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Acceptable + reduction + pediatric

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 lifestyle modification therapy (SOC) 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...
October 24, 2016: International Journal of Obesity: Journal of the International Association for the Study of Obesity
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)...
September 29, 2016: Brazilian Journal of Physical Therapy
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
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)
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
William F Sensakovic, Matthew Cody O'Dell, Ali Agha, Raymund Woo, Laura Varich
STUDY DESIGN: Retrospective Consecutive Cohort Series OBJECTIVE.: To develop a low-dose computed tomography (CT) protocol for use in robot-assisted pediatric spinal surgery. SUMMARY OF BACKGROUND DATA: CT scans are utilized preoperatively for preoperative planning, by navigation software during robot-assisted surgery, and postoperatively to assess surgical implant placement. Traditionally high radiation doses produced by CT scanning are a concern in the highly radiosensitive pediatric population...
August 10, 2016: Spine
Leila Kheirandish-Gozal, Hari P R Bandla, David Gozal
RATIONALE: Obstructive sleep apnea (OSA) is highly prevalent in children and is usually treated by adenotonsillectomy. Nonsurgical therapies for OSA consist primarily of antiinflammatory approaches and have gained popularity, but their efficacy remains to be critically examined. OBJECTIVES: To determine the effect of montelukast on pediatric OSA. METHODS: A prospective randomized double-blind controlled trial of polysomnographically diagnosed OSA in children ages 2-10 years who were treated with either oral montelukast (4 or 5 mg daily) or placebo for 16 weeks...
October 2016: Annals of the American Thoracic Society
H Sun, N Stockbridge, R L Ariagno, D Murphy, R M Nelson, W Rodriguez
OBJECTIVE: To identify suitable end points and surrogates for pediatric pulmonary arterial hypertension (PAH) as the lack of developmentally appropriate end point and clinical trials contribute to the unmet medical need. STUDY DESIGN: Reviewed the efficacy end points and surrogates for all trials (1995 to 2013) that were submitted to the Food and Drug Administration (FDA) to support the approval of PAH therapy and conducted literature search. RESULTS: An increase in the 6 min walking distance (6MWD) was used as a primary end point in 8/9 adult PAH trials...
December 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Don Hayes, Brian F Joy, Susan D Reynolds, Joseph D Tobias, Dmitry Tumin
BACKGROUND: The optimal ischemic time in pediatric lung transplantation (LTx) is unclear, as recent studies have challenged the relevance of 6 hours as an upper limit to acceptable ischemic time. METHODS: Pediatric LTx recipients transplanted between 1987 and 2013 were identified in the United Network for Organ Sharing (UNOS) registry to compare survival according to ischemic time, which was categorized as <4 hours, 4 to 6 hours and >6 hours. RESULTS: Nine hundred thirty patients, all <18 years of age and receiving a first-time LTx from a cadaveric donor, were included in our investigation...
May 27, 2016: Journal of Heart and Lung Transplantation
Hae Jin Kim, So-Young Yoo, Tae Yeon Jeon, Ji Hye Kim
PURPOSE: To evaluate image quality and dose reduction of ultra-low-dose pediatric chest CT reconstructed with model-based iterative reconstruction (MBIR), as compared with adaptive statistical iterative reconstruction (ASIR). MATERIALS AND METHODS: Fifty-seven patients (mean age 14 years, M:F=31:26) who underwent ultra-low-dose chest CT reconstructed with both MBIR and ASIR were enrolled in the study. The subjective and objective image qualities of both reconstruction techniques were assessed by 3 radiologists, and compared using statistical analysis...
September 2016: Clinical Imaging
Matthew J Brown, Michael R Ferrick
Transphyseal femoral neck fractures are an extremely rare event, mainly occurring in children subjected to an significant traumatic force. The diagnosis is usually suggested by clinical examination with radiographic confirmation. Management varies; however, no consensus exists as to proper treatment. Intervention is primarily focused on the prevention of avascular necrosis (AVN) of the femoral epiphysis. We present the case of a 20-month-old male with a delayed diagnosis of transphyseal femoral neck fracture...
2016: Open Orthopaedics Journal
Kumar Prashant, Devendra Lakhotia, Tulsi Das Bhattacharyya, Anil Kumar Mahanta, Aakhil Ravoof
BACKGROUND: The management of displaced supracondylar fracture of the humerus with closed reduction and percutaneous pin fixation is the most widely accepted method of treatment, but controversy continues regarding the pin fixation techniques. A prospective randomized controlled study was undertaken to compare the stability, functional outcome and iatrogenic ulnar nerve injury between lateral pin fixation and medial-lateral pin fixation. MATERIAL AND METHOD: Sixty-two patients with Gartland type III supracondylar fracture of the humerus were randomized into two groups-lateral pin fixation (n = 31) and medial-lateral pin fixation (n = 31)...
