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https://www.readbyqxmd.com/read/28550704/integrating-engagement-and-improvement-work-in-a-pediatric-hospital
#1
Mireille Brosseau, Diane Gagnon, Kristina Rohde, Jennifer Schellinck
Although geared towards a common goal - improved patient-centred care - quality improvement strategies and patient engagement-focused approaches are often developed and conducted in silos. The lack of integration may lead, on the one hand, to the uptake of patient suggestions that do not always take into consideration implications for the delivery of quality care and, on the other hand, to inadequate understanding of patient views required to create optimal services. The Children's Hospital of Eastern Ontario (CHEO)'s action plans to address gaps in patient engagement and quality improvement, two of its priority areas, were initially carried out in isolation of each other...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28549608/current-challenges-with-proximal-hypospadias-we-have-a-long-way-to-go
#2
REVIEW
Edward M Gong, Earl Y Cheng
BACKGROUND AND PURPOSE: Proximal hypospadias repair has continued to challenge the pediatric urologist despite great efforts to develop better techniques for repair. METHODS: In this article, we review the literature regarding modern proximal hypospadias repair approaches and outcomes. We also present our current approach to proximal hypospadias repair surgery and outcome tracking. Finally, we review the literature on surgical outcome tools that may help us standardize research...
April 21, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28549535/relationships-of-measured-iohexol-gfr-and-estimated-gfr-with-ckd-related-biomarkers-in-children-and-adolescents
#3
Derek K Ng, George J Schwartz, Bradley A Warady, Susan L Furth, Alvaro Muñoz
BACKGROUND: 2 valid and reliable estimated glomerular filtration rate (GFR) equations for the pediatric population have been developed from directly measured GFR data in the Chronic Kidney Disease in Children (CKiD) cohort: the full CKiD and bedside CKiD equations. Although adult GFR estimating equations replicate relationships of measured GFR with biomarkers, it is unclear whether similar patterns exist among children and adolescents with chronic kidney disease (CKD). STUDY DESIGN: Prospective cohort study in children and adolescents...
May 24, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28549165/impact-of-antimicrobial-stewardship-for-pediatric-outpatient-parenteral-antibiotic-therapy
#4
Adam L Hersh, Jared Olson, Chris Stockmann, Emily A Thorell, Elizabeth D Knackstedt, Lawanda Esquibel, Susan Sanderson, Andrew T Pavia
We developed an outpatient parenteral antibiotic therapy (OPAT) stewardship program in a freestanding children's hospital to improve the appropriateness of OPAT prescribing. Introduction of the program enabled expert review of nearly 90% of the patients being prepared for discharge with OPAT and was associated with a 24% reduction in OPAT use.
May 26, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28549148/risk-factors-for-invasive-fungal-disease-in-pediatric-cancer-and-hematopoietic-stem-cell-transplantation-a-systematic-review
#5
Brian T Fisher, Paula D Robinson, Thomas Lehrnbecher, William J Steinbach, Theoklis E Zaoutis, Bob Phillips, Lillian Sung
Background.: Although a number of risk factors have been associated with invasive fungal disease (IFD), a systematic review of the literature to document pediatric-specific factors has not been performed. Methods.: We used the Ovid SP platform to search Medline, Medline In-Process, and Embase for studies that identified risk factors for IFD in children with cancer or those who undergo hematopoietic stem cell transplantation (HSCT). We included studies if they consisted of children or adolescents (<25 years) who were receiving treatment for cancer or undergoing HSCT and if the study evaluated risk factors among patients with and those without IFD...
May 26, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28549059/elimination-diet-and-the-development-of-multiple-tree-nut-allergies
#6
Arnon Elizur, Jennifer B Bollyky, Whitney M Block
BACKGROUNDDespite its high prevalence, relatively little is known about the characteristics of patients with multiple tree-nuts allergies.METHODSPatients (n=60, aged 4-15 years), recruited for a multiple food (tree-nuts, peanut, milk, egg, soy, sesame and wheat) oral immunotherapy (OIT) study, filled a questionnaire on their initial allergy evaluation. Medical records were reviewed. At OIT enrollment (median interval, 7.5 years), patients underwent oral food challenges (OFC) to foods still eliminated.RESULTSThere was significantly less evidence for eliminating tree-nuts compared to other foods, as reflected by lower rate of acute reaction to the offending food, either as the trigger for initial allergy evaluation (5...
May 26, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28548996/distal-junctional-failure-following-pediatric-spinal-fusion
#7
Lorena V Floccari, Alvin W Su, Amy L McIntosh, Karl Rathjen, William J Shaughnessy, A Noelle Larson
BACKGROUND: Adjacent segment pathology is a known complication after spinal fusion, but little has been reported on junctional failure. A series of adolescent patients presented with acute distal junctional failure (DJF). We sought to determine any common features of these patients to develop a prevention strategy. METHODS: A retrospective review was conducted of pediatric patients who developed DJF after instrumented spinal fusion performed at 2 institutions from 1999 to 2013...
