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Children with medical complexity

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https://www.readbyqxmd.com/read/28527021/comorbidity-prevalence-and-treatment-outcome-in-children-and-adolescents-with-adhd
#1
Laura Reale, Beatrice Bartoli, Massimo Cartabia, Michele Zanetti, Maria Antonella Costantino, Maria Paola Canevini, Cristiano Termine, Maurizio Bonati
Although ADHD comorbidity has been widely studied, some issues remain unsolved. This multicenter observational study aims to examine comorbid psychiatric disorders in a clinical sample of newly diagnosed, treatment naïve children and adolescents with and without ADHD and, to compare treatment efficacy based on the type of comorbidity. We performed an analysis of the medical records of patients identified from the Regional ADHD Registry database, enrolled in 18 ADHD centers in the 2011-2016 period. 1919 of 2861 subjects evaluated (67%) met the diagnostic criteria for ADHD: 650 (34%) had only ADHD, while 1269 (66%) had at least one comorbid psychiatric disorder (learning disorders, 56%; sleep disorders, 23%; oppositional defiant disorder, 20%; anxiety disorders, 12%)...
May 19, 2017: European Child & Adolescent Psychiatry
https://www.readbyqxmd.com/read/28523862/transatlantic-medical-consultation-and-second-opinion-in-pediatric-cardiology-has-benefit-past-patient-care-a-case-study-in-videoconferencing
#2
Lubica Kovacikova, Martin Zahorec, Peter Skrak, Brian D Hanna, R Lee Vogel
BACKGROUND: Telemedicine is a rapidly evolving form of modern information and communication technology used to deliver clinical services and educational activities. OBJECTIVE: The aim of this article is to report and analyze our experience with transatlantic consultation via videoconferencing in pediatric cardiology. METHODS: In February, 2013, videoconferencing project was launched between a medium-volume pediatric cardiac center in Bratislava, Slovakia and subspecialty experts from a high-volume pediatric cardiac program at The Children's Hospital of Philadelphia (CHOP), USA...
May 19, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28521656/oral-feeding-difficulties-in-children-with-short-bowel-syndrome-a-narrative-review
#3
Judy Hopkins, Sharon A Cermak, Russell J Merritt
Children with short bowel syndrome (SBS) with associated intestinal failure may be unable to absorb sufficient nutrients to sustain life. Improvements in the medical management of SBS, including use of parenteral nutrition, has significantly increased life expectancy. Independence from parenteral nutrition further improves quality of life. However, children living with SBS often develop oral aversions and feeding difficulties. There is limited research and information on which to base interventions that will preserve and develop oral motor and feeding skills...
May 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28521207/strategies-to-support-transitions-from-hospital-to-home-for-children-with-medical-complexity-a-scoping-review
#4
REVIEW
Sydney Breneol, Julia Belliveau, Christine Cassidy, Janet A Curran
BACKGROUND: Children with medical complexity constitute a small but resource-intensive subgroup of children with special health care needs. Their medical fragility and resource-intensive needs put them at greater risk for inadequate transitions from hospital to home-based care, and subsequent adverse outcomes and hospital re-admissions. OBJECTIVE: This scoping literature review was conducted to map empirically researched interventions, frameworks, programs or models that could inform or support the transition from hospital to home for children with medical complexity...
May 4, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28515550/communication-impairments-in-children-with-inborn-errors-of-metabolism-a-preliminary-study
#5
Shivani Tiwari, Divya Kallianpur, Kelly Ann DeSilva
PURPOSE: Inborn Errors of Metabolism (IEMs) are a group of complex genetic conditions, predominantly affecting the pediatric population. While the understanding and identification of various IEMs has significantly improved over recent times, not much is known about the communication disorders in this population. The present study focused on identification and profiling of communication impairments in children diagnosed with IEMs. METHODS: Data was obtained retrospectively from medical records of children visiting a tertiary care hospital over a period of ten years (2005 - 2014)...
