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Pediatric overuse

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https://www.readbyqxmd.com/read/29752289/interventions-to-reduce-over-utilized-tests-and-treatments-in-bronchiolitis
#1
Amy Tyler, Paige Krack, Leigh Anne Bakel, Kimberly O'Hara, Douglas Scudamore, Irina Topoz, Julia Freeman, Angela Moss, Renee Allen, Angela Swanson, Lalit Bajaj
OBJECTIVES: The American Academy of Pediatrics published bronchiolitis clinical practice guidelines in 2014 recommending against the routine use of bronchodilators, chest radiographs, or respiratory viral testing in children with a clinical diagnosis of bronchiolitis. Our aim in this project was to align care with the American Academy of Pediatrics clinical practice guidelines by decreasing the overuse of these interventions. METHODS: This study included patients who were admitted to a non-ICU setting with a primary or secondary diagnosis of bronchiolitis...
May 11, 2018: Pediatrics
https://www.readbyqxmd.com/read/29677085/surgical-antimicrobial-prophylaxis-among-pediatric-patients-in-south-africa-comparing-two-healthcare-settings
#2
Nicolene van der Sandt, Natalie Schellack, Lindi A Mabope, Mothahadini Pb Mawela, Danie Kruger, Brian Godman
BACKGROUND: Appropriate use of surgical antimicrobial prophylaxis (SAP) is a concern in view of its impact on morbidity, mortality and costs. Little is currently known about SAP in South Africa. OBJECTIVE: Assess compliance to SAP guidelines for pediatric patients undergoing surgery in one of four surgical sub-specialties among hospitals in South Africa. METHODS: Eight month retrospective chart review in both a teaching hospital and a private hospital between February and August 2015...
April 19, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29626363/smartphone-addiction-risk-and-daytime-sleepiness-in-korean-adolescents
#3
Jee Eun Chung, Soo An Choi, Ki Tai Kim, Jeong Yee, Joo Hee Kim, Jin Won Seong, Jong Mi Seong, Ju Young Kim, Kyung Eun Lee, Hye Sun Gwak
AIM: Smartphone overuse can cause not only mobility problems in the wrists, fingers and neck but also interference with sleep habits. However, research on smartphone addiction and sleep disturbances is scarce. Therefore, we aimed to investigate daytime sleepiness in association with smartphone addiction risk in Korean adolescents. METHODS: A cross-sectional survey method was used in this study. The Pediatric Daytime Sleepiness Scale was used to assess daytime sleepiness, and the Korean Smartphone Addiction Proneness Scale index was used to evaluate the degree of risk for smartphone addiction...
April 6, 2018: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29625664/challenges-in-the-treatment-of-asthma-in-children-and-adolescents
#4
REVIEW
Stanley J Szefler, Bradley Chipps
OBJECTIVE: Despite the availability of effective treatments, asthma control in children and adolescents remains inadequate and rates of health care use are high. This follow-up to a recent review (O'Byrne et al, Eur Respir J. 2017;50[3]) examines a number of challenges in current pediatric asthma management compared with that of an adult perspective and discusses possible alternative strategies that might improve pediatric asthma management and control. DATA SOURCES: The evidence base for this review is limited because, historically, much of the research has been performed in adults...
April 2018: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/29618583/reducing-electrolyte-testing-in-hospitalized-children-by-using-quality-improvement-methods
#5
Michael J Tchou, Sonya Tang Girdwood, Benjamin Wormser, Meifawn Poole, Stephanie Davis-Rodriguez, J Timothy Caldwell, Lauren Shannon, Philip A Hagedorn, Eric Biondi, Jeffrey Simmons, Jeffrey Anderson, Patrick W Brady
BACKGROUND AND OBJECTIVES: Despite studies indicating a high rate of overuse, electrolyte testing remains common in pediatric inpatient care. Frequently repeated electrolyte tests often return normal results and can lead to patient harm and increased cost. We aimed to reduce electrolyte testing within a hospital medicine service by >25% within 6 months. METHODS: We conducted an improvement project in which we targeted 6 hospital medicine teams at a large academic children's hospital system by using the Model for Improvement...
April 4, 2018: Pediatrics
https://www.readbyqxmd.com/read/29605191/a-quality-improvement-intervention-to-reduce-emergency-department-radiography-for-bronchiolitis
#6
Joel Reiter, Adin Breuer, Oded Breuer, Saar Hashavya, David Rekhtman, Eitan Kerem, Malena Cohen-Cymberknoh
INTRODUCTION: Bronchiolitis is one of the most common infectious diseases in children and the most frequent cause of hospitalization in infants. Clinical practice guidelines recommend that a chest X-ray (CXR) should not be routinely obtained in the diagnosis of bronchiolitis, as studies have shown that they do not affect clinical outcomes, but rather lead to overuse of pharmacological agents and a longer length of hospital stay. OBJECTIVE: To determine whether active institution of bronchiolitis practice guidelines as part of a quality improvement project decreased the use of CXRs in the Pediatric Emergency Department (ED)...
