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Paediatric emergency medicine

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https://www.readbyqxmd.com/read/29371599/cell-death-based-treatment-of-childhood-cancer
#1
REVIEW
Mike-Andrew Westhoff, Nicolas Marschall, Michael Grunert, Georg Karpel-Massler, Stefan Burdach, Klaus-Michael Debatin
Any therapy that aims at eradicating a cancerous growth will have at its core a cell death-inducing component. Here we argue that paediatric oncology presents with its unique set of considerations and problems, which-while taking the lead from oncological research experiences obtained from the adult population-need to be clinically evaluated independently. This is particularly true when considering long-term side effects. Precision medicine offers a promising new approach in therapy, but given as a monotherapy and in a limited combination, as found in an apoptosis inducer/sensitiser combination, it will most likely lead to mutation escape of the target cell population and the emergence of resistance...
January 25, 2018: Cell Death & Disease
https://www.readbyqxmd.com/read/29355793/position-of-the-french-working-group-on-perioperative-haemostasis-gihp-on-viscoelastic-tests-what-role-for-which-indication-in-bleeding-situations
#2
Stéphanie Roullet, Emmanuel de Maistre, Brigitte Ickx, Normand Blais, Sophie Susen, David Faraoni, Delphine Garrigue, Fanny Bonhomme, Anne Godier, Dominique Lasne
PURPOSE: Viscoelastic tests (VETs), thromboelastography (TEG®) and thromboelastometry (ROTEM®) are global tests of coagulation performed on whole blood. They evaluate the mechanical strength of a clot as it builds and develops after coagulation itself. The time required to obtain haemostasis results remains a major problem for clinicians dealing with bleeding, although some teams have developed a rapid laboratory response strategy. Indeed, the value of rapid point-of-care diagnostic devices such as VETs has increased over the years...
January 17, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29240569/paediatric-procedural-sedation-and-analgesia-by-emergency-physicians-in-a-country-with-a-recent-establishment-of-emergency-medicine
#3
Maybritt I Kuypers, Gaël J P Smits, Eva P Baerends, Erick Oskam, Eef P J Reijners, Lisette A A Mignot-Evers, Wendy A M H Thijssen, Frans B Plötz, Erik H M Korsten
OBJECTIVES: Paediatric patients receive less procedural sedation and analgesia (PSA) in the emergency department compared with adults, especially in countries where emergency medicine is at an early stage of development. The objectives of this study were to evaluate the adverse events and efficacy of paediatric PSA in a country with a recent establishment of emergency medicine and to describe which factors aided implementation. METHODS: This is a prospective, multicentre, observational study of paediatric patients undergoing PSA by the first trained emergency physicians (EPs) in The Netherlands...
December 13, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29237400/accuracy-of-acute-burns-diagnosis-made-using-smartphones-and-tablets-a-questionnaire-based-study-among-medical-experts
#4
Lisa Blom, Constance Boissin, Nikki Allorto, Lee Wallis, Marie Hasselberg, Lucie Laflamme
BACKGROUND: Remote assistance for burns by medical experts can support nurses and general physicians in emergency care with diagnostic and management advice. Previous studies indicate a high diagnostic accuracy based on images viewed on a computer screen, but whether image-based analysis by experts using handheld devices is accurate remains to be determined. METHOD: A review of patient data from eight emergency centres in the Western Cape, South Africa, revealed 10 typical cases of burns commonly seen in children and adults...
December 13, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29158036/paediatric-weight-estimation-by-age-in-the-digital-era-optimising-a-necessary-evil
#5
Nicholas Appelbaum, Jonathan Clarke, Ian Maconochie, Ara Darzi
BACKGROUND: Age-based weight estimation methods are regularly used in paediatric emergency medicine despite their well-established inaccuracy. AIM: Determine the potential improvement in accuracy achievable by the use of a new mobile application, based on CDC/WHO weight-for-age centile data, which incorporates a gender assignment, a body habitus assessment, and which is capable of an age-in-months based calculation. METHODS: A theoretical, simulated validation study, comparing the performance of the widely used APLS/EPALS formulae against two contemporary habitus-adjusted methods, and the Helix Weight Estimation Tool...
November 17, 2017: Resuscitation
https://www.readbyqxmd.com/read/29111613/management-of-shiga-toxin-producing-escherichia-coli-infected-children-a-multi-national-multi-specialty-survey
#6
Stephen B Freedman, Silviu Grisaru, Jianling Xie, Susan Samuel, Andrew Dixon, Amy C Plint, David Schnadower
AIM: Research has highlighted the potential role that hydration status may play in predicting outcomes in Shiga toxin-producing Escherichia coli (STEC)-infected children. Because little is known about the management of STEC-infected children in the pre-haemolytic uremic syndrome phase, we compared paediatric emergency medicine and nephrologist-stated management approaches to STEC-infected children. METHODS: Members of the Pediatric Emergency Research Canada (PERC; n = 228), the Pediatric Emergency Medicine Collaborative Research Committee (PEM CRC; n = 221) and the Canadian Association of Pediatric Nephrologists (CAPN; n = 66) were surveyed...
