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Children with medical complexity

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https://www.readbyqxmd.com/read/29164082/acute-septic-arthritis-of-the-knee-caused-by-kingella-kingae-in-a-5-year-old-cameroonian-boy
#1
Nawal El Houmami, Dimitri Ceroni, Karine Codjo Seignon, Jean-Christophe Pons, Cédric Lambert, Guillaume André Durand, Philippe Minodier, Léopold Lamah, Philippe Bidet, Jacques Schrenzel, Didier Raoult, Pierre-Edouard Fournier
Kingella kingae is an important cause of invasive infections in young children from Western countries. Although increasing reports indicate that this organism is the leading agent of bone and joint infections in early childhood, data on K. kingae infections from resource-limited settings are scarce, and none has yet been reported in Africa. We herein report the diagnostic and epidemiological investigations of the first case of K. kingae arthritis identified in a child from sub-Saharan Africa. A 5-year-old Cameroonian boy presented with a sudden painful limp which appeared in the course of a mild rhinopharyngitis...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29162609/health-of-health-care-workers-in-canadian-nursing-homes-and-pediatric-hospitals-a-cross-sectional-study
#2
Matthias Hoben, Jennifer A Knopp-Sihota, Maryam Nesari, Stephanie A Chamberlain, Janet E Squires, Peter G Norton, Greta G Cummings, Bonnie J Stevens, Carole A Estabrooks
BACKGROUND: Poor health of health care workers affects quality of care, but research and health data for health care workers are scarce. Our aim was to compare physical/mental health among health care worker groups 1) within nursing homes and pediatric hospitals, 2) between the 2 settings and 3) with the physical/mental health of the Canadian population. METHODS: Using cross-sectional data collected as part of the Translating Research in Elder Care program and the Translating Research on Pain in Children program, we examined the health of health care workers...
November 21, 2017: CMAJ Open
https://www.readbyqxmd.com/read/29162355/-hot-tub-lung-a-case-report
#3
M Vergez, S Honjoya, S Guérin, C Delacourt, G Benoist
Hot tub lung is a type of hypersensitivity pneumonitis caused by inhalational exposure to the Mycobacterium avium complex. We report the case of a 14-year-old boy presenting dyspnea with hypoxemia, whose medical history and clinical course helped make the diagnosis. Infectious causes were considered first, and antibiotics were initiated without success. Further questioning and explorations led to discussing a hypersensitivity pneumonitis diagnosis. Relapse after exposure to a hot tub enabled us to confirm hot tub lung...
November 18, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29161160/upholding-ethical-decision-making-in-children-with-life-limiting-illnesses
#4
Edward Alan Glasper
Emeritus Professor Edward Alan Glasper from the University of Southampton discusses the complexities of care delivery to children in hospital who have life limiting medical conditions.
November 21, 2017: Compr Child Adolesc Nurs
https://www.readbyqxmd.com/read/29161075/metabolic-dysregulation-systemic-inflammation-and-pediatric-obesity-related-asthma
#5
Deepa Rastogi, Fernando Holguin
Obesity-related asthma is a distinct pediatric asthma phenotype. It is associated with higher disease burden, lower pulmonary function, and suboptimal response to current asthma medications. Recent studies have made inroads into elucidating its pathophysiology. Systemic immune responses in obese children with asthma are skewed to a nonatopic T-helper cell type 1 (Th1) pattern that correlates with pulmonary function deficits. The prevalence of metabolic dysregulation is also higher among obese children with asthma than among normal-weight children with asthma...
November 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29158774/psychosocial-factors-in-children-s-obesity-examples-from-an-innovative-line-of-inquiry
#6
Amanda W Harrist, Glade L Topham, Laura Hubbs-Tait, Lenka H Shriver, Taren M Swindle
In recent years, researchers and policymakers have recognized that obesity in childhood is not simply a medical problem, but is a complex social and psychological phenomenon. Our research team used an interpersonal and intrapersonal risk model to examine the psychosocial aspects of obesity among rural children. In this article, we describe how the global study of children's obesity has broadened over the last 10 to 15 years, and we present our model of interpersonal and intrapersonal risk factors, which includes complex pathways with many psychosocial variables...
December 2017: Child Development Perspectives
https://www.readbyqxmd.com/read/29158552/care-and-cost-consequences-of-pediatric-whole-genome-sequencing-compared-to-chromosome-microarray
#7
Robin Z Hayeems, Jasmin Bhawra, Kate Tsiplova, M Stephen Meyn, Nasim Monfared, Sarah Bowdin, D James Stavropoulos, Christian R Marshall, Raveen Basran, Cheryl Shuman, Shinya Ito, Iris Cohn, Courtney Hum, Marta Girdea, Michael Brudno, Ronald D Cohn, Stephen W Scherer, Wendy J Ungar
The clinical use of whole-genome sequencing (WGS) is expected to alter pediatric medical management. The study aimed to describe the type and cost of healthcare activities following pediatric WGS compared to chromosome microarray (CMA). Healthcare activities prompted by WGS and CMA were ascertained for 101 children with developmental delay over 1 year. Activities following receipt of non-diagnostic CMA were compared to WGS diagnostic and non-diagnostic results. Activities were costed in 2016 Canadian dollars (CDN)...
