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https://www.readbyqxmd.com/read/28533933/negative-wound-pressure-therapy-is-safe-and-useful-in-pediatric-burn-patients
#1
Yanhan Ren, Philip Chang, Robert L Sheridan
INTRODUCTION: Negative Pressure Wound Therapy (NPWT) has proven to be a powerful tool in facilitating healing of difficult wounds of a variety of etiologies. The pediatric experience with NPWT has been limited due to concerns about vascular compression and pain associated with treatment. METHOD: A retrospective review was performed to evaluate the therapeutic effect of NPWT on children with difficult wounds due to burns or soft-tissue trauma. NPWT was instituted in the operating room under general anesthesia using a commercially available system...
2017: International Journal of Burns and Trauma
https://www.readbyqxmd.com/read/28531789/do-picu-patients-meet-technical-criteria-for-performing-indirect-calorimetry
#2
Megan R Beggs, Gonzalo Garcia Guerra, Bodil M K Larsen
BACKGROUND & AIMS: Indirect calorimetry (IC) is considered gold standard for assessing energy needs of critically ill children as predictive equations and clinical status indicators are often unreliable. Accurate assessment of energy requirements in this vulnerable population is essential given the high risk of over or underfeeding and the consequences thereof. The proportion of patients and patient days in pediatric intensive care (PICU) for which energy expenditure (EE) can be measured using IC is currently unknown...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28530775/a-surgical-approach-to-iatrogenic-vascular-injuries-in-pediatric-cases
#3
Yüksel Beşir, Orhan Gökalp, Börteçin Eygi, Banu Bahriye Lafcı, Gamze Gökalp, Levent Yılık, Hasan İner, Ali Gürbüz
BACKGROUND: Surgical intervention is mandatory in many children who present with vascular trauma or in complicated cases after medical interventions. In this study, surgical interventions applied after vascular injuries in children were analyzed. METHODS: Between January 2002 and December 2012, 17 patients (aged under 18) who were admitted to the emergency room with vascular injuries were retrospectively analyzed. The data was collected through hospital records...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28529195/rapid-web-based-platform-for-assessment-of-orthopedic-surgery-patient-care-milestones-a-2-year-validation
#4
Kenneth R Gundle, Dayne T Mickelson, Arien Cherones, Jason Black, Doug P Hanel
OBJECTIVE: To determine the validity, feasibility, and responsiveness of a new web-based platform for rapid milestone-based evaluations of orthopedic surgery residents. SETTING: Single academic medical center, including a trauma center and pediatrics tertiary hospital. PARTICIPANTS: Forty residents (PG1-5) in an orthopedic residency program and their faculty evaluators. METHODS: Residents and faculty were trained and supported in the use of a novel trainee-initiated web-based evaluation system...
May 18, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28521330/pediatric-penetrating-neck-trauma-hard-signs-of-injury-and-selective-neck-exploration
#5
Rober A Tessler, Huong Nguyen, Christoper Newton, James Betts
BACKGROUND: Selective neck exploration and computed tomography angiography (CTA) in penetrating neck trauma have been well described in adults. However, data in the pediatric population are sparse. The extent to which these practices have been adopted in pediatric patients is unknown. METHODS: Retrospective, single-center cohort study of pediatric penetrating neck trauma for the years 2001 to 2014 in a dedicated children's hospital/Level 1 pediatric trauma center...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28520684/pediatric-trauma-undertriage-in-ohio
#6
Juan P Gurria, Lynn Haas, Misty Troutt, Suzanne Moody, Md Monir Hossain, Mohammad Alfrad Nobel Bhuiyan, Richard A Falcone
BACKGROUND: Appropriate and timely triage is an essential component of a trauma system. In the state of Ohio, there are 6 verified pediatric trauma centers (PTCs) across 8 state regions. The purpose of this study was to better understand the pediatric undertriage rates in the state. METHODS: We used the Ohio Trauma Registry from 2007 to 2012, consisting of 14,045 records of children younger than 16 years admitted to a hospital for more than 48 hours or who sustained a traumatic death...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28520680/acute-pediatric-monteggia-fractures-a-conservative-approach-to-stabilization
#7
Ian Foran, Vidyadhar V Upasani, Charles D Wallace, Elise Britt, Tracey P Bastrom, James D Bomar, Andrew T Pennock
BACKGROUND: In 2015, a multicenter study group proposed a treatment algorithm for pediatric Monteggia fractures based upon the ulnar fracture pattern. This strategy recommends surgical stabilization for all complete ulna fractures. The purpose of this study was to evaluate whether an initial nonoperative approach to pediatric Monteggia fractures resulted in poorer outcomes and a higher rate of complications. METHODS: This institutional review board approved retrospective study evaluated all Monteggia fractures presenting to a level 1 pediatric trauma center between 2008 and 2014...
