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https://www.readbyqxmd.com/read/28337687/assessing-the-culture-of-residency-using-the-c-change-resident-survey-validity-evidence-in-34-u-s-residency-programs
#1
Linda H Pololi, Arthur T Evans, Janet T Civian, Sandy Shea, Robert T Brennan
BACKGROUND: A practical instrument is needed to reliably measure the clinical learning environment and professionalism for residents. OBJECTIVE: To develop and present evidence of validity of an instrument to assess the culture of residency programs and the clinical learning environment. DESIGN: During 2014-2015, we surveyed residents using the C - Change Resident Survey to assess residents' perceptions of the culture in their programs. PARTICIPANTS: Residents in all years of training in 34 programs in internal medicine, pediatrics, and general surgery in 14 geographically diverse public and private academic health systems...
March 23, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28337087/medication-dosage-in-overweight-and-obese-children
#2
Kelly L Matson, Evan R Horton, Amanda C Capino
Approximately 31.8% of U.S. children ages 2 to 19 years are considered overweight or obese. This creates significant challenges to dosing medications that are primarily weight based (mg/kg) and in predicting pharmacokinetics parameters in pediatric patients. Obese individuals generally have a larger volume of distribution for lipophilic medications. Conversely, the Vd of hydrophilic medications may be increased or decreased due to increased lean body mass, blood volume, and decrease percentage of total body water...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28337081/a-comprehensive-list-of-items-to-be-included-on-a-pediatric-drug-monograph
#3
Lauren E Kelly, Shinya Ito, David Woods, Anthony J Nunn, Carol Taketomo, Matthijs de Hoog, Martin Offringa
OBJECTIVES: Children require special considerations for drug prescribing. Drug information summarized in a formulary containing drug monographs is essential for safe and effective prescribing. Currently, little is known about the information needs of those who prescribe and administer medicines to children. Our primary objective was to identify a list of important and relevant items to be included in a pediatric drug monograph. METHODS: Following the establishment of an expert steering committee and an environmental scan of adult and pediatric formulary monograph items, 46 participants from 25 countries were invited to complete a 2-round Delphi survey...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28334593/pediatric-postoperative-pulse-oximetry-monitoring-during-transport-to-the-postanesthesia-care-unit-reduces-frequency-of-hypoxemia
#4
Thomas J Caruso, Tara E Mokhtari, Monica J Coughlan, Diane S Wu, Juan L Marquez, Melissa Duan, Heather Freeman, Andrew Giustini, Mary Tweedy, Paul J Sharek
BACKGROUND: The standard use of pulse oximetry during the transport of postoperative patients from the operating room (OR) to the postanesthesia care unit (PACU) is not routinely practiced. A study was conducted to determine if the frequency of hypoxemia on admission to the PACU decreased after implementation of routine use of transport pulse oximeters for postoperative patients being transferred to the PACU. METHODS: In this prospective cohort study, which was conducted at an academic pediatric hospital, the primary outcome measure was the frequency of hypoxemic events on arrival to the PACU...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28333917/a-clinical-utility-study-of-exome-sequencing-versus-conventional-genetic-testing-in-pediatric-neurology
#5
Lisenka E L M Vissers, Kirsten J M van Nimwegen, Jolanda H Schieving, Erik-Jan Kamsteeg, Tjitske Kleefstra, Helger G Yntema, Rolph Pfundt, Gert Jan van der Wilt, Lotte Krabbenborg, Han G Brunner, Simone van der Burg, Janneke Grutters, Joris A Veltman, Michèl A A P Willemsen
PURPOSE: Implementation of novel genetic diagnostic tests is generally driven by technological advances because they promise shorter turnaround times and/or higher diagnostic yields. Other aspects, including impact on clinical management or cost-effectiveness, are often not assessed in detail prior to implementation. METHODS: We studied the clinical utility of whole-exome sequencing (WES) in complex pediatric neurology in terms of diagnostic yield and costs. We analyzed 150 patients (and their parents) presenting with complex neurological disorders of suspected genetic origin...
