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https://www.readbyqxmd.com/read/28108810/independent-risk-factors-for-recurrence-of-apparent-life-threatening-events-in-infants
#1
Riyo Ueda, Osamu Nomura, Takanobu Maekawa, Hirokazu Sakai, Satoshi Nakagawa, Akira Ishiguro
: The risk factors for recurrent apparent life-threatening event (ALTE) are unclear although the risk of recurrent ALTE is an important consideration for the management of ALTE patients. This study aimed to identify the risk factors for recurrent ALTE. We conducted a secondary analysis of the data from a single center retrospective cohort study in Japan conducted from March 2002 to January 2012, which included children diagnosed with ALTE at a pediatric emergency department (ED) in Tokyo...
January 20, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28108126/expert-perspectives-on-time-sensitivity-and-a-related-metric-for-children-involved-in-motor-vehicle-crashes
#2
Andrea N Doud, Samantha L Schoell, Ashley A Weaver, Jennifer W Talton, Ryan T Barnard, John K Petty, J Wayne Meredith, Joel D Stitzel
OBJECTIVE: Advanced Automatic Crash Notification (AACN) uses vehicle telemetry data to predict risk of serious injury among motor vehicle crash occupants and can thus improve the accuracy with which injured children are triaged by first responders. To better define serious injury for AACN systems (which typically use Abbreviated Injury Scale [AIS] metrics), an age-specific approach evaluating severity, time sensitivity (TS), and predictability of injury has been developed. This study outlines the development of the TS score...
January 17, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28095408/patient-safety-incidents-involving-sick-children-in-primary-care-in-england-and-wales-a-mixed-methods-analysis
#3
Philippa Rees, Adrian Edwards, Colin Powell, Peter Hibbert, Huw Williams, Meredith Makeham, Ben Carter, Donna Luff, Gareth Parry, Anthony Avery, Aziz Sheikh, Liam Donaldson, Andrew Carson-Stevens
BACKGROUND: The UK performs poorly relative to other economically developed countries on numerous indicators of care quality for children. The contribution of iatrogenic harm to these outcomes is unclear. As primary care is the first point of healthcare contact for most children, we sought to investigate the safety of care provided to children in this setting. METHODS AND FINDINGS: We undertook a mixed methods investigation of reports of primary care patient safety incidents involving sick children from England and Wales' National Reporting and Learning System between 1 January 2005 and 1 December 2013...
January 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28041758/emergency-medical-services-ems-versus-non-ems-transport-among-injured-children-in-the-united-states
#4
Michelle M Corrado, Junxin Shi, Krista K Wheeler, Jin Peng, Brian Kenney, Sarah Johnson, Huiyun Xiang
OBJECTIVES: This study aimed to assess the proportions of injured children transported to trauma centers by different transportation modes and evaluate the effect of transportation mode on inter-facility transfer rates using the US national trauma registry. METHODS: We analyzed data from the 2007-2012 National Trauma Data Bank (NTDB) to study trends of EMS versus non-EMS transport. Multivariable logistic regression was used to evaluate the association between transport mode and inter-facility transfer...
November 30, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28040554/proteinuria-during-dengue-fever-in-children
#5
Anne-Claire Andries, Veasna Duong, Julien Cappelle, Sivuth Ong, Alexandra Kerleguer, Sowath Ly, Arnaud Tarantola, Paul F Horwood, Anavaj Sakuntabhai, Philippe Dussart, Philippe Buchy
OBJECTIVES: This study aimed to investigate proteinuria occurring during dengue disease in children and assess if measurement of this parameter can help physicians in the clinical management of patients. METHODS: Proteinuria was assessed by dipstick and quantified by urine protein:creatinine ratio (UPCR) in samples from patients hospitalized with a confirmed dengue infection and in healthy controls. RESULTS: The dipstick tested positive in 42...