May 17, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28516800/undertriage-of-pediatric-major-trauma-patients-in-the-united-states
#8
Jin Peng, Krista Wheeler, Jonathan I Groner, Kathryn J Haley, Henry Xiang
Although trauma undertriage has been widely discussed in the literature, undertriage in the pediatric trauma population remains understudied. Using the 2009-2013 Nationwide Emergency Department Sample, we assessed the national undertriage rate in pediatric major trauma patients (age ≤16 years and injury severity score [ISS] >15), and identified factors associated with pediatric trauma undertriage. Nationally, 21.7% of pediatric major trauma patients were undertriaged. Children living in rural areas were more likely to be undertriaged ( P = ...
May 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28513521/otorhinolaryngological-emergencies-in-a-tertiary-hospital-in-port-harcourt
#9
U M Ibekwe
BACKGROUND: Emergencies are not uncommon in a typical otorhinolaryngological (ORL) clinic. The knowledge of the profile and prevalence of these emergencies will go a long way in helping to equip as well as aid proper and prompt management of these conditions so as to reduce their morbidity and mortality. PATIENTS AND METHODS: A descriptive retrospective 8 years review of all patients that presented to the ENT Surgery Department from January 2004 to December 2012...
May 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28511631/reversible-cerebral-vasoconstriction-syndrome-in-pediatrics-a-case-series-and-review
#10
Samantha W Coffino, Robert H Fryer
Reversible cerebral vasoconstriction syndrome is a transient vasculopathy associated with severe headaches and stroke. In most cases of reversible cerebral vasoconstriction syndrome, there is a precipitating event or trigger, such as pregnancy, serotonin agonist treatment or illicit drug use. The authors present 2 pediatric cases of reversible cerebral vasoconstriction syndrome and review the previous 11 pediatric cases in the literature. In many instances, the clinical and radiographic features are similar in both pediatric and adult cases...
June 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28509684/histone-complexed-dna-fragments-levels-are-associated-with-coagulopathy-endothelial-cell-damage-and-increased-mortality-after-severe-pediatric-trauma
#11
Robert T Russell, Sarah C Christiaans, Tate Nice, Morgan Banks, Vincent Mortellaro, Charity Morgan, Amy Duhachek-Stapelman, Steven J Lisco, Jeffrey D Kerby, Brant M Wagener, Mike K Chen, Jean-François Pittet
BACKGROUND: The release of damage-associated molecular pattern molecules (DAMPs) in the extracellular space secondary to injury has been shown to cause systemic activation of the coagulation system and endothelial cell damage. We hypothesized that pediatric trauma patients with increased levels of histone-complexed DNA fragments (hcDNA) would have evidence of coagulopathy and endothelial damage that would be associated with poor outcomes. METHODS: We conducted a prospective observational study of 149 pediatric trauma patients and 62 control patients at two level 1 pediatric trauma centers from 2013-2016...
May 15, 2017: Shock
https://www.readbyqxmd.com/read/28506480/the-epidemiology-of-inpatient-pediatric-trauma-in-united-states-hospitals-2000-to-2011
#12
Jamie Oliver, Jacob Avraham, Spiros Frangos, Sandra Tomita, Charles DiMaggio
BACKGROUND: This study provides important updates to the epidemiology of pediatric trauma in the United States. METHODS: Age-specific epidemiologic analysis of the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample, representing 2.4 million pediatric traumatic injury discharges in the US from 2000 to 2011. We present yearly data with overlying loess smoothing lines, proportions of common injuries and surgical procedures, and survey-adjusted logistic regression analysis...
April 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28506479/the-spectrum-and-management-of-noniatrogenic-vascular-trauma-in-the-pediatric-population
#13
Ahmed Kayssi, Maged Metias, Jacob C Langer, Graham Roche-Nagle, Augusto Zani, Thomas L Forbes, Paul Wales, Sebastian K King
BACKGROUND: To describe the spectrum of noniatrogenic pediatric vascular injuries and their outcomes at a large tertiary pediatric hospital. METHODS: Retrospective review of a prospectively-maintained trauma database, identifying children with noniatrogenic vascular injuries managed between 1994 and 2014. RESULTS: A total of 198 patients were identified. Those patients with a digital or intracerebral vascular injury (92/198) were excluded from further analysis...
April 29, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28503985/diagnostic-and-therapeutic-management-of-a-first-unprovoked-seizure-in-children-and-adolescents-with-a-focus-on-the-revised-diagnostic-criteria-for-epilepsy
#14
Arnold J Sansevere, Jennifer Avalone, Lauren Doyle Strauss, Archana A Patel, Anna Pinto, Maya Ramachandran, Ivan Sanchez Fernandez, Ann M Bergin, Amir Kimia, Phillip L Pearl, Tobias Loddenkemper
By definition, unprovoked seizures are not precipitated by an identifiable factor, such as fever or trauma. A thorough history and physical examination are essential to caring for pediatric patients with a potential first unprovoked seizure. Differential diagnosis, EEG, neuroimaging, laboratory tests, and initiation of treatment will be reviewed. Treatment is typically initiated after 2 unprovoked seizures, or after 1 seizure in select patients with distinct epilepsy syndromes. Recent expansion of the definition of epilepsy by the ILAE allows for the diagnosis of epilepsy to be made after the first seizure if the clinical presentation and supporting diagnostic studies suggest a greater than 60% chance of a second seizure...
