encircling the bowel, leading to transient partial small bowel obstruction. This likely represents a remnant vessel from the omphalomesenteric duct. Recurrent abdominal pain and vomiting in the pediatric population requires careful history and physical exam, and a willingness to entertain unusual diagnoses.
December 1, 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/27908954/chlorhexidine-impregnated-dressings-and-prevention-of-catheter-associated-bloodstream-infections-in-a-pediatric-intensive-care-unit
#14
Duygu Sönmez Düzkaya, Nejla Canbulat Sahiner, Gülzade Uysal, Tülay Yakut, Agop Çitak
BACKGROUND: Bloodstream infections related to use of catheters are associated with increased morbidity and mortality rates, prolonged hospital lengths of stay, and increased medical costs. OBJECTIVES: To compare the effectiveness of chlorhexidine-impregnated dressings with that of standard dressings in preventing catheter-related bloodstream infections. METHODS: A total of 100 children were randomly divided into 2 groups of 50 each: a chlorhexidine group and a standard group...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27908947/integrating-nurse-practitioners-into-intensive-care-units
#15
Shari Simone, Carmel A McComiskey, Brooke Andersen
As demand for nurse practitioners in all types of intensive care units continues to increase, ensuring successful integration of these nurses into adult and pediatric general and specialty intensive care units poses several challenges. Adding nurse practitioners requires strategic planning to define critical aspects of the care delivery model before the practitioners are hired, develop a comprehensive program for integrating and training these nurses, and create a plan for implementing the program. Key strategies to ensure successful integration include defining and implementing the role of nurse practitioners, providing options for orientation, and supporting and training novice nurse practitioners...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27908329/pediatric-sepsis
#16
REVIEW
Melanie K Prusakowski, Audrey P Chen
Pediatric sepsis is distinct from adult sepsis in its definitions, clinical presentations, and management. Recognition of pediatric sepsis is complicated by the various pediatric-specific comorbidities that contribute to its mortality and the age- and development-specific vital sign and clinical parameters that obscure its recognition. This article outlines the clinical presentation and management of sepsis in neonates, infants, and children, and highlights some key populations who require specialized care.
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27907953/management-of-the-pediatric-neurocritical-care-patient
#17
Christopher M Horvat, Haifa Mtaweh, Michael J Bell
Pediatric neurocritical care is a growing subspecialty of pediatric intensive care that focuses on the management of acute neurological diseases in children. A brief history of the field of pediatric neurocritical care is provided. Neuromonitoring strategies for children are reviewed. Management of major categories of acute childhood central neurologic diseases are reviewed, including treatment of diseases associated with intracranial hypertension, seizures and status epilepticus, stroke, central nervous system infection and inflammation, and hypoxic-ischemic injury...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907271/adult-attention-deficit-hyperactivity-disorder-diagnosis-management-and-treatment-in-the-dsm-5-era
#18
Joel L Young, David W Goodman
Objective: To increase awareness of adult attention-deficit/hyperactivity disorder (ADHD) in the primary care community and to provide guidance for the management of this condition. Despite its increasing prevalence, adult ADHD largely remains underdiagnosed and inappropriately treated in the United States. The publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), has provided more clear diagnostic criteria for adult ADHD, but a solid framework supporting the transition of ADHD management from pediatric to adult primary care is lacking...
November 17, 2016: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/27906995/assessment-of-the-world-health-organization-s-hiv-drug-resistance-early-warning-indicators-in-main-and-decentralized-outreach-antiretroviral-therapy-sites-in-namibia
#19
Nicholus Mutenda, Alexandra Bukowski, Anne-Marie Nitschke, Tuli Nakanyala, Ndapewa Hamunime, Tadesse Mekonen, Francina Tjituka, Greatjoy Mazibuko, Samson Mwinga, David Mabirizi, Evans Sagwa, Rosalia Indongo, Natalie Dean, Michael R Jordan, Steven Y Hong
BACKGROUND: The World Health Organization (WHO) early warning indicators (EWIs) of HIV drug resistance (HIVDR) assess factors at individual ART sites that are known to create situations favourable to the emergence of HIVDR. METHODS: In 2014, the Namibia HIV care and treatment program abstracted the following adult and pediatric EWIs from all public ART sites (50 main sites and 143 outreach sites): On-time pill pick-up, Retention in care, Pharmacy stock-outs, Dispensing practices, and Viral load suppression...
2016: PloS One
https://www.readbyqxmd.com/read/27906803/naspghan-clinical-practice-guideline-for-the-diagnosis-and-treatment-of-nonalcoholic-fatty-liver-disease-in-children
#20
Miriam B Vos, Stephanie H Abrams, Sarah E Barlow, Sonia Caprio, Stephen R Daniels, Rohit Kohli, Marialena Mouzaki, Pushpa Sathya, Jeffrey B Schwimmer, Shikha S Sundaram, Stavra A Xanthakos
Nonalcoholic fatty liver disease (NAFLD) is a highly prevalent chronic liver disease that occurs in the setting of insulin resistance and increased adiposity. It has rapidly evolved into the most common liver disease seen in the pediatric population and is a management challenge for general pediatric practitioners, subspecialists and for health systems. In this guideline, the expert committee on NAFLD (ECON) reviewed and summarized the available literature, formulating recommendations to guide screening and clinical care of children with NAFLD...
November 30, 2016: Journal of Pediatric Gastroenterology and Nutrition
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