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Primary care pediatrics

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https://www.readbyqxmd.com/read/28319803/social-economic-costs-of-type-1-diabetes-mellitus-in-pediatric-patients-in-spain-chrystal-observational-study
#1
Julio López-Bastida, Juan Pedro López-Siguero, Juan Oliva-Moreno, Magaly Perez-Nieves, Renata Villoro, Tatiana Dilla, María Merino, Dingfeng Jiang, Isaac Aranda-Reneo, Jesús Reviriego, Luis Alberto Vázquez
AIMS: To estimate the social-economic costs of Type 1 Diabetes Mellitus (T1DM) in patients aged 0-17years in Spain from a social perspective. METHODS: We conducted a cross-sectional observational study in 2014 of 275 T1DM pediatric outpatients distributed across 12 public health centers in Spain. Data on demographic and clinical characteristics, healthcare utilization and informal care were collected from medical records and questionnaires completed by clinicians and patients' caregivers...
March 7, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28319507/recombinant-factor-viia-is-associated-with-increased-thrombotic-complications-in-pediatric-cardiac-surgery-patients
#2
Laura Downey, Morgan L Brown, David Faraoni, David Zurakowski, James A DiNardo
BACKGROUND: Recombinant factor VIIa (rFVIIa) is routinely used as an off-label hemostatic agent in children undergoing cardiac surgery. Despite evidence that rFVIIa use is associated with an increased incidence of thrombotic complications in adult cardiac surgery, the safety of rFVIIa as a rescue hemostatic agent in the pediatric cardiac surgical population is less definitively delineated. In this retrospective study, we used propensity score matching to compare the incidence of thrombotic complications between children treated with rFVIIa and their matched controls...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28306215/primary-mediastinal-and-retroperitoneal-malignant-germ-cell-tumors-in-children-and-adolescents-results-of-the-tgm95-trial-a-study-of-the-french-society-of-pediatric-oncology-soci%C3%A3-t%C3%A3-fran%C3%A3-aise-des-cancers-de-l-enfant
#3
Hélène Sudour-Bonnange, Cécile Faure-Conter, Hélène Martelli, Frederic Hameury, Brice Fresneau, Daniel Orbach, Cécile Vérité
PURPOSE: To examine the clinical presentation, treatment and results in children and adolescents with primary mediastinal (PM) and retroperitoneal (RP) germ cell tumors (GCTs). METHODS: The TGM95 trial for malignant GCTs was conducted in France between 1995 and 2005 to evaluate a strategy adapted to prognostic factors with cisplatin-based chemotherapy and surgical management. We reviewed patients with TGCTs at PM and RP sites. RESULTS: Among 239 patients, there were 16 patients with PM and 5 with RP tumors, which represent 9% of all patients, highlighting the rarity of these extragonadal locations...
March 17, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28306212/tracheal-extubation-practices-following-adenotonsillectomy-in-children-effects-on-operating-room-efficiency-between-two-institutions
#4
Hiromi Kako, Marco Corridore, Sarah Seo, Charles Elmaraghy, Meredith Lind, Joseph D Tobias
BACKGROUND: Adenotonsillectomy is one of the most commonly performed operative procedures in children. It is imperative to find the most efficient and cost-effective methods of practice to facilitate operating room management while maintaining patient safety. We investigated the efficiency of two different approaches of tracheal extubation in pediatric patients following adenotonsillectomy at two tertiary care pediatric hospitals with large surgical volumes. The primary aim of the study was to determine the difference in the operating room time according to the institutional practice of tracheal extubation in the postanesthesia care unit (PACU) as compared to the operating room...
