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Academic Pediatrics

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https://www.readbyqxmd.com/read/28549221/preventing-underfeeding-and-overfeeding-a-clinician-s-guide-to-the-acquisition-and-implementation-of-indirect-calorimetry
#1
Amy K Ladd, Heather E Skillman, Matthew A Haemer, Peter M Mourani
BACKGROUND: In critically ill patients, indirect calorimetry (IC) is the gold standard to determine energy needs, as the use of predictive equations can result in underfeeding or overfeeding. The aim of this quality improvement (QI) initiative was to describe the rationale for and implementation of a process to target energy provision according to IC measurements in a tertiary academic medical center pediatric intensive care unit (PICU). MATERIALS AND METHODS: To justify the purchase of an indirect calorimeter for clinical use, a needs assessment was conducted, followed by a training and implementation period...
May 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28549024/the-epidemiology-of-hospital-death-following-pediatric-severe-sepsis-when-why-and-how-children-with-sepsis-die
#2
Scott L Weiss, Fran Balamuth, Josey Hensley, Julie C Fitzgerald, Jenny Bush, Vinay M Nadkarni, Neal J Thomas, Mark Hall, Jennifer Muszynski
OBJECTIVE: The epidemiology of in-hospital death after pediatric sepsis has not been well characterized. We investigated the timing, cause, mode, and attribution of death in children with severe sepsis, hypothesizing that refractory shock leading to early death is rare in the current era. DESIGN: Retrospective observational study. SETTING: Emergency departments and ICUs at two academic children's hospitals. PATIENTS: Seventy-nine patients less than 18 years old treated for severe sepsis/septic shock in 2012-2013 who died prior to hospital discharge...
May 25, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28547532/prehospital-blood-transfusions-in-pediatric-trauma-and-nontrauma-patients-a-single-center-review-of-safety-and-outcomes
#3
Aodhnait S Fahy, Cornelius A Thiels, Stephanie F Polites, Maile Parker, Michael B Ishitani, Christopher R Moir, Kathleen Berns, James R Stubbs, Donald H Jenkins, Scott P Zietlow, Martin D Zielinski
PURPOSE: Prehospital transfusions are a novel yet increasingly accepted intervention in the adult population as part of remote damage control resuscitation, but prehospital transfusions remain controversial in children. Our purpose was to review our pediatric prehospital transfusion experience over 12 years to describe the safety of prehospital transfusion in appropriately triaged trauma and nontrauma patients. METHODS: Children (<18 years) transfused with packed red blood cells (pRBC) or plasma during transport to a single regional academic medical center between 2002 and 2014 were identified...
May 25, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28536769/an-honest-day-s-work-pay-for-performance-in-a-pediatric-radiology-department
#4
REVIEW
George S Bisset
Compensation models in radiology take a variety of forms, but regardless of practice type, successful models must reward productivity, be simple, and epitomize fairness. The ideal model should also be flexible enough to transition, based upon the changing strategic goals of a department. The plan should be constructed around rewarding the behaviors that the organization values. In this minisymposium article the author presents the value of different types of compensation plans and discusses advantages and disadvantages...
June 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28536719/insulin-bolus-calculator-in-a-pediatric-hospital-safety-and-user-perceptions
#5
Mohammad B Ateya, Ranjit Aiyagari, Colleen Moran, Kanakadurga Singer
BACKGROUND: Insulin dosing in hospitalized pediatric patients is challenging and requires dosing to be matched with the specific clinical and nutritional circumstances. We implemented a customized subcutaneous insulin bolus dose calculator tool integrated with the electronic health record to improve patient care. Here we describe this tool, its utilization and safety, and assess user satisfaction and perceptions of the tool. METHODS: Blood glucose results for all patients who received insulin with and without the calculator tool were compared to assess safety...
May 24, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28535707/macular-pigment-optical-density-is-positively-associated-with-academic-performance-among-preadolescent-children
#6
Sasha M Barnett, Naiman A Khan, Anne M Walk, Lauren B Raine, Christopher Moulton, Neal J Cohen, Arthur F Kramer, Billy R Hammond, Lisa Renzi-Hammond, Charles H Hillman
OBJECTIVE: Macular pigment optical density (MPOD) - a non-invasive indicator of retinal xanthophylls and correlate of brain lutein - has been associated with superior cognitive function among adult populations. Given that lutein accumulation in the brain occurs in early life, it is possible that the cognitive implications of greater MPOD may be evident in childhood. METHODS: Participants aged 8-9 years (n = 56) completed MPOD measurements via heterochromatic flicker photometry...
May 23, 2017: Nutritional Neuroscience
https://www.readbyqxmd.com/read/28533102/real-time-electronic-dashboard-technology-and-its-use-to-improve-pediatric-radiology-workflow
#7
REVIEW
Randheer Shailam, Ariel Botwin, Markus Stout, Michael S Gee
The purpose of our study was to create a real-time electronic dashboard in the pediatric radiology reading room providing a visual display of updated information regarding scheduled and in-progress radiology examinations that could help radiologists to improve clinical workflow and efficiency. To accomplish this, a script was set up to automatically send real-time HL7 messages from the radiology information system (Epic Systems, Verona, WI) to an Iguana Interface engine, with relevant data regarding examinations stored in an SQL Server database for visual display on the dashboard...
