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Acceptable + reduction + pediatric

Alison J Dittmer, Domingo Molina, Cale A Jacobs, Janet Walker, Ryan D Muchow
INTRODUCTION: Following closed reduction and initial casting of pediatric forearm fractures, loss of reduction (LOR) occurs in ∼5% to 75% of fractures. Sugar-tong splinting has been shown to maintain acceptable reduction in pediatric distal radius fractures while potentially avoiding issues associated with circumferential casting. We hypothesized that the sugar-tong splint would be an acceptable method for initial immobilization to prevent LOR in distal, mid-shaft, and proximal pediatric forearm fractures...
November 6, 2018: Journal of Pediatric Orthopedics
M Lehner, F Hoffmann, B Kammer, M Heinrich, L Falkenthal, D Wendling-Keim, M Kurz
INTRODUCTION: In addition to infrastructural and conceptual planning, smooth interdisciplinary cooperation is crucial for trauma room care of severely injured children based on time-saving management and a clear set of priorities. The time to computed tomography (CT) is a well-accepted marker for the efficacy of trauma management. Up to now there are no guidelines in the literature for an adapted approach in pediatric trauma room care. METHODS: A step-by-step algorithm for pediatric trauma room care (Interdisciplinary Trauma Room Algorithm in Pediatric Surgery, iTRAPS ) was developed within the framework of an interdisciplinary team: pediatric surgeons, pediatric anaethesiologists, pediatric intensivists and pediatric radiologists...
October 25, 2018: Der Anaesthesist
Santiago Vallasciani, Badawiya Abdo, Zainab Rauf, Abeeda Anjum, Sanaa Ghulman, Hanan Alghammas, Waleed AlTaweel
BACKGROUND: Almost one-fifth of the population of Saudi Arabia lives in rural areas and may still lack access to specialty healthcare. Because of the growing demand for telehealth services, we initiated the virtual clinic (VC) concept for new referrals to the pediatric urology clinic (PUC), the primary tertiary care unit in Riyadh. METHODS: We conducted a retrospective analysis of costs and timing involved with the VC practice for a 1-year period. The cost analysis is based on savings realized by patients as a result of the VC evaluation...
October 25, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Craig S Derkay, Andrew E Bluher
PURPOSE OF REVIEW: Recurrent respiratory papillomatosis (RRP) is the most common as well as the costliest benign airway neoplasm in the United States [Ivancic et al. (2018). Laryngoscope Investig Otolaryngol 3:22; Derkay (1995). Arch Otolaryngol Head Neck Surg 121:1386]. In addition, it is potentially deadly, with risk of airway obstruction as well as a 3-7% risk of malignant conversion [Schraff et al. (2004). Arch Otolaryngol Head Neck Surg 130:1039]. This review highlights exciting advancements over the past 1-2 years in scientific understanding of the pathophysiology, epidemiology, natural history, prevention, and treatment of this difficult disease...
December 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Deepak Khandelwal, Namita Kalra, Rishi Tyagi, Amit Khatri, Komal Gupta
INTRODUCTION: Visiting a dentist can easily evoke strong fear reactions and acute anxiety in children. It is one of the most basic reasons for avoidance and neglect of dental care. It may obstruct delivery of dental care, as the child may be unwilling to accept the treatment being provided by the dentist. AIM: To evaluate and compare reduction in anxiety level in patients undergoing dental treatment at first dental visit. TECHNIQUE: The study was conducted on 400 patients coming to the Department of Pedodontics and Preventive Dentistry, Guru Teg Bahadur Hospital, University College of Medical Sciences, New Delhi, for their first dental visit...
September 1, 2018: Journal of Contemporary Dental Practice
Rajesh Arora, Puneet Mishra, Aditya Nath Aggarwal, Rahul Anshuman, Ravi Sreenivasan
Background: Pediatric forearm fractures are still considered an enigma in view of their propensity to redisplace in cast. The redisplacement may be a potential cause for malalignment. We prospectively analyzed the role of risk factors and above casting indices in predicting significant redisplacement of pediatric forearm fractures treated by closed reduction and cast. Materials and Methods: 113 patients of age range 2-13 years with displaced forearm fractures, treated by closed reduction and cast were included in this prospective study...
September 2018: Indian Journal of Orthopaedics
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 10years, range 0...
October 1, 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
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