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Pediatric hospital medicine

Zornitza Stark, Sebastian Lunke, Gemma R Brett, Natalie B Tan, Rachel Stapleton, Smitha Kumble, Alison Yeung, Dean G Phelan, Belinda Chong, Miriam Fanjul-Fernandez, Justine E Marum, Matthew Hunter, Anna Jarmolowicz, Yael Prawer, Jessica R Riseley, Matthew Regan, Justine Elliott, Melissa Martyn, Stephanie Best, Tiong Y Tan, Clara L Gaff, Susan M White
PurposeThe purpose of the study was to implement and prospectively evaluate the outcomes of a rapid genomic diagnosis program at two pediatric tertiary centers.MethodsRapid singleton whole-exome sequencing (rWES) was performed in acutely unwell pediatric patients with suspected monogenic disorders. Laboratory and clinical barriers to implementation were addressed through continuous multidisciplinary review of process parameters. Diagnostic and clinical utility and cost-effectiveness of rWES were assessed.ResultsOf 40 enrolled patients, 21 (52...
March 15, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
Albert C Hergenroeder, Douglas S Moodie, Daniel J Penny, Constance M Wiemann, Blanca Sanchez-Fournier, Lauren K Moore, Jane Head
OBJECTIVE: To describe changes in functional status between the last pediatric and first adult congenital heart disease (CHD) clinic visits in patients with moderate to severe CHD after implementing a healthcare transition (HCT) planning program. DESIGN: Quasi-experimental design. Patients were followed prospectively following the implementation of the intervention; Control patients transitioned from the Pediatric CHD Clinic into Adult CHD Clinic before the intervention...
March 15, 2018: Congenital Heart Disease
Mackensie A Yore, Matthew C Strehlow, Lily D Yan, Elizabeth A Pirrotta, Joan L Woods, Koy Somontha, Yim Sovannra, Lauren Auerbach, Rebecca Backer, Christophe Grundmann, Swaminatha V Mahadevan
BACKGROUND: Emergency medicine is a young specialty in many low- and middle-income countries (LMICs). Although many patients seeking emergency or acute care are children, little information is available about the needs and current treatment of this group in LMICs. In this observational study, we sought to describe characteristics, chief complaints, management, and outcomes of children presenting for unscheduled visits to two Cambodian public hospitals. METHODS: Children enrolled in the study presented without appointment for treatment at one of two Cambodian public referral hospitals during a 4-week period in 2012...
March 13, 2018: International Journal of Emergency Medicine
Mehdi Trifa, Dmitry Tumin, Hina Walia, Kathleen L Lemanek, Joseph D Tobias, Tarun Bhalla
Background: The use of complementary and alternative medicine (CAM) therapies has increased in children, especially in those with chronic health conditions. However, this increase may not translate into acceptance of CAM in the perioperative setting. We surveyed caregivers of patients undergoing surgery to determine their knowledge and acceptance of hypnotherapy, acupuncture, and music therapy as alternatives to standard medication in the perioperative period. Materials and methods: An anonymous, 12-question survey was administered to caregivers of children undergoing procedures under general anesthesia...
2018: Journal of Pain Research
Barbara P Yawn, Peter C Wollan, Matthew A Rank, Susan L Bertram, Young Juhn, Wilson Pace
PURPOSE: The purpose of this study was to assess patient and practice outcomes after introducing the Asthma APGAR (Activities, Persistent, triGGers, Asthma medications, Response to therapy) tools into primary care practices. METHODS: We used a pragmatic cluster-randomized controlled design in 18 US family medicine and pediatric practices to compare outcomes in patients with persistent asthma aged 5 to 45 years after introduction of the Asthma APGAR tools vs usual care...
March 2018: Annals of Family Medicine
M Colinart-Thomas, V Noël, G Roques, S Gordes-Grosjean, M Abely, C Pluchart
Sickle cell disease, a hemoglobin disorder with autosomal recessive transmission, is one of the most common genetic diseases screened in France. Thanks to early management, 95% of sickle cell patients reach adulthood and require transition from pediatric care to adult care. Through a retrospective study of records from serious sickle cell patients over 17 years old, followed in the hematology-oncology pediatric unit of Reims University Hospital Center in France, we analyzed transition conditions, compared pediatric and adult management, and proposed a plan for transition care...
