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https://www.readbyqxmd.com/read/29778713/concluding-commentary-on-current-trends-to-enhance-the-clinical-safety-of-pediatric-transfusion-focusing-on-prevention-of-untoward-complications-of-hsc-transplantation-newer-strategies-for-improving-the-standards-of-safety-quality-of-stem-cells-expansion-for
#1
REVIEW
Irena Sniecinski, Jerard Seghatchian
Clinical practice and related diagnostic, development and research [DDR] strategies in pediatric transfusion and transplantation cover a broad range of multidisciplinary studies, performed by many professionals involved in this most challenging clinical field [1]. This commentary on the current position and future perspectives in pediatric transfusion field is aimed to highlight major unresolved transfusion complications in pediatric patients, namely red blood cell and platelet alloimmunisation, and new ones such as nosocomial infection, thrombosis and multi-organ failure...
May 16, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29762333/hemodynamic-shock-caused-by-tension-pneumoperitoneum-in-a-5-year-old-girl
#2
Marie-Sophie Zentar, Laureline Berteloot, Naziha Khen Dunlop, Olivier Bustarret, Bénédicte Pigneur, Gérard Cheron, François Angoulvant
Tension pneumoperitoneum is a relatively rare occurrence in the pediatric population. However, tension pneumoperitoneum is associated with significant morbidity and mortality if it is not promptly diagnosed and treated. A 5-year-old girl was admitted to emergency department with abdominal pain. She was in shock, and the radiograph film of the abdomen revealed a voluminous tension pneumoperitoneum. Aggressive fluid challenges were performed in intensive care followed by urgent laparotomy. Primary abdominal compartment due to trapped gas caused a decreased venous return and visceral perfusion...
May 14, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29762292/a-dedicated-satellite-trauma-orthopaedic-program-operating-room-safely-increases-capacity
#3
Peter M Waters, Brian W Yang, Doreen White, Ellen Barth, Vincent Chiang, Arielle Mizrahi-Arnaud, William Sparks
BACKGROUND: Providing high-value care for urgent orthopaedic trauma patients requires effective and timely treatment. Herein, we describe the implementation of an innovative program utilizing the operating room (OR) capacity of a satellite campus to decrease stress on a pediatric tertiary care center without jeopardizing patient safety. METHODS: In addition to the daily emergency surgical room on the main campus, a dedicated orthopaedic trauma surgery OR was established in a satellite hospital location for 3 days per week in the summer and for 2 days per week for the rest of the year...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29752289/interventions-to-reduce-over-utilized-tests-and-treatments-in-bronchiolitis
#4
Amy Tyler, Paige Krack, Leigh Anne Bakel, Kimberly O'Hara, Douglas Scudamore, Irina Topoz, Julia Freeman, Angela Moss, Renee Allen, Angela Swanson, Lalit Bajaj
OBJECTIVES: The American Academy of Pediatrics published bronchiolitis clinical practice guidelines in 2014 recommending against the routine use of bronchodilators, chest radiographs, or respiratory viral testing in children with a clinical diagnosis of bronchiolitis. Our aim in this project was to align care with the American Academy of Pediatrics clinical practice guidelines by decreasing the overuse of these interventions. METHODS: This study included patients who were admitted to a non-ICU setting with a primary or secondary diagnosis of bronchiolitis...
May 11, 2018: Pediatrics
https://www.readbyqxmd.com/read/29737253/febrile-neutropenia-in-children-with-cancer-approach-to-diagnosis-and-treatment
#5
Rejin Kebudi, Hande Kizilocak
Febrile neutropenia is one of the major acute side effects of intensive treatment in pediatric cancer, necessitating prompt initiation of empirical broad-spectrum antibiotics. Patients may be classified as low or high risk according some risk factors (duration of neutropenia, depth of neutropenia, type of cancer, state of disease, bone marrow involvement, type of treatment, additional health problems). Initial evaluation of the febrile neutropenic child should include the history of the child, a detailed physical examination, blood culture (peripheral and catheter), urinalysis and culture, cultures of lesions...
May 8, 2018: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29720156/trends-in-healthcare-utilization-and-costs-associated-with-acute-otitis-media-in-the-united-states-during-2008-2014
#6
Sabine Tong, Caroline Amand, Alexia Kieffer, Moe H Kyaw
BACKGROUND: Acute otitis media (AOM) is the most common cause of pediatric medical visits and antibiotic prescriptions worldwide, but its current impact on the US healthcare system is not clear. The aim of this study was to investigate changes in the incidence of AOM from 2008, just before 13-valent pneumococcal conjugate vaccine was introduced, to 2014 using US insurance records in the Truven MarketScan® database. The study also examined the costs associated with index AOM events during the two most recent years for which data were available (2013-2014)...
