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https://www.readbyqxmd.com/read/28719479/a-simulation-based-quality-improvement-initiative-improves-pediatric-readiness-in-community-hospitals
#1
Travis Whitfill, Marcie Gawel, Marc Auerbach
BACKGROUND: The National Pediatric Readiness Project Pediatric Readiness Survey (PRS) measured pediatric readiness in 4149 US emergency departments (EDs) and noted an average score of 69 on a 100-point scale. This readiness score consists of 6 domains: coordination of pediatric patient care (19/100), physician/nurse staffing and training (10/100), quality improvement activities (7/100), patient safety initiatives (14/100), policies and procedures (17/100), and availability of pediatric equipment (33/100)...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28713509/mechanical-ventilation-practice-in-egyptian-pediatric-intensive-care-units
#2
Bassant Salah Meligy, Sally Kamal, Seham Awad El Sherbini
INTRODUCTION: Mechanical ventilation is one of the indispensable tools in pediatric intensive care units. Few studies addressed the epidemiology of pediatric patients on mechanical ventilation and the frequently used modes of ventilation. This is the first study to describe the practice of mechanical ventilation (MV) in Egyptian pediatric intensive care units (PICUs). METHODS: This prospective observational study was conducted from January 2014 to December 2014 in two pediatric intensive care units at Cairo University Pediatric Hospital...
May 2017: Electronic Physician
https://www.readbyqxmd.com/read/28707191/clostridium-difficile-colitis-and-colonoscopy-pediatric-perspective
#3
REVIEW
Randolph McConnie, Arthur Kastl
PURPOSE OF THE REVIEW: Review tests available for detection of Clostridium difficile (C. Diff) induced disease, including when such tests should be done in children and how they should be interpreted. RECENT FINDINGS: Multiple tests are available for detecting disease due to C. diff. These include colonoscopy and stool analysis. Colonoscopy with biopsy is the most sensitive test for detecting the presence of colitis. The toxins produced by the C. diff. (toxin A, toxin B, and binary toxin) are the agents that cause injury and disease...
August 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28705427/invasive-disease-by-streptococcus-pyogenes-patients-hospitalized-for-6-years
#4
Vanessa Arias-Constantí, Victoria Trenchs-Sainz de la Maza, Nuria Elvira Sanz-Marcos, Carmina Guitart-Pardellans, Amadeu Gené-Giralt, Carles Luaces-Cubells
INTRODUCTION AND OBJECTIVE: The last years an increase of severe cases of invasive disease (ID) due to Streptococcus pyogenes or streptococcus b-hemolytic group A (SGA) had been detected. The aim of this study was to analyze the epidemiology and the clinical features of ID due to SGA in a tertiary Pediatric Hospital. MATERIAL AND METHODS: Retrospective study in a Pediatric hospital, of all in-patients with final diagnosis of ID due to SGA during 6 years (2009-2014)...
July 10, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28699797/candidemia-and-invasive-candidiasis-among-hospitalized-neonates-and-pediatric-patients
#5
Rachel Harrington, Sylvia L Kindermann, Qingjiang Hou, Robert J Taylor, Nkechi Azie, David L Horn
OBJECTIVE: To investigate the epidemiology, treatment, length of stay (LOS) and costs for neonatal and pediatric inpatients with invasive candidiasis (IC). METHODS: The Cerner Health Facts Database was used to assess inpatients (2005-2014) identified by positive blood or cerebrospinal fluid (CSF) Candida cultures. Log-transformed LOS and cost were examined in candidemia-only patients (n= 191) using multivariable linear regression. RESULTS: 202 patients had a positive culture (blood: n = 192; CSF: n = 10; both: n = 2)...
July 12, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28695182/adolescent-total-knee-arthroplasty
#6
John R Martin, Alan K Sutak, Todd A Milbrandt, Valerie A Martin, Robert T Trousdale
BACKGROUND: Management of adolescent patients with end-stage arthritis is challenging. Nonoperative treatments may be ineffective and total knee arthroplasty (TKA) is rarely performed. Currently, minimal long-term data are available on the outcomes in this patient population. Our goal was to describe TKA for patients with end-stage arthritis who were aged 20 years and younger. METHODS: The Joint Registry at our institution was used to identify 19 patients (29 TKAs) aged 20 years and younger that underwent a primary TKA...
