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Pediatric simulation

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https://www.readbyqxmd.com/read/28328394/proposing-telecardiology-services-on-cloud-for-different-medical-institutions-a-model-of-reference
#1
Isabel De la Torre-Díez, Begoña Garcia-Zapirain, Miguel López-Coronado, Joel J P C Rodrigues
INTRODUCTION: For a cloud-based telecardiology solution to be established in any scenario, it is necessary to ensure optimum levels of security, as patient's data will not be in the same place from where access is gained. The main objective of this article is to present a secure, cloud-based solution for a telecardiology service in different scenarios: a hospital, a health center in a city, and a group of health centers in a rural area. METHODS: iCanCloud software is used to simulate the scenarios...
March 1, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28328281/educational-role-for-an-advanced-suturing-task-in-the-pediatric-laparoscopic-surgery-simulator
#2
Maeve O'Neill Trudeau, Brian Carrillo, Ahmed Nasr, Justin T Gerstle, Georges Azzie
BACKGROUND: Laparoscopic models are recognized as important training tools. Lower fidelity systems are used mainly for simpler tasks; an advanced suturing task may allow for additional training of experts. The purpose of this study was to explore the educational role of an advanced suturing task using motion analysis and establish the task's construct validity. METHODS: The pediatric laparoscopic surgery (PLS) simulator was customized with motion-tracking hardware and software...
March 22, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28323585/feasibility-of-hypoxic-challenge-testing-in-children-and-adolescents-with-congenital-heart-and-lung-disease
#3
Mandy E Spoorenberg, Erik H J Hulzebos, Tim Takken
BACKGROUND: This is a cross-sectional observational study to investigate the safety and feasibility of integrating changing body positions and physical activity in a hypoxic challenge test (HCT). The secondary objective was to compare oxygen saturation (Spo2) in two different locations (forehead and finger). METHODS: Included were 12 pediatric to young adult patients with congenital heart (N = 7) or lung disease (N = 5). An HCT was performed using breathing room air (21% oxygen) while sitting and breathing a normobaric hypoxic gas mixture (15% oxygen) through a facemask while seated, lying supine, standing, walking 3 km/h, and walking 5 km/h in a nonrandomized order...
December 1, 2016: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28292973/evaluation-of-functional-characteristics-of-4-oscillatory-positive-pressure-devices-in-a-simulated-cystic-fibrosis-model
#4
Hillary Van Fleet, Diane K Dunn, Neil L McNinch, Teresa A Volsko
BACKGROUND: Oscillatory positive expiratory pressure (OPEP) is an airway clearance therapy that delivers positive pressure and air-flow oscillations during exhalation. This study described functional characteristic differences of 4 OPEP devices during an active exhalation in a simulated model. We hypothesized peak pressure (Ppeak), positive expiratory pressure (PEP), oscillatory frequency (f), and pressure amplitude will differ, depending upon the device used, device resistance setting, and time (repeated consecutive active exhalations through the device)...
March 14, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28292706/effect-of-airflow-and-material-models-on-tissue-displacement-for-surgical-planning-of-pharyngeal-airways-in-pediatric-down-syndrome-patients
#5
Dhananjay Radhakrishnan Subramaniam, Goutham Mylavarapu, Robert J Fleck, Raouf S Amin, Sally R Shott, Ephraim J Gutmark
Pharyngeal narrowing in obstructive sleep apnea (OSA) results from flow-induced displacement of soft tissue. The objective of this study is to evaluate the effect of airflow parameters and material model on soft tissue displacement for planning surgical treatment in pediatric patients with OSA and Down syndrome (DS). Anatomically accurate, three-dimensional geometries of the pharynx and supporting tissue were reconstructed for one pediatric OSA patient with DS using magnetic resonance images. Six millimeters of adenoid tissue was virtually removed based on recommendations from the surgeon, to replicate the actual adenoidectomy...
