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Pediatric scheduling

Yu-Li Huang, Sarah M Bach
BACKGROUND: Patient access to care has been a known and continuing struggle for many health care providers. In spite of appointment lead time policies set by government or clinics, the problem persists. Justification for how lead time policies are determined is lacking. OBJECTIVES: This paper proposed a data-driven approach for how to best set feasible appointment target lead times given a clinic's capacity and appointment requests. METHODS: The proposed approach reallocates patient visits to minimize the deviation between actual appointment lead time and a feasible target lead time...
October 19, 2016: Applied Clinical Informatics
Kirsten Beck, Elaine Albert, Andrew Johnsen, Courtney Newhouse, John McGuire
Medical rounds in the Pediatric Intensive Care Unit (PICU) took about four hours each day to complete. The length of rounds was affecting the advancement of care of the patients, the engagement of sub-specialty providers who needed to be present on other rounds, and the engagement of the PICU faculty and staff due to overburdening waste created by the long duration of rounds. Specific interventions were identified aimed at reducing the duration of rounds each day, increasing engagement of the rounding team and satisfying the needs of the patients and families...
2016: BMJ Quality Improvement Reports
Devyani Deshpande, Shashikant Srivastava, Eric Nuermberger, Jotam G Pasipanodya, Soumya Swaminathan, Tawanda Gumbo
BACKGROUND:  No treatment regimens have been specifically designed for children, in whom tuberculosis is predominantly intracellular. Given their activity as monotherapy and their ability to penetrate many diseased anatomic sites that characterize disseminated tuberculosis, linezolid and moxifloxacin could be combined to form a regimen for this need. METHODS:  We examined microbial kill of intracellular Mycobacterium tuberculosis (Mtb) by the combination of linezolid and moxifloxacin multiple exposures in a 7-by-7 mathematical matrix...
November 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Devyani Deshpande, Shashikant Srivastava, Jotam G Pasipanodya, Stephen J Bush, Eric Nuermberger, Soumya Swaminathan, Tawanda Gumbo
BACKGROUND:  Infants and toddlers often present with disseminated and lymph node tuberculosis, in which Mycobacterium tuberculosis (Mtb) is predominantly intracellular. Linezolid, used to treat tuberculosis in adults, has not been formally studied in infants. Infants clear linezolid 5 times faster than adults and achieve lower 0- to 24-hour area under the concentration-time curves (AUC0-24). METHODS:  To mimic intracellular disease, we infected human-derived THP-1 macrophages with Mtb and inoculated hollow fiber systems...
November 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Corrie E Chumpitazi, Chris A Rees, Elizabeth A Camp, M Brooke Bernhardt
BACKGROUND: The Drug Enforcement Administration (DEA) changed hydrocodone-containing products (HCPs) from Schedule III to II status on October 6, 2014, making codeine-containing products (CCPs) the only non-Schedule II oral opioid agents. OBJECTIVES: We sought to describe prescribing patterns of oral opioid agents in the pediatric emergency department before and after the 2014 DEA rescheduling of HCPs. METHODS: We performed a cross-sectional study evaluating prescribing patterns in the pediatric emergency department at an urban, academic, quaternary care children's hospital system for 6 months before and 6 months after the DEA rescheduling of HCPs...
October 7, 2016: Journal of Emergency Medicine
Philippe Soyer, Anthony Dohan, Deepak Patkar, Andreas Gottschalk
PURPOSE: To investigate the safety of gadoterate meglumine and identify the incidence of nephrogenic systemic fibrosis (NSF). MATERIALS AND METHODS: An international prospective observational study was conducted from November 2008 to June 2013. A total of 35,499 adults and children who were scheduled to undergo contrast-enhanced MRI using gadoterate meglumine were analyzed (female, 53.1%; mean age: 49.5 years; range: 0-98 years). At least 3-month follow-up was planned for patients with an estimated creatinine clearance or glomerular filtration rate <60 mL/min (/1...
October 11, 2016: Journal of Magnetic Resonance Imaging: JMRI
Nagat S El-Shmaa, Doaa El Amrousy, Wael El Feky
OBJECTIVE: The objective of this study was to assess the effectiveness of pre-emptive dexmedetomidine versus amiodarone in preventing junctional ectopic tachycardia (JET) in pediatric cardiac surgery. DESIGN: This is a prospective, controlled study. SETTING: This study was carried out at a single university hospital. SUBJECTS AND METHODS: Ninety patients of both sexes, American Society of Anesthesiologists Physical Status II and III, age range from 2 to 18 years, and scheduled for elective cardiac surgery for congenital and acquired heart diseases were selected as the study participants...