March 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28302425/characteristics-of-pediatric-emergency-revisits-after-an-asthma-related-hospitalization
#5
Laurie H Johnson, Andrew F Beck, Robert S Kahn, Bin Huang, Patrick H Ryan, Kelly K Olano, Katherine A Auger
STUDY OBJECTIVE: We identify and characterize factors related to subsequent emergency revisits among children hospitalized for asthma. METHODS: This population-based, prospective, observational cohort included children aged 2 to 16 years, hospitalized for asthma at an urban pediatric facility and followed for greater than or equal to 12 months. The primary outcome was asthma-related emergency revisit within 12 months of discharge. Revisits were identified by billing codes, respiratory chief complaints, and medications administered (eg, albuterol, systemic corticosteroids), dispensed, or prescribed...
March 14, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28302365/food-insecurity-screening-in-pediatric-primary-care-can-offering-referrals-help-identify-families-in-need
#6
Clement J Bottino, Erinn T Rhodes, Catherine Kreatsoulas, Joanne E Cox, Eric W Fleegler
OBJECTIVE: To describe a clinical approach for food insecurity screening incorporating a menu offering food-assistance referrals, and to examine relationships between food insecurity and referral selection. METHODS: Caregivers of 3- to 10-year-old children presenting for well-child care completed a self-administered questionnaire on a laptop computer. Items included the US Household Food Security Survey Module: 6-Item Short Form (food insecurity screen) and a referral menu offering assistance with: 1) finding a food pantry, 2) getting hot meals, 3) applying for Supplemental Nutrition Assistance Program (SNAP), and 4) applying for Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)...
March 13, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28301859/brief-telephone-delivered-cognitive-behavioral-therapy-targeted-to-parents-of-children-with-functional-abdominal-pain-a-randomized-controlled-trial
#7
Rona L Levy, Shelby L Langer, Miranda A L van Tilburg, Joan M Romano, Tasha B Murphy, Lynn S Walker, Lloyd A Mancl, Robyn L Claar, Melissa M DuPen, William E Whitehead, Bisher Abdullah, Kimberly S Swanson, Melissa D Baker, Susan A Stoner, Dennis L Christie, Andrew D Feld
Pediatric functional abdominal pain disorders (FAPDs) are associated with increased health care utilization, school absences, and poor quality of life (QoL). Cost-effective and accessible interventions are needed. This multisite study tested the effects of a 3-session cognitive behavioral intervention delivered to parents, in-person or remotely, on the primary outcome of pain severity and secondary outcomes (process measures) of parental solicitousness, pain beliefs, catastrophizing, and child-reported coping...
April 2017: Pain
https://www.readbyqxmd.com/read/28301621/treatment-of-atopic-dermatitis-in-the-united-states-analysis-of-data-from-the-national-ambulatory-medical-care-survey
#8
Sean P McGregor, Michael E Farhangian, Karen E Huang, Steven R Feldman
<p>Introduction: Atopic dermatitis (AD) affects both adult and pediatric patients, and multiple practitioners encounter and manage AD. However, differences with regard to the treatment of AD between specialties are not well characterized. OBJECTIVE: The primary objective of this study was to determine if there is a difference between dermatologists and non-dermatology specialties with regard to treatment strategies for AD and to describe those differences. METHODS: Data from the 1993-2010 National Ambulatory Medical Care (NAMCS) and National Hospital Ambulatory Care (NHAMCS) Surveys were used to characterize outpatient visits made for AD...
March 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28292873/variation-in-inpatient-croup-management-and-outcomes
#9
Amy Tyler, Lisa McLeod, Brenda Beaty, Elizabeth Juarez-Colunga, Meghan Birkholz, Daniel Hyman, Allison Kempe, James Todd, Amanda F Dempsey
BACKGROUND AND OBJECTIVES: Croup is a clinical diagnosis, and the available evidence suggests that, except in rare cases, ancillary testing, such as radiologic imaging, is not helpful. Given the paucity of inpatient-specific evidence for croup care, we hypothesized that there would be marked variability in the use of not routinely indicated resources (NRIRs). Our primary study objective was to describe the variation and predictors of variation in the use of NRIRs. METHODS: This was a retrospective cohort study that used the Pediatric Health Information System database of generally healthy inpatients with croup aged 6 months to 15 years who were admitted between January 1, 2012 and September 30, 2014...
