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https://www.readbyqxmd.com/read/29925574/improving-guideline-based-streptococcal-pharyngitis-testing-a-quality-improvement-initiative
#1
Laura E Norton, Brian R Lee, Lory Harte, Keith Mann, Jason G Newland, R Alan Grimes, Angela L Myers
BACKGROUND AND OBJECTIVES: Acute pharyngitis is a common diagnosis in ambulatory pediatrics. The Infectious Diseases Society of America (IDSA) clinical practice guideline for group A streptococcal (GAS) pharyngitis recommends strict criteria for GAS testing to avoid misdiagnosis and unnecessary treatment of children who are colonized with group A Streptococcus . We sought to improve adherence to the IDSA guideline for testing and treatment of GAS pharyngitis in a large community pediatrics practice...
June 20, 2018: Pediatrics
https://www.readbyqxmd.com/read/29925468/hospital-type-predicts-computed-tomography-use-for-pediatric-appendicitis
#2
Kathryn Tinsley Anderson, Marisa A Bartz-Kurycki, Mary T Austin, Akemi L Kawaguchi, Lillian S Kao, Kevin P Lally, Kuojen Tsao
BACKGROUND: Evidence-based guidelines recommend ultrasound (US) over computed tomography (CT) as the primary imaging modality for suspected pediatric appendicitis. Continued high rates of CT use may result in significant unnecessary radiation exposure in children. The purpose of this study was to evaluate variables associated with preoperative CT use in pediatric appendectomy patients. METHODS: A retrospective cohort study of pediatric patients who underwent appendectomy for acute appendicitis in 2015-2016 at National Surgical Quality Improvement Program for Pediatrics (NSQIP-P) hospitals was conducted...
May 29, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29912455/pediatric-head-ct-exposure-doses-in-tunisia-a-pilot-study-towards-the-establishment-of-national-diagnostic-reference-levels
#3
Abir Bouaoun, Latifa Ben Omrane, Mohamed Mogaadi, Wièm Douira Khomsi, Asma Zidi, Azza Hammou
The purpose of this study was to assess and analyze the radiation doses during head pediatric CT from different CT units within six Tunisian hospitals representing different geographic regions in order to optimize the dose given and minimize the radiology risk to this category of patients and towards the derivation of national diagnostic reference levels. Patient data and exposure parameters were collected for four age groups (<1, 1-5, 5-10 and 10-15 y). Clinical protocols and exposure settings were analyzed...
April 18, 2018: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/29907534/significant-infections-in-liver-transplant-recipients-undergoing-endoscopic-retrograde-cholangiography-are-few-and-unaffected-by-prophylactic-antibiotics
#4
Divyanshoo R Kohli, Tilak U Shah, Doumit S BouHaidar, Ravi Vachhani, M Shadab Siddiqui
INTRODUCTION: Current practice guidelines recommend prophylactic antibiotics prior to endoscopic retrograde cholangiopancreatography (ERCP) in liver transplant recipients (LTR). This study evaluated the risk of clinically significant infections after ERCP in LTR who received antibiotic prophylaxis compared to those who did not. METHODS: This retrospective case-cohort study evaluated all LTR who underwent elective, outpatient ERCP from 2008 to 2015. Hospitalized patients, pediatric allograft recipients and patients with cholangitis or incomplete biliary drainage were excluded...
May 28, 2018: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29905617/impact-of-clinical-guidelines-on-revisits-after-ambulatory-pediatric-adenotonsillectomy
#5
Helen H Lee, Nicholas M Dalesio, Anthony T Lo Sasso, William C Van Cleve
BACKGROUND: Pediatric adenotonsillectomies are common and carry known risks of potentially severe complications. Complications that require a revisit, to either the emergency department or hospital readmission, increase costs and may be tied to lower reimbursements by federal programs. In 2011 and 2012, recommendations by pediatric and surgical organizations regarding selection of candidates for ambulatory procedures were issued. We hypothesized that guideline-associated changes in practice patterns would lower the odds of revisits...
