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https://www.readbyqxmd.com/read/29334532/cost-effectiveness-and-improved-parent-and-provider-satisfaction-with-outpatient-management-of-pediatric-oncology-patients-with-low-risk-fever-and-neutropenia
#1
Abhishek Bavle, Amanda Grimes, Sibo Zhao, Daniel Zinn, Andrea Jackson, Binita Patel, Timothy Porea, Ankhi Dutta, Heidi Russell, Andras Heczey
On the basis of significant evidence for safety, the international pediatric fever and neutropenia committee recommends the identification and management of patients with "low-risk fever and neutropenia" (LRFN), outpatient with oral antibiotics, instead of traditional inpatient management. The aim of our study was to compare the cost-per-patient with these 2 strategies, and to evaluate parent and provider satisfaction with the outpatient management of LRFN. Between March 2016 and February 2017, 17 LRFN patients (median absolute neutrophil count, 90/μL) were managed at a single institution, per new guidelines...
January 12, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29334446/pediatric-community-acquired-pneumonia
#2
Stephanie Posten, Jennifer Reed
Pediatric community acquired pneumonia (CAP) is frequently encountered by medical providers and is one of the most common reasons for hospital admission. CAP is known to cause significant morbidity and mortality, causing greater than 2 million deaths annually worldwide in children younger than five years old. The Infectious Disease Society of America (IDSA) released guidelines in 2011 with recommendations regarding appropriate diagnosis and management of community acquired pneumonia for children greater than 3 months age, with the goal of assisting providers in clinical decision making...
December 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/29333809/assessment-of-orofacial-pain-management-in-a-pediatric-emergency-department-and-at-home-after-discharge
#3
Yurena Aguilar de la Red, Gema Manrique Martín, Gloria Guerrero López, Concepción González Herrero, Paula López Vázquez, Concepción Míguez Navarro
INTRODUCTION: An inadequate pain management is common in the emergency department. Our objective was to analyze pain management among children with an orofacial infection or trauma in the emergency department and to assess compliance and satisfaction with analgesia prescribed at discharge. POPULATION AND METHODS: Cross-sectional, observational and analytical study in children attending the emergency department for an orofacial infection or trauma over 2 months. Pain management in the emergency department, analgesia prescribed at home and, following a call to parents, treatment provided and its adequacy to control pain were registered...
February 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29332776/compliance-with-a-national-standard-by-norwegian-helicopter-emergency-physicians
#4
Lars Petter Bjørnsen, Andrea Marie Solheim, Oddvar Uleberg, Eirik Skogvoll
OBJECTIVE: The "National Standard Requirements for Helicopter Emergency Medicine Services Physicians" gives recommendations on medical requirements for flight physicians. This study describes the level of formal competence, experience, and guideline compliance of Norwegian helicopter emergency medical service (HEMS) physicians. METHODS: In May 2013, all HEMS physicians with full-time engagement at Norwegian HEMS bases were invited to participate in a cross-sectional survey using a structured, Web-based questionnaire...
January 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29330018/testicular-adrenal-rest-tumor-screening-and-fertility-counseling-among-males-with-congenital-adrenal-hyperplasia
#5
Monika Chaudhari, Emilie K Johnson, Daniel DaJusta, Leena Nahata
BACKGROUND: Reduced fertility is a common potential problem among males with congenital adrenal hyperplasia (CAH), with nearly half experiencing impaired sperm production. The major cause of oligo/azoospermia in CAH is testicular adrenal rest tumors (TARTs). Studies indicate that ultrasound screening for TARTs should begin during childhood, yet it remains unclear whether boys with CAH are routinely screened for TARTs and/or counseled about infertility risk and potential interventions such as fertility testing and/or preservation...
