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https://www.readbyqxmd.com/read/27082664/uncommon-manifestations-of-intervertebral-disk-pathologic-conditions
#1
REVIEW
Felix E Diehn, Timothy P Maus, Jonathan M Morris, Carrie M Carr, Amy L Kotsenas, Patrick H Luetmer, Vance T Lehman, Kent R Thielen, Ahmad Nassr, John T Wald
Beyond the familiar disk herniations with typical clinical features, intervertebral disk pathologic conditions can have a wide spectrum of imaging and clinical manifestations. The goal of this review is to illustrate and discuss unusual manifestations of intervertebral disk pathologic conditions that radiologists may encounter, including disk herniations in unusual locations, those with atypical imaging features, and those with uncommon pathophysiologic findings. Examples of atypical disk herniations presented include dorsal epidural, intradural, symptomatic thoracic (including giant calcified), extreme lateral (retroperitoneal), fluorine 18 fluorodeoxyglucose-avid, acute intravertebral (Schmorl node), and massive lumbar disk herniations...
May 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/25556105/novice-nurses-experiences-with-palliative-and-end-of-life-communication
#2
COMPARATIVE STUDY
Verna L Hendricks-Ferguson, Kathleen J Sawin, Kitty Montgomery, Claretta Dupree, Celeste R Phillips-Salimi, Barb Carr, Joan E Haase
Health care providers recognize that delivery of effective communication with family members of children with life-threatening illnesses is essential to palliative and end-of-life care (PC/EOL). Parents value the presence of nurses during PC/EOL of their dying child. It is vital that nurses, regardless of their years of work experience, are competent and feel comfortable engaging family members of dying children in PC/EOL discussions. This qualitative-descriptive study used focus groups to explore the PC/EOL communication perspectives of 14 novice pediatric oncology nurses (eg, with less than 1 year of experience)...
July 2015: Journal of Pediatric Oncology Nursing: Official Journal of the Association of Pediatric Oncology Nurses
https://www.readbyqxmd.com/read/24395374/diagnostic-radiology-in-paediatric-palliative-care
#3
REVIEW
Preena Patel, Michelle Koh, Lucinda Carr, Kieran McHugh
Palliative care is an expanding specialty within paediatrics, which has attracted little attention in the paediatric radiological literature. Paediatric patients under a palliative care team will have numerous radiological tests which we traditionally categorise under organ systems rather than under the umbrella of palliative medicine. The prevalence of children with life-limiting illness is significant. It has been estimated to be one per thousand, and this may be an underestimate. In this review, we will focus on our experience at one institution, where radiology has proven to be an invaluable partner to palliative care...
January 2014: Pediatric Radiology
https://www.readbyqxmd.com/read/24340415/a-pediatric-residency-experience-with-surgical-co-management
#4
Anna Marie Carr, Matilde Irigoyen, Robert Samuel Wimmer, Allan Myron Arbeter
BACKGROUND AND OBJECTIVE: Acquisition of knowledge and skills in the care of surgical patients is defined as an essential element of training by the Pediatric Residency Review Committee. The pediatric-surgical comanagement model of care is increasingly utilized, yet its impact on residency training has not been described. The goal of this study was to describe a 5-year experience with a co-management model in a pediatric residency program. METHODS: We describe the planning and implementation of a surgical co-management model in a pediatric residency program and report on case volume and diversity from 2005 to 2010...
April 2013: Hospital Pediatrics
https://www.readbyqxmd.com/read/24315501/newborn-pulse-oximetry-screening-to-detect-critical-congenital-heart-disease
#5
Matthew A Studer, Ashley E Smith, Michael B Lustik, Michael R Carr
OBJECTIVES: To describe current practice and clarify provider opinion in the US with regard to newborn pulse oximetry screening (NPOx) for critical congenital heart disease. STUDY DESIGN: An internet-based questionnaire was forwarded to general pediatricians, neonatologists, and family medicine physicians. Physicians were surveyed regarding involvement in newborn medicine, knowledge of NPOx recommendations, and opinions regarding screening. NPOx protocol specifics were also queried...
March 2014: Journal of Pediatrics
https://www.readbyqxmd.com/read/24050795/a-pilot-study-describing-access-to-emergency-care-in-two-states-using-a-model-emergency-care-categorization-system
#6
Sage R Myers, Rama A Salhi, E Brooke Lerner, Rebecca Gilson, Andrea Kraus, John J Kelly, Stephen Hargarten, Brendan G Carr
OBJECTIVES: The Institute of Medicine (IOM)'s "Future of Emergency Care" report recommended the categorization and regionalization of emergency care, but no uniform system to categorize hospital emergency care capabilities has been developed. The absence of such a system limits the ability to benchmark outcomes, to develop regional systems of care, and of patients to make informed decisions when seeking emergency care. The authors sought to pilot the deployment of an emergency care categorization system in two states...
September 2013: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/23467635/safety-and-effectiveness-of-dexmedetomidine-in-the-pediatric-intensive-care-unit-sad-picu
#7
Laura Carney, Jennifer Kendrick, Roxane Carr
BACKGROUND: Critically ill children require sedation for comfort and to facilitate mechanical ventilation and interventions. Dexmedetomidine is a newer sedative with little safety data in pediatrics, particularly for therapy lasting longer than 48 h. OBJECTIVE: To quantify the frequency of adverse events and withdrawal syndromes associated with dexmedetomidine and to describe the use of this drug for continuous sedation in critically ill children. METHODS: In this retrospective study of patients who received dexmedetomidine for sedation in the pediatric intensive care unit, adverse events were assessed with the Naranjo scale to determine the likelihood of association with dexmedetomidine...
