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Primary care pediatrics

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https://www.readbyqxmd.com/read/29777782/financial-analysis-of-pediatric-resident-physician-primary-care-longitudinal-outpatient-experience
#1
Carole H Stipelman, Brad Poss, Laura Anne Stetson, Luca Boi, Michael Rogers, Caleb Puzey, Sri Koduri, Robert Kaplan, Vivian S Lee, Edward B Clark
PURPOSE: To determine whether residency training represents a net positive or negative cost to academic medical centers, we analyzed the cost of a residency program and clinical productivity of residents and faculty in outpatient primary care practice with or without residents. METHOD: Patient volume and revenue data (Current Procedural Terminology codes) from an academic primary care general pediatric clinic were evaluated for faculty clinics (faculty only) and resident teaching clinics (Longitudinal Outpatient Experience [LOE]) with 1-4 residents/faculty...
May 16, 2018: Academic Pediatrics
https://www.readbyqxmd.com/read/29776980/free-tax-services-in-pediatric-clinics
#2
Lucy E Marcil, Michael K Hole, Larissa M Wenren, Megan S Schuler, Barry S Zuckerman, Robert J Vinci
OBJECTIVES: The earned income tax credit (EITC), refundable monies for America's working poor, is associated with improved child health. Yet, 20% of eligible families do not receive it. We provided free tax preparation services in clinics serving low-income families and assessed use, financial impact, and accuracy. METHODS: Free tax preparation services ("StreetCred") were available at 4 clinics in Boston in 2016 and 2017. We surveyed a convenience sample of clients ( n = 244) about experiences with StreetCred and previous tax services and of nonparticipants ( n = 100; 69% response rate) and clinic staff ( n = 41; 48% response rate) about acceptability and feasibility...
May 18, 2018: Pediatrics
https://www.readbyqxmd.com/read/29775557/symptoms-of-obstructive-sleep-apnea-nasal-obstruction-and-enuresis-in-children-with-nonsyndromic-cleft-lip-and-palate-a-prevalence-study
#3
Marilyse de Bragança Lopes Fernandes, Alícia Graziela Noronha Silva Salgueiro, Eliete Janaína Bueno Bighetti, Ivy Kiemle Trindade-Suedam, Inge Elly Kiemle Trindade
OBJECTIVE: To estimate the prevalence of symptoms of obstructive sleep apnea (OSA), nasal obstruction, and enuresis in children with nonsyndromic unilateral cleft lip and palate. DESIGN: Prospective cross-sectional study. SETTING: Referral care center. PARTICIPANTS: One hundred seventy-four children aged 6 to 12 years of both genders. INTERVENTIONS: Symptoms of OSA and nasal obstruction were investigated by analysis of scores obtained by the Sleep Disturbance Scale for Children (SDSC) and Congestion Quantifier (CQ-5)...
January 1, 2018: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/29774474/perspectives-of-children-family-caregivers-and-health-professionals-about-pediatric-oncology-symptoms-a-systematic-review
#4
REVIEW
Lei Cheng, Liying Wang, Mengxue He, Sheng Feng, Yehui Zhu, Cheryl Rodgers
OBJECTIVES: To evaluate the existing body of evidence to determine the current state of knowledge regarding the perspectives of the following groups: (1) children with cancer, (2) family caregivers, and (3) healthcare professionals, about symptoms, as well as factors that may influence the symptom reports. METHODS: A systematic search was performed for all types of studies that included the perspectives of at least two groups of participants' symptom reports. Children included anyone younger than 19 years of age who was diagnosed with any type of cancer...
May 17, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29772916/home-oxygen-therapy-for-bronchiolitis-an-evaluation-of-the-primary-care-providers-experience-at-sea-level
#5
Erin E Dunbar, Michelle L Macy, James A Cranford, Nicole Sroufe, Marie Lozon, Marisa C Louie
Despite 90% of primary care providers at altitude reporting experience with home oxygen therapy for hypoxemic, otherwise well infants, its use at sea level is not well described. Our objective was to understand experience with home oxygen at sea level and determine potential barriers and benefits of its use. We surveyed all pediatricians and family medicine providers within a 30-mile radius of our pediatric hospital from May 2016 to December 2016. Forty-three percent of providers responded. Few (8%) had any experience with home oxygen therapy for bronchiolitis...