December 21, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29329877/-attitudes-towards-cow-s-milk-protein-allergy-management-by-spanish-gastroenterologist
#6
Alicia Isabel Pascual Pérez, Alejandra Méndez Sánchez, Óscar Segarra Cantón, Beatriz Espin Jaime, Santiago Jiménez Treviño, Carlos Bousoño García, Juan José Díaz Martín
INTRODUCTION: Food allergy is an increasing health problem in the developed world. Cow's milk protein is the main cause of food allergy in infants. Without an appropriate diagnostic workup, there is a high risk of both over- and underdiagnosis and therefore, over and undertreatment. The objective of our study was to analyze the variability in cow's milk protein allergy (CMPA) management by pediatric gastroenterologists in Spain. METHODS: A fifty item questionnaire, including open and closed items in a Likert's scale from 0 to 5, was drafted and distributed through the Spanish Society for Pediatric Gastroenterology, Hepatology and Nutrition (SEGHNP) e-mail list...
January 9, 2018: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/29329548/the-cost-of-a-pediatric-neurocritical-care-program-for-traumatic-brain-injury-a-retrospective-cohort-study
#7
Steven W Howard, Zidong Zhang, Paula Buchanan, Stephanie L Bernell, Christine Williams, Lindsey Pearson, Michael Huetsch, Jeff Gill, Jose A Pineda
BACKGROUND: Inpatient care for children with severe traumatic brain injury (sTBI) is expensive, with inpatient charges averaging over $70,000 per case (Hospital Inpatient, Children Only, National Statistics. Diagnoses- clinical classification software (CCS) principal diagnosis category 85 coma, stupor, and brain damage, and 233 intracranial injury. Diagnoses by Aggregate charges [ https://hcupnet.ahrq.gov/#setup ]). This ranks sTBI in the top quartile of pediatric conditions with the greatest inpatient costs (Hospital Inpatient, Children Only, National Statistics...
January 12, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29329492/failure-to-confirm-high-blood-pressures-in-pediatric-care-quantifying-the-risks-of-misclassification
#8
Corinna Koebnick, Yasmina Mohan, Xia Li, Amy H Porter, Matthew F Daley, Gang Luo, Beatriz D Kuizon
Pediatric practice guidelines call for repeating an elevated office blood pressure (BP) at the same visit, but there are few data available to support this recommendation. We compared the visit results in children aged 3 to 17 years with a BP reading ≥95th percentile (n = 186 732) based on the initial BP and the mean of two BP readings, using electronic medical records from 2012-2015. Failure to repeat an initial BP reading ≥95th percentile would lead to a false "hypertensive" visit result in 54.1% of children who would require follow-up visits...
January 12, 2018: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29325220/profile-risk-factors-and-outcome-of-acute-kidney-injury-in-pediatric-acute-on-chronic-liver-failure
#9
Bikrant Bihari Lal, Seema Alam, Vikrant Sood, Dinesh Rawat, Rajeev Khanna
There are no studies on acute kidney injury (AKI) in pediatric acute-on-chronic liver failure (ACLF). This study was planned with aim to describe the clinical presentation and outcome of AKI among pediatric ACLF patients METHODS: Data of all children 1-18 years of age presenting with ACLF (APASL definition) was reviewed. AKI was defined as per KDIGO guidelines. Poor outcome was defined as death or need for liver transplant within 3 months of development of AKI RESULTS: A total of 84 children with ACLF presented to us in the study period...
January 11, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29324529/inappropriately-timed-pediatric-orthopaedic-referrals-from-the-emergency-department-result-in-unnecessary-appointments-and-financial-burden-for-patients
#10
Taylor J Jackson, Todd J Blumberg, Apurva S Shah, Wudbhav N Sankar
BACKGROUND: Musculoskeletal injuries are among the most common reasons for emergency department (ED) visits in the pediatric population. Many such injuries can be managed with a single follow-up outpatient visit. However, untimely (ie, premature) referrals by emergency physicians to orthopaedic surgeons are common and may inadvertently create need for a second visit, generating unnecessary expenditures. We sought to elucidate the cost of premature musculoskeletal follow-up visits to the patients, families, and the health care system...
