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Pediatric clinic management

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https://www.readbyqxmd.com/read/28731841/survey-of-nutrition-management-practices-in-centers-for-pediatric-intestinal-rehabilitation
#1
Anita M Nucci, Kipp Ellsworth, Austin Michalski, Emily Nagel, Jackie Wessel
BACKGROUND: Nutrition management of pediatric intestinal failure (IF) requires interdisciplinary coordination of parenteral nutrition (PN) and enteral nutrition (EN) support. Nutrition strategies used by specialists in pediatric intestinal rehabilitation to promote gut adaptation and manage complications have not been previously summarized. METHODS: A practice survey was distributed to members of the dietitian subgroup of the American Society for Parenteral and Enteral Nutrition Pediatric Intestinal Failure Section...
July 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28731673/-kawasaki-disease-interdisciplinary-and-intersocieties-consensus-clinical-guidelines-brief-version
#2
(no author information available yet)
Kawasaki disease is an acute self-limiting systemic vasculitis. It is the most common cause of acquired heart disease, with the risk of developing coronary artery aneurysms, myocardial infarction and sudden death. Diagnosis is based on the presence of fever in addition to other clinical criteria. The quarter of the Kawasaki disease patients have "incomplete" presentation. Treatment with intravenous immunoglobulin within ten days of fever onset improves clinical outcomes and reduces the incidence of coronary artery dilation to less than 5%...
August 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28731535/ultrasound-guided-drainage-for-pediatric-soft-tissue-abscesses-decreases-clinical-failure-rates-compared-to-drainage-without-ultrasound-a-retrospective-study
#3
Romolo Joseph Gaspari, Alexandra Sanseverino
OBJECTIVES: Soft tissue abscesses are common in the pediatric emergency department (ED). Ultrasound (US) can be used to both diagnose soft tissue abscesses as well as guide drainage. We hypothesized that clinical failure rates would be less in pediatric patients with suspected skin abscesses when evaluated with US. METHODS: We performed a retrospective review of suspected pediatric skin abscesses at 4 EDs over a 22-month period. Cases were identified through electronic medical record descriptions, discharge diagnoses, and US database records...
July 21, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28731411/oral-immunotherapy-for-food-allergy-a-spanish-guideline-immunotherapy-egg-and-milk-spanish-guide-items-guide-part-i-cow-milk-and-egg-oral-immunotherapy-introduction-methodology-rationale-current-state-indications-contraindications-and-oral-immunotherapy-build
#4
A Martorell, E Alonso, L Echeverría, C Escudero, R García-Rodríguez, C Blasco, J Bone, J Borja-Segade, T Bracamonte, A Claver, J L Corzo, B De la Hoz, R Del Olmo, O Dominguez, V Fuentes-Aparicio, I Guallar, H Larramona, F Martín-Muñoz, V Matheu, A Michavila, I Ojeda, P Ojeda, M Piquer, P Poza, M Reche, P Rodríguez Del Río, M Rodríguez, F Ruano, S Sánchez-García, S Terrados, L Valdesoiro, M Vazquez-Ortiz
BACKGROUND AND OBJECTIVE: Cow milk and egg are the most frequent causes of food allergy in the first years of life. Oral immunotherapy (OIT) has been investigated as an alternative to avoidance diets. No clinical practice guidelines on the management of OIT with milk and egg are currently available. Objectives: To develop clinical guidelines for OIT based on available scientific evidence and the opinions of experts. METHODS: A review was made of studies published between 1984 and June 2016, doctoral theses published in Spain, summaries of communications at scientific meetings (SEAIC, SEICAP, EAACI, and AAAAI), and the consensus of opinion established by a group of experts from the scientific societies SEICAP and SEAIC...