October 2016: Annals of Cardiac Anaesthesia
Juan-Miguel Gil-Jaurena, Ramón Pérez-Caballero, Ana Pita-Fernández, María-Teresa González-López, Jairo Sánchez, Juan-Carlos De Agustín
BACKGROUND: Mid-line sternotomy is the commonest incision for cardiac surgery. Alternative approaches are becoming fashionable in many centres, amidst some reluctance because of learning curves and overall complexity. Our recent experience in starting a new program on minimally invasive pediatric cardiac surgery is presented. The rationale for a stepwise onset and the short-medium term results for a three-year span are displayed. METHODS: A three-step schedule is planned: First, an experienced surgeon (A) starts performing simple cases...
July 2016: Translational pediatrics
Ondina Lúcia Ceppas Resende, Maria Tereza Serrano Barbosa, Bruno Francisco Teixeira Simões, Luciane de Souza Velasque
INTRODUCTION: This study, developed in a federal hospital in the city of Rio de Janeiro, has aimed to analyze the social representation of chronic disease and its treatment, in the perspective of adolescents and their caregivers. METHODS: The sample consisted of 31 adolescents (11-21 years) with systemic lupus erythematosus and 19 caregivers (32-66 years), followed in the pediatrics and in the internal medicine outpatient clinics for a period of six months. Data was collected from the free association of words test, using chronic disease and treatment of chronic disease impulses, and later submitted to the Multiple Correspondence Analysis using the R software...
September 2016: Revista Brasileira de Reumatologia
Ozlem Ozkalayci, Coskun Araz, Sevi Burcak Cehreli, Resmiye Ebru Tirali, Zeynep Kayhan
STUDY OBJECTIVE: The study aimed to investigate the effects of listening to music or providing sound isolation on the depth of sedation and need for sedatives in pediatric dental patients. DESIGN: Prospective, randomized, and controlled study. SETTING: Tertiary, university hospital. PATIENTS: In total, 180 pediatric patients, American Society of Anesthesiologists physical status I and II, who were scheduled for dental procedures of tooth extraction, filling, amputation, and root treatment...
November 2016: Journal of Clinical Anesthesia
Johanna Kampers, Manuela Orjuela-Grimm, Tilmann Schober, Thomas F Schulz, Martina Stiefel, Christoph Klein, Dieter Körholz, Christine Mauz-Körholz, Hans Kreipe, Rita Beier, Britta Maecker-Kolhoff
Post-transplant lymphoproliferative disease (PTLD) is a severe complication after solid organ transplantation (SOT). Classical Hodgkin lymphoma-type (HL-) PTLD is a rare subtype, and systematic data on treatment and prognosis are lacking. We report on 17 pediatric patients with classical HL-PTLD. HL-PTLD developed late at a median of 8.1 years after SOT. It was commonly EBV-positive (16/17) and expressed both CD30 (all tumors) and CD20 (8/17 tumors). Patients were treated with chemotherapy +/- involved field radiotherapy (IF-RT) according to the respective GPOH-HD protocol tailored by stage and LDH...
August 11, 2016: Leukemia & Lymphoma
Amy E Green, John Ferrand, Gregory A Aarons
OBJECTIVE: The current study examines parent/caregiver and youth report of psychosocial and health-related functioning among youth served in public systems of care, with mood disorder only, comorbid mood disorder and chronic physical illness, and chronic physical illness only. METHOD: Participants were 539 youths (ages, 11-18; 64% male) with a mood disorder and/or chronic physical illness enrolled in a study of public sector care. Presence of mood disorder was based on youth report on the Diagnostic Interview Schedule for Children-IV...
October 2016: Journal of Developmental and Behavioral Pediatrics: JDBP
Jorrit W van As, Henk van den Berg, Elvira C van Dalen
BACKGROUND: Platinum-based therapy, including cisplatin, carboplatin, oxaliplatin or a combination of these, is used to treat a variety of paediatric malignancies. One of the most important adverse effects is the occurrence of hearing loss or ototoxicity. In an effort to prevent this ototoxicity, different otoprotective medical interventions have been studied. This review is the second update of a previously published Cochrane review. OBJECTIVES: To assess the efficacy of medical interventions to prevent hearing loss and to determine possible effects of these interventions on anti-tumour efficacy, toxicities other than hearing loss and quality of life in children with cancer treated with platinum-based therapy...