January 10, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29324528/titanium-elastic-nailing-has-superior-value-to-plate-fixation-of-midshaft-femur-fractures-in-children-5-to-11-years
#11
Jerad D Allen, Kevin Murr, Ferras Albitar, Cale Jacobs, Eric S Moghadamian, Ryan Muchow
BACKGROUND: American Academy of Orthopaedic Surgeons (AAOS) Clinical Practice Guidelines for pediatric femoral shaft fractures indicate titanium elastic nails (TENs) for children 5 to 11 years old. Growing evidence suggests these fractures may also be treated with open or submuscular plating. The purpose of this study was to compare estimated blood loss (EBL), operative time, fluoroscopy time, cost, and subjective and objective pain scores between TENs and plating techniques used in 5- to 11-year-old children with midshaft femur fractures based on length stability...
January 10, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29321111/a-systematic-review-of-the-pain-scales-in-adults-which-to-use
#12
REVIEW
Ozgur Karcioglu, Hakan Topacoglu, Ozgur Dikme, Ozlem Dikme
OBJECTIVE: The study analysed the Visual Analogue Scale (VAS), the Verbal Rating Scale (VRS) and the Numerical Rating Scale (NRS) to determine: 1. Were the compliance and usability different among scales? 2. Were any of the scales superior over the other(s) for clinical use? METHODS: A systematic review of currently published studies was performed following standard guidelines. Online database searches were performed for clinical trials published before November 2017, on the comparison of the pain scores in adults and preferences of the specific patient groups...
January 6, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29319624/long-term-outcome-of-one-step-kidney-transplantation-and-bladder-augmentation-procedure-in-pediatric-patients
#13
R Cleper, D Ben Meir, I Krause, P Livne, E Mor, M Davidovits, A Dagan
BACKGROUND: Guidelines for bladder augmentation (BA) in kidney transplant (KT) recipients are not well-defined. In our center, simultaneous BA with KT (BA-KT) is performed. We assessed transplantation outcomes of this unique extensive procedure. METHODS: A case-control single center retrospective study. Transplantation outcomes were compared with those of KT recipients who did not need BA. RESULTS: Compared to 22 patients who underwent KT only, for 9 who underwent BA-KT, surgical complications and the need for revision in the early posttransplantation period were similar; early graft function was better: estimated glomerular filtration rate (eGFR): 96...
January 10, 2018: Transplantation
https://www.readbyqxmd.com/read/29319488/canadian-urological-association-pediatric-urologists-of-canada-guidelines-on-the-investigation-and-management-of-antenatally-detected-hydronephrosis
#14
John-Paul Capolicchio, Luis H Braga, Konrad M Szymanski
No abstract text is available yet for this article.
December 22, 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/29319481/a-critical-review-of-recent-clinical-practice-guidelines-for-pediatric-urinary-tract-infection
#15
Michael Chua, Jessica Ming, Shang-Jen Chang, Joana Dos Santos, Niraj Mistry, Jan Michael Silangcruz, Mark Bayley, Martin Koyle
INTRODUCTION: Concerns regarding the quality, credibility, and applicability of recently published pediatric urinary tract infection (UTI) clinical practice guidelines have been raised due to the inconsistencies of recommendations between them. We aimed to determine the quality of the recent clinical practice guidelines on pediatric UTI by using the Appraisal of Guidelines Research and Evaluation (AGREE II) instrument, and summarize the standard of care in diagnosis and management of pediatric UTI from the top three clinical practice guidelines...
December 22, 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/29319209/effectiveness-of-antibacterial-prophylaxis-during-induction-chemotherapy-in-children-with-acute-lymphoblastic-leukemia
#16
M L Sulis, T M Blonquist, K E Stevenson, S K Hunt, S Kay-Green, U H Athale, L A Clavell, P D Cole, K M Kelly, C Laverdiere, J M Leclerc, B Michon, M A Schorin, J G Welch, D S Neuberg, S E Sallan, L B Silverman
BACKGROUND: Pediatric patients receiving induction chemotherapy for newly diagnosed acute lymphoblastic leukemia (ALL) are at high risk of developing life-threatening infections. We investigated whether uniform antibacterial guidelines, including mandatory antibacterial prophylaxis in afebrile patients during induction, decreases the incidence of microbiologically documented bacteremia. METHODS: Between 2012 and 2015, 230 patients with newly diagnosed ALL (aged 1-21) were enrolled on Dana-Farber Cancer Institute ALL Consortium Protocol 11-001 (DFCI 11-001)...
