Read by QxMD icon Read

Pediatric urgent care

Tony Zitek, Ignasia Tanone, Alexzza Ramos, Karina Fama, Ahmed S Ali
BACKGROUND: Urgent care centers (UCCs) can offer a cheap alternative to emergency departments (EDs) for some patients with acute complaints. However, if patients who initially present to a UCC are unnecessarily transferred to an ED, those patients may suffer undue financial harm. The group of patients transferred from UCCs to EDs have never previously been studied. OBJECTIVES: The primary objective of this study was to determine the fraction of transfers from a UCC to an ED that were unnecessary...
March 15, 2018: Journal of Emergency Medicine
Andrew McDowell, Neeraj Raizada, Sunil D Khaparde, Raghuram Rao, Sanjay Sarin, Aakshi Kalra, Virender Singh Salhotra, Sreenivas Achuthan Nair, Catharina Boehme, Claudia M Denkinger
BACKGROUND: Diagnosing tuberculosis (TB) in children presents considerable challenges. Upfront testing on Xpert® MTB/RIF ('Xpert')-a rapid molecular assay with high sensitivity and specificity-for pediatric presumptive TB patients, as recommended by India's Revised National Tuberculosis Control Program (RNTCP), can pave the way for early TB diagnosis. As part of an ongoing project implemented by Foundation for Innovative New Diagnostics (FIND) dedicated to providing upfront free-of-cost (FOC) Xpert testing to children seeking care in the public and private sectors, a qualitative assessment was designed to understand how national guidelines on TB diagnosis and Xpert technology have been integrated into the pediatric TB care practices of different health providers...
2018: PloS One
Faye M Evans, Juan C Duarte, Carolina Haylock Loor, Wayne Morriss
There is an urgent need to train more anesthesia providers in low- and middle-income countries (LMICs). There is also a need to provide more educational opportunities in subspecialty areas of anesthetic practice such as trauma management, pain management, obstetric anesthesia, and pediatric anesthesia. Together, these subspecialty areas make up a large proportion of the clinical workload in LMICs. In these countries, the quality of education may be variable, there may be few teachers, and opportunities for continued learning and mentorship are rare...
April 2018: Anesthesia and Analgesia
Rafael Arboleda Salazar, Jane Heggie, Piotr Wolski, Eric Horlick, Mark Osten, Massimiliano Meineri
BACKGROUND: Twenty percent of patients born with congenital heart disease present with right ventricular outflow tract abnormalities. These patients require multiple surgical procedures in their lifetime. Transcatheter pulmonary valve replacement (TPVR) has become a viable alternative to conventional pulmonary valve and right ventricular outflow tract surgery in pediatric and adult populations. In this retrospective review, we analyze the perioperative management of adult patients who underwent TPVR in our center...
March 14, 2018: Anesthesia and Analgesia
Amber Hoffman, Ingrid A Larson
It can be difficult to assist children with medical complexities (CMC) in maintaining wellness outside of hospital and emergency department settings. This growing population, with high use of medical technology and specialty care, has created a challenge for community providers who may infrequently care for children with these rare disorders and needs. CMCs have increased hospitalization rates and emergency care use. It is not realistic to believe that emergency health providers will know how to manage every type of CMC when they present for emergency care...
March 1, 2018: Pediatric Annals
Barbara P Yawn, Peter C Wollan, Matthew A Rank, Susan L Bertram, Young Juhn, Wilson Pace
PURPOSE: The purpose of this study was to assess patient and practice outcomes after introducing the Asthma APGAR (Activities, Persistent, triGGers, Asthma medications, Response to therapy) tools into primary care practices. METHODS: We used a pragmatic cluster-randomized controlled design in 18 US family medicine and pediatric practices to compare outcomes in patients with persistent asthma aged 5 to 45 years after introduction of the Asthma APGAR tools vs usual care...
March 2018: Annals of Family Medicine
Marianne Goudreault, Nago Humbert, France Gauvin, Monia Marzouki, Catherine K Beaumier, Dickens St-Vil, Nelson Piché
INTRODUCTION: Pediatric surgeons are often involved in the management of severely or terminally ill patients. However, articles addressing their specific roles in the context of palliative care are almost inexistent. We sought to characterize the involvement of pediatric surgeons caring for children near end of life. METHODS: Chart review of children who had a procedure under general anesthesia within 6months of their death over a five-year period at a tertiary children's hospital (excluding traumas and neonatology cases)...