March 2017: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/28514670/radiation-safety-in-children-with-congenital-and-acquired-heart-disease-a-scientific-position-statement-on-multimodality-dose-optimization-from-the-image-gently-alliance
#6
REVIEW
Kevin D Hill, Donald P Frush, B Kelly Han, Brian G Abbott, Aimee K Armstrong, Robert A DeKemp, Andrew C Glatz, S Bruce Greenberg, Alexander Sheldon Herbert, Henri Justino, Douglas Mah, Mahadevappa Mahesh, Cynthia K Rigsby, Timothy C Slesnick, Keith J Strauss, Sigal Trattner, Mohan N Viswanathan, Andrew J Einstein
There is a need for consensus recommendations for ionizing radiation dose optimization during multi-modality medical imaging in children with congenital and acquired heart disease (CAHD). These children often have complex diseases and may be exposed to a relatively high cumulative burden of ionizing radiation from medical imaging procedures including cardiac computed tomography, nuclear cardiology studies and fluoroscopically guided diagnostic and interventional catheterization and electrophysiology procedures...
May 17, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28514463/pediatric-psoriasis-comorbidity-screening-guidelines
#7
Emily Osier, Audrey S Wang, Megha M Tollefson, Kelly M Cordoro, Stephen R Daniels, Andrew Eichenfield, Joel M Gelfand, Alice B Gottlieb, Alexa B Kimball, Mark Lebwohl, Nehal N Mehta, Amy S Paller, Jeffrey B Schwimmer, Dennis M Styne, Abby S Van Voorhees, Wynnis L Tom, Lawrence F Eichenfield
Importance: Psoriasis is a complex inflammatory skin condition associated with serious medical comorbidities in adults, including obesity, hypertension, dyslipidemia, type 2 diabetes mellitus, psoriatic arthritis, nonalcoholic fatty liver disease, depression, anxiety, and decreased quality of life. Because psoriasis begins in childhood in almost one-third of patients, early identification of risk may be critical to minimizing effects on future health. Objective: To develop the first set of guidelines for comorbidity screening for patients with pediatric psoriasis based on current evidence...
May 17, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28509853/predictors-of-caregiver-burden-among-mothers-of-children-with-chronic-conditions
#8
Karina Javalkar, Eniko Rak, Alexandra Phillips, Cara Haberman, Maria Ferris, Miranda Van Tilburg
OBJECTIVE: The complex medical regimens of children and adolescents with chronic conditions can have a significant impact on families and households. Caregivers may experience burden, which can lead to negative health consequences and poor quality of life. The objective of this study was to determine child-related predictors and risk factors for caregiver burden among parents of children with chronic conditions. METHODS: We distributed an institutional review board (IRB)-approved, online cross-sectional survey to parents of children who attended the Victory Junction therapeutic camp...
May 16, 2017: Children
https://www.readbyqxmd.com/read/28507627/prenatally-diagnosis-and-outcome-of-fetuses-with-cardiac-rhabdomyoma-single-centre-experience
#9
Ramush Bejiqi, Ragip Retkoceri, Hana Bejiqi
BACKGROUND: Cardiac rhabdomyoma (CRs) are the most common primary tumour of the heart in infants and children. Usually are multiple and, basing on the location can cause a haemodynamic disturbance, dysrhythmias or heart failure during the fetal and early postnatal period. CRs have a natural history of spontaneous regression and are closely associated with tuberous sclerosis complex (TSC). It has an association with tuberous sclerosis (TS), and in those, the tumour may regress and disappear completely, or remain consistent in size...
April 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28499736/-children-s-medically-complex-diseases-unit-a-model-required-in-all-our-hospitals
#10
Francisco José Climent Alcalá, Marta García Fernández de Villalta, Luis Escosa García, Aroa Rodríguez Alonso, Luis Adolfo Albajara Velasco
INTRODUCTION: The increase in survival of children with severe diseases has led to the rise of children with chronic diseases, sometimes with lifelong disabilities. In 2008, a unit for the specific care of medically complex children (MCC) was created in Hospital La Paz. OBJECTIVES: To describe the work and care activities of this Unit. Patients and methods An analysis was performed on all discharge reports of the Unit between January 2014 and July 2016. RESULTS: The MCC Unit has 6 beds and daily outpatient clinic...
