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Pediatric palliative

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https://www.readbyqxmd.com/read/29470938/diagnostic-performance-of-mr-elastography-for-liver-fibrosis-in-children-and-young-adults-with-a-spectrum-of-liver-diseases
#1
Andrew T Trout, Rachel M Sheridan, Suraj D Serai, Stavra A Xanthakos, Weizhe Su, Bin Zhang, Daniel B Wallihan
Purpose To assess the diagnostic performance of magnetic resonance (MR) elastography-derived liver stiffness to detect liver fibrosis in a pediatric and young adult population with a spectrum of liver diseases. Materials and Methods This retrospective study included patients younger than 21 years of age who underwent MR elastography and liver biopsy within 3 months of one another between January 2012 and September 2016 for indications other than liver transplantation or Fontan palliation of congenital heart disease...
February 22, 2018: Radiology
https://www.readbyqxmd.com/read/29463062/palliative-care-for-children-in-hospital-essential-roles
#2
REVIEW
Ross Drake
Palliative care for children in pediatric hospitals is a vital part of the network of services supporting children with severe illness. This has been recognized, with a trend over the past decade for an increased number of pediatric palliative care (PPC) services established in pediatric hospitals. The inpatient team is in the unique position of influencing the early identification of children and their families, across the age and diagnostic spectrum, which could benefit from palliative care. These services have an opportunity to influence the integration of the palliative approach throughout the hospital, and in so doing, have the capacity to improve many aspects of care, including altering an increasingly futile and burdensome treatment trajectory, and ensuring improved symptom (physical and psychological) management...
February 19, 2018: Children
https://www.readbyqxmd.com/read/29461497/pediatric-palliative-care-for-children-with-progressive-non-malignant-diseases
#3
REVIEW
Harold Siden
A substantial number of children cared for by pediatric palliative care physicians have progressive non-malignant conditions. Some elements of their care overlap with care for children with cancer while other elements, especially prognosis and trajectory, have nuanced differences. This article reviews the population, physical-emotional and social concerns, and trajectory.
February 20, 2018: Children
https://www.readbyqxmd.com/read/29454680/cardiomyopathy-in-the-pediatric-patients
#4
REVIEW
Shi-Min Yuan
Pediatric cardiomyopathies are a group of myocardial diseases with complex taxonomies. Cardiomyopathy can occur in children at any age, and it is a common cause of heart failure and heart transplantation in children. The incidence of pediatric cardiomyopathy is increasing with time. They may be associated with variable comorbidities, which are most often arrhythmia, heart failure, and sudden death. Medical imaging technologies, including echocardiography, cardiac magnetic resonance, and nuclear cardiology, are helpful in reaching a diagnosis of cardiomyopathy...
January 31, 2018: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29451689/barriers-to-accessing-palliative-care-for-pediatric-patients-with-cancer-a-review-of-the-literature
#5
REVIEW
Emily R Haines, A Corey Frost, Heather L Kane, Franziska S Rokoske
Although many of the 16,000 children in the United States diagnosed who are with cancer each year could benefit from pediatric palliative care, these services remain underused. Evidence regarding the barriers impeding access to comprehensive palliative care is dispersed in the literature, and evidence specific to pediatric oncology remains particularly sparse. The purpose of the current review was to synthesize the existing literature regarding these barriers and the strategies offered to address them. The authors completed a literature search using the PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science databases...
February 16, 2018: Cancer
https://www.readbyqxmd.com/read/29436391/associations-between-pediatric-palliative-care-consultation-and-end-of-life-preparation-at-an-academic-medical-center-a-retrospective-ehr-analysis
#6
Matthew Stutz, Roy L Kao, Leanna Huard, Jonathan Grotts, Javier Sanz, Mindy K Ross
OBJECTIVES: Our aim in this study was to understand usage patterns of pediatric palliative care (PPC) consultation and associations with end-of-life preparation among pediatric patients who are deceased. METHODS: We reviewed 233 pediatric mortalities. Data extraction from the electronic health record included determination of PPC consultation by using Current Procedural Terminology codes. Diagnoses were identified by International Classification of Disease codes and were classified into categories of life-threatening complex chronic conditions (LT-CCCs)...
February 7, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29427739/predictors-of-late-palliative-care-referral-in-children-with-cancer
#7
Erica C Kaye, Jonathan Jerkins, Courtney A Gushue, Samantha DeMarsh, April Sykes, Zhaohua Lu, Jennifer M Snaman, Lindsay Blazin, Liza-Marie Johnson, Deena R Levine, R Ray Morrison, Justin N Baker
CONTEXT: Early integration of palliative care (PC) in the management of children with high-risk cancer is widely endorsed by patients, families, clinicians, and national organizations. However, optimal timing for PC consultation is not standardized, and variables that influence timing of PC integration for children with cancer remain unknown. OBJECTIVES: To investigate associations between demographic, disease, treatment, and end-of-life attributes and timing of PC consultation for children with high-risk cancer enrolled on a PC service...
