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https://www.readbyqxmd.com/read/28277262/eliminating-blood-culture-false-positives-harnessing-the-power-of-nursing-shared-governance
#1
Dawn Moeller
Our emergency department struggled with unacceptable blood culture contamination rates for several years. The objective of this project was to create a self-governing culture within nursing that would generate and sustain the achievement of monthly blood culture contamination rates below the national benchmark of 3% and the hospital laboratory acceptable threshold of 2.3%. METHODS: The ED shared governance council partnered with the laboratory team to review the monthly epidemiology reports for all adult and pediatric ED patients having blood cultures performed from January 2010 through December 2015...
October 26, 2016: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28271087/comparison-of-pediatric-and-general-orthopedic-surgeons-approaches-in-management-of-developmental-dysplasia-of-the-hip-and-flexible-flatfoot-the-road-to-clinical-consensus
#2
Ramin Haj Zargarbashi, Hirbod Nasiri Bonaki, Shayan Abdollah Zadegan, Taghi Baghdadi, Mohammad Hossein Nabian, Mehdi Ramezan Shirazi
Developmental dysplasia of the hip (DDH) and flatfoot are common pediatric orthopedic disorders, being referred to and managed by both general and pediatric orthopedic surgeons, through various modalities. Our study aimed to evaluate their consensus and perspective disagreements in terms of diagnostic and therapeutic approaches of the mentioned deformities. Forty participants in two groups of general orthopedic surgeons (GOS) (n=20) and pediatric orthopedic surgeons (POS) (n=20), were asked to answer an 8-item questionnaire on DDH and flexible flatfoot...
January 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28270279/feasibility-of-pediatric-chest-ct-using-spectral-filtration-on-third-generation-dual-source-ct
#3
Wei Liu, Jingjuan Liu, Huadan Xue, Xin Sui, Wei Song, Kai Xu, Weilin Wan, Zhenghong Li, Zhengyu Jin
Objective To prospectively investigate the radiation dose and image quality of pediatric chest CT using Sn100 kV on a third-generation dual-source CT (DSCT)in comparison to standard 100 kV chest CT. Methods From December 12,2015 to June 30,2016,45 consecutive pediatric patients referred for non-contrast chest CT scan in Peking Union Medical College Hospital were prospectively enrolled as study group. They were examined at 100 kV with a dedicated tin filter on a third-generation DSCT. These patients were retrospectively matched with 45 patients who were examined on a second-generation DSCT at 100 kV without tin filter...
February 20, 2017: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28251116/pediatric-hepatitis-b-treatment
#4
REVIEW
Haruki Komatsu, Ayano Inui, Tomoo Fujisawa
Although the introduction of hepatitis B vaccine has been contributing to the reduction in the prevalence of hepatitis B virus (HBV) carriers worldwide, the treatment of children with chronic HBV infection is a challenge to be addressed. HBeAg seroconversion, which induces low replication of HBV, is widely accepted as the first goal of antiviral treatment in children with chronic hepatitis B. However, spontaneous HBeAg seroconversion is highly expected in children with chronic HBV infection. Therefore, the identification of children who need antiviral treatment to induce HBeAg seroconversion is essential in the management of chronic HBV infection...
February 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28246898/external-validation-of-clinical-decision-rules-for-children-with-wrist-trauma
#5
Marjolein A M Mulders, Monique M J Walenkamp, Bente F H Dubois, Annelie Slaar, J Carel Goslings, Niels W L Schep
BACKGROUND: Clinical decision rules help to avoid potentially unnecessary radiographs of the wrist, reduce waiting times and save costs. OBJECTIVE: The primary aim of this study was to provide an overview of all existing non-validated clinical decision rules for wrist trauma in children and to externally validate these rules in a different cohort of patients. Secondarily, we aimed to compare the performance of these rules with the validated Amsterdam Pediatric Wrist Rules...
