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Paediatrics emergency

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https://www.readbyqxmd.com/read/29453296/understanding-the-characteristics-of-recurrent-visits-to-the-emergency-department-by-paediatric-patients-a-retrospective-observational-study-conducted-at-three-tertiary-hospitals-in-korea
#1
Byung-Soo Kim, Jung-Youn Kim, Sung-Hyuk Choi, Young-Hoon Yoon
OBJECTIVES: The number of paediatric patients visiting the emergency department (ED) continues to rise. In South Korea, approximately 25% of the patients who visit the ED are paediatric patients. In the USA, about 20% of the paediatric population were found to have visited the ED in the past year. A recent study demonstrated that 4.5%-8% of patients account for 25% of all ED visits. Therefore, the aim of this study was to identify the characteristics of recurrent visits. METHODS: Design: retrospective observational study...
February 16, 2018: BMJ Open
https://www.readbyqxmd.com/read/29453197/paediatric-hospital-admission-processes-and-outcomes-a-qualitative-study-of-parents-experiences-and-priorities
#2
JoAnna K Leyenaar, Paul A Rizzo, Emily R O'Brien, Peter K Lindenauer
BACKGROUND: Hospital admission, like hospital discharge, represents a transition of care associated with changes in setting, healthcare providers and clinical management. While considerable efforts have focused on improving the quality and safety of hospital-to-home transitions, there has been little focus on transitions into hospital. OBJECTIVES: Among children hospitalised with ambulatory care sensitive conditions, we aimed to characterise families' experiences as they transitioned from outpatient to inpatient care, identify hospital admission processes and outcomes most important to families and determine how parental perspectives differed between children admitted directly and through emergency departments (ED)...
February 16, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29453155/evaluation-of-the-triage-performed-by-registered-nurses-in-the-hospital-cl%C3%A3-nico-universitario-%C3%A2-lozano-blesa%C3%A2-emergency-service-saragossa-spain
#3
Isabel Viñuales, Araceli Monzón-Fernández, Manuel Viñuales, Teresa Sanclemente
OBJECTIVE: To evaluate nurses' triage quality and adequacy in Saragossa's Hospital Clínico and to compare the main characteristics of "urgent" and "non-urgent" visits to the Hospital Emergency Department (HED). METHOD: This exploratory-retrospective research study was carried out over the last 3 months of 2015 (paediatrics, gynaecological and ophthalmologic emergencies were excluded). Data were obtained from the "Puesto Clínico Hospitalario" programme used in the HED...
February 13, 2018: Enfermería Clínica
https://www.readbyqxmd.com/read/29449297/delivering-safe-and-effective-test-result-communication-management-and-follow-up-a-mixed-methods-study-protocol
#4
Maria R Dahm, Andrew Georgiou, Johanna I Westbrook, David Greenfield, Andrea R Horvath, Denis Wakefield, Ling Li, Ken Hillman, Patrick Bolton, Anthony Brown, Graham Jones, Robert Herkes, Robert Lindeman, Michael Legg, Meredith Makeham, Daniel Moses, Dauda Badmus, Craig Campbell, Rae-Anne Hardie, Julie Li, Euan McCaughey, Gorkem Sezgin, Judith Thomas, Nasir Wabe
INTRODUCTION: The failure to follow-up pathology and medical imaging test results poses patient-safety risks which threaten the effectiveness, quality and safety of patient care. The objective of this project is to: (1) improve the effectiveness and safety of test-result management through the establishment of clear governance processes of communication, responsibility and accountability; (2) harness health information technology (IT) to inform and monitor test-result management; (3) enhance the contribution of consumers to the establishment of safe and effective test-result management systems...
February 15, 2018: BMJ Open
https://www.readbyqxmd.com/read/29449214/invasive-bacterial-infections-in-young-afebrile-infants-with-a-history-of-fever
#5
Santiago Mintegi, Borja Gomez, Alba Carro, Haydee Diaz, Javier Benito
OBJECTIVE: To determine the prevalence of invasive bacterial infections (IBI, pathogenic bacteria in blood or cerebrospinal fluid) in infants less than 90 days old with fever without a source related to the presence or absence of fever on arrival to the emergency department (ED). DESIGN: Prospective registry-based cohort study. SETTING: Paediatric ED of a tertiary teaching hospital. PATIENTS: We included infants less than 90 days old with a history of fever evaluated in the ED from 2003 to 2016...
