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https://www.readbyqxmd.com/read/28816870/spinal-cord-injury-what-are-the-controversies
#1
Christopher S Ahuja, Gregory D Schroeder, Alexander R Vaccaro, Michael G Fehlings
Traumatic spinal cord injuries have a tremendous impact on individuals, families, and society as a whole. Substantial heterogeneity in the patient population, their presentation and underlying pathophysiology has sparked debates along the care spectrum from initial assessment to definitive treatment. This article reviews spinal cord injury (SCI) management followed by a discussion of the salient controversies in the field. Current care practices modeled on the American Association of Neurological Surgeons/Congress of Neurological Surgeons joint section guidelines are highlighted including key recommendations regarding immobilization, avoidance of hypotension, early International Standards for Neurological Classification of SCI examination and intensive care unit treatment...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28814444/implementing-an-inpatient-pediatric-prospective-audit-and-feedback-antimicrobial-stewardship-program-within-a-larger-medical-center
#2
Jennifer Lighter-Fisher, Sonya Desai, Anna Stachel, Vinh Philip Pham, Liana Klejmont, Yanina Dubrovskaya
BACKGROUND: Pediatric antimicrobial stewardship programs (ASPs) within larger institutions have unique opportunities to develop programs specialized to the needs of the pediatric program. In January 2013, our institution established a formalized pediatric ASP utilizing the prospective audit and feedback process. In an effort to standardize therapy and improve quality of care, members of the ASP developed evidence-based guidelines for management of common inpatient pediatric infections...
August 16, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28814443/antibiotic-use-by-pediatric-residents-identifying-opportunities-and-strategies-for-antimicrobial-stewardship
#3
Prateek J Shukla, Maria Behnam-Terneus, Beatriz Cunill-De Sautu, Geovanny F Perez
OBJECTIVES: To determine the antibiotic prescribing practices of pediatric residents and assess how they acquire knowledge leading to prescribing behaviors. METHODS: We performed a cross-sectional electronic survey of all pediatric residents at the Children's National Medical Center and Nicklaus Children's Hospital, assessing antibiotic prescribing patterns for common pediatric infections, use of antibiograms, and factors influencing antibiotic choice. RESULTS: Eighty-five surveys (45%) were returned complete and included in the analysis...
August 16, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28814258/management-of-complicated-pneumonia-in-childhood-a-review-of-recent-literature
#4
John B Darby, Amrita Singh, Ricardo Quinonez
BACKGROUND: Despite declining rates of community acquired pneumonia (CAP) in children, complicated pneumonia has been on the rise in the last two decades. The management of complicated pneumonia is challenging and continues to be an area of investigation. Despite recently published guidelines, many gaps exist and recent studies attempt to answer challenging questions. OBJECTIVE: To review recently published literature to inform the clinician on the most up to date management of complicated pneumonia in children...
August 16, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28813765/bronchiolitis-in-infants-and-children
#5
Alexandra Schaller, Carl S Galloway
Bronchiolitis is among the most common illnesses in infants and children, and is the most common cause for hospitalization in infants in the U.S. This illness can be caused by many viruses, most commonly respiratory syncytial virus. It is diagnosed clinically by history and physical exam findings, with a narrow role for ancillary testing. Management is supportive, with medications demonstrating limited utility in multiple studies. Preventive measures include hand hygiene, breastfeeding, avoiding tobacco smoke exposure, and isolation precautions for hospitalized patients...
June 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28813753/pre-guideline-trends-associated-with-chest-radiograph-usage-for-pediatric-community-acquired-pneumonia-in-emergency-department-settings
#6
Eric W Jones, Benjamin Meyer, Aaron M Berg, Benson S Hsu
BACKGROUND: Health care spending in the U.S. totaled $3 trillion in 2014 and continues to increase rapidly. Minimizing waste through clinical guidelines is a promising strategy to reduce spending without compromising patient care. In 2011, clinical guidelines recommended against the use of chest X-ray (CXR) for diagnosis of community-acquired pneumonia (CAP) in pediatric ambulatory settings. However, use of CXR has not changed post-guideline. Thus, understanding the drivers of CXR utilization prior to guideline implementation could improve guideline adherence...
