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https://www.readbyqxmd.com/read/28335406/factors-that-negatively-affect-the-prognosis-of-pediatric-community-acquired-pneumonia-in-district-hospital-in-tanzania
#1
Serena Caggiano, Nicola Ullmann, Elisa De Vitis, Marzia Trivelli, Chiara Mariani, Maria Podagrosi, Fabiana Ursitti, Chiara Bertolaso, Carolina Putotto, Marta Unolt, Andrea Pietravalle, Paola Pansa, Kajoro Mphayokulela, Maria Incoronata Lemmo, Michael Mkwambe, Joseph Kazaura, Marzia Duse, Francesco Nieddu, Chiara Azzari, Renato Cutrera
Community-acquired pneumonia (CAP) is still the most important cause of death in countries with scarce resources. All children (33 months ± 35 DS) discharged from the Pediatric Unit of Itigi Hospital, Tanzania, with a diagnosis of CAP from August 2014 to April 2015 were enrolled. Clinical data were gathered. Dried blood spot (DBS) samples for quantitative real-time polymerase chain reaction (PCR) for bacterial detection were collected in all 100 children included. Twenty-four percent of patients were identified with severe CAP and 11% died...
March 13, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28334885/full-volume-isotonic-0-9-vs-two-thirds-volume-hypotonic-0-18-intravenous-maintenance-fluids-in-preventing-hyponatremia-in-children-admitted-to-pediatric-intensive-care-unit-a-randomized-controlled-study
#2
Raksha S K, B Dakshayani, Premalatha R
Background: : We aimed to compare the effect of two different intravenous fluid regimes on the incidence of hyponatremia in children. Methods: : Children 1 month to 18 years of age, admitted to pediatric intensive care unit (PICU) of a tertiary care medical college hospital were randomized to receive either isotonic fluid (0.9% saline in 5% dextrose) at the standard maintenance rate or hypotonic fluid (0.18% saline in 5% dextrose) at two-thirds of the standard maintenance rate...
March 2, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28334875/white-matter-changes-in-paediatric-multiple-sclerosis-and-monophasic-demyelinating-disorders
#3
Giulia Longoni, Robert A Brown, Parya MomayyezSiahkal, Colm Elliott, Sridar Narayanan, Amit Bar-Or, Ruth Ann Marrie, E Ann Yeh, Massimo Filippi, Brenda Banwell, Douglas L Arnold
Most children who experience an acquired demyelinating syndrome of the central nervous system will have a monophasic disease course, with no further clinical or radiological symptoms. A subset will be diagnosed with multiple sclerosis, a life-long disorder. Using linear mixed effects models we examined longitudinal diffusion properties of normal-appearing white matter in 505 serial scans of 132 paediatric participants with acquired demyelinating syndromes followed for a median of 4.4 years, many from first clinical presentation, and 106 scans of 80 healthy paediatric participants...
March 14, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28334594/using-the-chronic-care-model-to-improve-pediatric-chronic-illness-care
#4
EDITORIAL
John S Adams, Lauren E Wisk
No abstract text is available yet for this article.