2017: Journal of Investigational Allergology & Clinical Immunology
https://www.readbyqxmd.com/read/28730845/evaluation-of-toxicity-after-acute-accidental-methotrexate-ingestions-in-children-under-6-years-old-a-16-year-multi-center-review
#5
Hannah Hays, Michael C Beuhler, Henry A Spiller, Julie Weber, James B Mowry, Mark L Ryan, Natalie E Spiller, Ashley Webb
CONTEXT: There is little data on the frequency of adverse events following acute methotrexate ingestions in pediatric patients. Likewise, recommendations for observation length, site and management strategies in this population are not well established. Therefore, most recommendations are modeled after management of chronic overdose in patients with underlying medical conditions. OBJECTIVE: The primary objective of this study is to determine the frequency of acute toxicity after acute methotrexate accidental unsupervised ingestions in patients less than six years...
July 21, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28729906/update-on-pediatric-sepsis-a-review
#6
REVIEW
Tatsuya Kawasaki
BACKGROUND: Sepsis is one of the leading causes of mortality among children worldwide. Unfortunately, however, reliable evidence was insufficient in pediatric sepsis and many aspects in clinical practice actually depend on expert consensus and some evidence in adult sepsis. More recent findings have given us deep insights into pediatric sepsis since the publication of the Surviving Sepsis Campaign guidelines 2012. MAIN TEXT: New knowledge was added regarding the hemodynamic management and the timely use of antimicrobials...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28728870/outpatient-dermatology-consultation-impacts-the-diagnosis-and-management-of-pediatric-oncology-patients-a-retrospective-study
#7
Hannah Song, Sarah N Robinson, Jennifer T Huang
BACKGROUND: The impact of dermatology consultation on the care of children with oncologic conditions is unknown. OBJECTIVE: To review outpatient dermatology visits and the resulting impact on diagnosis and management of pediatric oncology patients. METHOD: Retrospective review of pediatric oncology patients with outpatient dermatology visits at a tertiary care center from 2008 to 2015. RESULTS: The most common dermatologic diagnoses in 516 patients were skin infections (21...
July 17, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28728426/osteochondroma-of-the-hyoid-first-pediatric-case-and-literature-review
#8
Blake S Raggio, Samuel Ficenec, Thomas C Flowers, Claire Lawlor, Kimsey Rodriguez
Osteochondromas, the most common benign bone tumors, are cartilaginous neoplasms of unknown origin with rare malignant potential. Osteochondromas rarely occur in the head and neck, and diagnosis relies on a combination of clinical, radiological, and histological criteria. Excision is often curative. We describe the first reported case of hyoid osteochondroma in an adolescent male with multiple osteochondroma, discuss its surgical management, and perform a review of the salient literature. Osteochondroma represents a rare diagnosis to include in the differential of any midline neck mass...
July 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28727227/long-term-outcomes-of-simultaneous-heart-and-kidney-transplantation-in-pediatric-recipients
#9
Patricia L Weng, Juan Carlos Alejos, Nancy Halnon, Qiuheng Zhang, Elaine F Reed, Eileen Tsai Chambers
Pediatric sHKTx has become an effective therapy for patients with combined cardiac and renal failure. Often, these patients develop human leukocyte antigen antibodies from their previous allografts and are therefore more difficult to re-transplant. We describe the largest case series of a predominantly sensitized pediatric sHKTx with emphasis on medical management and patient outcomes. Demographics, clinical characteristics, antibody, and biopsy data were retrospectively collected from University of California, Los Angeles database and correlated with short- and long-term patient and allograft outcomes of all sHKTx performed between 2002 and 2015...
July 20, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28725955/biologics-in-juvenile-idiopathic-arthritis-a-narrative-review
#10
REVIEW
Federica Vanoni, Francesca Minoia, Clara Malattia
In the past years, pediatric rheumatology has seen a revolution in the treatments for rheumatic diseases, particularly juvenile idiopathic arthritis. Even if nonsteroidal anti-inflammatory drugs (NSAID), intra-articular corticosteroids (IAC) injections, and methotrexate remain the mainstay of the treatment for JIA patients, in aggressive disease, these treatments may be not sufficient to reach disease remission and to prevent long-term disability. Comprehension of immunological mechanisms involved in the pathogenesis of the diseases allowed to conceive new drugs targeting specific steps of the immune response...