February 28, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28208961/fracture-supracondylar-humerus-a-review
#6
REVIEW
Vineet Kumar, Ajai Singh
Fracture supracondylar humerus is one of the most common fractures encountered in pediatric age group at all levels (both rural and urban). Thus it needs a special review in its management protocol as per the changing trend. Modified Gartland classification is the most accepted classification and has its importance in decision making regarding management and prognosis. Neurovascular complications are mostly associated with Type III A, III B and Type IV variety and they most of the time need surgical intervention for stabilization, exploration of brachial artery, sometimes median nerve exploration and reduction of fracture...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28192225/a-randomized-trial-of-yoga-for-children-hospitalized-with-sickle-cell-vaso-occlusive-crisis
#7
Karen Moody, Bess Abrahams, Rebecca Baker, Ruth Santizo, Deepa Manwani, Veronica Carullo, Doris Eugenio, Aaron Carroll
CONTEXT: Sickle cell disease (SCD) vaso-occlusive crisis (VOC) remains an important cause of acute pain in pediatrics and the most common SCD complication. Pain management recommendations in SCD include nonpharmacological interventions. Yoga is one nonpharmacological intervention that has been shown to reduce pain in some populations, however, evidence is lacking in children with VOC. OBJECTIVES: The primary objective of this study was to compare the effect of yoga versus an attention control on pain in children with VOC...
February 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28188006/changes-in-hemostasis-caused-by-different-replacement-fluids-and-outcome-in-therapeutic-plasma-exchange-in-pediatric-patients-in-a-retrospective-single-center-study
#8
REVIEW
Volker Witt, Herbert Pichler, Elisabeth Beiglboeck, Friedrich Kursten, Lisa Weidner
BACKGROUND: Therapeutic plasma exchange (TPE) is a generally accepted and frequently performed procedure for numerous therapeutic indications in adults. Slowly, TPE is also becoming more and more popular in the treatment of pediatric patients. Although, we know that TPE is safe in pediatric patients, the outcome of children treated with TPE is rarely reported. Furthermore, there are only general recommendations regarding the plasma replacement fluid for children and these are adopted from adults...
February 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28138088/multi-center-evaluation-of-the-automated-immunohematology-instrument-the-ortho-vision-analyzer
#9
Agnes Aysola, Leslie Wheeler, Richard Brown, Rebecca Denham, Connie Colavecchia, Katerina Pavenski, Elizabeth Krok, Chelsea Hayes, Ellen Klapper
BACKGROUND: ORTHO VISION Analyzer (Vision), is an immunohematology instrument using ID-MT gel card technology with digital image processing. It has a continuous, random sample access with STAT priority processing. The efficiency and ease of operation of Vision was evaluated at 5 medical centers. METHODS: De-identified patient samples were tested on the ORTHO ProVue Analyzer (ProVue) and repeated on the Vision mimicking the daily workload pattern. Turnaround times (TAT) were collected and compared...
February 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28088398/mindfulness-based-stress-reduction-for-adolescents-with-functional-somatic-syndromes-a-pilot-cohort-study
#10
Ather Ali, Theresa R Weiss, Anne Dutton, Douglas McKee, Kim D Jones, Susmita Kashikar-Zuck, Wendy K Silverman, Eugene D Shapiro
OBJECTIVE: To assess the feasibility of a mindfulness-based stress reduction (MBSR) program for adolescents with widespread chronic pain and other functional somatic symptoms and to make preliminary assessments of its clinical utility. STUDY DESIGN: Three cohorts of subjects completed an 8-week MBSR program. Child- and parent-completed measures were collected at baseline and 8 and 12 weeks later. Measures included the Functional Disability Inventory (FDI), the Fibromyalgia/Symptom Impact Questionnaire-Revised (FIQR/SIQR), the Pediatric Quality of Life Inventory, the Multidimensional Anxiety Scale (MASC2), and the Perceived Stress Scale...
