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Pediatric overuse

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https://www.readbyqxmd.com/read/28298481/categorization-of-national-pediatric-quality-measures
#1
Samantha A House, Eric R Coon, Alan R Schroeder, Shawn L Ralston
BACKGROUND AND OBJECTIVE: The number of quality measures has grown dramatically in recent years. This growth has outpaced research characterizing content and impact of these metrics. Our study aimed to identify and classify nationally promoted quality metrics applicable to children, both by type and by content, and to analyze the representation of common pediatric issues among available measures. METHODS: We identified nationally applicable quality measure collections from organizational databases or clearinghouses, federal Web sites, and key informant interviews and then screened each measure for pediatric applicability...
March 15, 2017: Pediatrics
https://www.readbyqxmd.com/read/28287685/care-of-shoulder-pain-in-the-overhead-athlete
#2
Joseph Chorley, Richard E Eccles, Armand Scurfield
Shoulder complaints are common in the overhead athlete. Understanding the biomechanics of throwing and swimming requires understanding the importance of maintaining the glenohumeral relationship of the shoulder. Capsular laxity, humeral retrotorsion, glenoid retroversion, glenohumeral internal rotation deficit, and scapular dyskinesis can all contribute to shoulder dysfunction and pain. Injuries are more likely during peak height velocity, especially when coupled with overuse, previous injuries not adequately treated, or change in the demands on the shoulder such as a new technique, bigger field, or longer race...
March 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28277413/community-primary-care-provider-preferences-for-emergency-department-follow-up-recommendations-a-regional-study
#3
Marissa A Hendrickson, Eta Obeya, Andrew R Wey, Philippe R Gaillard
BACKGROUND: Children who present to emergency departments (EDs) for care are frequently advised to follow up with their primary care providers (PCPs) after discharge; little is known about whether PCPs agree that follow-up advised by EDs is appropriate for their patients. OBJECTIVES: The aims of this study were to determine PCP preferences for follow-up recommendations given to their pediatric patients at the time of ED visits and to compare these preferences to reported emergency medicine provider (EMP) practice...
March 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28165873/overuse-physeal-injuries-in-youth-athletes
#4
Amanda Arnold, Charles A Thigpen, Paul F Beattie, Michael J Kissenberth, Ellen Shanley
CONTEXT: Despite rising awareness of the risks associated with sports participation, overuse injuries continue to increase in youth athlete populations. Physeal injuries are one type of overuse injury exclusive to pediatric populations that are often sustained during athletic practice or competition. Overuse physeal injuries are, in theory, preventable; however, little consensus has been reached surrounding the risk factors, prevention, and treatment strategies. OBJECTIVE: This systematic review summarizes the best available evidence concerning overuse physeal injuries in youth and adolescent athletes...
March 2017: Sports Health
https://www.readbyqxmd.com/read/28155066/pediatric-musculoskeletal-injuries-role-of-ultrasound-and-magnetic-resonance-imaging
#5
REVIEW
C L Piccolo, M Galluzzo, S Ianniello, M Trinci, A Russo, E Rossi, M Zeccolini, A Laporta, G Guglielmi, V Miele
Pediatric musculoskeletal system is particularly prone to traumatic and sports-related injuries, both acute and chronic, i.e., overuse injuries, because of inherent conditions of weakness, such as the open physis, representing the weakest aspect within the bone, the ligamentous supports and changing biomechanics. Being aware that a quick diagnosis is essential to preserve the good functionality of the limb involved, it is mandatory for the radiologist to recognize the most common patterns of these injuries, identifying those requiring a prompt surgery, as well as be confident with the technique performed, and be supported by an important background experience and knowledge skills...
February 2, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28141723/anxiety-associated-with-asthma-exacerbations-and-overuse-of-medication-the-role-of-cultural-competency
#6
Yousuke T Horikawa, Tina Y Udaka, Janet K Crow, John I Takayama, Martin T Stein
Toshi, a 14-year-old Japanese boy, had uncontrolled asthma after relocating from Japan with his family 1 year ago. In Japan, he was diagnosed with moderate, persistent asthma, which was controlled with salmeterol and albuterol on an as needed basis. Since moving to the United States, Toshi complained of frequent dyspnea.Initially, he was seen by a Japanese physician who prescribed 200 mg of fluticasone 3 times a day and albuterol nebulization as needed. When Toshi came to the Pediatric Primary Care Clinic, he reported using his nebulizer up to 25 times daily...