June 12, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29905515/diagnosis-of-primary-ciliary-dyskinesia-an-official-american-thoracic-society-clinical-practice-guideline
#6
Adam J Shapiro, Stephanie D Davis, Deepika Polineni, Michele Manion, Margaret Rosenfeld, Sharon D Dell, Mark A Chilvers, Thomas W Ferkol, Maimoona A Zariwala, Scott D Sagel, Maureen Josephson, Lucy Morgan, Ozge Yilmaz, Kenneth N Olivier, Carlos Milla, Jessica E Pittman, M Leigh Anne Daniels, Marcus Herbert Jones, Ibrahim A Janahi, Stephanie M Ware, Sam J Daniel, Matthew L Cooper, Lawrence M Nogee, Billy Anton, Tori Eastvold, Lynn Ehrne, Elena Guadagno, Michael R Knowles, Margaret W Leigh, Valery Lavergne
BACKGROUND: This document presents the American Thoracic Society clinical practice guidelines for the diagnosis of primary ciliary dyskinesia (PCD). TARGET AUDIENCE: Clinicians investigating adult and pediatric patients for possible PCD. METHODS: Systematic reviews and, when appropriate, meta-analyses were conducted to summarize all available evidence pertinent to our clinical questions. Evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach for diagnosis and discussed by a multidisciplinary panel with expertise in PCD...
June 15, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29905398/comparison-of-fixed-versus-traditional-weight-based-dosing-of-rasburicase-in-a-pediatric-population
#7
Dimitrios A Savva, Nicole Herrera, Radha Rohatgi
BACKGROUND: The American Society of Clinical Oncology guidelines recommend rasburicase for the treatment of pediatric patients with hyperuricemia at risk of tumor lysis syndrome (TLS) using a weight-based dose of 0.1-0.2 mg/kg once daily for 1-7 days. However, there has been a trend in practice due to recent data showing benefit using a fixed-dose approach. The purpose of this study was to evaluate the efficacy and safety between fixed and weight-based dosing of rasburicase in a pediatric population...
June 15, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29904575/recent-advances-in-transfusions-in-neonates-infants
#8
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/29904370/vitamin-d-supplementation-guidelines-for-general-population-and-groups-at-risk-of-vitamin-d-deficiency-in-poland-recommendations-of-the-polish-society-of-pediatric-endocrinology-and-diabetes-and-the-expert-panel-with-participation-of-national-specialist-consultants
#9
REVIEW
Agnieszka Rusińska, Paweł Płudowski, Mieczysław Walczak, Maria K Borszewska-Kornacka, Artur Bossowski, Danuta Chlebna-Sokół, Justyna Czech-Kowalska, Anna Dobrzańska, Edward Franek, Ewa Helwich, Teresa Jackowska, Maria A Kalina, Jerzy Konstantynowicz, Janusz Książyk, Andrzej Lewiński, Jacek Łukaszkiewicz, Ewa Marcinowska-Suchowierska, Artur Mazur, Izabela Michałus, Jarosław Peregud-Pogorzelski, Hanna Romanowska, Marek Ruchała, Piotr Socha, Mieczysław Szalecki, Mirosław Wielgoś, Danuta Zwolińska, Arkadiusz Zygmunt
Introduction: Vitamin D deficiency is an important public health problem worldwide. Vitamin D deficiency confers a significant risk for both skeletal and non-skeletal disorders and a number of lifelong negative health outcomes. The objectives of this evidence-based guidelines document are to provide health care professionals in Poland, an updated recommendation for the prevention, diagnosis and treatment of vitamin D deficiency. Methods: A systematic literature search examining the prevention and treatment strategies for vitamin D deficiency was conducted...
2018: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/29902155/prevalence-of-cranial-mri-findings-in-girls-with-central-precocious-puberty-a-systematic-review-and-meta-analysis
#10
Sena Cantas-Orsdemir, Jane L Garb, Holley F Allen
CONTEXT: Some pediatric endocrinologists recommend that girls with central precocious puberty (CPP) have cranial magnetic resonance imaging (MRI) performed only if they are younger than 6 years of age. However, no practice guidelines exist. OBJECTIVE: To assess the frequency of intracranial lesions in girls with CPP. STUDY DESIGN: We searched six electronic databases (PubMed, Cochrane, Web of Science, SCOPUS, ProQuest, and Dissertation & Theses) from 1990 through December 2015...
June 14, 2018: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/29901556/universal-recommendations-for-the-management-of-acute-diarrhea-in-non-malnourished-children
#11
Alfredo Guarino, Andrea Lo Vecchio, Jorge Amil Dias, James A Berkley, Chris Boey, Dario Bruzzese, Mitchell B Cohen, Sylvia Cruchet, Ilaria Liguoro, Eduardo Salazar-Lindo, Bhupinder Sandhu, Philip M Sherman, Toshiaki Shimizu
OBJECTIVES: Despite a substantial consistency in recommendations for the management of children with acute gastroenteritis (AGE), a high variability in clinical practice and a high rate of inappropriate medical interventions persist in both developing and developed countries.Aim of this study was to develop a set of clinical recommendations for the management of non-severely malnourished children with AGE to be applied worldwide. METHODS: The Federation of International Societies of Pediatric Gastroenterology, Hepatology, and Nutrition (FISPGHAN) Working Group (WG) selected care protocols on the management of acute diarrhea in infants and children aged between 1 month and 18 years...
