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Children with medical complexity

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https://www.readbyqxmd.com/read/28634166/development-and-validation-of-the-pediatric-medical-complexity-algorithm-pmca-version-2-0
#1
Tamara D Simon, Mary Lawrence Cawthon, Jean Popalisky, Rita Mangione-Smith
BACKGROUND AND OBJECTIVES: The Pediatric Medical Complexity Algorithm (PMCA) was developed to stratify children by level of medical complexity. We sought to refine PMCA and evaluate its performance based on the duration of eligibility and completeness of Medicaid data. METHODS: PMCA version 1.0 was applied to a cohort of 299 children insured by Washington State Medicaid with ≥1 Seattle Children's Hospital outpatient, emergency department, and/or inpatient encounter in 2012...
June 20, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28629784/-from-paediatric-urological-care-to-adult-urology-assessment-of-a-transition-consultation-for-adolescents
#2
L Even, S Mouttalib, J Moscovici, M Soulie, P Rischmann, X Game, P Galinier, O Bouali
To provide an adequate lifelong urological care in the complex period of adolescence, a transition consultation conducted by a paediatric surgeon and an urologist was developed in our institution. As a real rite of passage, it allows the follow-up and the adapted care of urological conditions, sometimes complex, and permits the transition between childhood and the world of grown-ups. We reported our experience at the Children Hospital of our institution (paediatric surgery and urology departments). During a 6 months period (January-July 2015), forty-five young adults with a mean age of 17...
June 16, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28628521/experiences-of-acute-pain-in-children-who-present-to-a-healthcare-facility-for-treatment-a-systematic-review-of-qualitative-evidence
#3
Nicole Pope, Mary Tallon, Ruth McConigley, Gavin Leslie, Sally Wilson
BACKGROUND: Pain is a universal and complex phenomenon that is personal, subjective and specific. Despite growing knowledge in pediatric pain, management of children's pain remains sub-optimal and is linked to negative behavioral and physiological consequences later in life. As there is no synthesis of these studies, it was timely to undertake a systematic review. OBJECTIVES: To identify, evaluate and synthesize the existing qualitative evidence on children's experiences of acute pain, including pain management, within a healthcare facility...
June 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28622983/the-effect-of-a-comprehensive-care-transition-model-on-cost-and-utilization-for-medically-complex-children-with-cerebral-palsy
#4
Steven W Howard, Zidong Zhang, Paula Buchanan, Eric Armbrecht, Christine Williams, Geneva Wilson, Janna Hutchinson, Lindsey Pearson, Samantha Ellsworth, Caitlin M Byler, Travis Loux, Jing Wang, Steph Bernell, Nicholas Holekamp
INTRODUCTION: Our aim was to evaluate cost and acute care utilization related to an organized approach to care coordination and transitional care after major acute care hospitalization for children with medical complexities, including cerebral palsy. METHODS: A retrospective cohort of 32 patients from Ranken Jordan Pediatric Bridge Hospital (RJPBH) who received the Care Beyond the Bedside model was compared with 151 patients receiving standard care elsewhere across Missouri...
June 13, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28619360/further-delineation-of-cog8-cdg-a-case-with-novel-compound-heterozygous-mutations-diagnosed-by-targeted-exome-sequencing
#5
Aram Yang, Sung Yoon Cho, Ja-Hyun Jang, Jinsup Kim, Sook Za Kim, Beom Hee Lee, Han-Wook Yoo, Dong-Kyu Jin
Congenital disorders of glycosylation (CDG) are a rapidly expanding group of inherited metabolic disorders with highly variable clinical presentations caused by deficient glycosylation of proteins and/or lipids. CDG-IIh is a very rare subgroup of CDG caused by mutations in the conserved oligomeric Golgi (COG) complex gene, COG8, and so far, only two cases have been reported in the medical literature. Here, we describe an 8-year-old Korean boy with psychomotor retardation, hypotonia, failure to thrive, elevated serum liver enzymes, microcephaly, and talipes equinovarus...
June 13, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28610581/household-air-pollution-from-cooking-and-risk-of-adverse-health-and-birth-outcomes-in-bangladesh-a-nationwide-population-based-study
#6
Md Nuruzzaman Khan, Cherri Zhang B Nurs, M Mofizul Islam, Md Rafiqul Islam, Md Mizanur Rahman
BACKGROUND: Household air pollution (HAP) from cooking with solid fuels has become a leading cause of death and disability in many developing countries including Bangladesh. We assess the association between HAP and risk of selected adverse birth and maternal health outcomes. METHODS: Data for this study were extracted from Bangladesh Demographic and Health Survey conducted during 2007-2014. Selected adverse birth outcomes were acute respiratory infection (ARI) among children, stillbirth, low birth weight (LBW), under-five mortality, neonatal mortality and infant mortality...