May 2, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29718848/surgical-treatment-for-old-subaxial-cervical-dislocation-with-bilateral-locked-facets-in-a-3-year-old-girl-a-case-report
#7
Cheng Li, Lei Li, Jingzhu Duan, Lijun Zhang, Zhenjiang Liu
RATIONALE: This study aimed to describe the case of a 3-year-old girl with old bilateral facet dislocation on cervical vertebrae 6 and 7, who had spinal cord transection, received surgical treatment, and achieved a relative satisfactory therapeutic effect. PATIENT CONCERNS: A 3-year-old girl was urgently transferred to the hospital after a car accident. DIAGNOSES:: she was diagnosed with splenic rupture, intracranial hemorrhage, cervical dislocation, spinal transection, and Monteggia fracture of the left upper limb...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29688823/analysis-of-a-pediatric-telemedicine-program
#8
Shayan Vyas, Joanne Murren-Boezem, Patricia Solo-Josephson
BACKGROUND: Telemedicine serves millions of patients and is transforming healthcare delivery worldwide. In October of 2015, Nemours Children's Health System began offering direct-to-consumer (DTC) pediatric telemedicine on the Nemours CareConnect (NCC) platform. INTRODUCTION: Currently, there are no descriptive data available on pediatric-specific DTC 24/7 programs. This is the first article to our knowledge that provides data on such a program. MATERIALS AND METHODS: A retrospective data analysis of the first 1,000 visits was conducted...
April 24, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29682032/analysis-of-factors-influencing-outcome-of-depressed-fracture-of-skull
#9
Ritesh S Satardey, Srikant Balasubramaniam, Jayashree S Pandya, Rajesh C Mahey
Context: The outcome of patients with depressed fracture varies and depends on multiple factors. There has been no previous study on the significance of these factors on the outcome of depressed fracture of the skull and hence this study. Aims: The primary aim of our study is to find the factors affecting the outcome in cases of depressed skull fracture (DSF). This will help us improve outcomes and give more accurate prediction of long-term outcomes. Settings and Design: Prospective observational study...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29662324/clinical-and-molecular-genetic-features-of-hb-h-and-ae-bart-s-diseases-in-central-thai-children
#10
Chanchai Traivaree, Boonchai Boonyawat, Chalinee Monsereenusorn, Piya Rujkijyanont, Apichat Photia
Background: α-Thalassemia, one of the major thalassemia types in Thailand, is caused by either deletion or non-deletional mutation of one or both α-globin genes. Inactivation of three α-globin genes causes hemoglobin H (Hb H) disease, and the combination of Hb H disease with heterozygous hemoglobin E (Hb E) results in AE Bart's disease. Objective: This study aimed to characterize the clinical and hematological manifestations of 76 pediatric patients with Hb H and AE Bart's diseases treated at Phramongkutklao Hospital, a tertiary care center for thalassemia patients in central Thailand...
2018: Application of Clinical Genetics
https://www.readbyqxmd.com/read/29651758/the-role-of-emergency-medicine-clerkship-e-portfolio-to-monitor-the-learning-experience-of-students-in-different-settings-a-prospective-cohort-study
#11
Arif Alper Cevik, Sami Shaban, Margret El Zubeir, Fikri M Abu-Zidan
BACKGROUND: Although emergency departments provide acute care learning opportunities for medical students, student exposure to recommended curriculum presentations and procedures are limited. In this perspective, clinical environments providing learning opportunities for students should be monitored as part of an ongoing quality improvement process. This study aims to analyze student exposures and their involvement levels in two different hospitals (Tawam and Al Ain) so as to improve the teaching and learning activities...
April 12, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29626164/neighborhood-child-opportunity-and-individual-level-pediatric-acute-care-use-and-diagnoses
#12
Ellen E Kersten, Nancy E Adler, Laura Gottlieb, Douglas P Jutte, Sarah Robinson, Katrina Roundfield, Kaja Z LeWinn
: media-1vid110.1542/5751513300001PEDS-VA_2017-2309 Video Abstract OBJECTIVES: Although health care providers and systems are increasingly interested in patients' nonmedical needs as a means to improve health, little is known about neighborhood conditions that contribute to child health problems. We sought to determine if a novel, publicly available measure of neighborhood context, the Child Opportunity Index, was associated with pediatric acute care visit frequency and diagnoses. METHODS: This cross-sectional study included San Francisco residents <18 years of age with an emergency department and/or urgent care visit to any of 3 medical systems ( N = 47 175) between 2007 and 2011...
April 6, 2018: Pediatrics
https://www.readbyqxmd.com/read/29622697/fda-approval-summary-tocilizumab-for-treatment-of-chimeric-antigen-receptor-t-cell-induced-severe-or-life-threatening-cytokine-release-syndrome
#13
Robert Q Le, Liang Li, Weishi Yuan, Stacy S Shord, Lei Nie, Bahru A Habtemariam, Donna Przepiorka, Ann T Farrell, Richard Pazdur
On August 30, 2017, the U.S. Food and Drug Administration approved Actemra (tocilizumab, Genentech, Inc., South San Francisco, CA) for the treatment of severe or life-threatening chimeric antigen receptor (CAR) T cell-induced cytokine release syndrome (CRS) in adults and in pediatric patients 2 years of age and older. The approval was based on a retrospective analysis of data for patients who developed CRS after treatment with CTL019 and KTE-C19 on prospective clinical trials. Evaluable patients had been treated with intravenous tocilizumab 8 mg/kg (12 mg/kg for patients <30 kg) for severe or life-threatening CRS; only the first episode of CRS was included in the analysis...
