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https://www.readbyqxmd.com/read/28330689/evaluation-of-methohexital-as-an-alternative-to-propofol-in-a-high-volume-outpatient-pediatric-sedation-service
#1
Nicholas E Jones, Michael S Kelleman, Harold K Simon, Jana A Stockwell, Courtney McCracken, Michael D Mallory, Pradip P Kamat
BACKGROUND: Propofol is a preferred agent for many pediatric sedation providers because of its rapid onset and short duration of action. It allows for quick turn around times and enhanced throughput. Occasionally, intravenous (IV) methohexital (MHX), an ultra-short acting barbiturate is utilized instead of propofol. OBJECTIVE: Describe the experience with MHX in a primarily propofol driven outpatient sedation program and to see if it serves as an acceptable alternative when propofol is not the preferred pharmacologic option...
March 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28296782/the-safety-and-efficacy-of-dexmedetomidine-remifentanil-in-children-undergoing-flexible-bronchoscopy-a-retrospective-dose-finding-trial
#2
Xia Li, Xue Wang, Shuguang Jin, Dongsheng Zhang, Yanuo Li
Flexible bronchoscopy is more and more used for diagnosis and management of various pulmonary diseases in pediatrics. As poor coordination of children, the procedure is usually performed under general anesthesia with spontaneous or controlled ventilation to increase children and bronchoscopists' safety and comfort. Previous studies have reported that dexmedetomidine (DEX) could be safely and effectively used for flexible bronchoscopy in both adulate and children. However, there is no trial to evaluate the dose-finding of safety and efficacy of dexmedetomidine-remifentanil (DEX-RF) in children undergoing flexible bronchoscopy...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28262319/initiation-of-an-inhaled-corticosteroid-during-a-pediatric-emergency-visit-for-asthma-a%C3%A2-randomized-clinical-trial
#3
Esther M Sampayo, Maryann Mazer-Amirshahi, Elizabeth A Camp, Joseph J Zorc
STUDY OBJECTIVE: We determine whether prescribing an inhaled corticosteroid during a pediatric emergency department (ED) asthma visit increases ongoing use and improves outcomes. METHODS: This randomized trial enrolled children aged 1 to 18 years, with persistent asthma not previously prescribed a controller medication, and who were being discharged after ED asthma treatment. Intervention subjects received a 1-month prescription for an inhaled corticosteroid (fluticasone or budesonide by age) in addition to standard asthma therapy and instructions given to all patients...
February 24, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28216959/prescription-patterns-and-appropriateness-of-antibiotics-in-the-management-of-cough-cold-and-diarrhea-in-a-rural-tertiary-care-teaching-hospital
#4
Akram Ahmad, Muhammad Umair Khan, Sadiqa Malik, Guru Prasad Mohanta, S Parimalakrishnan, Isha Patel, Sameer Dhingra
BACKGROUND: Acute gastroenteritis and respiratory illnesses are the major causes of morbidity and mortality in children under 5 years of age. The objective of this study was to evaluate the prescription pattern of antibiotic utilization during the treatment of cough/cold and/or diarrhea in pediatric patients. METHODS: A descriptive, cross-sectional study was conducted for 6 months in pediatric units of a tertiary care hospital in South India. Children under 5 years of age presenting with illness related to diarrhea and/or cough/cold were included in this study...
October 2016: Journal of Pharmacy & Bioallied Sciences
https://www.readbyqxmd.com/read/28214369/diagnostic-accuracy-of-history-physical-exam-laboratory-tests-and-point-of-care-ultrasound-for-pediatric-acute-appendicitis-in-the-emergency-department-a-systematic-review-and-meta-analysis
#5
Roshanak Benabbas, Mark Hanna, Jay Shah, Richard Sinert
BACKGROUND: Acute appendicitis (AA) is the most common surgical emergency in children. Accurate and timely diagnosis is crucial but challenging due to atypical presentations and the inherent difficulty of obtaining a reliable history and physical examination in younger children. OBJECTIVES: To determine the utility of history, physical exam, laboratory tests, Pediatric Appendicitis Score (PAS) and Emergency Department-Point-of-Care Ultrasound (ED-POCUS) in the diagnosis of AA in ED pediatric patients...
