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https://www.readbyqxmd.com/read/28449382/current-use-of-chromosomal-microarray-by-australian-paediatricians-and-implications-for-the-implementation-of-next-generation-sequencing
#1
Victoria McKay, Daryl Efron, Elizabeth E Palmer, Susan M White, Chris Pearson, Margie Danchin
AIM: Chromosomal microarray (CMA) is an important diagnostic test for children with multiple congenital anomalies or certain developmental behavioural problems suggestive of an underlying genetic diagnosis. However, there are medical and ethical complexities to its use and few Australian policies to guide practice. We aimed to describe the current practice of Australian paediatricians in relation to CMA testing. We hypothesised that there are knowledge gaps in their use of CMA. METHODS: Online survey completed between September 2015 and January 2016 by paediatricians in secondary care settings...
April 27, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28444652/-establishment-of-specialized-pediatric-palliative-home-care-in-the-medical-valley-of-the-european-metropolitan-area-nuremberg
#2
Steven Hébert, Chara Gravou-Apostolatou, Wolfgang Rascher
Background As part of the 2007 health reform in Germany the structure of outpatient palliative care for children and adolescents was adopted for the first time and then implemented in Erlangen-Nuremberg in 2009. Methods The introduction of Pediatric Palliative Home Care (PPHC) at the Hospital for Children and Adolescents at the University of Erlangen-Nuremberg was retrospectively analyzed between the years 2009 to 2014. Referring medical records (paper-based and electronic) were evaluated systematically. Results Considering 69 patients within this study, 44 (63...
March 2017: Klinische Pädiatrie
https://www.readbyqxmd.com/read/28443269/epidemiology-and-risk-assessment-of-pediatric-venous-thromboembolism
#3
REVIEW
Arash Mahajerin, Stacy E Croteau
The incidence of diagnosed venous thromboembolism (VTE) has been increasing concurrent with advances in technology and medical care that enhance our ability to treat pediatric patients with critical illness or complex multiorgan system dysfunction. Although the overall incidence of VTE is estimated at 0.07-0.49 per 10,000 children, higher rates are observed in specific populations including hospitalized children, those with central venous catheters (CVCs) or patients convalescing from a major surgery. While the absolute number of pediatric VTE events may seem trivial compared to adults, the increasing incidence, associated with increased mortality and morbidity, the availability of novel therapies, and the impact on the cost of care have made investigation of VTE risk factors and prevention strategies a high priority...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28442472/functional-and-metabolomic-consequences-of-atp-dependent-potassium-channel-inactivation-in-human-islets
#4
Changhong Li, Amanda M Ackermann, Kara E Boodhansingh, Tricia R Bhatti, Chengyang Liu, Jonathan Schug, Nicolai Doliba, Bing Han, Karen E Cosgrove, Indraneel Banerjee, Franz M Matschinsky, Itzhak Nissim, Klaus H Kaestner, Ali Naji, N Scott Adzick, Mark J Dunne, Charles A Stanley, Diva D De León
Loss-of-function mutations of β-cell KATP channels cause the most severe form of congenital hyperinsulinism (KATPHI). KATPHI is characterized by fasting and protein-induced hypoglycemia that is unresponsive to medical therapy. For a better understanding of the pathophysiology of KATPHI, we examined cytosolic calcium, insulin secretion, oxygen consumption, and [U-(13)C]glucose metabolism in islets isolated from the pancreases of children with KATPHI who required pancreatectomy. Basal cytosolic calcium ([Ca(2+)] i ) and insulin secretion were higher in KATPHI islets compared to controls...
April 25, 2017: Diabetes
https://www.readbyqxmd.com/read/28438375/racial-and-ethnic-differences-in-pediatric-readmissions-for-common-chronic-conditions
#5
Kavita Parikh, Jay Berry, Matt Hall, Grant M Mussman, Amanda Montalbano, Joanna Thomson, Rustin Morse, Karen M Wilson, Samir S Shah
OBJECTIVE: To compare the timing and magnitude of variation of pediatric readmission rates across race/ethnicity for selected chronic conditions: asthma, diabetes, seizures, migraines, and depression. STUDY DESIGN: Retrospective analysis of hospitalizations at 48 children's hospitals in the 2013 Pediatric Health Information System database for children (ages 0-18 years) admitted for asthma (n = 36 910), seizure (n = 35 361), diabetes (n = 12 468), migraine (n = 5882), and depression (n = 5132)...
April 21, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28438026/intramuscular-lorazepam-for-status-epilepticus-in-children-with-complex-medical-and-physical-disabilities
#6
Peter N Johnson, Anna Nguyen, Stephen B Neely, Michael Johnson
BACKGROUND: A protocol was developed to achieve status epilepticus (SE) resolution: step 1, intramuscular (IM) lorazepam; step 2, repeat IM lorazepam; step 3, rectal diazepam. OBJECTIVE: The primary objective was to identify the number of patients with SE resolution after step 1. Secondary objectives included categorization of mean number of IM doses per episode and patient factors associated with SE resolution. METHODS: This was a retrospective study of patients <21 years old with complex medical and physical disabilities admitted over 5 years...