December 28, 2016: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28034883/an-evidence-based-algorithm-for-early-prognosis-of-severe-dengue-in-the-outpatient-setting
#6
Minh Tuan Nguyen, Thi Nhan Ho, Van Vinh Chau Nguyen, Thanh Hung Nguyen, Manh Tuan Ha, Van Tram Ta, Le Da Ha Nguyen, Loi Phan, Khoi Quang Han, Thi Hue Kien Duong, Nguyen Bich Chau Tran, Wills Bridget, Marcel Wolbers, Cameron P Simmons
BACKGROUND: Early prediction of severe dengue could significantly assist patient triage and case management METHODS: We prospectively investigated 7563 children with ≤3 days of fever recruited in the outpatient departments of six hospitals in southern Vietnam between 2010 and 2013. The primary endpoint of interest was severe dengue (2009 WHO Guidelines) and pre-defined risk variables were collected at the time of enrolment to enable prognostic model development. RESULTS: The analysis population comprised 7544 patients, of whom 2060 (27...
December 28, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28034476/defining-cases-of-severe-pediatric-diarrhea-for-an-efficacy-trial-of-an-enterotoxigenic-escherichia-coli-etec-vaccine-report-on-an-international-workshop-washington-dc-march-2016
#7
Thomas F Wierzba, Alexandra Bourgis
Enterotoxigenic Escherichia coli (ETEC) causes severe acute watery diarrhea. No ETEC vaccine is available but candidates are in development, including ETVAX, an oral, whole-cell inactivated vaccine. ETVAX is being tested in a descending-age trial in Bangladesh. If found safe and immunogenic, investigators may test it for efficacy in children. Like oral rotavirus vaccines, we expect that ETVAX will be most effective at decreasing the incidence of moderate-to-severe ETEC episodes. Thus, for an efficacy trial outcome, it will be necessary to triage patients into moderate-to-severe versus mild disease...
December 26, 2016: Vaccine
https://www.readbyqxmd.com/read/28031190/risk-factors-for-death-in-children-during-inpatient-treatment-of-severe-acute-malnutrition-a-prospective-cohort-study
#8
Maren Jh Rytter, Esther Babirekere-Iriso, Hanifa Namusoke, Vibeke B Christensen, Kim F Michaelsen, Christian Ritz, Charlotte G Mortensen, Ezekiel Mupere, Henrik Friis
BACKGROUND: Children who receive in-hospital treatment of severe acute malnutrition often have high mortality rates, and the reasons are not well understood. OBJECTIVE: We assessed risk factors for death in children who were treated for malnutrition in a hospital. DESIGN: In a prospective observational study of 120 children who were receiving in-hospital treatment of severe acute malnutrition in Uganda with therapeutic formulas F-75 and F-100, we collected data on symptoms, clinical findings, plasma markers of refeeding syndrome (electrolytes and phosphate), and acute phase reactants, and recorded the nutritional therapy given in hospital...
December 28, 2016: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28030608/predicting-hospitalised-paediatric-pneumonia-mortality-risk-an-external-validation-of-risc-and-mrisc-and-local-tool-development-risc-malawi-from-malawi
#9
Shubhada Hooli, Tim Colbourn, Norman Lufesi, Anthony Costello, Bejoy Nambiar, Satid Thammasitboon, Charles Makwenda, Charles Mwansambo, Eric D McCollum, Carina King
BACKGROUND: Pneumonia is the leading infectious cause of under-5 mortality in sub-Saharan Africa. Clinical prediction tools may aide case classification, triage, and allocation of hospital resources. We performed an external validation of two published prediction tools and compared this to a locally developed tool to identify children admitted with pneumonia at increased risk for in-hospital mortality in Malawi. METHODS: We retrospectively analyzed the performance of the Respiratory Index of Severity in Children (RISC) and modified RISC (mRISC) scores in a child pneumonia dataset prospectively collected during routine care at seven hospitals in Malawi between 2011-2014...
