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management of vomiting in children

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https://www.readbyqxmd.com/read/29436139/incidence-and-factors-contributing-to-postdischarge-nausea-and-vomiting-in-pediatric-ambulatory-surgical-cases
#1
Proshad N Efune, Abu Minhajuddin, Peter Szmuk
BACKGROUND: Little is known regarding the incidence and contributing factors of postdischarge nausea and vomiting in children. AIMS: The aim of this study was to determine the incidence of postdischarge nausea and vomiting in day surgery patients and to identify demographic, intraoperative, and postoperative variables that influence the risk. METHODS: In this prospective observational study, a postdischarge questionnaire was administered to parents of ambulatory patients who received anesthesia and the electronic records were reviewed...
March 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29433912/factors-influencing-emergency-department-care-of-young-children-at-risk-for-clinically-important-traumatic-brain-injury
#2
Tara Rhine, Shari L Wade, Nanhua Zhang, Huaiyu Zang, Stephanie Kennebeck, Lynn Babcock
OBJECTIVES: Care decisions for young children presenting to the emergency department (ED) with head injury are often challenging (e.g. whether to obtain neuroimaging). We sought to identify factors associated with acute management of children at-risk for clinically important traumatic brain injury (ciTBI) and describe symptom management. METHODS: Observational evaluation of children, ages 0-4years, presenting to a pediatric ED following minor head injury. Children with ≥1 risk element per the Pediatric Emergency Care Academic Research Network's decision rule were deemed "at-risk" for ciTBI...
January 31, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29429783/pediatric-stroke-and-its-mimics-limitations-of-a-pediatric-stroke-clinical-pathway
#3
Amy M DeLaroche, Lalitha Sivaswamy, Ahmad Farooqi, Nirupama Kannikeswaran
BACKGROUND: Acute stroke protocols improve delivery of care but it is unclear whether these resource intensive protocols are able to differentiate stroke from mimics in children. The aim of this study is to describe our institution's experience with stroke mimics identified through our pediatric stroke clinical pathway (PSCP). METHODS: The PSCP was implemented in our level 1 pediatric emergency department in June 2014 for children aged one month to 18 years. For patients managed using the PSCP from June 2014 to December 2016, demographic and clinical data were compared for patients diagnosed with stroke or a stroke mimic...
October 31, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/29390422/type-v-hypertriglyceridemia-in-children-a-therapeutic-challenge-in-pediatrics-a-case-report-and-a-review-of-the-literature
#4
Cristina Oana Mărginean, Lorena Elena Meliţ, Minodora Dobreanu, Maria Oana Mărginean
RATIONALE: Hypertriglyceridemia is defined as a level of triglycerides above 150 mg/dL. The complex causes and classification of hypertriglyceridemia lead to difficulties in the diagnosis and management of this condition. PATIENT CONCERNS: We present the case of a 15 years and 6 months old female teenager, admitted in our clinic for the following complaints: severe abdominal pain predominantly in the lateral left quadrant, nausea, vomiting, and the lack of stools for 2 days...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29373437/yield-and-costs-of-evaluating-children-with-cyclic-vomiting-syndrome
#5
Chantal Lucia-Casadonte, Kaitlin Whaley, Ashish Chogle
BACKGROUND: Cyclic vomiting syndrome (CVS) clinical guidelines recommend an algorithm of basic testing for standard patients, and more targeted testing, including laboratory and imaging studies, in the presence of specific red flags. The cost effectiveness of this screening of children with suspected CVS is lacking. OBJECTIVES: To determine if screening studies in CVS patients results in diagnostic change, and to estimate their healthcare cost. METHOD: Charts of patients (1-18 years) with suspected CVS were retrospectively reviewed at a single center...
January 25, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29358491/ketamine-procedural-sedation-in-the-emergency-department-of-an-urban-tertiary-hospital-in-dar-es-salaam-tanzania
#6
Zlatan Coralic, Hendry R Sawe, Juma A Mfinanga, Alfredo Cortez, Jennifer Koehl, Hannah Siroker, Teri A Reynolds
STUDY OBJECTIVE: We describe ketamine procedural sedations and associated adverse events in low-acuity and high-acuity patients in a resource-limited ED. METHODS: This was a prospective observational study of ketamine procedural sedations at the Emergency Medical Department at the Muhimbili National Hospital in Dar es Salaam, Tanzania. We observed consecutive procedural sedations and recorded patient demographics, medications, vital signs, pulse oximetry, capnography and a priori defined adverse events (using standard definitions in emergency medicine sedation guidelines)...
January 22, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29340927/achalasia-cardia-in-a-young-infant
#7
V Poornachand, K Kumarasamy, S P Karamath, V Seenivasan, Sumathi Bavanandam, Nirmala Dheivamani
Achalasia cardia is an esophageal motility disorder rarely reported in children and more so in young infants. Common clinical presentations include vomiting, dysphagia, regurgitation, recurrent pulmonary aspiration and failure to thrive. Diagnosis is made by barium swallow study and esophageal manometry, which is the gold standard test. Pharmocological management and endotherapy often fails and results in recurrence of symptoms. Laparoscopic Hellers myotomy, with or without anti-reflux procedure is the standard treatment of choice for children...
