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Evidence based practics pediatrics

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https://www.readbyqxmd.com/read/28631089/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#1
REVIEW
Alain Cariou, Jean-François Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28628596/from-disease-to-health-physical-therapy-health-promotion-practices-for-secondary-prevention-in-adult-and-pediatric-neurologic-populations
#2
Lori Quinn, Don Morgan
BACKGROUND AND PURPOSE: Over the last decade there has been a substantial increase in efforts to better understand how targeted physical activity and exercise interventions can be used to minimize secondary consequences arising from neurological damage in both adult and pediatric populations. This article offers an overview of contemporary research that addresses mediators of functional and neuroplastic adaptations associated with physical activity and exercise. We emphasize the important role that physical therapists can play to increase participation and improve well-being in adults and children with neurological disorders...
July 2017: Journal of Neurologic Physical Therapy: JNPT
https://www.readbyqxmd.com/read/28620754/variation-in-pediatric-post-ablation-care-a%C3%A2-survey-of-the-pediatric-and%C3%A2-congenital-electrophysiology-society-paces
#3
Brynn E Dechert, Macdonald Dick, David J Bradley, Martin J LaPage
Although catheter ablation is a standard treatment for pediatric arrhythmias, there are no consensus guidelines for follow-up care. This study describes the variation in post-ablation practices identified through a survey of the pediatric and congenital electrophysiology society (PACES). Pediatric and congenital electrophysiology society members were invited to participate in an online survey of post-ablation practices in September 2014. Survey questions targeted routine post-ablation practices for three common arrhythmia substrates: atrioventricular nodal reentry tachycardia, concealed accessory pathways (AP), and manifest APs...
June 15, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28612093/clinical-trial-design-in-juvenile-idiopathic-arthritis
#4
Stephen J Balevic, Mara L Becker, Michael Cohen-Wolkowiez, Laura E Schanberg
Randomized clinical trials provide the gold standard evidence base to guide clinical practice. Despite major advances in trial design, pediatric clinical trials are still difficult to perform and pose unique challenges, including the need to consider the impact of developmental changes in trial design. Advances within pediatric rheumatology combined with the need to comply with legislative requirements have driven new approaches to performing pediatric clinical trials such as utilization of large research networks, incorporation of patient and family stakeholders in the planning and implementation of clinical trials, and the development of novel trial designs...
June 13, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28612089/the-intensive-care-delirium-research-agenda-a-multinational-interprofessional-perspective
#5
REVIEW
Pratik P Pandharipande, E Wesley Ely, Rakesh C Arora, Michele C Balas, Malaz A Boustani, Gabriel Heras La Calle, Colm Cunningham, John W Devlin, Julius Elefante, Jin H Han, Alasdair M MacLullich, José R Maldonado, Alessandro Morandi, Dale M Needham, Valerie J Page, Louise Rose, Jorge I F Salluh, Tarek Sharshar, Yahya Shehabi, Yoanna Skrobik, Arjen J C Slooter, Heidi A B Smith
Delirium, a prevalent organ dysfunction in critically ill patients, is independently associated with increased morbidity. This last decade has witnessed an exponential growth in delirium research in hospitalized patients, including those critically ill, and this research has highlighted that delirium needs to be better understood mechanistically to help foster research that will ultimately lead to its prevention and treatment. In this invited, evidence-based paper, a multinational and interprofessional group of clinicians and researchers from within the fields of critical care medicine, psychiatry, pediatrics, anesthesiology, geriatrics, surgery, neurology, nursing, pharmacy, and the neurosciences sought to address five questions: (1) What is the current standard of care in managing ICU delirium? (2) What have been the major recent advances in delirium research and care? (3) What are the common delirium beliefs that have been challenged by recent trials? (4) What are the remaining areas of uncertainty in delirium research? (5) What are some of the top study areas/trials to be done in the next 10 years? Herein, we briefly review the epidemiology of delirium, the current best practices for management of critically ill patients at risk for delirium or experiencing delirium, identify recent advances in our understanding of delirium as well as gaps in knowledge, and discuss research opportunities and barriers to implementation, with the goal of promoting an integrated research agenda...
