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Acceptable + reduction + pediatric

M Catherine Sargent
Use of a single-leg spica cast for femoral fractures in ambulatory children 1 to 5 years of age facilitates care and mobilization of the patient. It may allow a shorter duration of cast treatment than is possible with a traditional one and one-half-leg spica cast, particularly in patients 1 to 3 years of age. The single-leg spica is indicated for children who are small enough to be lifted safely in the cast and who have an isolated, closed, low-energy femoral shaft fracture. The procedure consists of the following steps:Step 1: Obtain adequate sedation...
September 28, 2017: JBJS Essential Surgical Techniques
John K Lin, Benjamin J Lerman, James I Barnes, Brian C Boursiquot, Yuan Jin Tan, Alex Q L Robinson, Kara L Davis, Douglas K Owens, Jeremy D Goldhaber-Fiebert
Purpose The anti-CD19 chimeric antigen receptor T-cell therapy tisagenlecleucel was recently approved to treat relapsed or refractory pediatric acute lymphoblastic leukemia. With a one-time infusion cost of $475,000, tisagenlecleucel is currently the most expensive oncologic therapy. We aimed to determine whether tisagenlecleucel is cost effective compared with currently available treatments. Methods Markov modeling was used to evaluate tisagenlecleucel in pediatric relapsed or refractory acute lymphoblastic leukemia from a US health payer perspective over a lifetime horizon...
September 13, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
K B Fieten, R Schappin, W T Zijlstra, L Rijssenbeek-Nouwens, Y Meijer, S G M A Pasmans
BACKGROUND: A 6 week personalized integrative multidisciplinary treatment program (PIM) was developed for children with difficult to treat AD who appeared unresponsive to treatment according to current guidelines. OBJECTIVE: The aim of the present study was to identify clinical and psychosocial characteristics that predict long-term treatment success after PIM. METHODS: Treatment was considered successful when there was a 75% reduction on the Self-Administered Eczema Area and Severity Index and/or little impact of AD on daily life, measured with the Children's Dermatology Life Quality Index (score <= 6), six months after the end of PIM...
September 10, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Barak Rinat, Eytan Dujovny, Noam Bor, Nimrod Rozen, Guy Rubin
Objective High-grade pediatric supracondylar humerus fractures are commonly treated with closed reduction and internal fixation with percutaneous pinning. When this fails, open reduction followed by internal fixation is the widely accepted procedure of choice. Use of a lateral external fixator was recently described as an optional procedure, but evidence is scarce. Methods We investigated the outcomes of upper limbs treated by either open reduction with internal fixation or closed reduction and external fixation...
September 10, 2018: Journal of International Medical Research
P Bruijning-Verhagen, J A P van Dongen, J D M Verberk, R Pijnacker, R D van Gaalen, D Klinkenberg, H E de Melker, M-J J Mangen
BACKGROUND AND OBJECTIVE: Since 2013, a biennial rotavirus pattern has emerged in the Netherlands with alternating high and low endemic years and a nearly 50% reduction in rotavirus hospitalization rates overall, while infant rotavirus vaccination has remained below 1% throughout. As the rotavirus vaccination cost-effectiveness and risk-benefit ratio in high-income settings is highly influenced by the total rotavirus disease burden, we re-evaluated two infant vaccination strategies, taking into account this recent change in rotavirus epidemiology...
September 10, 2018: BMC Medicine
Angela N Migowa, William M Macharia, Pauline Samia, John Tole, Alfred K Keter
Background: Medication-related errors account for one out of every 131 outpatient deaths, and one out of 854 inpatient deaths. The risk is threefold greater in the pediatric population. In sub-Saharan Africa, research on medication-related errors has been obscured by other health priorities and poor recognition of harm attributable to such errors.Our primary objective was to assess the effect of introduction of a voice recognition system (VRS) on the prevalence of medication errors. The secondary objective was to describe characteristics of observed medication errors and determine acceptability of VRS by clinical service providers...
September 2018: Therapeutic Advances in Drug Safety
Ali Turgut, Serkan Erkuş, Anıl Koca, Levent Payzıner, Ali Osman Çiçek, Önder Kalenderer
OBJECTIVE: The aim of this study was to evaluate the most important factors which can cause "tight cast syndrome'' (TCS) in pediatric patients with distal radius fractures. METHODS: Patients, who were at or under 15 years old and treated conservatively with an diagnosis of distal radius fracture between August 2015 and August 2017 were included in to the study. Fifty four patients, who had been found to experience TCS were accepted as group 1 and sixty-two patients without TCS as group 2...