April 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28431063/left-ventricular-dysfunction-is-associated-with-frequent-premature-ventricular-complexes-and-asymptomatic-ventricular-tachycardia-in-children
#7
R A Bertels, L M Harteveld, L H Filippini, S A Clur, N A Blom
Aims: To assess the risk factors for left ventricular (LV) dysfunction in a paediatric population with idiopathic frequent premature ventricular contractions (PVCs) and asymptomatic ventricular tachycardias (VTs). Methods and Results: Paediatric patients with the diagnosis of idiopathic frequent PVCs and asymptomatic VTs were retrospectively evaluated. Frequent PVCs were defined as ≥5% on 24 h Holter recording. Left ventricular dysfunction was defined as a shortening fraction of ≤28%...
April 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28426522/patient-safety-culture-survey-in-pediatric-complex-care-settings-a-factor-analysis
#8
Amanda J Hessels, Meghan Murray, Bevin Cohen, Elaine L Larson
OBJECTIVES: Children with complex medical needs are increasing in number and demanding the services of pediatric long-term care facilities (pLTC), which require a focus on patient safety culture (PSC). However, no tool to measure PSC has been tested in this unique hybrid acute care-residential setting. The objective of this study was to evaluate the psychometric properties of the Nursing Home Survey on Patient Safety Culture tool slightly modified for use in the pLTC setting. METHODS: Factor analyses were performed on data collected from 239 staff at 3 pLTC in 2012...
April 19, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28422977/defining-the-complex-phenotype-of-severe-systemic-loxoscelism-using-a-large-electronic-health-record-cohort
#9
Jamie R Robinson, Vanessa E Kennedy, Youssef Doss, Lisa Bastarache, Joshua Denny, Jeremy L Warner
OBJECTIVE: Systemic loxoscelism is a rare illness resulting from the bite of the recluse spider and, in its most severe form, can lead to widespread hemolysis, coagulopathy, and death. We aim to describe the clinical features and outcomes of the largest known cohort of individuals with moderate to severe loxoscelism. METHODS: We performed a retrospective, cross sectional study from January 1, 1995, to December 31, 2015, at a tertiary-care academic medical center, to determine individuals with clinical records consistent with moderate to severe loxoscelism...
2017: PloS One
https://www.readbyqxmd.com/read/28417587/healthcare-utilization-and-spending-by-children-with-cancer-on-medicaid
#10
Emily L Mueller, Matt Hall, Jay G Berry, Aaron E Carroll, Michelle L Macy
BACKGROUND: Children with cancer are a unique patient population with high resource, complex healthcare needs. Understanding their healthcare utilization could highlight areas for care optimization. PROCEDURE: We performed a retrospective, cross-sectional analysis of the 2014 Truven Marketscan Medicaid Database to explore clinical attributes, utilization, and spending among children with cancer who were Medicaid enrollees. Eligible patients included children (ages 0-18 years) with cancer (Clinical Risk Group 8)...
April 18, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28412944/length-of-paediatric-inpatient-stay-socio-economic-status-and-hospital-configuration-a-retrospective-cohort-study
#11
Michelle Heys, Matthew Rajan, Mitch Blair
BACKGROUND: Variation in paediatric inpatient length of stay exists - whether this is driven by differences in patient characteristics or health service delivery is unclear. We will test the hypotheses that higher levels of deprivation are associated with prolonged length of stay and that differences in prolonged length of stay across 2 hospitals will be explained by demographic, clinical and process factors. METHODS: This is a retrospective cohort study of 2889 children aged less than 16 years admitted from 1st April 2009 to 30(th) March 2010...
April 17, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28408455/cell-therapy-trials-in-congenital-heart-disease
#12
REVIEW
Hidemasa Oh
Dramatic evolution in medical and catheter interventions and complex surgeries to treat children with congenital heart disease (CHD) has led to a growing number of patients with a multitude of long-term complications associated with morbidity and mortality. Heart failure in patients with hypoplastic left heart syndrome predicated by functional single ventricle lesions is associated with an increase in CHD prevalence and remains a significant challenge. Pathophysiological mechanisms contributing to the progression of CHD, including single ventricle lesions and dilated cardiomyopathy, and adult heart disease may inevitably differ...
April 14, 2017: Circulation Research
https://www.readbyqxmd.com/read/28403659/immunizing-children
#13
Hannah C Espeleta, Lana O Beasley, Leigh E Ridings, Tyler J Smith, Jennifer D Shields
Vaccinations are considered one of public health's greatest accomplishments. Despite evidence for vaccine effectiveness, uptake levels are still well below the Centers for Disease Control and Prevention's guidelines. The immunization decision-making process for parents is complex and depends on factors associated with knowledge and experiences. This qualitative study sought to expand on a previous decision-making model for immunizations by examining how individuals receive vaccination information, determining the role of experience in influencing decisions, and understanding how young adults might locate vaccination information in the future...