March 19, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28529195/rapid-web-based-platform-for-assessment-of-orthopedic-surgery-patient-care-milestones-a-2-year-validation
#8
Kenneth R Gundle, Dayne T Mickelson, Arien Cherones, Jason Black, Doug P Hanel
OBJECTIVE: To determine the validity, feasibility, and responsiveness of a new web-based platform for rapid milestone-based evaluations of orthopedic surgery residents. SETTING: Single academic medical center, including a trauma center and pediatrics tertiary hospital. PARTICIPANTS: Forty residents (PG1-5) in an orthopedic residency program and their faculty evaluators. METHODS: Residents and faculty were trained and supported in the use of a novel trainee-initiated web-based evaluation system...
May 18, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28528992/pediatric-ophthalmology-and-strabismus-fellowship-match-outcomes-2000-2015
#9
Gad Dotan, Daniel J Karr, Alex V Levin
PURPOSE: To analyze trends in US pediatric ophthalmology and strabismus (PO&S) Match over the last 16 years. MethodsWe reviewed the PO&S Match outcomes from 2000 to 2015, evaluating the number of participating programs, positions offered, and match rate, comparing it with other subspecialties, and analyzing results of US graduates versus international medical graduates (IMGs). A survey of PO&S program directors explored exposure to PO&S, policies on acceptance of IMGs, fellowship gross salary, job opportunities, and fellow placement after training...
May 18, 2017: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/28528199/robert-j-haggerty-md-faap-a-founder-of-academic-pediatrics
#10
James M Perrin, Ellen C Perrin
No abstract text is available yet for this article.
May 17, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28521026/tracking-career-paths-of-women-in-neurosurgery
#11
Jaclyn J Renfrow, Analiz Rodriguez, Taylor A Wilson, Isabelle M Germano, Aviva Abosch, Stacey Quintero Wolfe
BACKGROUND: Women represent a growing cohort of US neurosurgeons. OBJECTIVE: To describe postresidency fellowship, practice environment, and updated academic rank among female neurosurgeons. METHODS: Databases from the American Association of Neurological Surgeons (AANS) and the American Board of Neurological Surgery (ABNS) from 1964 to 2013 were reviewed for female neurosurgery residency graduates. Data on postresidency fellowships, practice environment (private vs academic), academic rank, board certification, and AANS/CNS (Congress of Neurological Surgeons) Joint Section on Women in Neurosurgery (WINS) membership were collected in 2016...
May 16, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28506211/interstitial-pneumonia-pattern-on-day-7-chest-radiograph-predicts-bronchopulmonary-dysplasia-in-preterm-infants
#12
Hye-Rim Kim, Ji Young Kim, Bo La Yun, Byoungkook Lee, Chang Won Choi, Beyong Il Kim
BACKGROUND: Early identification of infants at higher risk of developing bronchopulmonary dysplasia (BPD) may enable a targeted approach to reduce BPD. We aimed to evaluate the hypothesis that the interstitial pneumonia pattern on the day 7 chest radiograph predicts BPD or death before 36 weeks postmenstrual age (PMA). METHODS: A retrospective cohort study was performed on 336 preterm infants (birth weight < 1500 g and gestational age < 32 postmenstrual weeks) who were admitted to a single tertiary academic center between January 2008 and December 2014...
May 15, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28503078/variations-in-the-clinical-practice-of-physicians-managing-takayasu-arteritis-a-nationwide-survey
#13
Lillian Barra, Patrick Liang, Susanne M Benseler, David A Cabral, Aurore Fifi-Mah, Yueyang Li, Nataliya Milman, Marinka Twilt, Elaine Yacyshyn, Christian Pagnoux
OBJECTIVE: Takayasu arteritis (TAK) is a large vessel vasculitis that predominately affects young women and can cause severe ischemic complications. Given the rarity of TAK, the management of this condition is challenging. We aim to describe current rheumatologist practices for the management of TAK and identify discrepancies and gaps in knowledge. METHODS: An online survey (developed by the Canadian Vasculitis Network and approved by the Canadian Rheumatology Association) containing 48 questions with regard to the diagnosis, monitoring and treatment of TAK was distributed to 495 Canadian adult and pediatric rheu-matologists by email...
2017: Open Access Rheumatology: Research and Reviews
https://www.readbyqxmd.com/read/28501899/is-there-a-july-effect-in-pediatric-neurosurgery
#14
Yimo Lin, Rory R Mayer, Terence Verla, Jeffrey S Raskin, Sandi Lam
PURPOSE: The belief that July, when resident physicians' training year begins, may be associated with increased risk of patient morbidity and mortality is known as the "July effect." This study aimed to compare complication rates after pediatric neurosurgical procedures in the first versus last academic quarters in two national datasets. METHODS: Data were extracted from the National Surgical Quality Improvement Program-Pediatrics (NSQIP-P) database for year 2012 for 30-day complication events and the Kids' Inpatient Database (KID) for year 2012 for in-hospital complication events after pediatric neurosurgical procedures...