August 28, 2018: Acta Orthopaedica et Traumatologica Turcica
Sanjena Kumar Amuddhu, Yong Chen, Shireen Anne Nah
INTRODUCTION:  Recent literature advocates outpatient emergency department (ED) management of intussusception citing low recurrence rates and postreduction events after uncomplicated ileocolic reduction. However, few studies include both inpatient and outpatient cohorts. We performed a systematic review and meta-analysis to compare recurrence rates and length of hospital stay between the groups. METHODS:  Studies published in English up to January 2018 were searched from Medline, Embase, Google Scholar, and Cochrane databases, using a combination of the terms 'intussusception,' 'reduction,' and 'management'...
August 21, 2018: European Journal of Pediatric Surgery
Bulent Yazici, Ipek K Bulut, Aylin Oral, Taylan O Sezer, Sevgin Taner, Aysegül Akgün
OBJECTIVES: The value of baseline renal transplant scintigraphy (RTS) with technetium-99m diethylenetriaminepentaacetic acid (Tc-DTPA) performed within 2 days after transplantation in predicting early renal transplant outcome in pediatric recipients was assessed in this study. PATIENTS AND METHODS: Baseline RTS of 48 pediatric patients were studied retrospectively. Hilson's perfusion index, graft index (GI), time between peak perfusion and iliac artery (ΔP), and the ratios of peak perfusion to plateau (P : Pl), to peak iliac artery (P : A), and to peak uptake (P : U) were obtained...
October 2018: Nuclear Medicine Communications
Moustafa Rashed, Puja Banka, Ashita Barthur, Robert D MacDougal, Rahul H Rathod, Andrew J Powell, Ashwin Prakash
Performing coronary computed tomography angiography (CCTA) using third-generation dual source computed tomography (3G-DSCT) scanners results in radiation dose reduction without sacrificing image quality in adults. The largest dose reductions have been reported with prospectively gated, high-pitch imaging. However, there are limited data to determine if these benefits extend to pediatric patients. We evaluated image quality and radiation dose range of CCTA performed in children using a 3G-DSCT scanner. A retrospective review of 44 children (median age 10 years, range 0...
July 4, 2018: American Journal of Cardiology
Ashley N Chiara, Neha Kashalikar, Thomas C Pomfret, Kimberly Lenz, Donna M Faber, Joel Goldstein, Karen M Clements, Michael C Angelini, Patricia Leto, Paul L Jeffrey
BACKGROUND: In response to concerns surrounding pediatric behavioral health medication prescribing, the Massachusetts Medicaid Pharmacy Program implemented a Pediatric Behavioral Health Medication Initiative (PBHMI), proactively requiring prior authorization for specific behavioral health medications and combination regimens. A multidisciplinary therapeutic class management (TCM) workgroup retrospectively reviews complex cases and conducts prescriber outreach to encourage evidence-based practices in Massachusetts...
August 2018: Journal of Managed Care & Specialty Pharmacy
Surbhi Gupta, Andrea Caskey, Neelkamal Soares, Marilyn Augustyn
Sam is a 6-year-old boy with a diagnosis of autism spectrum disorder (ASD) who recently relocated and has an appointment with you, his new pediatric clinician, to establish care. He was previously followed by a psychiatrist for 2 years for additional diagnoses of insomnia, bipolar disorder, anxiety, attention deficit hyperactivity disorder, and intellectual disability. He has tried and (apparently) failed multiple psychotropic trials including stimulants, nonstimulants, mood stabilizers, atypical antipsychotics, and nonbenzodiazepine hypnotics...
July 2018: Journal of Developmental and Behavioral Pediatrics: JDBP
Benjamin O'Sullivan, Fahad Alam, Clyde Matava
This article will provide a framework for producing immersive 360-degree videos for pediatric and adult patients in hospitals. This information may be useful to hospitals across the globe who may wish to produce similar videos for their patients. Advancements in immersive 360-degree technologies have allowed us to produce our own "virtual experience" where our children can prepare for anesthesia by "experiencing" all the sights and sounds of receiving and recovering from an anesthetic. We have shown that health care professionals, children, and their parents find this form of preparation valid, acceptable and fun...
July 16, 2018: Journal of Medical Internet Research
Giovanni A Salum, Circe S Petersen, Rafaela B Jarros, Rudineia Toazza, Diogo DeSousa, Lidiane Nunes Borba, Stela Castro, Julia Gallegos, Paula Barrett, Rany Abend, Yair Bar-Haim, Daniel S Pine, Silvia H Koller, Gisele G Manfro
BACKGROUND: The objective of this study is to assess group differences in symptom reduction between individuals receiving group cognitive behavioral therapy (G-CBT) and attention bias modification (ABM) compared to their respective control interventions, control therapy (CT), and attention control training (ACT), in a 2 × 2 factorial design. METHODS: A total of 310 treatment-naive children (7-11 years of age) were assessed for eligibility and 79 children with generalized, separation or social anxiety disorder were randomized and received G-CBT (n = 42) or CT (n = 37)...
