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Pediatric clinic management

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https://www.readbyqxmd.com/read/29342449/increased-use-of-adrenaline-in-the-management-of-childhood-anaphylaxis-over-the-last-decade
#1
Kristina Rueter, Brennan Ta, Natasha Bear, Michaela Lucas, Meredith L Borland, Susan L Prescott
BACKGROUND: We recently determined that allergy training programs have improved physician recognition and diagnosis of pediatric anaphylaxis in the last decade. OBJECTIVE: To investigate for changes in management, in particular the appropriate use of adrenaline for the treatment of anaphylaxis in a tertiary pediatric emergency department (PED). METHODS: We conducted a retrospective case note study including children aged 0 to 16 years coded and verified for anaphylaxis comparing cases in years 2003/2004 with 2012...
January 13, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29339125/prevalence-and-outcomes-of-primary-immunodeficiency-in-hospitalized-children-in-the-united-states
#2
Zachary Rubin, Andrea Pappalardo, Alan Schwartz, James W Antoon
BACKGROUND: Primary immunodeficiency diseases (PIDDs) are rare yet life-threatening chronic conditions in children. The prevalence and outcomes of PIDDs in the pediatric population in the United States are not well understood. OBJECTIVE: The objectives of this study were to (1) determine the epidemiology of children hospitalized with PIDD in the United States and (2) characterize the clinical outcomes of hospitalized children with PIDDs. METHODS: Retrospective cohort analysis of the 2003-2012 Kids' Inpatient Database of children aged 2-18 years admitted with a primary or secondary diagnosis code of PIDD was performed...
January 12, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29338905/posterior-reversible-encephalopathy-syndrome-a-rare-childhood-case-with-unconsciousness
#3
Akira Komori, Daisuke Mizu, Koichi Ariyoshi
BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) is a condition characterized by seizures, altered consciousness, visual disturbances, and headache. Characteristic findings on neuroimaging include cerebral edema, typically involving the parieto-occipital white matter. PRES has been associated with hypertension, autoimmune disease, and Henoch-Schölein purpura (HSP), but few cases have been reported, and fewer cases of PRES have been reported in children. CASE REPORT: We report the case of a 4-year-old girl who presented with blindness and semi-consciousness...
January 12, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29336754/predictors-and-outcomes-of-nondiagnostic-ultrasound-for-acute-appendicitis-in-children
#4
Richard Sola, Blair A Wormer, William E Anderson, Thomas M Schmelzer, Graham H Cosper
Ultrasound assessments of children with possible acute appendicitis (AA) are often nondiagnostic. We aimed to identify the predictors of nondiagnostic ultrasound and to investigate the outcomes. A retrospective review was conducted on children aged 4 to 17 years evaluated in 2013 for AA with ultrasound at a tertiary hospital pediatric emergency department. Demographics, clinical data, and outcomes were analyzed. Of 528 children, 194 (36.7%) had diagnostic ultrasounds and 334 (63.3%) had nondiagnostic ultrasounds...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29334996/italian-guidelines-on-the-assessment-and-management-of-pediatric-head-injury-in-the-emergency-department
#5
REVIEW
Liviana Da Dalt, Niccolo' Parri, Angela Amigoni, Agostino Nocerino, Francesca Selmin, Renzo Manara, Paola Perretta, Maria Paola Vardeu, Silvia Bressan
OBJECTIVE: We aim to formulate evidence-based recommendations to assist physicians decision-making in the assessment and management of children younger than 16 years presenting to the emergency department (ED) following a blunt head trauma with no suspicion of non-accidental injury. METHODS: These guidelines were commissioned by the Italian Society of Pediatric Emergency Medicine and include a systematic review and analysis of the literature published since 2005...
January 15, 2018: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29334983/an-individually-tailored-family-centered-intervention-for-pediatric-obesity-in-primary-care-study-protocol-of-a-randomized-type-ii-hybrid-effectiveness-implementation-trial-raising-healthy-children-study
#6
Justin D Smith, Cady Berkel, Neil Jordan, David C Atkins, Shrikanth S Narayanan, Carlos Gallo, Kevin J Grimm, Thomas J Dishion, Anne M Mauricio, Jenna Rudo-Stern, Mariah K Meachum, Emily Winslow, Meg M Bruening
BACKGROUND: Pediatric obesity is a multi-faceted public health concern that can lead to cardiovascular diseases, cancers, and early mortality. Small changes in diet, physical activity, or BMI can significantly reduce the possibility of developing cardiometabolic risk factors. Family-based behavioral interventions are an underutilized, evidence-based approach that have been found to significantly prevent excess weight gain and obesity in children and adolescents. Poor program availability, low participation rates, and non-adherence are noted barriers to positive outcomes...
