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Paediatrics emergency

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https://www.readbyqxmd.com/read/28821516/a-retrospective-review-of-paediatric-head-injuries-in-asia-a-pan-asian-trauma-outcomes-study-patos-collaboration
#1
Shu-Ling Chong, Uzma Rahim Khan, Indumathy Santhanam, Jun Seok Seo, Quan Wang, Sabariah Faizah Jamaluddin, Quoc Ai Hoang Trong, Su Yah Chew, Marcus Eng Hock Ong
OBJECTIVE: We aim to examine the mechanisms of head-injured children presenting to participating centres in the Pan Asian Trauma Outcomes Study (PATOS) and to evaluate the association between mechanism of injury and severe outcomes. DESIGN AND SETTING: We performed a retrospective review of medical records among emergency departments (EDs) of eight PATOS centres, from September 2014 - August 2015. PARTICIPANTS: We included children <16 years old who presented within 24 hours of head injury and were admitted for observation or required a computed tomography (CT) of the brain from the ED...
August 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28819468/paediatric-fractures-in-a-sub-saharan-tertiary-care-center-a-cohort-analysis-of-demographic-characteristics-clinical-presentation-therapeutic-patterns-and-outcomes
#2
Marc Leroy Guifo, Joel Noutakdie Tochie, Blondel Nana Oumarou, Jean Roger Moulion Tapouh, Aristide Guy Bang, Aurelien Ndoumbe, Bonaventure Jemea, Maurice Aurelien Sosso
INTRODUCTION: Paediatric fractures are often of good prognosis due to auto-correction of insufficient fracture reduction by bone remodeling. In sub-Saharan Africa, traditional healers are renowned for managing fractures and there is a neglect for specialized pediatric fracture care. We aimed to determine the demographic characteristics, clinical presentation, treatment patterns and outcomes of paediatric fractures in a tertiary health care centre in Yaoundé. METHODS: We conducted a prospective cohort study of all consenting consecutive cases of fractures in patients younger than 16 years managed between January 2011 and June 2015 at the University Teaching Hospital, Cameroon...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28818544/trends-in-antimicrobial-resistance-in-bloodstream-infection-isolates-at-a-large-urban-hospital-in-malawi-1998-2016-a-surveillance-study
#3
Patrick Musicha, Jennifer E Cornick, Naor Bar-Zeev, Neil French, Clemens Masesa, Brigitte Denis, Neil Kennedy, Jane Mallewa, Melita A Gordon, Chisomo L Msefula, Robert S Heyderman, Dean B Everett, Nicholas A Feasey
BACKGROUND: Bacterial bloodstream infection is a common cause of morbidity and mortality in sub-Saharan Africa, yet few facilities are able to maintain long-term surveillance. The Malawi-Liverpool-Wellcome Trust Clinical Research Programme has done sentinel surveillance of bacteraemia since 1998. We report long-term trends in bloodstream infection and antimicrobial resistance from this surveillance. METHODS: In this surveillance study, we analysed blood cultures that were routinely taken from adult and paediatric patients with fever or suspicion of sepsis admitted to Queen Elizabeth Central Hospital, Blantyre, Malawi from 1998 to 2016...
August 14, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28815823/ten-years-of-simulation-based-training-in-pediatric-anesthesia-the-inception-evolution-and-dissemination-of-the-managing-emergencies-in-paediatric-anaesthesia-mepa-course
#4
Tobias C Everett, Ralph MacKinnon, David de Beer, Matthew Taylor, Matthew Dylan Bould
2016 marked the 10-year anniversary of the inception of the Managing Emergencies in Paediatric Anaesthesia (MEPA) course. This simulation-based program was originally created to allow trainees in pediatric anesthesia to experience operating room emergencies which although infrequent, would be considered key competencies for any practicing anesthetist with responsibility for providing care to children. Since its original manifestation, the course has evolved in content, scope, and worldwide availability, such that it is now available at over 60 locations on five continents...