January 17, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29335001/different-clinical-presentation-and-management-of-temporal-bone-fibrous-dysplasia-in-children
#8
REVIEW
Józef Mierzwiński, Justyna Kosowska, Justyna Tyra, Karolina Haber, Maria Drela, Dariusz Paczkowski, Paweł Burduk
BACKGROUND: Fibrous dysplasia is a slowly progressive benign fibro-osseous disorder that involves one or multiple bones with a unilateral distribution in most cases. It is a lesion of unknown etiology, uncertain pathogenesis, and diverse histopathology. Temporal bone involvement is the least frequently reported type, especially in children. We reviewed available articles regarding fibrous dysplasia with temporal bone involvement in children and added four patients aged 7 to 17 years who were diagnosed and treated in our institution from 2006 to 2017...
January 15, 2018: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29300049/hirschsprung-disease-integrating-basic-science-and-clinical-medicine-to-improve-outcomes
#9
REVIEW
Robert O Heuckeroth
Hirschsprung disease is defined by the absence of enteric neurons at the end of the bowel. The enteric nervous system (ENS) is the intrinsic nervous system of the bowel and regulates most aspects of bowel function. When the ENS is missing, there are no neurally mediated propulsive motility patterns, and the bowel remains contracted, causing functional obstruction. Symptoms of Hirschsprung disease include constipation, vomiting, abdominal distension and growth failure. Untreated disease usually causes death in childhood because bloodstream bacterial infections occur in the context of bowel inflammation (enterocolitis) or bowel perforation...
January 4, 2018: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29287863/demonstration-of-analgesic-effect-of-intranasal-ketamine-and-intranasal-fentanyl-for-postoperative-pain-after-pediatric-tonsillectomy
#10
RANDOMIZED CONTROLLED TRIAL
Alper Yenigun, Sinan Yilmaz, Remzi Dogan, Seda Sezen Goktas, Muhittin Calim, Orhan Ozturan
OBJECTIVE: Tonsillectomy is one of the oldest and most commonly performed surgical procedure in otolaryngology. Postoperative pain management is still an unsolved problem. In this study, our aim is to demonstrate the efficacy of intranasal ketamine and intranasal fentanyl for postoperative pain relief after tonsillectomy in children. MATERIAL AND METHOD: This randomized-controlled study was conducted to evaluate the effects of intranasal ketamine and intranasal fentanyl in children undergoing tonsillectomy...
January 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29279643/meckel-s-diverticulitis-masquerading-as-acute-pancreatitis-a-diagnostic-dilemma
#11
C Danny Darlington, G Fatima Shirly Anitha
Meckel's diverticulum is a remnant of the proximal part of the vitellointestinal duct and is the most common congenital anomaly of the gastrointestinal tract. It may either remain asymptomatic or present with myriad of clinical presentations. Gastrointestinal bleeding is the most common presentation in children whereas it is intestinal obstruction in the case of adults. We report a 9-year-old boy who presented with acute onset of periumbilical pain and nonbilious vomiting. His clinical and laboratory parameters were unremarkable, except for serum amylase levels...
November 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29262469/-association-between-behavioral-problems-and-gastrointestinal-disorders-among-children-with-autism-spectrum-disorder
#12
J Zhu, M Guo, T Yang, X Lai, Y Y Lei, M L He, J Chen, T Y Li
Objective: To investigate the relationship between gastrointestinal disorders (GID) and core symptoms or behavioral problems among the children with autism spectrum disorder (ASD) . Method: Totally 328 children with ASD and 202 normal controls were enrolled in this cross-sectional study from August 2013 to October 2016. The information about the gastrointestinal disorders, behavioral and emotional problems was collected by using questionnaires. Childhood Autism Rating Scale (CARS), Autism Behavior Checklist (ABC) were used to assess the core symptoms of the children with ASD...
December 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29237494/adherence-to-the-integrated-management-of-childhood-illness-guidelines-in-namibia-kenya-tanzania-and-uganda-evidence-from-the-national-service-provision-assessment-surveys
#13
Carsten Krüger, Monika Heinzel-Gutenbrunner, Mohammed Ali
BACKGROUND: Integrated Management of Childhood Illness (IMCI) is regarded as a standard public health approach to lowering child mortality in developing countries. However, little is known about how health workers adhere to the guidelines at the national level in sub-Saharan African countries. METHODS: Data from the Service Provision Assessment surveys of Namibia (NA) (survey year: 2009), Kenya (KE) (2010), Tanzania (TZ) (2006) and Uganda (UG) (2007) were analysed for adherence to the IMCI guidelines by health workers...
