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https://www.readbyqxmd.com/read/29333825/6-minutes
#1
Pablo R Justich Zabala
At present, there is a trend towards reducing the duration of office visits. In some regions of Spain, it has been set at 6 minutes per patient. This impacts on several levels: literally, many times it is impossible to complete the medical act; at an emotional level, because there is little possibility to establish an adequate doctor-patient relationship; and symbolically, for considering that the main aspects of humane health care are expendable. This takes place in a society that tends to see health care as a merchandise subject to market rules that gives priority to the immediate over the important...
February 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29331011/transfusion-related-acute-lung-injury-in-a-paediatric-intensive-care-unit-of-pakistan
#2
Muhammad Tariq Jamil, Zehra Dhanani, Qalab Abbas, Humaira Jurair, Farheen Karim Mahar, Anwarul Haque
Background: Transfusion-Related Acute Lung Injury (TRALI) is a major cause of transfusionrelated morbidity and mortality in the intensive care unit setting. There is a paucity of such data from Pakistan. The purpose of this study is to assess the incidence and outcome of TRALI in critically ill children admitted in a pediatric intensive care unit (PICU) of Pakistan. Methods: This is a retrospective cohort study of all critically ill or injured children who developed TRALI or "possible" TRALI after blood transfusion based on Canadian Conference Consensus criteria in a closed multidisciplinary-cardiothoracic PICU from January 2012 to June 2016...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29329922/a-multistate-investigation-of-health-care-associated-burkholderia-cepacia-complex-infections-related-to-liquid-docusate-sodium-contamination-january-october-2016
#3
Janet Glowicz, Matthew Crist, Carolyn Gould, Heather Moulton-Meissner, Judith Noble-Wang, Tom J B de Man, K Allison Perry, Zachary Miller, William C Yang, Stephen Langille, Jessica Ross, Bobbiejean Garcia, Janice Kim, Erin Epson, Stephanie Black, Massimo Pacilli, John J LiPuma, Ryan Fagan
BACKGROUND: Outbreaks of health care-associated infections (HAIs) caused by Burkholderia cepacia complex (Bcc) have been associated with medical devices and water-based products. Water is the most common raw ingredient in nonsterile liquid drugs, and the significance of organisms recovered from microbiologic testing during manufacturing is assessed using a risk-based approach. This incident demonstrates that lapses in manufacturing practices and quality control of nonsterile liquid drugs can have serious unintended consequences...
January 9, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29322489/measurement-in-pediatric-epilepsy-self-management-a-critical-review
#4
REVIEW
Gigi Smith, Avani C Modi, Erica K Johnson, Ross Shegog, Joan K Austin, Janelle L Wagner
Given the paucity of information available regarding self-management, the aims of this paper are to synthesize the literature on factors associated with and measures to assess self-management in pediatric epilepsy. INCLUSION CRITERIA: youth birth to 18 years with a seizure disorder or an epilepsy diagnosis and/or their caregivers, published 1985-2014 in English, and conducted in countries with a very high human development index. The review was conducted in 6 phases: (1) identification of bibliographical search criteria and databases; (2) abstract assessment; (3) full article review; (4) organization of final citations into categories; (5) identification of predictors, potential mediators/moderators, and outcomes associated with self-management factors and categorization of factors as influences, processes, or behaviors across individual, family, community, and health care domains; and (6) critique of self-management instrument studies...
January 11, 2018: Epilepsia
https://www.readbyqxmd.com/read/29322290/psychologists-and-pediatricians-in-the-primary-care-sandbox-communication-is-key-to-cooperative-play
#5
Anne E Pidano, Prerna Arora, Polly Y Gipson, Bradley O Hudson, Kriston B Schellinger
Recent literature, public policy, and funding opportunities call attention to the need for better increased integration of health and mental health care services in primary care settings so as to best meet the needs of children and families. There are many benefits to such integration, but pediatric primary care providers (PCPs) face multiple barriers to identifying and managing patients with mental health difficulties. One way to address this problem is through the integration of psychologists into primary care settings who can collaborate with PCPs to provide integrated behavioral health care to youth and families...