July 20, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28722615/assessing-the-short-term-global-health-experience-a-cross-sectional-study-of-demographics-socioeconomic-factors-and-disease-prevalence
#11
Olivia Geen, Allison Pumputis, Cristina Kochi, Andrew Costa, Karl Stobbe
Interest in short-term global health experiences to underserviced populations has grown rapidly in the last few decades. However, there remains very little research on what participants can expect to encounter. At the same time, it has been suggested that in order for physicians and workers to provide safe and effective care, volunteers should have a basic understanding of local culture, health systems, epidemiology, and socioeconomic needs of the community before arriving. Our objective was to add to the limited literature on what short-term global health trips can expect to encounter through a cross-sectional study of patient demographics, socioeconomic markers, and the prevalence of diseases encountered on a short-term medical service trip to Lima, Peru...
June 12, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28722590/a-qualitative-study-of-provider-perceptions-of-influences-on-uptake-of-pediatric-hospital-guidelines-in-lao-pdr
#12
Amy Z Gray, Douangdao Soukaloun, Bandith Soumphonphakdy
Strategies to improve the quality of hospital care are needed if ongoing gains in child health and survival are to be made. We previously reported on improvements in the quality of case management in hospitals following a guideline-based intervention in Lao PDR, with variation in the degree of change achieved between clinical conditions. This study aims to understand the factors that influenced the uptake of the guideline-based intervention, and its impact on care. This qualitative study was embedded in a mixed-methods evaluation of guideline implementation in nine hospitals in Lao PDR...
June 12, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28722481/clinical-management-of-pediatric-acute-onset-neuropsychiatric-syndrome-part-i-psychiatric-and-behavioral-interventions
#13
Margo Thienemann, Tanya Murphy, James Leckman, Richard Shaw, Kyle Williams, Cynthia Kapphahn, Jennifer Frankovich, Daniel Geller, Gail Bernstein, Kiki Chang, Josephine Elia, Susan Swedo
OBJECTIVE: This article outlines the consensus guidelines for symptomatic treatment for children with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Syndrome Associated with Streptococcal Infection (PANDAS). METHODS: Extant literature on behavioral, psychotherapeutic, and psychopharmacologic treatments for PANS and PANDAS was reviewed. Members of the PANS Research Consortium pooled their clinical experiences to find agreement on treatment of PANS and PANDAS symptoms...
July 19, 2017: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/28721545/is-topiramate-effective-for-migraine-prevention-in-patients-less-than-18%C3%A2-years-of-age-a-meta-analysis-of-randomized-controlled-trials
#14
REVIEW
Kai Le, Dafan Yu, Jiamin Wang, Abdoulaye Idriss Ali, Yijing Guo
BACKGROUND: Mainly based on evidence of success in adults, various medications are commonly used to prevent pediatric migraines. Topiramate has been approved for migraine prevention in children as young as 12 years of age. In this meta-analysis, we aimed to assess the currently published data pertaining to the efficacy of topiramate for migraine prevention in patients less than 18 years of age. METHODS: We searched PubMed/Medline, Embase and the Cochrane Library (from inception to April 2017) for randomized controlled trials (RCTs) published in English...
December 2017: Journal of Headache and Pain
https://www.readbyqxmd.com/read/28721285/ureteroscopy-for-stone-disease-expanding-roles-in-the-modern-era
#15
REVIEW
Adrian Ho, Piyush Sarmah, Ewa Bres-Niewada, Bhaskar K Somani
INTRODUCTION: The prevalence of urolithiasis is increasing worldwide and is causing significant morbidity and cost to the healthcare systems. While ureteroscopy (URS) has been established as a treatment option, our review highlights the expanding role of URS for the management of more complex stones and patients in the modern era. MATERIAL AND METHODS: Ureteroscopy has shown to have good outcomes with stone free rates (SFR) comparable to other treatment modalities...