February 7, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29425881/pediatric-oncology-provider-perceptions-of-a-pediatric-palliative-care-service-the-influence-of-emotional-esteem-and-emotional-labor
#8
Julia E Szymczak, Theodore Schall, Douglas L Hill, Jennifer K Walter, Shefali Parikh, Concetta DiDomenico, Chris Feudtner
CONTEXT: Pediatric palliative care consults for children with cancer often occur late in the course of disease and close to death, when earlier involvement would reduce suffering. The perceptions that pediatric oncology providers hold about the pediatric palliative care service (PPCS) may shape referral patterns. OBJECTIVE: To explore how pediatric oncology providers at one institution perceived the hospital's PPCS and the way these perceptions may influence the timing of consultation...
February 6, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29418063/perceptions-of-barriers-and-facilitators-to-early-integration-of-pediatric-palliative-care-a-national-survey-of-pediatric-oncology-providers
#9
Todd Dalberg, Neil L McNinch, Sarah Friebert
OBJECTIVES: The goal of this study was to assess pediatric oncology providers' perceptions of palliative care in order to validate previously identified barriers and facilitators to early integration of a pediatric palliative care team (PCT) in the care of children with cancer. METHODS: A 36-question survey based on preliminary, single-institution data was electronically distributed to pediatric oncology physicians, nurse practitioners, nurses, and social workers nationally...
February 8, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29417474/the-impact-of-fellowship-in-dietetics-on-clinical-practice
#10
Terezie Tolar Mosby
Medical nutrition therapy (MNT) in pediatric cancer treatment is essential. The Nutrition Department and the International Outreach Program at St. Jude Children's Research Hospital in Memphis, TN have worked together from 2005 to 2013 to develop and implement a training program for international dietitians working with pediatric oncology patients. During that time, St. Jude hosted 15 dietitians from various countries for this 3-week-long program. The curriculum provided experience in nutrition risk screening, nutrition care process, nutrition for cancer prevention, palliative care, and exposure to nutrition support...
February 7, 2018: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/29414846/pediatric-palliative-care-in-infants-and-neonates
#11
REVIEW
Brian S Carter
The application of palliative and hospice care to newborns in the neonatal intensive care unit (NICU) has been evident for over 30 years. This article addresses the history, current considerations, and anticipated future needs for palliative and hospice care in the NICU, and is based on recent literature review. Neonatologists have long managed the entirety of many newborns' short lives, given the relatively high mortality rates associated with prematurity and birth defects, but their ability or willingness to comprehensively address of the continuum of interdisciplinary palliative, end of life, and bereavement care has varied widely...
February 7, 2018: Children
https://www.readbyqxmd.com/read/29412772/physician-perspectives-on-palliative-care-for-children-with-advanced-heart-disease-a-comparison-between-pediatric-cardiology-and-palliative-care-physicians
#12
Emily Morell Balkin, Lynn A Sleeper, James N Kirkpatrick, Keith M Swetz, Mary Katherine Coggins, Joanne Wolfe, Elizabeth D Blume
BACKGROUND: While the importance of pediatric palliative care (PPC) for children with life-threatening illness is increasingly recognized, little is known about physicians' attitudes toward palliative care for children with heart disease. OBJECTIVE: To compare the perspectives of PPC physicians and pediatric cardiologists regarding palliative care in pediatric heart disease. DESIGN: Cross-sectional web-based surveys. RESULTS: Responses from 183 pediatric cardiologists were compared to those of 49 PPC physicians (response rates 31% [183/589] and 28% [49/175], respectively)...
February 7, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29410951/a-review-of-the-integrated-model-of-care-an-opportunity-to-respond-to-extensive-palliative-care-needs-in-pediatric-intensive-care-units-in-under-resourced-settings
#13
REVIEW
Michelle Grunauer, Caley Mikesell
It is estimated that 6.3 million children who die annually need pediatric palliative care (PPC) and that only about 10% of them receive the attention they need because about 98% of them live in under-resourced settings where PPC is not accessible. The consultative model and the integrated model of care (IMOC) are the most common strategies used to make PPC available to critically ill children. In the consultative model, the pediatric intensive care unit (PICU) team, the patient, or their family must request a palliative care (PC) consultation with the external PC team for a PICU patient to be evaluated for special care needs...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29406374/cerebral-oxygen-metabolism-before-and-after-rbc-transfusion-in-infants-following-major-surgical-procedures
#14
Felix Neunhoeffer, Michael Hofbeck, Martin Ulrich Schuhmann, Jörg Fuchs, Christian Schlensak, Martin Esslinger, Ines Gerbig, Vanya Icheva, Ellen Heimberg, Matthias Kumpf, Jörg Michel
OBJECTIVE: Although infants following major surgery frequently require RBC transfusions, there is still controversy concerning the best definition for requirement of transfusion in the individual patient. The aim of this study was to determine the impact of RBC transfusion on cerebral oxygen metabolism in noncardiac and cardiac postsurgical infants. DESIGN: Prospective observational cohort study. SETTING: Pediatric critical care unit of a tertiary referral center...