February 15, 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29448936/chitinase-3-like-1-is-a-biomarker-of-acute-kidney-injury-and-mortality-in-paediatric-severe-malaria
#6
Andrea L Conroy, Michael T Hawkes, Robyn Elphinstone, Robert O Opoka, Sophie Namasopo, Christopher Miller, Chandy C John, Kevin C Kain
BACKGROUND: Chitinase-3-like 1 (CHI3L1) is a glycoprotein elevated in paediatric severe malaria, and an emerging urinary biomarker of acute kidney injury (AKI). Based on the hypothesis that elevated CHI3L1 levels in malaria are associated with disease severity, the relationship between plasma CHI3L1 levels, AKI and mortality was investigated in Ugandan children enrolled in a clinical trial evaluating inhaled nitric oxide (iNO) as an adjunctive therapy for severe malaria. METHODS: Plasma CHI3L1 levels were measured daily for 4 days in children admitted to hospital with severe malaria and at day 14 follow up...
February 15, 2018: Malaria Journal
https://www.readbyqxmd.com/read/29446155/not-just-trust-factors-influencing-learners-attempts-to-perform-technical-skills-on-real-patients
#7
Susan L Bannister, Mark S Dolson, Lorelei Lingard, David A Keegan
CONTEXT: As part of their training, physicians are required to learn how to perform technical skills on patients. The previous literature reveals that this learning is complex and that many opportunities to perform these skills are not converted into attempts to do so by learners. This study sought to explore and understand this phenomenon better. METHODS: A multi-phased qualitative study including ethnographic observations, interviews and focus groups was conducted to explore the factors that influence technical skill learning...
February 15, 2018: Medical Education
https://www.readbyqxmd.com/read/29440127/ethics-and-patient-and-public-involvement-with-children-and-young-people
#8
Sarah Jane Mitchell, Anne-Marie Slowther, Jane Coad, Shazaan Akhtar, Elizabeth Hyde, Dena Khan, Jeremy Dale
Patient and public involvement (PPI) is important both in research and in quality improvement activities related to healthcare services . While PPI activities do not require formal ethical approval, they can raise a number of ethical concerns, through the introduction of complex technical medical concepts, challenging language or sensitive subject areas. There is very little published literature to guide ethical practice in this area. We have been conducting PPI with children and young people throughout a research study in paediatric palliative care...
February 9, 2018: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/29433429/the-management-of-children-with-bronchiolitis-in-the-australasian-hospital-setting-development-of-a-clinical-practice-guideline
#9
Sharon O'Brien, Sally Wilson, Fenella J Gill, Elizabeth Cotterell, Meredith L Borland, Edward Oakley, Stuart R Dalziel
BACKGROUND: Bronchiolitis is the commonest respiratory infection in children less than 12 months and cause of hospitalisation in infants under 6 months of age in Australasia. Unfortunately there is substantial variation in management, despite high levels of supporting evidence. This paper reports on the process, strengths and challenges of the hybrid approach used to develop the first Australasian management guideline relevant to the local population. METHOD: An adaption of the nine steps recommended by the National Health and Medical Research Council (NHMRC) and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology were utilised...
February 12, 2018: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/29433399/death-caused-by-appendicular-knotting-and-small-bowel-strangulation-in-a-child-a-case-report-and-review
#10
Andres Rodriguez Zorro, Jairo Hernando Vivas Diaz
Acute appendicitis is one of the most common surgical emergencies in paediatrics. However, acute appendicitis in early infancy is an uncommon condition. Furthermore, strangulation of the small intestine through appendicular knotting is described as very unusual in the literature and is generally not well-diagnosed in the clinical context. This article reports the case of a 23-month-old girl who entered the emergency department with a three-day history of abdominal symptoms and who died in less than 24 hours without receiving surgical intervention...
