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https://www.readbyqxmd.com/read/27914141/unfavorable-course-of-subclinical-hypothyroidism-in-children-with-hashimoto-s-thyroiditis-compared-to-those-with-isolated-non-autoimmune-hyperthyrotropinemia
#1
Yun Jeong Lee, So Yoon Jung, Hae Woon Jung, So Youn Kim, Young Ah Lee, Seong Yong Lee, Choong Ho Shin, Sei Won Yang
Subclinical hypothyroidism (SCH) is a common problem in pediatric population, and the natural history of SCH varies depending on its etiology. Whether Hashimoto's thyroiditis (HT) negatively affects the natural course of SCH was investigated in pediatric patients without concomitant diseases. Predictors for levothyroxine medication were also evaluated. Medical records of 109 children with SCH (91 girls, 5?18 years) diagnosed between 2005 and 2014 were retrospectively reviewed. Patients were classified into HT (n = 37) and isolated non-autoimmune hyperthyrotropinemia (iso-NAHT, n = 72)...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27914127/impact-of-initial-vancomycin-trough-concentration-on-clinical-and-microbiological-outcomes-of-methicillin-resistant-staphylococcus-aureus-bacteremia-in-children
#2
Ree Nar Yoo, Seo Hee Kim, Jina Lee
It is important to use vancomycin in a proper manner to ensure optimal drug exposure. Despite extensive use of vancomycin in children, studies on its optimal trough concentration (Ctrough) in the pediatric population remained rare. This retrospective study included children < 18 years old with culture-confirmed methicillin-resistant Staphylococcus aureus (MRSA) bacteremia who were hospitalized in our institute from January 2010 to April 2014. Clinical characteristics, initial vancomycin dose, Ctrough and clinical/microbiological outcomes were retrospectively collected from medical records...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27913773/pediatric-nutrition-assessment-anthropometrics-to-zinc
#3
Kelly Green Corkins, Erin E Teague
Pediatric patients with chronic illnesses or diseases or who require long-term nutrition support are most vulnerable to nutrition-related issues. Malnutrition in a pediatric patient may negatively affect long-term growth and development. Children also become malnourished much more quickly than adults. A comprehensive nutrition assessment that includes food and nutrition-related history, anthropometric measurements, biochemical data, medical tests and procedures, nutrition-focused physical findings, and patient history should be completed on these patients as no one parameter is a comprehensive indicator of nutrition status...
December 2, 2016: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/27913607/autoimmune-comorbidities-in-hashimoto-s-thyroiditis-different-patterns-of-association-in-adulthood-and-childhood-adolescence
#4
R M Ruggeri, F Trimarchi, G Giuffrida, R Certo, E Cama, A Campennì, A Alibrandi, F De Luca, M Wasniewska
OBJECTIVE: Hashimoto's thyroiditis (HT), the most common autoimmune thyroid disease at any age, is often associated with other autoimmune diseases. The present study was aimed to describe the type and frequency of non-thyroidal autoimmune diseases (NTADs) in HT patients and to delineate the clinical pattern of diseases clustering in pediatric/adolescent and adult age. DESIGN: Cross-sectional study. METHODS: 1053 newly diagnosed HT patients (500 adults (467 F, mean age 40...
February 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/27912926/acute-management-of-refractory-and-unstable-pediatric-supraventricular-tachycardia
#5
Jonathan Lewis, Gaurav Arora, Dana L Tudorascu, Robert W Hickey, Richard A Saladino, Mioara D Manole
OBJECTIVE: To characterize the management of acute pediatric supraventricular tachycardia (SVT), placing special emphasis on infants, patients refractory to adenosine (refractory SVT), and patients with hypotension, poor perfusion, or altered mental status (unstable SVT). STUDY DESIGN: Retrospective cohort study of patients 0-18 years of age without congenital heart disease who presented to our pediatric hospital from January 2003 to December 2012 for the treatment of acute SVT...
