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Office pediatrics

Daniel S Budnitz, Maribeth C Lovegrove, Mathew R P Sapiano, Justin Mathew, Scott R Kegler, Andrew I Geller, Christian Hampp
Expanding access to office-based medication-assisted treatment with buprenorphine/naloxone for opioid dependence is a key part of the national strategy to address the opioid abuse epidemic (1). However, as buprenorphine/naloxone prescribing increased, emergency department (ED) visits and hospitalizations for unsupervised ingestions by young children began to increase, with buprenorphine/naloxone ingestions becoming the most common cause of hospitalization for medication ingestions by young children during 2010-2011 (2)...
October 21, 2016: MMWR. Morbidity and Mortality Weekly Report
Erin E Shaughnessy, Erika L Stalets, Samir S Shah
PURPOSE OF REVIEW: This review covers the outpatient management of pediatric community-acquired pneumonia (CAP), discussing the changing microbiology of CAP since the introduction of the 13-valent pneumococcal conjugate vaccine in 2010, and providing an overview of national guideline recommendations for diagnostic evaluation and treatment. RECENT FINDINGS: Rates of invasive pneumococcal disease and pneumococcal antibiotic resistance have plummeted since widespread 13-valent pneumococcal conjugate vaccine immunization...
October 15, 2016: Current Opinion in Pediatrics
Jennifer Shin Zank, Rani Singh, Michele Carney
Vigorous coughing leading to internal carotid artery dissection has been described in the adult literature but has not been reported in the pediatric population. We describe an 8-year-old right-handed girl who had a 1-week history of increased work of breathing and vigorous coughing. She initially presented to her pediatrician's office for her respiratory symptoms which improved with steroid therapy and albuterol treatments. However, she developed evolving left-sided motor weakness over the course of 2 days and presented to our pediatric emergency department where she was found to have an ischemic stroke in the right corona radiata with a right internal carotid artery dissection...
October 2016: Pediatric Emergency Care
Derek P Bitner, Sharon F Freedman
PURPOSE: Diurnal fluctuation of intraocular pressure (IOP), implicated in progression of adult glaucoma, has been reported in children only in the context of office and short-term home monitoring. The purpose of this study was to evaluate long-term patterns of IOP fluctuation and changes resulting from outflow-enhancing intervention in pediatric glaucoma. METHODS: Parent-measured home-based rebound tonometry (Icare, Finland Oy) in pediatric glaucoma patients was studied prospectively...
October 1, 2016: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Mark Rosenfield, Kenneth J Ciuffreda
PURPOSE: The SVOne is a portable, Hartmann-Shack wavefront aberrometer, which can be attached to a smartphone to determine the refractive error of the eye objectively. Previous results have shown the device to provide measurements equivalent to those of standard clinical techniques in young, healthy adults. The aim of the present study was to compare the findings of the SVOne with retinoscopy, subjective refraction, and two commercially available autorefractors (Retinomax-3 and WAM-5500) in a pediatric population...
September 23, 2016: Optometry and Vision Science: Official Publication of the American Academy of Optometry
Manisha Gandhi, Anitra Beasley, Emily Vinas, Haleh Sangi-Haghpeykar, Susan M Ramin, Charlie C Kilpatrick
OBJECTIVE: To evaluate the use of mobile technology to facilitate resident learning, assess clinical knowledge, and guide curricular development in a busy clinical environment. METHODS: This was a cross-sectional study conducted in a large (N=48) urban obstetrics and gynecology residency program. Question sets were created in the following areas: office gynecology, general obstetrics, gynecologic surgery and urogynecology, maternal-fetal medicine and ultrasonography, reproductive endocrinology and pediatric gynecology, and gynecologic oncology...
October 2016: Obstetrics and Gynecology
Jane M Garbutt, Neil Bobenhouse, Sherry Dodd, Randall Sterkel, Robert C Strunk
OBJECTIVE: To determine if parents are receptive to discussing firearm safety with their pediatrician. STUDY DESIGN: Parents completed a self-administered paper survey during a pediatric office visit. Responses of those who confirmed and denied household firearms were compared using Fisher exact test. RESULTS: Between March 23 and May 21, 2015, 1246 of 1363 eligible parents (91.4%) completed the survey (22.6% African American, 79.5% at least some college education); 36% of respondents reported household firearms (owners)...