June 12, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29898974/practice-guideline-update-summary-efficacy-and-tolerability-of-the-new-antiepileptic-drugs-ii-treatment-resistant-epilepsy-report-of-the-guideline-development-dissemination-and-implementation-subcommittee-of-the-american-academy-of-neurology-and-the-american
#12
Andres M Kanner, Eric Ashman, David Gloss, Cynthia Harden, Blaise Bourgeois, Jocelyn F Bautista, Bassel Abou-Khalil, Evren Burakgazi-Dalkilic, Esmeralda Llanas Park, John Stern, Deborah Hirtz, Mark Nespeca, Barry Gidal, Edward Faught, Jacqueline French
OBJECTIVE: To update the 2004 American Academy of Neurology guideline for managing treatment-resistant (TR) epilepsy with second- and third-generation antiepileptic drugs (AEDs). METHODS: 2004 criteria were used to systemically review literature (January 2003 to November 2015), classify pertinent studies according to the therapeutic rating scheme, and link recommendations to evidence strength. RESULTS: Forty-two articles were included. RECOMMENDATIONS: The following are established as effective to reduce seizure frequency (Level A): immediate-release pregabalin and perampanel for TR adult focal epilepsy (TRAFE); vigabatrin for TRAFE (not first-line treatment); rufinamide for Lennox-Gastaut syndrome (LGS) (add-on therapy)...
June 13, 2018: Neurology
https://www.readbyqxmd.com/read/29898971/practice-guideline-update-summary-efficacy-and-tolerability-of-the-new-antiepileptic-drugs-i-treatment-of-new-onset-epilepsy-report-of-the-guideline-development-dissemination-and-implementation-subcommittee-of-the-american-academy-of-neurology-and-the-american
#13
Andres M Kanner, Eric Ashman, David Gloss, Cynthia Harden, Blaise Bourgeois, Jocelyn F Bautista, Bassel Abou-Khalil, Evren Burakgazi-Dalkilic, Esmeralda Llanas Park, John Stern, Deborah Hirtz, Mark Nespeca, Barry Gidal, Edward Faught, Jacqueline French
OBJECTIVE: To update the 2004 American Academy of Neurology (AAN) guideline for treating new-onset focal or generalized epilepsy with second- and third-generation antiepileptic drugs (AEDs). METHODS: The 2004 AAN criteria were used to systematically review literature (January 2003-November 2015), classify pertinent studies according to the therapeutic rating scheme, and link recommendations to evidence strength. RESULTS: Several second-generation AEDs are effective for new-onset focal epilepsy...
June 13, 2018: Neurology
https://www.readbyqxmd.com/read/29895740/kids-safe-and-smokefree-kiss-multilevel-intervention-to-reduce-child-tobacco-smoke-exposure-long-term-results-of-a-randomized-controlled-trial
#14
Stephen J Lepore, Bradley N Collins, Donna L Coffman, Jonathan P Winickoff, Uma S Nair, Beth Moughan, Tyra Bryant-Stephens, Daniel Taylor, David Fleece, Melissa Godfrey
BACKGROUND: Pediatricians following clinical practice guidelines for tobacco intervention (&ldquo;Ask, Advise, and Refer&rdquo; [AAR]) can motivate parents to reduce child tobacco smoke exposure (TSE). However, brief clinic interventions are unable to provide the more intensive, evidence-based behavioral treatments that facilitate the knowledge, skills, and confidence that parents need to both reduce child TSE and quit smoking. We hypothesized that a multilevel treatment model integrating pediatric clinic-level AAR with individual-level, telephone counseling would promote greater long-term (12-month) child TSE reduction and parent smoking cessation than clinic-level AAR alone...