February 9, 2018: Journal of Pediatric Surgery
Jennifer A Muszynski, Ron W Reeder, Mark W Hall, Robert A Berg, Thomas P Shanley, Christopher J L Newth, Murray M Pollack, David Wessel, Joseph Carcillo, Rick Harrison, Kathleen L Meert, J Michael Dean, Tammara Jenkins, Robert F Tamburro, Heidi J Dalton
OBJECTIVES: To determine RBC transfusion practice and relationships between RBC transfusion volume and mortality in infants and children treated with extracorporeal membrane oxygenation. DESIGN: Secondary analysis of a multicenter prospective observational study. SETTING: Eight pediatric institutions within the Eunice Kennedy Shriver National Institute of Child Health and Human Development's Collaborative Pediatric Critical Care Research Network...
March 6, 2018: Critical Care Medicine
Amy L Dimachkieh, Allison Dobbie, Damon R Olson, Mark A Lovell, Jeremy D Prager
OBJECTIVE: To review tracheal paragangliomas and describe the clinical presentation, radiologic findings, operative management, and histologic findings of a pediatric patient who presented with stridor refractory to traditional asthma therapy. METHODS: Chart review of an 8-year-old male who presented to a tertiary care pediatric hospital and literature review of tracheal paragangliomas. RESULTS: We present the case of an 8-year-old male who presented with new-onset of wheezing and dyspnea on exertion...
April 2018: International Journal of Pediatric Otorhinolaryngology
Timothy J Savage, Jane Kuypers, Helen Y Chu, Miranda C Bradford, Anne Marie Buccat, Xuan Qin, Eileen J Klein, Keith R Jerome, Janet A Englund, Alpana Waghmare
BACKGROUND: Severe respiratory disease associated with enterovirus D68 (EV-D68) has been reported in hospitalized pediatric patients. Virologic and clinical characteristics of EV-D68 infections exclusively in patients presenting to a hospital Emergency Department (ED) or urgent care have not been well defined. METHODS: Mid-nasal swabs from pediatric patients with respiratory symptoms presenting to the ED or urgent care were evaluated using a commercial multiplex PCR platform...
March 2, 2018: Influenza and Other Respiratory Viruses
Ellen M Raney, Harold J P van Bosse, Kevin G Shea, Joshua M Abzug, Richard M Schwend
INTRODUCTION: The opioid epidemic in the United States has reached crisis proportions. Urgent response is needed. Hydrocodone in combination with acetaminophen is the most prescribed drug in the United States. The most common source of opioids available for misuse is the unused portions of postoperative prescriptions. Among high school seniors, 80% of those who reported nonmedical use of prescription opioids previously had legitimate prescriptions but recreationally used leftover doses...
February 27, 2018: Journal of Pediatric Orthopedics
Neal L Benowitz, Natalie Nardone, Shonul Jain, Delia A Dempsey, Newton Addo, Gideon St Helen, Peyton Jacob
Background: Many adolescents are exposed to tobacco smoke, from either active smoking (CS) or secondhand smoke (SHS) exposure. Tobacco-specific biomarkers of exposure include cotinine (detects use in past 2-4 days) and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL; detects use for a month or longer). NNAL is expected to detect more intermittent tobacco exposure. We compared NNAL and cotinine as biomarkers of exposure to tobacco in urban adolescents and determined the optimal NNAL cutoff point to distinguish CS from SHS exposure...
February 23, 2018: Cancer Epidemiology, Biomarkers & Prevention
Per-Arne Lönnqvist
PURPOSE OF REVIEW: To put in perspective, the various challenges that faces pediatric anesthesiologists because of the recently lowered limits with regards to the viability of a fetus. Both medical and ethical considerations will be highlighted. RECENT FINDINGS: Issues related to: who should anesthetize these tiny babies; can we provide adequate and legal monitoring during the anesthetic; does these immature babies need hypnosis and amnesia and the moral/ethical implications associated with being involved with care of doubtful long-term outcome are reviewed...
February 22, 2018: Current Opinion in Anaesthesiology
Kalpana Thammineni, Jeffrey M Vinocur, Brian Harvey, Jeremiah S Menk, Michael Scott Kelleman, Anna-Maria Korakiti, Amanda S Thomas, James H Moller, James D St Louis, Lazaros K Kochilas
OBJECTIVE: Surgical coronary revascularisation in children with congenital heart disease (CHD) is a rare event for which limited information is available. In this study, we review the indications and outcomes of surgical coronary revascularisation from the Pediatric Cardiac Care Consortium, a large US-based multicentre registry of interventions for CHD. METHODS: This is a retrospective cohort study of children (<18 years old) with CHD who underwent surgical coronary revascularisation between 1982 and 2011...