May 1, 2018: Clinical Pediatrics
https://www.readbyqxmd.com/read/29771763/recognizing-diagnosing-and-preventing-child-maltreatment-an-update-for-pediatric-clinicians
#6
Fiona Danaher, Andrea Vandeven, Aine Blanchard, Alice W Newton
PURPOSE OF REVIEW: Despite an increasing understanding of the impact of emotional trauma and physical abuse on children, clinicians and hospitals still sometimes miss the diagnosis of abuse. The literature in 2017 focused on creating standardized approaches to recognition and diagnosis of physical abuse and occult injury, including using the electronic medical record to provide triggers for consultation of the hospital Child Protection Program. The American College of Radiology updated their standardized approach to the evaluation of physical abuse in the child, and other authors gave us screening tools for commercial exploitation, as well as guidance about how to recognize risks for emotional abuse in families...
May 15, 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29767462/soluble-fiber-use-in-pediatric-short-bowel-syndrome-a-survey-on-prevailing-practices
#7
Meredith Linley Harvie, Margaret Alyssa Tucker Norris, Wednesday Marie A Sevilla
BACKGROUND: In pediatric short bowel syndrome (SBS), adding fiber to enteral feedings is 1 treatment method to manage increased stool output. However, there are no standardized recommendations on the use of fiber in this setting, including type, dosage, titration strategies, etc. OBJECTIVE: The aim of this study is to determine current prevailing practices on the use of fiber in the treatment of chronic high stool output in the pediatric SBS population. METHODS: An anonymous electronic survey with 13 questions was sent through health professional electronic mailing lists...
May 16, 2018: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29764909/ohio-pediatric-asthma-repository-opportunities-to-revise-care-practices-to-decrease-time-to-physiologic-readiness-for-discharge
#8
Jeffrey M Simmons, Jocelyn M Biagini Myers, Lisa J Martin, Carolyn M Kercsmar, Christine L Schuler, Valentina V Pilipenko, John W Kroner, Hua He, Stephen R Austin, Huyen-Tran Nguyen, Kristie R Ross, Karen S McCoy, Sherman J Alter, Samantha M Gunkelman, Pierre A Vauthy, Gurjit K Khurana Hershey
BACKGROUND: Large-scale, multisite studies in which researchers evaluate patient- and systems-level factors associated with pediatric asthma exacerbation outcomes are lacking. We sought to investigate patient-level risks and system-level practices related to physiologic readiness for discharge (PRD) in the prospective Ohio Pediatric Asthma Repository. METHODS: Participants were children ages 2 to 17 years admitted to an Ohio Pediatric Asthma Repository hospital for asthma exacerbation...
May 15, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29762472/weaning-time-in-preterm-infants-an-audit-of-italian-primary-care-paediatricians
#9
Maria Elisabetta Baldassarre, Antonio Di Mauro, Annarita Pedico, Valentina Rizzo, Manuela Capozza, Fabio Meneghin, Gianluca Lista, Nicola Laforgia
INTRODUCTION: According to the 2016 Italian National Institute of Statistics (Istat) data in Italy, about 6.7% of all newborns are born prematurely. Due to the lack of data on current complementary feeding in preterm infants in Italy, the aim of the survey was to evaluate individual attitudes of primary care paediatricians, concerning the introduction of complementary foods in preterm infants. METHODS: An internet-based survey was conducted among primary care paediatricians, working in Italy, regarding (1) timing of the introduction of complementary foods to preterm newborns; (2) type of complementary foods introduced; (3) vitamin D and iron supplementations...