January 1, 2018: Medicine, Science, and the Law
https://www.readbyqxmd.com/read/29432617/outcomes-following-coronary-artery-bypass-grafting-with-microsurgery-in-paediatric-patients
#11
Mark S Shafarenko, Joseph Catapano, Shuhua Luo, Ronald M Zuker, Glen Van Arsdell, Gregory H Borschel
OBJECTIVES: Paediatric coronary artery bypass grafting is indicated in cases of clinically significant and symptomatic coronary stenosis, with frequent complications occurring in the perioperative period. To reduce complications and improve outcomes of these procedures, surgical microscopes have been used at our centre with the anastomosis performed by a microvascular surgeon. The purpose of this article is to report our institutional experience in all patients who have undergone paediatric coronary artery bypass grafting procedures with and without microvascular techniques...
February 8, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29429424/trends-in-rotavirus-from-2001-to-2015-in-two-paediatric-hospitals-in-atlanta-georgia
#12
B K Sederdahl, J Yi, R C Jerris, S E Gillespie, L F Westblade, C S Kraft, A L Shane, E J Anderson
We compared rotavirus detection patterns before (2001-2006) and after (2008-2015) rotavirus vaccine introduction. We also compared rotavirus detection patterns in odd (2009, 2011, 2013, 2015) and even (2008, 2010, 2012, 2014) years post-vaccine separately. Results of stool rotavirus antigen testing from inpatient, outpatient and emergency department encounters from July 2000 to July 2015 at two paediatric hospital laboratories in Atlanta, Georgia were reviewed. Post-vaccine, rotavirus detection declined (30...
February 12, 2018: Epidemiology and Infection
https://www.readbyqxmd.com/read/29416155/erector-spinae-plane-block-as-an-alternative-to-epidural-analgesia-for-post-operative-analgesia-following-video-assisted-thoracoscopic-surgery-a-case-study-and-a-literature-review-on-the-spread-of-local-anaesthetic-in-the-erector-spinae-plane
#13
Sanjib Das Adhikary, Ashlee Pruett, Mauricio Forero, Venkatesan Thiruvenkatarajan
Post-operative pain after minimally invasive video-assisted thoracoscopic surgery (VATS) in adults is commonly managed with oral and parenteral opioids and invasive regional techniques such as thoracic epidural blockade. Emerging research has shown that the novel erector spinae plane (ESP) block, can be employed as a simple and safe alternative analgesic technique for acute post-surgical, post-traumatic and chronic neuropathic thoracic pain in adults. We illustrate this by presenting a paediatric case of VATS, in which an ESP block provided better analgesia, due to greater dermatomal coverage, as well as reduced side-effects when compared with a thoracic epidural that had previously been employed on the same patient for a similar procedure on the opposite side...
January 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29412117/strategies-empowering-paediatric-drug-safety
#14
Marta Gentili, Marco Pozzi, Gabrielle Peeters, Sonia Radice, Carla Carnovale
Background Knowledge of drugs safety collected during the pre-marketing phase is inevitably limited because the randomized clinical trials (RCTs) are rarely designed to evaluate safety. The small and selective groups of enrolled individuals and the limited duration of trials may hamper the ability to characterise fully the safety profiles of drugs. Addionally, information about rare adverse drug reactions (ADRs) in special groups or drug-drug interactions (DDIs) is often incomplete or not available for most of the drugs commonly used in the daily clinical practice...
February 6, 2018: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/29406441/the-genesis-of-systems-of-care-for-transition-to-adulthood-services-new-emerging-models-in-primary-and-subspecialty-care
#15
Charmaine Wright, Caren Steinway, Sophia Jan
PURPOSE OF REVIEW: Transitioning adolescents and young adults with chronic conditions can be complex. Expert recommendations support a transition process that starts in early adolescence, provides continuous guidance and support and allows for care opportunities with patients and caregivers, with the patient alone and between paediatric and adult providers. As most of the guidance is focused on individual patients, providers and clinical programmes, much less is known about how health systems as a whole might support effective transitions of care...