January 10, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29315849/continuous-intravenous-vancomycin-in-children-with-normal-renal-function-hospitalized-in-hematology-oncology-prospective-validation-of-a-dosing-regimen-optimizing-steady-state-concentration
#17
Delphine Hoegy, Sylvain Goutelle, Nathalie Garnier, Cécile Rénard, Cécile Faure-Conter, Christophe Bergeron, Yves Bertrand, Nathalie Bleyzac
Continuous intravenous (IV) infusion has been shown to be the best option to administer vancomycin because of its time-dependent bactericidal activity. Available IV vancomycin dosing guidelines in pediatrics with normal renal function leads to less than 50% of patients achieving a vancomycin serum concentration (Css) in the target range (15 to 20 mg/l). The primary objective of this study was to prospectively validate an age-based dosing regimen in pediatric onco-hematology. The secondary objective was to investigate the influence on Css attainment of different variables...
January 6, 2018: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/29314219/pediatric-psoriasis-evolving-perspectives
#18
Lawrence F Eichenfield, Amy S Paller, Wynnis L Tom, Jeffrey Sugarman, Adelaide A Hebert, Sheila Fallon Friedlander, Elaine Siegfried, Nanette Silverberg, Kelly M Cordoro
BACKGROUND/OBJECTIVES: Childhood-onset psoriasis is a common skin disorder that has recently received increasing attention, particularly because of its significant medical, social, financial, and psychological burdens and its associated comorbidities. With limited data available and lack of standardized management guidelines for pediatric psoriasis, an expert panel desired to provide an updated critical overview and practical guidance for management of the affected population. METHODS: A panel of pediatric dermatologists with extensive experience in pediatric psoriasis defined and prioritized a core set of topics, performed an English-language literature review, prepared critical evaluations and presentations of topic areas, and carried out a consensus meeting and follow-up consensus manuscript...
January 4, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29313458/clinician-perspectives-on-strategies-to-improve-patient-maternal-immunization-acceptability-in-obstetrics-and-gynecology-practice-settings
#19
Paula M Frew, Laura A Randall, Fauzia Malik, Rupali Lamaye, Andrew Wilson, Sean T O'Leary, Daniel Salmon, Meghan Donnelly, Kevin Ault, Matthew Z Dudley, Vincent L Fenimore, Saad B Omer
Pregnancy is an ideal time to communicate with women about vaccines for themselves and their infants, yet maternal immunization rates remain suboptimal. This study aimed to identify clinic, provider, and staff-related attributes and facilitators to be utilized for a comprehensive vaccine intervention in ob-gyn clinical settings. We conducted in-depth interviews with 24 providers, both healthcare providers (e.g., physicians, nurse practitioners, midwives) and practice managers, from urban and suburban ob-gyn practices in Georgia and Colorado about their immunization attitudes, practices, and patient experiences...
January 9, 2018: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/29305313/effectiveness-of-the-gocheck-kids-vision-screener-in-detecting-amblyopia-risk-factors
#20
M Millicent W Peterseim, Ryan S Rhodes, Rupa N Patel, M Edward Wilson, Luke E Edmondson, Sarah A Logan, Edward W Cheeseman, Emily Shortridge, Rupal H Trivedi
Effectiveness of the GoCheck Kids Vision Screener in Detecting Amblyopia Risk Factors, MMW Peterseim, RS Rhodes, RN Patel, ME Wilson, LE Edmondson, SA Logan, EW Cheeseman, E Shortridge, RH Trivedi. INTRODUCTION: The GoCheck Kids smartphone photoscreening app (Gobiquity Mobile Health, Scottsdale, Arizona), introduced in 2014, is marketed to pediatricians with little published validation. We wished to evaluate the GoCheck Kids Screener for accuracy in detecting amblyopia risk factors (ARF) using 2013 AAPOS guidelines...
January 2, 2018: American Journal of Ophthalmology
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