May 25, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28548615/social-media-networking-in-pediatric-hydrocephalus-a-point-prevalence-analysis-of-utilization
#8
Ghassan Awad Elkarim, Naif M Alotaibi, Nardin Samuel, Shelly Wang, George M Ibrahim, Aria Fallah, Alexander G Weil, Abhaya V Kulkarni
OBJECTIVE A recent survey has shown that caregivers of children with shunt-treated hydrocephalus frequently use social media networks for support and information gathering. The objective of this study is to describe and assess social media utilization among users interested in hydrocephalus. METHODS Publicly accessible accounts and videos dedicated to the topic of hydrocephalus were comprehensively searched across 3 social media platforms (Facebook, Twitter, and YouTube) throughout March 2016. Summary statistics were calculated on standard metrics of social media popularity...
May 26, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28548027/dissociation-between-preserved-body-structural-description-and-impaired-body-image-following-a-pediatric-spinal-trauma
#9
Gerardo Salvato, Valeria Peviani, Elisa Scarano, Pina Scarpa, Alessandra Leo, Tiziana Redaelli, Michele Spinelli, Maurizio Sberna, Gabriella Bottini
In adult patients, Spinal Cord Injury (SCI) may influence the mental Body Representation (BR). Currently, there is no evidence on the modulation of SCI on BR during early stages of cognitive development. Here, we investigated BR in a 3-year-old child with complete SCI. The patient was administered with a specific battery assessing different BR components. We found evidence for putative classical neuropsychological dissociation between a preserved topological map with impaired semantic knowledge of the body...
May 26, 2017: Neurocase
https://www.readbyqxmd.com/read/28546755/pediatric-ventricular-assist-devices-current-challenges-and-future-prospects
#10
REVIEW
Sarah Burki, Iki Adachi
The field of mechanical circulatory support has made great strides in the preceding 2 decades. Although pediatric mechanical circulatory support has lagged behind that of adults, the gap between them is expected to close soon. The only device currently approved by the US Food and Drug Administration for use in children is the Berlin Heart EXCOR ventricular assist device (VAD). The prospective Berlin Heart Investigational Device Exemption Trial demonstrated good outcomes, such as bridge to transplantation or recovery, in ~90% of children supported with this device...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28546380/respiratory-implications-of-pediatric-neuromuscular-disease
#11
Howard B Panitch
Children with progressive neuromuscular weakness undergo a stereotypical progression of respiratory involvement, beginning with impaired airway clearance and progressing to nocturnal and then diurnal ventilatory failure. This review examines issues related to airway clearance and mucus mobilization, sleep problems, and use of assisted ventilation in children with neuromuscular diseases. Interventions for each of these problems have been created or adapted for the pediatric population. The use of airway clearance therapies and assisted ventilation have improved survival of children with neuromuscular weakness...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28546378/pediatric-lung-transplantation
#12
Stuart C Sweet
Pediatric lung transplant is a viable option for treatment of end-stage lung disease in children, with > 100 pediatric lung transplants reported to the Registry of the International Society of Heart and Lung Transplantation each year. Long-term success is limited by availability of donor organs, debilitation as a result of chronic disease, impaired mucus clearance resulting from both surgical and pharmacologic interventions, increased risk for infection resulting from immunosuppression, and most importantly late complications, such as chronic lung allograft dysfunction...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28546376/noninvasive-monitoring-of-oxygen-and-ventilation
#13
Craig D Smallwood, Brian K Walsh
Noninvasive monitoring of oxygenation and ventilation is an essential part of pediatric respiratory care. Carbon dioxide, gas exchange monitoring, transcutaneous monitoring, near-infrared spectroscopy, pulse oximetry, and electrical impedance tomography are examined. Although some of these technologies have been utilized for decades, incorporation into mechanical ventilators and recently developed methods may provide important clinical insights in a broader patient range. Less mature technologies (electrical impedance tomography and near-infrared spectroscopy) have been of particular interest, since they offer easy bedside application and potential for improved care of children with respiratory failure and other disorders...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28546375/extracorporeal-membrane-oxygenation-for-severe-pediatric-respiratory-failure
#14
John C Lin
Extracorporeal membrane oxygenation (ECMO) was developed initially in the 1960s to support refractory respiratory failure in addition to the cardiac support inherent in a venoarterial bypass circuit. Early successes occurred predominantly in the neonatal population with subsequent randomized controlled trials and comprehensive reviews concluding therapeutic efficacy for ECMO in neonatal respiratory failure. In contrast, the evidence supporting ECMO for respiratory failure in children is less definitive. However, although pediatric randomized controlled trials have not been completed, sufficient evidence in support of ECMO as a beneficial therapy for pediatric respiratory failure exists...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28546232/genetic-defects-in-pediatric-onset-adrenal-insufficiency-in-japan
#15
Naoko Amano, Satoshi Narumi, Mie Hayashi, Masaki Takagi, Kazuhide Imai, Toshirou Nakamura, Rumi Hachiya, Goro Sasaki, Keiko Homma, Tomohiro Ishii, Tomonobu Hasegawa
CONTEXT: Most patients with pediatric-onset primary adrenal insufficiency (PAI), such as 21-hydroxylase deficiency, can be diagnosed by measuring the urine or serum levels of steroid metabolites. However, the etiology is often difficult to determine in a subset of patients lacking characteristic biochemical findings. OBJECTIVE: To assess the frequency of genetic defects in Japanese children with biochemically uncharacterized PAI, and characterize the phenotypes of mutation-carrying patients...
