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Evidence based practics pediatrics

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https://www.readbyqxmd.com/read/29677085/surgical-antimicrobial-prophylaxis-among-pediatric-patients-in-south-africa-comparing-two-healthcare-settings
#1
Nicolene van der Sandt, Natalie Schellack, Lindi A Mabope, Mothahadini Pb Mawela, Danie Kruger, Brian Godman
BACKGROUND: Appropriate use of surgical antimicrobial prophylaxis (SAP) is a concern in view of its impact on morbidity, mortality and costs. Little is currently known about SAP in South Africa. OBJECTIVE: Assess compliance to SAP guidelines for pediatric patients undergoing surgery in one of four surgical sub-specialties among hospitals in South Africa. METHODS: Eight month retrospective chart review in both a teaching hospital and a private hospital between February and August 2015...
April 19, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29669522/home-based-bimanual-training-based-on-motor-learning-principles-in-children-with-unilateral-cerebral-palsy-and-their-parents-the-coad-study-rationale-and-protocols
#2
Marlous Schnackers, Laura Beckers, Yvonne Janssen-Potten, Pauline Aarts, Eugène Rameckers, Jan van der Burg, Imelda de Groot, Rob Smeets, Sander Geurts, Bert Steenbergen
BACKGROUND: Home-based training is considered an important intervention in rehabilitation of children with unilateral cerebral palsy. Despite consensus on the value of home-based upper limb training, no evidence-based best practice exists. Promoting compliance of children to adhere to an intensive program while keeping parental stress levels low is an important challenge when designing home-based training programs. Incorporating implicit motor learning principles emerges to be a promising method to resolve this challenge...
April 18, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29668024/nutrition-considerations-after-nicu-discharge
#3
Taylor Peters, Cecelia Pompeii-Wolfe
Preterm infants are at high nutrition risk during neonatal intensive care and well after discharge. Nutrition care should be individualized and provided by a multidisciplinary team including a dietitian. Breast milk, the gold standard for feeding, may not meet the increased needs of preterm infants and may require fortification or supplementation. Decisions regarding formula choice and calorie concentration can also be challenging and require individualization based on growth, intake, and individual need. Developmental milestones should be considered during the initation of complementary food...
April 1, 2018: Pediatric Annals
https://www.readbyqxmd.com/read/29663585/perioperative-anticoagulation-practices-for-pediatric-liver-transplantation
#4
Stylianos Voulgarelis, Bernadette Vitola, Stacee M Lerret, Johnny C Hong, John P Scott
Despite continued advancements in perioperative care for pediatric liver transplant (LT), graft-threatening vascular occlusion events including hepatic artery thrombosis (HAT) and portal vein thrombosis (PVT) remain a source of significant morbidity and mortality. Perioperative anticoagulation is commonly used for the prevention of HAT and PVT, but evidence-based guidelines are lacking. The goals of this survey were to determine the frequency of use of an anticoagulation protocol and to describe variation in anticoagulation practices among pediatric LT centers...
April 16, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29659467/a-standard-push-pull-protocol-for-waste-free-sampling-in-the-pediatric-intensive-care-unit
#5
Clare McBride, Suzan Miller-Hoover, James A Proudfoot
Blood sampling is a major source of blood loss in the pediatric intensive care unit (PICU). Blood-sparing sampling techniques such as the push-pull method can significantly reduce sampling-related blood loss and protect patients from anemia and blood transfusions. The push-pull method is supported by research evidence for central venous catheter (CVC) sampling, but research protocols differ and not all CVCs and laboratory tests have been studied. A standard push-pull protocol for the PICU was developed, implemented, and evaluated in this evidence-based practice project...