August 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28815416/what-is-the-evidence-for-paediatric-adolescent-bariatric-surgery
#5
REVIEW
Natalie Durkin, Ashish P Desai
PURPOSE OF REVIEW: In spite of the increasing prevalence of severe and complex obesity in children, surgery as a potential management option is still not widely accepted. The purpose of this review is to examine the evidence for surgical options in the severely obese paediatric population. Increasing evidence supports early rather than later use of bariatric surgery in the treatment of extreme obesity. RECENT FINDINGS: Prior to 2007, the feasibility and safety of surgery have been reported by predominantly small, sporadic single-centre retrospective case series...
August 16, 2017: Current Obesity Reports
https://www.readbyqxmd.com/read/28814419/chronic-cough-postacute-respiratory-illness-in-children-a-cohort-study
#6
Kerry-Ann F O'Grady, Benjamin J Drescher, Vikas Goyal, Natalie Phillips, Jason Acworth, Julie M Marchant, Anne B Chang
OBJECTIVE: Data on the aetiology of persistent cough at the transitional stage from subacute to chronic cough (>4 weeks duration) are scarce. We aimed to (1) identify the prevalence of chronic cough following acute respiratory illness (ARI) and (2) determine the diagnostic outcomes of children with chronic cough. DESIGN: Prospective cohort study. SETTING: A paediatric emergency department (ED) in Brisbane, Australia. PATIENTS: Children aged <15 years presenting with an ARI with cough...
August 16, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28812025/baseline-characteristics-of-the-paediatric-observation-priority-score-in-emergency-departments-outside-its-centre-of-derivation
#7
Damian Roland, Fawaz Arshad, Tim Coats, Ffion Davies
OBJECTIVES AND BACKGROUND: Scoring systems in Emergency Departments (EDs) are rarely validated. This study aimed to examine the Paediatric Observation Priority Score (POPS), a method of quantifying patient acuity, in EDs in the United Kingdom, and determine baseline performance characteristics. METHODS: POPS was implemented in 4 EDs for children (ages of 0 to 16) with participants grouped into 3 categories: discharged from ED, discharged but with return within 7 days, and admitted for less or more than 24 hours...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28811137/influence-of-guidelines-on-management-of-paediatric-mild-traumatic-brain-injury-ct-assessment-and-admission-policy
#8
J J Lenstra, A R A Pikstra, J M Fock, Z Metting, J van der Naalt
BACKGROUND: The annual number of paediatric injury-related emergency visits and application of computed tomography (CT) has substantially increased, with associated higher risk of malignancies. In 2010, a guideline for CT-assessment based on risk factors for patients with mild traumatic brain injury (mTBI) became effective in all Emergency Departments (ED) in the Netherlands. This study evaluated the influence of this guideline on the frequency of CT-assessments, hospital admissions and factors that are related to guideline adherence...
August 3, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28811117/bilayered-buccal-films-as-child-appropriate-dosage-form-for-systemic-administration-of-propranolol
#9
Angela Abruzzo, Fiore Pasquale Nicoletta, Francesco Dalena, Teresa Cerchiara, Barbara Luppi, Federica Bigucci
Buccal mucosa has emerged as an attractive site for systemic administration of drug in paediatric patients. This route is simple and non-invasive, even if the saliva wash-out effect and the relative permeability of the mucosa can reduce drug absorption. Mucoadhesive polymers represent a common employed strategy to increase the contact time of the formulation at the application site and to improve drug absorption. Among the different mucoadhesive dosage forms, buccal films are particularly addressed for paediatric population since they are thin, adaptable to the mucosal surface and able to offer an exact and flexible dose...
August 12, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28803588/the-history-of-paediatric-cardiology-on-stamps
#10
Hazım A Gursu, Ibrahim I Cetin
Paediatric cardiology is arguably the sub-specialty in which the greatest advances have been made in both disease diagnosis and treatment over the past half a century. Paediatric cardiology emerged as a discipline in the 1930s. Since then, advances in imaging techniques such as echocardiography, angiography, CT, or magnetic resonance and extracorporeal circulation have provided excellent diagnosis and treatment of CHD. The pioneers of paediatric cardiology are more than eponyms, for each used in new and original ways the tools and concepts available in his or her era...