March 23, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/28333546/pharmacokinetics-and-safety-of-vortioxetine-in-pediatric-patients
#6
Robert L Findling, Adelaide S Robb, Melissa DelBello, Michael Huss, Nora McNamara, Elias Sarkis, Russell Scheffer, Lis H Poulsen, Grace Chen, Ole Michael Lemming, Johan Areberg, Philippe Auby
OBJECTIVE: The primary objectives of this study were to evaluate the pharmacokinetics (PK) and tolerability of single and multiple doses of vortioxetine in children and adolescents with a depressive or anxiety disorder and to provide supportive information for appropriate dosing regimens for pediatric clinical trials. METHODS: This prospective, open-label, multinational, multisite, multiple-dose trial enrolled 48 patients (children and adolescents; 1:1 ratio) divided into 8 cohorts (4 adolescent and 4 child), with each cohort including 6 patients...
March 23, 2017: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/28329458/type-iv-total-anomalous-pulmonary-venous-connection
#7
James D St Louis, Elizabeth M Turk, Jeffrey P Jacobs, James E O'Brien
BACKGROUND: Mortality associated with correction of type IV total anomalous pulmonary venous connection (TAPVC) is generally reported in combination with other anatomic types. The objective of this study is to review surgical outcomes associated with the repair of type IV TAPVC by analyzing a multi-institutional cohort specific for this group. We also analyze patient-specific variables that may contribute to poor operative outcomes. METHODS: A retrospective review of the Pediatric Cardiac Care Consortium (PCCC) registry identified patients who underwent repair of type IV TAPVC between 1982 and 2007...
March 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28328609/evaluation-of-dentoalveolar-trauma-in-children-and-adolescents-a-modified-classification-system-and-surgical-treatment-strategies-for-its-management
#8
Nadia Theologie-Lygidakis, Ourania K Schoinohoriti, Minas Leventis, Ioannis Iatrou
OBJECTIVE: To retrospectively analyze dentoalveolar trauma in pediatric patients, propose a modified classification, and delineate an approach for its urgent care from the surgeon's perspective. PATIENTS AND METHODS: Clinical records of patients, attended at the 'A. and P. Kyriakou' Children's Hospital Department of Oral and Maxillofacial Surgery from 2000 to 2015, were retrieved and data were analyzed. RESULTS: A total of 365 cases of dentoalveolar trauma, affecting 363 children and adolescents (221 males and 142 females), with an age range from 1 to 15 years, were treated in the authors' department...
March 21, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28328172/acute-lymphoblastic-leukemia-in-adolescents-and-young-adults
#9
REVIEW
Michael E Rytting, Elias J Jabbour, Susan M O'Brien, Hagop M Kantarjian
Acute lymphoblastic leukemia (ALL) in the adolescent and young adult (AYA) population is a difficult clinical problem. The AYA population, generally regarded as patients aged 15 to 39 years, currently draws a good deal of attention, particularly in the area of therapy selection. The current trend is to treat this group of patients with leukemia regimens based on pediatric protocols, and results comparing pediatric approaches versus adult approaches to treatment are maturing. Results are pending from a large US trial in which pediatric-based treatment is given to AYA patients with ALL...
March 22, 2017: Cancer
https://www.readbyqxmd.com/read/28325486/mri-utilization-and-the-associated-use-of-sedation-and-anesthesia-in-a-pediatric-aco
#10
Joshua C Uffman, Dmitry Tumin, Vidya Raman, Arlyne Thung, Brent Adler, Joseph D Tobias
BACKGROUND AND OBJECTIVES: MRI is commonly used in the pediatric population and often requires sedation or general anesthesia to complete. This study used data from a pediatric accountable care organization (ACO) to investigate trends in MRI utilization and in the requirement for anesthesia to complete MRI examinations. METHODS: The Partners for Kids (PFK) ACO claims database was queried for MRI examination encounters involving patients 0 to 18 years old from 2009 to 2014, with utilization expressed as encounters per 10,000 PFK members-months...