November 22, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27911972/integrating-behavioral-health-into-pediatric-primary-care-implications-for-provider-time-and-cost
#6
Natasha Gouge, Jodi Polaha, Rachel Rogers, Amy Harden
OBJECTIVES: Integrating a behavioral health consultant (BHC) into primary care is associated with improved patient outcomes, fewer medical visits, and increased provider satisfaction; however, few studies have evaluated the feasibility of this model from an operations perspective. Specifically, time and cost have been identified as barriers to implementation. Our study aimed to examine time spent, patient volume, and revenue generated during days when the on-site BHC was available compared with days when the consultant was not...
December 2016: Southern Medical Journal
https://www.readbyqxmd.com/read/27911597/evidence-based-psychosocial-treatments-for-pediatric-elimination-disorders
#7
Jaclyn A Shepard, Joseph E Poler, Jesse H Grabman
Pediatric elimination disorders are common in childhood, yet psychosocial correlates are generally unclear. Given the physiological concomitants of both enuresis and encopresis, and the fact that many children with elimination disorders are initially brought to their primary care physician for treatment, medical evaluation and management are crucial and may serve as the first-line treatment approach. Scientific investigation on psychological and behavioral interventions has progressed over the past couple of decades, resulting in the identification of effective treatments for enuresis and encopresis...
December 2, 2016: Journal of Clinical Child and Adolescent Psychology
https://www.readbyqxmd.com/read/27910218/octreotide-use-and-safety-in-infants-with-hyperinsulinism
#8
Ann W McMahon, Gerold T Wharton, Paul Thornton, Diva D De Leon
BACKGROUND: Octreotide is a synthetic peptide analog of naturally occurring somatostatin. Octreotide is used off-label in children <6 years of age for hyperinsulinism, chylothorax, and gastrointestinal bleeding. There is a lack of controlled data on efficacy or potential adverse events from this off-label use. METHODS: Three pediatric hospitals participated in this study. Patients were hospitalized January 2007-December 2010 and administered octreotide for congenital hyperinsulinism (CHI) at least 1 day...
December 2, 2016: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/27910175/postanesthesia-evaluation-of-emotional-and-psychological-satisfaction-in-a-hispanic-population
#9
Angela Zauner, Alvaro Pinilla, Daniel Benitez, Alejandra Tellez, David Romero, Ana Suarez, Vanessa López, Eduardo Hermida
BACKGROUND: Patient satisfaction has a positive impact on clinical care. Different strategies, such as questionnaires, have been developed to evaluate and improve patient satisfaction. A validated pediatric anesthesia questionnaire previously showed the importance of perioperative care built upon a relationship of trust between healthcare providers and children and parents, and a comfortable environment in which satisfactory answers are provided. However, the questionnaire was validated in English, and no research exists on the use of satisfaction questionnaires in Spanish...
December 2, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27909093/barriers-of-pediatric-residents-to-speaking-up-about-patient-safety
#10
Rachel Landgren, Zeinab Alawadi, Caryn Douma, Eric J Thomas, Jason Etchegaray
BACKGROUND AND OBJECTIVES: Medical errors are a leading cause of death in the United States. Effective communication and speaking up are crucial factors in patient safety initiatives. We examined the reasons reported by pediatric residents for not speaking up about safety events when they are observed in practice. We also tested a priori hypotheses of associations between categories of barriers to speaking up with perceptions of safety and teamwork culture. METHODS: Pediatric residents completed an anonymous electronic survey measuring safety and teamwork culture along with an open-ended question asking them to list the top 3 barriers to speaking up about patient safety concerns...
