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Academic Pediatrics

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https://www.readbyqxmd.com/read/29345256/caregiver-perspectives-on-communication-during-hospitalization-at-an-academic-pediatric-institution-a-qualitative-study
#1
Lauren G Solan, Andrew F Beck, Stephanie A Shardo, Hadley S Sauers-Ford, Jeffrey M Simmons, Samir S Shah, Susan N Sherman
OBJECTIVE: Communication among those involved in a child's care during hospitalization can mitigate or exacerbate family stress and confusion. As part of a broader qualitative study, we present an in-depth understanding of communication issues experienced by families during their child's hospitalization and during the transition to home. METHODS: Focus groups and individual interviews stratified by socioeconomic status included caregivers of children recently discharged from a children's hospital after acute illnesses...
January 18, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29342293/genetic-analyses-in-small-for-gestational-age-newborns
#2
Susanne E Stalman, Nita Solanky, Miho Ishida, Cristina Alemán-Charlet, Sayeda Abu-Amero, Marielle Alders, Lucas Alvizi, William Baird, Charalambos Demetriou, Peter Henneman, Chela James, Lia C Knegt, Lydia J Leon, Marcel M A M Mannens, Adi N Mul, Nicole A Nibbering, Emma Peskett, Faisal I Rezwan, Carrie Ris-Stalpers, Joris A M van der Post, Gerdine A Kamp, Frans B Plötz, Jan M Wit, Philip Stanier, Gudrun E Moore, Raoul C Hennekam
Context: Small for gestational age (SGA) can be a result of fetal growth restriction, associated with perinatal morbidity and mortality. Mechanisms that control prenatal growth are poorly understood. Objective: The aim of the present study was to gain more insight into prenatal growth failure and determine an effective diagnostic approach in SGA newborns. We hypothesized that one or more CNVs and disturbed methylation and sequence variants may be present in genes known to be associated with fetal growth...
January 12, 2018: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29341985/dexmedetomidine-as-single-continuous-sedative-during-noninvasive-ventilation-typical-usage-hemodynamic-effects-and-withdrawal
#3
Brittany L Shutes, Samantha W Gee, Cheryl L Sargel, Kelsey A Fink, Joseph D Tobias
OBJECTIVES: Dexmedetomidine use in pediatric critical care is increasing. Its prolonged effects as a single continuous agent for sedation are not well described. The aim of the current study was to describe prolonged dexmedetomidine therapy without other continuous sedation, specifically the hemodynamic effects, discontinuation strategies, and risk factors for withdrawal. DESIGN: Retrospective chart review. SETTING: Large, single-center, quaternary care pediatric academic institution...
January 16, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29336197/neurosensory-deficits-vary-as-a-function-of-point-of-care-in-pediatric-mild-traumatic-brain-injury
#4
Andrew Mayer, Chris Wertz, Sephira Ryman, Eileen Storey, Grace Park, John Phillips, Andrew Burke Dodd, Scott Oglesbee, Richard Campbell, Ron Yeo, Ben Wasserott, Nicholas Shaff, John J Leddy, Rebekah Mannix, Kristy B Arbogast, Timothy Meier, Matthew Grady, Christina Master
Neurosensory abnormalities are frequently observed following pediatric mild traumatic brain injury (pmTBI) and may underlie the expression of several common concussion symptoms and delay recovery. Importantly, active evaluation of neurosensory functioning more closely approximates real-world (e.g., physical and academic) environments that provoke symptom-worsening. The current study determined whether symptom provocation (i.e., during neurosensory exam) improved classification accuracy relative to pre-exam symptom levels and whether symptoms varied as a function of point of care...
January 16, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29335008/multi-omics-differentially-classify-disease-state-and-treatment-outcome-in-pediatric-crohn-s-disease
#5
Gavin M Douglas, Richard Hansen, Casey M A Jones, Katherine A Dunn, André M Comeau, Joseph P Bielawski, Rachel Tayler, Emad M El-Omar, Richard K Russell, Georgina L Hold, Morgan G I Langille, Johan Van Limbergen
BACKGROUND: Crohn's disease (CD) has an unclear etiology, but there is growing evidence of a direct link with a dysbiotic microbiome. Many gut microbes have previously been associated with CD, but these have mainly been confounded with patients' ongoing treatments. Additionally, most analyses of CD patients' microbiomes have focused on microbes in stool samples, which yield different insights than profiling biopsy samples. RESULTS: We sequenced the 16S rRNA gene (16S) and carried out shotgun metagenomics (MGS) from the intestinal biopsies of 20 treatment-naïve CD and 20 control pediatric patients...
