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Pediatric clinic management

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https://www.readbyqxmd.com/read/28214152/clinical-and-genetic-diagnosis-of-familial-hypertrophic-cardiomyopathy-results-in-pediatric-cardiology
#1
Bárbara Cardoso, Inês Gomes, Petra Loureiro, Conceição Trigo, Fátima Ferreira Pinto
INTRODUCTION: Hypertrophic cardiomyopathy (HCM) is most often of autosomal dominant inheritance with incomplete penetrance and variable expression. The main purpose of family screening is to identify relatives with unrecognized HCM and to monitor those at risk for disease, in order to minimize complications and to assess risk of sudden cardiac death. The ESC and ACCF/AHA guidelines on the diagnosis and management of HCM recommend the screening of child relatives from the age of 10-12 years...
February 14, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28210820/update-review-and-clinical-presentation-in-adult-inferior-dislocation-of-hip
#2
REVIEW
Kevin Syam, Balaji Saibaba, Sameer Aggarwal, Sivaswaminathan Santhanam, Gopinath Palanisamy
Inferior dislocation of the hip is a rare clinical entity, wherein closed reduction maneuver could be challenging, especially if the attending surgeon is not familiar with the specific anatomy associated with this injury. Due to the rarity of this type of injury, large case series are lacking in the literature; hence, case reports form the major source of our knowledge regarding the clinical presentation and management. An extensive literature search revealed a change in age group presenting with this specific injury, with a male predilection...
February 16, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28205446/intramuscular-ziprasidone-dosing-for-acute-agitation-in-the-pediatric-emergency-department
#3
Tammy Nguyen, Jillian Stanton, Robin Foster
BACKGROUND: Intramuscular (IM) ziprasidone is often used to manage acute agitation. Limited data exist on the pediatric dosing of ziprasidone in the emergency department (ED). OBJECTIVE: To characterize the mg/kg dosing differences between pediatric ED patients who respond to an initial dose of ziprasidone versus patients who do not. METHODS: This was a retrospective, observational study of 5- to 18-year-old patients who were treated with IM ziprasidone in the pediatric ED from 2007 to 2015...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28205418/pediatric-neuroendocrine-carcinoid-tumors-management-pathology-and-imaging-findings-in-a-pediatric-referral-center
#4
Andrew J Degnan, Shannon Tocchio, Waleed Kurtom, Sameh S Tadros
BACKGROUND: While neuroendocrine (carcinoid) tumors are increasingly recognized in the adult population, they are often not suspected in children. PROCEDURE: Retrospective review of all well-differentiated neuroendocrine (carcinoid) tumors was performed based on pathology reports from a quaternary pediatric medical center between January 2003 and June 2016. Clinical presentations, treatment approaches, imaging findings, and outcomes were reviewed and analyzed. RESULTS: A total of 45 cases of pathology-proven carcinoid tumor were reported with an average age of 14...
February 16, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28204946/clinical-outcomes-in-children-with-henoch-sch%C3%A3-nlein-purpura-nephritis-without-crescents
#5
Jean Daniel Delbet, Julien Hogan, Bilal Aoun, Iulia Stoica, Rémi Salomon, Stéphane Decramer, Isabelle Brocheriou, Georges Deschênes, Tim Ulinski
BACKGROUND: Henoch-Schönlein purpura is the most common vasculitis in children. Its long-term prognosis depends on renal involvement. The management of Henoch-Schönlein purpura nephritis (HSPN) remains controversial. This study reports the prognosis of children with HSPN presenting with class 2 International Study of Kidney Disease in Children (ISKDC) nephritis. METHODS: All children with HSPN class 2 diagnosed between 1995 and 2015 in four pediatric nephrology centers were included, and clinical and biological data were collected from the medical files...
