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https://www.readbyqxmd.com/read/28719391/pediatric-and-congenital-hand-transplantation
#1
Sandra Amaral, L Scott Levin
PURPOSE OF REVIEW: We review the approach and challenges associated with pediatric hand transplantation, including new knowledge gleaned from our recent case of bilateral hand-forearm transplantation in an 8-year old child. RECENT FINDINGS: Bilateral heterologous hand-forearm transplantation was performed in a child with a prior kidney transplant in July 2015. The initial surgery necessitated a large team of experts in microvascular surgery, transplant surgery, orthopedics and plastic surgery as well as pediatric anesthesia...
July 14, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28713146/-being-persistent-without-being-pushy-student-reflections-on-vaccine-hesitancy
#2
Amy E Caruso Brown, Manika Suryadevara, Thomas R Welch, Ann S Botash
Our goal as pediatric educators is to graduate physicians who have witnessed effective approaches and have grasped the nuances of communication strategies between vaccine-hesitant families and health care providers. We identified vaccine hesitancy as a recurring topic in 19 of 304 medical student reflective narratives addressing an issue in professionalism or systems-based practice. We conducted content analysis on the narratives in order to gain a better understanding of student perceptions of visits in which they observed a provider discussing vaccine hesitancy with a parent...
2017: Narrative Inquiry in Bioethics
https://www.readbyqxmd.com/read/28710227/advancing-concussion-assessment-in-pediatrics-a-cap-a-prospective-concurrent-cohort-longitudinal-study-of-mild-traumatic-brain-injury-in-children-protocol-study
#3
Keith Owen Yeates, Miriam Beauchamp, William Craig, Quynh Doan, Roger Zemek, Bruce Bjornson, Jocelyn Gravel, Angelo Mikrogianakis, Bradley Goodyear, Nishard Abdeen, Christian Beaulieu, Mathieu Dehaes, Sylvain Deschenes, Ashley Harris, Catherine Lebel, Ryan Lamont, Tyler Williamson, Karen Maria Barlow, Francois Bernier, Brian L Brooks, Carolyn Emery, Stephen B Freedman, Kristina Kowalski, Kelly Mrklas, Lianne Tomfohr-Madsen, Kathryn J Schneider
INTRODUCTION: Paediatric mild traumatic brain injury (mTBI) is a public health burden. Clinicians urgently need evidence-based guidance to manage mTBI, but gold standards for diagnosing and predicting the outcomes of mTBI are lacking. The objective of the Advancing Concussion Assessment in Pediatrics (A-CAP) study is to assess a broad pool of neurobiological and psychosocial markers to examine associations with postinjury outcomes in a large sample of children with either mTBI or orthopaedic injury (OI), with the goal of improving the diagnosis and prognostication of outcomes of paediatric mTBI...
July 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28697643/parental-perceptions-about-informed-consent-assent-in-pediatric-research-in-jordan
#4
Omar F Khabour, Mahmoud A Alomari, Nihaya A Al-Sheyab
The informed consent/assent process during enrollment in pediatric research is integral to protecting children from possible harm. Here we explored parents' perceptions about the informed consent/assent process in Jordan. Therefore, focus group interviews were conducted that focused on the importance of consent/assent, the quality of the information provided during consent process, and the parents' perceptions toward written/verbal informed consent. Content thematic analysis approach was adopted in the transcription and translation processes of the interviews...
July 1, 2017: Journal of Empirical Research on Human Research Ethics: JERHRE
https://www.readbyqxmd.com/read/28691236/response-to-vogelstein-how-the-2012-aap-task-force-on-circumcision-went-wrong
#5
Robert S Van Howe
Vogelstein cautions medical organizations against jumping into the fray of controversial issues, yet proffers the 2012 American Academy of Pediatrics' Task Force policy position on infant male circumcision as 'an appropriate use of position-statements.' Only a scratch below the surface of this policy statement uncovers the Task Force's failure to consider Vogelstein's many caveats. The Task Force supported the cultural practice by putting undeserved emphasis on questionable scientific data, while ignoring or underplaying the importance of valid contrary scientific data...
July 9, 2017: Bioethics
https://www.readbyqxmd.com/read/28682718/the-ventricular-assist-device-in-the-life-of-the-child-a-phenomenological-pediatric-study
#6
Michael A van Manen
What is it like for a child to live with an artificial heart? The use of some medical therapies in children requires developmental considerations, is associated with psychosocial consequences, and calls for ethical sensitivities. A critical case is the ventricular assist device (VAD), a mechanical pump used to support the functioning of a failing heart. As a pediatric therapy, the device can be used as a temporary solution for poor heart function, a bridge to transplantation or recovery, or as a destination therapy...