March 8, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28290956/multidisciplinary-in-situ-simulation-based-training-as-a-postpartum-hemorrhage-quality-improvement-project
#6
Monica A Lutgendorf, Carmen Spalding, Elizabeth Drake, Dennis Spence, Jason O Heaton, Kristina V Morocco
BACKGROUND: Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290120/development-of-a-pediatric-physiologically-based-pharmacokinetic-model-of-clindamycin-using-opportunistic-pharmacokinetic-data
#7
Christoph P Hornik, Huali Wu, Andrea N Edginton, Kevin Watt, Michael Cohen-Wolkowiez, Daniel Gonzalez
Physiologically-based pharmacokinetic (PBPK) modeling is a powerful tool used to characterize maturational changes in drug disposition to inform dosing across childhood; however, its use is limited in pediatric drug development. Access to pediatric pharmacokinetic data is a barrier to widespread application of this model, which impedes its development and optimization. To support the development of a pediatric PBPK model, we sought to leverage opportunistically-collected plasma concentrations of the commonly used antibiotic clindamycin...
March 13, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28286528/evaluation-of-a-pilot-project-to-introduce-simulation-based-team-training-to-pediatric-surgery-trauma-room-care
#8
Markus Lehner, Ellen Heimberg, Florian Hoffmann, Oliver Heinzel, Hans-Joachim Kirschner, Martina Heinrich
Introduction. Several studies in pediatric trauma care have demonstrated substantial deficits in both prehospital and emergency department management. Methods. In February 2015 the PAEDSIM collaborative conducted a one and a half day interdisciplinary, simulation based team-training course in a simulated pediatric emergency department. 14 physicians from the medical fields of pediatric surgery, pediatric intensive care and emergency medicine, and anesthesia participated, as well as four pediatric nurses. After a theoretical introduction and familiarization with the simulator, course attendees alternately participated in six simulation scenarios and debriefings...
2017: International Journal of Pediatrics
https://www.readbyqxmd.com/read/28283725/realistic-phantoms-to-characterize-dosimetry-in-pediatric-ct
#9
Diana E Carver, Susan D Kost, Nicholas D Fraser, W Paul Segars, David R Pickens, Ronald R Price, Michael G Stabin
BACKGROUND: The estimation of organ doses and effective doses for children receiving CT examinations is of high interest. Newer, more realistic anthropomorphic body models can provide information on individual organ doses and improved estimates of effective dose. MATERIALS AND METHODS: Previously developed body models representing 50th-percentile individuals at reference ages (newborn, 1, 5, 10 and 15 years) were modified to represent 10th, 25th, 75th and 90th height percentiles for both genders and an expanded range of ages (3, 8 and 13 years)...
March 10, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28283724/radiation-dose-associated-with-ct-guided-drain-placement-for-pediatric-patients
#10
Cody J Schwartz, Ari J Isaacson, Lynn Ansley Fordham, Marija Ivanovic, J Bradford Taylor, Robert G Dixon
BACKGROUND: To date, there are limited radiation dose data on CT-guided procedures in pediatric patients. OBJECTIVE: Our goal was to quantify the radiation dose associated with pediatric CT-guided drain placement and follow-up drain evaluations in order to estimate effective dose. MATERIALS AND METHODS: We searched the electronic medical record and picture archiving and communication system (PACS) to identify all pediatric (<18 years old) CT-guided drain placements performed between January 2008 and December 2013 at our institution...
March 10, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28282325/the-impact-of-neonatal-simulations-on-trainees-stress-and-performance-a-parallel-group-randomized-trial
#11
Marie-Hélène Lizotte, Annie Janvier, Véronique Latraverse, Christian Lachance, Claire-Dominique Walker, Keith J Barrington, Ahmed Moussa
OBJECTIVES: Assess impact of neonatal simulation and simulated death on trainees' stress and performance. DESIGN: A parallel-group randomized trial (November 2011 to April 2012). SETTING: Sainte-Justine University Hospital, Montreal, Canada. SUBJECTS: Sixty-two pediatric trainees eligible, 59 consented, and 42 completed the study. INTERVENTIONS: Trainees performed two simulations where a term neonate was born pulseless...