May 2018: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
https://www.readbyqxmd.com/read/29651656/using-lithium-in-children-and-adolescents-with-bipolar-disorder-efficacy-tolerability-and-practical-considerations
#6
REVIEW
B Grant, J A Salpekar
Lithium has been an intriguing treatment option in psychiatry for over a century. While seemingly just a simple elemental compound, it has powerful treatment effects for both depression and bipolar disorder. The evidence base for treatment of pediatric bipolar disorder is relatively small, but, in recent years, additional clinical trial data have enabled lithium to re-emerge as a valuable and, in many cases, preferred treatment. Pharmacologically, lithium is complex, with varied effects at both intracellular and extracellular levels...
April 12, 2018: Paediatric Drugs
https://www.readbyqxmd.com/read/29650310/electronic-health-record-with-computerized-decision-support-tools-for-the-purposes-of-a-pediatric-cardiovascular-heart-disease-screening-program-in-crete
#7
Ilias Chatzakis, Kostas Vassilakis, Christos Lionis, Ioannis Germanakis
BACKGROUND AND OBJECTIVE: Early detection of cardiovascular (CV) disease or associated risk factors during childhood is of paramount importance, allowing for early treatment or lifestyle modifications, respectively. The objective of this study was to describe the development of an electronic health record (EHR), with integrated computerized decision support system (CDSS), specifically designed for supporting the needs of a pilot pediatric CV disease screening program applied on primary school students of a Mediterranean island...
June 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29626437/dynamic-reference-intervals-for-coagulation-parameters-from-infancy-to-adolescence
#8
Christina Weidhofer, Meyer Elias, Ristl Robin, Helmut Wiedemann, Janne Cadamuro, Kipman Ulrike, Jakob Zierk, Christoph Male, Peter Quehenberger, Elisabeth Haschke-Becher, Elisa Einwallner
INTRODUCTION: Practical and ethical challenges as well as time and costs have restricted the generation of pediatric reference intervals. Therefore, pediatric reference intervals on coagulation parameters based on solid evidence are still scarce. Furthermore, reference intervals by age-group cannot reflect the dynamics of age and sex specific coagulation values during childhood. This study is the first to close this gap and provide continuous age and sex dependent reference intervals during childhood in hemostasis...
April 4, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29622322/bronchiolitis-from-practice-guideline-to-clinical-practice
#9
REVIEW
Maybelle Kou, Vivian Hwang, Nadira Ramkellawan
The American Academy of Pediatrics' clinical practice guideline in bronchiolitis was last updated in 2014 with recommendations to improve care for pediatric patients with bronchiolitis. As most treatments of bronchiolitis are supportive, the guideline minimizes the breadth of treatments previously used and cautions the use of tests and therapies that have a limited evidence base. Emergency physicians must be familiar with the guidelines in order to apply best practices appropriately.
May 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29618625/getting-serious-about-the-early-life-epilepsies-lessons-from-the-world-of-pediatric-oncology
#10
REVIEW
Anne T Berg, Stewart Goldman
Early-life epilepsies represent a group of many individually rare and often complex developmental brain disorders associated with lifelong devastating consequences and high risk for early mortality. The quantity and quality of evidence needed to guide the evaluation and treatment to optimize outcomes of affected children is minimal; most children are treated within an evidence-free practice zone based solely on anecdote and lore. The remarkable advances in diagnostics and therapeutics are implemented haphazardly with no systematic effort to understand their effects and value...
April 4, 2018: Neurology
https://www.readbyqxmd.com/read/29608118/a-global-health-training-model-for-teaching-pediatric-clinical-decision-making-skills-to-rwandan-physical-therapists-a-case-report
#11
Kathryn Clark, Cara N Whalen Smith, Lori Kohls, Ines Musabyemariya, Egide Kayonga Ntagungira, Monika Mann, Steve R Fisher
BACKGROUND AND PURPOSE: There is increasing interest among physical therapists from high-income countries to participate in education development projects in low-income countries. However, there are few examples in the literature of effective developmental models or projects. This case report describes a model for improving pediatric clinical decision making skills among Rwandan physical therapists using best practices in clinical decision making, evidence-based practice where possible, and use of the International Classification of Functioning and Disability (ICF) model...