February 5, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29397055/a-cross-sectional-pilot-study-of-compassion-fatigue-burnout-and-compassion-satisfaction-in-pediatric-palliative-care-providers-in-the-united-states
#15
Samuel M Kase, Elisha D Waldman, Andrea S Weintraub
OBJECTIVE: Compassion fatigue (CF) is secondary traumatic distress experienced by providers from contact with patients' suffering. Burnout (BO) is job-related distress resulting from uncontrollable workplace factors that manifest in career dissatisfaction. Compassion satisfaction (CS) is emotional fulfillment derived from caring for others. The literature on BO in healthcare providers is extensive, whereas CF and CS have not been comprehensively studied. Because of ongoing exposure to patient and family distress, pediatric palliative care (PPC) providers may be at particular risk for CF...
February 5, 2018: Palliative & Supportive Care
https://www.readbyqxmd.com/read/29395891/hemodynamic-support-of-a-15-year-old-waiting-for-a-heart-transplant-is-there-a-role-for-levosimendan-in-pediatric-heart-failure
#16
I Goyer, D Brossier, B Toledano
Decompensated heart failure in children requires rapid and aggressive support. In refractory cases, invasive supportive care is essential to ensure cardiac output. This results in lengthy pediatric intensive care unit (PICU) stays, secondary morbidity, and high cost. Levosimendan may help palliate the pitfalls encountered with the usual treatment. It has been shown to improve hemodynamics and decrease morbidity and mortality from heart failure in adult trials and pediatric cohorts. We report the case of a 15-year-old boy with dilated cardiomyopathy and refractory ventricular dysfunction who was weaned from continuous inotropes and discharged from the PICU with levosimendan while waiting for heart transplantation...
February 2018: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29393811/treatment-of-medically-refractory-seizures-with-responsive-neurostimulation-2-pediatric-cases
#17
Malgosia A Kokoszka, Fedor Panov, Maite La Vega-Talbott, Patricia E McGoldrick, Steven M Wolf, Saadi Ghatan
The responsive neurostimulation (RNS) system, an adjunctive treatment for pharmacoresistant partial-onset seizures with 1 or 2 foci, has been available to patients aged 18 years or older since the device's FDA approval in 2013. Herein, the authors describe their off-label application of this technology in 2 pediatric patients and the consequent therapeutic benefit without surgical complications or treatment side effects. A 14-year-old nonambulatory, nonverbal male with severe developmental delay was considered for RNS therapy for medically and surgically refractory epilepsy with bilateral seizure onsets in the setting of a normal radiological examination and a known neuropathological diagnosis of type I cortical dysplasia...
February 2, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29392349/necrotizing-enterocolitis-in-infants-with-hypoplastic-left-heart-syndrome-following-stage-1-palliation-or-heart-transplant
#18
Nahed O ElHassan, Xinyu Tang, Jeffrey Gossett, Dala Zakaria, Ashley Ross, Sashi K Kona, Parthak Prodhan
Previous studies of necrotizing enterocolitis (NEC) among infants with hypoplastic left heart syndrome (HLHS) were conducted in single centers or had small sample sizes. This study aimed to determine the mortality rate and the risk factors for NEC among infants with HLHS who were discharged over a 10-year period (2004-2013) from 41 Pediatric Health Information System affiliated children's hospitals. Either stage 1 palliation and/or heart transplant were completed prior to patient's death or hospital discharge...
February 1, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29386073/personalized-and-yet-standardized-an-informed-approach-to-the-integration-of-bereavement-care-in-pediatric-oncology-settings
#19
Lori Wiener, Abby R Rosenberg, Wendy G Lichtenthal, Julia Tager, Meaghann S Weaver
OBJECTIVE: The death of a child has been associated with adverse parental outcomes, including a heightened risk for psychological distress, poor physical health, loss of employment income, and diminished psychosocial well-being. Psychosocial standards of care for centers serving pediatric cancer patients recommend maintaining at least one meaningful contact between the healthcare team and bereaved parents to identify families at risk for negative psychosocial sequelae and to provide resources for bereavement support...
February 1, 2018: Palliative & Supportive Care
https://www.readbyqxmd.com/read/29379824/palliative-care-opportunities-for-nursing
#20
EDITORIAL
Ayda Gan Nambayan
Ayda G. Nambayan, PhD, RN is the Training Consultant for The Ruth Foundation for Palliative and Hospice Care. Prior to this, she held various positions as a Consultant for Advanced Education and Training at Makati Medical Center, Philippines; a curriculum and distance learning developer for www.Cure4Kids.org, the educational website of the International Outreach Program of St. Jude Children's Research Hospital in Memphis, TN. In 2002, she retired from a faculty position from the University of Alabama at Birmingham, where she taught Adult Health Nursing for 25 years...
January 2018: Asia-Pacific Journal of Oncology Nursing
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