June 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28677072/disparity-in-access-and-outcomes-for-emergency-neonatal-surgery-intestinal-atresia-in-kampala-uganda
#7
Sarah Cairo, Nasser Kakembo, Phyllis Kisa, Arlene Muzira, Maija Cheung, James Healy, Doruk Ozgediz, John Sekabira
BACKGROUND/AIM: Intestinal atresia is one of the leading causes of neonatal intestinal obstruction (NIO). The purpose of this study was to analyze the presentation and outcome of IA and compare with those from both similar and high-income country settings. PATIENTS AND METHODS: A retrospective review of prospectively collected data from patient charts and pediatric surgical database for 2012-2015 was performed. Epidemiological data and patient characteristics were analyzed and outcomes were compared with those reported in other LMICs and high-income countries (HICs)...
August 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28675096/adverse-events-in-endoscopic-sinus-surgery-for-infectious-orbital-complications-of-sinusitis-30-day-nsqip-pediatric-outcomes
#8
Jeffrey Cheng, Beiyu Liu, Alfredo E Farjat, David W Jang
Objective Identify predictors of adverse events for children who underwent endoscopic sinus surgery for treatment of orbital complications associated with sinusitis. Study Design Cross-sectional analysis of a US national database. Setting American College of Surgeons National Surgical Quality Improvement Program (NSQIP), pediatric version (2012-2015). Subjects and Methods Patients were identified with a combination of codes from the International Classification of Diseases, Ninth Revision and 2014 Current Procedural Terminology...
July 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28669107/outcomes-and-costs-of-cardiac-surgery-in-adults-with-congenital-heart-disease
#9
Viviane G Nasr, David Faraoni, Anne Marie Valente, James A DiNardo
Advances in pediatric cardiac surgical and medical care have led to increased survival of patients with congenital heart disease (CHD). Consequently, many CHD patients survive long enough to require cardiac surgery as adults. Using the 2013 Nationwide Inpatient Sample (NIS) database, we compared costs and outcomes for adult patients undergoing surgery for treatment of CHD to a reference population of adults undergoing CABG. Patients were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9 CM) procedure codes...
July 1, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28661973/determinants-of-antibiotic-tailoring-in-pediatric-intensive-care-a-national-survey
#10
Patricia S Fontela, Caroline Quach, Mohammad E Karim, Douglas F Willson, Elaine Gilfoyle, James Dayre McNally, Milagros Gonzales, Jesse Papenburg, Steven Reynolds, Jacques Lacroix
OBJECTIVES: To describe the criteria that currently guide empiric antibiotic treatment in children admitted to Canadian PICUs. DESIGN: Cross-sectional survey. SETTING: Canadian PICUs. SUBJECTS: Pediatric intensivists and pediatric infectious diseases specialists. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We used focus groups and literature review to design the survey questions and its four clinical scenarios (sepsis, pneumonia, meningitis, and intra-abdominal infections)...
June 28, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28658197/hydrocortisone-therapy-in-catecholamine-resistant-pediatric-septic-shock-a-pragmatic-analysis-of-clinician-practice-and-association-with-outcomes
#11
Blake Nichols, Sherri Kubis, Jennifer Hewlett, Nadir Yehya, Vijay Srinivasan
OBJECTIVES: The 2012 Surviving Sepsis Campaign pediatric guidelines recommend stress dose hydrocortisone in children experiencing catecholamine-dependent septic shock with suspected or proven absolute adrenal insufficiency. We evaluated whether stress dose hydrocortisone therapy in children with catecholamine dependent septic shock correlated with random serum total cortisol levels and was associated with improved outcomes. DESIGN: Retrospective cohort study. SETTING: Non-cardiac PICU...
June 27, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28655033/venous-vs-arterial-lactate-and-30-day-mortality-in-pediatric-sepsis-reply
#12
Halden F Scott, Allison Kempe, Lalit Bajaj
No abstract text is available yet for this article.
June 26, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28654990/venous-vs-arterial-lactate-and-30-day-mortality-in-pediatric-sepsis
#13
Luregn J Schlapbach, Graeme MacLaren, Lahn Straney
No abstract text is available yet for this article.
June 26, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28654550/promoters-and-barriers-to-implementation-of-tracheal-intubation-airway-safety-bundle-a-mixed-method-analysis
#14
Katherine Finn Davis, Natalie Napolitano, Simon Li, Hayley Buffman, Kyle Rehder, Matthew Pinto, Sholeen Nett, J Dean Jarvis, Pradip Kamat, Ronald C Sanders, David A Turner, Janice E Sullivan, Kris Bysani, Anthony Lee, Margaret Parker, Michelle Adu-Darko, John Giuliano, Katherine Biagas, Vinay Nadkarni, Akira Nishisaki
OBJECTIVES: To describe promoters and barriers to implementation of an airway safety quality improvement bundle from the perspective of interdisciplinary frontline clinicians and ICU quality improvement leaders. DESIGN: Mixed methods. SETTING: Thirteen PICUs of the National Emergency Airway Registry for Children network. INTERVENTION: Remote or on-site focus groups with interdisciplinary ICU staff. Two semistructured interviews with ICU quality improvement leaders with quantitative and qualitative data-based feedbacks...