June 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28607213/consensus-guidelines-on-evaluation-and-management-of-the-febrile-child-presenting-to-the-emergency-department-in-india
#6
Prashant Mahajan, Prerna Batra, Neha Thakur, Reena Patel, Narendra Rai, Nitin Trivedi, Bernhard Fassl, Binita Shah, Marie Lozon, Rockerfeller A Oteng, Abhijeet Saha, Dheeraj Shah, Sagar Galwankar
JUSTIFICATION: No country-specific, evidence-based, consensus approach for the emergency department (ED) evaluation and management of the febrile child exist in India. PROCESS: We held two consensus meetings, performed an exhaustive literature review, and held ongoing web-based based discussions to arrive at a formal consensus on the proposed evaluation and management algorithm. The first meeting was held in Delhi in October 2015, under the auspices of Pediatric Emergency Medicine (PEM) Section of Academic College of Emergency Experts in India (ACEE-INDIA); and the second meeting was conducted at Pune during Emergency Medical Pediatrics and Recent Trends (EMPART 2016) in March 2016...
June 4, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/28604995/improving-healthcare-in-pediatric-oncology-development-and-testing-of-multiple-indicators-to-evaluate-a-hub-and-spoke-model
#7
Giulia Zucchetti, Nicoletta Bertorello, Angela Angelastro, Paola Gianino, Gianni Bona, Affif Barbara, Luigi Besenzon, Adalberto Brach Del Prever, Fernando Pesce, Marco Nangeroni, Franca Fagioli
PURPOSE: The hub-and-spoke is a new innovation model in healthcare that has been adopted in some countries to manage rare pathologies. We developed a set of indicators to assess current quality practices of the hub-and-spoke model adopted in the Interregional Pediatric Oncology Network in Northwest Italy and to promote patient, family, and professional healthcare empowerment. METHODS: Literature and evidence-based clinical guidelines were reviewed and multiprofessional team workshops were carried out to highlight some important issues on healthcare in pediatric oncology and to translate them into a set of multiple indicators...
June 6, 2017: Tumori
https://www.readbyqxmd.com/read/28599967/challenging-surgical-dogma-in-the-management-of-proximal-esophageal-atresia-with-distal-tracheoesophageal-fistula-outcomes-from-the-midwest-pediatric-surgery-consortium
#8
Dave R Lal, Samir K Gadepalli, Cynthia D Downard, Daniel J Ostlie, Peter C Minneci, Ruth M Swedler, Thomas H Chelius, Laura Cassidy, Cooper T Rapp, Deborah Billmire, Steven Bruch, R Carland Burns, Katherine J Deans, Mary E Fallat, Jason D Fraser, Julia Grabowski, Ferdynand Hebel, Michael A Helmrath, Ronald B Hirschl, Rashmi Kabre, Jonathan Kohler, Matthew P Landman, Charles M Leys, Grace Z Mak, Jessica Raque, Beth Rymeski, Jacqueline M Saito, Shawn D St Peter, Daniel von Allmen, Brad W Warner, Thomas T Sato
PURPOSE: Perioperative management of infants with esophageal atresia and tracheoesophageal fistula (EA/TEF) is frequently based on surgeon experience and dogma rather than evidence-based guidelines. This study examines whether commonly perceived important aspects of practice affect outcome in a contemporary multi-institutional cohort of patients undergoing primary repair for the most common type of esophageal atresia anomaly, proximal EA with distal TEF. METHODS: The Midwest Pediatric Surgery Consortium conducted a multicenter, retrospective study examining selected outcomes on infants diagnosed with proximal EA with distal TEF who underwent primary repair over a 5-year period (2009-2014), with a minimum 1-year follow up, across 11 centers...
June 1, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28599588/teaching-parents-about-responsive-feeding-through-a-vicarious-learning-video-a-pilot-randomized-controlled-trial
#9
Tracey Ledoux, Jessica Robinson, Tom Baranowski, Daniel P O'Connor
The American Academy of Pediatrics and World Health Organization recommend responsive feeding (RF) to promote healthy eating behaviors in early childhood. This project developed and tested a vicarious learning video to teach parents RF practices. A RF vicarious learning video was developed using community-based participatory research methods. Fifty parents of preschoolers were randomly assigned to watch Happier Meals or a control video about education. Knowledge and beliefs about RF practices were measured 1 week before and immediately after intervention...
June 1, 2017: Health Education & Behavior: the Official Publication of the Society for Public Health Education
https://www.readbyqxmd.com/read/28599026/transition-issues-and-challenges-for-youth-with-autism-spectrum-disorders
#10
Fred R Volkmar, Scott L J Jackson, Logan Hart
Earlier detection and effective, evidence-based practices are gradually improving outcomes for people with autism spectrum disorder (ASD). Although some continue to need intensive support as adults, an increasing number are now going to college, becoming independent, and marrying. With the transition to adulthood, people with ASD will face a number of significant challenges. Health care providers who are knowledgeable about these challenges can help foster better outcomes and support those requiring higher levels of care...