March 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28399664/ethical-considerations-surrounding-germline-next-generation-sequencing-of-children-with-cancer
#14
Liza-Marie Johnson, Kayla V Hamilton, Jessica M Valdez, Esther Knapp, Justin N Baker, Kim E Nichols
The advent of next-generation sequencing (NGS) has introduced an exciting new era in biomedical research. NGS forms the foundation of current genetic testing approaches, including targeted gene panel testing, as well as more comprehensive whole-exome and whole-genome sequencing. Together, these approaches promise to provide critical insights into the understanding of health and disease. However, with NGS testing come many ethical questions and concerns, particularly when testing involves children. These concerns are especially relevant for children with cancer, where the testing of tumor and germline tissues is increasingly being incorporated into clinical care...
May 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/28399095/-modern-principles-of-integrated-diagnostics-and-rehabilitation-of-perinatal-lesions-of-the-nervous-system-and-their-consequences
#15
S A Nemkova
The article is devoted to the comprehensive diagnosis and treatment of perinatal lesions of the nervous system and their consequences in children. Reflects modern approaches to data classification conditions, taking into account ideas on the etiology and pathogenesis of the disease, the clinical manifestations of the main syndromes (excitation and depression, hypertensive, convulsive, movement disorders) as the neonatal period, and in the formation of long-term effects (motor and mental delay and speech development, hyperkinetic syndrome, cerebral palsy and others)...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28398935/emergency-medical-services-utilization-by-children
#16
Parul Dayal, Timothy Horeczko, Cheryl Wraa, Larry Karsteadt, Wendy Chapman, Louis Bruhnke, Rebecca Litman, Timothy Ruttan, Nathan Kuppermann, James Marcin
OBJECTIVE: The aim of this study was to compare demographic and clinical features of children (0-14 years old) who arrived at general emergency departments (EDs) by emergency medical services (EMS) to those who arrived by private vehicles and other means in a rural, 3-county region of northern California. METHODS: We reviewed 507 ED records of children who arrived at EDs by EMS and those who arrived by other means in 2013. We also analyzed prehospital procedures performed on all children transported to an area hospital by EMS...
April 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28398525/a-longitudinal-analysis-of-data-quality-in-a-large-pediatric-data-research-network
#17
Ritu Khare, Levon Utidjian, Byron J Ruth, Michael G Kahn, Evanette Burrows, Keith Marsolo, Nandan Patibandla, Hanieh Razzaghi, Ryan Colvin, Daksha Ranade, Melody Kitzmiller, Daniel Eckrich, L Charles Bailey
Objective: PEDSnet is a clinical data research network (CDRN) that aggregates electronic health record data from multiple children's hospitals to enable large-scale research. Assessing data quality to ensure suitability for conducting research is a key requirement in PEDSnet. This study presents a range of data quality issues identified over a period of 18 months and interprets them to evaluate the research capacity of PEDSnet. Materials and Methods: Results were generated by a semiautomated data quality assessment workflow...
April 8, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28397510/a-profile-of-perceived-stress-factors-among-nursing-staff-working-with-intellectually-disabled-in-patients-at-the-free-state-psychiatric-complex-south-africa
#18
Maria Conradie, Danelle Erwee, Isabel Serfontein, Maré Visser, Frikkie J W Calitz, Gina Joubert
INTRODUCTION: Nursing staff working with intellectually disabled in-patients experience unique stress factors that can influence their personal well-being and work performance. OBJECTIVES: To compile a profile of stress factors experienced by nursing staff working with intellectually disabled in-patients at the Free State Psychiatric Complex (FSPC). METHODS: This descriptive study included 89 nursing staff members from this environment. A questionnaire was used to collect socio-demographic information and determine personal and occupational stressors...
March 16, 2017: Curationis
https://www.readbyqxmd.com/read/28396022/complexity-and-severity-of-pediatric-patients-treated-at-united-states-emergency-departments
#19
Joel D Hudgins, Michael C Monuteaux, Florence T Bourgeois, Lise E Nigrovic, Andrew M Fine, Lois K Lee, Rebekah Mannix, Susan C Lipsett, Mark I Neuman
OBJECTIVE: To compare the complexity and severity of presentation of children in general vs pediatric emergency departments (EDs). STUDY DESIGN: We performed a cross-sectional study of pediatric ED visits using the National Emergency Department Sample from 2008 to 2012. We classified EDs as "pediatric" if >75% of patients were <18 years old; all other EDs were classified as "general." The presence of an International Classification of Diseases, Ninth Revision code for a complex chronic condition was used as an indicator of patient complexity...
April 7, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28394995/video-analysis-of-factors-associated-with-response-time-to-physiologic-monitor-alarms-in-a-children-s-hospital
#20
Christopher P Bonafide, A Russell Localio, John H Holmes, Vinay M Nadkarni, Shannon Stemler, Matthew MacMurchy, Miriam Zander, Kathryn E Roberts, Richard Lin, Ron Keren
Importance: Bedside monitor alarms alert nurses to life-threatening physiologic changes among patients, but the response times of nurses are slow. Objective: To identify factors associated with physiologic monitor alarm response time. Design, Setting, and Participants: This prospective cohort study used 551 hours of video-recorded care administered by 38 nurses to 100 children in a children's hospital medical unit between July 22, 2014, and November 11, 2015...
April 10, 2017: JAMA Pediatrics
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