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https://www.readbyqxmd.com/read/29915778/pediatric-trauma-care-in-low-resource-settings-challenges-opportunities-and-solutions
#1
REVIEW
Andrew W Kiragu, Stephen J Dunlop, Njoki Mwarumba, Sanusi Gidado, Adesope Adesina, Michael Mwachiro, Daniel A Gbadero, Tina M Slusher
Trauma constitutes a significant cause of death and disability globally. The vast majority -about 95%, of the 5.8 million deaths each year, occur in low-and-middle-income countries (LMICs) 3-6. This includes almost 1 million children. The resource-adapted introduction of trauma care protocols, regionalized care and the growth specialized centers for trauma care within each LMIC are key to improved outcomes and the lowering of trauma-related morbidity and mortality globally. Resource limitations in LMICs make it necessary to develop injury prevention strategies and optimize the use of locally available resources when injury prevention measures fail...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29915537/preclinical-animal-models-for-dravet-syndrome-seizure-phenotypes-comorbidities-and-drug-screening
#2
REVIEW
Aliesha Griffin, Kyla R Hamling, SoonGweon Hong, Mana Anvar, Luke P Lee, Scott C Baraban
Epilepsy is a common chronic neurological disease affecting almost 3 million people in the United States and 50 million people worldwide. Despite availability of more than two dozen FDA-approved anti-epileptic drugs (AEDs), one-third of patients fail to receive adequate seizure control. Specifically, pediatric genetic epilepsies are often the most severe, debilitating and pharmaco-resistant forms of epilepsy. Epileptic syndromes share a common symptom of unprovoked seizures. While some epilepsies/forms of epilepsy are the result of acquired insults such as head trauma, febrile seizure, or viral infection, others have a genetic basis...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29913072/postgraduate-clinical-physiotherapy-education-in-acute-hospitals-a-cohort-study
#3
Emma K Bastick, David D O'Keeffe, Melanie K Farlie, Danielle T Ryan, Terry P Haines, Nikki Katz, Jessica L Knight, Laura K Keely, Kelly J Saber, Tamica R Sturgess, Elizabeth H Skinner
BACKGROUND: Junior physiotherapists require satisfactory clinical skills to work effectively within the acute hospital setting for service quality and consistency. OBJECTIVE: To investigate the effects of stream-specific clinical training on junior physiotherapist self-efficacy, self-rated confidence, and self-rated ability to work independently during weekend shifts. DESIGN: Prospective cohort study. PARTICIPANTS: Eighteen junior physiotherapists...
June 18, 2018: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/29912937/comparison-of-three-non-invasive-hemodynamic-monitoring-methods-in-critically-ill-children
#4
Chanapai Chaiyakulsil, Marut Chantra, Poomiporn Katanyuwong, Anant Khositseth, Nattachai Anantasit
INTRODUCTION: Hemodynamic parameters measurements were widely conducted using pulmonary artery catheter (PAC) with thermodilution as a reference standard. Due to its technical difficulties in children, transthoracic echocardiography (TTE) has been widely employed instead. Nonetheless, TTE requires expertise and is time-consuming. Noninvasive cardiac output monitoring such as ultrasonic cardiac output monitor (USCOM) and electrical velocimetry (EV) can be performed rapidly with less expertise requirement...
2018: PloS One
https://www.readbyqxmd.com/read/29912812/multicenter-review-of-current-practices-associated-with-venous-thromboembolism-prophylaxis-in-pediatric-patients-after-trauma
#5
Amee M Bigelow, Katherine T Flynn-O'Brien, Pippa M Simpson, Mahua Dasgupta, Sheila J Hanson
OBJECTIVES: Frequency of venous thromboembolism in pediatric trauma patients admitted to PICUs is not insignificant, ranging up to 6%. Risk factors have been identified in this population. However, there is little consensus of actual venous thromboembolism prophylaxis practice. We examined factors associated with venous thromboembolism prophylaxis in PICUs. DESIGN: A retrospective study evaluating associations with mechanical venous thromboembolism prophylaxis, pharmacologic venous thromboembolism prophylaxis, or dual therapy (DUAL) prophylaxis compared with no venous thromboembolism prophylaxis...
June 15, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29912069/the-impact-of-critical-care-nursing-certification-on-pediatric-patient-outcomes
#6
Patricia A Hickey, Kimberlee Gauvreau, Courtney Porter, Jean A Connor
OBJECTIVES: To examine the relationship of nursing and unit characteristics including Critical Care Registered Nurse certification on patient complications for children undergoing congenital heart surgery in free-standing children's hospitals in the United States. DESIGN: A cross-sectional descriptive survey of nursing and organizational characteristics was sent electronically. SETTING: Free-standing children's hospitals in the United States...
