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Pediatric readmission

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https://www.readbyqxmd.com/read/28438375/racial-and-ethnic-differences-in-pediatric-readmissions-for-common-chronic-conditions
#1
Kavita Parikh, Jay Berry, Matt Hall, Grant M Mussman, Amanda Montalbano, Joanna Thomson, Rustin Morse, Karen M Wilson, Samir S Shah
OBJECTIVE: To compare the timing and magnitude of variation of pediatric readmission rates across race/ethnicity for selected chronic conditions: asthma, diabetes, seizures, migraines, and depression. STUDY DESIGN: Retrospective analysis of hospitalizations at 48 children's hospitals in the 2013 Pediatric Health Information System database for children (ages 0-18 years) admitted for asthma (n = 36 910), seizure (n = 35 361), diabetes (n = 12 468), migraine (n = 5882), and depression (n = 5132)...
April 21, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28434635/readmissions-unplanned-emergency-room-visits-and-surgical-retreatment-rates-after-anti-reflux-procedures
#2
Hsin-Hsiao S Wang, Rohit Tejwani, Steven Wolf, John S Wiener, Jonathan C Routh
INTRODUCTION/BACKGROUND: The choice between endoscopic injection (EI) and ureteroneocystotomy (UNC) for surgical correction of vesicoureteral reflux (VUR) is controversial. OBJECTIVE: To compare postoperative outcomes of EI vs UNC. STUDY DESIGN: This study reviewed linked inpatient (SID), ambulatory surgery (SASD), and emergency department (SEDD) data from five states in the United States (2007-10) to identify pediatric patients with primary VUR undergoing EI or UNC as an initial surgical intervention...
April 7, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28433362/effect-of-preadmission-bowel-preparation-on-outcomes-of-elective-colorectal-procedures-in-young-children
#3
Guillermo J Ares, Irene Helenowski, Catherine J Hunter, Marybeth Madonna, Marleta Reynolds, Timothy Lautz
BACKGROUND: The utility of mechanical bowel preparation (MBP) to minimize infectious complications in elective colorectal surgery is contentious. Though data is scarce in children, adult studies suggest a benefit to MBP when administered with oral antibiotics (OAB). METHODS: After IRB approval, the Pediatric Health Information System (PHIS) was queried for young children undergoing elective colon surgery from 2011 to 2014. Patients were divided into: no bowel preparation (Group 1), MBP (Group 2), and MBP plus OAB (Group 3)...
March 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28432613/pediatric-tonsillectomy-is-a-resource-intensive-procedure-a-study-of-canadian-health-administrative-data
#4
Kimmo T T Murto, Sherri L Katz, Daniel I McIsaac, Matthew A Bromwich, Régis Vaillancourt, Carl van Walraven
BACKGROUND: The majority of pediatric surgeries are performed in a day surgery setting. The rate of adverse postoperative outcomes and the factors that influence them are poorly described in the Canadian setting. Concerns about the safety of adenotonsillectomy (AT) have been raised. The objective of this Ontario-based study was to determine the rates and risks of hospital readmission, emergency department (ED) visits, or deaths within 30 days following common pediatric surgeries, with an emphasis on AT...
April 21, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28420262/impact-of-an-educational-intervention-to-improve-physician-adherence-to-bronchiolitis-clinical-practice-guidelines-a-pre-post-intervention-study
#5
Marquita C Genies, Julia M Kim, Kristina Pyclik, Suzanne Rossi, Natalie Spicyn, Janet R Serwint
Bronchiolitis is the leading cause of infant hospitalizations in the United States. Despite clinical practice guidelines discouraging the utilization of non-evidence-based therapies, there continues to be wide variation in care and resource utilization. A pre-post physician focused educational intervention was conducted with the aims to reduce the use of non-evidence-based medical therapies, including bronchodilators, among patients admitted for bronchiolitis. Among patients meeting inclusion criteria (pre: n = 45; post: n = 47), bronchodilator use decreased by 50% ( P < ...
April 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28419343/utilizing-a-modified-care-coordination-measurement-tool-to-capture-value-for-a-pediatric-outpatient-parenteral-and-prolonged-oral-antibiotic-therapy-program
#6
Louise E Vaz, Cindi L Farnstrom, Kimberly K Felder, Judith Guzman-Cottrill, Hannah Rosenberg, Richard C Antonelli
Background.: Outpatient parenteral or prolonged oral antibiotic therapy (OPAT) programs reduce inpatient healthcare costs by shifting care to outpatient settings. Care coordination (CC) is a necessary component to successfully transition patients. Our objective was to assess outcomes of provider time spent on nonreimbursable CC activities in a pediatric OPAT program. Methods.: We used a qualitative feasibility pilot design and modified the Care Coordination Measurement Tool...