2016: PloS One
https://www.readbyqxmd.com/read/28030523/successful-introduction-of-fine-needle-aspiration-biopsy-for-diagnosis-of-pediatric-lymphadenopathy
#10
Candice Sher-Locketz, Pawel T Schubert, Samuel W Moore, Colleen A Wright
BACKGROUND: Accurate and rapid diagnosis of extrapulmonary nodal tuberculosis in children is of paramount importance in order to initiate immediate treatment and prevent complications. Fine needle aspiration biopsy (FNAB) provides a means of triage, and also identifies patients with suspected hematological or metastatic neoplasms.This study aims to demonstrate how a laboratory-run FNAB service, which largely replaced the previous surgical practice of lymph node excision biopsy can provide a clinically acceptable and effective diagnostic service...
December 27, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28030519/incorporating-a-computerized-cognitive-battery-into-the-emergency-department-care-of-pediatric-mild-traumatic-brain-injuries-is-it-feasible
#11
Aneesh M Khetani, Brian L Brooks, Angelo Mikrogianakis, Karen M Barlow
OBJECTIVES: The use of computers to test cognitive function acutely after a concussion is becoming increasingly popular, especially after sport-related concussion. Although commonly performed in the community, it is not yet performed routinely in the emergency department (ED), where most injured children present. The challenges of performing computerized cognitive testing (CCT) in a busy ED are considerable. The aim of this study was to evaluate the feasibility of CCT in the pediatric ED after concussion...
December 28, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28026705/a-screening-mechanism-to-recognize-and-support-at-risk-aboriginal-children
#12
Nancy L Young, Diane Jacko, Mary Jo Wabano, Lauren Hawthorne, Sarah Seabrook, Sheri Wabanosse, Koyo Usuba
OBJECTIVES: The Aboriginal Children's Health and Well-Being Measure© (ACHWM) was developed to assess health from the perspectives of Aboriginal children. The purpose of this paper is to document the screening process, embedded within the ACHWM, and assess its effectiveness. METHODS: The ACHWM was implemented in 2014/2015 with children 8 to 18 years of age living on the Wiikwemkoong Unceded Territory. Survey responses were screened to identify potential risk, using an automated algorithm run on computer tablets...
December 27, 2016: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
https://www.readbyqxmd.com/read/28017330/mortality-following-helicopter-versus-ground-transport-of-injured-children
#13
Stephanie F Polites, Martin D Zielinski, Aodhnait S Fahy, Amy E Wagie, Christopher R Moir, Donald H Jenkins, Scott P Zietlow, Elizabeth B Habermann
INTRODUCTION: Injured children may be transported to trauma centers by helicopter air ambulance (HAA); however, a benefit in outcomes to this expensive resource has not been consistently shown in the literature and there is concern that HAA is over-utilized. A study that adequately controls for selection biases in transport mode is needed to determine which injured children benefit from HAA. The purpose of this study was to determine if HAA impacts mortality differently in minimally and severely injured children and if there are predictors of over-triage of HAA in children that can be identified...
December 19, 2016: Injury
https://www.readbyqxmd.com/read/28012507/the-utility-of-a-handheld-metal-detector-in-detection-and-localization-of-pediatric-metallic-foreign-body-ingestion
#14
Javan Nation, Wen Jiang
OBJECTIVE: To test the ability of a handheld metal detector (HHMD) to identify the presence and location of ingested metallic foreign bodies (MFBs) in children. METHODS: Prospective case series enrolling children suspected of metallic foreign body ingestion presenting to the Emergency Department. Thirty-eight children were enrolled and the HHMD was used to detect the presence and location of a MFB. Results were compared to standard radiographic studies. RESULTS: Thirty-seven of the 38 ingested foreign bodies were MFBs...
January 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28011610/characteristics-and-outcomes-of-pediatric-patients-with-ebola-virus-disease-admitted-to-treatment-units-in-liberia-and-sierra-leone-a-retrospective-cohort-study
#15
Michael A Smit, Ian C Michelow, Justin Glavis-Bloom, Vanessa Wolfman, Adam C Levine
BACKGROUND: The clinical and virologic characteristics of Ebola virus disease (EVD) in children have not been thoroughly documented. METHODS: Consecutive children aged <18 years with real-time polymerase chain reaction (RT-PCR)-confirmed EVD were enrolled retrospectively in 5 Ebola treatment units in Liberia and Sierra Leone in 2014/2015. Data collection and medical management were based on standardized International Medical Corps protocols. We performed descriptive statistics, multivariate logistic regression, and Kaplan-Meier survival analyses...