February 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28192581/necrotizing-pneumonia
#6
Elitsa V Nicolaou, Allison H Bartlett
Necrotizing pneumonia refers to the development of necrosis, liquefication, and cavitation of the lung parenchyma from an infectious pathogen. Nearly 4% of all community-acquired pneumonias are necrotizing, although studies retrospectively evaluating the incidence have found it to be increasing during the past 20 years. Common presenting symptoms include fever, tachypnea, and cough, and most of those afflicted also develop complications such as parapneumonic effusions, empyemas, or bronchopleural fistulae. When compared to age-matched controls with parapneumonic effusions or severe pneumonias without a necrotizing component, those with necrotizing pneumonia have been shown to have more elevated white blood cell counts and inflammatory markers that take longer to normalize, a longer duration of symptoms despite initiation of therapy, and a longer hospital stay...
February 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28187061/bronchopulmonary-disease-caused-by-flagellated-protozoa-infection-in-15-chinese-children
#7
Jinrong Liu, Shaogang Li, Huimin Li, Yimu Fan, Haiming Yang, Hui Xu, Yuelin Shen, Shunying Zhao
BACKGROUND: Bronchopulmonary disease caused by flagellated protozoa infection (BPFP) is thought to be rare in children but may be an emerging or underestimated disease, especially in developing countries. METHODS: In this study, we retrospectively reviewed records of 15 patients who were presented with a cough, wheezing or bronchopulmonary disease of unknown causes during admission, and patients who were finally diagnosed with BPFP from January 2014 to January 2015 were enrolled...
April 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28141725/acute-agitation-and-self-injury-in-a-5-year-old-with-autism
#8
Jason Schweitzer, Christine James, Willough Jenkins, Michael I Reiff, Martin T Stein
A 5-year-old nonverbal child with autism spectrum disorder (ASD) was admitted to inpatient pediatrics with new onset agitation and self-injurious behavior. His parents described him as a pleasant child without previous episodes of self-injury. Four days before admission, the parents noted new irritability followed by 2 days of self-injury to the face without clear precipitant. His hitting intensified with closed fist to face, and he required parental physical restraint to prevent further injury. Car rides and ibuprofen provided only temporary relief...
February 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28115672/rickettsia-felis-infection-in-febrile-children-ghana
#9
Peter Sothmann, Christian Keller, Ralf Krumkamp, Benno Kreuels, Cassandra Aldrich, Nimako Sarpong, Stefanie Steierberg, Doris Winter, Kennedy Gyau Boahen, Ellis Owusu-Dabo, Jürgen May, Daniel Eibach
Rickettsial infections are an underrecognized cause of febrile illness in sub-Saharan Africa. To evaluate the epidemiology and clinical features of rickettsial disease in pediatric patients in Ghana, we screened blood samples from febrile children aged less than 15 years presenting to an outpatient department in Ghana's Ashanti Region for the presence of rickettsial DNA. We detected Rickettsia felis in 7/470 (1.5%) blood samples, using two independent real-time polymerase chain reactions. No other Rickettsia species were found...
January 23, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28108152/vocal-symptoms-and-voice-quality-in-children-with-allergy-and-asthma
#10
Emma Kallvik, Johannes Savolainen, Susanna Simberg
OBJECTIVES: The background for dysphonia is multifactorial, and health-related factors have been listed among the factors affecting voice. In previous studies with adult participants, allergy and asthma have been indicated to have a connection to vocal symptoms. With the majority of previous research being studies involving adult participants, it is unclear what the effect of allergy and asthma on children's voices is. The aim of this study was to investigate if allergies and asthma are risk factors for having vocal symptoms...