June 12, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29894519/pediatric-to-adult-healthcare-transitioning-for-adolescents-living-with-hiv-in-nigeria-a-national-survey
#15
Okikiolu A Badejo, William N A Menson, Nadia A Sam-Agudu, Jennifer Pharr, Salome Erekaha, Tamara Bruno, Gift Nwanne, Olabanjo Ogunsola, Jude Ilozumba, Olusegun Busari, Echezona E Ezeanolue
INTRODUCTION: The period of transition from pediatric to adult care has been associated with poor health outcomes among 10-19 year old adolescents living with HIV (ALHIV). This has prompted a focus on the quality of transition services, especially in high ALHIV-burden countries. Due to lack of guidelines, there are no healthcare transition standards for Nigeria's estimated 240,000 ALHIV. We conducted a nationwide survey to characterize routine transition procedures for Nigerian ALHIV...
2018: PloS One
https://www.readbyqxmd.com/read/29889938/association-of-gestational-diabetes-and-type-2-diabetes-exposure-in-utero-with-the-development-of-type-2-diabetes-in-first-nations-and-non-first-nations-offspring
#16
Brandy A Wicklow, Elizabeth A C Sellers, Atul K Sharma, Kristine Kroeker, Nathan C Nickel, Wanda Philips-Beck, Garry X Shen
Importance: Type 2 diabetes is increasing worldwide, disproportionately affecting First Nations (FN) people. Identifying early-life determinants of type 2 diabetes is important to address the intergenerational burden of illness. Objective: To investigate the association of in utero exposure to gestational diabetes and type 2 diabetes, stratified by FN status, with the development of type 2 diabetes in offspring. Design, Setting, and Participants: This cohort study was derived from the linkage of a pediatric diabetes clinical database and a population-based research data repository in Manitoba, Canada...
June 11, 2018: JAMA Pediatrics
https://www.readbyqxmd.com/read/29889726/evolution-of-delivery-room-management-for-meconium-stained-infants-recent-updates
#17
Shilpi Chabra
BACKGROUND: The approach to intrapartum and postnatal management of an infant born through meconium-stained amniotic fluid (MSAF) in the delivery room (DR) has changed several times over the last few decades, leading to confusion and anxiety among health care providers (nurses, nurse practitioners, respiratory therapists, midwives, and physicians). This article provides state-of-the-art insight into the evidence or lack thereof for the changes in guidelines. PURPOSE: To discuss the evidence for evolution of DR management of vigorous and nonvigorous infants born through any type of MSAF...
June 8, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29886914/development-of-consensus-based-best-practice-guidelines-for-perioperative-management-of-blood-loss-in-patients-undergoing-posterior-spinal-fusion-for-adolescent-idiopathic-scoliosis
#18
Nicholas D Fletcher, Michelle C Marks, Jahangir K Asghar, Steven W Hwang, Paul D Sponseller, Peter O Newton
STUDY DESIGN: Delphi process with multiple iterative rounds using a nominal group technique. OBJECTIVE: The aim of this study was to use expert opinion to achieve consensus on various methods for minimizing blood loss in patients undergoing posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS). BACKGROUND DATA: Perioperative blood loss management represents a critical component of safely performing PSF in children with AIS...
July 2018: Spine Deformity
https://www.readbyqxmd.com/read/29882678/screening-and-assessment-of-chronic-pain-among-children-with-cerebral-palsy-a-process-evaluation-of-a-pain-toolbox
#19
Taryn Orava, Christine Provvidenza, Ashleigh Townley, Shauna Kingsnorth
PURPOSE: Though high numbers of children with cerebral palsy experience chronic pain, it remains under-recognized. This paper describes an evaluation of implementation supports and adoption of the Chronic Pain Assessment Toolbox for Children with Disabilities (the Toolbox) to enhance pain screening and assessment practices within a pediatric rehabilitation and complex continuing care hospital. METHODS: A multicomponent knowledge translation strategy facilitated Toolbox adoption, inclusive of a clinical practice guideline, cerebral palsy practice points and assessment tools...
June 8, 2018: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29876329/peripheral-facial-palsy-in-emergency-department
#20
José Ferreira-Penêda, Raquel Robles, Isabel Gomes-Pinto, Pedro Valente, Nuno Barros-Lima, Artur Condé
Introduction: Peripheral facial palsy (PFP) is commonly diagnosed in every emergency department. Despite being a benign condition in most cases, PFP causes loss in quality of life mostly due to facial dysmorphia. The etiology of PFP remains unknown in most cases, while medical opinion on epidemiology, risk factors and optimal treatment is not consensual. The aim of this study was to review the demographic characteristics of our patients and the medical care administered in our emergency department...
May 2018: Iranian Journal of Otorhinolaryngology
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