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Pediatric pain

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https://www.readbyqxmd.com/read/28350727/an-adolescent-with-chest-pain-and-cardiac-hemangioma
#1
Marie L Shaner, Linda B Pauliks, Don Leach, John L Myers, Dennis Chang
Less than 5% of chest pain in children is cardiac in origin, yet this complaint still represents one of the top reasons children are referred to pediatric cardiologists. This article describes a patient whose cardiac tumor illustrates the challenges of evaluating pediatric chest pain and the Standardized Clinical Assessment and Management Plan algorithm that can help.
April 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28350720/pulmonary-embolism-mimicking-infectious-pleuritis
#2
Kenichi Tetsuhara, Satoshi Tsuji, Satoko Uematsu, Koichi Kamei
The diagnosis of pulmonary thromboembolism (PE) is often delayed because it is usually misdiagnosed as pneumonia or deep vein thrombosis. We report an unusual case of PE misdiagnosed as viral pleuritis on the first arrival at the emergency department (ED) in our hospital. A 14-year-old girl with no previous significant medical history was referred to the ED with pleuritic and chest pain with low-grade fever 4 days before admission.Echography showed a small amount of left pleural effusion. A 12-lead electrocardiogram was normal...
March 27, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28346581/home-based-hypnotherapy-self-exercises-vs-individual-hypnotherapy-with-a-therapist-for-treatment-of-pediatric-irritable-bowel-syndrome-functional-abdominal-pain-or-functional-abdominal-pain-syndrome-a-randomized-clinical-trial
#3
Juliette M T M Rutten, Arine M Vlieger, Carla Frankenhuis, Elvira K George, Michael Groeneweg, Obbe F Norbruis, Walther Tjon A Ten, Herbert M van Wering, Marcel G W Dijkgraaf, Maruschka P Merkus, Marc A Benninga
Importance: Individual gut-directed hypnotherapy (HT) is effective in pediatric irritable bowel syndrome (IBS) and functional abdominal pain or functional abdominal pain syndrome (FAP[S]). It is, however, unavailable to many children. Objective: To compare the effectiveness of HT by means of home-based self-exercises using a CD with that of individual HT (iHT) performed by qualified therapists. Design, Setting, and Participants: This noninferiority randomized clinical trial with a follow-up of 1 year after the end of treatment was conducted from July 15, 2011, through June 24, 2013, at 9 secondary and tertiary care centers throughout the Netherlands...
March 27, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28345747/survey-of-opioid-tapering-practices-of-pediatric-healthcare-providers-a-national-perspective
#4
Fisher Deborah, Suzanne W Ameringer
OBJECTIVE: The purpose of this study was to describe the current opioid tapering practice. DESIGN: Cross-sectional, online, survey research. PARTICIPANTS: Pediatric healthcare providers from a national sample of practicing nurse practitioners, physician assistants, and physicians who participate in five different pediatric pain and/or palliative care list serves. RESULTS: One hundred four participants responded to the survey...
January 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/28343240/childhood-angular-kyphosis-a-plea-for-involvement-of-the-pediatric-neurosurgeon
#5
E Cornips, S Koudijs, J Vles, L van Rhijn
INTRODUCTION: Childhood angular kyphosis is rare, as most children are affected by a mixed kyphotic and scoliotic deformity. Published series involving a mix of kyphosis and kyphoscoliosis, pediatric and adult, congenital and acquired cases are almost exclusively authored by orthopedic surgeons, suggesting that (pediatric) neurosurgeons are not involved. CASE SERIES: We present five cases that illustrate the spectrum of angular kyphosis, and these were treated by a multidisciplinary team including child neurologist, orthopedic surgeon, and pediatric neurosurgeon as complementary partners...
