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https://www.readbyqxmd.com/read/29677063/the-anesthesia-perioperative-call-for-help-experience-at-a-quaternary-pediatric-medical-center-analysis-of-67-564-anesthesia-encounters
#1
Bistra G Vlassakova, Sean M Sinnott, Nissa Askins, Matthew X Callahan, Izabela C Leahy, David Zurakowski, Paul R Hickey, Joseph P Cravero
BACKGROUND: During the past several decades, anesthesia has become increasingly safe. Truly major adverse events are rare, and anesthesia quality researchers have instituted programs to evaluate "near miss" or less critical adverse events to evaluate the safety of anesthesia delivery. In this study, we aimed to evaluate calls for emergency help in our institution as a surrogate for pending critical events. We hypothesized that calls would be more common in patients with high American Society of Anesthesiologists (ASA) physical status, history of prematurity, and children with recent respiratory illness compared to those without these characteristics...
April 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29676680/midline-central-fluid-percussion-model-of-traumatic-brain-injury-in-pediatric-and-adolescent-rats
#2
Rachel K Rowe, Jordan L Harrison, Timothy W Ellis, P David Adelson, Jonathan Lifshitz
OBJECTIVE Experimental traumatic brain injury (TBI) models hold significant validity to the human condition, with each model replicating a subset of clinical features and symptoms. TBI is the leading cause of mortality and morbidity in children and teenagers; thus, it is critical to develop preclinical models of these ages to test emerging treatments. Midline fluid percussion injury (FPI) might best represent mild and diffuse clinical brain injury because of the acute behavioral deficits, the late onset of behavioral morbidities, and the absence of gross histopathology...
April 20, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29672356/improving-documentation-of-inpatient-problem-list-in-electronic-health-record-a-quality-improvement-project
#3
Prabi Rajbhandari, Moises Auron, Sarah Worley, Michelle Marks
BACKGROUND: The problem list is critical in electronic documentation. It is a powerful tool for clinical decision-making because it provides a concise view of all patient problems in one place and is also a criterion for the Medicare meaningful use incentive program. OBJECTIVE: To measure the rate of utilization of problem list in electronic health records (EHR) in a pediatric hospital medicine unit and implement sequential interventions to increase the rate of use of problem list to more than 80% by the end of 2015, as measured by at least one documented hospital problem at discharge...
April 19, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29671836/children-s-experience-of-symptoms-narratives-through-words-and-images
#4
REVIEW
Barbara M Sourkes
Children who live with a complex chronic or life-threatening illness face extraordinary challenges. Whether they are receiving disease-oriented treatment (aimed at potential cure or prolongation of life) or palliative treatment-or both concurrently-our challenge is to enhance their comfort and minimize their distress. Symptom management is thus a critical component of pediatric palliative care. Symptoms may be either physical or psychological in nature (or a confluence of both) and their effective management has a direct impact on the child's quality of life...
April 19, 2018: Children
https://www.readbyqxmd.com/read/29669752/an-adaptable-pediatrics-faculty-mentoring-model
#5
Joan M Cranmer, Amy M Scurlock, Rachel B Hale, Wendy L Ward, Parthak Prodhan, Judith L Weber, Patrick H Casey, Richard F Jacobs
An effective faculty mentoring program (FMP) is 1 approach that academic departments can use to promote professional fulfillment, faculty retention, and mitigate the risks of faculty burnout. Mentoring has both direct benefits for junior faculty mentees as they navigate the academic promotion process with their mentors, in addition to broader departmental and institutional benefits, with regard to recruitment, retention, and academic productivity. We describe a successful FMP model that has been adapted for use in 6 other pediatrics departments, summarizing the key personnel, mentoring process, and program evaluation methods...
April 18, 2018: Pediatrics
https://www.readbyqxmd.com/read/29669602/cerebral-vasculitis-and-lateral-rectus-palsy-two-rare-central-nervous-system-complications-of-dengue-fever-two-case-reports-and-review-of-the-literature
#6
H M M Herath, J S Hewavithana, C M De Silva, O A R Kularathna, N P Weerasinghe
BACKGROUND: Dengue fever is a common mosquito-borne viral illness with a clinical spectrum ranging from a simple febrile illness to potentially life-threatening complications such as dengue hemorrhagic fever and dengue shock syndrome. Dengue infection can affect many organs, including the central nervous system. The neurological manifestations reported in dengue infections are meningitis, encephalitis, stroke, acute disseminated encephalomyelitis, and Guillain-Barré syndrome. CASE PRESENTATION: We report the cases of two interesting patients with confirmed dengue infection who presented with complications of possible central nervous system vasculitis and cranial nerve palsy...
April 19, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29667952/useful-pharmacodynamic-endpoints-in-children-selection-measurement-and-next-steps
#7
REVIEW
Lauren E Kelly, Yashwant Sinha, Charlotte I S Barker, Joseph F Standing, Martin Offringa
Pharmacodynamic (PD) endpoints are essential for establishing the benefit-to-risk ratio for therapeutic interventions in children and neonates. This article discusses the selection of an appropriate measure of response, the PD endpoint, which is a critical methodological step in designing pediatric efficacy and safety studies. We provide an overview of existing guidance on the choice of PD endpoints in pediatric clinical research. We identified several considerations relevant to the selection and measurement of PD endpoints in pediatric clinical trials, including the use of biomarkers, modeling, compliance, scoring systems, and validated measurement tools...