August 14, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28803163/-hirschsprung-associated-enterocolitis-observational-study-in-a-paediatric-emergency-care-unit
#11
Margarita Sellers, Clara Udaondo, Bárbara Moreno, Gonzalo Martínez-Alés, Jesús Díez, Leopoldo Martínez, María de Ceano-Vivas
INTRODUCTION: Hirschsprung-associated enterocolitis is a significant cause of morbidity and mortality in infants with Hirschsprung's disease. The fact that the symptoms are so variable and unspecific leads to a slow or incorrect diagnosis. The purpose of this study is to identify clinical factors associated with the diagnosis, as well as to evaluate the subsequent management of children with suspected Hirschsprung-associated enterocolitis in a paediatric emergency department. MATERIAL AND METHODS: A retrospective descriptive study was conducted on patients with Hirschsprung's disease who were seen in a paediatric emergency department between April 2011 and November 2015 due to clinical symptoms compatible with enterocolitis...
August 9, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28802093/clinical-aspects-of-opium-adulterated-with-lead-in-iran-a-review
#12
Samira Alinejad, Jan Aaseth, Mohammad Abdollahi, Hossein Hassanian-Moghaddam, Omid Mehrpour
Adulteration of drugs with poisonous substances during production or consumption has caused numerous health problems. Among contaminants that have the potential of producing poisonous effects are the heavy metals lead, arsenic and thallium that make up an important group of toxic substances. The emergence of these new health problems related to opioid abuse has precipitated this MiniReview on the status of the most hazardous and common opioid adulterants. In fact, adulterated opium is a major public health problem and can threaten the health of users...
August 12, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28801485/identifying-discordance-between-senior-physicians-and-trainees-on-the-root-cause-of-ed-revisits
#13
Michael P Goldman, Michael C Monuteaux, Catherine Perron, Richard G Bachur
OBJECTIVE: Analysis of 72-hour ED revisits is a common emergency medicine quality assurance (QA) practice. Our aim was to compare the perceived root cause for 72-hour ED revisits between senior physicians (attendings) and trainees. We proposed that discordance in perception of why the revisit occurred would guide improvements in 72-hour revisits QA and elucidate innovative educational opportunities. METHODS: Questionnaire-based observational study conducted in an urban academic paediatric ED...
August 11, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28801483/characteristics-of-youth-agreeing-to-electronic-sexually-transmitted-infection-risk-assessment-in-the-emergency-department
#14
Fahd A Ahmad, Donna B Jeffe, Katie Plax, Kenneth B Schechtman, Dwight E Doerhoff, Jane M Garbutt, David M Jaffe
OBJECTIVES: Adolescents and young adults are at high risk for sexually transmitted infections (STIs). We previously reported an increase in STI testing of adolescents in our ED by obtaining a sexual history using an Audio-enhanced Computer-Assisted Self-Interview (ACASI). We now examine associations among demographics, sexual behaviour, chief complaint and willingness to be tested. METHODS: This was a prospective study conducted in a paediatric ED between April and December 2011...
August 11, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28799220/c-reactive-protein-concentrations-can-help-to-determine-which-febrile-infants-under-three-months-should-receive-blood-cultures-during-influenza-seasons
#15
Weiran Li, Shuanghong Luo, Yu Zhu, Yang Wen, Min Shu, Chaomin Wan
AIM: We explored whether C-reactive protein (CRP) concentrations could indicate which infants with fever without source (FWS) should receive undergo blood culture tests during influenza seasons. METHODS: This retrospective study focused on patients under three months of age with FWS who had received blood culture tests at the West China Second University Hospital Paediatric Emergency Department during the influenza seasons from June 2013 to January 2015. The statistical analysis comprised: specificity, sensitivity, multilevel likelihood ratios, receiver operating characteristic analysis and a multivariate logistic regression model...