November 20, 2017: European Journal of Human Genetics: EJHG
https://www.readbyqxmd.com/read/29157584/impaired-objective-and-subjective-sleep-in-children-and-adolescents-with-inflammatory-bowel-disease-compared-to-healthy-controls
#8
Laura Mählmann, Markus Gerber, Raoul I Furlano, Corinne Legeret, Nadeem Kalak, Edith Holsboer-Trachsler, Serge Brand
OBJECTIVE: Poor sleep and higher inflammation markers are associated, and impaired sleep quality is common among patients with inflammatory bowel disease (IBD). However, information on sleep among children and adolescents with IBD is currently lacking. The aims of the present study were to compare subjective and objective sleep of children and adolescents with IBD with healthy controls and to shed more light on the relationship between sleep and inflammation. We expected that poor sleep, as assessed via sleep electroencephalography recordings, would be observed among participants with IBD, but particularly among participants in an active state of disease...
November 2017: Sleep Medicine
https://www.readbyqxmd.com/read/29157496/medical-considerations-in-children-and-adolescents-with-eating-disorders
#9
REVIEW
Diane DerMarderosian, Heather A Chapman, Christina Tortolani, Matthew D Willis
Eating disorders are a group of psychiatric disorders with potentially fatal medical complications. Early integrated care including the family as well as pediatric medicine, nutrition, psychology and psychiatry is critical for improving prognosis and limiting negative outcomes. Mental health services are a critical component of treatment; timely weight restoration maximizes efficacy. Despite being relatively common, there are many misperceptions about eating disorders, their severity, and the associated morbidity and mortality...
January 2018: Child and Adolescent Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/29147890/food-allergy-in-children-an-overview
#10
REVIEW
Jaidev M Devdas, Christopher Mckie, Adam T Fox, Vinod H Ratageri
The estimated prevalence of food allergy amongst children in the west is around 6-8% but there is paucity of data in the Indian population. There is a complex interplay of environmental influences and genetic factors in the immuno-pathogenesis and manifestations of food allergy. A reliable thorough clinical history, combined with positive skin prick tests or food-specific IgE, is essential for a more precise diagnosis of food allergy. Currently there is no cure for food allergy. The management of food allergy usually includes strict avoidance, patient education and provision of emergency medication (adrenaline-autoinjectors)...
November 17, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29136227/developmental-outcome-of-9-year-old-children-born-after-pgs-follow-up-of-a-randomized-trial
#11
Derk Kuiper, Anne Bennema, Sacha la Bastide-van Gemert, Jorien Seggers, Pamela Schendelaar, Sebastiaan Mastenbroek, Annemieke Hoek, Maas Jan Heineman, Tessa J Roseboom, Joke H Kok, Mijna Hadders-Algra
STUDY QUESTION: Does Day-3 cleavage-stage PGS affect neurodevelopment of 9-year-old IVF offspring? SUMMARY ANSWER: We did not find evidence of adverse consequences of Day-3 cleavage-stage PGS on neurodevelopment of 9-year-old IVF offspring, although children born after IVF with or without PGS often had a non-optimal neurological condition. WHAT IS KNOWN ALREADY: Knowledge on long-term sequelae for development and health of children born following PGS is lacking...
November 10, 2017: Human Reproduction
https://www.readbyqxmd.com/read/29127498/dynamics-in-prevalence-of-down-syndrome-in-children-with-congenital-heart-disease
#12
Constanze Pfitzer, Paul C Helm, Lisa-Maria Rosenthal, Felix Berger, Ulrike M M Bauer, Katharina Rl Schmitt
We assessed the dynamics in the prevalence of children with congenital heart disease (CHD) and Down syndrome in Germany with regard to phenotype, severity, and gender. Data from patients with CHD and Down syndrome born between 1980 and 2014 were analyzed, who are registered with the German National Register for Congenital Heart Defects. One thousand six hundred eighteen CHD patients with Down syndrome were identified. The prevalence of children born with both Down syndrome and CHD was constant from 2005 to 2009 but increased from 2010 to 2014...
November 10, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29126501/overview-of-paediatric-ibd
#13
David C Wilson, Richard K Russell
Inflammatory bowel disease (IBD) is a chronic complex disease of children and adults requiring a range of medications and surgical techniques to induce and maintain remission. In common with other immune-mediated inflammatory disorders, it has shown an ever-increasing rise in incidence worldwide over the last 50 years. The cause of IBD arises from interactions between the microbiome in the gut and the gastrointestinal and systemic immune system in genetically susceptible persons, and with environmental triggers to both develop IBD and have relapses of IBD...
December 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29125321/two-futures-financial-and-practical-realities-for-parents-of-living-with-a-life-limited-child
#14
Duncan C Randall
Today more and more children are living with complex health care needs, many of these children are living with life limiting and/or threatening conditions, some are medically fragile. To live a childhood these children must live in communities and with their families. In most cases this means the child's carers, their parents, most often their mothers, are required to undertake a great deal of the child's care. During a project on parental coping I became aware of the ways in which parents were restructuring their working lives in order to meet the demands of the nursing and medical care needs of their children...