April 18, 2018: Pediatric Research
https://www.readbyqxmd.com/read/29664874/traumatic-brain-injury-and-infectious-encephalopathy-in-children-from-four-resource-limited-settings-in-africa
#8
Ericka L Fink, Amelie von Saint Andre-von Arnim, Rashmi Kumar, Patrick T Wilson, Tigist Bacha, Abenezer Tirsit Aklilu, Tsegazeab Laeke Teklemariam, Shubhada Hooli, Lisine Tuyisenge, Easmon Otupiri, Anthony Fabio, John Gianakas, Patrick M Kochanek, Derek C Angus, Robert C Tasker
OBJECTIVES: To assess the frequency, interventions, and outcomes of children presenting with traumatic brain injury or infectious encephalopathy in low-resource settings. DESIGN: Prospective study. SETTING: Four hospitals in Sub-Saharan Africa. PATIENTS: Children age 1 day to 17 years old evaluated at the hospital with traumatic brain injury or infectious encephalopathy. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We evaluated the frequency and outcomes of children presenting consecutively over 4 weeks to any hospital department with traumatic brain injury or infectious encephalopathy...
April 16, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29663424/primary-endpoints-in-pediatric-efficacy-trials-submitted-to-the-us-fda
#9
Dionna J Green, Janelle M Burnham, Paul Schuette, Xiaomei I Liu, Brian M Maas, Lynne Yao, Susan K McCune, Joseph Chen, John N van den Anker, Gilbert J Burckart
The selection of appropriate endpoints in pediatric drug development trials is a critical aspect of trial design. Given the high pediatric trial failure rate, selecting optimal trial design elements, such as the primary efficacy endpoint, is essential to ensuring increased potential for trial success. The objectives of this study were to identify the primary efficacy endpoints measured in pediatric drug development trials submitted to the US Food and Drug Administration and to relate endpoint attributes to trial and label outcome...
April 17, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29660965/a-clinically-focused-systematic-review-of-social-communication-in-pediatric-tbi
#10
Angela Hein Ciccia, Leah Beekman, Emily Ditmars
BACKGROUND: Social communication is a persistent area of need after pediatric traumatic brain injury; however, it continues to be misunderstood, under-recognized, and under-treated. Clinicians must have a working understanding of current evidence and practice recommendations to support practice. OBJECTIVES: 1) To analyze recent evidence in social communication published in the last ten years, which is specific to pediatric TBI and 2) To translate these findings for clinicians...
April 7, 2018: NeuroRehabilitation
https://www.readbyqxmd.com/read/29660215/polygenic-risk-for-psychiatric-disorders-correlates-with-executive-function-in-typical-development
#11
Andrew J Schork, Timothy T Brown, Donald J Hagler, Wesley K Thompson, Chi-Hua Chen, Anders M Dale, Terry L Jernigan, Natacha Akshoomoff
Executive functions are a diverse and critical suite of cognitive abilities that are often disrupted in individuals with psychiatric disorders. Despite their moderate to high heritability, little is known about the molecular genetic factors that contribute to variability in executive function and how these factors may be related to those that predispose to psychiatric illness. We examined the relationship between polygenic risk scores built from large genome-wide association studies of psychiatric illness and executive functioning in typically developing children...
April 16, 2018: Genes, Brain, and Behavior
https://www.readbyqxmd.com/read/29659416/a-pilot-randomized-controlled-trial-of-an-intervention-to-promote-psychological-well-being-in-critically-ill-children-soothing-through-touch-reading-and-music
#12
Janet E Rennick, Robyn Stremler, Linda Horwood, Marilyn Aita, Tanya Lavoie, Annette Majnemer, Marie Antonacci, Alyssa Knox, Evelyn Constantin
OBJECTIVES: To examine the feasibility and acceptability of a PICU Soothing intervention using touch, reading, and music. DESIGN: Nonblinded, pilot randomized controlled trial. SETTING: The PICU and medical-surgical wards of one Canadian pediatric hospital. PATIENTS: Twenty PICU patients age 2-14 years old and their parents, randomized to an intervention group (n = 10) or control group (n = 10). INTERVENTION: PICU Soothing consisted of: 1) parental comforting (touch and reading), followed by 2) a quiet period with music via soft headbands, administered once daily throughout hospitalization...