March 15, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28324682/gene-expression-analysis-in-untreated-absence-epilepsy-demonstrates-an-inconsistent-pattern
#11
Markus von Deimling, Robert Häsler, Verena Steinbach, Paul-Martin Holterhus, Sarah von Spiczak, Ulrich Stephani, Ingo Helbig, Hiltrud Muhle
OBJECTIVE: Childhood and Juvenile Absence Epilepsy account for 30% of all genetic generalized epilepsies with a strong genetic contribution. At the current state the genetic background remains to be resolved. The aim of this study was to identify disease associated transcripts pinpointing potential underlying disease mechanisms in patients with CAE and JAE. METHODS: We performed gene expression analysis from peripheral blood mononuclear cells (PBMCs) in 30 patients with newly-diagnosed absence epilepsy prior to initiating treatment and 30 healthy age - and gender-matched pediatric controls...
February 28, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28324390/evaluation-of-administered-dose-using-portal-images-in-craniospinal-irradiation-of-pediatric-patients
#12
Carina Marques Coelho, Raquel Calçada, Sofia Rodrigues, Juan Antonio Barragán, Ana Cravo Sá, Ana Paula Macedo, Maria de Fátima Monsanto
This study aimed to assess the administered dose based on portal imaging in craniospinal pediatric irradiation by evaluating cases in which portal images did or did not account for the total administered dose. We also intended to calculate the mean increase in total administered dose. Data were collected from General University Hospital Gregorio Marañón; we evaluated the total dose administered, total dose planned, number of portal images per treatment and corresponding monitor units of two different groups: one in which the dose from portal images is deducted from the total administered dose (D), and another in which it was not (N)...
March 21, 2017: Radiological Physics and Technology
https://www.readbyqxmd.com/read/28322573/blood-lead-levels-and-neurodevelopmental-function-in-perinatally-hiv-exposed-uninfected-children-in-a-us-based-longitudinal-cohort-study
#13
Katherine Tassiopoulos, Yanling Huo, Joseph Braun, Paige L Williams, Renee Smith, Ann Aschengrau, Sharon Nichols, Rohan Hazra, William A Meyer, Katherine Knapp, Nagamah S Deygoo, George R Seage Iii
BACKGROUND: While children's exposure to environmental lead in the U.S. has decreased, areas of elevated levels remain. Because lead exposure is a risk factor for developmental delays, it should be considered when studying neurodevelopmental effects of in-utero antiretroviral medication (ARV) exposure in the growing population of perinatally HIV-exposed, uninfected children (PHEU). We compared blood lead levels (BPb) in PHEU children enrolled in the Surveillance Monitoring of ART Toxicities (SMARTT) Study to U...
March 21, 2017: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/28319559/pediatric-solid-tumors-in-africa-different-biology
#14
John K M Nyagetuba, Erik N Hansen
PURPOSE OF REVIEW: To review the recent literature regarding biologic characteristics of pediatric solid tumors in African children. RECENT FINDINGS: Data regarding pediatric solid tumors in Africa, while increasing, remain sparse when considering the ethnic and geographic diversity of the continent. Recent work, especially regarding nephroblastoma in Kenya, has identified some biologic variability among local tribes but also when compared with North American tumors...
March 17, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28319548/tanshinone-iia-attenuates-sevoflurane-neurotoxicity-in-neonatal-mice
#15
Yimeng Xia, Heng Xu, Chenfei Jia, Xiaodong Hu, Yu Kang, Xiaoxuan Yang, Qingsheng Xue, Guorong Tao, Buwei Yu
BACKGROUND: Sevoflurane is the most widely used inhalational anesthetic in pediatric medicine. Despite this, sevoflurane has been reported to exert potentially neurotoxic effects on the developing brain. Clinical interventions and treatments for these effects are limited. Tanshinone IIA (Tan IIA), extracted from Salvia miltiorrhiza (Danshen), has been documented to alleviate cognitive decline in traditional applications. Therefore, we hypothesized that preadministration of Tan IIA may attenuate sevoflurane-induced neurotoxicity, suggesting that Tan IIA is a new and promising drug capable of counteracting the effects of cognitive dysfunction produced by general anesthetics...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28319075/autologous-hematopoietic-stem-cell-transplantation-for-pediatric-multiple-sclerosis-a-registry-based-study-of-the-autoimmune-diseases-working-party-adwp-and-pediatric-diseases-working-party-pdwp-of-the-european-society-for-blood-and-marrow-transplantation-ebmt
#16
J Burman, K Kirgizov, K Carlson, M Badoglio, G L Mancardi, G De Luca, B Casanova, J Ouyang, R Bembeeva, J Haas, P Bader, J Snowden, D Farge
Autologous hematopoietic stem cell transplantation (aHSCT) is a promising therapy for multiple sclerosis (MS), which has mainly been used in adults. The purpose of this study was to investigate efficacy and adverse events of aHSCT in the treatment of children with MS using data from the European Society for Blood and Marrow Transplantation registry. Twenty-one patients with a median follow-up time of 2.8 years could be identified. PFS at 3 years was 100%, 16 patients improved in expanded disability status scale score and only 2 patients experienced a clinical relapse...