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334593/pediatric-postoperative-pulse-oximetry-monitoring-during-transport-to-the-postanesthesia-care-unit-reduces-frequency-of-hypoxemia
#5
Thomas J Caruso, Tara E Mokhtari, Monica J Coughlan, Diane S Wu, Juan L Marquez, Melissa Duan, Heather Freeman, Andrew Giustini, Mary Tweedy, Paul J Sharek
BACKGROUND: The standard use of pulse oximetry during the transport of postoperative patients from the operating room (OR) to the postanesthesia care unit (PACU) is not routinely practiced. A study was conducted to determine if the frequency of hypoxemia on admission to the PACU decreased after implementation of routine use of transport pulse oximeters for postoperative patients being transferred to the PACU. METHODS: In this prospective cohort study, which was conducted at an academic pediatric hospital, the primary outcome measure was the frequency of hypoxemic events on arrival to the PACU...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334588/applying-the-chronic-care-model-to-improve-care-and-outcomes-at-a-pediatric-medical-center
#6
Jennifer Lail, Pamela J Schoettker, Denise L White, Bhavna Mehta, Uma R Kotagal
BACKGROUND: Cincinnati Children's Hospital Medical Center launched the Condition Outcomes Improvement Initiative in 2012 to help disease-based teams use the principles of improvement science to implement components of the Chronic Care Model and improve outpatient care delivery for populations of children with chronic and complex conditions. The goal was to improve outcomes by 20% from baseline. METHODS: Initiative activities included review of the evidence to choose and measure outcomes, development of condition-specific patient registries and tools for data collection, patient stratification, planning and coordinating care before and after visits, and self-management support...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334566/improving-communication-with-primary-care-physicians-at-the-time-of-hospital-discharge
#7
Lauren A Destino, Amy Dixit, Julie L Pantaleoni, Matthew S Wood, Natalie M Pageler, Joe Kim, Terry S Platchek
BACKGROUND: Communication with primary care physicians (PCPs) at the time of a patient's hospital discharge is important to safely transition care to home. The goal of this quality improvement initiative was to increase discharge communication to PCPs at an academic children's hospital. METHODS: A multidisciplinary team at Lucile Packard Children's Hospital Stanford used Lean A3 problem solving methodology to address the problem of inadequate discharge communication with PCPs...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334565/year-end-resident-clinic-handoffs-narrative-review-and-recommendations-for-improvement
#8
Amber T Pincavage, Michael J Donnelly, John Q Young, Vineet M Arora
BACKGROUND: Year-end clinic handoffs in resident continuity clinics are an important patient safety issue. METHODS: Intervention articles addressing the year-end resident clinic handoff were identified in a targeted literature search. These articles were reviewed and abstracted to summarize the current literature. On the basis of these reviews and consensus expert opinion, recommendations to improve year-end clinic handoffs were developed. RESULTS: Of 23 identified articles, 10 intervention articles in the fields of internal medicine, internal medicine-pediatrics, psychiatry, and family medicine were ultimately included...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334560/development-and-preliminary-testing-of-the-coordination-process-error-reporting-tool-cpert-a-prospective-clinical-surveillance-mechanism-for-teamwork-errors-in-the-pediatric-cardiac-icu
#9
Katherine E Bates, Judy A Shea, Geoffrey L Bird, Cynthia Field, Deipanjan Nandi, Robert E Shaddy, Joshua P Metlay
BACKGROUND: Patient safety reporting systems (PSRSs) may not detect teamwork or coordination process errors that affect all dimensions of quality defined by the Institute of Medicine. This study aimed to develop and observe the performance of a novel tool, the Coordination Process Error Reporting Tool (CPERT), as a prospective clinical surveillance mechanism for teamwork errors in the pediatric cardiac ICU. METHODS: Providers and parents used the qualitative nominal group technique to identify coordination process error examples...
December 2016: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334497/the-development-and-implementation-of-the-sweet-peer-review-programme-for-pediatric-diabetes-centres
#10
Stephen Parsons, Sheridan Waldron, Fiona Campbell, Mauro S Pinto, Zdenek Sumnik, Andriani Gerasimidi-Vazeou
This paper describes the background to the development, implementation, and subsequent management of a programme of peer review of Pediatric Diabetes Centres belonging to the SWEET Group The paper summarizes the overall purpose of the programme, lists the principles upon which the programme is founded, and sets out the intended outcomes of the programme Details are given of the way in which the programme is delivered and summarizes the key findings from the 16 centres reviewed to date Finally the paper highlights the feedback that has been received from those who have been reviewed and those who have acted as reviewers and discusses ways in which the programme can be further developed in the future...
