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Primary care pediatrics

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https://www.readbyqxmd.com/read/29333808/the-perspective-of-primary-health-care-pediatricians-regarding-childhood-anemia-and-iron-supplementation
#1
Yanina Sguassero, Marcia M Guerrero, Mariana Romero
INTRODUCTION: Iron deficiency anemia is common in low- and middle-income countries. According to the evidence, the impact of ferrous sulfate supplementation in the pediatric population is low. Our objective was to analyze the perspective of pediatricians regarding anemia and iron supplementation. POPULATION AND METHODS: Qualitative, exploratory study. Semi-structured interviews were conducted with primary health care pediatricians from Rosario. Three core inquiry concepts were included: importance of this problem, clinical practice, and representations about iron supplementation...
February 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29330083/rationale-and-design-of-the-clinic-and-community-approaches-to-healthy-weight-randomized-trial
#2
Lauren Fiechtner, Meghan Perkins, Vincent Biggs, Nancy Langhans, Mona Sharifi, Giselle O'Connor, Sarah Price, Joseph Locascio, Karen Kuhlthau, Jo-Ann Kwass, Candace Nelson, Thomas Land, Matt Longjohn, Valerie Lawson, Katherine Hohman, Elsie M Taveras
BACKGROUND: Recent studies have demonstrated the effectiveness of family-centered, pediatric weight management programs in reducing childhood obesity. Yet, programs to optimize the care of low-income children with obesity are needed. We sought to examine the comparative effectiveness of two, potentially scalable pediatric weight management programs delivered to low-income children in a clinical or community setting. MATERIALS AND METHODS: The Clinic and Community Approaches to Healthy Weight trial is a randomized trial in two communities in Massachusetts that serve a large population of low-income children and families...
January 9, 2018: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29329727/parent-activation-in-the-pediatric-emergency-department-theory-vs-reality
#3
Danica B Liberman, Phung K Pham
OBJECTIVE: To measure parent activation and test for its associations with sociodemographics, clinical factors, and short-term outcomes. METHODS: By convenience sampling, 246 parents of children treated in an emergency department (ED) of a children's hospital completed the Parent-Patient Activation Measure (P-PAM) and answered sociodemographic questions. Clinical information was abstracted from medical records. Phone calls to parents and primary care physician offices were conducted within one-month post-ED visit for information about short-term outcomes...
January 8, 2018: Patient Education and Counseling
https://www.readbyqxmd.com/read/29329145/orthopaedic-management-of-leg-length-discrepancy-in-proteus-syndrome-a-case-series
#4
Molly M Crenshaw, Cara G Goerlich, Lauren E Ivey, Julie C Sapp, Kim M Keppler-Noreuil, Allison C Scott, Leslie G Biesecker, Laura L Tosi
INTRODUCTION: Proteus syndrome (PS) is a rare mosaic disorder comprising asymmetric bony and soft tissue overgrowth leading to significant morbidity. Placement of growth inhibition hardware with subsequent epiphyseal arrest improves leg-length and angular deformities in pediatric patients without PS. The purpose of this study was to review the surgical approach and present outcomes, complications, and recommendations in 8 patients with PS and leg-length discrepancy (LLD). METHODS: We conducted a retrospective chart review of 8 patients with PS whose primary reason for surgery was LLD...
January 11, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29326814/paediatric-dentistry-novel-evolvement
#5
REVIEW
Saleha Shah
Pediatric dentistry provides primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, together with special health care needs. This specialty encompasses a variety of skills, disciplines, procedures and techniques that share a common origin with other dental specialties however these have been modified and reformed to the distinctive requirements of infants, children, adolescents and special health care needs. Disciplines comprise of behavior guidance, care of the medically and developmentally compromised and disabled patient, supervision of orofacial growth and development, caries prevention, sedation, pharmacological management, and hospital dentistry including other traditional fields of dentistry...