April 17, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28419275/clinical-care-guideline-for-improving-pediatric-acute-musculoskeletal-infection-outcomes
#7
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/28408077/does-timing-of-gastroschisis-repair-matter-a-comparison-using-the-acs-nsqip-pediatric-database
#8
Lori A Gurien, Melvin S Dassinger, Jeffrey M Burford, Marie E Saylors, Samuel D Smith
BACKGROUND: There is no consensus on optimal timing of gastroschisis repair. The 2012-2014 ACS NSQIP Pediatric Participant Use Data File was used to compare outcomes of primary versus staged gastroschisis repair. METHODS: Cases were divided into primary repair (0-1day) and staged repair (4-14days). Baseline characteristics and outcomes were compared for primary versus staged closure using Fisher's exact tests for categorical variables and Wilcoxon rank-sum tests for continuous variables...
February 21, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28390616/five-years-experience-with-outpatient-thyroglossal-duct-cyst-surgery
#9
Ana Coelho, Catarina Sousa, Ana Sofia Marinho, Joana Barbosa-Sequeira, João Ribeiro-Castro, Fátima Carvalho, João Moreira-Pinto
OBJECTIVES: Many pediatric surgeons feel uncomfortable doing Sistrunk procedure without drain placement and in an outpatient setting. This study aimed to review our pediatric surgery department's experience in managing thyroglossal duct cyst surgery and to prove feasibility and safety of Sistrunk procedure without drain placement in an outpatient setting. METHODS: A retrospective review was performed of all patients who underwent Sistrunk procedure, between January 2011 and December 2015, in our department...
May 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28346589/comparison-of-antibiotic-therapy-and-appendectomy-for-acute-uncomplicated-appendicitis-in-children-a-meta-analysis
#10
Libin Huang, Yuan Yin, Lie Yang, Cun Wang, Yuan Li, Zongguang Zhou
Importance: Antibiotic therapy for acute uncomplicated appendicitis is effective in adult patients, but its application in pediatric patients remains controversial. Objective: To compare the safety and efficacy of antibiotic treatment vs appendectomy as the primary therapy for acute uncomplicated appendicitis in pediatric patients. Data Sources: The PubMed, MEDLINE, EMBASE, and Cochrane Library databases and the Cochrane Controlled Trials Register for randomized clinical trials were searched through April 17, 2016...
March 27, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28341068/clinical-characteristics-of-pyogenic-flexor-tenosynovitis-in-pediatric-patients
#11
Christopher M Brusalis, Stephanie Thibaudeau, Robert B Carrigan, Ines C Lin, Benjamin Chang, Apurva S Shah
PURPOSE: To characterize the clinical presentation, common pathogens, antimicrobial susceptibility, and treatment methods associated with pyogenic flexor tenosynovitis (PFT) in pediatric patients. METHODS: Patients who underwent surgical treatment for PFT at a large tertiary-care children's hospital between 2001 and 2015 were identified. Descriptive summary statistics were reported on patient demographics, presenting symptoms and clinical examination features, culture results, treatment strategies, and early complications...
March 21, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28336475/intraoperative-rupture-of-ovarian-dermoid-cysts-in-the-pediatric-and-adolescent-population-should-this-change-your-surgical-management
#12
Krista J Childress, Gisselle Perez-Milicua, Julie Hakim, Oluyemisi Adeyemi-Fowode, Jennifer L Bercaw-Pratt, Xiomara M Santos, Jennifer E Dietrich
STUDY OBJECTIVE: 1) To determine the incidence of chemical peritonitis after cystectomy for ovarian dermoid cysts with intraoperative cyst rupture in the pediatric and adolescent population. 2) To examine the intraoperative and postoperative outcomes of cystectomies performed for ovarian dermoid cysts by laparoscopy and laparotomy, especially those with intraoperative cyst rupture. DESIGN: A retrospective cohort study of females who underwent ovarian cystectomy with proven ovarian dermoid pathology between July 2007 and July 2015...
March 20, 2017: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/28336042/acute-hematogenous-osteomyelitis-in-children-pathogenesis-diagnosis-and-treatment
#13
REVIEW
Shawn S Funk, Lawson A B Copley
Acute hematogenous osteomyelitis (AHO) in children is an ideal condition to study due to its representation of a wide spectrum of disorders that comprise pediatric musculoskeletal infection. Proper care for children with AHO is multidisciplinary and collaborative. AHO continues to present a significant clinical challenge due to evolving epidemiology and complex pathogenesis. A guideline-driven, multidisciplinary approach has been introduced and shown to effectively reduce hospital stay, improve the timing and selection of empirical antibiotic administration, reduce delay to initial MRI, reduce the rate of readmission, and shorten antibiotic duration...
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28328692/experience-with-a-care-process-model-in-the-evaluation-of-pediatric-musculoskeletal-infections-in-a-pediatric-emergency-department
#14
Lina Patel, Jeff Michael, Nancy Allen, Lisa Schroeder, Lisa Berglund, Jason G Newland
OBJECTIVES: Care process models (CPMs) for certain conditions have improved clinical outcomes in children. This study describes the implementation and impact of a CPM for the evaluation of musculoskeletal infections in a pediatric emergency department (ED). METHODS: A retrospective pre-post intervention study was performed to analyze the impact of a musculoskeletal infection CPM. Patients were identified retrospectively through electronic order history for imaging of an extremity or joint and recommended laboratory tests...
