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Pediatric Psychiatry

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https://www.readbyqxmd.com/read/28801871/pediatric-delirium-evaluation-management-and-special-considerations
#1
REVIEW
Nasuh Malas, Khyati Brahmbhatt, Cristin McDermott, Allanceson Smith, Roberto Ortiz-Aguayo, Susan Turkel
Delirium describes a syndrome of acute brain dysfunction with severe consequences on patient outcomes, medical cost, morbidity, and mortality. It represents a final common pathway of numerous pathophysiologic disturbances disrupting cerebral homeostasis. The diagnosis is predicated on recognition of the clinical features of the syndrome through ongoing clinical assessment. Early identification can be aided by routine screening, particularly in high-risk populations. Evaluation and management are continuous and simultaneous processes involving a multidisciplinary care team including child psychiatry consultation...
August 12, 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/28795915/where-teachers-are-few-documenting-available-faculty-in-five-tanzanian-medical-schools
#2
Charles A Mkony, Ephata E Kaaya, Alex J Goodell, Sarah B Macfarlane
Background Faced with one of the lowest physician-to-population ratios in the world, the Government of Tanzania is urging its medical schools to train more physicians. The annual number of medical students admitted across the country rose from 55 in the 1990s to 1,680 approved places for the 2015/16 academic year. These escalating numbers strain existing faculty. Objective To describe the availability of faculty in medical schools in Tanzania. Design We identified faculty lists published on the Internet by five Tanzanian medical schools for the 2011/12 academic year and analyzed the appointment status, rank, discipline, and qualifications of faculty members...
December 2016: Global Health Action
https://www.readbyqxmd.com/read/28794910/first-report-of-two-rare-entities-in-a-family-49-xxxxy-and-45-x
#3
Yavuz Şahin, Aysegül Özcan
49,XXXXY and 45,X syndromes are sex chromosome aneuploidies in which the affected individuals present with hypergonadotropic hypogonadism, short or long stature, and skeletal malformations. Psychological, endocrinological, and orthopaedic disorders constitute the major problems in the clinical follow-up. We report a family with two rare entities: 49,XXXXY and 45, X. Sex chromosome abnormalities should especially be in mind in the evaluation of patients with micropenis, mental retardation, and hypergonadotropic hypogonadism...
September 2017: Journal of Pediatric Genetics
https://www.readbyqxmd.com/read/28747934/avoidant-restrictive-food-intake-disorder-in-an-11-year-old-south-american-boy-medical-and-cultural-challenges
#4
Jonah Schermbrucker, Melissa Kimber, Natasha Johnson, Sarah Kearney, Jennifer Couturier
Avoidant/Restrictive Food Intake Disorder (ARFID) is new in the DSM-5, replacing the DSM-IV-TR diagnosis of Feeding Disorder of Infancy or Early Childhood. ARFID has no age criterion, and therefore addresses eating disturbances across the lifespan. This report illustrates the case of an 11-year-old boy of Colombian ancestry with ARFID and explores the role of culture in the diagnosis of ARFID. To date, literature describing this disorder is limited. ARFID is often seen in the child and adolescent population and can have significant medical consequences, including weight loss, hemodynamic instability, and growth retardation...
July 2017: Journal of the Canadian Academy of Child and Adolescent Psychiatry
https://www.readbyqxmd.com/read/28747930/parental-involvement-and-child-and-adolescent-eating-disorders-perspectives-from-residents-in-psychiatry-pediatrics-and-family-medicine
#5
Tamara Davidson Marcon, Laura Girz, Amanda Stillar, Carole Tessier, Adele Lafrance
OBJECTIVES: Best practice guidelines encourage the involvement of parents in the assessment and treatment of child/adolescent eating disorders (ED). This study investigated medical residents' perspectives regarding parental involvement as well as their expectations for future practice in the assessment and treatment of ED. METHOD: Five hundred and eighty-four medical residents from 17 Canadian residency programs specializing in family medicine, pediatrics, and psychiatry completed a web-based survey...
