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https://www.readbyqxmd.com/read/28060178/assessment-of-splints-applied-for-pediatric-fractures-in-an-emergency-department-urgent-care-environment
#1
Joshua M Abzug, Brandon S Schwartz, Aaron J Johnson
BACKGROUND: Fractures are common in the pediatric population. The initial evaluation is rarely by an orthopaedic surgeon, but commonly an emergency room or urgent care center physician/extender. This typically involves splint application by a nonorthopaedist to immobilize the extremity and provide stabilization. Iatrogenic injuries from inappropriate splint placement are a potential public health and legal concern that can lead to complications. The primary purpose of this study was to prospectively evaluate the adequacy of all splints placed on patients who presented to a pediatric orthopaedic office; secondary outcomes included assessing prevalence and types of complications that were associated with inadequate splints...
January 5, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28034356/improving-cancer-care-for-children-in-the-developing-world-challenges-and-strategies
#2
Zakiya Al Lamki
Cancer is a global health problem particularly in developing countries where the burden of cancer is ever increasing and claiming the lives of about 100,000 children under the age of 15 years every year. Majority of these occur in the Low and Middle Income Countries (LMICs) where 90% of world children live. Contributing factors to this trend is the reduction of communicable diseases and emergence of new infections, improvement of nutrition and socio-economic conditions, industrialization and urbanization. However, due to its complexity, childhood cancer is given the least priority by the governments' funding...
December 30, 2016: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28031377/urine-cotinine-screening-detect-nearly-ubiquitous-tobacco-smoke-exposure-in-urban-adolescents
#3
Neal L Benowitz, Shonul Jain, Delia A Dempsey, Natalie Nardone, Gideon St Helen, Peyton Jacob
INTRODUCTION: Routine biochemical assessment of tobacco smoke exposure could lead to more effective interventions to reduce or prevent secondhand smoke (SHS)-related disease in adolescents. Our aim was to determine using urine cotinine (major nicotine metabolite) measurement the prevalence of tobacco smoke exposure among adolescents receiving outpatient care at an urban public hospital. METHODS: Surplus urine was collected in 466 adolescents attending pediatric or urgent care clinics at San Francisco General Hospital, serving families with lower levels of income and education, in 2013-14...
December 28, 2016: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/28005912/benchmarking-prehospital-and-emergency-department-care-for-argentine-children-with-traumatic-brain-injury-for-the-south-american-guideline-adherence-group
#4
Monica S Vavilala, Silvia B Lujan, Qian Qiu, Gustavo J Petroni, Nicolás M Ballarini, Nahuel Guadagnoli, María Alejandra Depetris, Gabriela A Faguaga, Gloria M Baggio, Leonardo O Busso, Mirta E García, Osvaldo R González Carrillo, Paula L Medici, Silvia S Sáenz, Elida E Vanella, Anthony Fabio, Michael J Bell
OBJECTIVE: There is little information on the type of early care provided to children with traumatic brain injury (TBI) in low middle income countries. We benchmarked early prehospital [PH] and emergency department [ED] pediatric TBI care in Argentina. METHODS: We conducted a secondary analysis of data from patients previously enrolled in a prospective seven center study of children with TBI. Eligible participants were patients 0-18 years, and had diagnosis of TBI (admission Glasgow Coma scale score [GCS] < 13 or with GCS 14-15 and abnormal head CT scan within 48 hours of admission, and head AIS > 0)...
2016: PloS One
https://www.readbyqxmd.com/read/27955991/antibiotic-prescription-patterns-for-upper-respiratory-tract-infections-in-the-outpatient-qatari-population-in-the-private-sector
#5
Adeel Ajwad Butt, Cristina S Navasero, Bright Thomas, Salih Al Marri, Huda Al Katheeri, Asmaa Al Thani, Abdullatif Al Khal, Tasnim Khan, Abdul-Badi Abou-Samra
BACKGROUND: Antibiotics are often inappropriately prescribed for upper respiratory tract infections (URTIs) in developed countries. Data on the proportion of inappropriate prescriptions are lacking from the Middle East and other developing countries. METHODS: Health insurance claims for all antibiotics prescribed for URTIs in the private sector in the State of Qatar between May 2014 and December 2015 were retrieved. During the study period, health insurance was limited to Qatari nationals...