May 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28808845/targeted-treatment-in-severe-traumatic-brain-injury-in-the-age-of-precision-medicine
#7
Anthony A Figaji, A Graham Fieggen, Ncedile Mankahla, Nico Enslin, Ursula K Rohlwink
In recent years, much progress has been made in our understanding of traumatic brain injury (TBI). Clinical outcomes have progressively improved, but evidence-based guidelines for how we manage patients remain surprisingly weak. The problem is that the many interventions and strategies that have been investigated in randomized controlled trials have all disappointed. These include many concepts that had become standard care in TBI. And that is just for adult TBI; in children, the situation is even worse. Not only is pediatric care more difficult than adult care because physiological norms change with age, but also there is less evidence for clinical practice...
August 14, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28808486/the-saudi-thoracic-society-guidelines-for-diagnosis-and-management-of-noncystic-fibrosis-bronchiectasis
#8
Hamdan Al-Jahdali, Abdullah Alshimemeri, Abdullah Mobeireek, Amr S Albanna, Nehad N Al Shirawi, Siraj Wali, Khaled Alkattan, Abdulrahman A Alrajhi, Khalid Mobaireek, Hassan S Alorainy, Mohamed S Al-Hajjaj, Anne B Chang, Stefano Aliberti
This is the first guideline developed by the Saudi Thoracic Society for the diagnosis and management of noncystic fibrosis bronchiectasis. Local experts including pulmonologists, infectious disease specialists, thoracic surgeons, respiratory therapists, and others from adult and pediatric departments provided the best practice evidence recommendations based on the available international and local literature. The main objective of this guideline is to utilize the current published evidence to develop recommendations about management of bronchiectasis suitable to our local health-care system and available resources...
July 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28807643/-use-of-subcutaneous-route-for-comfort-care%C3%A2-in-neonatal-palliative-population-systematic-review-and-survey-of-practices-in-france
#9
N Pouvreau, J Tandonnet, O Tandonnet, L Renesme
INTRODUCTION: Subcutaneous hydration (hypodermoclysis) and drug administration is a widely used method of analgesic therapy in adult palliative care medicine. Very little is known about its use in neonatal medicine. Evidence-based guidelines do not exist due to a lack of data. In this study, the advantages of subcutaneous analgesic therapy in terms of comfort in neonatal palliative care situations were investigated. METHODS: This report details the results of a systematic review associated with a survey in neonatal intensive care units (NICUs) and pediatric palliative care departments (PPCTs) in France...
August 11, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28807611/initial-treatment-for-nonsyndromic-early-life-epilepsy-an-unexpected-consensus
#10
Renée A Shellhaas, Anne T Berg, Zachary M Grinspan, Courtney J Wusthoff, John J Millichap, Tobias Loddenkemper, Jason Coryell, Russell P Saneto, Catherine J Chu, Sucheta M Joshi, Joseph E Sullivan, Kelly G Knupp, Eric H Kossoff, Cynthia Keator, Elaine C Wirrell, John R Mytinger, Ignacio Valencia, Shavonne Massey, William D Gaillard
OBJECTIVE: There are no evidence-based guidelines on the preferred approach to treating early-life epilepsy. We examined initial therapy selection in a contemporary US cohort of children with newly diagnosed, nonsyndromic, early-life epilepsy (onset before age three years). METHODS: Seventeen pediatric epilepsy centers participated in a prospective cohort study of children with newly diagnosed epilepsy with onset under 36 months of age. Details regarding demographics, seizure types, and initial medication selections were obtained from medical records...
June 27, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28806464/beyond-back-to-sleep-ways-to-further-reduce-the-risk-of-sudden-infant-death-syndrome
#11
Fern R Hauck, Kawai O Tanabe
Sudden infant death syndrome (SIDS) remains the leading cause of postneonatal mortality in the United States, despite reduction in rates of more than 50% since the initiation of the "Back to Sleep" (now called "Safe to Sleep") campaign in 1994. In recent years, the rate of decline in SIDS deaths has plateaued, even with the ongoing educational efforts that promote safe sleep and other risk reduction measures. The 2016 American Academy of Pediatrics guidelines for reducing the risk of SIDS focus heavily on sleep practices, bedding, and location, but also include factors that often receive less attention (ie, prenatal care, maternal smoking, alcohol and drug use, and childhood vaccinations)...
