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https://www.readbyqxmd.com/read/29040247/use-of-ondansetron-for-vomiting-after-head-trauma-does-it-mask-clinically-significant-traumatic-brain-injury
#1
Israel Green-Hopkins, Michael C Monuteaux, Lois Lee, Lise Nigrovic, Rebekah Mannix, Sara Schutzman
OBJECTIVES: We describe ondansetron use in children with head injury evaluated in pediatric emergency departments and its association with return visits and late diagnoses of intracranial injuries requiring intervention. METHODS: Children ages 6 months to 18 years discharged without neuroimaging from 35 pediatric emergency departments with a diagnosis of head injury from 2009 to 2013 were identified retrospectively from the Pediatric Health Information System. We evaluated the rates of ondansetron use during the study period and of the association of ondansetron treatment with the diagnosis of intracranial injury, skull fracture, and return visits within 72 hours requiring admission or operative intervention...
October 16, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29032966/safety-and-efficacy-of-uninterrupted-perioperative-enteral-feeding-in-pediatric-burn-patients
#2
Folasade Imeokparia, Morgan Johnson, Rajan K Thakkar, Sheila Giles, Teresa Capello, Renata Fabia
INTRODUCTION: Burn injuries are a significant cause of morbidity. Early enteral nutrition has been shown to improve outcomes, however enteral nutrition is often held for procedures receiving general anesthesia. Limited data is available on uninterrupted perioperative nutrition in pediatric burn patients. METHODS: A single, American Burn Association verified burn center database was queried for patients ≤18 years of age with ≥15% total body surface area (TBSA) burn injuries who underwent surgeries with general anesthesia...
October 9, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29031787/assessing-prediction-accuracy-for-outcomes-of-ventilator-associated-events-and-infections-in-critically-ill-children-a-prospective-cohort-study
#3
Yolanda Peña-López, Montserrat Pujol, Magda Campins, Leonel Lagunes, Joan Balcells, Jordi Rello
OBJECTIVES: To assess the prediction accuracy of 2008 Center for Disease Control and Prevention (CDC) definitions for ventilator-associated pneumonia (VAP)/ventilator-associated tracheobronchitis (VAT), 2013-CDC definitions for ventilator-associated events (VAE) and a new VAE algorithm (Ped-VAE) in children. METHODS: Prospective 13-month cohort study at a multidisciplinary Pediatric Intensive Care Unit (PICU). Primary end-points were duration of ventilation episode, PICU/hospitalization length of stay from episode (LOS), and episode mortality...
October 11, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29028420/the-effect-of-telemedicine-on-resource-utilization-and-hospital-disposition-in-critically-ill-pediatric-transport-patients
#4
Kimberly Fugok, Nicholas B Slamon
PURPOSE: Pediatric transport teams rely on communication to report patient data to medical command officers, who create care plans and determine disposition. Common destinations are the emergency department (ED), pediatric intensive care unit (PICU), or regular inpatient care area (RIPCA). Telephone report does not result in complete understanding of the patient's condition. Further workup in the ED is often required. Telemedicine allows the patient to be directly seen; parents to be interviewed; and laboratory studies, radiographs, and vital signs to be reviewed...
October 13, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29027866/magnetic-resonance-imaging-guided-laser-interstitial-thermal-therapy-as-treatment-for-intractable-insular-epilepsy-in-children
#5
M Scott Perry, David J Donahue, Saleem I Malik, Cynthia G Keator, Angel Hernandez, Rohit K Reddy, Freedom F Perkins, Mark R Lee, Dave F Clarke
OBJECTIVE Seizure onset within the insula is increasingly recognized as a cause of intractable epilepsy. Surgery within the insula is difficult, with considerable risks, given the rich vascular supply and location near critical cortex. MRI-guided laser interstitial thermal therapy (LiTT) provides an attractive treatment option for insular epilepsy, allowing direct ablation of abnormal tissue while sparing nearby normal cortex. Herein, the authors describe their experience using this technique in a large cohort of children undergoing treatment of intractable localization-related epilepsy of insular onset...
October 13, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29025601/a-neoplasm-with-fip1l1-pdgfra-fusion-presenting-as-pediatric-t-cell-lymphoblastic-leukemia-lymphoma-without-eosinophilia
#6
Matthew J Oberley, Christopher Denton, Jianling Ji, Matthew Hiemenz, Deepa Bhojwani, Dejerianne Ostrow, Samuel Wu, Paul Gaynon, Gordana Raca
The 2016 World Health Organization (2016 WHO) classification of hematopoietic malignancies classifies neoplasms with a fusion between the FIP1L1 and PDGFRA genes in 4q12 into a group called "myeloid and lymphoid neoplasms with eosinophilia and abnormalities of PDGFRA, PDGFRB or FGFR1 or with PCM1-JAK2". Neoplasms characterized by this fusion are pluripotent stem cell disorders that can show both myeloid and lymphoid differentiation. They typically occur in adult patients and most are characterized by eosinophilia...