January 12, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28028189/implementation-of-a-%C3%AE-agonist-airway-clearance-protocol-in-a-pediatric-icu
#11
Gary R Lowe, J Randy Willis, Shasha Bai, Mark J Heulitt
BACKGROUND: Respiratory therapist (RT)-driven protocols have been in use for over 30 years. Protocols have been reported to decrease unnecessary or harmful therapy, health-care costs, and hospital stay. This study represents the evaluation of an original respiratory care protocol in the pediatric ICU at Arkansas Children's Hospital for β-agonist and airway clearance interventions where one did not exist. METHODS: This project was composed of 2 parts: a survey administered to RTs and licensed independent practitioners and a retrospective review of outcome data comparing a therapist-driven β-agonist/airway clearance protocol with physician-directed respiratory care ordering in a patient population admitted for acute respiratory failure...
December 27, 2016: Respiratory Care
https://www.readbyqxmd.com/read/28017963/the-impacts-of-the-interaction-of-genetic-variation-cyp11%C3%AE-2-and-nedd4l-with-sodium-intake-on-pediatric-obesity-with-gender-difference-a-three-year-panel-study
#12
M Lee, D Y Kwon, J Park
Backgrounds/ObjectivesThis panel study was to predict the incidences of pediatric obesity by the interaction of sodium (Na) intake and 9 SNPs of salt-sensitive genes (SSGs), ACE, ADD1 G460W, AGT M235T, CYP11β2, GNB3 C285T, GRK4 A142V, GRK4 A486V, NEDD4L and SLC12A3, selected from GWAS.Subjects/MethodsNon-obese (non-OB) Korean children of 9 years old were recruited from eight elementary schools in Seoul in 2007 and 2009, each. Follow-up subjects (total=798) in 2010 and 2012 were final participants. Participants were classified as obese group (OB) for those whose BMI were over the 85th percentile using the 'Korean National Growth Charts', and others were classified as non-OB...
December 26, 2016: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/28011445/drivers-and-barriers-to-acceptance-of-web-based-aftercare-of-patients-in-inpatient-routine-care-a-cross-sectional-survey
#13
Severin Hennemann, Manfred E Beutel, Rüdiger Zwerenz
BACKGROUND: Web-based aftercare can help to stabilize treatment effects and support transition after inpatient treatment, yet uptake by patients seems limited in routine care and little is known about the mechanisms of adoption and implementation. OBJECTIVE: The aim of this study was to (1) determine acceptance of Web-based aftercare and (2) explore its drivers and barriers in different subgroups of a mixed inpatient sample. METHOD: In a cross-sectional design, 38...
December 23, 2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27924146/mindfulness-based-intervention-for-female-adolescents-with-chronic-pain-a-pilot-randomized-trial
#14
Nicholas Chadi, Audrey McMahon, Majorie Vadnais, Catherine Malboeuf-Hurtubise, Anissa Djemli, Patricia L Dobkin, Jacques Lacroix, Thuy Mai Luu, Nancy Haley
OBJECTIVE: To test the feasibility of a randomized-controlled trial measuring the impact of an adapted mindfulness-based intervention (MBI) in female adolescents with chronic pain. METHODS: This was a single center, single-blind, prospective, experimental, longitudinal trial conducted in a pediatric tertiary care center. Participants had a history of chronic pain during at least three months. They were randomized into an intervention group or a wait-list control group...
2016: Journal of the Canadian Academy of Child and Adolescent Psychiatry
https://www.readbyqxmd.com/read/27919346/disease-control-via-intensified-lipoprotein-apheresis-in-three-siblings-with-familial-hypercholesterolemia
#15
Christina Taylan, Andrea Schlune, Thomas Meissner, Karolis Ažukaitis, Floris E A Udink Ten Cate, Lutz T Weber
BACKGROUND: Familial hypercholesterolemia (FH), the prevalent monogenic form of hypercholesterolemia, carries the risk of premature coronary heart disease. Lipoprotein-apheresis is established in children with severe dyslipidemia. We present 3 siblings with a negative/negative residual low-density lipoprotein (LDL) receptor mutation (p.Trp577Arg), unresponsive to drug treatment. OBJECTIVE: Intensified lipoprotein-apheresis is well tolerated and results in permanently low lipid values without harming the health-related quality of life in children...
