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https://www.readbyqxmd.com/read/28447934/acute-kidney-injury-in-pediatric-patients-diagnosis-and-management-in-the-emergency-department
#1
Daniel Mohrer, Melissa Langhan
Pediatric acute kidney injury is a condition that is underdiagnosed among children seen in the emergency department, and it has been associated with significant morbidity and mortality, including increased risk for chronic kidney disease. The most common etiologies in pediatric patients are now known to be due to hypovolemia, sepsis, shock, and cardiac dysfunction. This issue compares 3 classification systems for the diagnosis and staging of acute kidney injury and reviews the etiologies that lead to kidney injury in children...
May 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28445241/serum-neutrophil-gelatinase-associated-lipocalin-a-diagnostic-marker-in-pediatric-sepsis
#2
Nagwan Yossery Saleh, Wafaa Moustafa M Abo El Fotoh, Mahmoud A El-Hawy
OBJECTIVES: Sepsis is a life-threatening condition that arises when the response of the body to infection injures its own tissues and organs. The early prediction of sepsis by current clinical and laboratory methods remains inadequate. Serum neutrophil gelatinase-associated lipocalin level is increased in sepsis irrespective of renal dysfunction. Therefore, we aimed to correlate the serum neutrophil gelatinase-associated lipocalin value determined at admission with clinical progression and severity of disease in critically ill children and to declare its role as a potential diagnostic and prognostic marker for sepsis in critically ill children in the emergency department...
April 25, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28444383/optimizing-drug-dose-alerts-using-commercial-software-throughout-an-integrated-health-care-system
#3
Salim M Saiyed, Peter J Greco, Glenn Fernandes, David C Kaelber
All default electronic health record and drug reference database vendor drug-dose alerting recommendations (single dose, daily dose, dose frequency, and dose duration) were silently turned on in inpatient, outpatient, and emergency department areas for pediatric-only and nonpediatric-only populations. Drug-dose alerts were evaluated during a 3-month period. Drug-dose alerts fired on 12% of orders (104 098/834 911). System-level and drug-specific strategies to decrease drug-dose alerts were analyzed. System-level strategies included: (1) turning off all minimum drug-dosing alerts, (2) turning off all incomplete information drug-dosing alerts, (3) increasing the maximum single-dose drug-dose alert threshold to 125%, (4) increasing the daily dose maximum drug-dose alert threshold to 125%, and (5) increasing the dose frequency drug-dose alert threshold to more than 2 doses per day above initial threshold...
April 24, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28444080/rhabdomyolysis-as-a-manifestation-of-a-metabolic-disease-a-case-report
#4
Marta Sousa Moniz, Maria Inês Mascarenhas, Carlos Escobar, Pedro Nunes, Clara Abadesso, Helena Loureiro, Helena Almeida
Rhabdomyolysis is a process of muscle destruction that can present with varying clinical manifestations. In pediatric patients, its main etiology is infectious diseases. We present a previously healthy adolescent who was admitted to our emergency department with a four-day history of myalgia, muscle weakness and dark urine. At presentation, she was dehydrated. Blood analysis revealed acute renal failure and increased muscular enzymes. She was transferred to our pediatric intensive care unit. Medical therapies for correction of dehydration and the ionic and metabolic consequences of renal failure were performed...
January 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28442924/a-framework-for-measuring-self-management-effectiveness-and-health-care-use-among-pediatric-asthma-patients-and-families
#5
REVIEW
Pavani Rangachari
Asthma is associated with substantial health care expenditures, including an estimated US$56 billion per year in direct costs. A recurring theme in the asthma management literature is that costly asthma symptoms, including hospitalizations and multiple emergency department (ED)/outpatient visits, can often be prevented through patient/family adherence to the national (National Institutes of Health Expert Panel Report-3) guidelines for effective self-management of asthma, specifically 1) medication adherence and 2) environmental trigger avoidance, as outlined in the patient's personalized Asthma-Action Plan...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28441243/emergency-point-of-care-ultrasound-diagnosis-of-retained-soft-tissue-foreign-bodies-in-the-pediatric-emergency-department
#6
Terry Varshney, Charisse W Kwan, Jason W Fischer, Alyssa Abo
The presence of a foreign body (FB), its depth and size, is often indeterminate by clinical examination. Conventional imaging such as a radiograph can fail to visualize soft tissue FBs. We present 2 cases where point-of-care ultrasound was used to detect previously unidentified FBs.
April 24, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28441242/identifying-undiagnosed-pediatric-mental-illness-in-the-emergency-department
#7
La Vonne A Downey, Leslie S Zun
BACKGROUND: It is well known that pediatric psychiatric patients frequent emergency department (ED), but the number of patients with undiagnosed psychiatric illness presenting to an ED is not well known. Identification and referral of these patients may provide an opportunity for improved patient care. The primary study objective was to identify a tool that can screen for unsuspected psychiatric illness in pediatric patients who present to the ED with non-psychiatric-related complaints...