January 10, 2018: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/29321079/the-enactment-stage-of-end-of-life-decision-making-for-children
#6
Jane Elizabeth Sullivan, Lynn Heather Gillam, Paul Terence Monagle
OBJECTIVES: Typically pediatric end-of-life decision-making studies have examined the decision-making process, factors, and doctors' and parents' roles. Less attention has focussed on what happens after an end-of-life decision is made; that is, decision enactment and its outcome. This study explored the views and experiences of bereaved parents in end-of-life decision-making for their child. Findings reported relate to parents' experiences of acting on their decision. It is argued that this is one significant stage of the decision-making process...
January 11, 2018: Palliative & Supportive Care
https://www.readbyqxmd.com/read/29319635/low-dose-epinephrine-boluses-for-acute-hypotension-in-the-picu
#7
Pamela D Reiter, Jennifer Roth, Beth Wathen, Jaime LaVelle, Leslie A Ridall
OBJECTIVES: To describe the use of low-dose bolus epinephrine in critically ill children during an acute hypotensive episode or prearrest condition. DESIGN: Institutional Review Board approved, single-center, retrospective medical chart review. SETTING: Large medical-surgical PICU within a freestanding, tertiary care children's hospital. PATIENTS: Patients admitted to the PICU between June 1, 2015, and June 1, 2016, who received low-dose (≤ 5 µg/kg) IV bolus epinephrine...
January 9, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29319634/hyperoxia-and-hypocapnia-during-pediatric-extracorporeal-membrane-oxygenation-associations-with-complications-mortality-and-functional-status-among-survivors
#8
Katherine Cashen, Ron Reeder, Heidi J Dalton, Robert A Berg, Thomas P Shanley, Christopher J L Newth, Murray M Pollack, David Wessel, Joseph Carcillo, Rick Harrison, J Michael Dean, Robert Tamburro, Kathleen L Meert
OBJECTIVES: To determine the frequency of hyperoxia and hypocapnia during pediatric extracorporeal membrane oxygenation and their relationships to complications, mortality, and functional status among survivors. DESIGN: Secondary analysis of data collected prospectively by the Collaborative Pediatric Critical Care Research Network. SETTING: Eight Collaborative Pediatric Critical Care Research Network-affiliated hospitals. PATIENTS: Age less than 19 years and treated with extracorporeal membrane oxygenation...
January 9, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29319481/a-critical-review-of-recent-clinical-practice-guidelines-for-pediatric-urinary-tract-infection
#9
Michael Chua, Jessica Ming, Shang-Jen Chang, Joana Dos Santos, Niraj Mistry, Jan Michael Silangcruz, Mark Bayley, Martin Koyle
INTRODUCTION: Concerns regarding the quality, credibility, and applicability of recently published pediatric urinary tract infection (UTI) clinical practice guidelines have been raised due to the inconsistencies of recommendations between them. We aimed to determine the quality of the recent clinical practice guidelines on pediatric UTI by using the Appraisal of Guidelines Research and Evaluation (AGREE II) instrument, and summarize the standard of care in diagnosis and management of pediatric UTI from the top three clinical practice guidelines...
December 22, 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/29318344/severe-casualties-from-bastille-day-attack-in-nice-france
#10
Federico Solla, Joseph Carboni, Arnaud Fernandez, Audrey Dupont, Nathalie Chivoret, Gilles Brézac, Virginie Rampal, Jean Bréaud
PURPOSE: To describe the most severe casualties from the July 14th, 2016 terror attack in Nice that were treated at the Lenval University Children's Hospital (LUCH) of Nice (France). METHODS: Retrospective study about casualties treated at LUCH from Bastille Day Attack with injuries resulting in the need for surgery, resuscitation, or death. The type of lesions and surgery, duration of hospitalizations, complications, psychological status, and outcome at discharge were collected...