February 15, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28204945/spectrum-of-mutations-in-chinese-children-with-steroid-resistant-nephrotic-syndrome
#6
Fang Wang, Yanqin Zhang, Jianhua Mao, Zihua Yu, Zhuwen Yi, Li Yu, Jun Sun, Xiuxiu Wei, Fangrui Ding, Hongwen Zhang, Huijie Xiao, Yong Yao, Weizhen Tan, Svjetlana Lovric, Jie Ding, Friedhelm Hildebrandt
BACKGROUND: The aim of this study was to elucidate whether genetic screening test results of pediatric patients with steroid-resistant nephrotic syndrome (SRNS) vary with ethnicity. METHODS: Using high-throughput DNA sequencing, 28 nephrotic syndrome-related genes were analyzed in 110 chil-dren affected by SRNS and 10 children with isolated proteinuria enrolled by 5 centers in China (67 boys, 53 girls). Their age at disease onset ranged from 1 day to 208 months (median, 48...
February 15, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28203028/-unerupted-first-deciduous-molar-located-higher-to-the-first-premolar-a-case-report
#7
Y Zhan, H Liu
Tooth eruption is defined as the movement of a tooth from its site of development within the alveolar process to its functional position in the oral cavity. The process of tooth eruption can be divided into different phases: pre-eruptive bone stage, alveolar bone stage, mucosal stage, preocclusal stage, occlusal stage and maturation stage. Any disturbance in these phases can lead to eruptive anomalies. The incidence of unerupted teeth is usually higher among permanent teeth than among deciduous ones. Of the primary teeth reported as unerupted, second deciduous molars are the teeth most frequently involved, followed by primary central incisors...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28193793/guidance-on-completing-a-written-allergy-and-anaphylaxis-emergency-plan
#8
Julie Wang, Scott H Sicherer
Anaphylaxis is a potentially life-threatening, severe allergic reaction. The immediate assessment of patients having an allergic reaction and prompt administration of epinephrine, if criteria for anaphylaxis are met, promote optimal outcomes. National and international guidelines for the management of anaphylaxis, including those for management of allergic reactions at school, as well as several clinical reports from the American Academy of Pediatrics, recommend the provision of written emergency action plans to those at risk of anaphylaxis, in addition to the prescription of epinephrine autoinjectors...
February 13, 2017: Pediatrics
https://www.readbyqxmd.com/read/28193791/epinephrine-for-first-aid-management-of-anaphylaxis
#9
Scott H Sicherer, F Estelle R Simons
Anaphylaxis is a severe, generalized allergic or hypersensitivity reaction that is rapid in onset and may cause death. Epinephrine (adrenaline) can be life-saving when administered as rapidly as possible once anaphylaxis is recognized. This clinical report from the American Academy of Pediatrics is an update of the 2007 clinical report on this topic. It provides information to help clinicians identify patients at risk of anaphylaxis and new information about epinephrine and epinephrine autoinjectors (EAs). The report also highlights the importance of patient and family education about the recognition and management of anaphylaxis in the community...
February 13, 2017: Pediatrics
https://www.readbyqxmd.com/read/28193298/does-drug-induced-sleep-endoscopy-change-the-surgical-decision-in-surgically-na%C3%A3-ve-non-syndromic-children-with-snoring-sleep-disordered-breathing-from-the-standard-adenotonsillectomy-a-retrospective-cohort-study
#10
Malak Jamal Gazzaz, André Isaac, Scott Anderson, Noura Alsufyani, Yaser Alrajhi, Hamdy El-Hakim
BACKGROUND: Adenotonsillectomy is the most commonly performed operation for pediatric snoring/sleep disordered breathing (S/SDB). However, 20-40% of patients will fail to improve. Drug-induced sleep endoscopy (DISE) may provide a more individualized surgical plan and limit unsuccessful surgeries. The aim of this study was to assess the impact of DISE on surgical decision-making in surgically naïve children with S/SDB. METHODS: A retrospective observational cohort study was undertaken at the Stollery Children's Hospital...