December 9, 2016: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/27931463/guideline-for-monitoring-and-management-of-pediatric-patients-before-during-and-after-sedation-for-diagnostic-and-therapeutic-procedures-update-2016
#6
(no author information available yet)
The safe sedation of children for procedures requires a systematic approach that includes the following: no administration of sedating medication without the safety net of medical/dental supervision, careful presedation evaluation for underlying medical or surgical conditions that would place the child at increased risk from sedating medications, appropriate fasting for elective procedures and a balance between the depth of sedation and risk for those who are unable to fast because of the urgent nature of the procedure, a focused airway examination for large (kissing) tonsils or anatomic airway abnormalities that might increase thepotential for airway obstruction, a clear understanding of the medication's pharmacokinetic and pharmacodynamic effects and drug interactions, appropriate training and skills in airway management to allow rescue of the patient, age- and size-appropriate equipment for airway management and venous access, appropriate medications and reversal agents, sufficient numbers of staff to both carry out the procedure and monitor the patient, appropriate physiologic monitoring during and after the procedure, a properly equipped and staffed recovery area, recovery to the presedation level of consciousness before discharge from medical/dental supervision, and appropriate discharge instructions...
October 2016: Pediatric Dentistry
https://www.readbyqxmd.com/read/27925849/development-and-prospective-federal-state-wide-evaluation-of-a-device-for-height-based-dose-recommendations-in-prehospital-pediatric-emergencies-a-simple-tool-to-prevent-most-severe-drug-errors
#7
Jost Kaufmann, Bernhard Roth, Thomas Engelhardt, Alex Lechleuthner, Michael Laschat, Christoph Hadamitzky, Frank Wappler, Martin Hellmich
OBJECTIVE: Drug dosing errors pose a particular threat to children in prehospital emergency care. With the Pediatric emergency ruler (PaedER), we developed a simple height-based dose recommendation system and evaluated its effectiveness in a pre-post interventional trial as the Ethics Committee disapproved randomization due to the expected positive effect of the PaedER on outcome. METHODS: Pre-interventional data were retrospectively retrieved from the electronic records and medical protocols of the Cologne Emergency Medical Service over a two-year period prior to the introduction of the PaedER...
December 7, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27893516/caregiver-expectations-and-satisfaction-of-urgent-care-in-a-pediatric-emergency-department
#8
Greg P Marconi, Phung K Pham, Alan L Nager
Health care delivery expectations that may affect patient and caregiver satisfaction are not clearly understood. This study examined caregiver expectations and satisfaction with urgent care in a pediatric emergency department. Of 201 caregivers surveyed, we found that caregivers have specific expectations regarding clinical care of their child in terms of radiographic imaging, blood testing, antibiotics, pain management, and subspecialty consultation. Caregivers were generally less dissatisfied with the actual care provided than the urgent care physicians expected...
November 23, 2016: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27872800/invisible-seams-preventing-childhood-obesity-through-an-improved-obstetrics-pediatrics-care-continuum
#9
EDITORIAL
Craig W Moscetti, Nicolaas P Pronk
Progress in altering the current obesity epidemic among children and adolescents remains elusive. Evidence continues to underscore the challenges of altering weight status as children age. Further, weight loss interventions among children and adults alike tend to demonstrate efficacy in the short-term, however individuals tend to slowly revert back to their original weight status over time. New understanding of obesity's early origins suggests the need to rethink current approaches, particularly within healthcare...