March 14, 2017: Pediatrics
https://www.readbyqxmd.com/read/28292850/clinical-outcomes-of-bronchiolitis-after-implementation-of-a-general-ward-high-flow-nasal-cannula-guideline
#10
Jeffrey Riese, Timothy Porter, Jamie Fierce, Alison Riese, Troy Richardson, Brian K Alverson
OBJECTIVE: The goal of this study was to assess the association of the introduction of a ward's high-flow nasal cannula (HFNC) guideline with clinical outcomes of infants with bronchiolitis. METHODS: We conducted a retrospective, pre-post intervention study with an interrupted time series analysis of infants admitted with bronchiolitis between 2010 and 2014 at an urban, tertiary care children's hospital. Patients admitted in the 24 months before and after initiation of a guideline for HFNC use on the general wards were compared...
March 14, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28292580/-analysis-of-parental-knowledge-and-care-in-childhood-fever
#11
Maria-Cristina Pérez-Conesa, Inés Sánchez Pina, Saida Ridao Manonellas, Antoni Tormo Esparza, Verónica García Hernando, Marta López Fernández
OBJECTIVE: To describe the parental knowledge and care of fever in children under 2years. Relate this data with socio-demographic with characteristics. DESIGN: Cross-sectional and correlation multicenter study. LOCATION: Five teams of Primary Care in Barcelona. PARTICIPANTS: Parents of children under 2years attended to administer a vaccine included in the pediatric systematic calendar. A total of 311 subjects participated...
March 11, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28292451/long-acting-reversible-contraception-an-essential-guide-for-pediatric-primary-care-providers
#12
REVIEW
Suzanne Allen, Erin Barlow
Long-acting reversible contraception (LARC) methods are 20% more effective than traditional contraceptives and are recommended by the American Academy of Pediatrics and American College of Obstetrics and Gynecology as first-line contraception for adolescent girls. Large studies show that LARC use reduces unintended pregnancies, increases user satisfaction, and prolongs duration of use. This article prepares the primary care provider (PCP) with knowledge on safety, efficacy, eligibility, confidentiality, anticipatory guidance, how to find a LARC provider, and guidance on common side effects so the PCP can confidently counsel adolescent patients on LARC methods...
April 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28292409/therapeutic-options-to-treat-pediatric-obesity
#13
REVIEW
Allen F Browne
Obesity in children and adolescents is a severe health, psychosocial, and economic problem. Treatment of obesity should be based on the physiology, biochemistry, and genetics of the disease. Treatment is designed to prevent the comorbidities of obesity and allow a healthy, high-quality, and productive life. Treatment is based on healthy living and usually involves tools such as pharmacotherapy, medical device therapy, and bariatric surgery. Bariatric surgery is not acceptable to most patients, parents, primary care providers, and payers...
April 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28291151/research-interest-in-pediatric-emergency-medicine-fellows
#14
Kenneth A Michelson, Lise E Nigrovic, Joshua Nagler, Constance M McAneney, Rakesh D Mistry
OBJECTIVE: Factors predictive of research career interest among pediatric emergency medicine (PEM) fellows are not known. We sought to determine the prevalence and determinants of interest in research careers among PEM fellows. METHODS: We performed an electronically distributed national survey of current PEM fellows. We assessed demographics, barriers to successful research, and beliefs about research using 4-point ordinal scales. The primary outcome was the fellow-reported predicted percentage of time devoted to clinical research 5 years after graduation...