March 9, 2018: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Kristl Tomlin, Lucia Mirea, Amy Williamson
STUDY OBJECTIVE: The American Academy of Pediatrics and American College of Obstetricians and Gynecologists have identified the menstrual cycle as essential in assessing overall health of adolescent girls. Menses should be considered a "vital sign" and documentation of last menstrual period (LMP) is recommended at every patient encounter. The aim of this study is to estimate and compare LMP documentation among adolescent and pediatric healthcare providers. STUDY DESIGN, SETTING, AND PARTICIPANTS: A retrospective cohort study identified a random sample of 50 female patients seen in the general pediatrics (PEDS), adolescent medicine (AM), and pediatric and adolescent gynecology (PAG) ambulatory clinics at Phoenix Children's Hospital between January 1, 2016 and March 31, 2016...
March 7, 2018: Journal of Pediatric and Adolescent Gynecology
Corrie E McDaniel, Wren Haaland, Joshua Parlaman, Chuan Zhou, Arti D Desai
OBJECTIVES: The majority of children with community acquired pneumonia (CAP) are primarily evaluated in community hospital emergency departments (EDs); however, studies on the management of pediatric CAP have largely targeted care provided in free-standing children's hospital EDs or inpatient settings. The objectives of this study were to examine whether implementation of a CAP pathway within three community hospital EDs and inpatient units improved process measures related to appropriate laboratory testing and antibiotic prescribing, and to compare performance on these measures between the community hospitals and a free-standing children's hospital...
March 7, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Wenti Xu, Liru Guo, Xiaochun Dong, Xiaoxia Li, Penghui Zhou, Qiang Ni, Xinying Zhou, Abram L Wagner, Lin Li
Severe acute respiratory infection (SARI) occupies a huge disease and economic burden in the world. The aim of this study was to describe the frequency and types of different infectious etiologies among hospitalized patients with SARI in Tianjin, China, from 2015-2016. SARI patients' basic information was collected, along with a throat or serum sample. Nine viruses were detected by RT-PCR, and Mycoplasma pneumoniae was detected by the serodia Myco II gelatin particle agglutination test. 585 specimens from 2290 SARI cases were collected...
February 28, 2018: Japanese Journal of Infectious Diseases
Meredith Merz Lind, Marco Corridore, Cameron Sheehan, Melissa Moore-Clingenpeel, Tensing Maa
Objective To design and assess an advanced pediatric airway management course, through simulation-based team training and with multiple disciplines, to emphasize communication and cooperation across subspecialties and to provide a common skill set and knowledge base. Methods Trainees from anesthesiology, emergency medicine, critical care, pediatric surgery, and otolaryngology at a tertiary children's hospital participated in a 1-day workshop emphasizing airway skills and complex airway simulations. Small groups were multidisciplinary to promote teamwork...
February 1, 2018: Otolaryngology—Head and Neck Surgery
R Serene Perkins, Maura Boyce, Megan C Byrtek, Regina C Ellis, Cindy Hill, Paul S Fitzpatrick, Shaban Demirel
Background: Randomized trials on clinical outcomes of music are conflicting, with few performed in the postoperative pediatric population. We aimed to determine if there was a benefit of a live, customized bedside music delivery program (MyMusicRx® ) for children hospitalized after pediatric surgery. We present our perspective on the utility of music medicine, review others' work in this area, and discuss future directions. Methods: All admitted postsurgical patients aged between 5 and 18 years were considered...
2018: Frontiers in Oncology
Lauren N Ko, Daniela Kroshinsky
BACKGROUND: Although considered an outpatient specialty, dermatology plays an important role in inpatient medicine. We characterized the activity and structure of dermatology consultation services in select U.S. hospitals. METHODS: In this cross sectional study, a 31-question survey was distributed in person to 32 board-certified dermatologists at the 2017 Society of Dermatology Hospitalists meeting. RESULTS: Thirty participants completed the survey (yield 93...
February 22, 2018: International Journal of Dermatology
Darcy A Thompson, Deborah A Federspiel
Darcy A Thompson is an Associate Professor of pediatrics at the University of Colorado School of Medicine. Her main research seeks to address early childhood obesity in low-income children. She works in the Lifestyle Medicine clinic at Children's Hospital Colorado, a clinic focused on caring for children with obesity and related comorbidities. She is also an Associate Medical Director for the Research Institute at Children's Hospital Colorado. Her training includes a Master of Public Health degree, a medical degree (Yale University) and the Robert Wood Johnson Clinical Scholars Fellowship (University of Washington)...