March 2017: Preventive Medicine Reports
https://www.readbyqxmd.com/read/27846070/implementation-and-operational-research-an-integrated-and-comprehensive-service-delivery-model-to-improve-pediatric-and-maternal-hiv-care-in-rural-africa
#10
Anna Gamell, Tracy R Glass, Lameck B Luwanda, Herry Mapesi, Leila Samson, Tom Mtoi, Angelo Nyamtema, Lukas Muri, Alex Ntamatungiro, Marcel Tanner, Christoph Hatz, Manuel Battegay, Emilio Letang
BACKGROUND: Strategies to improve HIV diagnosis and linkage into care, antiretroviral treatment coverage, and treatment outcomes of mothers and children are urgently needed in sub-Saharan Africa. METHODS: From December 2012, we implemented an intervention package to improve prevention of mother-to-child transmission (PMTCT) and pediatric HIV care in our rural Tanzanian clinic, consisting of: (1) creation of a PMTCT and pediatric unit integrated within the reproductive and child health clinic; (2) implementation of electronic medical records; (3) provider-initiated HIV testing and counseling in the hospital wards; and (4) early infant diagnosis test performed locally...
December 15, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27812166/survival-outcomes-in-a-pediatric-antiretroviral-treatment-cohort-in-southern-malawi
#11
Jason C Brophy, Michael T Hawkes, Edson Mwinjiwa, Gabriel Mateyu, Sumeet K Sodhi, Adrienne K Chan
BACKGROUND: Pediatric uptake and outcomes in antiretroviral treatment (ART) programmes have lagged behind adult programmes. We describe outcomes from a population-based pediatric ART cohort in rural southern Malawi. METHODS: Data were analyzed on children who initiated ART from October/2003 -September/2011. Demographics and diagnoses were described and survival analyses conducted to assess the impact of age, presenting features at enrolment, and drug selection. RESULTS: The cohort consisted of 2203 children <15 years of age...
2016: PloS One
https://www.readbyqxmd.com/read/27801708/pediatric-critical-care-transport-as-a-conduit-to-terminal-extubation-at-home-a-case-series
#12
Corina Noje, Meghan L Bernier, Philomena M Costabile, Bruce L Klein, Sapna R Kudchadkar
OBJECTIVES: To present our single-center's experience with three palliative critical care transports home from the PICU for terminal extubation. DESIGN: We performed a retrospective chart review of patients transported between January 1, 2012, and December 31, 2014. SETTING: All cases were identified from our institutional pediatric transport database. PATIENTS: Patients were terminally ill children unable to separate from mechanical ventilation in the PICU, who were transported home for terminal extubation and end-of-life care according to their families' wishes...
January 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27786589/current-management-of-severe-dengue-infection
#13
Tau Hong Lee, Linda Kay Lee, David Chien Lye, Yee Sin Leo
Traditionally a disease mainly affecting the pediatric population, dengue burden has increased significantly in recent decades and adults with severe disease may become more common. There is currently no effective anti-viral agent available for the treatment of dengue and supportive care is the mainstay of management. Areas covered: We present a review of current literature on dengue severity classification systems and the management of severe dengue in adults. In particular, emphasis was placed on organ impairment in dengue and management of elderly individuals with multiple medical problems...
January 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/27757471/appointment-lead-time-policy-development-to-improve-patient-access-to-care
#14
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
https://www.readbyqxmd.com/read/27753717/pediatric-referrals-to-an-emergency-department-from-urgent-care-centers
#15
Robert P Olympia, Robert Wilkinson, Jennifer Dunnick, Brendan J Dougherty, Debra Zauner
OBJECTIVE: The aims of this study were to describe pediatric emergency department (ED) referrals from urgent care centers and to determine the percentage of referrals considered essential and serious. METHODS: A prospective study was conducted between April 2013 and April 2015 on patients younger than 21 years referred directly to an ED in central Pennsylvania from surrounding urgent care centers. Referrals were considered essential or serious based on investigations/procedures performed or medications/consultations received in the ED...