June 14, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29910631/clonidine-versus-other-adjuncts-added-to-local-anesthetics-for-pediatric-neuraxial-blocks-a-systematic-review-and-meta-analysis
#7
REVIEW
Yang Yang, Ling-Yu Yu, Wen-Sheng Zhang
Background: Clonidine is a common adjunct to local anesthetics for pediatric neuraxial block; however, the pros and cons between clonidine and other adjuncts remain unclear. Thus, we performed this meta-analysis of randomized controlled trials to assess the efficacy and adverse effects between clonidine and other adjuncts added to local anesthetics. Materials and methods: The systematic search, data extraction, critical appraisal, and pooled analysis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29908681/the-impact-of-early-enteral-nutrition-on-pediatric-acute-respiratory-failure
#8
Amanda Haney, Emily Burritt, Christopher J Babbitt
BACKGROUND AND AIMS: Children who are critically ill undergo metabolic stress and it is important that they receive adequate calories and protein in order to recover. Our objective was to investigate the impact of early enteral nutrition (EEN) on pediatric intensive care (PICU) patients with acute respiratory failure. METHODS: A retrospective cohort study was performed on all patients admitted to a 20 bed PICU at a tertiary children's hospital over a 30 month period...
August 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29907669/feasibility-and-reliability-of-the-spondyloarthritis-research-consortium-of-canada-sacroiliac-joint-structural-score-in-children
#9
Pamela F Weiss, Walter P Maksymowych, Robert G Lambert, Jacob L Jaremko, David M Biko, Joel Paschke, Timothy G Brandon, Rui Xiao, Nancy A Chauvin
OBJECTIVE: There is a critical need for measures to evaluate structural progression in the pediatric sacroiliac joint (SIJ). We aimed to evaluate the construct validity and reliability of the Spondyloarthritis Research Consortium of Canada SIJ Structural Score (SSS) in children with suspected or confirmed juvenile spondyloarthritis. METHODS: The SSS assesses structural lesions of the SIJ on magnetic resonance imaging (MRI) through the cartilaginous part of the joint...
June 15, 2018: Journal of Rheumatology
https://www.readbyqxmd.com/read/29907141/serum-and-urine-fgf23-and-igfbp-7-for-the-prediction-of-acute-kidney-injury-in-critically-ill-children
#10
Zhenjiang Bai, Fang Fang, Zhong Xu, Chunjiu Lu, Xueqin Wang, Jiao Chen, Jian Pan, Jian Wang, Yanhong Li
BACKGROUND: Fibroblast growth factor 23 (FGF23) and insulin-like growth factor binding protein 7 (IGFBP-7) are suggested to be biomarkers for predicting acute kidney injury (AKI). We compared them with proposed AKI biomarker of cystatin C (CysC), and aimed (1) to examine whether concentrations of these biomarkers vary with age, body weight, illness severity assessed by pediatric risk of mortality III score, and kidney function assessed by estimated glomerular filtration rate (eGFR), (2) to determine the association between these biomarkers and AKI, and (3) to evaluate whether these biomarkers could serve as early independent predictors of AKI in critically ill children...
June 15, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29905634/ability-to-assent-in-pediatric-critical-care-research-a-prospective-environmental-scan-of-two-canadian-picus
#11
Katharine J O'Hearn, Dori-Ann Martin, Maryse Dagenais, Kusum Menon
OBJECTIVES: To determine the number of patients considered not appropriate to approach for assent within the first 24 hours of PICU admission. DESIGN: Exploratory prospective 1-month environmental scan. SETTING: Two tertiary Canadian PICUs. PATIENTS: Ninety patients age newborn to 17 years old admitted to the PICU during September 2016 (Site 1) or May 2017 (Site 2). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: At PICU admission, 81% of patients were deemed not appropriate to approach for assent most commonly due to age, influence of psychotropic medications, and/or mechanical ventilation...
June 13, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29905632/an-ethical-claim-for-providing-medical-recommendations-in-pediatric-intensive-care
#12
Katie M Moynihan, Melanie A Jansen, Shih-Ning Liaw, Peta M A Alexander, Robert D Truog
The Declaration of Geneva was recently revised to emphasize patient autonomy and the importance of clinicians sharing medical knowledge. This reflects the welcome evolution of the doctor-patient relationship from one of paternalism to more informed, shared decision-making. Unfortunately, there is an increasing trend for clinicians to avoid making recommendations, instead providing a "menu" of care options from which patients and families must choose. This seems to be underpinned by the belief that it is unacceptably paternalistic to give guidance as to which course of action may be best to take...
June 13, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29904575/recent-advances-in-transfusions-in-neonates-infants
#13
REVIEW
Ruchika Goel, Cassandra D Josephson
Transfusions of red blood cells (RBCs), platelets, and plasma are critical therapies for infants and neonates (particularly preterm neonates) in the neonatal intensive care unit, who are the most frequently transfused subpopulation across all ages. Although traditionally a significant gap has existed between the blood utilization and the evidence base essential to adequately guide transfusion practices in infants and neonates, pediatric transfusion medicine is evolving from infancy and gradually coming of age...