February 5, 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29401675/the-taste-of-commercially-available-clarithromycin-oral-pharmaceutical-suspensions-in-the-palestinian-market-electronic-tongue-and-in-vivo-evaluation
#16
Nawaf Abu-Khalaf, Abdel Naser Zaid, Nidal Jaradat, Alaaldin AlKilany, Basima Abu Rumaila, Rowa Al Ramahi, Shrouq Shweiki, Safaa Nidal, Nibal Surakhi
Background: The taste of oral liquid dosage forms is a crucial factor that impacts paediatric patient compliance. The electronic tongue (ET) is an emerging tool that could be useful in taste assessment in order to minimize the involvement of humans in such evaluations. Purpose: The aim of this study is to evaluate the taste of commercially available clarithromycin (CM) oral pharmaceutical suspensions in the Palestinian market. Method: Commercially available CM suspensions (the brand Klacid® and two generic K1 and K2) were assayed using the high performance liquid chromatography (HPLC) method...
February 3, 2018: Sensors
https://www.readbyqxmd.com/read/29396792/role-of-interventional-radiology-in-managing-pediatric-liver-tumors-part-2-percutaneous-interventions
#17
REVIEW
C Matthew Hawkins, Alexander J Towbin, Derek J Roebuck, Eric J Monroe, Anne E Gill, Avnesh S Thakor, Richard B Towbin, Anne Marie Cahill, Matthew P Lungren
Hepatoblastoma and hepatocellular carcinoma (HCC) are the most common pediatric liver malignancies, with hepatoblastoma occurring more commonly in younger children and HCC occurring more commonly in older children and adolescents. Although surgical resection (including transplant when necessary) and systemic chemotherapy have improved overall survival rate for hepatoblastoma to approximately 80% from 30%, a number of children with this tumor type are not eligible for operative treatment. In contradistinction, pediatric HCC continues to carry a dismal prognosis with an overall 5-year survival rate of 30%...
February 2, 2018: Pediatric Radiology
https://www.readbyqxmd.com/read/29395403/the-value-of-whatsapp-communication-in-paediatric-burn-care
#18
R Martinez, A D Rogers, A Numanoglu, H Rode
BACKGROUND: Telemedicine is increasingly applied in developed settings to facilitate transfer of information to and from burn surgeons across vast geographic areas. WhatsApp is a widely available and extremely user-friendly encrypted smartphone application that does not require the expensive physical and personnel infrastructure that characterizes many of these telemedicine systems. The aim of this study was to review the use of WhatsApp to facilitate paediatric burn injury consultations to a regional burn centre in a developing country, where burn care continues to be thwarted by administrative apathy, poor resource allocation and lack of attention to medical and nursing education at all levels...
January 27, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29395152/controversies-in-the-management-of-ovarian-tumours-in-prepubertal-children-a-baps-and-uk-cclg-surgeons-cancer-group-national-survey
#19
Sarah Braungart, Ross J Craigie, Paul D Losty
BACKGROUND: No clear treatment and follow-up protocols have been established for prepubertal patients with ovarian tumours. The lack of adequate prospective data in the literature includes all aspects of their management. A significant number of children with ovarian masses present out of hours as a surgical emergency and are initially managed by paediatric surgeons without special interest in surgical oncology. Clear guidance on the management of such tumours is therefore fundamental...
December 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29391051/short-course-antimicrobial-therapy-for-paediatric-respiratory-infections-safer-study-protocol-for-a-randomized-controlled-trial
#20
Jeffrey Pernica, Stuart Harman, April Kam, Jacob Bailey, Redjana Carciumaru, Sarah Khan, Martha Fulford, Lehana Thabane, Robert Slinger, Cheryl Main, Marek Smieja, Mark Loeb
BACKGROUND: Community-acquired pneumonia (CAP) is commonly diagnosed in children. The Infectious Disease Society of America guidelines recommend 10 days of high-dose amoxicillin for the treatment of non-severe CAP but 5-day "short course" therapy may be just as effective. Randomized trials in adults have already demonstrated non-inferiority of 5-day short-course treatment for adults hospitalized with severe CAP and for adults with mild CAP treated as outpatients. Minimizing exposure to antimicrobials is desirable to avoid harms including diarrhoea, rashes, severe allergic reactions, increased circulating antimicrobial resistance, and microbiome disruption...
February 1, 2018: Trials
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