October 8, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27748332/implementation-of-a-pediatric-emergency-triage-system-in-xiamen-china
#16
Gang-Xi Lin, Yin-Ling Yang, Denise Kudirka, Colleen Church, Collin K K Yong, Fiona Reilly, Qi-Yi Zeng
BACKGROUND: Pediatric emergency rooms (PERs) in Chinese hospitals are perpetually full of sick and injured children because of the lack of sufficiently developed community hospitals and low access to family physicians. The aim of this study was to evaluate the clinical value of a new five-level Chinese pediatric emergency triage system (CPETS), modeled after the Canadian Triage System and Acuity Scale. METHODS: In this study, we compared CPETS outcomes in our PER relative to those of the prior two-level system...
2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27672551/use-of-fungal-diagnostics-and-therapy-in-pediatric-cancer-patients-in-resource-limited-settings
#17
Sheena Mukkada, Jeannette Kirby, Nopporn Apiwattanakul, Randall T Hayden, Miguela A Caniza
Fungal diseases are an important cause of mortality in immunocompromised hosts, and their incidence in pediatric cancer patients in low- to middle-income countries is underestimated. In this review, we present relevant, up-to-date information about the most common opportunistic and endemic fungal diseases among children with cancer, their geographic distribution, and recommended diagnostics and treatment. Efforts to improve the care of children with cancer and fungal disease must address the urgent need for sustainable and cost-effective solutions that improve training, fungal disease testing capability, and the use of available resources...
September 2016: Current Clinical Microbiology Reports
https://www.readbyqxmd.com/read/27668922/system-stresses-in-2-pediatric-emergency-departments-and-2-pediatric-urgent-care-centers-during-the-2014-enterovirus-d68-outbreak
#18
Gregory P Conners, Stacy J Doyle, Milton A Fowler, Lisa L Schroeder, Thomas W Tryon
OBJECTIVE: To describe the association of an unprecedented large-scale Enterovirus-D68 outbreak in 2014 with changes in patient volume and acuity and system stress in 2 pediatric emergency departments and 2 pediatric urgent care centers of a single children's hospital. METHODS: We compared measures of patient volume, acuity, and system stress during the 2014 Enterovirus-D68 outbreak and the corresponding dates of the previous year. RESULTS: Both settings experienced large census increases during the Enterovirus-D68 outbreak; patient census increased significantly more in the pediatric urgent care setting (20...
September 23, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27614548/virtual-gaming-to-develop-students-pediatric-nursing-skills-a-usability-test
#19
Margaret Verkuyl, Lynda Atack, Paula Mastrilli, Daria Romaniuk
BACKGROUND: As competition for specialty clinical placements increases, there is an urgent need to create safe, stimulating, alternative learning environments for students. OBJECTIVE: To address that clinical gap, our team developed a virtual game-based simulation to help nursing students develop their pediatric nursing skills. DESIGN: A usability study was conducted using the Technology Acceptance Model as a research framework. SETTING AND PARTICIPANTS: The study was conducted at a community college and included nursing students, nursing faculty/clinicians and two gaming experts...
November 2016: Nurse Education Today
https://www.readbyqxmd.com/read/27599265/effects-of-social-needs-screening-and-in-person-service-navigation-on-child-health-a-randomized-clinical-trial
#20
Laura M Gottlieb, Danielle Hessler, Dayna Long, Ellen Laves, Abigail R Burns, Anais Amaya, Patricia Sweeney, Christine Schudel, Nancy E Adler
Importance: Social determinants of health shape both children's immediate health and their lifetime risk for disease. Increasingly, pediatric health care organizations are intervening to address family social adversity. However, little evidence is available on the effectiveness of related interventions. Objective: To evaluate the effects of social needs screening and in-person resource navigation services on social needs and child health. Design, Setting, and Participants: Patients were randomized to intervention or active control conditions by the day of the week...
September 6, 2016: JAMA Pediatrics
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