January 17, 2017: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/28103276/comparison-of-the-effect-of-two-kinds-of-iranian-honey-and-diphenhydramine-on-nocturnal-cough-and-the-sleep-quality-in-coughing-children-and-their-parents
#11
Parviz Ayazi, Abolfazl Mahyar, Mahdieh Yousef-Zanjani, Abbas Allami, Neda Esmailzadehha, Taraneh Beyhaghi
Coughing in a child induced by upper respiratory tract infections (URTIs) can be a problem, both for the child and its parents. Current studies show a lack of proven efficacy for over-the counter (OTC) medications, but promising data support the use of honey for children. The aim of this study was to compare the effects of two kinds of Iranian honey with diphenhydramine (DPH) on nocturnal pediatric coughs and the sleep quality of children and their parents. This was a clinical trial (registered in IRCT; No...
2017: PloS One
https://www.readbyqxmd.com/read/28029746/respiratory-manifestations-in-38-patients-with-alstr%C3%A3-m-syndrome
#12
Caroline Boerwinkle, Jan D Marshall, Joy Bryant, William A Gahl, Kenneth N Olivier, Meral Gunay-Aygun
OBJECTIVES: Alström syndrome (AS) is a rare, multi-system condition characterized by retinal degeneration, sensorineural hearing loss, obesity, insulin-resistant diabetes, hypertriglyceridemia, cardiomyopathy, hepatorenal disease, and recurrent respiratory infections. It belongs to a group of genetic disorders known as primary ciliopathies, which includes autosomal dominant and recessive polycystic kidney diseases, as well as Joubert and Bardet-Biedl syndromes. Prior studies have suggested phenotypic overlap between primary ciliopathies affecting the non-motile, sensory cilia, and primary ciliary dyskinesia (PCD), a motile ciliopathy characterized by respiratory tract disease...
December 28, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28028956/assessment-of-clinical-symptoms-and-multichannel-intraluminal-impedance-and-ph-monitoring-in-children-after-thoracoscopic-repair-of-esophageal-atresia-and-distal-tracheoesophageal-fistula
#13
Barbara M Iwańczak, Agnieszka Kosmowska-Miśków, Anna Kofla-Dłubacz, Mateusz Palczewski, Michał Grabiński, Katarzyna Pawłowska, Krzysztof Matusiewicz, Dariusz Patkowski
BACKGROUND: Motility disturbances of the esophagus and gastroesophageal reflux disease (GERD) are observed frequently in children after repair of congenital esophageal atresia with distal tracheoesophageal fistula (EA/TEF). Recently, in many pediatric surgical centers, thoracoscopic repair was introduced, which theoretically would change the postoperative course. OBJECTIVES: The goal of the study was to assess physical development, disease symptoms, and GERD symptom frequency in children who underwent thoracoscopic surgery of congenital EA/TEF...
September 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28027807/-thoracoscopic-lobectomy-for-the-treatment-of-tracheal-bronchus-a-pediatric-case-report
#14
Carlos García-Hernández, Lourdes Carvajal Figueroa, Ángel Celorio Alcántara, Sergio Landa-Juárez, Edmur Salinas Hernández
BACKGROUND: Tracheal bronchus is considered a rare, congenital anomaly, which implies the abnormal origin of a bronchus. When related to repetitive infections the bronchus must be resected, usually via an open procedure. OBJECTIVE: The aim of this paper is to present the case of a patient with tracheal bronchus of the upper right lobe who presented with repetitive pneumonias. Additionally, this text intends to expose the methodology for its diagnosis and surgical resolution through a thoracoscopic lobectomy...
December 24, 2016: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/27998905/care-variations-and-outcomes-for-children-hospitalized-with-bacterial-tracheostomy-associated-respiratory-infections
#15
Christopher J Russell, Wendy J Mack, Sheree M Schrager, Susan Wu
OBJECTIVES: Identify hospital-level care variations and association with length of stay (LOS) and hospital revisit in children with tracheostomies hospitalized for bacterial respiratory tract infections (bRTIs). METHODS: A multicenter, retrospective cohort study that used the Pediatric Health Information System database between 2007 and 2014 of patients with tracheostomies aged ≤18 years with a primary diagnosis of bRTI (eg, tracheitis) or a primary diagnosis of a bRTI symptom (eg, cough) and a secondary diagnosis of bRTI...