January 15, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29334567/pediatric-vascular-trauma-practice-patterns-and-resource-availability-a-survey-of-acs-designated-pediatric-trauma-centers
#7
Patrick C Bonasso, Lori A Gurien, Samuel D Smith, Marie E Saylors, M Sidney Dassinger
BACKGROUND: Variation exists in pediatric vascular trauma management. We aim to determine practice patterns for vascular trauma management at American College of Surgeons (ACS) verified pediatric trauma centers and evaluate the resources available for management of vascular trauma at both freestanding children's hospitals (FSCH) and pediatric hospitals within general adult hospitals (PHGAH). METHODS: Pediatric surgeons and trauma medical directors at ACS designated pediatric surgery trauma centers completed a survey designed to evaluate anticipated management of traumatic arterial injuries and resource availability...
January 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29334535/simultaneous-presentation-of-wilms-tumor-and-contralateral-ganglioneuroma-in-a-child-case-report-and-literature-review
#8
Zuhal Bayramoglu, Ibrahim Adaletli, Emine Caliskan, Isin Kilicaslan, Cagla S Karaoglan, Alaattin Celik, Feryal Gun Soysal, Sema B Bay, Bulent Zulfikar
We demonstrate a 4-year-old girl who presented with progressive, asymmetrical, firm abdominal distention and was diagnosed with synchronous Wilms' tumor and left para-aortic ganglioneuroma (GN). Although synchronous tumors in the pediatric population are commonly associated with malignancy-predisposing syndromes, the patient in question was found to be otherwise healthy and had no clinical evidence nor family history of a syndrome. This case is the second one in the literature diagnosed with synchronous presentation of Wilms' tumor and GN in a previously healthy child...
January 12, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29334446/pediatric-community-acquired-pneumonia
#9
Stephanie Posten, Jennifer Reed
Pediatric community acquired pneumonia (CAP) is frequently encountered by medical providers and is one of the most common reasons for hospital admission. CAP is known to cause significant morbidity and mortality, causing greater than 2 million deaths annually worldwide in children younger than five years old. The Infectious Disease Society of America (IDSA) released guidelines in 2011 with recommendations regarding appropriate diagnosis and management of community acquired pneumonia for children greater than 3 months age, with the goal of assisting providers in clinical decision making...
December 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/29333911/the-challenge-of-pediatric-uveitis-tertiary-referral-center-experience-in-the-united-states
#10
Mariantonia Ferrara, Laura Eggenschwiler, Andrew Stephenson, Alyssa Montieth, Nakhoul Nakhoul, Rafael Araùjo-Miranda, C Stephen Foster
PURPOSE: To describe the distribution, clinical findings, visual outcomes, treatment, and complications of children with uveitis at a tertiary referral ophthalmic center. METHODS: Retrospective cohort study. We reviewed the medical records of all patients ≤16 years with uveitis referred to Massachusetts Eye Research and Surgery Institution from March 2005 to July 2016. RESULTS: Of 286 included children, 62.24% were female. Mean age of onset was 8...
January 15, 2018: Ocular Immunology and Inflammation
https://www.readbyqxmd.com/read/29333837/-biodegradable-airway-stent-for-the-treatment-of-bronchial-obstruction-in-the-child-case-report
#11
Giselle Cuestas, Verónica Rodríguez, Flavia Doormann, Patricio Bellia Munzón, Gastón Bellia Munzón
Bronchial obstruction is infrequent in the child. The main cause is malacia or benign stenosis. Management alternatives range from conservative treatment to complex surgical and/or endoscopic techniques. Placement of a stent can play a key role in situations where there is no other therapeutic option. However, the ideal stent is not yet available. In the last few years, progress has been made in the development and characterization of novel biodegradable materials in order to overcome the drawbacks of traditional stents made of silicone or metal...
February 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29333808/the-perspective-of-primary-health-care-pediatricians-regarding-childhood-anemia-and-iron-supplementation
#12
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/29333786/the-added-value-of-the-lateral-chest-radiograph-for-diagnosing-community-acquired-pneumonia-in-the-pediatric-emergency-department
#13
Michalle Soudack, Semion Plotkin, Aviva Ben-Shlush, Lisa Raviv-Zilka, Jeffrey M Jacobson, Michael Benacon, Arie Augarten
BACKGROUND: Opinions differ as to the need of a lateral radiograph for diagnosing community acquired pneumonia in children referred to the emergency department. A lateral radiograph increases the ionizing radiation burden but at the same time may improve specificity and sensitivity in this population. OBJECTIVES: To determine the value of the frontal and lateral chest radiographs compared to frontal view stand-alone images for the management of children with suspected community acquired pneumonia seen in a pediatric emergency department...