May 25, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28545931/validating-a-questionnaire-prehospital-preparedness-for-pediatric-trauma-patients
#16
Karin Bölenius, Christin Vestin, Britt-Inger Saveman, Lina Gyllencreutz
In recent decades, prehospital emergency care has undergone extensive development. Today, prehospital emergency nurses (PENs) are well trained and provide advanced care to patients of all ages. Caring for pediatric trauma patients is considered to be particularly demanding. However, in Sweden and internationally, there is a lack of research regarding PENs' preparedness for caring for pediatric trauma patients. OBJECTIVE: The development and testing of a questionnaire on self-reported preparedness among PENs caring for pediatric trauma patients in a prehospital emergency setting...
May 22, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28545834/the-relationship-of-the-subtypes-of-preterm-birth-with-retinopathy-of-prematurity
#17
Anne M Lynch, Brandie D Wagner, Jennifer K Hodges, Tamara S Thevarajah, Emily A Mccourt, Ashlee M Cerda, Naresh Mandava, Ronald S Gibbs, Alan G Palestine
BACKGROUND: Retinopathy of prematurity (ROP) is an adverse outcome of preterm birth (PTB) and is a leading cause of childhood blindness. The relationship between the subtypes of PTB with ROP is understudied. OBJECTIVE: To investigate if there is a difference in the incidence of type 1 or type 2 ROP in infants with PTB resulting from spontaneous preterm labor (SPTL), a medical indication (MIPTB), or preterm-premature rupture of the membranes (PPROM). STUDY DESIGN: A retrospective cohort study of 827 infants screened for ROP who delivered at a single tertiary care center in Colorado...
May 22, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28545781/tests-for-serum-transglutaminase-and-endomysial-antibodies-do-not-detect-most-patients-with-celiac-disease-and-persistent-villous-atrophy-on-gluten-free-diets-a-meta-analysis
#18
Jocelyn A Silvester, Satya Kurada, Andrea Szwajcer, Ciarán P Kelly, Daniel A Leffler, Donald R Duerksen
BACKGROUND & AIMS: Tests to measure serum endomysial antibodies (EMA) and antibodies to tissue transglutaminase (tTG) were developed to screen for celiac disease in patients consuming gluten. However, they are commonly used to monitor patients on a gluten-free diet (GFD). We conducted a meta-analysis to assess the sensitivity and specificity of tTG IgA and EMA IgA assays in identifying patients with celiac disease who have persistent villous atrophy despite a GFD. METHODS: We searched PUBMED, EMBASE, BIOSIS, SCOPUS, clinicaltrials...
May 22, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28545764/implementation-of-an-enhanced-recovery-protocol-in-pediatric-colorectal-surgery
#19
Heather L Short, Kurt F Heiss, Katelyn Burch, Curtis Travers, John Edney, Claudia Venable, Mehul V Raval
PURPOSE: Enhanced recovery protocols (ERPs) have been shown to improve outcomes in adult surgical populations. Our purpose was to compare outcomes before and after implementation of an ERP in children undergoing elective colorectal surgery. METHODS: A pediatric-specific colorectal ERP was developed and implemented at a single center starting in January 2015. A retrospective review was performed including 43 patients in the pre-ERP period (2012-2014) and 36 patients in the post-ERP period (2015-2016)...
May 12, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28545753/specific-components-of-pediatricians-medication-related-care-predict-attention-deficit-hyperactivity-disorder-symptom-improvement
#20
Jeffery N Epstein, Kelly J Kelleher, Rebecca Baum, William B Brinkman, James Peugh, William Gardner, Phil Lichtenstein, Joshua M Langberg
OBJECTIVE: The development of attention-deficit/hyperactivity disorder (ADHD) care quality measurements is a prerequisite to improving the quality of community-based pediatric care of children with ADHD. Unfortunately, the evidence base for existing ADHD care quality metrics is poor. The objective of this study was to identify which components of ADHD care best predict patient outcomes. METHOD: Parents of 372 medication-naïve children in grades 1 to 5 presenting to their community-based pediatrician (N = 195) for an ADHD-related concern and who were subsequently prescribed ADHD medication were identified...
June 2017: Journal of the American Academy of Child and Adolescent Psychiatry
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