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Pediatric quality

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https://www.readbyqxmd.com/read/28437787/a-comparison-of-three-different-volumes-of-levobupivacaine-for-caudal-block-in-children-undergoing-orchidopexy-and-inguinal-hernia-repair
#1
Vesna Marjanovic, Ivana Budic, Marija Stevic, Dusica Simic
OBJECTIVE: The aim of this study was to compare the efficacy of three different volumes of 0.25% levobupivacaine caudally administered on the effect of intra- and post-operative analgesia in children undergoing orchidopexy and inguinal hernia repair. SUBJECTS AND METHODS: Forty children, aged 1 to 7 years, American Society of Anesthesiologists (ASA) physical status I and II, were randomized into 3 different groups according to the applied volumes of 0.25% levobupivacaine: group 1 (n=13): 0...
April 23, 2017: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
https://www.readbyqxmd.com/read/28437682/sleep-problems-in-pediatric-epilepsy-and-adhd-the-impact-of-comorbidity
#2
Ozalp Ekinci, Çetin Okuyaz, Serkan Gunes, Nuran Ekinci, Merve Kalınlı, Muhammet Emin Tan, Halenur Teke, Meltem Çobanoğulları Direk, Semra Erdoğan
AIMS: Attention-deficit hyperactivity disorder (ADHD) is a frequent comorbidity in pediatric epilepsy. Although sleep problems are commonly reported in both children with primary ADHD and epilepsy, those with epilepsy-ADHD comorbidity have not been well studied. This study aimed to compare sleep problems among three groups of children: 1) children with epilepsy, 2) children with epilepsy and ADHD (epilepsy-ADHD), and 3) children with primary ADHD. METHODS: 53 children with epilepsy, 35 children with epilepsy-ADHD, and 52 children with primary ADHD completed the Children's Sleep Habits Questionnaire (CSHQ)...
April 21, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28437620/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-guidelines-for-management-of-dyslipidemia-and-prevention-of-cardiovascular-disease
#3
Paul S Jellinger, Yehuda Handelsman, Paul D Rosenblit, Zachary T Bloomgarden, Vivian A Fonseca, Alan J Garber, George Grunberger, Chris K Guerin, David S H Bell, Jeffrey I Mechanick, Rachel Pessah-Pollack, Kathleen Wyne, Donald Smith, Eliot A Brinton, Sergio Fazio, Michael Davidson
OBJECTIVE: The development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). METHODS: Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols...
April 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28434984/the-nonpalpable-testis-a-narrative-review
#4
REVIEW
Courtney L Shepard, Kate H Kraft
PURPOSE: While the nonpalpable testis represents only a small portion of all cryptorchid testes, it remains a clinical challenge for pediatric urologists. Many controversies about the best evaluation and management exist. This narrative review serves as an update on what is known about the nonpalpable testis: etiology, pre-operative evaluation, the best surgical management, novel techniques, and ongoing controversies. MATERIALS AND METHODS: A Pubmed® and MEDLINE® search limited to January 2000 to January 2017 was performed using relevant key terms...
April 20, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28434455/creating-a-pediatric-joint-council-to-promote-patient-safety-and-quality-governance-and-accountability-across-johns-hopkins-medicine
#5
Michael Rosen, Brigitta U Mueller, Aaron M Milstone, Denise R Remus, Renee Demski, Peter J Pronovost, Marlene R Miller
BACKGROUND: Large multihospital health systems with multiple children's hospitals are relatively few in number. With a paucity of national pediatric measures for quality and patient safety, there are unique challenges to ensuring consistent levels of care across diverse health care delivery settings. At Johns Hopkins Medicine, a Pediatric Joint Council was created to help ensure high-quality and safe care across a health system encompassing two full-service children's hospitals and two community hospitals with significant pediatric volumes across two states...