September 27, 2016: Cochrane Database of Systematic Reviews
Pınar Uran, Esra Yürümez, Ayla Aysev, Birim Günay Kılıç
OBJECTIVE: Adolescents who were admitted to the child and adolescent psychiatry clinic were compared with respect to the premenstrual symptom severity, psychiatric comorbidities and health related quality of life (HRQoL). METHODS: The research group was identified using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version and Premenstrual Assessment Form. They completed the Pediatric Quality of Life Inventory (The PedsQL)...
September 27, 2016: International Journal of Psychiatry in Clinical Practice
Lisa A Hark, Eileen L Mayro, Judie Tran, Michael Pond, Rachel Schneider, Justin Torosian, Melanie Snitzer, Nooreen Dabbish, Alex V Levin
BACKGROUND: The Wills Eye Vision Screening Program for Children is a community-based vision screening program for children in urban Philadelphia elementary schools that aims to provide vision screening, remedy refractive error by providing glasses, and refer children with suspected nonrefractive eye disease for eye care. METHODS: Children in grades K-5 from 45 Philadelphia elementary schools were screened for distance and near visual acuity, stereopsis, and color vision from January 2014 to June 2015...
September 16, 2016: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
T Banti, A Carsin, B Chabrol, R Reynaud, A Fabre
: Infant food diversification has undergone a rapid succession of good practice recommendations in France, but there has been no assessment of pediatrician practices on food diversification. OBJECTIVE: To assess the practices of pediatricians in relation to current recommendations of the French Society of Pediatrics on infant food diversification. METHODS: This was an observational study conducted from 1 November 2014 to 31 March 2015. The study population consisted of 97 pediatricians in the Var department and 84 pediatric residents assigned to the University of Aix-Marseille in France...
October 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Siew Choo Su, Ian Brent Masters, Helen Buntain, Kieran Frawley, Anubhav Sarikwal, Debbie Watson, Frances Ware, Jan Wuth, Anne Bernadette Chang
INTRODUCTION: Flexible bronchoscopy (FB) is the current gold standard for diagnosing tracheobronchomalacia. However, it is not always feasible and virtual bronchoscopy (VB), acquired from chest multi-detector CT (MDCT) scan is an alternative diagnostic tool. We determined the sensitivity, specificity, and positive and negative predictive values of VB compared to FB in diagnosing tracheobronchomalacia. METHODS: Children aged <18-years scheduled for FB and MDCT were recruited...
September 18, 2016: Pediatric Pulmonology
James H Hertzog, Thomas E Pearson, Marc A Priest, Ellen Spurrier, Ryan R Davies
Ventricular assist devices (VADs) for the mechanical support of cardiac failure are being used more frequently in children of increasingly younger age. These children have significant and multiple medical comorbidities, and their length of hospital stay has been increasing. As this population of hospitalized VAD-supported children increases, so does the possibility of their need for interfacility transport for specialized diagnostic or therapeutic procedures. Reports on such transports are limited to 3 children who underwent scheduled elective transfers...
September 2016: Air Medical Journal
Romain Guilhaumou, Amélie Marsot, Julien Dupouey, Claire Galambrun, Audrey Boulamery, Carole Coze, Nicolas Simon, Nicolas André
BACKGROUND: In pediatric cancer patients, determination of optimal vancomycin dosage is essential because of high risk of inadequate concentrations and bacterial resistance. The aim of this study was to determine vancomycin pharmacokinetic parameters in this population and propose dosage optimization to achieve optimal concentration. METHODS: We retrospectively reviewed the use of vancomycin in pediatric cancer patients with febrile neutropenia (hematological or solid tumor disease)...
October 2016: Therapeutic Drug Monitoring
Troy Z Horvat, Joshua J Pecoraro, Ryan J Daley, Larry W Buie, Amber C King, Raajit K Rampal, Martin S Tallman, Jae H Park, Dan Douer
Asparaginase administration has become a crucial component of front-line pediatric and pediatric-insipired multi-agent regimens for the treatment of acute lymphoblastic leukemia (ALL). The aim of this retrospective study was to assess the safety and feasibility of switching to Erwinia asparaginase after pegaspargase intolerance in adult ALL patients treated at Memorial Sloan Kettering Cancer Center. Our analysis included 10 patients, with a median age of 39 years (range 20-72), male predominance (90%), and a typical B-cell to T-cell ratio (70:30%) for ALL...
August 26, 2016: Leukemia Research
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