March 25, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28340189/the-relationship-between-pain-severity-and-alcohol-use-among-school-aged-children-and-adolescents-the-moderating-role-of-drinking-motives
#6
Claudia Horn-Hofmann, Zina Trost, Anne Hublet, Sylvie Mrug, Joris Van Damme, Tine Vervoort
Objective. : Evidence from adult samples suggests a co-occurrence between pain and alcohol abuse. However, studies in adolescents are scarce and results are inconsistent, with some studies observing heightened and others observing reduced alcohol consumption in adolescents suffering from pain. We hypothesized that in adolescents the association between pain and alcohol use will be moderated by drinking motives. Methods. : Data from a large representative sample of Flemish school children and adolescents (N = 10,650, 50...
March 15, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339998/executive-functioning-in-pediatric-chronic-pain-do-deficits-exist
#7
Karen E Weiss, Cynthia Harbeck-Weber, Michael J Zaccariello, Jacqueline N Kimondo, Tracy E Harrison, Barbara K Bruce
Objective. : Despite ample research documenting deficits in executive functioning for adults with chronic pain, the literature on pediatric patients with chronic pain is limited and provides mixed results. The current study sought to further investigate the nature of executive dysfunction in this population and also examine the relationships between pain intensity, duration, and catastrophizing with sustained attention, working memory, and self- and parent-report of executive functioning...
March 6, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339428/does-conservative-treatment-change-the-brain-in-patients-with-chronic-musculoskeletal-pain-a-systematic-review
#8
Jeroen Kregel, Iris Coppieters, Robby DePauw, Anneleen Malfliet, Lieven Danneels, Jo Nijs, Barbara Cagnie, Mira Meeus
BACKGROUND: Chronic musculoskeletal pain is characterized by maladaptive central neuroplastic changes. Many observational studies have demonstrated that chronic pain states are associated with brain alterations regarding structure and/or function. Rehabilitation of patients with chronic musculoskeletal pain may include cognitive, exercise, or multimodal therapies. OBJECTIVE: The current review aims to provide a constructive overview of the existing literature reporting neural correlates, based on brain magnetic resonance imaging (MRI) techniques, following conservative treatment in chronic musculoskeletal pain patients...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28332374/comparison-of-dexmedetomidine-and-fentanyl-as-an-adjuvant-to-ropivacaine-for-postoperative-epidural-analgesia-in-pediatric-orthopedic-surgery
#9
Sang Jun Park, Seokyung Shin, Shin Hyung Kim, Hyun Woo Kim, Seung Hyun Kim, Hae Yoon Do, Yong Seon Choi
PURPOSE: Opioids are commonly used as an epidural adjuvant to local anesthetics, but are associated with potentially serious side effects, such as respiratory depression. The aim of this study was to compare the efficacy and safety of dexmedetomidine with that of fentanyl as an adjuvant to epidural ropivacaine in pediatric orthopedic surgery. MATERIALS AND METHODS: This study enrolled 60 children (3-12 years old) scheduled for orthopedic surgery of the lower extremities and lumbar epidural patient-controlled analgesia (PCA)...
May 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28332249/fifty-years-of-the-american-academy-of-pediatrics-section-on-anesthesiology-a-history-of-our-specialty
#10
Rita Agarwal, Jennifer Riefe, Constance S Houck
The American Academy of Pediatrics Section on Anesthesiology and Pain Medicine celebrated its 50th Anniversary in 2015. The Section was one of the first and only subspecialty organizations in anesthesiology at the time. This special article will focus on the contributions of the Section to the practice of pediatric anesthesiology in the areas of advocacy, education and member contributions. In 1986, the Section created the Robert M. Smith Award to honor those members who had made significant advances in the practice of pediatric anesthesiology...