May 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28433454/a-randomized-comparison-of-three-chest-compression-techniques-and-associated-hemodynamic-effect-during-infant-cpr-a-randomized-manikin-study
#6
Jacek Smereka, Lukasz Szarpak, Antonio Rodríguez-Núñez, Jerzy R Ladny, Steve Leung, Kurt Ruetzler
INTRODUCTION: Pediatric cardiac arrest is an uncommon but critical life-threatening event requiring effective cardiopulmonary resuscitation. High-quality cardio-pulmonary resuscitation (CPR) is essential, but is poorly performed, even by highly skilled healthcare providers. The recently described two-thumb chest compression technique (nTTT) consists of the two thumbs directed at the angle of 90° to the chest while having the fingers fist-clenched. This technique might facilitate adequate chest-compression depth, chest-compression rate and rate of full chest-pressure relief...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28432019/feasibility-of-mini-tablets-as-a-flexible-drug-delivery-tool
#7
Biplob Mitra, Jessica Chang, Sy-Juen Wu, Chad N Wolfe, Robert L Ternik, Thomas Z Gunter, Michael C Victor
Mini-tablets have potential applications as a flexible drug delivery tool in addition to their generally perceived use as multi-particulates. That is, mini-tablets could provide flexibility in dose finding studies and/or allow for combination therapies in the clinic. Moreover, mini-tablets with well controlled quality attributes could be a prudent choice for administering solid dosage forms as a single unit or composite of multiple mini-tablets in patient populations with swallowing difficulties (e.g., pediatric and geriatric populations)...
April 18, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28431439/-quality-of-and-attendance-at-healthy-child-clinics-in%C3%A2-germany
#8
Alexandra Weithase, Mandy Vogel, Henriette Kiep, Sarah Schwarz, Laura Meißner, Janine Herrmann, Kristin Rieger, Christiane Koch, Volker Schuster, Wieland Kiess
Background For several years the German healthy child clinics program has been a highly appreciated preventive measure and is subject to constant development. However, attendance depends on the families' sociodemographic situation. Findings are documented in a medical checkup booklet (the so-called Gelbes Heft). Currently, there is no procedure to use the data collected for epidemiological purposes nor to evaluate the pediatric prevention measures in Germany. Methods Between 2011 and 2016, we recruited 3480 study participants for our population-based cohort study LIFE Child in Leipzig...
April 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28430703/evidence-based-recommendations-for-pediatric-orthopaedic-practice
#9
Kishore Mulpuri, Emily K Schaeffer, H Kerr Graham, Mininder S Kocher, James Sanders, Ira Zaltz
BACKGROUND: Evidence-based medicine has become the cornerstone to guide clinical practice decision-making. Evidence-based medicine integrates the strongest available evidence with clinical expertise to make decisions about clinical care. The quality of the evidence depends upon the soundness of the study methodology to allow for meaningful interpretation of the clinical results. The purpose of this review is to analyze the methodological design and clinical findings of published pediatric orthopaedic studies to determine their ability to change or influence clinical practice...
April 20, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28427137/-bibliometric-analysis-of-scientific-articles-on-epidemiological-study-of-burns-in-china
#10
W F Cheng, Z A Shen, D X Zhao, D W Li, Y R Shang
Objective: To analyze the current status of epidemiological study of burns in China, and to explore the related strategies. Methods: Retrospective or cross-sectional scientific articles in Chinese or English on epidemiological study of burns in China published from January 2005 to December 2015 were systemically retrieved from 4 databases. The databases include PubMed, Embase, China Biology Medicine disc, and Chinese Journals Full-text Database. From the results retrieved, data with regard to publication year, journal distribution, number of institutions participated in the study, affiliation of the first author and its location, and admission time span and age of patients in all the scientific articles were collected...
April 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28425688/pediatric-epilepsy-and-psychiatric-comorbidity-preliminary-observational-data-from-a-prospective-study
#11
Michela Gatta, Alessia Raffagnato, Stefania Mannarini, Laura Balottin, Irene Toldo, Marilena Vecchi, Clementina Boniver
BACKGROUND: Several studies have confirmed psychiatric comorbidity and a worse quality of life in children with epilepsy, but the clinical assessment and monitoring of these patients often pays insufficient attention to their psychological aspects alongside their neurological issues. The present study aims to describe the distribution of psychopathologies and their clinical evolution over 18 months in a sample of children followed up since the onset of their epilepsy. METHODS: After being diagnosed with epilepsy, 49 subjects (age 4-18y) were followed up with psychiatric and psychological assessments based on the use of dimensional and categorical psychometric tools...
