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Pediatric overuse

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https://www.readbyqxmd.com/read/28894729/procalcitonin-for-diagnostics-and-treatment-decisions-in-pediatric-lower-respiratory-tract-infections
#1
Philipp Baumann, Gurli Baer, Jessica Bonhoeffer, Aline Fuchs, Verena Gotta, Ulrich Heininger, Nicole Ritz, Gabor Szinnai, Jan Bonhoeffer
Mortality and morbidity remain high in pediatric lower respiratory tract infections (LRTIs) despite progress in research and implementation of global diagnostic and treatment strategies in the last decade. Still, 120 million annual episodes of pneumonia affect children younger than 5 years each year leading to 1.3 million fatalities with the major burden of disease carried by low- and middle-income countries (95%). The definition of pneumonia is still challenging. Traditional diagnostic measures (i.e., chest radiographs, C-reactive protein) are unable to distinguish viral and from bacterial etiology...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28828471/why-it-is-so-hard-to-talk-about-overuse-in-pediatrics-and-why-it-matters
#2
Shawn L Ralston, Alan R Schroeder
No abstract text is available yet for this article.
August 21, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28763554/does-this-child-have-pneumonia-the-rational-clinical-examination-systematic-review
#3
REVIEW
Sonal N Shah, Richard G Bachur, David L Simel, Mark I Neuman
Importance: Pneumonia is a leading cause of morbidity and mortality in children. It is important to identify the clinical symptoms and physical examination findings associated with pneumonia to improve timely diagnosis, prevent significant morbidity, and limit antibiotic overuse. Objective: To systematically review the accuracy of symptoms and physical examination findings in identifying children with radiographic pneumonia. Data Sources and Study Selection: MEDLINE and Embase (1956 to May 2017) were searched, along with reference lists from retrieved articles, to identify diagnostic studies of pediatric pneumonia across a broad age range that had to include children younger than age 5 years (although some studies enrolled children up to age 19 years); 3644 unique articles were identified, of which 23 met inclusion criteria...
August 1, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28746259/variations-in-antibiotic-and-azithromycin-prescribing-for-children-by-geography-and-specialty-united-states-2013
#4
Katherine E Fleming-Dutra, Alicia Demirjian, Monina Bartoces, Rebecca M Roberts, Thomas H Taylor, Lauri A Hicks
BACKGROUND: Using antibiotics appropriately is critical to slow spread of antibiotic resistance, a major public health problem. Children, especially young children, receive more antibiotics than other age groups. Our objective was to describe antibiotic use in children in the United States (US) and use of azithromycin, which is recommended infrequently for pediatric conditions. METHODS: We used QuintilesIMS Xponent 2013 data to calculate the number and rate of oral antibiotic prescriptions for children by age (0-2, 3-9 and 10-19 years) and agent...
July 19, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28728423/changing-antibiotic-prescribing-in-a-primary-care-network-the-role-of-readiness-to-change-and-group-dynamics-in-success
#5
Suratha Elango, Julia E Szymczak, Ian M Bennett, Rinad S Beidas, Rachel M Werner
Overuse of broad-spectrum antibiotics in outpatient pediatrics remains a significant issue and there is limited evidence on how to effectively implement outpatient stewardship interventions. This study examines the relationship between readiness to change and modifiable factors affecting success of a primary care network antibiotic stewardship intervention. A survey designed to measure readiness to accept a health care innovation was administered to 209 clinicians. Practices were split in half into "high" versus "low" readiness to change...
July 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28628411/sports-and-the-growing-musculoskeletal-system-sports-imaging-series
#6
Jie C Nguyen, Scott E Sheehan, Kirkland W Davis, Kara G Gill
Increased youth participation in sports has resulted in increased injury tolls due to shifts toward participation in competitive sports at earlier ages, increased training intensity and competition schedules, as well as specialization into one sport. The physiology of the growing musculoskeletal system makes the growing athlete particularly vulnerable to specific types of injuries. Radiologists must understand the differences between pediatric and adult athletes to recognize the particular injuries to which these young athletes are prone...
July 2017: Radiology
https://www.readbyqxmd.com/read/28495389/clinical-trainees-responses-to-parents-who-question-evidence-based-recommendations
#7
Sydney E Philpott, Holly O Witteman, Katherine M Jones, David S Sonderman, Anne-Sophie Julien, Mary C Politi
OBJECTIVE: We examined clinicians' attitudes, beliefs, and behavioral intentions about discussing evidence and eliciting values when patients question recommendations. METHODS: We randomized trainees to read one of three scenarios about a parent of a one-year-old: 1) overuse (parent requests antibiotics for presumed viral infection); 2) equipoise (tubes for recurrent ear infections); 3) underuse (parent hesitates about vaccination). Participants then answered survey questions...
May 2, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28458416/a-study-of-antimicrobial-use-in-children-admitted-to-pediatric-medicine-ward-of-a-tertiary-care-hospital
#8
Sandip Baidya, Avijit Hazra, Supratim Datta, Amal Kanti Das
OBJECTIVES: Antimicrobials are frequently used in tertiary care hospitals. We conducted an observational study on children admitted to a teaching hospital in Eastern India, to generate a profile of antimicrobial use and suspected adverse drug reactions (ADRs) attributable to them. MATERIALS AND METHODS: Hospitalized children of either sex, aged between 1 month and 12 years, were studied. Baseline demographic and clinical features, duration of hospital stay, antimicrobials received in hospital along with dosing and indications and details of suspected ADRs attributable to their use were recorded...
January 2017: Indian Journal of Pharmacology
https://www.readbyqxmd.com/read/28377653/clinical-and-radiological-evaluation-of-turmeric-powder-as-a-pulpotomy-medicament-in-primary-teeth-an-in-vivo-study
#9
Rajiv N Purohit, Manohar Bhatt, Kanchan Purohit, Jitendra Acharya, Rajesh Kumar, Rakesh Garg
Many plants with biological and antimicrobiological properties have been studied since there has been a relevant increase in the incidence of antibiotic overuse and misuse. In dentistry, phytomedicines have been used as anti-inflammatory, antibiotic, analgesic, and sedative agents. Turmeric is used extensively in foods for its flavor and color, as well as having a long tradition of use in the Chinese and Ayurvedic systems of medicine, particularly as an anti-inflammatory and for the treatment of flatulence, jaundice, menstrual difficulties, hematuria, hemorrhage, and colic...
January 2017: International Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/28298481/categorization-of-national-pediatric-quality-measures
#10
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...
April 2017: Pediatrics
https://www.readbyqxmd.com/read/28287685/care-of-shoulder-pain-in-the-overhead-athlete
#11
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
#12
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
#13
REVIEW
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
#14
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...
March 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28141723/anxiety-associated-with-asthma-exacerbations-and-overuse-of-medication-the-role-of-cultural-competency
#15
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
#16
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
#17
REVIEW
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
#18
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
#19
REVIEW
(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
#20
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
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