May 9, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28492436/continuous-regional-anesthesia-and-inpatient-rehabilitation-for-pediatric-complex-regional-pain-syndrome
#11
Carolina Donado, Kimberly Lobo, María Fe Velarde-Álvarez, Joseph Kim, Anne Kenney, Deirdre Logan, Charles B Berde
BACKGROUND: Evidence supports treatment of pediatric complex regional pain syndromes (CRPS) with physical and occupational therapy and cognitive-behavioral therapy. Some patients have persistent pain and/or limb dysfunction despite these treatments. We performed a retrospective study of pediatric patients with CRPS treated by continuous epidural or peripheral perineural local anesthetic infusions along with inpatient rehabilitation at Boston Children's Hospital. METHODS: After approval from the institutional review board, electronic medical records were reviewed for patients treated between September 2003 and September 2014...
May 10, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28491301/short-and-long-term-results-of-an-inpatient-programme-to-manage-complex-regional-pain-syndrome-in-children-and-adolescents
#12
Giovanni Cucchiaro, Kevin Craig, Kerri Marks, Kristin Cooley, Thalitha Kay Black Cox, Jennifer Schwartz
The aim of this retrospective study was to determine whether an inpatient approach and the use of regional anaesthesia techniques can accelerate the recovery to normal functions in children with Complex Regional Pain Syndrome (CRPS). This study looked at the data of patients admitted to the rehabilitation unit with a diagnosis of CRPS from January 2010 to April 2015. Variables such as hospital stay, medications administered, regional anaesthesia procedures, changes in functional status prior to treatment and at the time of discharge, psychological evaluation and diagnosis were evaluated...
May 2017: British Journal of Pain
https://www.readbyqxmd.com/read/28487434/fifteen-minute-consultation-practical-pain-management-in-paediatric-palliative-care
#13
Emily Jane Harrop, Karen Brombley, Katherine Boyce
Pain and distress in the paediatric palliative care population can be very difficult to manage. Clinical scenarios range from the acute management of cancer-related pain at the end of life to the ongoing long-term support of children with complex multimodal pain related to progressive neurological conditions. Understanding the child's underlying condition, possible causes of pain and their preferred mode of communication are important to the delivery of holistic care. Modification of environmental factors, basic care consideration and non-pharmacological measures have a large role to play, alongside conventional analgesics...
May 9, 2017: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/28484356/associations-of-body-mass-index-and-gestational-weight-gain-with-term-pregnancy-outcomes
#14
Tatjana Barisic, Vjekoslav Mandic, Ivana Barac
INTRODUCTION: Obesity is one of the greatest health problems in the world. The World Health Organization (WHO) defined obesity as a disease in which the excess of adipose tissue accumulates in such a degree that is endangers health. Obesity is a very complex multifactor disease that is developed under the influence of genetic and metabolic factors, environment, social and cultural environment as well as bad habits. The causes of obesity can be numerous. The most common source of obesity is the development of energetic imbalance...
March 2017: Materia Socio-medica
https://www.readbyqxmd.com/read/28482392/-three-cases-with-familial-mediterranean-fever-misdiagnosed-as-juvenile-idiopathic-arthritis
#15
J Li, Y Zhang, W Wang, L Q Zhong, H M Song
Objective: To explore the key points of diagnosis and treatment of familial Mediterranean fever(FMF). Method: The clinical data of 3 cases with FMF misdiagnosed as Juvenile idiopathic arthritis(JIA)seen from January 2014 to June 2016 in Peking Union Medical College Hospital were retrospectively collected. The clinical manifestations, gene mutation characteristics, treatment and prognosis were also evaluated. Result: Two cases were male and 1 was female. The mean age of onset was 17 months (3 months to 36 months), while the average age of diagnosis was 6 years and 8 months (24 months to 11 years)...