February 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28079916/adolescent-shin-pain
#7
Jeremy Korsh, Douglas Matijakovich, Charles Gatt
Shin pain is a common complaint in adolescent athletes. The term "shin splints" has historically been applied to these patients. Shin splints, more often than not, refers to a stress reaction of the tibia from overuse. Overuse injuries occur when repetitive microtrauma to the bone exceeds the biologic healing potential. Diagnosis is based on typical history and physical examination findings. Plain radiographs and advanced imaging are rarely necessary but can provide valuable prognostic information. Treatment consists of adequate rest and exercise modification...
January 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28049113/update-on-pediatric-overuse
#8
Eric R Coon, Paul C Young, Ricardo A Quinonez, Daniel J Morgan, Sanket S Dhruva, Alan R Schroeder
As concerns over health care-related harms and costs continue to mount, efforts to identify and combat medical overuse are needed. Although much of the recent attention has focused on health care for adults, children are also harmed by overuse. Using a structured PubMed search and manual tables of contents review, we identified important articles on pediatric overuse published in 2015. These articles were evaluated according to the quality of the methods, the magnitude of clinical effect, and the number of patients potentially affected and were categorized into overdiagnosis, overtreatment, and overutilization...
February 2017: Pediatrics
https://www.readbyqxmd.com/read/28002131/premedication-use-before-infliximab-administration-a-cross-sectional-analysis
#9
Joseph Picoraro, Gabriel Winberry, Corey A Siegel, Wael El-Matary, Jonathan Moses, Andrew Grossman, K T Park
BACKGROUND: Premedications are commonly given to patients with inflammatory bowel disease before intravenous infliximab administration. We aimed to (1) describe practice variability; and (2) determine clinician rationale for premedicating patients with inflammatory bowel disease before infliximab administration. METHODS: We developed a cross-sectional electronic survey after comprehensive literature review to assess practice variability and clinician rationale for premedication use before infliximab...
January 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/27940793/media-and-young-minds
#10
(no author information available yet)
Infants, toddlers, and preschoolers are now growing up in environments saturated with a variety of traditional and new technologies, which they are adopting at increasing rates. Although there has been much hope for the educational potential of interactive media for young children, accompanied by fears about their overuse during this crucial period of rapid brain development, research in this area still remains limited. This policy statement reviews the existing literature on television, videos, and mobile/interactive technologies; their potential for educational benefit; and related health concerns for young children (0 to 5 years of age)...
November 2016: Pediatrics
https://www.readbyqxmd.com/read/27852453/current-use-and-outcomes-of-helicopter-transport-in-pediatric-trauma-a-review-of-18-291-transports
#11
Brian R Englum, Kristy L Rialon, Jina Kim, Mark L Shapiro, John E Scarborough, Henry E Rice, Obinna O Adibe, Elisabeth T Tracy
PURPOSE: The role of helicopter emergency medical services (HEMS) in pediatric trauma remains controversial. We examined its use in pediatric trauma and its effectiveness in children with moderate/severe injuries. METHODS: All blunt/penetrating trauma patients ≤18years old in the National Trauma Data Bank were evaluated for use of HEMS and in-hospital mortality. In a comparative effectiveness study, only patients treated at level I/II pediatric centers with injury severity score (ISS)≥9 were included...
January 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27811516/ankle-injuries-in-the-pediatric-athlete
#12
John B Erickson, Walter P Samora, Kevin E Klingele
Foot and ankle injuries are the second most common reason for young athletes to present to a primary care physician, and account for up to 30% of visits to sports medicine clinics in this population. Heightened performance expectations placed on today's young athletes have led to intense training and competition demands. With increasing rates of sport participation among children and adolescents, it is important for treating physicians to have an understanding of the evaluation and management of ankle injuries seen in the pediatric athlete...
December 2016: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/27811514/overuse-injuries-in-the-pediatric-population
#13
Mark Wu, Ryan Fallon, Benton E Heyworth
Athletic overuse injuries are becoming an increasingly common entity in the active pediatric population. The prevalence of these injuries may be attributed to the combination of an underdeveloped musculoskeletal system, increased participation in competitive sport at a younger age, and increased duration and intensity of training. Many of these injuries may go unreported and/or undiagnosed, as they do not all result in time lost from sports, and are not always appreciated on imaging. Left unrecognized, untreated, or poorly managed, overuse injuries can have long-term health consequences for young athletes...