September 8, 2016: Journal of Pediatrics
K Eckert, N Janssen, M Franz, P Liedgens
BACKGROUND: Removing boys' foreskins, even for medical reasons, is increasingly and critically discussed. The aim of this study is to retrospectively verify if the indication for the removal of boys' foreskins was justified. The study is based on the records of boys who underwent preputial operation in an outpatient medical office for pediatric surgery. METHODS: Preoperative clinical findings, complaints, applied conservative and/or surgical procedures and histological results of the resected foreskins of boys, who underwent preputial operation between 2013-2015, were retrospectively analyzed...
September 16, 2016: Der Urologe. Ausg. A
Bruce Taubman, Jennifer McHugh, Florence Rosen, Okan U Elci
The authors enrolled 95 patients in a primary care office who presented with a concussion. Of these patients, 63% were sport concussions. The authors matched 90 of these patients to children in the authors' practice presenting for sports physicals or regular check-ups in the following demographics: age, participating in a particular sport, having attention-deficit disorder/attention-deficit hyperactivity disorder, gender, and grade. The authors found the odds of recurrent concussions, in a primary care pediatric office, to be a ratio of 2...
September 12, 2016: Journal of Child Neurology
Bruno Gonçalves Schröder E Souza, Tiago Evangelista de Melo, Tales Pereira Lisboa, Marcos Bastos Miranda, Thiago Gonçalves Schroder E Souza, Valdeci Manoel de Oliveira
OBJECTIVE: to obtain information about the current knowledge and habits of parents who transport children in cars in Brazil. METHODS: a cross-sectional survey was conducted using specifically designed self-responded questionnaires, to parents of children attending a private pediatric office in town in southwest Brazil. Data was collected about children's age, gender, height and weight, possession of automobile children's restraint systems (CRS), its type, frequency and adequacy of use, reasons for not possessing or not using the devices...
September 13, 2016: Traffic Injury Prevention
Leslie A Sim, Jocelyn Lebow, Zhen Wang, Afton Koball, M Hassan Murad
CONTEXT: Although practice guidelines suggest that primary care providers working with children and adolescents incorporate BMI surveillance and counseling into routine practice, the evidence base for this practice is unclear. OBJECTIVE: To determine the effect of brief, primary care interventions for pediatric weight management on BMI. DATA SOURCES: Medline, CENTRAL, Embase, PsycInfo, and CINAHL were searched for relevant publications from January 1976 to March 2016 and cross-referenced with published studies...
September 12, 2016: Pediatrics
Kathleen J Maguire, Norman Y Otsuka
: Shoulder dislocation is relatively uncommon in the younger pediatric population. Because of the relative strength of the surrounding soft tissue structures of the shoulder compared with the proximal humeral physis, subluxation or dislocation resulting from a traumatic event or application of force is rare and instead a proximal humeral physeal injury occurs. Case presentation - We present a 5-year-old male who presented to the office with post-traumatic left shoulder pain for about 1 week...
September 3, 2016: Journal of Pediatric Orthopedics. Part B
Hector E James
OBJECTIVE The author describes the creation, structuring, and development of a pediatric neurosurgery telemedicine clinic (TMC) to provide telehealth across geographical, time, social, and cultural barriers. METHODS In July 2009 the University of Florida (UF) Division of Pediatric Neurosurgery received a request from the Southeast Georgia Health District (Area 9-2) to provide a TMC to meet regional needs. The Children's Medical Services (CMS) of the State of Georgia installed telemedicine equipment and site-to-site connectivity...
September 2, 2016: Journal of Neurosurgery. Pediatrics
Bruce Taubman, Florence Rosen, Jennifer McHugh, Matthew F Grady, Okan U Elci
Immediate cognitive and physical rest in the concussed patient is almost universally recommended in the concussion literature. The authors conducted a prospective observational in a primary care pediatric office to examine the effect of delayed cognitive and physical rest had on recovery time in pediatric concussion. The authors found that patients who started cognitive and physical rest immediately after injury were more likely to recover within 30 days compared to patients who delayed cognitive and physical rest for 1-7 days after their injury (67% vs 35%, P = ...