April 5, 2018: Oncologist
https://www.readbyqxmd.com/read/29613981/phacomorphic-angle-closure-following-silicone-oil-tamponade-in-a-pediatric-patient
#14
Victoria C Leung, Simon Fung, Rajeev Muni, Asim Ali
PURPOSE: To report a case of phacomorphic glaucoma following retinal detachment repair with silicone oil in a pediatric patient. STUDY DESIGN: Case report. METHODS: A chart review was conducted at St. Michael's Hospital and The Hospital for Sick Children (Toronto, Canada), where the patient received ophthalmic care from July 28, 2015 onwards. RESULTS: A 14 year-old boy with a history of traumatic retinal detachment and proliferative vitreoretinopathy in the left eye, requiring two pars plana vitrectomies, membrane peel, and silicone oil tamponade, presented with one-day history of decreased vision in the left eye, severe headache, nausea, and vomiting...
April 2, 2018: Journal of Glaucoma
https://www.readbyqxmd.com/read/29605347/diagnosis-and-management-of-pediatric-sinusitis-a-survey-of-primary-care-otolaryngology-and-urgent-care-providers
#15
Laurie Newton, Amanda Kotowski, Melissa Grinker, Robert Chun
OBJECTIVES: The aims of this project were two-fold: 1) To assess pediatric primary care (PCP), pediatric otolaryngology (ENT) and pediatric urgent care (UC) providers' perception of their adherence to the 2013 American Academy of Pediatrics (AAP) established guidelines for the diagnosis and management of acute bacterial rhinosinusitis (ABRS) in children 1-18 years old and 2) to assess the same providers' practice patterns in the diagnosis and management of pediatric chronic rhinosinusitis (PCRS)...
May 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29596282/intimate-partner-violence-educational-materials-in-the-acute-care-setting-acceptability-and-impact-on-female-caregiver-attitudes-toward-screening
#16
Kimberly A Randell, Ashley Sherman, Irene Walsh, Donna OʼMalley, Mary Denise Dowd
OBJECTIVES: This study aimed to determine acceptability of intimate partner violence (IPV) materials and effect of the materials on caregiver attitudes toward IPV screening. METHODS: We used an anonymous computerized survey to assess approval of IPV materials and screening, and willingness to disclose IPV in response to screening among mothers bringing a child to an urban pediatric emergency department or 2 suburban pediatric urgent care centers affiliated with a free-standing academic children's hospital...
March 28, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29594089/the-need-for-specialized-pediatric-cardiac-critical-care-training-program-in-limited-resource-settings
#17
REVIEW
Indah K Murni, Ndidiamaka L Musa
Congenital heart disease (CHD) is one of the major global health problems with the highest birth prevalence in low- and middle-income countries. In these populous countries, basic health services for the children with CHD, including surgery, are lacking. Even though surgery is performed, outcome after cardiac surgery is influenced by the quality of the postoperative management with a reported high morbidity and mortality. Henceforth, there is an urgent need for comprehensive interventions to provide high quality cardiac intensive care programs to improve the quality of pediatric cardiac surgery services in order to address high morbidity and mortality after cardiac surgery...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29592767/drug-shortages-in-a-pediatric-stem-cell-transplantation-ward-challenges-and-implications-a-5-year-bilan
#18
B Claus, T Bauters, G Laureys
This article describes the implications of shortages of pharmaceutical products used in conditioning and supportive care regimens of pediatric patients undergoing a hematopoietic stem cell transplantation in a tertiary care hospital. Between July 2011 and July 2016, a total of 84 individual shortages, affecting 22 different drugs (79.8% supportive care drugs; 20.2% chemotherapeutics) were detected with a mean duration of 85 days (SD 138) per individual drug shortage. Eighteen shortages were critical and very urgent...
January 1, 2018: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29565527/pediatric-emergency-transport-communication-and-coordination-are-key-to-improving-outcomes
#19
Abraham Gallegos, Vijay Prasad, Calvin G Lowe
Pediatric patients who are critically ill or who require urgent subspecialty evaluation or specialized imaging, equipment, or procedures must often be transferred to tertiary care centers. The safe execution of interfacility transfer requires the coordination between the facility healthcare teams at each end of the transfer as well as the transport team. This issue discusses the process of interfacility transfer, the required services, the role of the emergency clinician, the role of the pediatric transport team, and the commonly used diagnostic studies and treatment needed during interfacility transfers of pediatric patients...
April 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/29551428/most-transfers-from-urgent-care-centers-to-emergency-departments-are-discharged-and-many-are-unnecessary
#20
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
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