March 9, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28281287/application-of-a-lumped-parameter-model-to-study-the-feasibility-of-simultaneous-implantation-of-a-continuous-flow-ventricular-assist-device-vad-and-a-pulsatile-flow-vad-in-bivad-patients
#12
Arianna Di Molfetta, Gianfranco Ferrari, Roberta Iacobelli, Sergio Filippelli, Libera Fresiello, Paolo Guccione, Alessandra Toscano, Antonio Amodeo
The aim of this work is to develop and test a lumped parameter model of the cardiovascular system to simulate the simultaneous use of pulsatile (P) and continuous flow (C) ventricular assist devices (VADs) on the same patient. Echocardiographic and hemodynamic data of five pediatric patients undergoing VAD implantation were retrospectively collected and used to simulate the patients' baseline condition with the numerical model. Once the baseline hemodynamic was reproduced for each patient, the following assistance modalities were simulated: (a) CVAD assisting the right ventricle and PVAD assisting the left ventricle (RCF + LPF), (b) CVAD assisting the left ventricle and PVAD assisting the right ventricle (LCF + RPF)...
March 2017: Artificial Organs
https://www.readbyqxmd.com/read/28274487/manipulation-peak-forces-across-spinal-regions-for-children-using-mannequin-simulators
#13
John J Triano, Steven Lester, David Starmer, Elise G Hewitt
OBJECTIVE: The purpose of this work was to create an exploratory database of manipulation treatment force variability as a function of the intent of an experienced clinician sub-specializing in the care of children to match treatment to childhood category. Data of this type are necessary for realistic planning of dose-response and safety studies on therapeutic benefit. METHODS: The project evaluated the transmitted peak forces of procedures applied to mannequins of different stature for younger and older children...
March 5, 2017: Journal of Manipulative and Physiological Therapeutics
https://www.readbyqxmd.com/read/28269234/engineering-based-assessment-for-a-shape-design-of-a-pediatric-eptfe-pulmonary-conduit-valve
#14
Yusuke Tsuboko, Yasuyuki Shiraishi, Akihiro Yamada, Tomoyuki Yambe, Hidekazu Miura, Seitaro Mura, Masaaki Yamagishi
The authors examined the hemodynamic characteristics of expanded polytetrafluoroethylene (ePTFE) pulmonary valved conduits quantitatively by our originally developed pediatric pulmonary mechanical circulatory system, in order to suggest the optimal shape design. The system consisted of pneumatically driven right atrium and ventricle model, a pulmonary valve chamber, and elastic pulmonary compliance model with peripheral vascular resistance units, a venous reservoir. We employed two different types of ePTFE valve and evaluated the relationship between the leaflets motion and hemodynamic characteristics by using a high-speed video camera...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28250007/population-pharmacokinetics-of-intravenous-erwinia-asparaginase-in-pediatric-acute-lymphoblastic-leukemia-patients
#15
Sebastiaan D T Sassen, Ron A A Mathôt, Rob Pieters, Robin Q H Kloos, Valérie de Haas, Gertjan J L Kaspers, Cor van den Bos, Wim J E Tissing, Maroeska Te Loo, Marc B Bierings, Wouter J W Kollen, Christian M Zwaan, Inge M van der Sluis
Erwinia asparaginase is an important component in the treatment of pediatric acute lymphoblastic leukemia. A large variability in serum concentrations has been observed after intravenous Erwinia asparaginase. Currently, Dutch Childhood Oncology Group protocols dose alterations are based on trough concentrations to ensure adequate asparaginase activity (≥100 IU/L). The aim of this study was to describe the population pharmacokinetics of intravenous Erwinia asparaginase to quantify and gather insight into inter-individual and inter-occasion variability...