May 15, 2018: Nutrients
https://www.readbyqxmd.com/read/29762333/hemodynamic-shock-caused-by-tension-pneumoperitoneum-in-a-5-year-old-girl
#10
Marie-Sophie Zentar, Laureline Berteloot, Naziha Khen Dunlop, Olivier Bustarret, Bénédicte Pigneur, Gérard Cheron, François Angoulvant
Tension pneumoperitoneum is a relatively rare occurrence in the pediatric population. However, tension pneumoperitoneum is associated with significant morbidity and mortality if it is not promptly diagnosed and treated. A 5-year-old girl was admitted to emergency department with abdominal pain. She was in shock, and the radiograph film of the abdomen revealed a voluminous tension pneumoperitoneum. Aggressive fluid challenges were performed in intensive care followed by urgent laparotomy. Primary abdominal compartment due to trapped gas caused a decreased venous return and visceral perfusion...
May 14, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29760843/multicenter-study-of-albuterol-use-among-infants-hospitalized-with-bronchiolitis
#11
Anna Condella, Jonathan M Mansbach, Kohei Hasegawa, Peter S Dayan, Ashley F Sullivan, Janice A Espinola, Carlos A Camargo
Introduction: Although bronchiolitis is a common reason for infant hospitalization, significant heterogeneity persists in its management. The American Academy of Pediatrics currently recommends that inhaled albuterol not be used in routine care of children with bronchiolitis. Our objective was to identify factors associated with pre-admission (e.g., emergency department or primary care) use of albuterol among infants hospitalized for bronchiolitis. Methods: We analyzed data from a 17-center observational study of 1,016 infants (age <1 year) hospitalized with bronchiolitis between 2011-2014...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29758130/pediatric-heart-transplantation-at-adult-specialty-centers-in-the-us-a-multicenter-registry-analysis
#12
Son Q Duong, Johnathan G Yabes, Jeffery J Teuteberg, Diana A Shellmer, Brian Feingold
Recent OPTN bylaw revisions mandate US transplant programs have an "approved pediatric component" in order to perform heart transplantation (HT) in patients <18 years old. The impact of this change on adolescents, a group known to be at high-risk for graft loss and nonadherence, is unknown. We studied all US pediatric (age <18 years) HT from 2000-2015 to compare graft survival between centers organized primarily for adult versus pediatric care. Centers were designated as pediatric- or adult-specialty care according to the ratio of pediatric:adult HT performed and minimum age of HT (pediatric-specialty defined as ratio>0...
May 14, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29757076/economic-evaluation-of-concussion-programs-in-the-state-of-idaho-the-collective-potential-of-prevention-and-clinical-care
#13
Susie Bergeron, Hilary Flint, Zeynep Hansen
Concussion, or mild traumatic brain injury, especially among young children, teenagers, and young adults, is a significant problem in Ada County, Idaho, and the United States. Although much has been learned about concussion, considerable controversy and gaps in knowledge still exist in many areas of research, leading to variation in concussion assessment, treatment, and management protocols. Health systems can positively impact concussion outcomes through community education and outreach, and provision of timely, coordinated, evidence-based clinical care...
May 14, 2018: Population Health Management
https://www.readbyqxmd.com/read/29757013/impact-of-a-behavioral-sleep-intervention-on-new-school-entrants-social-emotional-functioning-and-sleep-a-translational-randomized-trial
#14
Harriet Hiscock, Jon Quach, Kate Paton, Rebecca Peat, Lisa Gold, Sarah Arnup, Kah-Ling Sia, Elizabeth Nicolaou, Melissa Wake
OBJECTIVE/BACKGROUND: Determine the effects and costs of a brief behavioral sleep intervention, previously shown to improve child social-emotional functioning, sleep, and parent mental health, in a translational trial. PARTICIPANTS: Three hundred thirty-four school entrant children from 47 primary schools in Melbourne, Australia, with parent-reported moderate to severe behavioral sleep problems. METHODS: intervention group received sleep hygiene practices and standardized behavioral strategies delivered by trained school nurses in 2013 and 2014...
May 14, 2018: Behavioral Sleep Medicine
https://www.readbyqxmd.com/read/29754513/value-based-treatment-of-common-pediatric-fractures-by-primary-care
#15
Rhett MacNeille, William L Hennrikus
No abstract text is available yet for this article.