July 2017: Journal of the Canadian Academy of Child and Adolescent Psychiatry
https://www.readbyqxmd.com/read/28707231/a-medical-student-run-child-and-adolescent-psychiatry-clinic-one-institution-s-experience
#6
Cassandra A Murzl, Tyler A Durns, Lorin T Mowrey, Andrew S Tubbs, Sally A Boeve
OBJECTIVE: This report examines the experience of one institution's development of the first student-run psychiatry clinic that serves both adult and pediatric populations. METHODS: The clinic is held weekly with pre-clinical and clinical medical student volunteers under the supervision of board-certified adult and child psychiatrists. The development and evolution of the clinic over time are evaluated with particular attention to obstacles overcome. Medical student volunteers were surveyed retrospectively to evaluate their experience with patients with psychiatric illness, skill development, and interest in psychiatry...
July 13, 2017: Academic Psychiatry
https://www.readbyqxmd.com/read/28699564/detecting-clinically-relevant-new-information-in-clinical-notes-across-specialties-and-settings
#7
Rui Zhang, Serguei V S Pakhomov, Elliot G Arsoniadis, Janet T Lee, Yan Wang, Genevieve B Melton
BACKGROUND: Automated methods for identifying clinically relevant new versus redundant information in electronic health record (EHR) clinical notes is useful for clinicians and researchers involved in patient care and clinical research, respectively. We evaluated methods to automatically identify clinically relevant new information in clinical notes, and compared the quantity of redundant information across specialties and clinical settings. METHODS: Statistical language models augmented with semantic similarity measures were evaluated as a means to detect and quantify clinically relevant new and redundant information over longitudinal clinical notes for a given patient...
July 5, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28688664/a-novel-flight-surgeon-training-model-at-a-joint-military-and-civilian-surgical-residency-program
#8
Erik S DeSoucy, Scott A Zakaluzny, Joseph M Galante
BACKGROUND: Graduating military preliminary interns are often required to fill flight surgeon billets. General surgery preliminary interns get experience evaluating surgical and trauma patients, but receive very little training in primary care and flight medicine. At a joint military and civilian training program, we developed a supplemental curriculum to help transition our interns into flight medicine. METHODS: From 2013 to 2016, we developed a lecture series focused on aerospace medicine, primary care, and specialty topics including dermatology, ophthalmology, orthopedics, pediatrics, psychiatry, and women's health...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28659239/a-causality-algorithm-to-guide-diagnosis-and-treatment-of-catatonia-due-to-autoimmune-conditions-in-children-and-adolescents
#9
Vladimir Ferrafiat, Marie Raffin, Elena Freri, Tiziana Granata, Nardo Nardocci, Federica Zibordi, Nicolas Bodeau, Xavier Benarous, Bertrand Olliac, Elise Riquin, Jean Xavier, Sylvie Viaux, Julien Haroche, Zahir Amoura, Priscille Gerardin, David Cohen, Angèle Consoli
OBJECTIVES: Pediatric catatonia is a rare and life-threatening syndrome. Around 20% of juvenile catatonia is associated with organic condition (Consoli et al., 2012). Autoimmune conditions represent a diagnostic and therapeutic challenge since specific antibodies can be missed. To facilitate decision making, we recently formulated a causality assessment score (CAUS) using a stepwise approach and an immunosuppressive therapeutic challenge (Ferrafiat et al., 2016). Our objectives were to validate retrospectively CAUS and to define its threshold for an accurate distinction between organic catatonia and non-organic catatonia, and specifically between autoimmune catatonia and non-organic catatonia...
June 25, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28631372/patient-and-provider-characteristics-related-with-prescribing-of-adhd-medication-nationwide-health-insurance-claims-database-study-in-korea
#10
Inmyung Song, Mo Se Lee, Eui-Kyung Lee, Ju-Young Shin
BACKGROUND: Little is known about the association between prescribing of attention deficit hyperactivity disorder (ADHD) medication and the patient's age, gender, and type of medical institution in Asia region. INTRODUCTION: This study investigates the prevalence and factors of diagnosis and pharmacological treatment of ADHD in the pediatric population. METHODS: Using the Korea Health Insurance database, study participants were identified as pediatric patients (≤17 years) with at least 1 diagnosis of ADHD (ICD-10, F90) from January 1, 2007 to December 31, 2011...