January 1, 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28497263/radiologic-head-ct-interpretation-errors-in-pediatric-abusive-and-non-abusive-head-trauma-patients
#15
Stephen F Kralik, Whitney Finke, Isaac C Wu, Roberta A Hibbard, Ralph A Hicks, Chang Y Ho
BACKGROUND: Pediatric head trauma, including abusive head trauma, is a significant cause of morbidity and mortality. OBJECTIVE: The purpose of this research was to identify and evaluate radiologic interpretation errors of head CTs performed on abusive and non-abusive pediatric head trauma patients from a community setting referred for a secondary interpretation at a tertiary pediatric hospital. MATERIALS AND METHODS: A retrospective search identified 184 patients <5 years of age with head CT for known or potential head trauma who had a primary interpretation performed at a referring community hospital by a board-certified radiologist...
May 11, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28496392/differences-in-the-management-of-pediatric-facial-trauma
#16
REVIEW
Tara L Braun, Amy S Xue, Renata S Maricevich
Craniofacial trauma is common in the pediatric population, with most cases limited to soft tissue and dentoalveolar injury. Although facial fractures are relatively rare in children compared with adults, they are often associated with severe injury and cause significant morbidity and disability. Initial evaluation of a child with facial trauma generally involves stabilizing the patient and identifying any severe concomitant injuries before diagnosing and managing facial injuries. The management of pediatric facial fractures is relatively more conservative than that of adults, and nonsurgical management is preferred when possible to prevent the disruption of future growth and development...
May 2017: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/28493614/accuracy-of-physical-exam-ankle-brachial-index-and-ultrasonography-in-the-diagnosis-of-arterial-injury-in-patients-with-penetrating-extremity-trauma-a-systematic-review-and-meta-analysis
#17
Ian S deSouza, Roshanak Benabbas, Sean McKee, Bardiya Zangbar, Ashika Jain, Lorenzo Paladino, Leon Boudourakis, Richard Sinert
BACKGROUND: Penetrating Extremity Trauma (PET) may result in arterial injury, a rare but limb- and life-threatening surgical emergency. Accurate and timely diagnosis is vital to enable potential intervention and prevent significant morbidity. OBJECTIVES: Using a systematic review/meta-analysis approach, we determined the utility of Physical Examination (exam), Ankle-Brachial Index (ABI), and Ultrasonography (US) in the diagnosis of arterial injury in ED patients who have sustained PET...
May 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28493595/empathy-in-pediatric-intensive-care-nurses-part-1-behavioral-and-psychological-correlates
#18
Margot Latimer, Philip L Jackson, Fanny Eugène, Emily Macleod, Tara Hatfield, Etienne Vachon-Presseau, Pierre-Emmanuel Michon, Kenneth M Prkachin
AIM: To determine if differences exist between pediatric intensive care nurses and allied health professionals in empathy, secondary trauma, burnout, pain exposure and pain ratings of self and others. Early and late career differences were also examined. BACKGROUND: Nurses are routinely exposed to patient pain expression. This work context may make them vulnerable to adverse outcomes such as desensitization to patient pain or a compromise in personal wellbeing. DESIGN: Cross-sectional study...
May 11, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28492407/the-spleen-not-taken-differences-in-management-and-outcomes-of-blunt-splenic-injuries-in-teenagers-cared-for-by-adult-and-pediatric-trauma-teams-in-a-single-institution
#19
Sean O'Connor, Andrea N Doud, Leah M Sieren, Preston R Miller, Kristen A Zeller
BACKGROUND: Non-operative management (NOM) of blunt splenic injury, initially touted for the care of pediatric patients, has become the standard of care for stable trauma patients of all ages. In our institution, trauma patients <16 years old are managed by the pediatric surgery service and patients ≥16 years are managed by the adult trauma service. Angioembolization is routinely employed for adults with blunt splenic injury but rarely used for pediatric patients. A retrospective chart review was performed to determine if more liberal use of angioembolization increases the success rate of NOM of blunt splenic injury in adolescents...
May 11, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28490224/prevalence-of-abnormal-magnetic-resonance-imaging-findings-in-children-with-persistent-symptoms-after-pediatric-sports-related-concussion
#20
Robert H Bonow, Seth D Friedman, Francisco A Perez, Richard G Ellenbogen, Samuel R Browd, Christine L MacDonald, Monica S Vavilala, Frederick P Rivara
A subset of patients experience persistent symptoms after pediatric concussion, and magnetic resonance imaging (MRI) is commonly used to evaluate for pathology. The utility of this practice is unclear. We conducted a retrospective cohort study to describe the MRI findings in children with concussion. A registry of all patients seen at our institution from January 2010 through March 2016 with pediatric sports-related concussion was cross-referenced with a database of radiographic studies. Radiology reports were reviewed for abnormal findings...
May 10, 2017: Journal of Neurotrauma
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