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Pediatric clinical research

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https://www.readbyqxmd.com/read/28719333/bidirectional-exchange-in-global-health-moving-toward-true-global-health-partnership
#1
Gitanjli Arora, Christiana Russ, Maneesh Batra, Sabrina M Butteris, Jennifer Watts, Michael B Pitt
Although there has been rapid growth in global health educational experiences over the last two decades, the flow of learners remains overwhelmingly one directional; providers from high-resourced settings travel to limited-resourced environments to participate in clinical care, education, and/or research. Increasingly, there has been a call to promote parity in partnerships, including the development of bidirectional exchanges, where trainees from each institution travel to the partner's setting to learn from and teach each other...
July 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28717937/clinical-presentation-and-outcomes-of-childhood-onset-membranous-lupus-nephritis
#2
Maria Pereira, Eyal Muscal, Karen Eldin, M John Hicks, Anna Carmela P Sagcal-Gironella, Marietta DeGuzman, Scott E Wenderfer
BACKGROUND: Best practices for managing childhood-onset membranous lupus nephritis (MLN) are not yet established. Most studies involve primarily or exclusively adult cohorts or pediatric cohorts with combinations of pure or mixed membranous and proliferative nephritis. METHODS: We performed a single-center cohort study of consecutively diagnosed children with pure MLN from 1990 and 2016. Patients received care in Houston, Texas, one of the most diverse metropolitan areas in North America...
July 17, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28712662/enteropathogen-detection-in-children-with-diarrhoea-or-vomiting-or-both-comparing-rectal-flocked-swabs-with-stool-specimens-an-outpatient-cohort-study
#3
Stephen B Freedman, Jianling Xie, Alberto Nettel-Aguirre, Bonita Lee, Linda Chui, Xiao-Li Pang, Ran Zhuo, Brendon Parsons, James A Dickinson, Otto G Vanderkooi, Samina Ali, Lara Osterreicher, Karen Lowerison, Phillip I Tarr
BACKGROUND: Enteropathogen detection traditionally relies on diarrhoeal stool samples, but these are inconvenient to collect if they are not immediately available, leading to suboptimum return rates of samples and delayed or missed diagnostic opportunities. We sought to compare the enteropathogen yields of rectal swabs and stool specimens in children with diarrhoea or vomiting, or both. METHODS: The Alberta Provincial Pediatric EnTeric Infection TEam (APPETITE) did a study in three outpatient cohorts in Calgary and Edmonton (AB, Canada)-children enrolled in the Pediatric Emergency Research Canada emergency departments, children receiving routine vaccinations at a Calgary health clinic, and symptomatic children who met criteria for treatment at home...
July 13, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28708590/whole-exome-analysis-in-osteosarcoma-to-identify-a-personalized-therapy
#4
Caterina Chiappetta, Massimiliano Mancini, Francesca Lessi, Paolo Aretini, Veronica De Gregorio, Chiara Puggioni, Raffaella Carletti, Vincenzo Petrozza, Prospero Civita, Sara Franceschi, Antonio G Naccarato, Carlo Della Rocca, Chiara M Mazzanti, Claudio Di Cristofano
Osteosarcoma is the most common pediatric primary non-hematopoietic bone tumor. Survival of these young patients is related to the response to chemotherapy and development of metastases. Despite many advances in cancer research, chemotherapy regimens for osteosarcoma are still based on non-selective cytotoxic drugs. It is essential to investigate new specific molecular therapies for osteosarcoma to increase the survival rate of these patients. We performed exomic sequence analyses of 8 diagnostic biopsies of patients with conventional high grade osteosarcoma to advance our understanding of their genetic underpinnings and to correlate the genetic alteration with the clinical and pathological features of each patient to identify a personalized therapy...
July 5, 2017: Oncotarget
https://www.readbyqxmd.com/read/28706173/-development-and-evaluation-of-a-self-reflection-program-for-intensive-care-unit-nurses-who-have-experienced-the-death-of-pediatric-patients
#5
Hyun Ju Kang, Kyung Sook Bang
PURPOSE: This study aims to develop a self-reflection program for nurses who have experienced the death of pediatric patients in the intensive care unit and to evaluate its effectiveness. METHODS: The self-reflection program was developed by means of the following four steps: establishment of the goal through investigation of an initial request, drawing up the program, preliminary research, and implementation and improvement of the program. The study employed a methodological triangulation to evaluate the effectiveness of the program...