February 13, 2017: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28192574/primary-care-asthma-management-inhaled-corticosteroids-and-other-clinical-pearls
#11
Zachary Marcus, Nanah Suk Park
Most children in the United States with intermittent, mild, and moderate persistent asthma are cared for by primary care practitioners (PCPs). Despite inhaled corticosteroids (ICS) being highly effective at controlling asthma symptoms, many PCPs are uncomfortable prescribing these medications. Cumbersome guidelines, increasing numbers of medication choices, and concerns regarding side effects are some of the barriers to prescribing ICS for children with asthma. This article serves as a quick-start guide for PCPs that (1) condenses the routine diagnosis and management of asthma into concise clinical tools for children who would benefit from ICS therapy and (2) provides clinical pearls to aid in the treatment of mild- to moderate-persistent asthma...
February 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28192567/development-and-internal-validation-of-a-clinical-risk-score-for-treating-children-with-mild-head-trauma-and-intracranial-injury
#12
Jacob K Greenberg, Yan Yan, Christopher R Carpenter, Angela Lumba-Brown, Martin S Keller, Jose A Pineda, Ross C Brownson, David D Limbrick
Importance: The appropriate treatment of children with mild traumatic brain injury (mTBI) and intracranial injury (ICI) on computed tomographic imaging remains unclear. Evidence-based risk assessments may improve patient safety and reduce resource use. Objective: To derive a risk score predicting the need for intensive care unit observation in children with mTBI and ICI. Design, Setting, and Participants: This retrospective analysis of the prospective Pediatric Emergency Care Applied Research Network (PECARN) head injury cohort study included patients enrolled in 25 North American emergency departments from 2004 to 2006...
February 13, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28192551/effectiveness-of-computer-automation-for-the-diagnosis-and-management-of-childhood-type-2-diabetes-a-randomized-clinical-trial
#13
Tamara S Hannon, Tamara M Dugan, Chandan K Saha, Steven J McKee, Stephen M Downs, Aaron E Carroll
Importance: Type 2 diabetes (T2D) is increasingly common in young individuals. Primary prevention and screening among children and adolescents who are at substantial risk for T2D are recommended, but implementation of T2D screening practices in the pediatric primary care setting is uncommon. Objective: To determine the feasibility and effectiveness of a computerized clinical decision support system to identify pediatric patients at high risk for T2D and to coordinate screening for and diagnosis of prediabetes and T2D...
February 13, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28192225/a-randomized-trial-of-yoga-for-children-hospitalized-with-sickle-cell-vaso-occlusive-crisis
#14
Karen Moody, Bess Abrahams, Rebecca Baker, Ruth Santizo, Deepa Manwani, Veronica Carullo, Doris Eugenio, Aaron Carroll
CONTEXT: Sickle cell disease (SCD) vaso-occlusive crisis (VOC) remains an important cause of acute pain in pediatrics and the most common SCD complication. Pain management recommendations in SCD include nonpharmacological interventions. Yoga is one nonpharmacological intervention that has been shown to reduce pain in some populations, however, evidence is lacking in children with VOC. OBJECTIVES: The primary objective of this study was to compare the effect of yoga versus an attention control on pain in children with VOC...
February 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28188036/outcomes-of-an-accelerated-care-pathway-for-pediatric-blunt-solid-organ-injuries-in-a-public-healthcare-system
#15
Oluwatomilayo Daodu, Mary Brindle, Carlos R Alvarez-Allende, Lisette Lockyer, Bryce Weber, Steven R Lopushinsky
PURPOSE: An accelerated clinical care pathway for solid organ abdominal injuries was implemented at a level one pediatric trauma center. The impact on resource utilization and demonstration of protocol safety was assessed. METHODS: Data were collected retrospectively on patients admitted with blunt abdominal solid organ injuries from 2012 to 2015. Patients were subdivided into pre- and post-protocol groups. Length of hospital stay (LOS) and failure of non-operative treatment were the primary outcomes of interest...