October 2016: Pediatric Diabetes
https://www.readbyqxmd.com/read/28334487/growing-up-with-perinatal-human-immunodeficiency-virus-a-life-not-expected
#11
Elaine Fay Williams
AIM AND OBJECTIVES: To describe the lived experience of young adults with perinatally acquired HIV (PaHIV). BACKGROUND: The advancement of the highly active antiretroviral treatment, PaHIV-infection has transformed into a chronic lifelong illness that is faced by young adults who grew up with HIV. The known challenges that are associated with HIV are poverty, stigma and social and emotional isolation. DESIGN: This was a qualitative single interview study of a convenience sample of PaHIV-infected young adults receiving care at a large metropolitan pediatric hospital...
March 23, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28333917/a-clinical-utility-study-of-exome-sequencing-versus-conventional-genetic-testing-in-pediatric-neurology
#12
Lisenka E L M Vissers, Kirsten J M van Nimwegen, Jolanda H Schieving, Erik-Jan Kamsteeg, Tjitske Kleefstra, Helger G Yntema, Rolph Pfundt, Gert Jan van der Wilt, Lotte Krabbenborg, Han G Brunner, Simone van der Burg, Janneke Grutters, Joris A Veltman, Michèl A A P Willemsen
PURPOSE: Implementation of novel genetic diagnostic tests is generally driven by technological advances because they promise shorter turnaround times and/or higher diagnostic yields. Other aspects, including impact on clinical management or cost-effectiveness, are often not assessed in detail prior to implementation. METHODS: We studied the clinical utility of whole-exome sequencing (WES) in complex pediatric neurology in terms of diagnostic yield and costs. We analyzed 150 patients (and their parents) presenting with complex neurological disorders of suspected genetic origin...
March 23, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/28333779/impact-of-chronic-suppurative-otitis-media-in-pediatric-cochlear-implant-recipients-insight-into-the-challenges-from-a-tertiary-referral-center-in-uk
#13
Paramita Baruah, Kate Hanvey, Richard Irving, Konstance Tzifa
OBJECTIVE: Analyze the presentation and evolution of chronic suppurative otitis media (CSOM) in children with cochlear implants (CI) and explore the merit of early intervention. STUDY DESIGN: Retrospective patient review. SETTING: Tertiary referral hospital and cochlear implant programme. PATIENTS: Children with a CI who developed CSOM. INTERVENTION: Tympanoplasty. MAIN OUTCOME MEASURES: Disease control, recurrence of cholesteatoma, cochlear implant preservation...
March 22, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28333771/classification-of-acute-pancreatitis-in-the-pediatric-population-clinical-report-from-the-naspghan-pancreas-committee
#14
Maisam Abu-El-Haija, Soma Kumar, Flora Szabo, Steven Werlin, Darwin Conwell, Peter Banks, Veronique D Morinville
INTRODUCTION: Acute pancreatitis (AP) is an emerging problem in pediatrics, with most cases resolving spontaneously. However, approximately 10-30% are believed to develop "severe acute pancreatitis" (SAP). METHODS: This consensus statement on the classification of AP in pediatrics was developed through a working group that performed an evidence-based search for classification of AP in adult pancreatitis, definitions and criteria of Systemic Inflammatory Response Syndrome (SIRS), and organ failure in pediatrics...
March 22, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28333769/the-incidence-of-low-seroimmunity-to-hepatitis-b-virus-in-children-with-inflammatory-bowel-disease
#15
Abhishek Watts, William E Bennett, Jean P Molleston, Sandeep K Gupta, Joseph M Croffie, Shamaila Waseem, Brian A McFerron, Steven J Steiner, Sanjay Kumar, Charles P Vanderpool, Emily C Hon, Molly A Bozic, Girish C Subbarao, Marian D Pfefferkorn
OBJECTIVES: Patients with inflammatory bowel disease (IBD) often receive immunosuppressive therapy which may make them vulnerable to infections such as hepatitis B. We hypothesized that hepatitis B virus (HBV) titers are low in the vaccinated pediatric IBD population. The aims of our study were to identify the incidence of lower titers of hepatitis B surface antibody (HBsAb) and determine which patient factors may be associated with lower HBsAb titers. METHODS: Patients with diagnosis of IBD, ages 5-18 years, were prospectively enrolled...