January 2013: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/22479107/use-of-methadone-for-prevention-of-opioid-withdrawal-in-critically-ill-children
#8
Sonia A Jeffries, Rumi McGloin, Alexander F Pitfield, Roxane R Carr
BACKGROUND: Opioids are commonly administered to critically ill children for analgesia and sedation, but many patients experience opioid withdrawal upon discontinuation. The authors' institution developed a protocol for using methadone to prevent opioid withdrawal in children who have received morphine by continuous IV infusion for 5 days or longer in the pediatric intensive care unit (PICU). OBJECTIVES: The primary objectives were to determine if opioids were tapered according to the protocol and to determine the conversion ratio for IV morphine to oral methadone that was used...
January 2012: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/22341416/uniquely-shaped-cardiovascular-stents-enhance-the-pressure-generation-of-intravascular-blood-pumps
#9
Amy L Throckmorton, James P Carr, William B Moskowitz, James J Gangemi, Christopher M Haggerty, Ajit P Yoganathan
OBJECTIVE: Advances in the geometric design of blood-contacting components are critically important as the use of minimally invasive, intravascular blood pumps becomes more pervasive in the treatment of adult and pediatric patients with congestive heart failure. The present study reports on the evaluation of uniquely shaped filaments and diffuser blades in the development of a protective stent for an intravascular cavopulmonary assist device for patients with a single ventricle. METHODS: We performed numeric modeling, hydraulic testing of 11 stents with an axial flow blood pump, and blood bag experiments (n = 6) of the top-performing stent geometries to measure the levels of hemolysis...
September 2012: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/21122020/regionalized-care-for-time-critical-conditions-lessons-learned-from-existing-networks
#10
Brendan G Carr, J Matthew Edwards, Ricardo Martinez
The 2010 Academic Emergency Medicine (AEM) consensus conference "Beyond Regionalization" aimed to place the design of a 21st century emergency care delivery system at the center of emergency medicine's (EM's) health policy research agenda. To examine the lessons learned from existing regional systems, consensus conference organizers convened a panel discussion made up of experts from the fields of acute care surgery, interventional cardiology, acute ischemic stroke, cardiac arrest, critical care medicine, pediatric EM, and medical toxicology...
December 2010: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/20333891/hospital-acquired-acute-hyponatremia-and-reports-of-pediatric-deaths
#11
Christine Koczmara, Andrew W Wade, Peter Skippen, Mary Jane Campigotto, Kim Streitenberger, Roxane Carr, Elaine Wong, Karen Robertson
Information from four voluntary reports of hospital-acquired acute hyponatremia leading to the death of otherwise healthy children is highlighted. In this column, we present two cases and information from a recent ISMP Canada Safety Bulletin, as well as two cases reported to ISMP United States. Information is shared to enhance health care practitioners' awareness of the potential for acute hyponatremia and to provide an overview of some of the potential underlying factors.
2010: Dynamics: the Official Journal of the Canadian Association of Critical Care Nurses
https://www.readbyqxmd.com/read/19644353/the-pediatric-surgeons-contribution-to-in-utero-treatment-of-twin-to-twin-transfusion-syndrome
#12
Fran├žois I Luks, Stephen R Carr, Christopher S Muratore, Barbara M O'Brien, Thomas F Tracy
OBJECTIVE: To evaluate the outcome of twin-to-twin transfusion syndrome (TTTS) treated using a combination of endoscopic fetal surgery-specific techniques and surgical restraint. SUMMARY BACKGROUND DATA: TTTS is a condition of identical twins that, if progressive and left untreated, leads to 100% mortality. The best treatment option is obliteration of the intertwin placental anastomoses, but fetal surgery carries significant maternal and fetal risks. Even if successful, percutaneous endoscopic laser ablation of placental vessels (LASER) causes premature rupture of membranes (PROM) in 10% to 20% of pregnancies...
September 2009: Annals of Surgery
https://www.readbyqxmd.com/read/17666231/autism-spectrum-disorders-in-early-childhood-an-overview-for-practicing-physicians
#13
REVIEW
James E Carr, Linda A LeBlanc
Autism spectrum disorders (ASDs) affect approximately 1 in 166 children in the United States, making it likely for the average physician to encounter patients with ASDs in his or her practice. In particular, pediatricians and developmental neurologists play a critical role in early identification, resource referrals, and management of a variety of comorbid physical and medical concerns. This article reviews the current literature on ASDs and provides recommendations for practice in areas critical to the provision of medical services...
June 2007: Primary Care
https://www.readbyqxmd.com/read/12793951/impedance-cardiographic-waveforms-in-children-involvement-in-left-ventricular-ejection-time-determination-during-anesthesia
#14
Eric Wodey, Lotfi Senhadji, Jean Yves Bansard, Xavier Beneux, Claude Ecoffey, Fran├žois Carre
OBJECTIVE: The physiologic basis of the impedance cardiographic (ICG) signal is still a matter of debate. An accurate determination of left ventricular ejection time (LVET) is needed to calculate stroke volume. In children, several shapes of the ICG signal are observed during anesthesia or in critical care. The aim of this study was to determine the relationship between the shape of the ICG signal and various morphologic and hemodynamic determinants obtained with Doppler echocardiography to highlight the effect of the various shapes in the accuracy of LVET determination...
July 2001: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/6444143/pediatric-emergency-care-in-a-metropolitan-area
#15
G C Fifield, C Magnuson, W P Carr, A S Deinard
Regional emergency medical services (EMS) system planning requires a data base describing the population to be served. No such regional data base exists for childhood emergencies. This study was undertaken for two reasons: (1) to establish, in a metropolitan region, the demographics of the population and the type of clinical problems for which pediatric emergency care is sought, and (2) to determine if the critical care categories used for EMS planning accurately reflect the emergency care needs of pediatric patients in the region...
1984: Journal of Emergency Medicine
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