February 21, 2018: Journal of Comparative Effectiveness Research
Aaron Cunningham, Marc Auerbach, Mark Cicero, Mubeen Jafri
BACKGROUND: Recent mass casualty events in the United States have highlighted the need for public preparedness to prevent death from uncontrolled hemorrhage. The Pediatric Trauma Society (PTS) reviewed the literature regarding pediatric tourniquet usage with the aim to provide recommendations about the utility of this adjunct for hemorrhage control in children. METHODS: Search terms "pediatric" and "tourniquet" were used to query the US National Library of Medicine National Institutes of Health for pertinent literature...
February 17, 2018: Journal of Trauma and Acute Care Surgery
Pratap Kumar Patra, Manish Kumar
Background: Data on rheumatological disorders in children from developing countries like India are scarce. Hence, this study aimed to understand the clinical and epidemiological profile of rheumatological disorders in children as this can help organize comprehensive evidence-based health care services. Methodology: A retrospective hospital-based study was designed in pediatric rheumatology clinic of the All India Institute of Medical Sciences, Patna, India, from January 2015 to December 2016...
January 2018: Journal of Natural Science, Biology, and Medicine
Kriti Mishra, V Siddharth
Context: A limited number of caregivers of children with developmental delay access rehabilitation facilities in India. The study explored utilization of rehabilitation services at a tertiary care setup in southwestern Rajasthan and various factors influencing it. Aims: The aim of this study is to explore rehabilitation service utilization among children with developmental delay at a tertiary care setup and to ascertain factors that influence this pattern. Settings: This study was conducted at the department of physical medicine and rehabilitation at tertiary care setup...
January 2018: Journal of Neurosciences in Rural Practice
Mindy Galleher, Briana Crowe, Mitchell Selhorst
Objectives: The purposes of this study were to: (1) assess the benefit of adding manual therapy (MT) to physical therapy care in pediatric patients with anterior hip pain; (2) assess the relative risk of adverse reactions when MT is used; and (3) report the types of MT used. Methods: This study was a retrospective chart review of patients treated in a hospital-based sports medicine clinic. The charts of 201 patients (mean age = 14.23 ± 2.15 years) met the inclusion criteria and were reviewed...
December 2017: Journal of Manual & Manipulative Therapy
Priya Bhaskar, Mallikarjuna Rettiganti, Jeffrey M Gossett, Punkaj Gupta
Background: The existing training pathways to become a pediatric cardiac intensivist are very variable with physicians coming from varied training backgrounds of pediatric critical care, pediatric cardiology, neonatology, or pediatric anesthesia. Aim: To evaluate the impact of cardiac Intensive Care Unit (ICU) attending physician training background on outcomes in children undergoing heart operations. Setting and Design: Patients in the age group from 1 day to 18 years undergoing heart operation at a Pediatric Health Information System database participating hospital were included (2010-2015)...
January 2018: Annals of Pediatric Cardiology
Joanna Thomson, Heidi Sucharew, Andrea T Cruz, Lise E Nigrovic, Stephen B Freedman, Aris C Garro, Fran Balamuth, Rakesh D Mistry, Joseph L Arms, Paul T Ishimine, Dina M Kulik, Mark I Neuman, Samir S Shah
OBJECTIVES: To determine age-specific reference values and quantify age-related changes for cerebrospinal fluid (CSF) white blood cell (WBC) counts and protein and glucose concentrations in infants ≤60 days of age. METHODS: This multicenter, cross-sectional study included infants ≤60 days old with CSF cultures and complete CSF profiles obtained within 24 hours of presentation. Those with conditions suspected or known to cause abnormal CSF parameters (eg, meningitis) and those with a hospital length of stay of >72 hours were excluded...
February 2, 2018: Pediatrics
Anupam B Kharbanda, Eric W Christensen, Nanette C Dudley, Lalit Bajaj, Michelle D Stevenson, Charles G Macias, Manoj K Mittal, Richard G Bachur, Jonathan E Bennett, Kelly Sinclair, Brianna McMichael, Peter S Dayan
OBJECTIVE: The use of computed tomography (CT) and ultrasound (US) in patients with acute abdominal pain has substantial variation across pediatric emergency departments (ED). This study compares the cost of diagnosing and treating suspected appendicitis across a multi-center network of children's hospitals. METHODS: This study is a secondary analysis using de-identified data of a prospective, observational study of patients with suspected appendicitis at nine pediatric EDs...
February 10, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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