June 2017: Journal of Korean Academy of Nursing
https://www.readbyqxmd.com/read/28705656/impact-of-enteroviral-polymerase-chain-reaction-testing-on-length-of-stay-for-infants-60-days-old-or-younger
#6
Paul L Aronson, Todd W Lyons, Andrea T Cruz, Stephen B Freedman, Pamela J Okada, Alesia H Fleming, Joseph L Arms, Amy D Thompson, Suzanne M Schmidt, Jeffrey Louie, Michael J Alfonzo, Michael C Monuteaux, Lise E Nigrovic
OBJECTIVE: To determine the impact of a cerebrospinal fluid enterovirus polymerase chain reaction (PCR) test performance on hospital length of stay (LOS) in a large multicenter cohort of infants undergoing evaluation for central nervous system infection. STUDY DESIGN: We performed a planned secondary analysis of a retrospective cohort of hospitalized infants ≤60 days of age who had a cerebrospinal fluid culture obtained at 1 of 18 participating centers (2005-2013)...
July 10, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28705022/evaluation-of-dose-and-outcomes-for-pediatric-vilazodone-ingestions
#7
Christopher E Gaw, Henry A Spiller, Jason L Russell, Thiphalak Chounthirath, Gary A Smith
BACKGROUND: Selective serotonin reuptake inhibitor (SSRI) exposures among children younger than 6 years of age are generally well tolerated. Vilazodone is an SSRI with partial agonism at the 5-HT1A receptor with demonstrated clinical efficacy for depression whose off-label usage is likely to increase. Recent evidence suggests that unintentional ingestion of vilazodone in children under 6 years old is associated with more severe clinical effects than other SSRIs. We chose to evaluate dose and outcomes for pediatric vilazodone ingestions...
July 14, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28704168/integrating-agricultural-injury-prevention-with-rural-pediatrics-a-pilot-assessment
#8
Julie Kaprelian, Richard L Berg, Kathrine Lynn Barnes, Barbara Marlenga
BACKGROUND: Childhood agricultural injuries are an important public health problem. Pediatricians are a trusted source of expertise in children's health and safety and could serve as a sphere of influence to augment child agricultural injury prevention efforts. The purpose of this pilot study was to begin to explore the perspectives of pediatricians in a large rural health clinic about addressing child agricultural injury prevention within their practice. METHODS: Structured interviews were conducted with nine pediatricians who maintain a clinical practice of at least 2 days a week and care for newborns through adolescents...
July 13, 2017: Journal of Agromedicine
https://www.readbyqxmd.com/read/28702841/comparison-of-ketamine-and-ketofol-for-deep-sedation-and-analgesia-in-children-undergoing-laser-procedure
#9
Marija Stevic, Nina Ristic, Ivana Budic, Nebojsa Ladjevic, Branislav Trifunovic, Ivan Rakic, Marko Majstorovic, Ivana Burazor, Dusica Simic
The aim of our study was to research and evaluate cardiovascular and respiratory stability, clinical efficacy, and safety of two different anesthetic agents in pediatric patients who underwent Pulse dye (wavelength 595 nm, pulse duration 0-40 ms, power 0-40 J) and CO2 (wavelength 10,600 nm, intensity-fraxel mod with SX index 4 to 8, power 0-30 W) laser procedure. This prospective non-blinded study included 203 pediatric patients ASA I-II, aged between 1 month and 12 years who underwent short-term procedural sedation and analgesia for the laser procedure...
July 12, 2017: Lasers in Medical Science
https://www.readbyqxmd.com/read/28701360/multicentre-randomised-clinical-trial-of-paediatric-concussion-assessment-of-rest-and-exertion-pedcare-a-study-to-determine-when-to-resume-physical-activities-following-concussion-in-children
#10
Andrée-Anne Ledoux, Nicholas J Barrowman, Kathy Boutis, Adrienne Davis, Sarah Reid, Gurinder Sangha, Ken J Farion, Kevin Belanger, Mark S Tremblay, Keith Owen Yeates, Carol DeMatteo, Nick Reed, Roger Zemek
INTRODUCTION: Rest until symptom-free, followed by a progressive stepwise return to activities, is often prescribed in the management of paediatric concussions. Recent evidence suggests prolonged rest may hinder recovery, and early resumption of physical activity may be associated with more rapid recovery postconcussion. The primary objective is to determine whether the early reintroduction of non-contact physical activity beginning 72 hours postinjury reduces postconcussive symptoms at 2 weeks in children following an acute concussion as compared with a rest until asymptomatic protocol...