August 31, 2016: Journal of Child Neurology
Nicholas D Fletcher, Bryan J Sirmon, Ashton S Mansour, William E Carpenter, Laura A Ward
PURPOSE: Outcomes are excellent following surgical management of displaced supracondylar humerus fractures. Short delays until surgical fixation have been shown to be equivalent to immediate fixation with regards to complications. We hypothesized that insurance coverage may impact access to care and the patient's ability to return to the operating room for outpatient surgery. METHODS: A retrospective review of supracondylar humerus fractures treated at a large urban pediatric hospital from 2008 to 2012 was performed...
October 2016: Journal of Children's Orthopaedics
Kate Russell, Sara E Oliver, Lillianne Lewis, Wanda D Barfield, Janet Cragan, Dana Meaney-Delman, J Erin Staples, Marc Fischer, Georgina Peacock, Titilope Oduyebo, Emily E Petersen, Sherif Zaki, Cynthia A Moore, Sonja A Rasmussen
CDC has updated its interim guidance for U.S. health care providers caring for infants born to mothers with possible Zika virus infection during pregnancy (1). Laboratory testing is recommended for 1) infants born to mothers with laboratory evidence of Zika virus infection during pregnancy and 2) infants who have abnormal clinical or neuroimaging findings suggestive of congenital Zika syndrome and a maternal epidemiologic link suggesting possible transmission, regardless of maternal Zika virus test results...
2016: MMWR. Morbidity and Mortality Weekly Report
Dana Dykes, Elizabeth Williams, Peter Margolis, Jennifer Ruschman, Julianne Bick, Shehzad Saeed, Lisa Opipari
Standardization of Inflammatory Bowel Disease (IBD) care through participation in the ImproveCareNow (ICN) Network has improved outcomes for pediatric patients with IBD, but under the current care model, our improvements have plateaued. Current ICN model care guidelines recommend health supervision visits every six months. We identified a gap in our practice's ability to ensure either a routine six month follow-up or a rapid follow-up after a disease flare, and a significant number of patients with active disease status during a six month period lacked timely reassessment after interventions or medication changes...
2016: BMJ Quality Improvement Reports
Elise W Sarvas, Scott A Schwantes, Jeffrey M Karp
Pediatric dentists are the primary providers of dental homes for children with life-threatening and complex chronic conditions. These children are increasingly living at home and seeking health care in community-based settings, including dental offices. Pediatric dentists may feel ill prepared to assume the roles and responsibilities of a pediatric palliative care provider due to limited education and training during dental school and residency; however, they should be sensitive to the palliative care needs of children and families...
2016: Pediatric Dentistry
Roger C Haut, Feng Wei
This review was prepared for the American Society of Mechanical Engineers H.R. Lissner Medal. It specifically discusses research performed in Michigan State University (MSU) on pediatric cranial bone mechanics and patterns of fracture. Cranial fractures are often seen during the investigation of pediatric trauma cases litigated in courts. While forensic anthropologists and biomechanists are often called on to testify in these cases, there is little basic science developed in support of their testimony. The following is a review of studies conducted in MSU and supported by the National Institute of Justice to begin an understanding of the mechanics and patterns of pediatric cranial bone fracture...
August 16, 2016: Journal of Biomechanical Engineering
Katherine A Pohlman, Linda Carroll, Lisa Hartling, Ross Tsuyuki, Sunita Vohra
OBJECTIVE: The purpose of this cross-sectional survey was to evaluate attitudes and opinions of doctors of chiropractic (DCs) specializing in pediatric care toward patient safety. METHODS: The Medical Office Survey on Patient Safety Culture of the Agency for Healthcare Research and Quality was adapted for providers who use spinal manipulation therapy and sent out to 2 US chiropractic organizations' pediatric council members (n = 400) between February and April 2014...
September 2016: Journal of Manipulative and Physiological Therapeutics
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