August 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28801303/health-care-providers-knowledge-of-hpv-vaccination-barriers-and-strategies-in-a-state-with-low-hpv-vaccine-receipt-mixed-methods-study
#12
Echo L Warner, Qian Ding, Lisa Pappas, Julia Bodson, Brynn Fowler, Ryan Mooney, Anne C Kirchhoff, Deanna Kepka
BACKGROUND: Human papillomavirus (HPV) vaccination is below national goals in the United States. Health care providers are at the forefront of improving vaccination in the United States, given their close interactions with patients and parents. OBJECTIVE: The objective of this study was to assess the associations between demographic and practice characteristics of the health care providers with the knowledge of HPV vaccination and HPV vaccine guidelines. Furthermore, our aim was to contextualize the providers' perceptions of barriers to HPV vaccination and strategies for improving vaccination in a state with low HPV vaccine receipt...
August 11, 2017: JMIR Cancer
https://www.readbyqxmd.com/read/28781151/2016-guideline-strategies-for-the-use-of%C3%A2-antifungal-agents-in-patients-with-hematological-malignancies-or-hematopoietic-stem-cell-transplantation-recipients-in-taiwan
#13
REVIEW
Bor-Sheng Ko, Wei-Ting Chen, Hsiang-Chi Kung, Un-In Wu, Jih-Luh Tang, Ming Yao, Yee-Chun Chen, Hwei-Fang Tien, Shan-Chwen Chang, Yin-Ching Chuang, Dong-Tsamn Lin
The Infectious Diseases Society of Taiwan (IDST), the Hematology Society of Taiwan, the Taiwan Society of Blood and Marrow Transplantation, Medical Foundation in Memory of Dr. Deh-Lin Cheng, Foundation of Professor Wei-Chuan Hsieh for Infectious Diseases Research and Education, and CY Lee's Research Foundation for Pediatric Infectious Diseases and Vaccines cooperatively published this guideline for the use of antifungal agents in hematological patients with invasive fungal diseases (IFDs) in Taiwan. The guideline is the first one endorsed by IDST focusing on selection of antifungal strategies, including prophylaxis, empirical (or symptom-driven) and pre-emptive (or diagnostic-driven) strategy...
July 25, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28781150/2016-guidelines-for-the-use-of-antifungal-agents-in-patients-with-invasive-fungal-diseases-in-taiwan
#14
REVIEW
Hsiang-Chi Kung, Po-Yen Huang, Wei-Ting Chen, Bor-Sheng Ko, Yee-Chun Chen, Shan-Chwen Chang, Yin-Ching Chuang
The Infectious Diseases Society of Taiwan, Medical Foundation in Memory of Dr. Deh-Lin Cheng, Foundation of Professor Wei-Chuan Hsieh for Infectious Diseases Research and Education, and CY Lee's Research Foundation for Pediatric Infectious Diseases and Vaccines have updated the guidelines for the use of antifungal agents in adult patients with invasive fungal diseases in Taiwan. This guideline replaces the 2009 version. Recommendations are provided for Candida, Cryptococcus, Aspergillus and Mucormycetes. The focus is based on up-to-date evidence on indications for treatment or prophylaxis of the most common clinical problems...
July 25, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28772287/a-systematic-review-of-speech-assessments-for-children-with-autism-spectrum-disorder-recommendations-for-best-practice
#15
Kate Broome, Patricia McCabe, Kimberley Docking, Maree Doble
Purpose: The purpose of this systematic review was to provide a summary and evaluation of speech assessments used with children with autism spectrum disorders (ASD). A subsequent narrative review was completed to ascertain the core components of an evidence-based pediatric speech assessment, which, together with the results of the systematic review, provide clinical and research guidelines for best practice. Method: A systematic search of eight databases was used to find peer-reviewed research articles published between 1990 and 2014 assessing the speech of children with ASD...