July 12, 2017: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/28700566/enhancing-pediatric-clinical-trial-feasibility-through-the-use-of-bayesian-statistics
#11
Robin A Huff, Jeff D Maca, Mala Puri, Earl W Seltzer
BACKGROUND: Pediatric clinical trials commonly experience recruitment challenges, including limited numbers of patients and investigators, inclusion/exclusion criteria that further reduce the patient pool, and a competitive research landscape created by pediatric regulatory commitments. To overcome these challenges, innovative approaches are needed. METHODS: This article explores the use of Bayesian statistics to improve pediatric trial feasibility, using pediatric type 2 diabetes as an example...
July 12, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28700565/nasal-continuous-positive-airway-pressure-influences-bottle-feeding-in-preterm-lambs
#12
Nathalie Samson, Audrey Michaud, Rahmeh Othman, Charlène Nadeau, Stéphanie Nault, Danny Cantin, Michaël Sage, Céline Catelin, Jean-Paul Praud
BACKGROUND: In preterm infants, the time from initiation to full oral feeding can take weeks, which represents a very worrisome problem in neonatal medicine. Although current knowledge suggests that oral feeding should be introduced early, this is often delayed due to the need for prolonged nasal continuous positive airway pressure (nCPAP). Indeed, most caregivers fear that nCPAP could disrupt sucking-swallowing-breathing coordination and induce tracheal aspiration. The goal of the present study was to assess the impact of nCPAP delivered by the Infant Flow System on the physiology of sucking-swallowing-breathing coordination during bottle-feeding in preterm lambs over 24 h...
July 12, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28700523/dried-blood-spots-combined-with-ultra-high-performance-liquid-chromatography-mass-spectrometry-for-the-quantification-of-the-antipsychotics-risperidone-aripiprazole-pipamperone-and-their-major-metabolites
#13
Camille Tron, Sanne M Kloosterboer, Bart C H van der Nagel, Rixt A Wijma, Bram Dierckx, Gwen C Dieleman, Teun van Gelder, Birgit C P Koch
BACKGROUND: Risperidone, aripiprazole, and pipamperone are antipsychotic drugs frequently prescribed for the treatment of comorbid behavioral problems in children with autism spectrum disorders. Therapeutic drug monitoring (TDM) could be useful to decrease side effects and to improve patient outcome. Dried blood spot (DBS) sample collection seems to be an attractive technique to develop TDM of these drugs in a pediatric population. The aim of this work was to develop and validate a DBS assay suitable for TDM and home sampling...
August 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28699564/detecting-clinically-relevant-new-information-in-clinical-notes-across-specialties-and-settings
#14
Rui Zhang, Serguei V S Pakhomov, Elliot G Arsoniadis, Janet T Lee, Yan Wang, Genevieve B Melton
BACKGROUND: Automated methods for identifying clinically relevant new versus redundant information in electronic health record (EHR) clinical notes is useful for clinicians and researchers involved in patient care and clinical research, respectively. We evaluated methods to automatically identify clinically relevant new information in clinical notes, and compared the quantity of redundant information across specialties and clinical settings. METHODS: Statistical language models augmented with semantic similarity measures were evaluated as a means to detect and quantify clinically relevant new and redundant information over longitudinal clinical notes for a given patient...