January 15, 2018: Microbiome
https://www.readbyqxmd.com/read/29331555/preoperative-thromboelastographic-profile-of-patients-with-congenital-heart-disease-association-of-hypercoagulability-and-decreased-heparin-response
#6
Zhe Amy Fang, Rachel Bernier, Sirisha Emani, Sitaram Emani, Gregory Matte, James A DiNardo, David Faraoni, Juan C Ibla
OBJECTIVE: To describe the demographic and thromboelastographic characteristics of patients with congenital heart disease presenting with decreased heparin response before cardiac surgery. DESIGN: Retrospective, observational study. SETTING: Single institution, tertiary, academic, university hospital. PARTICIPANTS: The study comprised 496 pediatric and adult patients undergoing cardiac surgery for congenital heart disease...
December 12, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29331328/pilot-clinical-trial-of-high-flow-oxygen-therapy-in-children-with-asthma-in-the-emergency-service
#7
Yolanda Ballestero, Jimena De Pedro, Nancy Portillo, Otilia Martinez-Mugica, Eunate Arana-Arri, Javier Benito
OBJECTIVES: To assess the efficacy of high-flow nasal cannula (HFNC) oxygen therapy and safety in children with asthma and moderate respiratory failure in the emergency department (ED). STUDY DESIGN: This was a prospective randomized pilot trial of children (aged 1-14 years) presenting to a tertiary academic pediatric ED with moderate-to-severe asthma exacerbations between September 2012 and December 2015. Patients with a pulmonary score (PS) ≥6 or oxygen saturation <94% with a face mask despite initial treatment (salbutamol/ipratropium bromide and corticosteroids) were randomized to HFNC or to conventional oxygen therapy...
January 11, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29331304/gender-representation-in-urological-subspecialties
#8
Oluwarotimi S Nettey, Joceline S Fuchs, Stephanie J Kielb, Edward M Schaeffer
OBJECTIVE: To examine associations between urologic subspecialization, surgeon gender and practice patterns among certifying urologists over the last 13 years. MATERIALS AND METHODS: Demographic data of certifying and recertifying urologists (2004 to 2015) was obtained from the American Board of Urology (ABU). We investigated gender-specific trends in self-reported practice type (academic practice, private practice), subspecialization, and employment as a full-time versus part-time physician, relative to certification year and cycle...
January 10, 2018: Urology
https://www.readbyqxmd.com/read/29330018/testicular-adrenal-rest-tumor-screening-and-fertility-counseling-among-males-with-congenital-adrenal-hyperplasia
#9
Monika Chaudhari, Emilie K Johnson, Daniel DaJusta, Leena Nahata
BACKGROUND: Reduced fertility is a common potential problem among males with congenital adrenal hyperplasia (CAH), with nearly half experiencing impaired sperm production. The major cause of oligo/azoospermia in CAH is testicular adrenal rest tumors (TARTs). Studies indicate that ultrasound screening for TARTs should begin during childhood, yet it remains unclear whether boys with CAH are routinely screened for TARTs and/or counseled about infertility risk and potential interventions such as fertility testing and/or preservation...
December 21, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29329548/the-cost-of-a-pediatric-neurocritical-care-program-for-traumatic-brain-injury-a-retrospective-cohort-study
#10
Steven W Howard, Zidong Zhang, Paula Buchanan, Stephanie L Bernell, Christine Williams, Lindsey Pearson, Michael Huetsch, Jeff Gill, Jose A Pineda
BACKGROUND: Inpatient care for children with severe traumatic brain injury (sTBI) is expensive, with inpatient charges averaging over $70,000 per case (Hospital Inpatient, Children Only, National Statistics. Diagnoses- clinical classification software (CCS) principal diagnosis category 85 coma, stupor, and brain damage, and 233 intracranial injury. Diagnoses by Aggregate charges [ https://hcupnet.ahrq.gov/#setup ]). This ranks sTBI in the top quartile of pediatric conditions with the greatest inpatient costs (Hospital Inpatient, Children Only, National Statistics...