March 23, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28332046/ramp-lesions-in-acl-deficient-knees-in-children-and-adolescent-population-a-high-prevalence-confirmed-in-intercondylar-and-posteromedial-exploration
#11
Matthieu Malatray, Sebastien Raux, Adrien Peltier, Clemence Pfirrmann, Romain Seil, Franck Chotel
PURPOSE: Ramp lesions are common in ACL deficient knees. Their diagnosis is difficult and, therefore, they may be underestimated. So far, no study analyzed their prevalence in a pediatric population. The diagnosis of these Ramp lesions is of major clinical relevance because of a frequent misestimating and technic difficulties. Ramp lesions might be associated with residual knee pain and instability after ACL reconstruction. The aim of this study was to evaluate the prevalence of ramp lesions explored through a systematic intercondylar and posteromedial arthroscopic approach during an ACL reconstruction in a pediatric and adolescent population...
March 22, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28328699/a-mindfulness-program-adapted-for-adolescents-with-chronic-pain-feasibility-acceptability-and-initial-outcomes
#12
Danielle A Ruskin, Michelle M Gagnon, Sara A Kohut, Jennifer N Stinson, Kathryn S Walker
OBJECTIVES: Pediatric chronic pain is a major health issue which can lead to significant interference in daily functioning. Mindfulness-based interventions (MBI's), which emphasize acceptance rather than control of pain, have gained increasing attention as a viable treatment option among adults with chronic pain. The effectiveness of MBIs for chronic pain in pediatric populations remains largely unknown. This prospective pre-post interventional study was conducted to examine the feasibility, acceptability, and initial effectiveness of an 8-week group MBI for adolescents (MBI-A) with chronic pain...
March 21, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28328689/adult-chest-pain-in-the-pediatric-emergency-department-treatment-and-timeliness-from-door-in-to-door-out
#13
Jeffrey H Sacks, Peter B Flueckiger, Philip R Spandorfer, William T Mahle, Brian E Costello
OBJECTIVES: The American College of Cardiology Foundation/American Heart Association guidelines for acute coronary syndrome (ACS) recommend immediate aspirin (ASA) administration, an electrocardiogram (ECG) in less than 10 minutes, and a door-in to door-out (DIDO) time less than 30 minutes for interfacility transfer. We sought to determine if compliance is hindered when adults with suspected ACS present to pediatric facilities. METHODS: Visits to the 2 tertiary care emergency departments of a pediatric healthcare system using an adult chest pain protocol were examined from October 2006 to September 2012...
March 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28327261/sex-differences-in-pediatric-dental-pain-perception
#14
Gabriela F Almeida, Daniele L Longo, Mariana Trevizan, Fabrício K de Carvalho, Paulo Nelson-Filho, Erika C Küchler, Alexandra M Queiroz
PURPOSE: To evaluate sex-related differences in dental pain perception in children. METHODS: Fifty-two children who received a dental procedure with local anesthesia were selected to participate. Pain perception levels were assessed with the Wong-Baker FACES Pain Rating Scale. Twenty-four and 48 hours following the procedure, the parents were contacted by phone for a verbal survey to assess their child's postoperative pain. Age, type of dental procedure, and behavior were also evaluated as covariables...
September 15, 2016: Journal of Dentistry for Children
https://www.readbyqxmd.com/read/28323671/codeine-and-opioid-metabolism-implications-and-alternatives-for-pediatric-pain-management
#15
Vidya Chidambaran, Senthilkumar Sadhasivam, Mohamed Mahmoud
PURPOSE OF REVIEW: Use of perioperative opioids for surgical pain management of children presents clinical challenges because of concerns of serious adverse effects including life-threatening respiratory depression. This is especially true for children with history of obstructive sleep apnea. This review will explore current knowledge of clinically relevant factors and genetic polymorphisms that affect opioid metabolism and postoperative outcomes in children. RECENT FINDINGS: Within the past several years, an increasing number of case reports have illustrated clinically important respiratory depression, anoxic brain injuries and even death among children receiving appropriate weight-based dosages of codeine and other opioids for analgesia at home setting particularly following tonsillectomy...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28320603/influence-of-dietary-and-physical-activity-restriction-on-pediatric-adenotonsillectomy-postoperative-care-in-brazil-a-randomized-clinical-trial
#16
Denise Manica, Leo Sekine, Larissa S Abreu, Michelle Manzini, Luísi Rabaioli, Marcel M Valério, Manoela P Oliveira, João A Bergamaschi, Luciano A Fernandes, Gabriel Kuhl, Cláudia Schweiger
INTRODUCTION: Although culturally food and physical activity restriction are part of the routine postoperative care of many Brazilian surgeons, current evidences from other countries support no such recommendations. OBJECTIVE: To determine whether dietary and physical restriction effectively lead to a decrease on postoperative complications of adenotonsillectomy in children when compared to no restriction. METHODS: We have designed a randomized clinical trial comparing two intervention: no specific counseling on diet or activity (Group A), and restriction recommendations on diet and physical activities (Group B)...