April 24, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28441241/pelvic-inflammatory-disease-in-a-pediatric-emergency-department-epidemiology-and-treatment
#8
Michelle Solomon, Lisa Tuchman, Katie Hayes, Gia Badolato, Monika K Goyal
OBJECTIVES: Most adolescent cases of pelvic inflammatory disease (PID) are diagnosed in the emergency department (ED). An important step to prevent PID-related morbidity among this high-risk population is to quantify prevalence and microbial patterns and identify testing and treatment gaps. METHODS: We performed a retrospective, cross-sectional study of all visits by adolescents to an urban children's ED with an International Classification of Diseases, Ninth Revision, diagnosis of PID in 2012...
April 24, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28441240/emergency-department-management-of-bronchiolitis-in-the-united-states
#9
Constance Gong, Terri Byczkowski, Constance McAneney, Monika K Goyal, Todd A Florin
OBJECTIVE: The aim of this study was to examine differences between general and pediatric emergency departments (PEDs) in adherence to the American Academy of Pediatrics bronchiolitis management guidelines. METHODS: We conducted a nationally representative study of ED visits by infants younger than 24 months with bronchiolitis from 2002 to 2011 using the National Hospital Ambulatory Medical Care Survey. Diagnostic testing (complete blood counts, radiographs) and medication use (albuterol, corticosteroids, antibiotics and intravenous fluids) in general emergency departments (GEDs) were compared with those in PEDs before and after 2006 American Academy of Pediatrics guideline publication...
April 24, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28435900/characteristics-of-orbital-wall-fractures-in-preschool-and-school-aged-children
#10
Dong Jin Yang, Youn-Jung Kim, Dong-Woo Seo, Hyung-Joo Lee, In-June Park, Chang Hwan Sohn, Jung Min Ryoo, Jong Seung Lee, Won Young Kim, Kyoung Soo Lim
OBJECTIVE: This study aimed to evaluate the injury patterns in pediatric patients with an orbital wall fracture (OWF) and to identify the differences in injury patterns between preschool and school-aged patients with OWF who presented to the emergency department. METHODS: We performed a retrospective observational study in the emergency department of a tertiary hospital between January 2004 and March 2014. A total of 177 pediatric patients (<18 years) with OWF who underwent facial bone computed tomography scans with specific discharge codes were included...
March 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28435500/skin-to-intramuscular-compartment-thigh-measurement-by-ultrasound-in-pediatric-population
#11
Myto Duong, Albert Botchway, Jonathan Dela Cruz, Richard Austin, Kevin McDaniel, Cassie Jaeger
INTRODUCTION: Pediatric obesity threatens the efficacy of medications given intramuscularly. In anaphylactic patients, epinephrine auto-injector needle lengths are potentially too short to reach the muscle compartment in patients with elevated body habitus. The objective of the study was to determine needle-length requirements for intramuscular injections in pediatric patients. METHODS: We used ultrasound to measure the distance from skin to muscle compartment of the thigh in 200 pediatric patients of various weight and body mass index who presented to the emergency department...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28434635/readmissions-unplanned-emergency-room-visits-and-surgical-retreatment-rates-after-anti-reflux-procedures
#12
Hsin-Hsiao S Wang, Rohit Tejwani, Steven Wolf, John S Wiener, Jonathan C Routh
INTRODUCTION/BACKGROUND: The choice between endoscopic injection (EI) and ureteroneocystotomy (UNC) for surgical correction of vesicoureteral reflux (VUR) is controversial. OBJECTIVE: To compare postoperative outcomes of EI vs UNC. STUDY DESIGN: This study reviewed linked inpatient (SID), ambulatory surgery (SASD), and emergency department (SEDD) data from five states in the United States (2007-10) to identify pediatric patients with primary VUR undergoing EI or UNC as an initial surgical intervention...
April 7, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28434051/evidence-of-a-link-between-fever-and-microscopic-hematuria-in-children
#13
Rama Schwartz, Rotem Distal, Arthur Shapiro, Yehezkel Waisman
Despite the common conception that febrile illnesses are associated with microscopic hematuria in children, a review of the literature failed to disclose supportive evidence. The aim of this study was to evaluate this relationship. Background data were collected for a convenience sample of children aged 4-18 years who presented to the emergency department (ED) of a tertiary pediatric medical center. Vital signs were measured and a midstream urine specimen was collected. Specimens positive for the presence of blood (>5 erythrocytes/μl; Combur 10 Test Strips) were examined microscopically...