April 20, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28425236/predictors-of-health-related-quality-of-life-in-childhood-epilepsy-and-comparison-with-healthy-children-findings-from-an-indian-study
#12
Dipika Bansal, Chandrika Azad, Kapil Gudala, Anil Dasari
BACKGROUND/AIM: Children with epilepsy have reduced health-related quality of life (HRQOL) due to disease and medications. We aimed to assess child-reported HRQOL in Indian children with epilepsy and compare it with that in healthy children. MATERIALS AND METHODS: A cross-sectional study of 256 children with epilepsy aged between 5 and 18 years on antiepileptic drug (AED) treatment for at least 3 months was performed and 125 age and sex matched healthy children were included...
April 18, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28423474/nasal-obstructive-disorders-impair-health-related-quality-of-life-in-adolescents-with-persistent-allergic-rhinitis-a-real-life-study
#13
Meritxell Valls-Mateus, Franklin Marino-Sanchez, Karen Ruiz-Echevarría, Paulina Cardenas-Escalante, Rosa Jiménez-Feijoo, Jaime Blasco-Lozano, María Teresa Giner-Muñoz, Oliver Haag, Isam Alobid, Ana María Plaza Martin, Joaquim Mullol
BACKGROUND: We previously reported a higher prevalence of nasal obstructive disorders (NOD) in pediatric patients with persistent allergic rhinitis (PER) not responding to medical treatment. The aim of this study was to determine the impact of NOD on quality of life (QoL) in this population. METHODS: Real-life prospective study including 142 patients (41 children, 6-11 yo and 101 adolescents, 12-17 yo) with moderate and severe PER. After two months of medical treatment (intranasal steroids and antihistamines) patients were asked if their symptoms had improved (yes/no) and classified accordingly in R, responders and NR, non-responders...
April 19, 2017: Pediatric Allergy and Immunology
https://www.readbyqxmd.com/read/28423223/implementation-and-preliminary-effectiveness-of-a-real-time-pain-management-smartphone-app-for-adolescents-with-cancer-a-multicenter-pilot-clinical-study
#14
Lindsay A Jibb, Bonnie J Stevens, Paul C Nathan, Emily Seto, Joseph A Cafazzo, Donna L Johnston, Vanessa Hum, Jennifer N Stinson
BACKGROUND: Pain in adolescents with cancer (12-18 years) is common and negatively impacts health-related quality of life (HRQL). The Pain Squad+ smartphone app, which provides adolescents with real-time pain self-management support, was developed to address this issue. This study evaluated the implementation of the app to inform a future randomized controlled trial (RCT) and obtain treatment effect estimates for pain intensity, pain interference, HRQL, and self-efficacy. PROCEDURE: A one-group baseline/poststudy design with 40 adolescents recruited from two pediatric tertiary care centers was used...
April 19, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28421650/keeping-up-with-the-kids-diffusion-of-innovation-in-pediatric-emergency-medicine-among-emergency-physicians
#15
Robert L Cloutier, Rakesh D Mistry, Stephen Cico, Chris Merritt, Samuel H F Lam, Marc Auerbach, L Melissa Skaugset, Jean Klig, Meg Wolff, Myto Duong, Jennifer Walthall
With 30,000,000 emergency department (ED) visits annually, children account for nearly one fourth of all ED visits in the United States. Despite these statistics, EDs across the country remain underprepared to care for pediatric patients [1, 2]. Based on published data, only 45% of EDs report having a pediatric quality improvement plan in place, one third of hospitals do not weigh children in kilograms, less than half have disaster plans in place for pediatric patients and more than 15% are missing critical pediatric emergency equipment [1]...