November 10, 2017: Compr Child Adolesc Nurs
https://www.readbyqxmd.com/read/29122828/referrals-to-a-perinatal-specialist-palliative-care-consult-service-in-ireland-2012-2015
#15
Des L McMahon, Marie Twomey, Maeve O'Reilly, Mary Devins
OBJECTIVE: To analyse the referral patterns of perinatal patients referred to a specialist palliative care service (SPCS), their demographics, diagnoses, duration of illness, place of death and symptom profile. DESIGN: A retrospective chart review of all perinatal referrals over a 4-year period to the end of 2015. SETTING: A consultant-led paediatric SPCS at Our Lady's Children's Hospital, Crumlin, Dublin, and the Coombe Women & Infants University Hospital, Dublin...
November 9, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29122229/-study-of-genetic-variants-in-the-bdnf-comt-dat1-and-sert-genes-in-colombian-children-with-attention-deficit-disorder
#16
Jenny Ortega-Rojas, Carlos E Arboleda-Bustos, Luis Morales, Bruno A Benítez, Diana Beltrán, Álvaro Izquierdo, Humberto Arboleda, Rafael Vásquez
BACKGROUND: Attention deficit and hyperactive disorder (ADHD) is highly prevalent among children in Bogota City. Both genetic and environmental factors play a very important role in the etiology of ADHD. However, to date few studies have addressed the association of genetic variants and ADHD in the Colombian population. OBJECTIVES: To test the genetic association between polymorphisms in the DAT1, HTTLPR, COMT and BDNF genes and ADHD in a sample from Bogota City...
October 2017: Revista Colombiana de Psiquiatría
https://www.readbyqxmd.com/read/29121247/prediction-of-individual-outcomes-for-asthma-sufferers
#17
B Storlie Curtis, E Branda Megan, R Gionfriddo Michael, D Shah Nilay, A Rank Matthew
We consider the problem of individual-specific medication level recommendation (initiation, removal, increase, or decrease) for asthma sufferers. Asthma is one of the most common chronic diseases in both adults and children, affecting 8% of the US population and costing $37-63 billion/year in the United States of America. Asthma is a complex disease, whose symptoms may wax and wane, making it difficult for clinicians to predict outcomes and prognosis. Improved ability to predict prognosis can inform decision making and may promote conversations between clinician and provider around optimizing medication therapy...
November 6, 2017: Biostatistics
https://www.readbyqxmd.com/read/29119824/an-innovative-health-care-delivery-model-for-children-with-medical-complexity
#18
Anne Elizabeth Glassgow, Molly A Martin, Rachel Caskey, Melishia Bansa, Michael Gerges, Mary Johnson, Monika Marko, Kenita Perry-Bell, Heather J Risser, Peter J Smith, Benjamin Van Voorhees
Children with medical complexity (CMC) account for a disproportionate share of pediatric health-care utilization and cost that is largely attributable to long hospitalizations, frequent hospital readmissions, and high use of emergency departments. In response, the Centers for Medicare and Medicaid Services Health Care Innovation Center supports the development and testing of innovative health-care payment and service delivery models. The purpose of this article is to describe the CMS-funded coordinated health care for complex kids (CHECK) program, an innovative system of health-care delivery that provides improved, comprehensive, and well-coordinated services to CMC...
September 2017: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
https://www.readbyqxmd.com/read/29119811/22q11-deletion-syndrome-parents-and-children-s-experiences-of-educational-and-healthcare-provision-in-the-united-kingdom
#19
Wendy Cohen, Elspeth McCartney, Lisa Crampin
22q11 deletion syndrome (22q11DS) is a genetic syndrome, prevalence around 1:4000-1:6000 live births, with a complex array of associated features, impacting on healthcare and educational support. This study reports the perceptions of families and individuals with 22q11DS in relation to these needs. Individuals and families of those with 22q11DS were approached though two national charities - the Max Appeal and 22Crew. An initial observational survey design was used to gather views via questions probing access to healthcare and educational experiences...
June 2017: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
https://www.readbyqxmd.com/read/29115880/treatment-response-heterogeneity-in-asthma-the-role-of-genetic-variation
#20
Susanne J H Vijverberg, Niloufar Farzan, Elise M A Slob, Anne H Neerincx, Anke H Maitland-van der Zee
Asthmatic patients show a large heterogeneity in response to asthma medication. Rapidly evolving genotyping technologies have led to the identification of various genetic variants associated with treatment outcomes. Areas covered: This review focuses on the current knowledge of genetic variants influencing treatment response to the most commonly used asthma medicines: short- and long-acting beta-2 agonists (SABA/LABA), inhaled corticosteroids (ICS) and leukotriene modifiers. This review shows that various genetic variants have been identified, but none are currently used to guide asthma treatment...
November 8, 2017: Expert Review of Respiratory Medicine
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