June 13, 2017: Environmental Health: a Global Access Science Source
https://www.readbyqxmd.com/read/28603565/current-concepts-congenital-scoliosis
#7
Agnivesh Tikoo, Manish K Kothari, Kunal Shah, Abhay Nene
BACKGROUND: Congenital scoliosis is one of the 'difficult to treat' scenarios which a spine surgeon has to face. Multiple factors including the age of child at presentation, no definite pattern of deformity and associated anomalies hinder the execution of the ideal treatment plan. All patients of congenital scoliosis need to be investigated in detail. X rays and MRI of spine is usually ordered first. Screening investigations to rule out VACTERL (Visceral, Anorectal, Cardiac, Tracheo-esophageal fistula, Renal and Lung) abnormalities are required...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28602695/-presumed-cardiac-arrest-in-children-and-young-adults-a-misnomer
#8
Katherine S Allan, Laurie J Morrison, Arnold Pinter, Jack V Tu, Paul Dorian
AIM: To use a novel methodology to assess the incidence and specific causes of Out-of-Hospital Cardiac Arrest (OHCA) within a young urban cohort. METHODS: All EMS attended OHCA patients in a large urban area, between 2009 and 2012, aged 2-45 years, treated or untreated, who died or survived, and that were designated as "no obvious cause" etiology by trained data abstractors were included. Using multisource (medical and coroner) records, an expert panel adjudicated the causes of the OHCAs as: confirmed cardiac causes, confirmed non- cardiac causes, and other causes...
June 7, 2017: Resuscitation
https://www.readbyqxmd.com/read/28596445/development-of-a-new-care-model-for-hospitalized-children-with-medical-complexity
#9
Christine M White, Joanna E Thomson, Angela M Statile, Katherine A Auger, Ndidi Unaka, Matthew Carroll, Karen Tucker, Derek Fletcher, David E Hall, Jeffrey M Simmons, Patrick W Brady
Children with medical complexity are a rapidly growing inpatient population with frequent, lengthy, and costly hospitalizations. During hospitalization, these patients require care coordination among multiple subspecialties and their outpatient medical homes. At a large freestanding children's hospital, a new inpatient model of care was developed in an effort to consistently provide coordinated, family-centered, and efficient care. In addition to expanding the multidisciplinary team to include a pharmacist, dietician, and social worker, the team redesign included: (1) medication reconciliation rounds, (2) care coordination rounds, and (3) multidisciplinary weekly handoff with outpatient providers...
June 8, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28595818/do-not-resuscitate-orders-and-high-risk-pediatric%C3%A2-surgery-professional-nuisance-or%C3%A2-medical%C3%A2-necessity
#10
Lauren M Baumann, Kibileri Williams, Fizan Abdullah, Richard J Hendrickson, Tolulope A Oyetunji
BACKGROUND: There is a paucity of data in the literature regarding end-of-life care and do-not-resuscitate (DNR) status of the pediatric surgical patient, although invasive procedures are frequently performed in very high risk and critically ill children. Despite significant efforts in adult medicine to enhance discussions around end-of-life care, little is known about similar endeavors in the pediatric population. METHODS: A retrospective review of the National Surgical Quality Improvement Program Pediatric database was performed...
May 11, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28594695/wrist-arthroscopy-in-children-and-adolescent-with-chronic-wrist-pain-arthroscopic-findings-compared-with-mri
#11
Ashok L Ramavath, P N Unnikrishnan, Harvey L George, Paramasivam Sathyamoorthy, Colin E Bruce
BACKGROUND: Wrist arthroscopy is a dynamic diagnostic procedure and its indications are growing as a treatment modality in the adult population. The aim of the study was to retrospectively report our series of pediatric and adolescence with chronic wrist pain, with or without wrist instability who underwent wrist arthroscopy after failing at least 4 months of conservative management. Our secondary aim was to report the sensitivity and specificity of clinical examination and magnetic resonance imaging evaluation for various injury subgroups against the gold standard of the arthroscopic findings...
July 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28592761/acute-lymphoblastic-leukemia-pathophysiology-and-current-therapy
#12
Kiyotoshi Imai
Acute lymphoblastic leukemia (ALL) is seen in both children and adults, but its incidence peaks between 2 and 5 years and also increases in the older population. Although most children can be cured, the prognosis of adults with ALL remains poor. Recent identification of novel genetic alterations and sequence mutations has contributed to the elucidation of the pathogenesis of ALL. The World Health Organization classification was revised in 2016. ALL was included within the subgroup of myeloid neoplasms and acute leukemia...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28588070/risk-factors-for-fractures-in-children-hospitalized-in-intensive-and-intermediate-care-units
#13
Ian S Zenlea, Patrice Melvin, Susanna Y Huh, Nilesh Mehta, Suzanne J Reidy, Erinn T Rhodes, Nina S Ma
BACKGROUND AND OBJECTIVES: Fragility fractures are increasingly recognized in hospitalized children. Our study aim was to identify risk factors for fracture in children hospitalized in intensive and intermediate care units. METHODS: We conducted a retrospective, case-control study comparing the clinical characteristics of children with fractures (cases) to children without fractures (controls) matched for age, sex, hospital unit, admission quarter and year, ICU length of stay, severity of illness, and resource utilization...