January 2018: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29325519/providers-preferences-for-pediatric-oral-health-information-in-the-electronic-health-record-a-cross-sectional-survey
#6
Christopher M Shea, Kea Turner, B Alex White, Ye Zhu, R Gary Rozier
BACKGROUND: The majority of primary care physicians support integration of children's oral health promotion and disease prevention into their practices but can experience challenges integrating oral health services into their workflow. Most electronic health records (EHRs) in primary care settings do not include oral health information for pediatric patients. Therefore, it is important to understand providers' preferences for oral health information within the EHR. The objectives of this study are to assess (1) the relative importance of various elements of pediatric oral health information for primary care providers to have in the EHR and (2) the extent to which practice and provider characteristics are associated with these information preferences...
January 11, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29325237/neuroleptic-malignant-syndrome-diagnosis-and-management
#7
Michael R Ware, David B Feller, Karen L Hall
Objective: To provide an overview of neuroleptic malignant syndrome (NMS) for the general practitioner with the most up-to-date information on etiology, workup, and management. Data Sources: The search using PubMed included articles with the key words neuroleptic malignant syndrome, antipsychotics, neuroleptics, diagnosis, and treatment of neuroleptic malignant syndrome published in English from January 2000 to 2017. Single-case reports and articles dealing with the pediatric patient population were excluded...
January 4, 2018: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/29324477/assuring-quality-for-non-hospital-based-biologic-infusions-in-pediatric-inflammatory-bowel-disease-a-clinical-report-from-the-north-american-society-for-pediatric-gastroenterology-hepatology-and-nutrition
#8
Elaine Barfield, Robbyn Sockolow, Edward Hoffenberg, Shehzad Saeed, Sandra Kim, Leah Siebold, Joseph Picoraro, Jonathan Moses, Dana Dykes, Andrew Grossman, Ghassan Wahbeh, K T Park
The primary aim of this Clinical Report by the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition is to provide formal guidance to pediatric gastroenterologists and clinicians, health systems, and insurance payers regarding home- and office-based infusions for biologic therapies in pediatric inflammatory bowel disease (IBD). Patients in North America are increasingly denied coverage by payers based on "place of service" codes at hospital-based infusion units where the treating clinicians primarily provide care...
January 10, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29323695/lead-toxicity-in-the-pediatric-patient-with-sickle-cell-disease-unique-risks-and-management
#9
Josephine Misun Jung, Radhika Peddinti
Lead toxicity is the result of lead ingestion, one of the most common ingestions in the pediatric population. Nationwide and statewide efforts to recognize and curtail this epidemic have led to declining rates of toxicity. In patients with sickle cell disease (SCD), lead toxicity can be an elusive diagnosis due to overlapping symptom profiles, and inconsistent follow-up with a primary care physician can make the diagnosis even more difficult. In this article, two illustrative cases of lead toxicity in patients with SCD are described...
January 1, 2018: Pediatric Annals
https://www.readbyqxmd.com/read/29323688/preventing-hiv-infection-what-pediatricians-should-know-about-hiv-pre-exposure-prophylaxis
#10
Sabrina Fernandez
I recently diagnosed my first adolescent patient with new-onset HIV. As a primary care pediatrician, these cases are rare. I cried with the shock of the initial diagnosis, just as the patient did when I told him. One of my first thoughts was how could I have served him better. He had been inconsistent with condom use, and had several partners. I had encouraged safe sex practices, told him to talk to his partners about pregnancy prevention, and screened for sexually transmitted disease nearly every time he came into my office...