December 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29198971/characteristics-of-feeding-tube-dependency-with-respect-to-food-aversive-behaviour-and-growth
#14
Markus Wilken, Peter Bartmann, Terence M Dovey, Soyhan Bagci
The use of feeding tubes in pediatric medical procedures and management has dramatically increased over the last three decades. With this increase, the prevalence of Feeding Tube Dependency (FTD) - a reliance on enteral feeding following medical recovery due to lack of oral intake of nutrition, despite being able to eat- has increased too. It has been suggested, that cases with FTD show avoidant feeding behaviours such as food refusal, gagging or swallowing resistance, but evidence for this hypothesis is scarce...
December 2, 2017: Appetite
https://www.readbyqxmd.com/read/29148203/the-ins-and-outs-of-intussusception-where-best-practice-reduces-the-need-for-surgery
#15
Spencer W Beasley
Intussusception may be difficult to diagnose because the classical triad of symptoms is evident at the time of presentation in only about 20% of cases. This may lead to delays in making the correct diagnosis. The most common presenting features are colicky abdominal pain, vomiting, pallor, lethargy and listlessness. In recent years, the algorithms of management of intussusception have changed significantly: a routine plain abdominal X-ray has been replaced by ultrasonography, previously perceived contraindications to attempting an enema reduction no longer apply, gas has largely replaced barium for enema reduction, incomplete initial reduction is an indication for a delayed repeat enema if the child is stable clinically and partial reduction has been achieved, the indications for surgery have been tightened and laparoscopy affords an alternative surgical approach...
November 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29129298/latest-insights-on-the-relationship-between-symptoms-and-biologic-findings-in-adults-with-eosinophilic-esophagitis
#16
REVIEW
Ekaterina Safroneeva, Alex Straumann, Alain M Schoepfer
Patients with eosinophilic esophagitis (EoE) present with symptoms accompanied by behavioral adaptions to living with this condition. These include swallowing- and nonswallowing-associated pain in adulthood. In children, EoE symptoms vary with age and include vomiting, abdominal pain, and dysphagia. Studies using validated patient-reported outcome measures have demonstrated that symptoms in EoE are associated with severe biologic alterations and that patients on the low biologic severity spectrum have few symptoms...
January 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29112111/pediatric-minoxidil-exposures-reported-to-texas-poison-centers
#17
Mathias B Forrester
OBJECTIVES: It has been suggested that ingestion of even small amounts of minoxidil by young children may result in serious adverse effects. The intent of this study was to describe pediatric minoxidil exposures reported to a statewide poison center system. METHODS: Cases were minoxidil exposures among patients 5 years or younger reported to Texas poison centers during 2000 to 2014. The distribution by various demographic and clinical factors was determined. RESULTS: Of 125 total cases, 58% were male and 78% aged 1 to 2 years...
July 3, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29071378/comparison-of-pecarn-and-catch-clinical-decision-rules-in-children-with-minor-blunt-head-trauma
#18
Ö Bozan, G Aksel, H A Kahraman, Ö Giritli, S E Eroğlu
INTRODUCTION AND PURPOSE: Computerized brain tomography (CBT) imaging plays a key role in the management of patients with head trauma, and there is an indication for CBT in moderate and severe injuries. However, it is difficult to determine an indication for CBT in patients with minor head trauma. The primary aim of this study is to compare the efficiency of the most commonly used clinical decision rules: the guidelines of the Pediatric Emergency Care Applied Research Network (PECARN), and those of the Canadian Assessment of Tomography for Childhood Head Injury (CATCH)...
October 25, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29048518/disease-related-predictors-of-health-related-quality-of-life-in-youth-with-eosinophilic-esophagitis
#19
Mary K Lynch, Margaux J Barnes, Reed A Dimmitt, Lisa Martin, Marc E Rothenberg, Burel R Goodin
Objective: To evaluate relations between health-related quality of life (HRQoL) and clinical symptom presentation in youth with eosinophilic esophagitis (EoE). We hypothesized that presence of dysphagia, reflux, nausea/vomiting, and epigastric pain would be related to poorer HRQoL. In predictive models, it was hypothesized that dysphagia, reflux, nausea/vomiting, and epigastric pain would each significantly and uniquely predict poorer HRQoL. Methods: This cross-sectional, two-study design included 91 dyads comprised children with EoE and their respective caregivers across two tertiary children's hospitals, Site 1 in the Midwest (N = 47) and Site 2 in the Deep South (N = 44)...
October 12, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/29030932/a-prospective-audit-of-pain-profiles-following-general-and-urological-surgery-in-children
#20
Caroline A Wilson, David Sommerfield, Thomas F E Drake-Brockman, Claudia Lagrange, Anoop Ramgolam, Britta S von Ungern-Sternberg
BACKGROUND: Postoperative pain is frequently undertreated in children both in hospital and at home following discharge. Pain has both short- and long-term consequences for children, their families, and the healthcare system. A greater understanding of procedure-specific postoperative pain trajectories is required to improve pain management. AIM: To determine the duration and severity of acute postoperative pain experienced by children undergoing 8 different general and urological procedures (primary outcomes)...
November 2017: Paediatric Anaesthesia
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