March 20, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28318950/cholesteryl-ester-storage-disease-an-underdiagnosed-cause-of-cirrhosis-in-adults
#17
REVIEW
Mamta Pant, Kiyoko Oshima
Cholesteryl Ester Storage Disease (CESD), is a rare multisystem autosomal recessive disorder and belongs to the broad family of lysosomal storage disorders. It can present anytime from infancy and childhood to even adulthood. The clinical manifestations are generally severe in infants and with milder forms in adults. One of the prominent sites of involvement is liver. Due to low awareness of this condition among physicians including surgical pathologists, majority of the liver biopsies, especially from the adults are often misdiagnosed as non-alcoholic fatty liver disease/non-alcoholic steatohepatitis or cryptogenic cirrhosis...
February 9, 2017: Annals of Diagnostic Pathology
https://www.readbyqxmd.com/read/28318197/-generalized-eruptive-histiocytosis-juvenile-xanthogranuloma-clinical-spectrum-in-a-pediatric-patient
#18
Ruth Alperovich, Pedro T Grassino, Raúl Asial, Luis Pasteris, María Del Carmen Boente
Both, generalized eruptive histiocytosis and juvenile xanthogranuloma are dendritic histiocytic disorders (also known as non-Langerhans cells histiocytosis) that share clinicopathological and immunohistiochemical characteristics. We present a 3-year-old female patient with skin lesions that were clinically compatible with generalized eruptive histiocytosis, confirmed by histopathological and immunohistochemical studies. During her development the disorder compromised the central nervous system, and surgical intervention of one symptomatic lesion was needed...
April 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28318190/successful-administration-of-measles-rubella-mumps-vaccine-by-graded-challenge-in-a-case-with-anaphylaxis-after-prior-vaccination
#19
Tuba Tuncel, Ozlem Sancakli, Ece Ozdogru
Egg allergy is one of the most common food allergies during childhood along with cow's milk allergy. The measles-mumpsrubella (MMR) vaccine is included in the pediatric immunization schedule and contains egg protein. The currently accepted opinion is that the MMR vaccination should be done in a single dose under medical observation in patients with egg allergy. Although it is reported that the MMR vaccine is safe for that patients, there are some patients who developed anaphylaxis. Generally, the development of anaphylaxis after the previous vaccination is reported as a contraindication...
April 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28318175/psychosocial-care-in-the-department-of-pediatric-hematology-and-oncology-of-public-hospitals-in-argentina
#20
Débora Farberman, Teresa Méndez, Leticia García, Lucía Salvia, Silvia Otarolac
BACKGROUND: Blood diseases and cancer are part of a group of rare conditions in pediatrics. In general, cancer treatments are prolonged (months or years), so psychosocial support has been introduced to provide comprehensive care to these patients. OBJECTIVE: To explore psychosocial care provided at the public hospitals of Argentina to children and adolescents with cancer. Population and Methods. An electronic questionnaire was sent to the heads of the Departments of Hematology and Oncology, Mental Health, and Social Services of 27 public hospitals providing care to pediatric patients with cancer...
April 1, 2017: Archivos Argentinos de Pediatría
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