October 2017: Cancer Genetics
https://www.readbyqxmd.com/read/29023355/utility-of-mobile-communication-devices-as-a-tool-to-improve-adherence-to-antiretroviral-treatment-in-hiv-infected-children-and-young-adults-in-argentina
#7
Erica Stankievich, Adriana Malanca, Irene Foradori, Silvina Ivalo, Marcelo Losso
BACKGROUND: Optimal adherence is critical to achieve the benefits of antiretroviral treatment (ART). The aim of the study is to evaluate the use of mobile devices as a strategy to improve adherence to ART, measured by Viral Load (VL) in HIV+ patients less than 25 years of age. METHODS: A prospective study was conducted in a cohort of HIV+ patients less than 25 years of age. HIV+ patients, on ART, VL >1000 copies/mL, using mobile devices and suboptimal adherence (SOA) were included...
October 7, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29023307/interrater-agreement-of-eeg-interpretation-after-pediatric-cardiac-arrest-using-standardized-critical-care-eeg-terminology
#8
Nicholas S Abend, Shavonne L Massey, Mark Fitzgerald, France Fung, Natalie J Atkin, Rui Xiao, Alexis A Topjian
PURPOSE: We evaluated interrater agreement of EEG interpretation in a cohort of critically ill children resuscitated after cardiac arrest using standardized EEG terminology. METHODS: Four pediatric electroencephalographers scored 10-minute EEG segments from 72 consecutive children obtained 24 hours after return of circulation using the American Clinical Neurophysiology Society's (ACNS) Standardized Critical Care EEG terminology. The percent of perfect agreement and the kappa coefficient were calculated for each of the standardized EEG variables and a predetermined composite EEG background category...
October 10, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/29023218/out-of-hospital-pediatric-patient-safety-events-results-of-the-csi-chart-review
#9
Garth Meckler, Matthew Hansen, William Lambert, Kerth O'Brien, Caitlin Dickinson, Kathryn Dickinson, Joshua Van Otterloo, Jeanne-Marie Guise
OBJECTIVE: Studies of adult hospital patients have identified medical errors as a significant cause of morbidity and mortality. Little is known about the frequency and nature of pediatric patient safety events in the out-of-hospital setting. We sought to quantify pediatric patient safety events in EMS and identify patient, call, and care characteristics associated with potentially severe events. METHODS: As part of the Children's Safety Initiative -EMS, expert panels independently reviewed charts of pediatric critical ambulance transports in a metropolitan area over a three-year period...
October 12, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29022369/psychosocially-supportive-design-the-case-for-greater-attention-to-social-space-within-the-pediatric-hospital
#10
Rebecca McLaughlan
OBJECTIVE: Models of patient and family-centered care advocate catering to psychosocial needs when designing healthcare facilities yet there is little evidence available to determine how the built environment can cater to psychosocial needs. This article highlights the obstacles to overcoming this knowledge deficit in the pursuit of evidence-based guidelines to inform social provisions within the pediatric hospital setting. It will propose a working definition for psychosocial space and identify new research directions to enhance understandings of the relationship between social space and well-being...
January 1, 2017: HERD
https://www.readbyqxmd.com/read/29022225/pediatric-intensive-care-pittsburg-critical-care-medicine-series-r-scott-watson-ann-e-thompson-eds-published-by-oxford-university-press-new-york-2017-isbn-978-0-19-991802-7-pages-311
#11
https://www.readbyqxmd.com/read/29019757/pediatric-ovarian-torsion-spectrum-of-imaging-findings
#12
Akosua Sintim-Damoa, Anand Shyamcharan Majmudar, Harris L Cohen, Louis Swig Parvey
The accurate diagnosis of ovarian torsion is imperative, as loss of the ovary can have long-term consequences in terms of fertility. However, a nonspecific clinical presentation in conjunction with a highly variable imaging appearance makes the diagnosis of ovarian torsion challenging. This is complicated even further in the pediatric population, as these patients cannot always articulate their symptoms or provide an adequate medical history. Therefore, imaging has a critical role in the diagnosis of ovarian torsion in pediatric patients...
October 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29019753/imaging-of-pediatric-growth-plate-disturbances
#13
Jie C Nguyen, B Keegan Markhardt, Arnold C Merrow, Jerry R Dwek
The growth plates, or physes, are visible on virtually all images obtained in skeletally immature children. The proper function of these growth plates depends on an intricate balance between chondrocyte proliferation, which requires nourishment from the epiphyseal vessels, and chondrocyte death, which requires the integrity of the metaphyseal vessels. Therefore, injury to the growth plate (ie, direct insult) or vascular compromise on either side of the growth plate (ie, indirect insult) can cause growth plate dysfunction...