June 30, 2017: Central European Journal of Urology
https://www.readbyqxmd.com/read/28719391/pediatric-and-congenital-hand-transplantation
#16
Sandra Amaral, L Scott Levin
PURPOSE OF REVIEW: We review the approach and challenges associated with pediatric hand transplantation, including new knowledge gleaned from our recent case of bilateral hand-forearm transplantation in an 8-year old child. RECENT FINDINGS: Bilateral heterologous hand-forearm transplantation was performed in a child with a prior kidney transplant in July 2015. The initial surgery necessitated a large team of experts in microvascular surgery, transplant surgery, orthopedics and plastic surgery as well as pediatric anesthesia...
July 14, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28717937/clinical-presentation-and-outcomes-of-childhood-onset-membranous-lupus-nephritis
#17
Maria Pereira, Eyal Muscal, Karen Eldin, M John Hicks, Anna Carmela P Sagcal-Gironella, Marietta DeGuzman, Scott E Wenderfer
BACKGROUND: Best practices for managing childhood-onset membranous lupus nephritis (MLN) are not yet established. Most studies involve primarily or exclusively adult cohorts or pediatric cohorts with combinations of pure or mixed membranous and proliferative nephritis. METHODS: We performed a single-center cohort study of consecutively diagnosed children with pure MLN from 1990 and 2016. Patients received care in Houston, Texas, one of the most diverse metropolitan areas in North America...
July 17, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28716516/hypertonia
#18
Sarah Helen Evans, Mark William Cameron, Justin Michael Burton
Hypertonia is the abnormal increase in muscle tone as a result of upper motor neuron lesions. There are three following clinical types: spasticity, dystonia, and rigidity. Management of hypertonia is individualized and should be directed by the patient and/or family׳s goals of care as well as the underlying cause of the hypertonia. Treatment options include stretching, strengthening, positioning, oral medications, botulinum toxin injections, phenol injections, as well as surgical procedures. Without effective management, hypertonia can result in muscle imbalance, abnormal movement patterns, pain, joint contracture, joint deformity, and ultimately negatively impact a patient׳s function...
July 14, 2017: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/28716515/calming-the-storm-dysautonomia-for-the-pediatrician
#19
Justin M Burton, Olga M Morozova
Dysautonomia is a potentially life-threatening syndrome seen in many different types of brain injuries. It involves paroxysmal sympathetic hyperactivity and typically includes a constellation of symptoms, including: tachycardia, tachypnea, hyperthermia, hypertension, diaphoresis, hypertonia, and/or decerebrate or decorticate posturing. It is a clinical diagnosis of exclusion. A multimodal treatment approach is necessary including environmental modifications along with pharmacotherapy. Early management can help prevent comorbidities including secondary brain injury while also improving patient outcomes...
July 14, 2017: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/28716081/impact-of-a-nurse-led-telephone-intervention-on-satisfaction-and-health-outcomes-of-children-with-inflammatory-rheumatic-diseases-and-their-families-a-crossover-randomized-clinical-trial
#20
Anne-Sylvie Ramelet, Béatrice Fonjallaz, Laura Rio, Sandra Zoni, Pierluigi Ballabeni, Joachim Rapin, Christophe Gueniat, Michaël Hofer
BACKGROUND: Children suffering from rheumatic disease are faced with multidimensional challenges that affect their quality of life and family dynamics. Symptom management and monitoring of the course of the disease over time are important to minimize disability and pain. Poor disease control and anticipation of the need for treatment changes may be prompted by specialist medical follow-up and regular nurse-led consultations with the patient and families, in which information and support is provided...
July 17, 2017: BMC Pediatrics
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