December 2016: Hospital Pediatrics
https://www.readbyqxmd.com/read/27909087/stand-up-and-be-counted-measuring-and-mapping-the-rheumatology-workforce-in-canada
#11
Claire E H Barber, Lauren Jewett, Elizabeth M Badley, Diane Lacaille, Alfred Cividino, Vandana Ahluwalia, Henry Averns, Cory Baillie, Janet Ellsworth, Janet Pope, Deborah Levy, Christine Charnock, Claire McGowan, J Carter Thorne, Cheryl Barnabe, Michel Zummer, Katie Lundon, Robert S McDougall, John G Thomson, Elaine A Yacyshyn, Dianne Mosher, Julie Brophy, Thanu Nadarajah Ruban, Deborah A Marshall
OBJECTIVE: To characterize the practicing rheumatologist workforce, the Canadian Rheumatology Association (CRA) launched the Stand Up and Be Counted workforce survey in 2015. METHODS: The survey was distributed electronically to 695 individuals, of whom 519 were expected to be practicing rheumatologists. Demographic and practice information were elicited. We estimated the number of full-time equivalent rheumatologists per 75,000 population from the median proportion of time devoted to clinical practice multiplied by provincial rheumatologist numbers from the Canadian Medical Association...
December 1, 2016: Journal of Rheumatology
https://www.readbyqxmd.com/read/27909013/comparison-of-cerebrospinal-fluid-opening-pressure-in-children-with-demyelinating-disease-to-children-with-primary-intracranial-hypertension
#12
Bethanie Morgan-Followell, Shawn C Aylward
The authors aimed to compare the opening pressures of children with demyelinating disease to children with primary intracranial hypertension. Medical records were reviewed for a primary diagnosis of demyelinating disease, or primary intracranial hypertension. Diagnosis of demyelinating disease was made according to either the 2007 or 2012 International Pediatric Multiple Sclerosis Study Group criteria. Primary intracranial hypertension diagnosis was confirmed by presence of elevated opening pressure, normal cerebrospinal fluid composition and neuroimaging...
November 30, 2016: Journal of Child Neurology
https://www.readbyqxmd.com/read/27908974/effects-of-a-humor-therapy-program-on-stress-levels-in-pediatric-inpatients
#13
Julio C Sánchez, Luis F Echeverri, Manuel J Londoño, Sergio A Ochoa, Andrés F Quiroz, César R Romero, Joaquín O Ruiz
OBJECTIVE: Disease and hospitalization generate stress, which can affect the response to treatment. Humor has been used in many hospitals to decrease stress. The aim of this study was to evaluate the impact of a humor therapy program on stress levels in pediatric inpatients. METHODS: In the first phase, an intervention and a control group were studied over 2 consecutive 3-month periods; the interventions were performed by a team of artists trained in humor therapy...
December 1, 2016: Hospital Pediatrics
https://www.readbyqxmd.com/read/27908954/chlorhexidine-impregnated-dressings-and-prevention-of-catheter-associated-bloodstream-infections-in-a-pediatric-intensive-care-unit
#14
Duygu Sönmez Düzkaya, Nejla Canbulat Sahiner, Gülzade Uysal, Tülay Yakut, Agop Çitak
BACKGROUND: Bloodstream infections related to use of catheters are associated with increased morbidity and mortality rates, prolonged hospital lengths of stay, and increased medical costs. OBJECTIVES: To compare the effectiveness of chlorhexidine-impregnated dressings with that of standard dressings in preventing catheter-related bloodstream infections. METHODS: A total of 100 children were randomly divided into 2 groups of 50 each: a chlorhexidine group and a standard group...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27908819/endovascular-treatment-of-a-traumatic-thoracic-aortic-injury-in-an-eight-year-old-patient-case-report-and-review-of-literature
#15
Maen Aboul Hosn, Rachael Nicholson, Joseph Turek, William J Sharp, Luigi Pascarella
Traumatic aortic injuries in children and adolescents are rare. Although endovascular repair has become the preferred approach for such injuries in adults, open repair has endured as the gold standard in children owing mainly to the smaller aortic and access vessel diameter and the scarcity of long term follow up data. We report a successful endovascular repair of a traumatic thoracic aortic injury in an eight year old girl using a Zenith Alpha thoracic endograft (Cook Medical, Bloomington, Ind). We also review the literature on endovascular treatment of traumatic aortic injuries in the pediatric population...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27908650/musculoskeletal-conditions-in-a-pediatric-population-with-ehlers-danlos-syndrome
#16
Courtney M Stern, Michael J Pepin, Joan M Stoler, Dennis E Kramer, Samantha A Spencer, Cynthia J Stein
OBJECTIVE: To describe musculoskeletal conditions in children with Ehlers-Danlos syndrome (EDS). STUDY DESIGN: A retrospective medical record review was performed, which evaluated 205 patients with EDS (ages 6-19 years) seen in sports medicine or orthopedic clinic at a large pediatric hospital over a 5-year period. RESULTS: Female (n = 147) and male (n = 57) patients were identified (mean age 12.7 years). The most common EDS subtype (55...