May 1, 2018: Clinical Pediatrics
https://www.readbyqxmd.com/read/29752972/urologic-phenotype-and-patterns-of-care-in-patients-with-megacystis-microcolon-intestinal-hypoperistalsis-syndrome-presenting-to-a-major-pediatric-transplantation-center
#16
Lee A Hugar, Rajeev Chaudhry, Thomas W Fuller, Glenn M Cannon, Francis X Schneck, Michael C Ost, Heidi A Stephany
OBJECTIVES: To describe the phenotype, referral pattern, and trends of urologic management for children with megacystis microcolon intestinal hypoperistalsis syndrome. METHODS: We performed a retrospective review of all patients with megacystis microcolon intestinal hypoperistalsis syndrome treated at a large tertiary children's medical center over a 14-year period. Our primary outcomes included the rate of urology referral, urodynamic characteristics of bladder function, and the proportion of patients managed with clean intermittent catheterization...
May 9, 2018: Urology
https://www.readbyqxmd.com/read/29752853/dexmedetomidine-for-the-reduction-of-emergence-delirium-in-children-undergoing-tonsillectomy-with-propofol-anesthesia-a-double-blind-randomized-study
#17
Adelais G Tsiotou, Anna Malisiova, Elena Kouptsova, Maria Mavri, Maria Anagnostopoulou, Evagelia Kalliardou
BACKGROUND: Postanesthesia emergence delirium is a motor agitation state complicating pediatric anesthesia. We investigated the efficacy of dexmedetomidine in reducing emergence delirium in children undergoing tonsillectomy with and without adenoidectomy using total intravenous anesthesia with propofol. METHODS: This was a prospective, single-center, double-blind, randomized study. The primary outcome was the presence or absence of emergence delirium with and without dexmedetomidine...
May 12, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29752289/interventions-to-reduce-over-utilized-tests-and-treatments-in-bronchiolitis
#18
Amy Tyler, Paige Krack, Leigh Anne Bakel, Kimberly O'Hara, Douglas Scudamore, Irina Topoz, Julia Freeman, Angela Moss, Renee Allen, Angela Swanson, Lalit Bajaj
OBJECTIVES: The American Academy of Pediatrics published bronchiolitis clinical practice guidelines in 2014 recommending against the routine use of bronchodilators, chest radiographs, or respiratory viral testing in children with a clinical diagnosis of bronchiolitis. Our aim in this project was to align care with the American Academy of Pediatrics clinical practice guidelines by decreasing the overuse of these interventions. METHODS: This study included patients who were admitted to a non-ICU setting with a primary or secondary diagnosis of bronchiolitis...
May 11, 2018: Pediatrics
https://www.readbyqxmd.com/read/29750690/rates-of-perioperative-respiratory-adverse-events-among-caucasian-and-african-american-children-undergoing-general-anesthesia
#19
Sarah Tariq, Madiha Syed, Timothy Martin, Xu Zhang, Michael Schmitz
BACKGROUND: Perioperative respiratory adverse events (PRAEs) account for the major cause of morbidity and mortality in children undergoing general anesthesia. In our institutional clinical practice, we suspected that African American children experienced untoward respiratory events more frequently than other racial groups. Identification of high-risk groups can guide decision making in the perioperative period, and aggressive optimization of specific care can enhance safety and improve outcomes...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29750288/recognizing-and-managing-children-with-a-pediatric-cancer-predisposition-syndrome-a-guide-for-the-pediatrician
#20
Stephanie A Coury, Katherine A Schneider, Jaclyn Schienda, Wen-Hann Tan
It is estimated that at least 8% to 10% of children diagnosed with cancer have an inherited cancer predisposition syndrome. Pediatricians may be called upon to (1) identify children with symptoms suggestive of cancer that require further diagnostic testing, (2) identify children who should be referred to cancer genetics based on their personal and family histories, and (3) provide primary care to children who have an inherited cancer syndrome. This review article provides a list of clinical warning signs suggestive of childhood malignancy, discusses the personal and family history "red flags" suggestive of hereditary cancer, offers checklists to help identify patients who are candidates for cancer genetics evaluation, and describes features of the major pediatric cancer syndromes involving solid tumors and surveillance guidelines...
May 1, 2018: Pediatric Annals
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