January 1, 2018: Pediatric Annals
https://www.readbyqxmd.com/read/29322352/supraclavicular-catheterization-of-the-brachiocephalic-vein-a-way-to-prevent-or-reduce-catheter-maintenance-related-complications-in-children
#11
Flora Habas, Julien Baleine, Christophe Milési, Clémentine Combes, Marie-Noëlle Didelot, Sara Romano-Bertrand, Delphine Grau, Sylvie Parer, Catherine Baud, Gilles Cambonie
Placement of a central venous catheter (CVC) in the brachiocephalic vein (BCV) via the ultrasound (US)-guided supraclavicular approach was recently described in children. We aimed to determine the CVC maintenance-related complications at this site compared to the others (i.e., the femoral, the subclavian, and the jugular). We performed a retrospective data collection of prospectively registered data on CVC in young children hospitalized in a pediatric intensive care unit (PICU) during a 4-year period (May 2011 to May 2015)...
January 10, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29322290/psychologists-and-pediatricians-in-the-primary-care-sandbox-communication-is-key-to-cooperative-play
#12
Anne E Pidano, Prerna Arora, Polly Y Gipson, Bradley O Hudson, Kriston B Schellinger
Recent literature, public policy, and funding opportunities call attention to the need for better increased integration of health and mental health care services in primary care settings so as to best meet the needs of children and families. There are many benefits to such integration, but pediatric primary care providers (PCPs) face multiple barriers to identifying and managing patients with mental health difficulties. One way to address this problem is through the integration of psychologists into primary care settings who can collaborate with PCPs to provide integrated behavioral health care to youth and families...
January 10, 2018: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/29320539/the-impact-of-electronic-consultation-on-a-canadian-tertiary-care-pediatric-specialty-referral-system-a-prospective-single-center-observational-study
#13
Lillian Lai, Clare Liddy, Erin Keely, Amir Afkham, Julia Kurzawa, Nishard Abdeen, Tobey Audcent, Matthew Bromwich, Jason Brophy, Sasha Carsen, Annick Fournier, Leigh Fraser-Roberts, Hazen Gandy, Charles Hui, Donna Johnston, Kathryn Keely, Ken Kontio, Christine Lamontagne, Nathalie Major, Michael O'Connor, Dhenuka Radhakrishnan, Joe Reisman, Marjorie Robb, Lindy Samson, Erick Sell, William Splinter, Judy van Stralen, Sunita Venkateswaran, Kimmo Murto
BACKGROUND: Champlain BASE™ (Building Access to Specialists through eConsultation) is a web-based asynchronous electronic communication service that allows primary-care- practitioners (PCPs) to submit "elective" clinical questions to a specialist. For adults, PCPs have reported improved access and timeliness to specialist advice, averted face-to-face specialist referrals in up to 40% of cases and high provider satisfaction. OBJECTIVE: To determine whether the expansion of eConsult to a pediatric setting would result in similar measures of improved healthcare system process and high provider acceptance reported in adults...
2018: PloS One
https://www.readbyqxmd.com/read/29316006/extubation-in-the-operating-room-after-pediatric-liver-transplant-a-retrospective-cohort-study
#14
Harshad G Gurnaney, Scott D Cook-Sather, Abraham Shaked, Kim M Olthoff, Elizabeth B Rand, Arul M Lingappan, Mohamed A Rehman
BACKGROUND: Early extubation immediately following liver transplantation is increasingly common in adult practice. Some pediatric institutions have begun to adopt this strategy. Careful patient selection is essential in minimizing risk. METHODS: This retrospective cohort study evaluated infants and children who underwent liver transplantation between July 2011 and December 2014. Our primary objective was to determine early extubation rate. Secondary objectives were to identify clinical factors associated with successful early extubation compared with delayed extubation and to examine significant postoperative complications, intensive care unit length of stay, and hospital length of stay...
January 8, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29315136/renal-replacement-therapy-in-the-critically-ill-child
#15
Claire A Westrope, Sarah Fleming, Melpo Kapetanstrataki, Roger C Parslow, Kevin P Morris
OBJECTIVES: Although renal replacement therapy is widely used in critically ill children, there have been few comprehensive population-based studies of its use. This article describes renal replacement therapy use, and associated outcomes, in critically ill children across the United Kingdom in the largest cohort study of this patient group. DESIGN: A retrospective observational study using prospectively collected data. SETTING: Data from the Pediatric Intensive Care Audit Network database which collects data on all children admitted to U...