November 2016: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/27773937/effect-of-phentermine-on-weight-reduction-in-a-pediatric-weight-management-clinic
#16
J R Ryder, A Kaizer, K D Rudser, A Gross, A S Kelly, C K Fox
Phentermine is the most widely prescribed obesity medication in adults, yet studies of its use in the pediatric population are limited. We conducted a retrospective chart review of adolescents with obesity treated in a pediatric weight management clinic to examine the weight loss effectiveness of phentermine added to standard of care (SOC) lifestyle modification therapy versus SOC alone. All patients receiving phentermine plus SOC (n=25) were matched with a comparison group receiving only SOC (n=274). Differences at 1, 3 and 6 months were evaluated using generalized estimated equations adjusting for age, sex and baseline body mass index (BMI) and robust variance standard error estimates for confidence intervals and P-values...
January 2017: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/27706462/effectiveness-of-prophylactic-non-invasive-ventilation-on-respiratory-function-in-the-postoperative-phase-of-pediatric-cardiac-surgery-a-randomized-controlled-trial
#17
Camilla R S Silva, Lívia B Andrade, Danielle A S X Maux, Andreza L Bezerra, Maria C M B Duarte
Objective: To evaluate the effectiveness of prophylactic, non-invasive ventilation (NIV) on respiratory function in seven- to 16-year-old children in the post-operative phase of cardiac surgery. Method: A randomized, controlled trial with 50 children who had undergone cardiac surgery with median sternotomy. After extubation, patients were randomly assigned to one of two groups: control group (n=26), which received instructions regarding posture, early ambulation, and cough stimulation, and CPAP group (continuous positive airway pressure; n=24), which received the same instructions as the control group and CPAP=10 cmH20 twice daily for 30 minutes from the 1st to the 5th post-operative day (POD)...
November 2016: Brazilian Journal of Physical Therapy
https://www.readbyqxmd.com/read/27685196/two-year-follow-up-of-outcomes-related-to-scarring-and-distress-in-children-with-severe-burns
#18
Paul Wurzer, Abigail A Forbes, Gabriel Hundeshagen, Clark R Andersen, Kathryn M Epperson, Walter J Meyer, Lars P Kamolz, Ludwik K Branski, Oscar E Suman, David N Herndon, Celeste C Finnerty
PURPOSE: We assessed the perception of scarring and distress by pediatric burn survivors with burns covering more than one-third of total body surface area (TBSA) for up to 2 years post-burn. METHODS: Children with severe burns were admitted to our hospital between 2004 and 2012, and consented to this IRB-approved-study. Subjects completed at least one Scars Problems and/or Distress questionnaire between discharge and 24 months post burn. Outcomes were modeled with generalized estimating equations or using mixed linear models...
August 16, 2016: Disability and Rehabilitation
https://www.readbyqxmd.com/read/27684849/elastic-stable-intramedullary-nailing-for-severely-displaced-distal-tibial-fractures-in-children
#19
Kaiying Shen, Haiqing Cai, Zhigang Wang, Yunlan Xu
Elastic stable intramedullary nailing (ESIN) has became a well-accepted method of osteosynthesis of diaphyseal fractures in the skeletally immature patient for many advantages, the purpose of this study is to evaluate the preliminary results of this minimally invasive treatment for severely displaced distal tibial diaphyseal metaphyseal junction (DTDMJ) fractures.This study was carried out over a 6-year period. Twenty-one severely displaced DTDMJ fractures treated using ESIN were evaluated clinically and radiographically...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27602915/cost-analysis-and-performance-in-distal-pediatric-forearm-fractures-is-a-short-arm-cast-superior-to-a-sugar-tong-splint
#20
Joshua S Acree, John Schlechter, Scott Buzin
The aim of this study is to compare splint versus cast immobilization for maintaining alignment following closed reduction of distal 1/3 radius and both-bone forearm fractures. We performed a retrospective review of patient records between 5 and 14 years old with a distal 1/3 radius or radius and ulna fracture requiring reduction. A cost comparison was also performed using facility costs for materials. Reduction was maintained with acceptable alignment in most cases (94%). Although a sugar-tong splint slightly maintained fracture alignment better, this was not significant...
September 3, 2016: Journal of Pediatric Orthopedics. Part B
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