October 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29019744/pediatric-liver-transplant-techniques-and-complications
#14
Natally Horvat, Antonio Sergio Zafred Marcelino, Joao Vicente Horvat, Tássia Regina Yamanari, Jose de Arimateia Batista Araújo-Filho, Pedro Panizza, Joao Seda-Neto, Eduardo Antunes da Fonseca, Francisco Cesar Carnevale, Luciana Mendes de Oliveira Cerri, Paulo Chapchap, Giovanni Guido Cerri
Liver transplant is considered to be the last-resort treatment approach for pediatric patients with end-stage liver disease. Despite the remarkable advance in survival rates, liver transplant remains an intricate surgery with significant morbidity and mortality. Early diagnosis of complications is crucial for patient survival but is challenging given the lack of specificity in clinical presentation. Knowledge of the liver and vascular anatomy of the donor and the recipient or recipients before surgery is also important to avoid complications...
October 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29019630/prolonged-hospital-discharge-for-children-with-technology-dependency-a-source-of-health-care-disparities
#15
Sarah A Sobotka, Rishi K Agrawal, Michael E Msall
Children with ventilator assistance have been supported in living at home since 1981 when parental advocacy ushered in a change to Medicaid policy. As the population of children who use medical technology such as long-term ventilation increases, we must critically evaluate our systems for preparing families for home life. Discharge delays persist in the modern era because of fragmentation between hospital and home systems. These discharge delays result in children spending time in less developmentally rich environments, further exacerbating the health and development disparities of children with complex disabilities...
October 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/29017389/the-canadian-laboratory-initiative-on-pediatric-reference-intervals-a-caliper-white-paper
#16
Khosrow Adeli, Victoria Higgins, Karin Trajcevski, Nicole White-Al Habeeb
Laboratory investigations provide physicians with objective data to aid in disease diagnosis, clinical decision making, and patient follow up. Clinical interpretation of laboratory test results relies heavily on the availability of appropriate population-based reference intervals (i.e. normative values) or decision limits developed through clinical outcome studies. Although reference intervals are fundamental to accurate laboratory test interpretation, and thus critically important to healthcare, the need for sound evidence-based reference intervals has been largely overlooked, particularly in the pediatric population...
October 11, 2017: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/29017081/safety-of-intravenous-lacosamide-in-critically-ill-children
#17
Sarah S Welsh, Nan Lin, Alexis A Topjian, Nicholas S Abend
PURPOSE: Acute seizures are common in critically ill children. These patients would benefit from intravenous anti-seizure medications with few adverse effects. We reviewed the usage and effects of intravenous lacosamide in critically ill children with seizures or status epilepticus. METHODS: This retrospective series included consecutive patients who received at least one dose of intravenous lacosamide from April 2011 to February 2016 in the pediatric intensive care unit of a quaternary care children's hospital, including patients with new lacosamide initiation and continuation of outpatient oral lacosamide...
October 3, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29016364/burnout-and-psychological-distress-among-pediatric-critical-care-physicians-in-the-united-states
#18
Asha N Shenoi, Meena Kalyanaraman, Aravind Pillai, Preethi S Raghava, Scottie Day
OBJECTIVES: To estimate the prevalence of physician burnout, psychological distress, and its association with selected personal and practice characteristics among pediatric critical care physicians and to evaluate the relationship between burnout and psychological distress. DESIGN: Cross-sectional, online survey. SETTING: Pediatric critical care practices in the United States. SUBJECTS: Pediatric critical care physicians...
October 7, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28992737/asenapine-iloperidone-and-lurasidone-exposures-in-young-children-reported-to-u-s-poison-centers
#19
Gina Stassinos, Wendy Klein-Schwartz
CONTEXT: Asenapine, iloperidone and lurasidone are relatively new atypical antipsychotics. There is limited information on toxicity on pediatric exposures to these drugs. The objective of this study was to compare toxicity associated with asenapine, iloperidone and lurasidone exposures in young children. METHODS: A retrospective study of U.S. National Poison Data System from 2010 to 2015 of single substance exposures to asenapine, iloperidone or lurasidone in children <6 years of age that were followed to known outcome was performed...
October 10, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28992658/-the-pl%C3%A3-ner-model-for-the-school-entry-screening-is-a-role-model-for-the-future
#20
Josef Weigl
Background The Plöner Model is a stepwise-selective model, similar to the one practised in all of Bavaria since 2008. It was already developed in 2002/2003 for the school entry screening and has been in use since then. Such models are intermittently criticized since not each child is seen by a doctor. Methods The procedure and data of the Plöner Model are analyzed and put into a wider context within Germany and beyond. The current programs in place are therefore categorized into 3 groups and compared with regard to public heath ethics criteria...
October 9, 2017: Das Gesundheitswesen
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