January 12, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29329165/repeat-rapid-response-events-in-children-characteristics-and-outcomes
#11
Kristen M Meulmester, Nancy Jaimon, Aarti C Bavare
OBJECTIVE: We describe the characteristics and outcomes of pediatric repeat rapid response events within a single hospitalization. We hypothesized that triggers for repeat rapid response and initial rapid response events are similar, and repeat rapid response events are associated with high prevalence of medical complexity and worse outcomes. DESIGN: A 3-year retrospective study. SETTING: High-volume tertiary academic pediatric hospital. PATIENTS: All rapid response events were reviewed to identify repeat rapid response events...
January 11, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29320751/uterine-rhabdomyosarcoma-in-adults
#12
Andre Pinto, Ryan M Kahn, Andrew E Rosenberg, Brian Slomovitz, Charles Matthew Quick, Michella K Whisman, Marilyn Huang
Rhabdomyosarcoma (RMS) is an aggressive mesenchymal tumor most commonly diagnosed in the pediatric population, and when occurring in adults, tends to develop in the deep soft tissue of the limbs. Primary uterine RMS comprises an even more restricted subset, with little known or reported when compared to most other gynecologic sarcomas. Our goal with this study was to retrospectively evaluate cases from two academic institutions and describe the main histopathologic findings of this rare gynecologic malignancy...
January 7, 2018: Human Pathology
https://www.readbyqxmd.com/read/29320539/the-impact-of-electronic-consultation-on-a-canadian-tertiary-care-pediatric-specialty-referral-system-a-prospective-single-center-observational-study
#13
Lillian Lai, Clare Liddy, Erin Keely, Amir Afkham, Julia Kurzawa, Nishard Abdeen, Tobey Audcent, Matthew Bromwich, Jason Brophy, Sasha Carsen, Annick Fournier, Leigh Fraser-Roberts, Hazen Gandy, Charles Hui, Donna Johnston, Kathryn Keely, Ken Kontio, Christine Lamontagne, Nathalie Major, Michael O'Connor, Dhenuka Radhakrishnan, Joe Reisman, Marjorie Robb, Lindy Samson, Erick Sell, William Splinter, Judy van Stralen, Sunita Venkateswaran, Kimmo Murto
BACKGROUND: Champlain BASE™ (Building Access to Specialists through eConsultation) is a web-based asynchronous electronic communication service that allows primary-care- practitioners (PCPs) to submit "elective" clinical questions to a specialist. For adults, PCPs have reported improved access and timeliness to specialist advice, averted face-to-face specialist referrals in up to 40% of cases and high provider satisfaction. OBJECTIVE: To determine whether the expansion of eConsult to a pediatric setting would result in similar measures of improved healthcare system process and high provider acceptance reported in adults...
2018: PloS One
https://www.readbyqxmd.com/read/29319662/historical-analysis-of-bibliometric-trends-in-the-journal-of-pediatric-orthopaedics-with-a-particular-focus-on-sex
#14
James P Fischer, Austin E Wininger, David C Scofield, Aamir Tucker, Ethan J Kacena-Merrell, Elizabeth C Whipple, Melissa A Kacena, Randall T Loder
BACKGROUND: Orthopaedics is the clinical discipline with the lowest percentage of female residents and faculty. Pediatric orthopaedics has a higher percentage of women than other orthopaedic subspecialties. It was the purpose of this study to examine bibliometric trends in the Journal of Pediatric Orthopaedics (JPO) with a specific focus on sex. METHODS: A bibliometeric analysis for the years 2015, 2005, 1995, 1985, 1981 was performed. The names of first and corresponding authors; corresponding author position; country of origin; number of institutions, countries, authors, printed pages, and references was tabulated...