June 24, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28654549/workload-of-team-leaders-and-team-members-during-a-simulated-sepsis-scenario
#15
Nancy M Tofil, Yiqun Lin, John Zhong, Dawn Taylor Peterson, Marjorie Lee White, Vincent Grant, David J Grant, Ronald Gottesman, Stephanie N Sudikoff, Mark Adler, Kimberly Marohn, Jennifer Davidson, Adam Cheng
OBJECTIVES: Crisis resource management principles dictate appropriate distribution of mental and/or physical workload so as not to overwhelm any one team member. Workload during pediatric emergencies is not well studied. The National Aeronautics and Space Administration-Task Load Index is a multidimensional tool designed to assess workload validated in multiple settings. Low workload is defined as less than 40, moderate 40-60, and greater than 60 signify high workloads. Our hypothesis is that workload among both team leaders and team members is moderate to high during a simulated pediatric sepsis scenario and that team leaders would have a higher workload than team members...
June 24, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28634578/neonatal-venous-thromboembolism
#16
REVIEW
Kristina M Haley
Neonates are the pediatric population at highest risk for development of venous thromboembolism (VTE), and the incidence of VTE in the neonatal population is increasing. This is especially true in the critically ill population. Several large studies indicate that the incidence of neonatal VTE is up almost threefold in the last two decades. Central lines, fluid fluctuations, sepsis, liver dysfunction, and inflammation contribute to the risk profile for VTE development in ill neonates. In addition, the neonatal hemostatic system is different from that of older children and adults...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28632946/emerging-biomarkers-of-illness-severity-urinary-metabolites-associated-with-sepsis-and-necrotizing-methicillin-resistant-staphylococcus-aureus-pneumonia
#17
Lilliam Ambroggio, Todd A Florin, Samir S Shah, Richard Ruddy, Larisa Yeomans, Julie Trexel, Kathleen A Stringer
STUDY OBJECTIVE: To illustrate the potential of metabolomics to identify novel biomarkers of illness severity in a child with fatal necrotizing pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA). DESIGN: Case report with two control groups and a metabolomics analysis. PATIENTS: An infant with fatal MRSA pneumonia, four children with influenza pneumonia (pneumonia control group), and seven healthy children with no known infections (healthy control group)...
June 20, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28632924/metabolomics-as-a-driver-in-advancing-precision-medicine-in-sepsis
#18
Michelle Eckerle, Lilliam Ambroggio, Michael Puskarich, Brent Winston, Alan E Jones, Theodore J Standiford, Kathleen A Stringer
OBJECTIVE: The objective of this review is to explain the science of metabolomics-a science of systems biology that measures and studies endogenous small molecules (metabolites) that are present in a single biological sample-and its application to the diagnosis and treatment of sepsis. In addition, we discuss how discovery through metabolomics can contribute to the development of precision medicine targets for this complex disease state and the potential avenues for those new discoveries to be applied in the clinical environment...
June 20, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28625245/-effects-of-different-sedation-regimens-on-sedation-and-inflammatory-response-in-critically-ill-children-with-multiple-trauma
#19
Wenjia Tong, Conglei Song, Danqun Jin, Jingmin Sun, Yating Wang, Daliang Xu
OBJECTIVE: To compare the sedation and anti-inflammatory effects of dexmedetomidine and midazolam on critical ill children with multiple trauma. METHODS: A prospective randomized controlled trial was conducted. Sixty-five critical ill children with multiple trauma admitted to pediatric intensive care unit (PICU) of Anhui Province Children's Hospital from January 2014 to September 2016 were enrolled, who were randomly divided into dexmedetomidine group (33 cases) and midazolam group (32 cases)...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28622279/hydrogen-sulphide-in-exhaled-gases-from-ventilated-septic-neonates-and-children-a-preliminary-report
#20
Natalie Bee, Ruth White, Andy J Petros
OBJECTIVES: There is increasing interest in hydrogen sulphide as a marker of pathologic conditions or predictors of outcome. We speculate that as hydrogen sulphide is a diffusible molecule, if there is an increase in plasma hydrogen sulphide in sepsis, it may accumulate in the alveolar space and be detected in exhaled gas. "We wished to determine whether we could detect hydrogen sulphide in exhaled gases of ventilated children and neonates and if the levels changed in sepsis." DESIGN: Prospective, observational study...
June 15, 2017: Pediatric Critical Care Medicine
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