August 11, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28799175/low-age-low-birth-weight-and-congenital-heart-disease-are-risk-factors-for-intensive-care-in-infants-with-bronchiolitis
#16
Minna Mecklin, Paula Heikkilä, Matti Korppi
AIM: This study evaluated the incidence and risk factors for intensive care and respiratory support in infant bronchiolitis. METHODS: This retrospective descriptive case-control study focused on 105 patients treated in the paediatric intensive care unit (PICU) and 210 controls treated in the emergency department or on the paediatric ward in Tampere University Hospital in Finland between 2000-2015. Statistically significant risk factors in non-adjusted analyses were included in the adjusted logistic regression...
August 11, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28798812/clinical-epidemiological-and-therapeutic-profile-of-patients-with-a-retinoblastoma-diagnosis-experience-in-the-costa-rica-national-children-s-hospital-oncology-unit-from-january-2009-to-december-2015
#17
Jennie Chen Lo, Carlos Rodríguez, Rigoberto Monestel, Arnoldo Zúñiga
INTRODUCTION: Retinoblastoma represents only 3% of paediatric cancers, but it is the most prevalent intraocular tumour in this population. It develops in the retina as a primitive neuroectodermal tumour that affects development during gestation. The tumour presents in two different forms depending on whether or not it expresses a genetic modification. For patients diagnosed at preschool age, 75% are unilateral non-hereditary cases. While enucleation is the preferred treatment for advanced stages of the tumour, other modalities, such as systemic and intraocular chemotherapy, radiotherapy and local treatments with thermotherapy, cryotherapy, and brachytherapy can be used to try to preserve the eye...
2017: Ecancermedicalscience
https://www.readbyqxmd.com/read/28794881/procalcitonin-a-promising-diagnostic-marker-for-sepsis-and-antibiotic-therapy
#18
REVIEW
Ashitha L Vijayan, Vanimaya, Shilpa Ravindran, R Saikant, S Lakshmi, R Kartik, Manoj G
BACKGROUND: Sepsis is a global healthcare problem, characterized by whole body inflammation in response to microbial infection, which leads to organ dysfunction. It is becoming a frequent complication in hospitalized patients. Early and differential diagnosis of sepsis is needed critically to avoid unnecessary usage of antimicrobial agents and for proper antibiotic treatments through the screening of biomarkers that sustains with diagnostic significance. MAIN BODY OF ABSTRACT: Current targeting conventional markers (C-reactive protein, white blood cell, tumour necrosis factor-α, interleukins, etc...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28794866/who-safer-surgery-checklist-compliance-amongst-paediatric-emergency-plastic-surgery-patients-in-an-uk-hospital
#19
Welmoed W Keijzer, Riaz A Agha, Aina Greig
INTRODUCTION: The WHO Safer Surgery checklist has become an important component of perioperative safety. Our objective, was to determine the compliance of completing the checklist for paediatric emergency plastic surgery patients at our unit. METHODS: An initial baseline was performed with 70 patients over two months at our unit. Following this, we raised awareness at an audit meeting and closed the audit loop using 80 patients over two months. The audit is reported in line with SQUIRE 2...
September 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28793861/viral-and-bacterial-upper-respiratory-tract-infection-in-hospital-health-care-workers-over-time-and-association-with-symptoms
#20
C Raina MacIntyre, Abrar Ahmad Chughtai, Yi Zhang, Holly Seale, Peng Yang, Joshua Chen, Yang Pan, Daitao Zhang, Quanyi Wang
BACKGROUND: Bacterial colonisation of the respiratory tract is commonly described and usually thought to be of no clinical significance. The aim of this study was to examine the presence and significance of bacteria and viruses in the upper respiratory tract of healthcare workers (HCWs), and association with respiratory symptoms. METHODS: A prospective cohort study was conducted in China and 223 HCWs were recruited from fever clinics and respiratory, paediatric, emergency/Intensive medication wards...
August 9, 2017: BMC Infectious Diseases
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