May 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/28674673/pediatric-medicine-development-an-overview-and-comparison-of-regulatory-processes-in-the-european-union-and-united-states
#7
Dobromir Penkov, Paolo Tomasi, Irmgard Eichler, Dianne Murphy, Lynne P Yao, Jean Temeck
Pediatric legislation in the US and the EU is driving pediatric product development on an international scale. To facilitate harmonization and global development of pediatric medicines, it is important to understand the legislative requirements that must be met along with incentives that exist in the US and the EU to include pediatric patients in therapeutic clinical trials. Although there are many similarities, differences exist. This review is an effort to enhance understanding of the pediatric legislation in both regions...
May 1, 2017: Therapeutic Innovation & Regulatory Science
https://www.readbyqxmd.com/read/28659167/deviations-from-the-expected-relationship-between-serum-fgf23-and-other-markers-in-children-with-ckd-a-cross-sectional-study
#8
Daisy Liu, Ana Catalina Alvarez-Elías, Brooke Wile, Vladimir Belostotsky, Guido Filler
BACKGROUND: High levels of fibroblast growth factor-23 (FGF23) are associated with mortality. In chronic kidney disease (CKD), FGF23 levels rise as renal function declines. We analyzed the contribution of laboratory values to the variance of FGF23 levels in relationship to a curve of expected FGF23 levels for a given GFR. METHODS: Following approval by the research ethics boards, we measured FGF23, CysC eGFR, creatinine, urea, albumin, calcium, phosphate, vitamin D metabolites, PTH, alkaline phosphatase, CRP, and venous gases in 141 pediatric CKD patients (45, 37, 32, 13 and 14 CKD stages I, II, III, IV, and V, respectively)...
June 28, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28640695/gadolinium-brain-deposition-after-macrocyclic-gadolinium-administration-a-pediatric-case-control-study
#9
Daniel Tibussek, Christin Rademacher, Julian Caspers, Bernd Turowski, Jörg Schaper, Gerald Antoch, Dirk Klee
Purpose To determine whether signal intensity (SI) in T1 sequences as a potential indicator of gadolinium deposition increases after repeated administration of the macrocyclic gadolinium-based contrast agents (GBCAs) gadoteridol and gadoterate meglumine in a pediatric cohort. Materials and Methods This retrospective case-control study of children with brain tumors who underwent nine or more contrast material-enhanced brain magnetic resonance (MR) imaging studies from 2008 to 2015 was approved by the local ethics board...
June 21, 2017: Radiology
https://www.readbyqxmd.com/read/28640031/identifying-gaps-in-the-performance-of-pediatric-trainees-who-receive-marginal-unsatisfactory-ratings
#10
Su-Ting T Li, Daniel J Tancredi, Alan Schwartz, Ann Guillot, Ann Burke, R Franklin Trimm, Susan Guralnick, John D Mahan, Kimberly A Gifford
PURPOSE: To perform a derivation study to determine in which subcompetencies marginal/unsatisfactory pediatric residents had the greatest deficits compared with their satisfactorily performing peers and which subcompetencies best discriminated between marginal/unsatisfactory and satisfactorily performing residents. METHOD: Multi-institutional cohort study of all 21 milestones (rated on four or five levels) reported to the Accreditation Council for Graduate Medical Education, and global marginal/unsatisfactory versus satisfactory performance reported to the American Board of Pediatrics...
June 20, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28638969/introduction-childhood-and-disability
#11
EDITORIAL
Erica K Salter
From growth attenuation therapy for severely developmentally disabled children to the post-natal management of infants with trisomy 13 and 18, pediatric treatment decisions regularly involve assessments of the probability and severity of a child's disability. Because these decisions are almost always made by surrogate decision-makers (parents and caregivers) and because these decision-makers must often make decisions based on both prognostic guesses and potentially biased quality of life judgments, they are among the most ethically complex in pediatric care...
June 21, 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/28638256/comparison-of-ultrasonography-and-low-dose-computed-tomography-for-the-diagnosis-of-pediatric-urolithiasis-in-the-emergency-department
#12
Recep Sade, Hayri Ogul, Suat Eren, Akin Levent, Mecit Kantarci
OBJECTIVE: This study aimed to compare ultrasonography (US) and low-dose computed tomography (LDCT) for diagnosing pediatric urolithiasis in the emergency department. MATERIALS AND METHODS: This retrospective study was approved by our institutional ethics committee, and informed consent was waived. From March 2016 to March 2017, 100 consecutive patients met the selection criteria and were enrolled in the study. Patients were randomly selected in a 1:1 ratio and were allocated to one of the following two imaging groups: US or abdominal LDCT...
June 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28625022/ethical-moral-and-theological-insights-into-advances-in-male-pediatric-and-adolescent-fertility-preservation
#13
REVIEW
J J Ramstein, J Halpern, A J Gadzinski, R E Brannigan, J F Smith
The successful treatment of boys with cancer has led to increasing attention to preserving their quality of life after completing cancer therapy. One of the top priorities for living a full life is keeping open the opportunity to have children. While sperm banking for males facing sterilizing cancer treatment can be effective, this approach requires subsequent use of reproductive procedures such as in vitro fertilization (IVF) or intrauterine insemination (IUI) to achieve a pregnancy. Advances in fertility preservation techniques may allow pre-pubertal boys to conceive using advanced stem cell technologies and stem cell transplantation in the future...