June 6, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28587882/combined-vitrectomy-and-glaucoma-drainage-device-implantation-surgical-approach-for-complex-pediatric-glaucomas
#14
Cem Ozgonul, Cagri G Besirli, Brenda L Bohnsack
PURPOSE: To evaluate efficacy of combined vitrectomy with posteriorly-placed glaucoma drainage device (GDD) in lowering intraocular pressure (IOP) in children. PATIENTS AND METHODS: Retrospective case review identified 20 children who underwent vitrectomy with posteriorly-placed GDD with minimal 6-months follow-up. First eye operated on was included. Success was defined as IOP 5-20 mmHg, no additional IOP-lowering surgery or visually-devastating complications. RESULTS: Patients with primary infantile-onset glaucoma (25%), traumatic glaucoma (15%), Peters anomaly (15%), microphthalmia (25%), glaucoma following cataract surgery (10%), microspherophakia (5%), and retinopathy of prematurity (5%) were included...
June 3, 2017: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/28587274/parent-perspective-on-care-coordination-services-for-their-child-with-medical-complexity
#15
Rhonda G Cady, John L Belew
The overarching goal of care coordination is communication and co-management across settings. Children with medical complexity require care from multiple services and providers, and the many benefits of care coordination on health and patient experience outcomes have been documented. Despite these findings, parents still report their greatest challenge is communication gaps. When this occurs, parents assume responsibility for aggregating and sharing health information across providers and settings. A new primary-specialty care coordination partnership model for children with medical complexity works to address these challenges and bridge communication gaps...
June 6, 2017: Children
https://www.readbyqxmd.com/read/28586275/good-food-bad-food-and-white-rice-understanding-child-feeding-using-visual-narrative-elicitation
#16
Chelsea Wentworth
Visual-narrative elicitation, a process combing photo elicitation and pile sorting in applied medical anthropology, sheds light on food consumption patterns in urban areas of Vanuatu where childhood malnutrition is a persistent problem. Groups of participants took photographs of the foods they feed their children, and the resources and barriers they encounter in accessing foodstuffs. This revealed how imported and local foods are assigned value as "good" or "bad" foods when contributing to dietary diversity and creating appropriate meals for children, particularly in the context of consuming white rice...
June 6, 2017: Medical Anthropology
https://www.readbyqxmd.com/read/28586256/pediatric-palliative-care-a-five-year-retrospective-chart-review-study
#17
Susan E Thrane, Scott H Maurer, Susan M Cohen, Carol May, Susan M Sereika
BACKGROUND: More children are living with serious illness. However, survival and complexity of illnesses have not been described. OBJECTIVE: To describe types of illnesses, timing of referral, and time to death following referral to palliative care; to examine the associations between demographics and clinical characteristics and patient survival; and to examine whether average daily pain decreases after referral. DESIGN: Retrospective chart review of all children ages 2-16 years referred to palliative care at one large children's hospital during the five-year study period from January 1, 2009, through December 31, 2013...
June 6, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28583501/otorhinolaryngologic-manifestations-of-hartsfield-syndrome-case-series-and-review-of-literature
#18
Jeremie D Oliver, Deanna C Menapace, Shelagh A Cofer
Diagnosis of Hartsfield syndrome includes recognition of three distinct clinical anomalies: holoprosencephaly, ectrodactyly, and bilateral cleft-lip and palate syndrome. A family including three male siblings all affected by Hartsfield syndrome presented to our institution for care. An autosomal dominant variant in Fibroblast Growth Factor Receptor 1 (FGFR1) was identified. This report focuses on otorhinolaryngologic manifestationsof Hartsfield syndrome, previously undescribed, including midline defects of holoprosencephaly, bilateral cleft-lip and palate, retrognathia, gastroesophageal reflux disease, external ear anomalies, eustachian tube dysfunction, and midface abnormalities, in addition to multidisciplinary, long-term management strategies...
July 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28580851/-female-child-sexual-abuse
#19
Andrea Enyedy, Roland Csorba
INTRODUCTION AND AIM: The prevalence of child sexual abuse is 12-13% worldwide (18% by girls, 8% by boys). The exact knowledge of sexual abuse and the spread of the adequate medical diagnosis is an essential medical, social and national requirement. In our present study we examine the medical diagnosis of female child sexual abuse. METHOD: Selective literature research in the available international and domestic databases. RESULTS: Majority of children assessed for suspected sexual abuse have normal genital and anal findings...
June 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28577610/feeding-disorders
#20
REVIEW
Natalie Morris, Rachel M Knight, Teryn Bruni, Laura Sayers, Amy Drayton
Feeding disorders often present in children with complex medical histories as well as those with neurodevelopmental disabilities. If untreated, feeding problems will likely persist and may lead to additional developmental and medical complications. Treatment of pediatric feeding disorders should involve an interdisciplinary team, but the core intervention should include behavioral feeding techniques as they are the only empirically supported therapy for feeding disorders.
July 2017: Child and Adolescent Psychiatric Clinics of North America
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