January 29, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28187115/clinical-course-of-enterovirus-d68-in-hospitalized-children
#16
Jennifer E Schuster, Rangaraj Selvarangan, Ferdaus Hassan, Kayla B Briggs, Lindsay Hays, Jenna O Miller, Barbara Pahud, Henry T Puls, Mary Ann Queen, Marita T Thompson, Gina Weddle, Mary Anne Jackson
BACKGROUND: Enterovirus D68 (EV-D68) has been sporadically reported as a cause of respiratory tract infections. In 2014, an international outbreak of EV-D68 occurred and caused severe respiratory disease in the pediatric population. METHODS: A retrospective chart review was performed of children admitted to Children's Mercy Hospital from August 1, 2014, to September 15, 2014, with positive multiplex polymerase chain reaction testing for EV/rhinovirus (RV). Specimens were subsequently tested for EV-D68, and clinical data were obtained from the medical records...
March 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28187065/clinical-course-of-enterovirus-d68-in-hospitalized-children
#17
Jennifer E Schuster, Rangaraj Selvarangan, Ferdaus Hassan, Kayla B Briggs, Lindsay Hays, Jenna O Miller, Barbara Pahud, Henry T Puls, Mary Ann Queen, Marita T Thompson, Gina Weddle, Mary Anne Jackson
BACKGROUND: Enterovirus D68 (EV-D68) has been sporadically reported as a cause of respiratory tract infections. In 2014, an international outbreak of EV-D68 occurred and caused severe respiratory disease in the pediatric population. METHODS: A retrospective chart review was performed of children admitted to Children's Mercy Hospital from August 1-September 15, 2014 with positive multiplex PCR testing for enterovirus/rhinovirus (EV/RV). Specimens were subsequently tested for EV-D68, and clinical data were obtained from the medical records...
December 13, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28185747/lack-of-utility-of-measuring-serum-bilirubin-concentration-in-distinguishing-perforation-status-of-pediatric-appendicitis
#18
William Bonadio, Santina Bruno, David Attaway, Logesh Dharmar, Derek Tam, Peter Homel
BACKGROUND: Pediatric appendicitis is a common, potentially serious condition. Determining perforation status is crucial to planning effective management. PURPOSE: Determine the efficacy of serum total bilirubin concentration [STBC] in distinguishing perforation status in children with appendicitis. METHODS: Retrospective review of 257 cases of appendicitis who received abdominal CT scan and measurement of STBC. RESULTS: There were 109 with perforation vs 148 without perforation...
January 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28183549/hypocapnia-measured-by-end-tidal-carbon-dioxide-tension-during-anesthesia-is-associated-with-increased-30-day-mortality-rate
#19
Philippe Dony, Michele Dramaix, Jean G Boogaerts
STUDY OBJECTIVE: To evaluate the relationship between intraoperative end-tidal carbon dioxide (etco2) values and clinical outcomes with special attention on 30-day postoperative mortality and secondarily on hospital length of stay (LOS). DESIGN: Retrospective, observational study. SETTING: Surgical theaters of the University Hospital Center of Charleroi. PATIENTS: Five thousand three hundred seventeen patients ASA I-IV undergoing various surgical procedures (except pediatric and cardiac surgery) under general anesthesia...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183375/translating-clinical-trials-into-clinical-practice-a-survey-assessing-the-potential-impact-of-the-pediatric-heart-network-infant-single-ventricle-trial
#20
Victor Zak, Daphne T Hsu, Victoria L Pemberton, Jami C Levine, Andrew M Atz, James F Cnota, Chitra Ravishankar, Piers Barker, Linda M Lambert, Brian W McCrindle, Michele A Frommelt, Karen Altmann, Shan Chen, Richard V Williams
BACKGROUND: A few studies have evaluated the impact of clinical trial results on practice in paediatric cardiology. The Infant Single Ventricle (ISV) Trial results published in 2010 did not support routine use of the angiotensin-converting enzyme inhibitor enalapril in infants with single-ventricle physiology. We sought to assess the influence of these findings on clinical practice. METHODS: A web-based survey was distributed via e-mail to over 2000 paediatric cardiologists, intensivists, cardiothoracic surgeons, and cardiac advance practice nurses during three distribution periods...
February 10, 2017: Cardiology in the Young
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