June 18, 2017: Andrology
https://www.readbyqxmd.com/read/28612650/pediatric-nurses-ethical-difficulties-in-the-bedside-care-of-children
#14
Kwisoon Choe, Yoonjung Kim, Yoonseo Yang
BACKGROUND: Pediatric nurses experience ethically difficult situations in their everyday work. Several studies have been conducted to reveal ethical issues among pediatric nurses; we do not think their ethical difficulties have been explored sufficiently from their own perspective. OBJECTIVES: This study aimed to explore the ethical difficulties faced by pediatric nurses during bedside care for hospitalized children. METHODS: A phenomenological approach was used to collect and analyze interview data from 14 female pediatric nurses in South Korea...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28609432/protective-effects-of-amniotic-fluid-in-the-setting-of-necrotizing-enterocolitis
#15
REVIEW
Soham Dasgupta, Sunil Kumar Jain
Necrotizing Enterocolitis (NEC) is the most common life threatening condition affecting preterm infants. NEC occurs in 1-5% of all neonatal intensive care admissions and 5-10% of very low birth weight infants. The protective role of human breast milk (BM) has been well established. It has also been shown that amniotic fluid (AF) and breast milk have many similarities in terms of presence of growth and other immune-modulatory factors. This finding led to the initial hypothesis that AF may exert similar protective effects against the development of NEC as does BM...
June 13, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28562463/an-ethical-justification-for-termination-of-resuscitation-protocols-for-pediatric-patients
#16
Michael G Muñoz, David H Beyda
OBJECTIVE: The aim of this article was to compare specific characteristics and outcomes among adult and pediatric out-of-hospital cardiac arrest (OHCA) patients to show that the existing literature warrants the design and implementation of pediatric studies that would specifically evaluate termination of resuscitation protocols. We also address the emotional and practical concerns associated with ceasing resuscitation efforts on scene when treating pediatric patients. METHODS: Relevant prospective and retrospective studies were used to compare characteristics and outcomes between adult and pediatric OHCA patients...
July 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28562269/ethical-conduct-of-research-in-children-pediatricians-and-their-irb-part-2-of-2
#17
REVIEW
Carlos D Rose
In part 1 of this series, we discussed the historical, ethical, and legal background that provides justification for the current system of protection of subjects of human experimentation. We also discussed briefly the implementation of those principles in institutional review board (IRB) operations. In part 2, we focus on legislation dealing with pediatric research, the rules and ethics of assent, and then turn our attention to minimal-risk studies. To that end, we discuss the minimal-risk threshold and the process of balancing benefit and risk in IRB decisions for pediatric studies...
May 11, 2017: Pediatrics
https://www.readbyqxmd.com/read/28557746/ethical-conduct-of-research-in-children-pediatricians-and-their-irb-part-1-of-2
#18
REVIEW
Carlos D Rose
As human experimentation continues to grow into an ever more complex and sophisticated endeavor, the relevant ethical and regulatory structures become more intricate. When pediatricians and general practitioners are invited by pharmaceutical companies to enroll their offices in a clinical trial or a multicenter observational study or when they develop their own research questions, they frequently find themselves at a loss in the human research environment. The legal and regulatory complexity may have an unintended deterring effect at a time when office-based high quality pediatric research is urgently needed to support evidence-based medicine...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28523117/evaluation-of-pediatric-residents-attitudes-toward-ethical-conflict-a-cross-sectional-study-in-tehran-iran
#19
Maliheh Kadivar, Marjan Mardani-Hamooleh, Shiva Shayestefar
Ethical conflicts are recognized as critical aspects in assessing competence in clinical communication. Moreover, pediatrics residents may face more problems, compared to other disciplines; due to the specific characteristics of the age group receiving services as well as the presence of their families. This study has been conducted with the aim of determining the attitude and perspective of pediatric residents toward ethical conflicts in the field of pediatrics. This descriptive, cross-sectional study was carried out on all residents of Tehran University of Medical Sciences (90 residents), selected through census method, in 2014...
2017: Journal of Medical Ethics and History of Medicine
https://www.readbyqxmd.com/read/28513861/regulatory-and-ethical-issues-in-pediatric-clinical-research-recommendations-from-a-panel-discussion
#20
Nilima Kshirsagar, Soumya Swaminathan, Pramod Jog, Samir Dalwai, Roli Mathur, Chandra Shekhar, Bernd Meibohm, Y K Gupta, Nusrat Shafiq, Gangadhar Sunkara, V G Somani, Prasad Kulkarni, Brian Tseng, Dhvani Mehta
No abstract text is available yet for this article.
August 2017: Journal of Clinical Pharmacology
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