February 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27929695/secondhand-smoke-exposure-illness-severity-and-resource-utilization-in-pediatric-emergency-department-patients-with-respiratory-illnesses
#16
Ashley L Merianos, Cinnamon A Dixon, E Melinda Mahabee-Gittens
OBJECTIVE: Hospital-based data reveal that children who have secondhand smoke exposure (SHSe) experience severe respiratory illnesses and greater resource utilization. Our objective was to assess the relationship between SHSe and illness severity/resource utilization among children presenting to the pediatric emergency department (PED) with three common respiratory conditions - asthma, bronchiolitis, and pneumonia. METHODS: A retrospective review of a yearlong consecutive sample of PED patients with SHSe status documentation and asthma, bronchiolitis, or pneumonia diagnoses was performed...
December 8, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/27899166/pain-management-of-acute-appendicitis-in-canadian-pediatric-emergency-departments
#17
Andrea L Robb, Samina Ali, Naveen Poonai, Graham C Thompson
OBJECTIVES: Children with suspected appendicitis are at risk for suboptimal pain management. We sought to describe pain management patterns for suspected appendicitis across Canadian pediatric emergency departments (PEDs). METHODS: A retrospective medical record review was undertaken at 12 Canadian PEDs. Children ages 3 to 17 years who were admitted to the hospital in February or October 2010 with suspected appendicitis were included. Patients were excluded if partially assessed or treated at another hospital...
November 30, 2016: CJEM
https://www.readbyqxmd.com/read/27898679/patient-reported-barriers-to-adherence-to-antiretroviral-therapy-a-systematic-review-and-meta-analysis
#18
Zara Shubber, Edward J Mills, Jean B Nachega, Rachel Vreeman, Marcelo Freitas, Peter Bock, Sabin Nsanzimana, Martina Penazzato, Tsitsi Appolo, Meg Doherty, Nathan Ford
BACKGROUND: Maintaining high levels of adherence to antiretroviral therapy (ART) is a challenge across settings and populations. Understanding the relative importance of different barriers to adherence will help inform the targeting of different interventions and future research priorities. METHODS AND FINDINGS: We searched MEDLINE via PubMed, Embase, Web of Science, and PsychINFO from 01 January 1997 to 31 March 2016 for studies reporting barriers to adherence to ART...
November 2016: PLoS Medicine
https://www.readbyqxmd.com/read/27876588/predicting-subsequent-high-frequency-low-acuity-utilization-of-the-pediatric-emergency-department
#19
Margaret E Samuels-Kalow, Matthew W Bryan, Kathy N Shaw
OBJECTIVE: To derive and test a predictive model for high-frequency (>= four visits/year), low-acuity (Emergency Severity Index 4 or 5) utilization of the pediatric emergency department. METHODS: The study sample used three years of data (2012-14) from a single tertiary care children's hospital for patients <21 years of age. Utilization in 2013 defined the index visit; prior utilization was drawn from 2012; and 2014 was used for outcome measurement. Candidate predictor variables were those that would be available at the time of triage...
November 19, 2016: Academic Pediatrics
https://www.readbyqxmd.com/read/27852453/current-use-and-outcomes-of-helicopter-transport-in-pediatric-trauma-a-review-of-18-291-transports
#20
Brian R Englum, Kristy L Rialon, Jina Kim, Mark L Shapiro, John E Scarborough, Henry E Rice, Obinna O Adibe, Elisabeth T Tracy
PURPOSE: The role of helicopter emergency medical services (HEMS) in pediatric trauma remains controversial. We examined its use in pediatric trauma and its effectiveness in children with moderate/severe injuries. METHODS: All blunt/penetrating trauma patients ≤18years old in the National Trauma Data Bank were evaluated for use of HEMS and in-hospital mortality. In a comparative effectiveness study, only patients treated at level I/II pediatric centers with injury severity score (ISS)≥9 were included...
October 27, 2016: Journal of Pediatric Surgery
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