January 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29333010/sinusoidal-obstruction-syndrome-during-treatment-for-wilms-tumor-a-life-threatening-complication
#14
Sidharth Totadri, Amita Trehan, Deepak Bansal, Richa Jain
Context: Survival rates exceed 90% in Wilms' tumor (WT). Actinomycin-D (ACT-D) which is indispensable in the management of WT is associated with the development of sinusoidal obstruction syndrome (SOS), a potentially fatal complication. Aims: The aim is to study the presentation, management, and outcome of SOS complicating ACT-D administration in WT. Settings and Design: Retrospective file review conducted in a Pediatric Hematology-Oncology unit...
October 2017: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/29332587/lysosomal-acid-lipase-deficiency-could-dyslipidemia-drive-the-diagnosis
#15
Ornella Guardamagna
LAL-deficiency (LAL-D) is a rare and systemic condition, secondary to LIPA gene mutations, responsible for lysosomal accumulation of cholesteryl esters and triglycerides, whose manifestations are very heterogeneous in terms of age of onset, severity and type of clinical and radiological manifestations. Dyslipidemia, hepatomegaly and hepatosteatosis with increased levels of transaminases are the most common features. The increased risk of premature atherosclerosis and cardiovascular disorders,, secondary to a generalized alteration of lipid profile and lipoprotein dysfunction associated with LAL-D, has been increasingly pointed out...
January 11, 2018: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29331555/preoperative-thromboelastographic-profile-of-patients-with-congenital-heart-disease-association-of-hypercoagulability-and-decreased-heparin-response
#16
Zhe Amy Fang, Rachel Bernier, Sirisha Emani, Sitaram Emani, Gregory Matte, James A DiNardo, David Faraoni, Juan C Ibla
OBJECTIVE: To describe the demographic and thromboelastographic characteristics of patients with congenital heart disease presenting with decreased heparin response before cardiac surgery. DESIGN: Retrospective, observational study. SETTING: Single institution, tertiary, academic, university hospital. PARTICIPANTS: The study comprised 496 pediatric and adult patients undergoing cardiac surgery for congenital heart disease...
December 12, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29331328/pilot-clinical-trial-of-high-flow-oxygen-therapy-in-children-with-asthma-in-the-emergency-service
#17
Yolanda Ballestero, Jimena De Pedro, Nancy Portillo, Otilia Martinez-Mugica, Eunate Arana-Arri, Javier Benito
OBJECTIVES: To assess the efficacy of high-flow nasal cannula (HFNC) oxygen therapy and safety in children with asthma and moderate respiratory failure in the emergency department (ED). STUDY DESIGN: This was a prospective randomized pilot trial of children (aged 1-14 years) presenting to a tertiary academic pediatric ED with moderate-to-severe asthma exacerbations between September 2012 and December 2015. Patients with a pulmonary score (PS) ≥6 or oxygen saturation <94% with a face mask despite initial treatment (salbutamol/ipratropium bromide and corticosteroids) were randomized to HFNC or to conventional oxygen therapy...
January 11, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29331260/multifaceted-behavior-of-meckel-s-diverticulum-in-children
#18
Qingjiang Chen, Zhigang Gao, Lifeng Zhang, Yuebin Zhang, Tao Pan, Duote Cai, Qixing Xiong, Qiang Shu, Yunzhong Qian
PURPOSE/BACKGROUND: Meckel's diverticulum (MD) is one of the most common congenital malformations of gastrointestinal tract in children. However, the nonspecific clinical manifestations of MD often cause a diagnostic as well as therapeutic challenge to pediatric surgeon. This study aimed to review our experience in managing this disease while evaluating the management strategies. METHODS: We retrospectively analyzed the clinical data of all patients diagnosed with MD admitted to our center between January 2010 and December 2015...
December 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29330083/rationale-and-design-of-the-clinic-and-community-approaches-to-healthy-weight-randomized-trial
#19
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/29329877/-attitudes-towards-cow-s-milk-protein-allergy-management-by-spanish-gastroenterologist
#20
Alicia Isabel Pascual Pérez, Alejandra Méndez Sánchez, Óscar Segarra Cantón, Beatriz Espin Jaime, Santiago Jiménez Treviño, Carlos Bousoño García, Juan José Díaz Martín
INTRODUCTION: Food allergy is an increasing health problem in the developed world. Cow's milk protein is the main cause of food allergy in infants. Without an appropriate diagnostic workup, there is a high risk of both over- and underdiagnosis and therefore, over and undertreatment. The objective of our study was to analyze the variability in cow's milk protein allergy (CMPA) management by pediatric gastroenterologists in Spain. METHODS: A fifty item questionnaire, including open and closed items in a Likert's scale from 0 to 5, was drafted and distributed through the Spanish Society for Pediatric Gastroenterology, Hepatology and Nutrition (SEGHNP) e-mail list...
January 9, 2018: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
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