April 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29582079/2017-update-on-pediatric-medical-overuse-a-review
#7
Eric R Coon, Paul C Young, Ricardo A Quinonez, Daniel J Morgan, Sanket S Dhruva, Alan R Schroeder
Importance: Medical overuse has historically focused on adult health care, but interest in how children are affected by medical overuse is increasing. This review examines important research articles published in 2016 that address pediatric overuse. Observations: A structured search of PubMed and a manual review of the tables of contents of 10 journals identified 169 articles related to pediatric overuse published in 2016, from which 8 were selected based on the quality of methods and potential harm to patients in terms of prevalence and magnitude...
March 26, 2018: JAMA Pediatrics
https://www.readbyqxmd.com/read/29532065/medical-overuse-in-pediatric-end-of-life-care-reply
#8
Shawn L Ralston, Alan R Schroeder
No abstract text is available yet for this article.
March 12, 2018: JAMA Pediatrics
https://www.readbyqxmd.com/read/29532064/medical-overuse-in-pediatric-end-of-life-care
#9
Amanda Jichlinski
No abstract text is available yet for this article.
March 12, 2018: JAMA Pediatrics
https://www.readbyqxmd.com/read/29446796/posttraumatic-headache
#10
Raquel Langdon, Sharief Taraman
After sustaining a concussion or mild traumatic brain injury, headaches are one of the most common complaints. The pathophysiologic changes that occur in the setting of injury likely contribute to or cause posttraumatic headaches. Posttraumatic headaches often present as migraine or tension-type headaches. Unlike pain from other types of injuries, headaches following mild traumatic brain injury are more likely to persist. Preexisting conditions such as migraine and mood disorders may influence posttraumatic headache and complicate management...
February 1, 2018: Pediatric Annals
https://www.readbyqxmd.com/read/29434387/antimicrobial-utilization-pattern-in-pediatric-patients-in-tertiary-care-hospital-eastern-ethiopia-the-need-for-antimicrobial-stewardship
#11
Samuel Girma, Mekonnen Sisay, Getnet Mengistu, Firehiwot Amare, Dumessa Edessa
Background: Antimicrobials are among the most frequently prescribed medications for pediatric patients. However, inappropriate use of them can increase morbidity, mortality, healthcare costs, and largely antimicrobial resistance. This study aims to assess the antimicrobial utilization pattern in the pediatric ward of Hiwot Fana Specialized University Hospital. Methods: Retrospective cross-sectional study was conducted to assess the antimicrobial utilization. In this study, 403 pediatric medical records selected by systematic random sampling were reviewed...
February 2018: Hospital Pharmacy
https://www.readbyqxmd.com/read/29429363/recent-advances-in-the-management-of-chronic-migraine-in-children
#12
Marco Antônio Arruda, Camila Flaksberg Chevis, Marcelo Eduardo Bigal
Migraine is a chronic-recurrent disorder that progresses in some adults and also in many children. Chronic migraine (CM) is the clinical result of this process. Since migraine does not progress in most children, identifying the risk factors for progression is an important public health priority that should be matched by evidence-based treatment. Areas covered: Herein we conduct a systematic review on the comorbidities and treatment of CM in children and adolescents in the last ten years, summarizing evidence-based recommendations for disease management...
March 2018: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/29402662/pharmacist-managed-short-acting-beta-agonist-refill-service-in-a-general-pediatric-clinic
#13
Brooke L Gildon, Barnabas John, Michelle Condren, Shellie Keast, Roxanne Maglunog, Jeremy L Johnson, Christopher Robertson
OBJECTIVES: To use a pharmacist-managed short-acting beta agonist (SABA) service (1) to determine the patient's rationale for SABA refill requests, (2) to assess adherence to current controller therapy and current level of disease control, and (3) to characterize the pharmacist's recommendations made in response to a patient's SABA refill request. SETTING: An academic-based general pediatric clinic. PRACTICE DESCRIPTION: SABA overuse is a marker of increased morbidity and mortality in children with asthma...
February 3, 2018: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/29340791/treatment-of-disabling-headache-with-greater-occipital-nerve-injections-in-a-large-population-of-childhood-and-adolescent-patients-a-service-evaluation
#14
Francesca Puledda, Peter J Goadsby, Prab Prabhakar
BACKGROUND: Pediatric headache disorders can be extremely disabling, with marked reduction in the quality of life of children and their carers. Evidenced-based options for the treatment of primary headache disorders with preventive medication is limited and clinical outcomes are often unsatisfactory. Greater occipital nerve injections represent a rapid and well-tolerated therapeutic option, which is widely used in clinical practice in adults, and has previously shown a good outcome in a pediatric population...