June 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28594525/update-in-pediatric-musculoskeletal-infections-when-it-is-when-it-isn-t-and-what-to-do
#11
Alexandre Arkader, Christopher M Brusalis, William C Warner, James H Conway, Kenneth Noonan
Musculoskeletal infections, including osteomyelitis, septic arthritis, and pyomyositis, are a substantial cause of morbidity in children and adolescents. The increased virulence of infectious agents and the increased prevalence of antimicrobial-resistant pathogens, particularly methicillin-resistant Staphylococcus aureus, have resulted in a more complicated clinical course for diagnosis and management, which is evidenced by an increased length of hospital stays, incidence of complications, and number of surgical interventions...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28593864/oral-immunotherapy-for-food-allergy-a-spanish-guideline-egg-and-milk-immunotherapy-spanish-guide-items-guide-part-ii
#12
A Martorell, E Alonso, L Echeverría, C Escudero, R García-Rodríguez, C Blasco, J Bone, J Borja-Segade, T Bracamonte, A Claver, J L Corzo, B De la Hoz, R Del Olmo, O Dominguez, V Fuentes-Aparicio, I Guallar, H Larramona, F Martín-Muñoz, V Matheu, A Michavila, I Ojeda, P Ojeda, M Piquer, P Poza, M Reche, P Rodríguez Del Río, M Rodríguez, F Ruano, S Sánchez-García, S Terrados, L Valdesoiro, M Vazquez-Ortiz
BACKGROUND AND OBJECTIVE: Cow´s milk and egg are the most frequent causes of food allergy in the first years of life. Treatments such as oral immunotherapy (OIT) have been investigated as an alternative to avoidance diets. No clinical practice guides on the management of OIT with milk and egg are currently available. Objectives: To develop a clinical guide on OIT based on the available scientific evidence and the opinions of experts. METHODS: A review was made of studies published in the period between 1984 and June 2016, Doctoral Theses published in Spain, and summaries of communications at congresses (SEAIC, SEICAP, EAACI, AAAAI), with evaluation of the opinion consensus established by a group of experts pertaining to the scientific societies SEICAP and SEAIC...
June 8, 2017: Journal of Investigational Allergology & Clinical Immunology
https://www.readbyqxmd.com/read/28593863/oral-immunotherapy-for-food-allergy-a-spanish-guideline-egg-and-milk-immunotherapy-spanish-guide-items-guide-part-i
#13
A Martorell, E Alonso, L Echeverría, C Escudero, R García-Rodríguez, C Blasco, J Bone, J Borja-Segade, T Bracamonte, A Claver, J L Corzo, B De la Hoz, R Del Olmo, O Dominguez, V Fuentes-Aparicio, I Guallar, H Larramona, F Martín-Muñoz, V Matheu, A Michavila, I Ojeda, P Ojeda, M Piquer, P Poza, M Reche, P Rodríguez Del Río, M Rodríguez, F Ruano, S Sánchez-García, S Terrados, L Valdesoiro, M Vazquez-Ortiz
BACKGROUND AND OBJECTIVE: Cow´s milk and egg are the most frequent causes of food allergy in the first years of life. Treatments such as oral immunotherapy (OIT) have been investigated as an alternative to avoidance diets. No clinical practice guides on the management of OIT with milk and egg are currently available. Objectives: To develop a clinical guide on OIT based on the available scientific evidence and the opinions of experts. METHODS: A review was made of studies published in the period between 1984 and June 2016, Doctoral Theses published in Spain, and summaries of communications at congresses (SEAIC, SEICAP, EAACI, AAAAI), with evaluation of the opinion consensus established by a group of experts pertaining to the scientific societies SEICAP and SEAIC...
June 6, 2017: Journal of Investigational Allergology & Clinical Immunology
https://www.readbyqxmd.com/read/28589256/treatment-of-congenital-pulmonary-airway-malformations-a-systematic-review-from-the-apsa-outcomes-and-evidence-based-practice-committee
#14
Cynthia D Downard, Casey M Calkins, Regan F Williams, Elizabeth J Renaud, Tim Jancelewicz, Julia Grabowski, Roshni Dasgupta, Milissa McKee, Robert Baird, Mary T Austin, Meghan A Arnold, Adam B Goldin, Julia Shelton, Saleem Islam
PURPOSE: Variation in management characterizes treatment of infants with a congenital pulmonary airway malformation (CPAM). This review addresses six clinically applicable questions using available evidence to provide recommendations for the treatment of these patients. METHODS: Questions regarding the management of a pediatric patient with a CPAM were generated. English language articles published between 1960 and 2014 were compiled after searching Medline and OvidSP...