April 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28420900/intracranial-pressure-monitoring-for-pediatric-acute-encephalopathy
#16
Nobuyuki Nosaka, Kohei Tsukahara, Emily Knaup, Toshihiko Yabuuchi, Tomonobu Kikkawa, Yosuke Fujii, Masato Yashiro, Takao Yasuhara, Ayumi Okada, Toyomu Ugawa, Atsunori Nakao, Hirokazu Tsukahara, Isao Date
Newly published clinical practice guidelines recommend intracranial pressure (ICP) monitoring in critical care for the management of pediatric acute encephalopathy (pAE), but the utility of ICP monitoring for pAE has been poorly studied. We recently performed direct ICP monitoring for two patients. We observed that although the direct ICP monitoring had clinical benefits with less body weight gain and no vasopressor use in both cases, this monitoring technique is still invasive. Future studies should determine the utility of non-invasive ICP monitoring systems in pAE to further improve the quality of intensive-care management...
April 2017: Acta Medica Okayama
https://www.readbyqxmd.com/read/28420280/enteric-coated-budesonide-for-the-induction-and-maintenance-of-remission-of-crohn-s-disease-in-children
#17
Stanley A Cohen, Marina Aloi, Ramalingam Arumugam, Robert Baker, Kevin Bax, Jaroslaw Kierkuś, Sibylle Koletzko, Paolo Lionetti, Tore Persson, Stefan Eklund
OBJECTIVE: These studies evaluated the safety and efficacy of enteric-coated budesonide for the induction and maintenance of remission of mild-to-moderate Crohn's disease (CD) in children. METHODS: The consecutive, multicenter, open-label, non-comparative studies enrolled patients aged 6-17 years. In the induction study, patients with active CD of the ileum and/or ascending colon received budesonide 9 mg or 6 mg once daily for 8 weeks; in the maintenance study, patients in remission received budesonide 6 mg once daily for 12 weeks...
April 19, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28420264/the-rate-of-sepsis-in-a-national-pediatric-population-2006-to-2012
#18
Kristin A Schuller, Benson S Hsu, Allyson B Thompson
INTRODUCTION: The rate of pediatric severe sepsis is reported to be on the rise in the United States, increasing by approximately 6000 cases annually. The goal of this study was to determine the rate of pediatric sepsis per 100 000 inpatient discharges over time. METHODS: The 2006, 2009, and 2012 Agency for Healthcare Research and Quality Healthcare Cost Utilization Project Kid's Inpatient Databases were used to analyze the rate of sepsis in children over time...
April 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28419275/clinical-care-guideline-for-improving-pediatric-acute-musculoskeletal-infection-outcomes
#19
Murray D Spruiell, Justin Benjamin Searns, Travis C Heare, Jesse L Roberts, Erin Wylie, Laura Pyle, Nathan Donaldson, Jaime R Stewart, Heather Heizer, Jennifer Reese, Halden F Scott, Kelly Pearce, Colin J Anderson, Mark Erickson, Sarah K Parker
Background.: Acute pediatric musculoskeletal infections are common, leading to significant use of resources and antimicrobial exposure. In order to decrease variability and improve the quality of care, Children's Hospital Colorado implemented a clinical care guideline (CCG) for these infections. The purpose of this study is to evaluate clinical and resource outcomes PRE and POST this CCG. Methods.: Retrospective chart review evaluated patients admitted to a large pediatric quaternary referral center (CHCO) diagnosed with acute osteomyelitis, septic arthritis, pyomyositis, and/or musculoskeletal abscess prior to and after guideline implementation...
April 17, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28419084/neonatal-resuscitation-in-global-health-settings-an-examination-of-the-past-to-prepare-for-the-future
#20
REVIEW
Beena D Kamath-Rayne, Sara K Berkelhamer, K C Ashish, Hege L Ersdal, Susan Niermeyer
BACKGROUND: As rates of childhood mortality decline, neonatal deaths account for nearly half of under-5 deaths worldwide. Intrapartum-related events (birth asphyxia) contribute to approximately one-quarter of neonatal deaths, many of which can be prevented by simple resuscitation and newborn care interventions. METHODS: This paper reviews various lines of research that have influenced the global neonatal resuscitation landscape. A brief situational analysis of asphyxia-related newborn mortality in low-resource settings is linked to renewed efforts to reduce neonatal mortality in the Every Newborn Action Plan...
April 18, 2017: Pediatric Research
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