September 2016: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
Diane Armao, Terry Hartman, Christopher M Shea, Cassandra Sams, Marija Ivanovic, Lynn Ansley Fordham, J Keith Smith
Pediatric CT radiation dose optimization is a challenging process for pediatric-focused facilities and community hospitals alike. Ongoing experience and trial-and-error approaches to dose reduction in the large academic hospital setting may position these centers to help community hospitals that strive for CT quality improvement. We describe our hands-on approach in a pilot project to create a partnership between an academic medical center and a community hospital to develop a toolkit for implementing CT dose reduction...
November 2016: Journal of the American College of Radiology: JACR
Meredith Rayner, Frank Muscara, Anica Dimovski, Maria C McCarthy, Jackie Yamada, Vicki A Anderson, Kylie Burke, Robyn Walser, Jan M Nicholson
BACKGROUND: A substantial proportion of parents whose child is diagnosed with a life-threatening illness, experience high levels of distress that can lead to long-term difficulties in mental health, family functioning and child adjustment. This study evaluates the efficacy of an Acceptance Commitment Therapy-based group intervention designed to reduce distress symptoms in these parents. The program is delivered using videoconferencing to overcome factors that prevent participation in traditional face-to-face therapy...
2016: BMC Psychiatry
Yue-Li Zhu, Wei Hu, Xian-Bin Yu, Yao-Sen Wu, Liao-Jun Sun
BACKGROUND: No randomized controlled studies have confirmed the advantages of the joystick technique over the traditional manual traction. The objective of this study was to compare the results of the joystick technique and the traditional manual traction for facilitating closed reduction of pediatric supracondylar humeral fractures. METHODS: From February 2009 to December 2012, sixty eight children were included in this study. Group A included 34 fractures reduced by the joystick technique...
September 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
P A Hannan, J A Khan, A Khan, S Safiullah
Dosage form is a mean used for the delivery of drug to a living body. In order to get the desired effect the drug should be delivered to its site of action at such rate and concentration to achieve the maximum therapeutic effect and minimum adverse effect. Since oral route is still widely accepted route but having a common drawback of difficulty in swallowing of tablets and capsules. Therefore a lot of research has been done on novel drug delivery systems. This review is about oral dispersible tablets a novel approach in drug delivery systems that are now a day's more focused in formulation world, and laid a new path that, helped the patients to build their compliance level with the therapy, also reduced the cost and ease the administration especially in case of pediatrics and geriatrics...
January 2016: Indian Journal of Pharmaceutical Sciences
Marco Corradin, Lorenza Marengo, Antonio Andreacchio, Matteo Paonessa, Vanessa Giacometti, Antoine Samba, Marie Rousset, Federico Canavese
PURPOSE: The olecranon fracture is an uncommon injury reported to incur many possible complications in children. The aim of this study was to compare the outcome of two different surgical techniques in isolated olecranon fracture. METHODS: We retrospectively evaluated 22 children with isolated olecranon fracture treated by open reduction and tension band wiring fixation versus closed reduction and percutaneous screw fixation. We compared the dislocation before and after surgery by radiography...
July 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
M Jung, N Zepf, B Fuchs
Cancer Related Fatigue (CRF) is known as one of the strongest and incriminating side effects of cancer for adults and children. By now there is a lack of valid assessments and sufficient therapy in pediatric oncology. For children it is a tough challenge to accept this overwhelming tiredness and lower activity level in their daily life routines. First positive effects in CFR therapy were found by adults, but this specific scientific field is very young and therefore mostly unexplored. 4 databases for medical and therapeutic journals were systematically searched for RCTs, CCTs and CTs...
May 2016: Klinische Pädiatrie
Tarrah B Mitchell, Christina M Amaro, Ric G Steele
OBJECTIVE: Although the primary care setting has been recommended as an acceptable environment for pediatric overweight/obesity treatment, a quantitative analysis has not been conducted to determine the effectiveness of pediatric weight management interventions delivered in these settings. Therefore, the purpose of the current study was to conduct a meta-analysis of weight management interventions for youth in primary care settings. METHOD: A literature search using PsycINFO and PubMed was conducted to identify articles published through October 2015...
April 18, 2016: Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association
Christine A Ho
Despite the increasing popularity of operative treatment in adolescent tibia fractures, casting remains a viable first-line treatment. Because the selection bias in published reports does not allow direct comparison between casting and flexible nail treatment of closed pediatric tibia fractures, it is unclear whether flexible nailing offers any advantages over casting. This overview discusses parameters of acceptable alignment, indications, techniques for successful reduction and casting, subsequent inpatient and outpatient management including wedging of casted tibia fractures, expected outcomes, and comparison of casting with flexible nailing...
June 2016: Journal of Pediatric Orthopedics
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