December 2016: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/27726754/imaging-of-sports-related-injuries-of-the-lower-extremity-in-pediatric-patients
#14
M Cody O'Dell, Diego Jaramillo, Laura Bancroft, Laura Varich, Gregory Logsdon, Sabah Servaes
With increasing participation and intensity of training in youth sports in the United States, the incidence of sports-related injuries is increasing, and the types of injuries are shifting. In this article, the authors review sports injuries of the lower extremity, including both acute and overuse injuries, that are common in or specific to the pediatric population. Common traumatic injuries that occur in individuals of all ages (eg, tears of the acetabular labrum and anterior cruciate ligament) are not addressed, although these occur routinely in pediatric sports...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27697331/variation-in-utilization-and-need-for-tympanostomy-tubes-across-england-and-new-england
#15
Devin M Parker, Laura Schang, Jared R Wasserman, Weston D Viles, Gwyn Bevan, David C Goodman
OBJECTIVES: To compare rates of typmanostomy tube insertions for otitis media with effusion with estimates of need in 2 countries. STUDY DESIGN: This cross-sectional analysis used all-payer claims to calculate rates of tympanostomy tube insertions for insured children ages 2-8 years (2007-2010) across pediatric surgical areas (PSA) for Northern New England (NNE; Maine, Vermont, and New Hampshire) and the English National Health Service Primary Care Trusts (PCT)...
September 30, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27649041/implementation-of-a-clinical-pathway-for-chest-pain-in-a-pediatric-emergency-department
#16
Shaun Mohan, Deipanjan Nandi, Paul Stephens, Mirna MʼFarrej, R Lee Vogel, Christopher P Bonafide
OBJECTIVE: To evaluate the impact of a pediatric emergency department (ED) chest pain clinical pathway on resource utilization. METHODS: Motivated by perceived overuse of cardiology consultation for non-cardiac chest pain in the ED, clinicians from the Divisions of Cardiology and Emergency Medicine collaboratively developed a chest pain clinical pathway, educated staff, and implemented the pathway on March 1, 2014. We reviewed records of children aged 3 to 18 years without prior diagnoses of heart disease who presented to the ED with chest pain between March 1, 2013, and April 22, 2015...
September 20, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27637662/shoulder-injuries-in-pediatric-athletes
#17
REVIEW
James E Moyer, Jennifer M Brey
Shoulder injuries in pediatric athletes are typically caused by acute or overuse injuries. The developing structures of the shoulder lead to injury patterns that are distinct from those of adult athletes. Overuse injuries often affect the physeal structures of the proximal humerus and can lead to pain and loss of sports participation. Shoulder instability is common in pediatric athletes, and recurrence is also a concern in this population. Fractures of the proximal humerus and clavicle are typically treated with conservative management, but there is a trend toward surgical intervention...
October 2016: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/27637661/pediatric-elbow-and-wrist-pathology-related-to-sports-participation
#18
REVIEW
Matthew D Ellington, Eric W Edmonds
Pediatric overuse injuries are becoming more prevalent in today's society with more children competitively playing year-round sports at a younger age. The importance of prompt diagnosis and treatment is paramount to the treatment for these injuries, second only to rest and activity modification. This article will focus on overuse injuries of the upper extremity, specifically: little league elbow, elbow osteochondritis dissecans, and gymnast wrist. It will also discuss the pathophysiology, diagnosis, imaging, and treatment of each of these entities...
October 2016: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/27600715/osteochondritis-dissecans-lesions-in-family-members-does-a-positive-family-history-impact-phenotypic-potency
#19
Alex L Gornitzky, R Justin Mistovich, Brittany Atuahuene, Eileen P Storey, Theodore J Ganley
BACKGROUND: Although repetitive microtrauma and athletic overuse patterns are most commonly associated with osteochondritis dissecans (OCD), recent studies have identified a potential genetic predisposition for OCD. Several case series have documented family pedigrees that support autosomal-dominant inheritance, but the families in these studies were all selected as a result of unique histories that may not accurately represent OCD inheritance patterns at large. Because there has been little investigation beyond these case reports, we aimed to describe a broader, more representative pattern of OCD inheritance applicable to all affected patients...
September 6, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27573090/sports-specialization-and-intensive-training-in-young-athletes
#20
Joel S Brenner
Sports specialization is becoming the norm in youth sports for a variety of reasons. When sports specialization occurs too early, detrimental effects may occur, both physically and psychologically. If the timing is correct and sports specialization is performed under the correct conditions, the athlete may be successful in reaching specific goals. Young athletes who train intensively, whether specialized or not, can also be at risk of adverse effects on the mind and body. The purpose of this clinical report is to assist pediatricians in counseling their young athlete patients and their parents regarding sports specialization and intensive training...
September 2016: Pediatrics
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