January 6, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29315172/fertility-preservation-services-for-women-with-newly-diagnosed-cancer-a-national-assessment
#15
William D Winkelman, Mitchell P Rosen, Evelyn Mok-Lin
OBJECTIVE: To study the resources available for cancer patients once referred for fertility preservation. MATERIALS AND METHODS: Cross-sectional study clinics that are members of the Society for Assisted Reproductive Technology assess support for fertility preservation. RESULTS: Surveys were distributed to a total of 1135 members at 394 Society for Assisted Reproductive Technology clinics. Responses were received from 99 individuals representing a total of 84 unique clinics (21...
January 8, 2018: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29304919/cranial-tumor-surgical-outcomes-at-a-high-volume-academic-referral-center
#16
Desmond A Brown, Benjamin T Himes, Brittny T Major, Benjamin F Mundell, Ravi Kumar, Bruce Kall, Fredric B Meyer, Michael J Link, Bruce E Pollock, John D Atkinson, Jamie J Van Gompel, W Richard Marsh, Giuseppe Lanzino, Mohamad Bydon, Ian F Parney
OBJECTIVE: To determine adverse event rates for adult cranial neuro-oncologic surgeries performed at a high-volume quaternary academic center and assess the impact of resident participation on perioperative complication rates. PATIENTS AND METHODS: All adult patients undergoing neurosurgical intervention for an intracranial neoplastic lesion between January 1, 2009, and December 31, 2013, were included. Cases were categorized as biopsy, extra-axial/skull base, intra-axial, or transsphenoidal...
January 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29299817/two-novel-urban-health-primary-care-residency-tracks-that-focus-on-community-level-structural-vulnerabilities
#17
Benjamin J Oldfield, Bennett W Clark, Monica C Mix, Katherine C Shaw, Janet R Serwint, Sanjay V Desai, Rachel M Kruzan, Rosalyn W Stewart, Sebastian Ruhs, Leonard S Feldman
BACKGROUND: Although residency programs are well situated for developing a physician workforce with knowledge, skills, and attitudes that incorporate the strengths and reflect the priorities of community organizations, few curricula explicitly do so. AIM: To develop urban health primary care tracks for internal medicine and combined internal medicine-pediatrics residents. SETTING: Academic hospital, community health center, and community-based organizations...
January 3, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29298244/national-imaging-trends-of-recurrent-pediatric-urolithiasis
#18
Lindsey Barrick, Daniel M Cohen, Megan S Schober, Andrew Schwaderer
OBJECTIVES: The aim of this study was to examine computed tomography (CT) and ultrasound (US) utilization trends in incident and prevalent pediatric emergency department (ED) urolithiasis patients before and after imaging guideline release. METHODS: We reviewed imaging modalities for children with 2 or more ED encounters between January 1, 2006, and September 1, 2013, for urolithiasis using the Pediatric Health Information System database. Z scores compared the proportion of patient encounters receiving CT and US before (January 1, 2006, to December 31, 2010) and after (January 1, 2011, to September 1, 2013) the release of imaging guidelines...
January 2, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29298243/adolescent-coping-strategies-in-the-emergency-department
#19
Allison Cheng, Rita Manfredi, Gia Badolato, Monika Goyal
OBJECTIVES: The objective of this study was to describe coping mechanisms used by adolescents during emergency treatment. METHODS: A convenience sample of adolescent patients (aged 12-18 years) was surveyed in our large (87,000 annual visits) urban academic pediatric emergency department (ED) with an adapted Adolescent Coping Orientation for Problem Experiences survey. Parents were surveyed about their perceptions of their child's coping mechanisms. Participants were excluded if they were non-English speaking, in police custody, had altered mental status, or were hemodynamically unstable...
January 2, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29287873/barriers-to-pediatric-cochlear-implantation-a-parental-survey
#20
Charles Q Yang, Brian K Reilly, Diego A Preciado
OBJECTIVE: This study aims to (1) determine barriers in the pediatric cochlear implantation process specific to publicly insured patients, wherein delayed implantation has been reported, and (2) compare the perceived barriers between publicly and privately insured patients. SETTING: Tertiary care cochlear implantation center at academic pediatric hospital. STUDY DESIGN: Cross-sectional survey, retrospective chart review. METHODS: The validated, 39 item Barriers to Care Questionnaire was administered to the parents of 80 recipients of cochlear implantation by two surgeons between 2013 and 2016...
January 2018: International Journal of Pediatric Otorhinolaryngology
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