July 5, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28698351/subdissociative-intranasal-ketamine-plus-standard-pain-therapy-versus-standard-pain-therapy-in-the-treatment-of-paediatric-sickle-cell-disease-vaso-occlusive-crises-in-resource-limited-settings-study-protocol-for-a-randomised-controlled-trial
#15
James R Young, Hendry Robert Sawe, Juma A Mfinanga, Ernest Nshom, Ethan Helm, Charity G Moore, Michael S Runyon, Stacy L Reynolds
INTRODUCTION: Pediatric sickle cell disease, highly prevalent in sub-Saharan Africa, carries great morbidity and mortality risk. Limited resources and monitoring make management of acute vaso-occlusive crises challenging. This study aims to evaluate the efficacy and safety of subdissociative intranasal ketamine as a cheap, readily available and easily administered adjunct to standard pain therapy. We hypothesise that subdissociative, intranasal ketamine may significantly augment current approaches to pain management in resource-limited settings in a safe and cost-effective manner...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28697269/pediatric-cellulitis-a-red-hot-concern
#16
Andrew Shriner, Laurie Wilkie
Cellulitis and other skin and soft tissue infections are a common reason for children to seek care, both in the primary care setting and the emergency department. Cellulitis is a common skin and soft-tissue infection that is usually caused by streptococci bacteria or, less commonly, Staphylococcus aureus. Most children recover quickly from cellulitis, but a small subset will require hospitalization. Practitioners need to be skilled in the diagnosis and treatment of cellulitis, including recognition of the need for inpatient treatment...
July 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28696786/effect-of-early-and-prophylactic-nonsteroidal-anti-inflammatory-drugs-on-flare-duration-in-pediatric-acute-onset-neuropsychiatric-syndrome-an-observational-study-of-patients-followed-by-an-academic-community-based-pediatric-acute-onset-neuropsychiatric-syndrome
#17
Kayla D Brown, Cristan Farmer, G Mark Freeman, Ellen J Spartz, Bahare Farhadian, Margo Thienemann, Jennifer Frankovich
INTRODUCTION: Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) is characterized by the sudden onset of severe obsessive-compulsive symptoms and/or eating restriction along with at least two coinciding neuropsychiatric symptoms. When associated with group A Streptococcus, the syndrome is labeled Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infections (PANDAS). An abnormal immune response to infection and subsequent neuroinflammation is postulated to play an etiologic role...
July 11, 2017: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/28696783/course-of-neuropsychiatric-symptoms-after-introduction-and-removal-of-nonsteroidal-anti-inflammatory-drugs-a-pediatric-observational-study
#18
Ellen J Spartz, G Mark Freeman, Kayla Brown, Bahare Farhadian, Margo Thienemann, Jennifer Frankovich
OBJECTIVE: Accumulating evidence suggests that anti-inflammatory interventions can modulate neuropsychiatric symptoms. Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) is characterized by an abrupt and dramatic onset of obsessive-compulsive (OC) symptoms and/or severely restrictive food intake and at least two coinciding, equally debilitating neuropsychiatric symptoms. When associated with group A Streptococcus, the syndrome is labeled Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infections (PANDAS)...
July 11, 2017: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/28696526/highlights-from-the-2016-north-american-cystic-fibrosis-conference
#19
REVIEW
Edith T Zemanick, Cori L Daines, Elisabeth P Dellon, Charles R Esther, BreAnna Kinghorn, Thida Ong, Marianne S Muhlebach
The 30th annual North American Cystic Fibrosis Conference (NACFC) was held in Orlando, FL, on October 27-29, 2016. Abstracts were published in a supplement to Pediatric Pulmonology. This review summarizes several major topic areas addressed at the conference: the pathophysiology of cystic fibrosis (CF) lung disease, clinical trials, clinical management issues, and quality improvement. We sought to provide an overview of emerging concepts in several areas of CF research and care, rather than a comprehensive review of the conference...
July 11, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28696044/practice-patterns-of-palliative-radiation-therapy-in-pediatric-oncology-patients-in-an-international-pediatric-research-consortium
#20
Avani Dholakia Rao, Qinyu Chen, Ralph P Ermoian, Sara R Alcorn, Maria Luisa S Figueiredo, Michael J Chen, Karin Dieckmann, Shannon M MacDonald, Matthew M Ladra, Daria Kobyzeva, Alexey V Nechesnyuk, Kristina Nilsson, Eric C Ford, Brian A Winey, Rosangela C Villar, Stephanie A Terezakis
BACKGROUND/OBJECTIVES: The practice of palliative radiation therapy (RT) is based on extrapolation from adult literature. We evaluated patterns of pediatric palliative RT to describe regimens used to identify opportunity for future pediatric-specific clinical trials. DESIGN/METHODS: Six international institutions with pediatric expertise completed a 122-item survey evaluating patterns of palliative RT for patients ≤21 years old from 2010 to 2015. Two institutions use proton RT...
July 11, 2017: Pediatric Blood & Cancer
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