May 4, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28482105/epidemiology-and-clinical-features-of-human-coronaviruses-in-the-pediatric-population
#16
Litty Varghese, Philip Zachariah, Celibell Vargas, Philip LaRussa, Ryan T Demmer, Yoko E Furuya, Susan Whittier, Carrie Reed, Melissa S Stockwell, Lisa Saiman
Background.: The epidemiology and clinical features of human coronaviruses (HCoVs) in children are not fully characterized. Methods.: A retrospective study of children with HCoV detected by reverse-transcriptase polymerase chain reaction (RT-PCR) was performed for a community cohort and a children's hospital in the same community from January 2013 to December 2014. The RT-PCR assay detected HCoV 229E, HKU1, NL63, and OC43 in nasal swabs from symptomatic children ≤18 years...
May 8, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28474389/developmental-functioning-and-medical-co-morbidity-profile-of-children-with-complex-and-essential-autism
#17
Jaimie Flor, Jayne Bellando, Maya Lopez, Amy Shui
Children with Autism Spectrum Disorders (ASD) may be characterized as "complex" (those with microcephaly and/or dysmorphology) or "essential" (those with neither of these two). Previous studies found subjects in the complex group exhibited lower IQ scores, poorer response to behavioral intervention, more seizures and more abnormal EEGs and brain MRIs compared to the essential group. The objective of this study was to determine if there are differences in complex versus essential subjects based on several developmental/psychological measures as well as certain medical comorbidities...
May 5, 2017: Autism Research: Official Journal of the International Society for Autism Research
https://www.readbyqxmd.com/read/28471395/after-the-visit-an-overview-of-government-and-community-programs-supporting-children-with-medical-complexity
#18
REVIEW
Kaitlyn B Olson
The optimal care of children with medical complexity (CMC) requires involvement from a network of professionals that includes physicians, nurses, ancillary service providers, and educators. Pediatric health care providers typically have early and frequent contact with the families of CMC. Therefore, they are in a unique position to connect families to developmental, educational, and psychosocial supports. This article reviews important government and community programs that support CMC living in the United States...
May 4, 2017: Children
https://www.readbyqxmd.com/read/28466610/neonatal-cardiac-surgery-in-the-new-era-lessons-learned-from-1000-consecutive-cases
#19
Gabriel Amir, Georgy Frenkel, Elchanan Bruckheimer, Alexander Lowenthal, Amichay Rotstein, Jacob Katz, Yelena Zeitlin, Ofer Schiller, Einat Birk
BACKGROUND: neonatal cardiac surgery has evolved over the last 50 years with a large percentage of the patients achieving complete physiological repair in the neonatal period. The remaining patients achieve staged palliation with an increasing amount of success. OBJECTIVES: To report our experience with 1000 neonatal cardiac surgical procedures performed in the last 10 years. METHODS: We conducted a retrospective analysis of surgical outcome in all neonatal patients who underwent cardiac surgery between January 2007 and July 2016 at Schneider Children's Medical Center of Israel...
November 2016: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28466116/cultural-sensitive-care-provision-in-a-public-child-and-adolescent-mental-health-centre-a-case-study-from-the-toulouse-university-hospital-intercultural-consultation
#20
Gesine Sturm, Sylvie Bonnet, Yolaine Coussot, Katja Journot, Jean-Philippe Raynaud
Child and adolescent mental health services in Europe are confronted with children with increasingly diverse socio-cultural backgrounds. Clinicians encounter cultural environments of hyperdiversity in terms of languages and countries of origin, growing diversity within groups, and accelerated change with regards to social and administrational situations (Hannah, in: DelVecchio Good et al. (eds) Shattering culture: American medicine responds to cultural diversity, Russel Sage Foundation, New York, 2011). Children and families who live in these complex constellations face multiple vulnerabilizing factors related to overlapping or intersecting social identities (Crenshaw in Univ Chic Leg Forum 140:139-167, 1989)...
May 2, 2017: Culture, Medicine and Psychiatry
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