November 7, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29039368/connecting-parents-to-a-pediatric-emergency-department-designing-a-mobile-app-based-on-patient-centred-care-principles
#7
Frederic Ehrler, Johan N Siebert, Jessica Rochat, Franck Schneider, Annick Galetto, Alain Gervaix, Christian Lovis
INTRODUCTION: Patient centred care fosters a holistic approach of care switching the focus from a disease perspective to a patient's experience perspective. Patient centred care is of particular importance in the context of paediatric emergency medicine. Indeed, parents entering a paediatric emergency department (PED) are usually under stress caused by their children's illness, the unfamiliar setting of the PED and delays of care. All these factors can deteriorate their experience as well as the relationships between healthcare providers, the patients and their parents...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28979529/free-open-access-med-ical-edu-cation-for-critical-care-practitioners
#8
EDITORIAL
Olusegun Olusanya, James Day, Justin Kirk-Bayley, Tamas Szakmany
Free Open Access Med(ical edu)cation refers to an online community of knowledge relating to medicine. Originating from practitioners in emergency medicine, it has since spread to critical care, internal medicine, prehospital medicine, paediatrics, and allied health professionals and continues to grow at an advanced rate. Weblogs ('blog' for short), emails, social media (in particular Twitter), recorded audio material ((podcasts), and video material are all produced on a daily basis and contribute to the continual professional development of trainees and consultants worldwide...
February 2017: Journal of the Intensive Care Society
https://www.readbyqxmd.com/read/28941075/patient-perspectives-on-priorities-for-emergency-medicine-research-the-perspex-study
#9
Stuart Vb McLay, David McCutcheon, Glenn Arendts, Stephen Pj Macdonald, Daniel M Fatovich
OBJECTIVES: To determine the priorities for emergency medicine research of patients currently in an ED and to compare their priorities with those of ACEM researchers. METHODS: A survey of current patients in the EDs of Royal Perth Hospital and Armadale Health Service. Patients gave their reason for presentation, suggested three important research priorities for emergency medicine and ranked their top 5 choices from a pre-specified list published by the ACEM researchers...
September 21, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28855237/predict-prioritisation-study-establishing-the-research-priorities-of-paediatric-emergency-medicine-physicians-in-australia-and-new-zealand
#10
Heather Carol Deane, Catherine L Wilson, Franz E Babl, Stuart R Dalziel, John Alexander Cheek, Simon S Craig, Ed Oakley, Meredith Borland, Nicholas G Cheng, Michael Zhang, Elizabeth Cotterell, Tibor Schuster, David Krieser
BACKGROUND: The Paediatric Research in Emergency Departments International Collaborative (PREDICT) performs multicentre research in Australia and New Zealand. Research priorities are difficult to determine, often relying on individual interests or prior work. OBJECTIVE: To identify the research priorities of paediatric emergency medicine (PEM) specialists working in Australia and New Zealand. METHODS: Online surveys were administered in a two-stage, modified Delphi study...
August 30, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28845599/paediatric-emergency-medicine-point-of-care-ultrasound-fundamental-or-fad
#11
Peter J Snelling, Mark Tessaro
No abstract text is available yet for this article.
October 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28801485/identifying-discordance-between-senior-physicians-and-trainees-on-the-root-cause-of-ed-revisits
#12
Michael P Goldman, Michael C Monuteaux, Catherine Perron, Richard G Bachur
OBJECTIVE: Analysis of 72-hour ED revisits is a common emergency medicine quality assurance (QA) practice. Our aim was to compare the perceived root cause for 72-hour ED revisits between senior physicians (attendings) and trainees. We proposed that discordance in perception of why the revisit occurred would guide improvements in 72-hour revisits QA and elucidate innovative educational opportunities. METHODS: Questionnaire-based observational study conducted in an urban academic paediatric ED...
August 11, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28700417/genetics-of-paediatric-cardiomyopathies
#13
Stephanie M Ware
PURPOSE OF REVIEW: Paediatric cardiomyopathy is a rare disease with a genetic basis. The purpose of this review is to discuss the current status of genetic findings in the paediatric cardiomyopathy population and present recent progress in utilizing this information for management and therapy. RECENT FINDINGS: With increased clinical genetic testing, an understanding of the genetic causes of cardiomyopathy is improving and novel causes are identified at a rapid rate...