August 15, 2017: American Journal of Speech-language Pathology
https://www.readbyqxmd.com/read/28759346/antiemetics-american-society-of-clinical-oncology-clinical-practice-guideline-update
#16
Paul J Hesketh, Mark G Kris, Ethan Basch, Kari Bohlke, Sally Y Barbour, Rebecca Anne Clark-Snow, Michael A Danso, Kristopher Dennis, L Lee Dupuis, Stacie B Dusetzina, Cathy Eng, Petra C Feyer, Karin Jordan, Kimberly Noonan, Dee Sparacio, Mark R Somerfield, Gary H Lyman
Purpose To update the ASCO guideline for antiemetics in oncology. Methods ASCO convened an Expert Panel and conducted a systematic review of the medical literature for the period of November 2009 to June 2016. Results Forty-one publications were included in this systematic review. A phase III randomized controlled trial demonstrated that adding olanzapine to antiemetic prophylaxis reduces the likelihood of nausea among adult patients who are treated with high emetic risk antineoplastic agents. Randomized controlled trials also support an expanded role for neurokinin 1 receptor antagonists in patients who are treated with chemotherapy...
July 31, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28758610/reducing-second-gram-negative-antibiotic-therapy-on-pediatric-oncology-and-hematopoietic-stem-cell-transplantation-services
#17
Rachel L Wattier, Emily R Levy, Amit J Sabnis, Christopher C Dvorak, Andrew D Auerbach
OBJECTIVE To evaluate interventions to reduce avoidable antibiotic use on pediatric oncology and hematopoietic stem cell transplantation (HSCT) services. DESIGN Interrupted time series. SETTING Academic pediatric hospital with separate oncology and HSCT services. PARTICIPANTS Children admitted to the services during baseline (October 2011-August 2013) and 2 intervention periods, September 2013-June 2015 and July 2015-June 2016, including 1,525 oncology hospitalizations and 301 HSCT hospitalizations. INTERVENTION In phase 1, we completed an update of the institutional febrile neutropenia (FN) guideline for the pediatric oncology service, recommending first-line β-lactam monotherapy rather than routine use of 2 gram-negative agents...
July 31, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28756639/diagnosis-and-treatment-of-community-acquired-pneumonia-in-adults-2016-clinical-practice-guidelines-by-the-chinese-thoracic-society-chinese-medical-association
#18
REVIEW
Bin Cao, Yi Huang, Dan-Yang She, Qi-Jian Cheng, Fan Hong, Xin-Lun Tian, Jin-Fu Xu, Jing Zhang, Yu Chen, Ning Shen, Hui Wang, Mei Jiang, Xiang-Yan Zhang, Yi Shi, Bei He, Li-Xian He, You-Ning Liu, Jie-Ming Qu
Community-acquired pneumonia (CAP) in adults is an infectious disease with high morbidity in China and the rest of the world. With the changing pattern in the etiological profile of CAP and advances in medical techniques in diagnosis and treatment over time, Chinese Thoracic Society of Chinese Medical Association updated its CAP guideline in 2016 to address the standard management of CAP in Chinese adults. Extensive and comprehensive literature search was made to collect the data and evidence for experts to review and evaluate the level of evidence...
July 29, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28754601/magnesium-sulfate-infusion-for-acute-asthma-in-the-emergency-department
#19
REVIEW
Jose Enrique Irazuzta, Nicolas Chiriboga
OBJECTIVES: To describe the role of intravenous magnesium sulfate (MgSO4) as therapy for acute severe asthma in the pediatric emergency department (ED). SOURCE: Publications were searched in the PubMed and Cochrane databases using the following keywords: magnesium AND asthma AND children AND clinical trial. A total of 53 publications were retrieved using this criteria. References of relevant articles were also screened. The authors included the summary of relevant publications where intravenous magnesium sulfate was studied in children (age <18 years) with acute asthma...
July 26, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28754198/practice-paper-of-the-academy-of-nutrition-and-dietetics-classic-and-modified-ketogenic-diets-for-treatment-of-epilepsy
#20
Kelly Roehl, Sarika L Sewak
Ketogenic diet (KD) therapy is an established form of treatment for both pediatric and adult patients with intractable epilepsy. Ketogenic diet is a term that refers to any diet therapy in which dietary composition would be expected to result in a ketogenic state of human metabolism. While historically considered a last-resort therapy, classic KDs and their modified counterparts, including the modified Atkins diet and low glycemic index treatment, are gaining ground for use across the spectrum of seizure disorders...
August 2017: Journal of the Academy of Nutrition and Dietetics
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