April 13, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29657372/targeted-interventions-in-critically-ill-children-with-severe-dengue
#13
Suchitra Ranjit, Gokul Ramanathan, Balasubramaniam Ramakrishnan, Niranjan Kissoon
Background: The World Health Organization guidelines provide suggestions on early recognition and treatment of severe dengue (SD); however, mortality in this group can be high and is related both to disease severity and the treatment complications. Subjects and Methods: In this prospective observational study, we report our results where standard therapy (ST) was enhanced by Intensive Care Unit (ICU) supportive measures that have proven beneficial in other conditions that share similar pathophysiology of capillary leak and fluid overload...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29656703/the-ethics-of-concurrent-care-for-children-a-social-justice-perspective
#14
Kim Mooney-Doyle, Jessica Keim-Malpass, Lisa C Lindley
Recent estimates indicate that over 40,000 children die annually in the United States and a majority have life-limiting conditions. Children at end of life require extensive healthcare resources, including multiple hospital readmissions and emergency room visits. Yet, many children still suffer from symptoms at end of life-including fatigue, pain, dyspnea, and anxiety-with less than 10% of these children utilizing hospice care services. A critical barrier to pediatric hospice use was the original federal regulations associated with the hospice care that required a diagnosis of 6 months to live and the discontinuation of all curative treatments...
January 1, 2018: Nursing Ethics
https://www.readbyqxmd.com/read/29652752/practice-change-from-intermittent-medication-boluses-to-bolusing-from-a-continuous-infusion-in-pediatric-critical-care-a-quality-improvement-project
#15
Jessica L Hochstetler, A Jill Thompson, Natalie M Ball, Melissa C Evans, Shaun C Frame, A Lauren Haney, Amelia K Little, Jaime L O'Donnell, Bryna M Rickett, Elizabeth H Mack
OBJECTIVES: To determine whether implementing a guideline to bolus medications from continuous infusions in PICUs affects nursing satisfaction, patient safety, central line entries, medication utilization, or cost. DESIGN: This is a pre- and postimplementation quality improvement study. SETTING: An 11-bed ICU and 14-bed cardiac ICU in a university-affiliated children's hospital. PATIENTS: Patients less than 18 years old admitted to the PICU or pediatric cardiac ICU receiving a continuous infusion of dexmedetomidine, midazolam, fentanyl, morphine, vecuronium, or cisatracurium from May 2015 to May 2016, excluding November 2015 (washout period), were eligible for inclusion...
April 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29652750/a-needs-assessment-of-brain-death-education-in-pediatric-critical-care-medicine-fellowships
#16
Andrew M Ausmus, Pippa M Simpson, Liyun Zhang, Tara L Petersen
OBJECTIVES: To assess the current training in brain death examination provided during pediatric critical care medicine fellowship. DESIGN: Internet-based survey. SETTING: United States pediatric critical care medicine fellowship programs. SUBJECTS: Sixty-four pediatric critical care medicine fellowship program directors and 230 current pediatric critical care medicine fellows/recent graduates were invited to participate...
April 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29651949/nerve-growth-factor-early-studies-and-recent-clinical-trials
#17
Maria Luisa Rocco, Marzia Soligo, Luigi Manni, Luigi Aloe
Since its discovery, nerve growth factor (NGF) has long occupied a critical role in developmental and adult neurobiology for its many important regulatory functions on the survival, growth and differentiation of nerve cells in the peripheral and central nervous system. NGF is the first discovered member of a family of neurotrophic factors, collectively indicated as neurotrophins, (which include brain-derived neurotrophic factor, neurotrophin-3 and neurotrophin 4/5). NGF was discovered for its action on the survival and differentiation of selected populations of peripheral neurons...
April 11, 2018: Current Neuropharmacology
https://www.readbyqxmd.com/read/29651540/identifying-non-invasive-tools-to-distinguish-acute-myocarditis-from-dilated-cardiomyopathy-in-children
#18
Divya Suthar, Debra A Dodd, Justin Godown
There is often a diagnostic dilemma in pediatric patients presenting with depressed ventricular function, as myocarditis and dilated cardiomyopathy (DCM) of other etiologies can appear very similar. Accurate identification is critical to guide treatment and to provide families with the most accurate expectation of long-term outcomes. The objective of this study was to identify patterns of clinical presentation and to assess non-invasive measures to differentiate patients with acute myocarditis from other forms of DCM...
April 12, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29648880/evolving-challenges-in-pediatric-pulmonary-medicine-new-opportunities-to-re-invigorate-the-field
#19
Joseph M Collaco, Steven H Abman
Thirty years after the first board certification examination for pediatric pulmonology was administered there remain substantial challenges in attracting trainees and sustaining and retaining clinician-scientists in the field. In fact, significant workforce shortages are predicted to exist with current fellowship graduation rates and the aging of the existing workforce. However, the rapid diagnostic and therapeutic advances occurring in the field should serve as draw for trainees. In addition, pediatric pulmonologists provide unique expertise for the diversity and severity of respiratory conditions that is not duplicated by generalists, allergists, intensivists, or neonatologists...
April 12, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29643628/pediatric-critical-incidents-reported-over-15-years-at-a-tertiary-care-teaching-hospital-of-a-developing-country
#20
Shemila Abbasi, Fauzia Anis Khan, Sobia Khan
Background and Aims: The role of critical incident (CI) reporting is well established in improving patient safety but only a limited number of available reports relate to pediatric incidents. Our aim was to analyze the reported CIs specific to pediatric patients in our database and to reevaluate the value of this program in addressing issues in pediatric anesthesia practice. Material and Methods: Incidents related to pediatric population from neonatal period till the age of 12 years were selected...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
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