June 6, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28577640/parent-refusal-of-topical-fluoride-for-their-children-clinical-strategies-and-future-research-priorities-to-improve-evidence-based-pediatric-dental-practice
#15
REVIEW
Donald L Chi
A growing number of parents are refusing topical fluoride for their children during preventive dental and medical visits. This nascent clinical and public health problem warrants attention from dental professionals and the scientific community. Clinical and community-based strategies are available to improve fluoride-related communications with parents and the public. In terms of future research priorities, there is a need to develop screening tools to identify parents who are likely to refuse topical fluoride and diagnostic instruments to uncover the reasons for topical fluoride refusal...
July 2017: Dental Clinics of North America
https://www.readbyqxmd.com/read/28574294/guidelines-for-the-provision-and-assessment-of-nutrition-support-therapy-in-the-pediatric-critically-ill-patient-society-of-critical-care-medicine-and-american-society-for-parenteral-and-enteral-nutrition
#16
Nilesh M Mehta, Heather E Skillman, Sharon Y Irving, Jorge A Coss-Bu, Sarah Vermilyea, Elizabeth Anne Farrington, Liam McKeever, Amber M Hall, Praveen S Goday, Carol Braunschweig
This document represents the first collaboration between 2 organizations-the American Society for Parenteral and Enteral Nutrition and the Society of Critical Care Medicine-to describe best practices in nutrition therapy in critically ill children. The target of these guidelines is intended to be the pediatric critically ill patient (>1 month and <18 years) expected to require a length of stay >2-3 days in a PICU admitting medical, surgical, and cardiac patients. In total, 2032 citations were scanned for relevance...
May 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28562106/enteral-nutrition-in-pediatric-intestinal-failure-does-initial-feeding-impact-on-intestinal-adaptation
#17
Teresa Capriati, Valerio Nobili, Laura Stronati, Salvatore Cucchiara, Francesca Laureti, Alessandra Liguori, Elaine Tyndall, Antonella Diamanti
Primary IF can be due to impaired gut length or impaired gut function; short bowel syndrome (SBS) is the leading cause of IF. In IF patients complete enteral starvation should be avoided whenever possible and enteral/oral nutrition (EN/ON) should be employed at the maximum tolerated amount in each phase of the clinical evolution of IF. Intraluminal nutrients have stimulatory effects on epithelial cells and on trophism that enhance intestinal adaptation. Areas covered: Evidence for nutritional interventions in pediatric IF is limited and of poor quality...
June 8, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28558342/the-measurement-properties-of-pediatric-observational-pain-scales-a-systematic-review-of-reviews
#18
REVIEW
Randi Dovland Andersen, Ann Langius-Eklöf, Britt Nakstad, Tomm Bernklev, Leena Jylli
BACKGROUND: Valid observational pain scales are needed to assess pain and ensure sufficient treatment of pain in children that lack the verbal ability to self-report pain. Published reviews attempt to synthesize results from primary studies validating these scales and based on the findings recommendations may be given, for example which pain scales are the most appropriate for use in different pediatric populations. OBJECTIVES: The aims of this review were to describe how systematic reviews have evaluated and recommended observational pain scales for use in children aged 0-18 years and appraise the evidence underlying these recommendations...
May 20, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28557776/the-breastfeeding-friendly-pediatric-office-practice
#19
Joan Younger Meek, Amy J Hatcher
The landscape of breastfeeding has changed over the past several decades as more women initiate breastfeeding in the postpartum period and more hospitals are designated as Baby-Friendly Hospitals by following the evidence-based Ten Steps to Successful Breastfeeding. The number of births in such facilities has increased more than sixfold over the past decade. With more women breastfeeding and stays in the maternity facilities lasting only a few days, the vast majority of continued breastfeeding support occurs in the community...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28557746/ethical-conduct-of-research-in-children-pediatricians-and-their-irb-part-1-of-2
#20
REVIEW
Carlos D Rose
As human experimentation continues to grow into an ever more complex and sophisticated endeavor, the relevant ethical and regulatory structures become more intricate. When pediatricians and general practitioners are invited by pharmaceutical companies to enroll their offices in a clinical trial or a multicenter observational study or when they develop their own research questions, they frequently find themselves at a loss in the human research environment. The legal and regulatory complexity may have an unintended deterring effect at a time when office-based high quality pediatric research is urgently needed to support evidence-based medicine...
May 2017: Pediatrics
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