April 2, 2018: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/29603734/school-based-physical-therapy-services-and-student-functional-performance-at-school
#12
Sarah Westcott Mccoy, Susan K Effgen, Lisa A Chiarello, Lynn M Jeffries, Alejandro G Villasante Tezanos
AIM: We explored relationships of school-based physical therapy to standardized outcomes of students receiving physical therapy. METHOD: Using a practice-based evidence research design, School Function Assessment (SFA) outcomes of 296 students with disabilities (mean age 7y 4mo [standard deviation 2y]; 166 males, 130 females), served by 109 physical therapists, were explored. After training, therapists completed 10 SFA scales on students at the beginning and end of the school year...
March 30, 2018: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/29594260/endocrine-disorders-in-primary-mitochondrial-disease
#13
Iman S Al-Gadi, Richard H Haas, Marni J Falk, Amy Goldstein, Shana E McCormack
Context: Endocrine disorders are common in individuals with mitochondrial disease. To develop evidence-based screening practices in this high-risk population, updated age-stratified estimates of the prevalence of endocrine conditions are needed. Objective: To measure the point prevalence of selected endocrine disorders in individuals with mitochondrial disease. Design Setting and Patients: The North American Mitochondrial Disease Consortium Patient Registry is a large, prospective, physician-curated cohort study of individuals with mitochondrial disease...
April 1, 2018: Journal of the Endocrine Society
https://www.readbyqxmd.com/read/29592918/consensus-based-recommendations-for-the-management-of-uveitis-associated-with-juvenile-idiopathic-arthritis-the-share-initiative
#14
Tamas Constantin, Ivan Foeldvari, Jordi Anton, Joke de Boer, Severine Czitrom-Guillaume, Clive Edelsten, Raz Gepstein, Arnd Heiligenhaus, Clarissa A Pilkington, Gabriele Simonini, Yosef Uziel, Sebastian J Vastert, Nico M Wulffraat, Anne-Mieke Haasnoot, Karoline Walscheid, Annamária Pálinkás, Reshma Pattani, Zoltán Györgyi, Richárd Kozma, Victor Boom, Andrea Ponyi, Angelo Ravelli, Athimalaipet V Ramanan
BACKGROUND: In 2012, a European initiative called S ingle Hub and Access point for pediatric Rheumatology in Europe (SHARE) was launched to optimise and disseminate diagnostic and management regimens in Europe for children and young adults with rheumatic diseases. Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children and uveitis is possibly its most devastating extra-articular manifestation. Evidence-based guidelines are sparse and management is mostly based on physicians' experience...
March 28, 2018: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/29592851/development-of-a-provisional-essential-medicines-list-for-children-in-canada-consensus-process
#15
Hannah Woods, Efosa Oronsaye, Anjli Bali, Yathavan Rajakulasingam, Taehoon Lee, Norman Umali, Eyal Cohen, Yaron Finkelstein, Martin Offringa, Nav Persaud
BACKGROUND: Worldwide, many countries have developed a list of essential medicines for children to improve prescribing. We aimed to create an essential medicines list for children in Canada. METHODS: We adapted the previously created preliminary list of essential medicines for adults in Canada and the WHO Model List of Essential Medicines for Children to create a provisional list of essential medicines for children in Canada. Canadian clinicians made suggestions for changes...
March 26, 2018: CMAJ Open
https://www.readbyqxmd.com/read/29570554/paediatric-intestinal-pseudo-obstruction-evidence-and-consensus-based-recommendations-from-an-espghan-led-expert-group
#16
Nikhil Thapar, Efstratios Saliakellis, Marc A Benninga, Osvaldo Borrelli, Joe Curry, Christophe Faure, Roberto De Giorgio, Girish Gupte, Charles H Knowles, Annamaria Staiano, Yvan Vandenplas, Carlo Di Lorenzo
OBJECTIVES: Chronic intestinal pseudo-obstructive (CIPO) conditions are considered the most severe disorders of gut motility. They continue to present significant challenges in clinical care despite considerable recent progress in our understanding of pathophysiology, resulting in unacceptable levels of morbidity and mortality. Major contributors to the disappointing lack of progress in paediatric CIPO include a dearth of clarity and uniformity across all aspects of clinical care from definition and diagnosis to management...