March 22, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28333768/management-of-pediatric-non-alcoholic-fatty-liver-disease-by-academic-hepatologists-in-canada-a-nationwide-survey
#16
Marialena Mouzaki, Simon C Ling, Richard A Schreiber, Binita M Kamath
BACKGROUND: The literature on the optimal clinical management of pediatric patients with non-alcoholic fatty liver disease (NAFLD) is limited. The objective of this study was to identify discrepancies in the care provided to patients with NAFLD by hepatologists practicing in academic centers across Canada. METHODS: A nationwide survey was distributed electronically to all pediatric hepatologists practicing in university-affiliated hospitals using the infrastructure of the Canadian Pediatric Hepatology Research Group...
March 22, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28333765/adherence-to-celiac-disease-and-eosinophilic-esophagitis-biopsy-guidelines-is-poor-in-children
#17
Thomas Wallach, Robert M Genta, Benjamin Lebwohl, Peter H R Green, Norelle R Reilly
OBJECTIVES: Celiac disease (CD) and eosinophilic esophagitis (EoE) are underdiagnosed gastrointestinal conditions which adversely impact children's health. Prior studies have shown that diagnostic guidelines for CD are not consistently followed in adults. The aims of this study are to assess the frequency with which endoscopists comply with diagnostic guidelines for CD and EoE in children, and to determine whether an association exists between adherence to biopsy guidelines and disease detection in pediatric patients...
March 22, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28333703/higher-fresh-gas-flow-rates-decrease-tidal-volume-during-pressure-control-ventilation
#18
Shazia Mohammad, Nikolaus Gravenstein, Drew Gonsalves, Terrie Vasilopoulos, Samsun Lampotang
BACKGROUND: We observed that increasing fresh gas flow (FGF) decreased exhaled tidal volume (VT) during pressure control ventilation (PCV). A literature search produced no such description whereby unintended VT changes occur with FGF changes during PCV. METHODS: To model an infant's lungs, 1 lung of a mechanical lung model (Dual Adult TTL 1600; Michigan Instruments, Inc, Grand Rapids, MI) was set at a compliance of 0.0068 L/cm H2O. An Rp50 resistor (27.2 cm H2O/L/s at 15 L/min) simulated normal bronchial resistance...
March 22, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28333698/misuse-of-pediatric-medications-and-parent-physician-communication-an-interactive-voice-response-intervention
#19
Kathleen E Walsh, Janine Bacic, Barrett D Phillips, William G Adams
BACKGROUND: Children take 1 medication each week on average at home. Better communication between parents and providers could support safer home medication use and prevent misuse of pediatric medications, such as intentional underdosing or overdosing. Our primary objective was to assess the impact of an interactive voice response system on parent-provider communication about medications. METHODS: Parents of children 4 months to 11 years of age with upcoming well child visits were invited to call our interactive voice response system, called Personal Health Partner (PHP), which asked questions about the child's health and medication use...
March 22, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28333694/high-flow-nasal-cannula-therapy-beyond-the-perinatal-period
#20
Michael Lee, Joshua Nagler
PURPOSE OF REVIEW: High-flow nasal cannula (HFNC) is emerging as a means of oxygen delivery and respiratory support for a range of conditions outside the perinatal period. We aim to review the mechanisms of action and advantages of HFNC and to summarize current findings regarding clinical benefit in specific pediatric disease processes and in patients with significant respiratory distress. RECENT FINDINGS: Currently published studies outside the neonatal population demonstrate both safety and efficacy of this mode of respiratory support...
March 22, 2017: Current Opinion in Pediatrics
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