January 9, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29315204/moral-distress-model-reconstructed-using-grounded-theory
#11
Hsun-Kuei Ko, Chi-Chun Chin, Min-Tao Hsu
BACKGROUND: The problems of nurse burnout and manpower shortage relate to moral distress. Thus, having a good understanding of moral distress is critical to developing strategies that effectively improve the clinical ethical climate and improve nursing retention in Taiwan. PURPOSE: The aim of this study was to reconstruct the model of moral distress using the grounded theory. METHODS: Twenty-five staff nurses at work units who attend to the needs of adult, pediatric, acute, and critical disease or end-of-life-care patients were recruited as participants using theoretical sampling from three teaching hospitals in Taiwan...
February 2018: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/29315136/renal-replacement-therapy-in-the-critically-ill-child
#12
Claire A Westrope, Sarah Fleming, Melpo Kapetanstrataki, Roger C Parslow, Kevin P Morris
OBJECTIVES: Although renal replacement therapy is widely used in critically ill children, there have been few comprehensive population-based studies of its use. This article describes renal replacement therapy use, and associated outcomes, in critically ill children across the United Kingdom in the largest cohort study of this patient group. DESIGN: A retrospective observational study using prospectively collected data. SETTING: Data from the Pediatric Intensive Care Audit Network database which collects data on all children admitted to U...
January 8, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29314219/pediatric-psoriasis-evolving-perspectives
#13
Lawrence F Eichenfield, Amy S Paller, Wynnis L Tom, Jeffrey Sugarman, Adelaide A Hebert, Sheila Fallon Friedlander, Elaine Siegfried, Nanette Silverberg, Kelly M Cordoro
BACKGROUND/OBJECTIVES: Childhood-onset psoriasis is a common skin disorder that has recently received increasing attention, particularly because of its significant medical, social, financial, and psychological burdens and its associated comorbidities. With limited data available and lack of standardized management guidelines for pediatric psoriasis, an expert panel desired to provide an updated critical overview and practical guidance for management of the affected population. METHODS: A panel of pediatric dermatologists with extensive experience in pediatric psoriasis defined and prioritized a core set of topics, performed an English-language literature review, prepared critical evaluations and presentations of topic areas, and carried out a consensus meeting and follow-up consensus manuscript...
January 4, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29313744/dyspnea-in-children-with-life-threatening-and-life-limiting-complex-chronic-conditions
#14
Lucas Pieper, Boris Zernikow, Ross Drake, Michael Frosch, Michael Printz, Julia Wager
BACKGROUND: Dyspnea is one of the most frequent symptoms in children with complex chronic conditions (CCC) requiring palliative care. Although it is a subject of high importance, there has been little research on dyspnea in critically ill children. OBJECTIVE: The purpose of this systematic review was to investigate the prevalence and causes of dyspnea in children with CCC and to identify the current state of research on the measurements, treatments, and the evaluation of therapeutic interventions...
January 9, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29309748/turner-syndrome-transition-from-childhood-to-adolescence
#15
Ioanna Kosteria, Christina Kanaka-Gantenbein
Transition from pediatric to adult care for young women with Turner Syndrome (TS) is characterized by high drop-out rates and inadequate follow-up, leading to increased morbidity and mortality. The complexity of the health issues young women with TS face or new problems that may arise warrants a well-structured and efficiently coordinated gradual transition plan, which is adapted to the individual needs of the emerging young adult and is based on interdisciplinary communication between physicians. In order to achieve a high level of care, it is important for the patient to be sincerely informed about her condition but also supported throughout this critical period of rising responsibility and autonomy by an experienced, multidisciplinary team...