October 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28688998/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#14
Alain Cariou, Jean-Francois Payen, Karim Asehnoune, Gérard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigué, Laure de Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
July 5, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28677825/the-impact-after-50-years-of-a-new-medical-education-programme-with-a-regional-workforce-mission
#15
Richard Hays, Sarah Bowles, Terry Brown, Anthony Lawler, James Vickers
BACKGROUND: Tasmania established its medical programme in 1965 to produce graduates to address medical workforce recruitment challenges. Many Tasmanian graduates work in Tasmania, but workforce problems continue. This paper reports the workforce outcomes of the first 42 graduating cohorts. METHODS: A database for all University of Tasmania medical graduates from the years 1970 to 2011 was developed by combining information from university, registration and local workforce survey databases...
July 5, 2017: Australian Journal of Rural Health
https://www.readbyqxmd.com/read/28631089/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#16
REVIEW
Alain Cariou, Jean-François Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28618012/metabolomic-signature-of-brain-cancer
#17
REVIEW
Renu Pandey, Laura Caflisch, Alessia Lodi, Andrew J Brenner, Stefano Tiziani
Despite advances in surgery and adjuvant therapy, brain tumors represent one of the leading causes of cancer-related mortality and morbidity in both adults and children. Gliomas constitute about 60% of all cerebral tumors, showing varying degrees of malignancy. They are difficult to treat due to dismal prognosis and limited therapeutics. Metabolomics is the untargeted and targeted analyses of endogenous and exogenous small molecules, which charact erizes the phenotype of an individual. This emerging "omics" science provides functional readouts of cellular activity that contribute greatly to the understanding of cancer biology including brain tumor biology...
November 2017: Molecular Carcinogenesis
https://www.readbyqxmd.com/read/28532628/milestones-barriers-and-beacons-shared-decision-making-in-canada-inches-ahead
#18
France Légaré, Dawn Stacey, Pierre-Gerlier Forest, Marie-France Coutu, Patrick Archambault, Laura Boland, Holly O Witteman, Annie LeBlanc, Krystina B Lewis, Anik M C Giguere
Canada's approach to shared decision making (SDM) remains as disparate as its healthcare system; a conglomerate of 14 public plans - ten provincial, three territorial and one federal. The healthcare research funding environment has been largely positive for SDM because there was funding for knowledge translation research which also encompassed SDM. The funding climate currently places new emphasis on patient involvement in research and on patient empowerment in healthcare. SDM fields have expanded from primary care to elder care, paediatrics, emergency and critical care medicine, cardiology, nutrition, occupational therapy and workplace rehabilitation...
May 19, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28530457/-patient-turnover-in-a-multidisciplinary-emergency-department
#19
Csaba Varga, Zsuzsanna Lelovics, Viktor Soós, Tibor Oláh
INTRODUCTION: More than twenty emergency departments were opened across Hungary in the past years. Data deficiency on patient flow, trends and lack of knowledge of indicators could raise numerous logistical and organisational problems. AIM: Collection, analysis and provision of data to facilitate successful operations of emergency medical care services. METHOD: During a three-year period investigated, at the multidisciplinary Emergency Department of "Moritz Kaposi" Teaching Hospital, data on patient flow (n = 106,203), epidemiology, triage and international classification of diseases were analysed...
May 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28410792/accuracy-of-pecarn-catch-and-chalice-head-injury-decision-rules-in-children-a-prospective-cohort-study
#20
Franz E Babl, Meredith L Borland, Natalie Phillips, Amit Kochar, Sarah Dalton, Mary McCaskill, John A Cheek, Yuri Gilhotra, Jeremy Furyk, Jocelyn Neutze, Mark D Lyttle, Silvia Bressan, Susan Donath, Charlotte Molesworth, Kim Jachno, Brenton Ward, Amanda Williams, Amy Baylis, Louise Crowe, Ed Oakley, Stuart R Dalziel
BACKGROUND: Clinical decision rules can help to determine the need for CT imaging in children with head injuries. We aimed to validate three clinical decision rules (PECARN, CATCH, and CHALICE) in a large sample of children. METHODS: In this prospective observational study, we included children and adolescents (aged <18 years) with head injuries of any severity who presented to the emergency departments of ten Australian and New Zealand hospitals. We assessed the diagnostic accuracy of PECARN (stratified into children aged <2 years and ≥2 years), CATCH, and CHALICE in predicting each rule-specific outcome measure (clinically important traumatic brain injury [TBI], need for neurological intervention, and clinically significant intracranial injury, respectively)...
June 17, 2017: Lancet
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