January 16, 2018: Journal of Headache and Pain
https://www.readbyqxmd.com/read/29319496/geographic-variations-in-antibiotic-prescription-for-pediatric-acute-upper-respiratory-tract-infections-in-south-korea
#15
Youn Jung, Hyemin Cho, Eunhee Ji, Eun-Ji Park, Sunmee Jang
OBJECTIVE: This study aimed to investigate the factors affecting the geographic differences in antibiotic prescription rates in pediatric upper respiratory tract infections (URI) patients in South Korea. MATERIALS AND METHODS: We performed a nationwide cross-sectional study using 228 administrative districts of Korea, which are the unit of analysis. Prescription rate of antibiotics, the outcome variable, was measured as the proportion of antibiotic prescription days out of total visit days for the treatment of acute URIs using National Health Insurance Service (NHIS) claims data for 2012...
April 2018: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29273482/a-novel-host-protein-assay-outperforms-routine-parameters-for-distinguishing-between-bacterial-and-viral-lower-respiratory-tract-infections
#16
Michal Stein, Shelly Lipman-Arens, Kfir Oved, Asi Cohen, Ellen Bamberger, Roy Navon, Olga Boico, Tom Friedman, Liat Etshtein, Meital Paz, Tanya M Gottlieb, Or Kriger, Yura Fonar, Ester Pri-Or, Renata Yacobov, Yaniv Dotan, Amit Hochberg, Moti Grupper, Irina Chistyakov, Israel Potasman, Isaac Srugo, Eran Eden, Adi Klein
Bacterial and viral lower respiratory tract infections (LRTIs) are often clinically indistinguishable, leading to antibiotic overuse. We compared the diagnostic accuracy of a new assay that combines 3 host-biomarkers (TRAIL, IP-10, CRP) with parameters in routine use to distinguish bacterial from viral LRTIs. Study cohort included 184 potentially eligible pediatric and adult patients. Reference standard diagnosis was based on adjudication by an expert panel following comprehensive clinical and laboratory investigation (including respiratory PCRs)...
March 2018: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/29215711/triage-tools-for-detecting-cervical-spine-injury-in-pediatric-trauma-patients
#17
REVIEW
Annelie Slaar, M M Fockens, Junfeng Wang, Mario Maas, David J Wilson, J Carel Goslings, Niels Wl Schep, Rick R van Rijn
BACKGROUND: Pediatric cervical spine injury (CSI) after blunt trauma is rare. Nonetheless, missing these injuries can have severe consequences. To prevent the overuse of radiographic imaging, two clinical decision tools have been developed: The National Emergency X-Radiography Utilization Study (NEXUS) criteria and the Canadian C-spine Rule (CCR). Both tools are proven to be accurate in deciding whether or not diagnostic imaging is needed in adults presenting for blunt trauma screening at the emergency department...
December 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29168013/clinical-features-and-treatment-of-pediatric-patients-with-drug-induced-anaphylaxis-a-study-based-on-pharmacovigilance-data
#18
Yan Xing, Hua Zhang, Shusen Sun, Xiang Ma, Roy A Pleasants, Huilin Tang, Hangci Zheng, Suodi Zhai, Tiansheng Wang
We assessed the clinical features and treatment of pediatric patients with drug-induced anaphylaxis in clinical settings. Pediatric drug-induced anaphylaxis cases collected by the Beijing Pharmacovigilance Database from 2004 to 2014 were analyzed. A total of 91 cases were identified. Drug-induced anaphylaxis was primarily caused by antibiotics (53%). Children of 0-5 years were more likely to develop cyanosis symptoms than children of 13-17 years (OR = 5.14, 95%CI [1.74, 15.20], P = 0.002). Children of 13-17 years were more likely to develop hypotension than children of 6-12 years (OR = 11...
January 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29153252/antimicrobial-stewardship-in-pediatric-post-acute-care-facilities
#19
Candace L Johnson, Meaghan Jain, Lisa Saiman, Natalie Neu
Providers in pediatric post-acute care facilities were surveyed about knowledge of and resources for antimicrobial stewardship. All agreed that antibiotics were overused in such pediatric facilities, but 60% had not implemented stewardship strategies. Lack of treatment guidelines (47%) was identified as the most common barrier to antimicrobial stewardship.
April 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29117014/what-s-new-in-pediatric-upper-extremity-sports-injuries
#20
Jennifer J Beck, Connor G Richmond, Marc A Tompkins, Ann Heyer, Kevin G Shea, Aristides I Cruz
BACKGROUND: Sports injuries are common in pediatric and adolescent patients and the evaluation and treatment of these injuries continues to evolve. The purpose of this review is to provide a comprehensive appraisal of the most recent literature, highlighting updates on sports-related upper extremity injuries in pediatric patients. METHODS: An electronic search of the PubMed, EMBASE, and Google Scholar databases was performed for keywords related to pediatric overhead athletes, osteochondritis dissecans (OCD) of the capitellum, medial epicondyle fractures, shoulder instability, and clavicle fractures...
February 2018: Journal of Pediatric Orthopedics
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