June 20, 2017: Asia-Pacific Psychiatry: Official Journal of the Pacific Rim College of Psychiatrists
https://www.readbyqxmd.com/read/28612089/the-intensive-care-delirium-research-agenda-a-multinational-interprofessional-perspective
#11
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/28595685/implementing-psychopharmacology-rounds-in-a-nursing-facility-to-improve-antipsychotic-usage
#12
Evan Sasson, Marian James, Berhane Wubshet, Darko Todorov, Henry Cohen
OBJECTIVES: Evaluate whether implementing of pharmacy-led psychopharmacology rounds in a nursing facility will improve the rate of antipsychotic use. DESIGN: Single-center, prospective; medication use evaluation (MUE). SETTING: Rutland Nursing Home, Brooklyn, New York. PARTICIPANTS: Nursing facility residents, excluding the pediatric unit. INTERVENTIONS: Weekly interdisciplinary psychopharmacology rounds that include: clinical pharmacists, nurse managers, medical director, social workers, and administration...
June 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28579208/louis-delasiauve-1804-1893-an-alienist-at-the-dawn-of-epileptology-and-pediatric-psychiatry
#13
REVIEW
O Walusinski
This paper aims to honor the memory of the alienist Louis Delasiauve (1804-1893). His classification of the different types of epilepsy based on clinical symptoms is still relevant today and made him a precursor of contemporary epileptology. In 1851, Delasiauve clinically and etiologically isolated 'acute mental confusion' (acute confusional state) from all other forms of dementia. Never deviating from his republican and progressive ideals, he devoted himself throughout the 19th century to treating those insane asylum patients who received the poorest care: epileptics and children with intellectual disabilities...
June 1, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28561211/-increasing-consumption-of-crystal-meth-in-saxony-and-its-risks-for-mother-and-child-experiences-at-a-level-i-perinatal-center-from-a-pediatric-viewpoint
#14
Jürgen Dinger, Nicole Näther, Pauline Wimberger, Ulrich S Zimmermann, Jochen Schmitt, Jörg Reichert, Mario Rüdiger
Over the past several years, the number of first-time users of methamphetamine considerably increased within the Free State of Saxony. This number also, and especially, includes women of child-bearing age and young mothers. A supportive intervention aimed at reducing the effects of drug abuse should begin in a timely way - during pregnancy at latest, but better before it. To develop an optimal care protocol for both the mother and her child, more knowledge regarding the personal conditions of the women as well as the specific features of later child development after prenatal methamphetamine exposure (PME) is vital...
April 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/28561203/relationship-between-daily-dose-serum-concentration-and-clinical-response-to-quetiapine-in-children-and-adolescents-with-psychotic-and-mood-disorders
#15
Laura Albantakis, Karin Egberts, Rainer Burger, Christine Kulpok, Claudia Mehler-Wex, Regina Taurines, Stefan Unterecker, Christoph Wewetzer, Marcel Romanos, Manfred Gerlach
Introduction In child and adolescent psychiatry, therapeutic drug monitoring (TDM) is strongly recommended. However, therapeutic ranges (TR) are defined only for adults. The objectives of this naturalistic study were to assess the relationships between serum quetiapine concentration, daily dose, and clinical outcomes as well as the determinants of pharmacokinetic variability. Furthermore, it was elucidated whether the recommended TR for adult patients with psychotic disorders is valid for children and adolescents...