May 13, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28497263/radiologic-head-ct-interpretation-errors-in-pediatric-abusive-and-non-abusive-head-trauma-patients
#15
Stephen F Kralik, Whitney Finke, Isaac C Wu, Roberta A Hibbard, Ralph A Hicks, Chang Y Ho
BACKGROUND: Pediatric head trauma, including abusive head trauma, is a significant cause of morbidity and mortality. OBJECTIVE: The purpose of this research was to identify and evaluate radiologic interpretation errors of head CTs performed on abusive and non-abusive pediatric head trauma patients from a community setting referred for a secondary interpretation at a tertiary pediatric hospital. MATERIALS AND METHODS: A retrospective search identified 184 patients <5 years of age with head CT for known or potential head trauma who had a primary interpretation performed at a referring community hospital by a board-certified radiologist...
May 11, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28493451/the-effect-of-an-electronic-health-record-based-tool-on-abnormal-pediatric-blood-pressure-recognition
#16
Sarah A Twichell, Corinna J Rea, Patrice Melvin, Andrew J Capraro, Joshua C Mandel, Michael A Ferguson, Daniel J Nigrin, Kenneth D Mandl, Dionne Graham, Justin P Zachariah
BACKGROUND: Recognition of high blood pressure (BP) in children is poor, partly due to the need to compute age-sex-height referenced percentiles. This study examined the change in abnormal BP recognition before versus after the introduction of an electronic health record (EHR) app designed to calculate BP percentiles with a training lecture. METHODS AND RESULTS: Clinical data were extracted on all ambulatory, non-urgent encounters for children 3-18 years old seen in primary care, endocrinology, cardiology, or nephrology clinics at an urban, academic hospital in the year before and the year after app introduction...
May 11, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28489619/pediatric-resident-academic-projects-while-on-global-health-electives-ten-years-of-experience-at-the-university-of-minnesota
#17
Michael B Pitt, Tina M Slusher, Cynthia R Howard, Valerie B Cole, Sophia P Gladding
PURPOSE: Many residency programs require residents to complete an academic project as part of a global health (GH) elective. However, there has been little description of the range of projects residents have pursued during GH electives or the extent to which these projects are consistent with proposed best practices. METHOD: The authors conducted a document review of 67 written summaries or copies of presentations of academic projects (hereafter, summaries) completed by pediatric and medicine-pediatric residents at the University of Minnesota while on GH electives from 2005 to 2015...
May 9, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28487930/the-effects-of-medication-alerts-on-prescriber-response-in-a-pediatric-hospital
#18
Judith W Dexheimer, Eric S Kirkendall, Michal Kouril, Philip A Hagedorn, Thomas Minich, Leo L Duan, Monifa Mahdi, Rhonda Szczesniak, S Andrew Spooner
OBJECTIVE: More than 70% of hospitals in the United States have electronic health records (EHRs). Clinical decision support (CDS) presents clinicians with electronic alerts during the course of patient care; however, alert fatigue can influence a provider's response to any EHR alert. The primary goal was to evaluate the effects of alert burden on user response to the alerts. METHODS: We performed a retrospective study of medication alerts over a 24-month period (1/2013-12/2014) in a large pediatric academic medical center...
May 10, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28487733/do-routine-preoperative-and-intraoperative-urine-cultures-benefit-pediatric-vesicoureteral-reflux-surgery
#19
Daniel R Hettel, Bradley C Gill, Audrey C Rhee
Objective. To determine if routine preoperative and intraoperative urine cultures (UCx) are necessary in pediatric vesicoureteral (VUR) reflux surgery by identifying their association with each other, preoperative symptoms, and surgical outcomes. Materials and Methods. A retrospective review of patients undergoing ureteral reimplant(s) for primary VUR at a tertiary academic medical center between years 2000 and 2014 was done. Preoperative UCx were defined as those within 30 days before surgery. A positive culture was defined as >50,000 colony forming units of a single organism...
2017: Advances in Urology
https://www.readbyqxmd.com/read/28486556/antenatal-corticosteroids-for-neonates-born-before-25-weeks-a-systematic-review-and-meta-analysis
#20
Mangesh Deshmukh, Sanjay Patole
BACKGROUND: Efficacy of antenatal corticosteroids before 25 weeks of gestation is unclear. OBJECTIVE: To assess and compare neonatal outcomes following ANC exposure at 22, 23 and 24 weeks of gestation by conducting systematic review and meta- analysis. METHODS: A systematic review of randomised controlled trials (RCT) and non-RCTs reporting on neonatal outcomes after exposure to ANC up to 246 weeks of gestation using the Cochrane systematic review methodology...
2017: PloS One
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