July 3, 2018: Journal of Child and Adolescent Psychopharmacology
Apurva Nidgundi Dev, Usha Lohith, Brigetta Pascal, Chandrika S Dutt, Sunil Narayan Dutt
OBJECTIVE: To study parental perspectives on re/habilitation services offered for pediatric cochlear implant (CI) users at a non-profit organization in India. METHODOLOGY: A non-standardized questionnaire comprising 46 items was created to understand perspectives of parents of pediatric CI users. Questions were designed to examine re/habilitation services from the angles of service delivery, parental stress levels, reasons for delay in obtaining services, sources of emotional support, concerns, and fears during each stage starting from diagnosis of hearing loss to CI surgery, re/habilitation services and parents' views of their children post-CI...
June 29, 2018: Cochlear Implants International
Justin Raudabaugh, Aaron K Smith, Bria Moore, Juan Carlos Ramirez-Giraldo, Natalie Januzis, Terry Yoshizumi
OBJECTIVE: The purpose of this study is to evaluate the potential of an automated kilo-voltage selection software for the reduction of lens dose in pediatric CT scans. MATERIALS AND METHODS: Two metal oxide semiconductor field effect transistor (MOSFET) detectors measured the lens dose in two anthropomorphic 1- and 5-year-old phantoms. These phantoms were scanned using a clinical pediatric brain protocol at 120 kVp as a control with the MDCT scanner. Scans were then repeated using automated kilovoltage software...
September 2018: AJR. American Journal of Roentgenology
Jing Peng, Nan Pang, Ying Wang, Xiao-Le Wang, Jian Chen, Juan Xiong, Pan Peng, Can-Hui Zhu, Miriam Barakael Kessi, Fang He, Fei Yin
BACKGROUND: The purposes of this study were three-fold: (i) to determine the contribution of known genes to the causation of a broad-spectrum of pediatric drug-resistant epilepsy (DRE), (ii) to compare the diagnostic yield and cost among different next-generation sequencing (NGS) approaches, and especially (iii) to assess how NGS approaches can benefit patients by improving diagnosis and treatment efficiency. METHODS: This study enrolled 273 pediatric DRE patients with no obvious acquired etiology...
June 22, 2018: CNS Neuroscience & Therapeutics
Cassandra Vanderwall, Jens Eickhoff, R Randall Clark, Aaron L Carrel
BACKGROUND: The age and sex standardized body mass index (BMIz) is a simple and widely utilized screening tool for obesity in children and adolescents. The purpose of this study was to evaluate the relationship between the BMIz trajectory versus the percent body fat (%FAT) trajectory, and if BMIz could predict significant changes in %FAT in a sample of obese children and adolescents. METHODS: In this longitudinal observational study, body composition was measured by dual energy x-ray absorptiometry (DXA) in obese children within a multidisciplinary pediatric fitness clinic at an academic medical center over a 3-year time period...
June 8, 2018: BMC Pediatrics
John M Hoffman, Frédéric Noo, Stefano Young, Scott S Hsieh, Michael McNitt-Gray
PURPOSE: To facilitate investigations into the impacts of acquisition and reconstruction parameters on quantitative imaging, radiomics and CAD using CT imaging, we previously released an open-source implementation of a conventional weighted filtered backprojection reconstruction called FreeCT_wFBP. Our purpose was to extend that work by providing an open-source implementation of a model-based iterative reconstruction method using coordinate descent optimization, called FreeCT_ICD. METHODS: Model-based iterative reconstruction offers the potential for substantial radiation dose reduction, but can impose substantial computational processing and storage requirements...
June 1, 2018: Medical Physics
Arti D Desai, Elizabeth A Jacob-Files, Sarah J Lowry, Douglas J Opel, Rita Mangione-Smith, Maria T Britto, Waylon J Howard
OBJECTIVE: To develop and test a caregiver-reported experience measure for pediatric hospital-to-home transitions. DATA SOURCES/STUDY SETTING: Primary data were collected between 07/2014 and 05/2015 from caregivers within 2-8 weeks of their child's discharge from a tertiary care children's hospital. STUDY DESIGN/DATA COLLECTION: We used a step-wise approach to developing the measure that included drafting de novo survey items based on caregiver interviews (n = 18), pretesting items using cognitive interviews (n = 18), and pilot testing revised items among an independent sample of caregivers (n = 500)...
August 2018: Health Services Research
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