February 22, 2017: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28319509/a-high-preoperative-pain-and-symptom-profile-predicts-worse-pain-outcomes-for-children-after-spine-fusion-surgery
#17
Terri Voepel-Lewis, Michelle S Caird, Alan R Tait, Shobha Malviya, Frances A Farley, Ying Li, Matthew D Abbott, Tara van Veen, Afton L Hassett, Daniel J Clauw
BACKGROUND: Preoperative pain predicts persistent pain after spine fusion, yet little is understood about the nature of that pain, related symptoms, and how these symptoms relate to postoperative pain outcomes. This prospective study examined children's baseline pain and symptom profiles and the association between a high symptom profile and postoperative outcomes. METHODS: Seventy children (aged 10-17 years) scheduled for correction of idiopathic scoliosis completed pain and symptom surveys during their preoperative visit (ie, pain intensity [0-10 numeric rating scores], a pediatric version of the 2011 fibromyalgia survey criteria [including pain locations and symptom severity scale], neuropathic pain symptoms [painDETECT], and Patient-Reported Outcome Measurement System measures of fatigue, depression, function, pain interference, and pain catastrophizing)...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28319024/the-prostatic-utricle-an-under-recognized-condition-resulting-in-significant-morbidity-in-boys-with-both-hypospadias-and-normal-external-genitalia
#18
Austin G Hester, Stanley J Kogan
INTRODUCTION: Pediatric presentations of a prostatic utricle have received only scant attention. Though recognized with increased frequency in boys with hypospadias, little is described about their incidence and potential for morbidity in boys with normal external genitalia. METHODS: We initially reviewed a cohort of 64 patients with hypospadias seen over a 3-year period to determine the frequency of investigative lower urinary tract studies and utricle identification...
March 1, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28318932/patellar-instability-treated-with-distal-femoral-osteotomy
#19
Ishaan Swarup, Osama Elattar, S Robert Rozbruch
BACKGROUND: Patellar instability can cause significant disability in both pediatric and adult patients, and it is associated with several factors including genu valgum. In this study, we describe the role of a lateral opening wedge distal femoral osteotomy (DFO) combined with lateral retinacular release in addressing genu valgum with associated patellar instability. The rationale for this approach is to medialize the patellar tendon insertion and decrease the Q angle with DFO. METHODS: A consecutive series of patients were studied, and our outcomes of interest included improvements in radiographic measures and patient outcomes...
March 17, 2017: Knee
https://www.readbyqxmd.com/read/28318748/computer-tablet-distraction-reduces-pain-and-anxiety-in-pediatric-burn-patients-undergoing-hydrotherapy-a-randomized-trial
#20
Sherwood Burns-Nader, Lindsay Joe, Kelly Pinion
BACKGROUND: Distraction is often used in conjunction with analgesics to minimize pain in pediatric burn patients during treatment procedures. Computer tablets provide many options for distraction items in one tool and are often used during medical procedures. Few studies have examined the effectiveness of tablet distraction in improving the care of pediatric burn patients. AIM: This study examines the effectiveness of tablet distraction provided by a child life specialist to minimize pain and anxiety in pediatric burn patients undergoing hydrotherapy...
March 15, 2017: Burns: Journal of the International Society for Burn Injuries
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