March 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28327274/physician-extenders-on-surgical-services-a%C3%A2-systematic-review
#15
Jagdeep Johal, Andrew Dodd
BACKGROUND: With the introduction of resident duty hour restrictions and the resulting in-house trainee shortages, a long-term solution to ensure safe and efficient patient care is needed. One solution is the integration of nurse practitioners (NPs) and physician assistants (PAs) in a variety of health care settings. We sought to examine the use of NPs and PAs on surgical/trauma services and their effect on patient outcomes and resident workload. METHODS: We performed a systematic review of EMBASE, Medline, CINAHL, and the Cochrane Central Register of Controlled Trials...
April 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28315803/cranioplasty-complications-and-costs-a-national-population-level-analysis-using-the-marketscan-longitudinal-database
#16
Amy Li, Tej Deepak Azad, Anand Veeravagu, Inderpreet Bhatti, Chao Long, John K Ratliff, Gordon Li
OBJECTIVE: To characterize cranioplasty complications and costs at a population level using a longitudinal national claims database. METHODS: We identified cranioplasty patients between 2007-2014 in the MarketScan national database. We evaluated age, autograft usage, cranioplasty size, and cranioplasty timing on postoperative outcomes. We further analyzed associated costs. A subset analysis of adult cranioplasty patients with emergent indications, including stroke and trauma, was also performed...
March 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28292873/variation-in-inpatient-croup-management-and-outcomes
#17
Amy Tyler, Lisa McLeod, Brenda Beaty, Elizabeth Juarez-Colunga, Meghan Birkholz, Daniel Hyman, Allison Kempe, James Todd, Amanda F Dempsey
BACKGROUND AND OBJECTIVES: Croup is a clinical diagnosis, and the available evidence suggests that, except in rare cases, ancillary testing, such as radiologic imaging, is not helpful. Given the paucity of inpatient-specific evidence for croup care, we hypothesized that there would be marked variability in the use of not routinely indicated resources (NRIRs). Our primary study objective was to describe the variation and predictors of variation in the use of NRIRs. METHODS: This was a retrospective cohort study that used the Pediatric Health Information System database of generally healthy inpatients with croup aged 6 months to 15 years who were admitted between January 1, 2012 and September 30, 2014...
March 14, 2017: Pediatrics
https://www.readbyqxmd.com/read/28292850/clinical-outcomes-of-bronchiolitis-after-implementation-of-a-general-ward-high-flow-nasal-cannula-guideline
#18
Jeffrey Riese, Timothy Porter, Jamie Fierce, Alison Riese, Troy Richardson, Brian K Alverson
OBJECTIVE: The goal of this study was to assess the association of the introduction of a ward's high-flow nasal cannula (HFNC) guideline with clinical outcomes of infants with bronchiolitis. METHODS: We conducted a retrospective, pre-post intervention study with an interrupted time series analysis of infants admitted with bronchiolitis between 2010 and 2014 at an urban, tertiary care children's hospital. Patients admitted in the 24 months before and after initiation of a guideline for HFNC use on the general wards were compared...
April 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28289595/case-report-of-a-novel-mutation-of-the-eya1-gene-in-a-patient-with-branchio-oto-renal-syndrome
#19
L Spahiu, B Merovci, V Ismaili Jaha, A Batalli Këpuska, H Jashari
Branchio-oto-renal (BOR) syndrome is an autosomal dominant disorder characterized by the coexistence of branchial cysts or fistulae, external ear malformation with pre-auricular pits or tags, hearing impairment and renal malformations. However, the presence of the main features varies in affected families. Here, we present a 16-year-old boy admitted to the Department of Nephrology at the Pediatric Clinic, University Clinical Center of Kosovo, Pristina, Republic of Kosovo because of severe renal insufficiency diagnosed 6 years ago, which progressed to end-stage renal failure...
December 1, 2016: Balkan Journal of Medical Genetics: BJMG
https://www.readbyqxmd.com/read/28288777/outcomes-after-pediatric-open-laparoscopic-and-robotic-pyeloplasty-at-academic-institutions
#20
Yvonne Y Chan, Blythe Durbin-Johnson, Renea M Sturm, Eric A Kurzrock
INTRODUCTION: Patient age and hospital volume have been shown to affect perioperative outcomes after pediatric pyeloplasty. However, there are few multicenter studies that focus on outcomes at teaching hospitals, where many of the operations are performed. OBJECTIVE: The goal was to determine if surgical approach, age, case volume, or other factors influence perioperative outcomes in a large contemporary cohort. STUDY DESIGN: Using the clinical database/resource manager (CDB/RM) of the University Health-System Consortium (UHC), children who underwent open, laparoscopic, or robotic pyeloplasty from 2011 to 2014 were identified at 102 academic institutions...
February 2017: Journal of Pediatric Urology
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