April 22, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28433455/peritoneal-fluid-localization-on-fast-examination-in-the-pediatric-trauma-patient
#14
Timothy E Brenkert, Cynthia Adams, Rebecca L Vieira, Rachel G Rempell
OBJECTIVE: To determine the location of intraperitoneal free fluid on FAST exam in pediatric patients undergoing evaluation for trauma. METHODS: Retrospective review of all FAST exams positive for intraperitoneal free fluid performed in patients sustaining trauma between August 2009 and February 2016 in an urban pediatric emergency department. Positive results were categorized into one of nine potential intraperitoneal locations; 4 each in the right and left upper quadrants, and the pelvis...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28433211/adverse-events-during-a-randomized-trial-of-ketamine-versus-co-administration-of-ketamine-and-propofol-for-procedural-sedation-in-a-pediatric-emergency-department
#15
Keith Weisz, Lalit Bajaj, Sara J Deakyne, Lina Brou, Alison Brent, Joseph Wathen, Genie E Roosevelt
BACKGROUND: The co-administration of ketamine and propofol (CoKP) is thought to maximize the beneficial profile of each medication, while minimizing the respective adverse effects of each medication. OBJECTIVE: Our objective was to compare adverse events between ketamine monotherapy (KM) and CoKP for procedural sedation and analgesia (PSA) in a pediatric emergency department (ED). METHODS: This was a prospective, randomized, single-blinded, controlled trial of KM vs...
April 19, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28432613/pediatric-tonsillectomy-is-a-resource-intensive-procedure-a-study-of-canadian-health-administrative-data
#16
Kimmo T T Murto, Sherri L Katz, Daniel I McIsaac, Matthew A Bromwich, Régis Vaillancourt, Carl van Walraven
BACKGROUND: The majority of pediatric surgeries are performed in a day surgery setting. The rate of adverse postoperative outcomes and the factors that influence them are poorly described in the Canadian setting. Concerns about the safety of adenotonsillectomy (AT) have been raised. The objective of this Ontario-based study was to determine the rates and risks of hospital readmission, emergency department (ED) visits, or deaths within 30 days following common pediatric surgeries, with an emphasis on AT...
April 21, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28427414/observational-study-of-interleukin-21-il-21-does-not-distinguish-kawasaki-disease-from-other-causes-of-fever-in-children
#17
Rachel Engelberg, Meghan Martin, Brian H Wrotniak, Mark Daniel Hicar
BACKGROUND: Kawasaki disease (KD) is a febrile childhood vasculitis of unknown etiology. The diagnosis is highly concerning as over a quarter of children who fail to receive timely treatment with intravenous immunoglobulin (IVIG) will develop coronary aneurysms. Diagnosis relies on proper symptomatology and is supported by non-specific markers of inflammation. Previous studies have identified elevated plasma levels of interleukin-21 (IL-21) as a sensitive and specific biomarker in KD...
April 20, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28426447/measles-cases-in-children-requiring-hospital-access-in-an-academic-pediatric-hospital-in-italy-2008-2013
#18
Marta Ciofi Degli Atti, Antonietta Filia, Antonino Bella, Annamaria Sisto, Maria Antonietta Barbieri, Antonino Reale, Massimiliano Raponi
BACKGROUND: The Lazio Region is one of the Italian regions where sustained measles transmission continues to occur. We investigated measles cases reported by the Emergency Department (ED) of the largest pediatric hospital in Italy, located in Lazio. METHODS: We reviewed clinical records of all measles cases from 0 to 18 years of age evaluated in the ED in 2008-2013. We compared demographic and clinical characteristics of patients admitted to the inpatient setting with those of patients discharged home, to assess possible determinants of hospital admission...
April 18, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28423460/individual-and-neighborhood-characteristics-of-children-seeking-emergency-department-care-for-firearm-injuries-within-the-pecarn-network
#19
Patrick M Carter, Lawrence J Cook, Michelle L Macy, Mark R Zonfrillo, Rachel M Stanley, James M Chamberlain, Joel A Fein, Elizabeth R Alpern, Rebecca Cunningham
OBJECTIVE: To describe the characteristics of children seeking emergency care for firearm injuries within the PECARN network, and assess the influence of both individual and neighborhood factors on firearm-related injury risk. METHODS: This was a retrospective, multicenter cross-sectional analysis of children (<19-years-old) presenting to 16 pediatric EDs (2004-2008). ICD-9-CM E-codes were used to identify and categorize firearm injuries by mechanism/intent. Neighborhood variables were derived from home address data...
April 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28422636/impact-of-pans-and-pandas-exacerbations-on-occupational-performance-a-mixed-methods-study
#20
Janice Trigilio Tona, Sutanuka Bhattacharjya, Denise Calaprice
OBJECTIVE: Pediatric acute-onset neuropsychiatric syndrome (PANS) includes pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and involves sudden-onset neuropsychiatric symptoms, including obsessions, compulsions, sensory difficulties, and dysgraphia after infection or other triggers. Our objective was to identify problems with areas of occupation, body functions, and performance skills during exacerbations. METHOD: In this online retrospective study, based on the Occupational Therapy Practice Framework: Domain and Process (2nd ed...
May 2017: American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association
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