January 5, 2018: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/29308758/-predictive-value-of-four-pediatric-scores-of-critical-illness-and-mortality-on-evaluating-mortality-risk-in-pediatric-critical-patients
#16
Lidan Zhang, Huimin Huang, Yucai Cheng, Lingling Xu, Xueqiong Huang, Yuxin Pei, Wen Tang, Zhaoyuan Qin
OBJECTIVE: To assess the performance of pediatric clinical illness score (PCIS), pediatric risk of mortality score III (PRISM III), pediatric logistic organ dysfunction score 2 (PELOD-2), and pediatric multiple organ dysfunction score (P-MODS) in predicting mortality in critically ill pediatric patients. METHODS: The data of critically ill pediatric patients admitted to Pediatric Intensive Care Unit (PICU) of First Affiliated Hospital of Sun Yat-Sen University from August 2012 to May 2017 were retrospectively analyzed...
January 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29302123/bloodless-repair-for-a-3-6-kilogram-transposition-of-the-great-arteries-with-jehovah-s-witness-faith
#17
Jeffery L Burnside, Todd M Ratliff, Ashley B Hodge, Daniel Gomez, Mark Galantowicz, Aymen Naguib
Achieving pediatric cardiac surgery using cardiopulmonary bypass (CPB) without allogeneic blood transfusion is challenging. There are many clinical and economic factors that point to the importance of avoiding blood transfusions. In some instances, honoring patients or parents beliefs may be the reason for avoiding blood transfusions. For example, patients or parents of the Jehovah's Witness faith refuse blood transfusion based on their religious beliefs. Over the last decade, our institution has seen a steady increase in our pediatric Jehovah's Witness patient population...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29301735/integrating-patient-centered-electronic-health-record-communication-training-into-resident-onboarding-curriculum-development-and-post-implementation-survey-among-housestaff
#18
Maria Alcocer Alkureishi, Wei Wei Lee, Sandra Webb, Vineet Arora
BACKGROUND: Electronic health record (EHR) use can enhance or undermine the ability of providers to deliver effective, humanistic patient-centered care. Given patient-centered care has been found to positively impact patient health outcomes, it is critical to provide formal education on patient-centered EHR communication skills. Unfortunately, despite increasing worldwide EHR adoption, few institutions educate trainees on EHR communication best practices. OBJECTIVE: The goal of this research was to develop and deliver mandatory patient-centered EHR training to all incoming housestaff at the University of Chicago...
January 4, 2018: JMIR Medical Education
https://www.readbyqxmd.com/read/29301012/diagnosis-of-heroin-overdose-in-an-8-year-old-boy-reliable-contribution-of-toxicological-investigations
#19
M Soichot, S Julliand, J Filatriau, A Hurbain, E Bourgogne, A Mihoubi, H Gourlain, B Delhotal-Landes
Toxicological investigations are often required by clinicians in comatose patients with suspected poisoning. However, the usefulness of toxicological analyses to support a diagnosis of acute poisoning is debated among clinicians and the interpretation of laboratory tests is challenging given the wide diversity of analytical techniques available. We report the case of an 8-year-old boy who was admitted to an intensive care unit with severe respiratory depression and neurological impairment. In order to formulate appropriate hypothesizes about the diagnosis and circumstances of intoxication, clinicians consulted toxicologists for a comprehensive toxicological screening...
December 28, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/29297749/life-limiting-conditions-at-a-university-pediatric-tertiary-care-center-a-cross-sectional-study
#20
Annemarie Bösch, Julia Wager, Boris Zernikow, Ralf Thalemann, Heidi Frenzel, Heiko Krude, Tobias Reindl
BACKGROUND: The increasing number of children with life-threatening and life-limiting conditions requires an individualized approach and additional supportive care in hospitals. However, these patients' characteristics and their prevalence in a pediatric tertiary hospital setting have not been systematically analyzed. OBJECTIVE: This study aimed to determine the proportion of hospitalized children who are receiving care for life-threatening diseases with feasible curative treatments and for life-limiting diseases (LLDs) with inevitable premature death as opposed to care for acute or chronic diseases; additionally, it sought to compare patient characteristics, clinical features, and symptoms within these subgroups...
January 3, 2018: Journal of Palliative Medicine
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