February 22, 2018: Heart: Official Journal of the British Cardiac Society
Michael B Mwandri, Timothy C Hardcastle
BACKGROUND: Botswana is notable among countries with high rates of Road Traffic Collisions (RTC); like many other lower-middle-income countries (LMICs), it lacks trauma systems. The World Health Organization recommends 'Essential Trauma Care' in countries with no formal trauma systems. The proportion of injuries in Emergency Departments and the care process were investigated to gain an overview for enabling the design of a relevant LMICs trauma system. METHOD: Blunt and penetrating trauma patients were included from three major hospitals, examining the proportion of injuries, patient characteristics, the care process and comparing these between pediatrics and adults...
February 15, 2018: World Journal of Surgery
Nagma Dalvi, Lalitha Sivaswamy
Life-threatening headaches in children can present in an apoplectic manner that garners immediate medical attention, or in an insidious, more dangerous form that may go unnoticed for a relatively long period of time. The recognition of certain clinical characteristics that accompany the headache should prompt recognition and referral to an institution equipped with neuroimaging facilities, pediatric neurosurgeons, and neurologists. Thunderclap headaches, which reach a peak within a very short period of time, may be the presenting feature of conditions such as arterial dissection, venous sinus thrombosis, and reversible cerebral vasoconstriction syndrome, which can be addressed by specific pharmacological options instituted in an intensive care setting...
February 1, 2018: Pediatric Annals
E H Pieter van Dijkhuizen, Tsipi Egert, Yona Egert, Wendy Costello, Casper Schoemaker, Marlous Fernhout, Mirjam Kepic, Alberto Martini, Silvia Scala, Ingrid Rotstein-Grein, Sebastiaan J Vastert, Nico M Wulffraat
BACKGROUND: To assess the views of juvenile idiopathic arthritis (JIA) patients and their parents on the care and treatment they receive in referral pediatric rheumatology centers throughout Europe. METHODS: In a collaboration between physicians and patient associations, a questionnaire was developed, covering various domains of JIA care, including demographics, diagnosis, referrals to various health care professionals, access to pain and fatigue management and support groups, information they received about the disease and awareness of and participation in research...
February 8, 2018: Pediatric Rheumatology Online Journal
Ryoko Harada, Kenji Ishikura, Shunsuke Shinozuka, Naoaki Mikami, Riku Hamada, Hiroshi Hataya, Yoshihiko Morikawa, Tae Omori, Hirotaka Takahashi, Yuko Hamasaki, Tetsuji Kaneko, Kazumoto Iijima, Masataka Honda
BACKGROUND: In pediatric patients, due to variations in baseline serum creatinine (Cr) reference values, renal dysfunctions sometimes go unnoticed. In addition, renally excreted drugs need dose adjustment while nephrotoxic drugs should be avoided altogether in patients with impaired renal function. However, most physicians are apparently unaware of these facts and may administer these drugs to vulnerable patients. METHODS: We administered a questionnaire to all physicians and pharmacists specializing in pediatric medical care at six Tokyo metropolitan government-run hospitals in Japan...
February 6, 2018: Clinical and Experimental Nephrology
J Herman Kan, Robert C Orth, Terry A Yen, Erica K Schallert, Wei Zhang, Lane F Donnelly
PURPOSE: The proliferation of pediatric urgent care centers has increased the need for diagnostic imaging support, but the impact of employing radiology technologists at these centers is not known. The purpose of this study was to evaluate radiographic impact and quality at urgent care centers with and without radiology technologists. METHODS: A retrospective case-control study was conducted comparing 235 radiographic examinations (study) performed without and 83 examinations (control) performed with a radiology technologist at the authors' pediatric urgent care centers...
February 2, 2018: Journal of the American College of Radiology: JACR
Corrie E Chumpitazi, Elizabeth A Camp, Divya R Bhamidipati, Almea M Montillo, A Chantal Caviness, Lesby Mayorquin, Faria A Pereira
BACKGROUND: There is no evidence of an association between fasting time and the incidence of adverse events during procedural sedation and analgesia. Pediatric and adult emergency medicine guidelines support avoiding delaying procedures based on fasting time. General pediatric guidelines outside emergent care settings continue to be vague and do not support a set fasting period for urgent and emergent procedures. OBJECTIVE: To describe shortened preprocedural fasting and vomiting event rates during the implementation of a shortened fasting protocol...
January 9, 2018: American Journal of Emergency Medicine
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"