March 2017: Haematologica
https://www.readbyqxmd.com/read/28246338/decreasing-prescribing-errors-during-pediatric-emergencies-a-randomized-simulation-trial
#16
Guylaine Larose, Arielle Levy, Benoit Bailey, Barbara Cummins-McManus, Denis Lebel, Jocelyn Gravel
OBJECTIVE: To evaluate whether a clinical aid providing precalculated medication doses decreases prescribing errors among residents during pediatric simulated cardiopulmonary arrest and anaphylaxis. METHODS: A crossover randomized trial was conducted in a tertiary care hospital simulation center with residents rotating in the pediatric emergency department. The intervention was a reference book providing weight-based precalculated doses. The control group used a card providing milligram-per-kilogram doses...
March 2017: Pediatrics
https://www.readbyqxmd.com/read/28240650/access-to-developmental-pediatrics-evaluations-for-at-risk-children
#17
Manuel E Jimenez, Emmanuel M Alcaraz, Jerome Williams, Brian L Strom
OBJECTIVE: To determine a national average wait time for developmental pediatric evaluations and to understand differences in access based on whether an appointment is requested by an English or Spanish-speaking caller. METHODS: We conducted a mystery shopper study in which a bilingual research assistant called developmental pediatrics programs affiliated with US children's hospitals listed on a public directory requesting an appointment for his simulated child experiencing a developmental problem...
February 23, 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28236558/dosimetry-applications-in-gate-monte-carlo-toolkit
#18
Panagiotis Papadimitroulas
PURPOSE: Monte Carlo (MC) simulations are a well-established method for studying physical processes in medical physics. The purpose of this review is to present GATE dosimetry applications on diagnostic and therapeutic simulated protocols. There is a significant need for accurate quantification of the absorbed dose in several specific applications such as preclinical and pediatric studies. METHODS: GATE is an open-source MC toolkit for simulating imaging, radiotherapy (RT) and dosimetry applications in a user-friendly environment, which is well validated and widely accepted by the scientific community...
February 21, 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28230619/population-pharmacokinetics-of-topiramate-in-japanese-pediatric-and-adult-patients-with-epilepsy-using-routinely-monitored-data
#19
Masato Takeuchi, Ikuko Yano, Satoko Ito, Mitsuhiro Sugimoto, Shota Yamamoto, Atsushi Yonezawa, Akio Ikeda, Kazuo Matsubara
BACKGROUND: Topiramate is a second-generation antiepileptic drug used as monotherapy and adjunctive therapy in adults and children with partial seizures. A population pharmacokinetic (PPK) analysis was performed to improve the topiramate dosage adjustment for individualized treatment. METHODS: Patients whose steady-state serum concentration of topiramate was routinely monitored at Kyoto University Hospital from April 2012 to March 2013 were included in the model-building data...
April 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28227466/engineering-based-assessment-for-a-shape-design-of-a-pediatric-eptfe-pulmonary-conduit-valve
#20
Yusuke Tsuboko, Yasuyuki Shiraishi, Akihiro Yamada, Tomoyuki Yambe, Hidekazu Miura, Seitaro Mura, Masaaki Yamagishi, Yusuke Tsuboko, Yasuyuki Shiraishi, Akihiro Yamada, Tomoyuki Yambe, Hidekazu Miura, Seitaro Mura, Masaaki Yamagishi, Akihiro Yamada, Seitaro Mura, Yasuyuki Shiraishi, Tomoyuki Yambe, Yusuke Tsuboko, Hidekazu Miura, Masaaki Yamagishi
The authors examined the hemodynamic characteristics of expanded polytetrafluoroethylene (ePTFE) pulmonary valved conduits quantitatively by our originally developed pediatric pulmonary mechanical circulatory system, in order to suggest the optimal shape design. The system consisted of pneumatically driven right atrium and ventricle model, a pulmonary valve chamber, and elastic pulmonary compliance model with peripheral vascular resistance units, a venous reservoir. We employed two different types of ePTFE valve and evaluated the relationship between the leaflets motion and hemodynamic characteristics by using a high-speed video camera...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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