May 23, 2017: Pharmacopsychiatry
https://www.readbyqxmd.com/read/28538605/the-heads-ed-evaluating-the-clinical-use-of-a-brief-action-oriented-pediatric-mental-health-screening-tool
#16
Mario Cappelli, Roger Zemek, Christine Polihronis, Nathalie R Thibedeau, Allison Kennedy, Clare Gray, Mona Jabbour, Sarah Reid, Paula Cloutier
OBJECTIVES: This effectiveness study aimed to evaluate the clinical use of the HEADS-ED tool for patients presenting to a pediatric emergency department (PED) for mental health (MH) care. METHODS: In this pragmatic trial, PED physicians used the HEADS-ED to guide their assessment and identify areas of MH need in 639 patients (mean [SD], 15.16 [1.40] years; female, 72.6%) who presented to the emergency department with MH concerns between May 2013 and March 2014. RESULTS: The HEADS-ED guided consultation to psychiatry/crisis, with 86% receiving a recommended consult...
May 23, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28516854/mother-father-and-teacher-agreement-on-victimization-and-bullying-in-children-with-psychiatric-disorders
#17
Susan Dickerson Mayes, Susan L Calhoun, Farhat Siddiqui, Raman Baweja, Daniel A Waschbusch, Richard E Mattison, Dara E Babinski
Bullying is a significant international problem, and parent-teacher agreement on identifying perpetrators and victims is poor in general population studies. The goal of our study is to assess informant discrepancies in children with mental health disorders. Parents and teachers completed the Pediatric Behavior Scale as part of a diagnostic evaluation for 1,723 children (ages 2-16 years) referred to a psychiatry clinic over the past 10 years. Mother and father bullying and victimization ratings on the Pediatric Behavior Scale were similar, but parent-teacher agreement was poor...
June 1, 2017: Violence and Victims
https://www.readbyqxmd.com/read/28506544/development-of-the-vanderbilt-assessment-for-delirium-in-infants-and-children-to-standardize-pediatric-delirium-assessment-by-psychiatrists
#18
REVIEW
Maalobeeka Gangopadhyay, Heidi Smith, Maryland Pao, Gabrielle Silver, Deepmala Deepmala, Claire De Souza, Georgina Garcia, Lisa Giles, Danica Denton, Natalie Jacobowski, Pratik Pandharipande, Catherine Fuchs
BACKGROUND: Pediatric delirium assessment is complicated by variations in baseline language and cognitive skills, impairment during illness, and absence of pediatric-specific modifiers within the Diagnostic and Statistical Manual of Mental Disorders delirium criterion. OBJECTIVE: To develop a standardized approach to pediatric delirium assessment by psychiatrists. METHODS: A multidisciplinary group of clinicians used Diagnostic and Statistical Manual criterion as the foundation for the Vanderbilt Assessment for Delirium in Infants and Children (VADIC)...
July 2017: Psychosomatics
https://www.readbyqxmd.com/read/28498004/a-sequential-implementation-model-for-workforce-development-a-case-study-of-medical-residency-training-for-substance-use-concerns
#19
Patricia S O'Sullivan, Patrick Yuan, Derek D Satre, Maria Wamsley, Jason Satterfield
PROBLEM: In graduate medical education, residency programs are often educationally isolated from each other, with varying needs and patient populations, so strategies are needed when attempting to implement training in evidence-based practices across multiple residencies. INTERVENTION: Using implementation science as a guide, we adapted a community development model to sequentially implement an evidence-based intervention, Screening, Brief Intervention, and Referral to Treatment (SBIRT) for alcohol and drug use problems, across internal medicine, pediatrics, emergency medicine, psychiatry, and obstetrics and gynecology residency programs...
May 12, 2017: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/28474997/availability-of-outpatient-mental-health-care-by-pediatricians-and-child-psychiatrists-in-five-u-s-cities
#20
Shireen Cama, Monica Malowney, Anna Jo Bodurtha Smith, Margaret Spottswood, Elisa Cheng, Louis Ostrowsky, Jose Rengifo, J Wesley Boyd
The authors sought to assess the availability of outpatient mental health care through pediatrician and child psychiatrist offices in the United States and to characterize differences in appointment availability by location, provider type, and insurance across five cities. To do so, the authors posed as parents of a 12-year-old child with depression, gave a predetermined insurance type, and asked to make the first available appointment with the specified provider. They called the offices of 601 individual pediatricians and 312 child psychiatrists located in five U...
January 1, 2017: International Journal of Health Services: Planning, Administration, Evaluation
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