March 13, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28290144/the-effects-of-framed-messages-for-engaging-adolescents-with-online-smoking-prevention-interventions
#15
Darren Mays, Kirsten B Hawkins, Christine Bredfeldt, Hilary Wolf, Kenneth P Tercyak
Messages emphasizing the harms of smoking (loss-framed) or the benefits of not smoking (gain-framed) may be effective for engaging adolescents with tobacco prevention resources. This novel approach could help to close a gap in tobacco prevention intervention delivery in the pediatric primary care setting. To examine the effects of framed messages for engaging adolescents with an evidence-based smoking prevention website, adolescents ages 12 to 17 presenting for primary care well-visits were recruited for a three-arm experiment...
March 13, 2017: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/28290063/behavioral-health-integration-in-large-multi-group-pediatric-practice
#16
REVIEW
Abigail Boden Schlesinger
There is increasing interest in methods to improve access to behavioral health services for children and adolescents. Children's Community Pediatric Behavioral Health Service (CCPBHS) is an integrated behavioral health service whose method of (a) creating a leadership team with empowered administrative and clinical stakeholders who can act on a commitment to change and (b) having a clear mission statement with integrated administrative and clinical care processes can serve as a model for implementing integration efforts within the medical home...
March 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/28289613/effect-of-perioperative-management-on-outcome-of-patients-after-craniosynostosis-surgery
#17
Abdoljalil Kalantar Hormozi, Nastaran Mahdavi, Mohammad Mehdi Foroozanfar, Seyed Sajad Razavi, Razavi Mohajerani, Ahmad Eghbali, Amir Ali Mafi, Haleh Hashemzadeh, Alireza Mahdavi
BACKGROUND: Craniosynostosis results from premature closure of one or more cranial sutures, leading to deformed calvaria and craniofacial skeleton at birth. Postoperative complications and outcome in intensive care unit (ICU) is related to surgical method and perioperative management. This study determined the perioperative risk factors, which affect outcome of patients after craniosynostosis surgery. METHODS: In a retrospective study, 178 patients with craniosynostosis who underwent primary cranial reconstruction were included...
January 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28288150/-unknown-title
#18
Janneke Dekker, Stuart B Hooper, Jeroen J van Vonderen, Ruben Sgm Witlox, Enrico Lopriore, Arjan B Te Pas
BACKGROUND: Caffeine promotes spontaneous breathing by antagonizing adenosine. We assessed the direct effect of caffeine on respiratory effort in preterm infants at birth. METHODS: Thirty infants of 24-30 weeks of gestation were randomized for receiving caffeine directly after birth in the delivery room (caffeine DR-group) or later in the neonatal intensive care unit (control-group). Primary outcome was respiratory effort, expressed as minute volume, tidal volumes, respiratory rate, rate of rise to maximum tidal volume and recruitment breaths at 7-9 minutes after birth...
March 13, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28288026/delirium-and-mortality-in-critically-ill-children-epidemiology-and-outcomes-of-pediatric-delirium
#19
Chani Traube, Gabrielle Silver, Linda M Gerber, Savneet Kaur, Elizabeth A Mauer, Abigail Kerson, Christine Joyce, Bruce M Greenwald
OBJECTIVES: Delirium occurs frequently in adults and is an independent predictor of mortality. However, the epidemiology and outcomes of pediatric delirium are not well-characterized. The primary objectives of this study were to describe the frequency of delirium in critically ill children, its duration, associated risk factors, and effect on in-hospital outcomes, including mortality. Secondary objectives included determination of delirium subtype, and effect of delirium on duration of mechanical ventilation, and length of hospital stay...
March 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28287682/return-to-school-and-learning-after-concussion-tips-for-pediatricians
#20
Matthew F Grady, Christina L Master
Concussion in children and adolescents is a common injury that is usually managed by the primary care provider. Students with a concussion may present with a variety of symptoms, and these symptoms interfere with regular school participation. Optimizing the timing and progression of return to school and learning is often challenging, but with a careful history and concussion-specific examination, the primary care provider can identify potential barriers to school reentry. This review focuses on developing a systematic approach to the initial concussion evaluation and developing customized school accommodations to aid in the school reentry process...
March 1, 2017: Pediatric Annals
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