2018: F1000Research
https://www.readbyqxmd.com/read/29903452/functional-topography-of-the-human-cerebellum
#14
Catherine J Stoodley, Jeremy D Schmahmann
Accumulating evidence points to a critical role for the human cerebellum in both motor and nonmotor behaviors. A core tenet of this new understanding of cerebellar function is the existence of functional subregions within the cerebellum that differentially support motor, cognitive, and affective behaviors. This cerebellar functional topography - based on converging evidence from neuroanatomic, neuroimaging, and clinical studies - is evident in both adult and pediatric populations. The sensorimotor homunculi in the anterior lobe and lobule VIII established in early tract tracing and electrophysiologic studies are evident in both task-based and resting-state human functional imaging studies...
2018: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/29901527/knowledge-accrual-following-participation-in-pediatric-fundamental-critical-care-support-course-in-gaborone-botswana
#15
Megan Cox, Natasha Afonso, Loeto Mazhani, David Kloeck, Mohan Mysore, Kevin Roy, Segolame Setlhare, Tlamelo Daman, Peter A Meaney
OBJECTIVES: To describe provider characteristics, knowledge acquisition, perceived relevance, and instruction quality of the Society of Critical Care Medicine's Pediatric Fundamentals of Critical Care Support course pilot implementation in Botswana. DESIGN: Observational, single center. SETTING: Academic, upper middle-income country. SUBJECTS: Healthcare providers in Botswana. INTERVENTIONS: A cohort of healthcare providers completed the standard 2-day Pediatric Fundamentals of Critical Care Support course and qualitative survey during the course...
June 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29900894/string-test-a-new-tool-for-tuberculosis-diagnosis-and-drug-resistance-detection-in-children
#16
Belén Rocío Imperiale, Cecilia Nieves, Belén Mancino, Myriam Sanjurjo, Silvina Tártara, Ángela Beatríz Di Giulio, Juan Carlos Palomino, Nora Susana Morcillo, Anandi Martin
Background: There is a critical need to improve the diagnostic accuracy of tuberculosis (TB) in children. Several techniques have been developed to improve the quality of sputum samples; however, these procedures are very unpleasant and invasive and require hospitalization and trained personnel. This study aims to explore the potential use of a new and noninvasive tool, "string test," for TB diagnosis in children and in adults not able to render sputum samples and at risk of developing multidrug-resistant TB (MDR-TB)...
April 2018: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/29900801/biobanking-in-the-pediatric-critical-care-setting-adolescent-young-adult-perspectives
#17
Erin D Paquette, Sabrina F Derrington, Avani Shukla, Neha Sinha, Sarah Oswald, Lauren Sorce, Kelly N Michelson
Biorepository research in children raises numerous ethical questions that are heightened in the pediatric intensive care unit (PICU) setting. We conducted a cross-sectional, interview-based study of 20 adolescent/young adult (A/YA) PICU patients and 75 parents of PICU patients to elucidate perspectives on biorepository research. A/YAs had a positive attitude toward biobanking. In young adults, comprehension was higher for knowledge of a choice to withdraw and participate in the research and lower for purpose, procedures, risks, and benefits of participation...
June 1, 2018: Journal of Empirical Research on Human Research Ethics: JERHRE
https://www.readbyqxmd.com/read/29900403/feedback-quality-using-an-observation-form
#18
Gary L Beck Dallaghan, Joy Higgins, Adam Reinhardt
Background: Direct observations with focused feedback are critical components for medical student education. Numerous challenges exist in providing useful comments to students during their clerkships. Students' evaluations of the clerkship indicated they were not receiving feedback from preceptors or house officers. Objective: To encourage direct observation with feedback, Structured Patient Care Observation (SPCO) forms were used to evaluate third-year medical students during patient encounters...
January 2018: Journal of Medical Education and Curricular Development
https://www.readbyqxmd.com/read/29898236/diagnosis-and-evaluation-of-eating-disorders-in-the-pediatric-patient
#19
Briana Sacco, Urszula Kelley
Recognizing eating disorders in the pediatric population can be challenging for outpatient providers. With the high prevalence of these disorders in children and adolescents, it is critical that pediatricians recognize these disorders and connect these children and families with available treatments. This article provides a review of the current diagnostic criteria for pica, rumination disorder, anorexia nervosa, bulimia nervosa, avoidant restrictive food intake disorder, binge-eating disorder, other specified feeding or eating disorder, and unspecified feeding or eating disorder as described in The Diagnostic and Statistical Manual of Mental Disorders, fifth edition...
June 1, 2018: Pediatric Annals
https://www.readbyqxmd.com/read/29894446/parental-presence-at-the-bedside-of-critically-ill-children-in-a-unit-with-unrestricted-visitation
#20
Jennifer R Foster, Farhana I AlOthmani, Jamie A Seabrook, Tariq AlOfisan, Yasser M AlGarni, Amrita Sarpal
OBJECTIVES: To determine the percentage of time that critically ill children have a parent at the bedside and to identify extrinsic factors that are associated with percent of time with parental presence at the bedside. DESIGN: Prospective cohort study. SETTING: PICU in a single tertiary care children's hospital. SUBJECTS: Primary two parents of all children admitted to the PICU on 12 preselected days during a 1-year period from 2014 to 2015...
June 11, 2018: Pediatric Critical Care Medicine
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