January 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/27994904/bronchial-foreign-body-alerting-of-a-bronchial-tumor-the-need-of-a-follow-up-radiography
#16
Nahida El-Rifai, Samar Shahine, Hassan Sidani, Ali Sabeh Aion, Antoine Deschildre, Marie-Christine Copin
Lung tumors are extremely rare in the pediatric population, comprising only 0.2% of all malignancies in children. Among them, mucoepidermoid carcinoma (MEC) is even rarer with a reported frequency of 0.1% to 0.2%. MEC is defined by the World Health Organization as a tumor characterized by a combination of mucus-secreting, squamous, and intermediate cell types. We describe the case of a 4-year-old girl who presented with a history of intermittent fever and nonproductive cough of 1-month duration after foreign body aspiration...
2016: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/27989273/beyond-test-and-treat-malaria-diagnosis-for-improved-pediatric-fever-management-in-sub-saharan-africa
#17
Emily White Johansson
BACKGROUND: Malaria rapid diagnostic tests (RDTs) have great potential to improve quality care and rational drug use in malaria-endemic settings although studies have shown common RDT non-compliance. Yet, evidence has largely been derived from limited hospital settings in few countries. This article reviews a PhD thesis that analyzed national surveys from multiple sub-Saharan African countries to generate large-scale evidence of malaria diagnosis practices and its determinants across different contexts...
2016: Global Health Action
https://www.readbyqxmd.com/read/27956727/assessment-of-cytokine-and-chemokine-signatures-as-potential-biomarkers-of-childhood-community-acquired-pneumonia-severity-a-nested-cohort-study-in-india
#18
Shanie Saghafian-Hedengren, Joseph L Mathew, Eva Hagel, Sunit Singhi, Pallab Ray, Sofia Ygberg, Anna Nilsson
BACKGROUND: Pediatric community-acquired pneumonia (CAP) is a leading cause of childhood mortality in developing countries. In resource-poor settings, pneumonia diagnosis is commonly made clinically, based on World Health Organization guidelines, where breathing difficulty or cough and age-adjusted tachypnea suffice to establish diagnosis. Also, the severity of CAP is generally based on clinical features and existing biomarkers do not reliably correlate to either clinical severity or outcome...
January 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27940698/use-of-low-value-pediatric-services-among-the-commercially-insured
#19
Kao-Ping Chua, Aaron L Schwartz, Anna Volerman, Rena M Conti, Elbert S Huang
BACKGROUND: Claims-based measures of "low-value" pediatric services could facilitate the implementation of interventions to reduce the provision of potentially harmful services to children. However, few such measures have been developed. METHODS: We developed claims-based measures of 20 services that typically do not improve child health according to evidence-based guidelines (eg, cough and cold medicines). Using these measures and claims from 4.4 million commercially insured US children in the 2014 Truven MarketScan Commercial Claims and Encounters database, we calculated the proportion of children who received at least 1 low-value pediatric service during the year, as well as total and out-of-pocket spending on these services...
December 2016: Pediatrics
https://www.readbyqxmd.com/read/27940507/titanium-dioxide-in-toothpaste-causing-yellow-nail-syndrome
#20
Ting-Yuan Hsu, Chun-Chen Lin, Ming-Dar Lee, Brian Pin-Hsuan Chang, Jeng-Daw Tsai
Yellow nail syndrome (YNS) is an uncommon disorder, the classic triad of which consists of yellow nails, lymphedema, and respiratory symptoms. Few pediatric cases have been reported. We report a 9-year-old girl with yellowish nail discoloration for 1 year accompanied by respiratory symptoms, including chronic cough, recurrent pneumonia, bronchiectasis, and chronic sinusitis. The patient was diagnosed with YNS. Knowing that a relationship between YNS and titanium has been reported, we collected her nail clippings and detected titanium in them by energy dispersive radiograph fluorescence...
January 2017: Pediatrics
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