November 28, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27908536/the-sensitivity-and-negative-predictive-value-of-a-pediatric-cervical-spine-clearance-algorithm-that-minimizes-computerized-tomography
#17
Mary Arbuthnot, David P Mooney
BACKGROUND: It is crucial to identify cervical spine injuries while minimizing ionizing radiation. This study analyzes the sensitivity and negative predictive value of a pediatric cervical spine clearance algorithm. METHODS: We performed a retrospective review of all children <21years old who were admitted following blunt trauma and underwent cervical spine clearance utilizing our institution's cervical spine clearance algorithm over a 10-year period. Age, gender, International Classification of Diseases 9th Edition diagnosis codes, presence or absence of cervical collar on arrival, Injury Severity Score, and type of cervical spine imaging obtained were extracted from the trauma registry and electronic medical record...
October 27, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27908273/pharmacokinetic-and-pharmacodynamic-features-of-nanoemulsion-following-oral-intravenous-topical-and-nasal-route
#18
Hira Choudhury, Bapi Gorain, Bappaditya Chatterjee, Uttam Kumar Mandal, Pinaki Sengupta, Rakesh Kumar Tekade
Most of the active pharmaceutical ingredients discovered recently in pharmaceutical field exhibits poor aqueous solubility that pose major problem in their oral administration. The oral administration of these drugs gets further complicated due to their short bioavailability, inconsistent absorption and inter/intra subject variability. Pharmaceutical emulsion holds a significant place as a primary choice of oral drug delivery system for lipophilic drugs used in pediatric and geriatric patients. Pharmacokinetic studies on nanoemulsion mediated drugs delivery approach indicates practical feasibility in regards to their clinical translation and commercialization...
December 1, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27907271/adult-attention-deficit-hyperactivity-disorder-diagnosis-management-and-treatment-in-the-dsm-5-era
#19
Joel L Young, David W Goodman
Objective: To increase awareness of adult attention-deficit/hyperactivity disorder (ADHD) in the primary care community and to provide guidance for the management of this condition. Despite its increasing prevalence, adult ADHD largely remains underdiagnosed and inappropriately treated in the United States. The publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), has provided more clear diagnostic criteria for adult ADHD, but a solid framework supporting the transition of ADHD management from pediatric to adult primary care is lacking...
November 17, 2016: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/27906845/an-algorithmic-approach-using-ultrasonography-in-the-diagnosis-of-pediatric-nasal-bone-fracture
#20
Ikkei Tamada, Takaaki Mori, Nobuaki Inoue, Hirokazu Shido, Marie Aoki, Yukie Nakamura, Ruri Kamogawa
BACKGROUND: Ultrasonography (US) was recently reported as a reliable modality for diagnosing nasal bone fractures. However, whether US is reliable as a screening tool in the pediatric emergency department (ED) remains unknown. This prospective cohort study had a 2-fold aim: to assess the utility of US in the diagnosis of pediatric nasal bone fracture, and to evaluate the validity of our protocol for managing pediatric nasal bone fractures (Fuchu-Kids algorithm). PATIENTS AND METHODS: Among the patients who presented at the ED with facial trauma, those with a suspected nasal bone fracture were enrolled in the study...
November 30, 2016: Journal of Craniofacial Surgery
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