January 8, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29314789/risk-factors-for-hospitalizations-due-to-bacterial-respiratory-tract-infections-after-tracheotomy
#16
Christopher J Russell, Cary Thurm, Matt Hall, Tamara D Simon, Michael N Neely, Jay G Berry
OBJECTIVE: Identify characteristics associated with hospital readmission due to bacterial respiratory tract infections (bRTI) after tracheotomy. STUDY DESIGN: Retrospective study of 8009 children 0-17 years undergoing tracheotomy from 2007 to 2013 at 48 children's hospitals in the Pediatric Health Information System database. The primary outcome was first hospital admission after tracheotomy for bRTI (ie, primary diagnosis of bRTI or a primary diagnosis of bRTI symptom and secondary diagnosis of bRTI)...
January 4, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29313137/fungal-peritonitis-in-the-standardizing-care-to-improve-outcomes-in-pediatric-end-stage-renal-disease-scope-collaborative
#17
Raj Munshi, Christine B Sethna, Troy Richardson, Jonathan Rodean, Samhar Al-Akash, Sushil Gupta, Alicia M Neu, Bradley A Warady
BACKGROUND: Fungal peritonitis is a serious complication among peritoneal dialysis (PD) patients. The Standardizing Care to Improve Outcomes in Pediatric End Stage Renal Disease (SCOPE) Collaborative is a North American multicenter quality improvement initiative with the primary aim to reduce catheter-related infections in children on chronic dialysis. OBJECTIVE: To describe the epidemiology of fungal peritonitis and outcomes of affected patients among pediatric subjects receiving chronic PD and enrolled in SCOPE...
January 8, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29311177/medical-students-views-of-medicine-as-a-calling-and-selection-of-a-primary-care-related-residency
#18
Audiey C Kao, Andrew J Jager
With the US health care system facing a primary care physician shortage, we evaluated whether medical students who saw medicine as a calling were more likely to enter a family medicine, internal medicine, or pediatrics residency program. Of the 591 4th-year medical students who responded to a survey item on medicine as a calling, 237 strongly agreed that the "practice of medicine is a calling." Students who strongly agreed that medicine was a calling had higher odds (P=.003) of selecting a primary care-related residency...
January 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29311172/the-influence-of-family-physicians-within-the-south-african-district-health-system-a-cross-sectional-study
#19
Klaus B von Pressentin, Robert J Mash, Laurel Baldwin-Ragaven, Roelf Petrus Gerhardus Botha, Indiran Govender, Wilhelm Johannes Steinberg, Tonya M Esterhuizen
PURPOSE: Evidence of the influence of family physicians on health care is required to assist managers and policy makers with human resource planning in Africa. The international argument for family physicians derives mainly from research in high-income countries, so this study aimed to evaluate the influence of family physicians on the South African district health system. METHODS: We conducted a cross-sectional observational study in 7 South African provinces, comparing 15 district hospitals and 15 community health centers (primary care facilities) with family physicians and the same numbers without family physicians...
January 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29305113/developing-a-postpartum-depression-screening-and-referral-procedure-in-pediatric-primary-care
#20
Julee Waldrop, Alasia Ledford, Leslie Chandler Perry, Linda S Beeber
INTRODUCTION: Postpartum depression affects approximately 10% to 20% of mothers and impairs a mother's ability to engage with her child at an emotional and cognitive level, placing the child at greater risk for impaired development. Early diagnosis and management can reduce its negative impacts. Despite mothers being receptive to screening, screening rates are less than 50%. METHODS: This article provides an appraisal of the current state of the evidence on implementing screening for postpartum depression in pediatric primary care...
January 2, 2018: Journal of Pediatric Health Care
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