March 22, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29570147/nutrition-in-pediatric-inflammatory-bowel-disease-a-position-paper-on-behalf-of-the-porto-inflammatory-bowel-disease-group-of-the-european-society-of-pediatric-gastroenterology-hepatology-and-nutrition
#17
Erasmo Miele, Raanan Shamir, Marina Aloi, Amit Assa, Christian Braegger, Jiri Bronsky, Lissy de Ridder, Johanna C Escher, Iva Hojsak, Sanja Kolaček, Sibylle Koletzko, Arie Levine, Paolo Lionetti, Massimo Martinelli, Frank Ruemmele, Richard K Russell, Rotem Sigall Boneh, Johan van Limbergen, Gigi Veereman, Annamaria Staiano
BACKGROUND AND AIMS: A growing body of evidence supports the need for detailed attention to nutrition and diet in children with inflammatory bowel disease (IBD). We aimed to define the steps in instituting dietary or nutritional management in light of the current evidence and to offer a useful and practical guide to physicians and dieticians involved in the care of pediatric IBD patients. METHODS: A group of 20 experts in pediatric IBD participated in an iterative consensus process including 2 face-to-face meetings, following an open call to Nutrition Committee of the European Society of Pediatric Gastroenterology, Hepatology and Nutrition Porto, IBD Interest, and Nutrition Committee...
April 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29558972/dolutegravir-based-anti-retroviral-therapy-is-effective-and-safe-in-hiv-infected-paediatric-patients
#18
Eugenia Bruzzese, Andrea Lo Vecchio, Andrea Smarrazzo, Orsola Tambaro, Giulia Palmiero, Giovanni Bonadies, Alfredo Guarino
BACKGROUND: Treatment of HIV infection in adolescents is challenging due to long duration of therapy and poor adherence. Recently, the integrase strand transfer inhibitor dolutegravir (DTG) has been approved for the use in adolescents with HIV, but evidence in clinical practice is very limited. METHODS: We describe six cases of HIV-infected children/adolescents successfully treated with DTG-based regimen. Data relative to children/adolescents managed at the Referral Center for Pediatric HIV/AIDS of the University of Naples were reviewed...
March 20, 2018: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29557187/parental-self-assessment-of-behavioral-effectiveness-in-young-children-and-views-on-corporal-punishment-in-an-academic-pediatric-practice
#19
Lance B Irons, Heidi Flatin, Maya T Harrington, Turaj Vazifedan, John W Harrington
This article assesses parental confidence and current behavioral techniques used by mostly African American caregivers of young children in an urban Southeastern setting, including their use and attitudes toward corporal punishment (CP). Two hundred and fifty parental participants of children aged 18 months to 5 years completed a survey on factors affecting their behavioral management and views on CP. Statistical analysis included χ2 test and logistic regression with confidence interval significance determined at P <...
March 1, 2018: Clinical Pediatrics
https://www.readbyqxmd.com/read/29549437/treatment-of-eosinophilic-esophagitis-in-the-pediatric-patient-an-evidence-based-approach
#20
REVIEW
Mery Munoz-Persy, Alfredo J Lucendo
Eosinophilic esophagitis (EoE) is a unique form of non-IgE-mediated food allergy characterized by esophageal eosinophilic infiltration that commonly causes dysphagia and food impaction in children and adolescents. Assessing the efficacy of dietary restrictions or drug therapies to achieve clinical and histologic resolution of EoE through randomized controlled trials and meta-analyses has resulted in new evidence-based guidelines. Avoiding food triggers is the only therapy targeting the cause of the disease...
March 17, 2018: European Journal of Pediatrics
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