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https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#1
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29148202/common-paediatric-conditions-of-the-lower-limb
#2
REVIEW
Ashlee M Dobbe, Paul J Gibbons
Growing children are susceptible to a number of disorders to their lower extremities of varying degrees of severity. The diagnosis and management of these conditions can be challenging. With musculoskeletal symptoms being one of the leading reasons for visits to general practitioners, a working knowledge of the basics of these disorders can help in the appropriate diagnosis, treatment, counselling, and specialist referral. This review covers common disorders affecting the hip, the knee and the foot. The aim is to assist general practitioners in recognising developmental norms and differentiating physiological from pathological conditions and to identify when a specialist referral is necessary...
November 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29138043/non-traumatic-limping-in-paediatric-emergencies-epidemiology-evaluation-and-results
#3
M I Lázaro Carreño, R Fraile Currius, A García Clemente
INTRODUCTION: Non-traumatic limping is a common reason for consultation in paediatric emergencies. Although transient synovitis of the hip (TS) is the most frequent diagnosis, there are cases of limping secondary to serious pathologies. The aim of this review is to describe the variables related to non-traumatic limp that come to the paediatric emergency department to establish the best management protocol, making the most of resources and speeding up emergency care. MATERIAL AND METHOD: A prospective study was conducted, selecting all children less than 15 years old who consulted aspaediatric emergencies for non-traumatic limping during the 2014...
November 11, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29113732/oxidative-stress-in-ageing-and-disease-development-studied-by-ft-ir-spectroscopy
#4
Jane Anastassopoulou, Maria Kyriakidou, Stylianos Kyriazis, Andreas F Mavrogenis, Vasiliki Mamareli, Ioannis Mamarelis, Marianna Petra, Efthymia Malesiou, Christoforos Kotoulas, Panagiota Kolovou, Emmanouil Koutoulakis, Athina Markouizou, Theophile Theophanides
FT-IR spectroscopy was used to investigate the effect of oxidative stress and to approach the mechanism on cancer bone demineralization, aortic valve mineralization and heterotopic ossification on disease development. The FT-IR spectra obtained from paediatric, adult bone and ex vivo irradiated adult healthy bone with a dose of 20Gy were compared with those of healthy bone. The increase of band intensity changes of vasCH2,vsCH2 in the region 3000-2850cm(-1) depended on aging, the disease progression and the dose of irradiation...
November 4, 2017: Mechanisms of Ageing and Development
https://www.readbyqxmd.com/read/29092995/clicky-hip-alone-is-not-a-true-risk-factor-for-developmental-dysplasia-of-the-hip
#5
K Nie, S Rymaruk, R W Paton
AIMS: A clicky hip is a common referral for clinical and sonographic screening for developmental dysplasia of the hip (DDH). There is controversy regarding whether it represents a true risk factor for pathological DDH. Therefore a 20-year prospective, longitudinal, observational study was undertaken to assess the relationship between the presence of a neonatal clicky hip and pathological DDH. PATIENTS AND METHODS: A total of 362 infants from 1997 to 2016 were referred with clicky hips to our 'one-stop' paediatric hip screening clinic...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29081857/analysis-of-a-paediatric-orthopaedic-network-a-six-year-experience-in-the-south-west-of-the-united-kingdom
#6
D Bruce, C Kocialkowski, F Bintcliffe, F Monsell, J Barnes, R Brown
PURPOSE: We report our experience of a paediatric orthopaedic network, based on a 'hub and spoke' model, covering the South West of the United Kingdom. We identify the areas of most clinical concern, the effect of the network on stream-lining patient management and the benefits of the network to the clinician. METHODS: Prospective data were collected from the minutes of the bi-annual meetings of the South West Paediatric Network (UK) between November 2006 and May 2012...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29081850/obstacles-to-reduction-in-infantile-developmental-dysplasia-of-the-hip
#7
K Studer, N Williams, P Studer, M Baker, A Glynn, B K Foster, P J Cundy
PURPOSE: Identification of anatomical structures that block -reduction in developmental dysplasia of the hip (DDH) is -important for the management of this challenging condition. Obstacles to reduction seen on arthrogram are well-known. However, despite the increasing use of MRI in the assessment of adequacy of reduction in DDH, the interpretation of MRI patho-anatomy is ill-defined with a lack of relevant literature to guide clinicians. METHOD: This is a retrospective analysis of the MRI of patients with DDH treated by closed reduction over a five-year period (between 2009 and 2014)...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29081847/an-independent-assessment-of-reliability-of-the-melbourne-cerebral-palsy-hip-classification-system
#8
M W Shrader, A L Koenig, M Falk, M Belthur, C Boan
PURPOSE: Neuromuscular (NM) hip dysplasia is common in patients with cerebral palsy (CP). Traditionally, migration percentage (MP) has been used to measure the severity of NM hip dysplasia; however, the MP has some limitations. The purpose of this study is to determine the intra- and inter-reliability of the Melbourne Cerebral Palsy Hip Classification System in the typical paediatric population of patients with CP. METHODS: A total of 65 anteroposterior pelvis radiographs in patients (age range 12 years to 21 years) with CP spanning all grades (I to VI) of the classification system were identified and collected for analysis in this institutional review board approved study...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29068288/timing-of-surgical-intervention-for-developmental-dysplasia-of-the-hip-a-randomised-controlled-trial-hip-op
#9
Charlotte L Williams, Susie Weller, Lisa Roberts, Isabel Reading, Andrew Cook, Louisa Little, Wendy Wood, Louise Stanton, Andreas Roposch, Nicholas Mp Clarke
BACKGROUND: Developmental dysplasia of the hip (DDH) is a very common congenital disorder, and late-presenting cases often require surgical treatment. Surgical reduction of the hip may be complicated by avascular necrosis (AVN), which occurs as a result of interruption to the femoral head blood supply during treatment and can result in long-term problems. Some surgeons delay surgical treatment until the ossific nucleus (ON) has developed, whereas others believe that the earlier the reduction is performed, the better the result...
October 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29044835/screening-and-referral-for-children-with-physical-disabilities
#10
REVIEW
Andrew G Georgiadis, Pam Thomason, Kate Willoughby, H Kerr Graham
The clinical care of children with physical disabilities is a major priority for paediatricians and paediatric orthopaedic surgeons. Cerebral palsy (CP) is the prototypical condition and remains the most common cause of physical disability in developed countries. The incidence is approximately 2 per 1000 live births, translating to between 600 and 700 new children per annum in Australia, with approximately 34 000 children and adults currently living with CP. This figure is predicted to rise inexorably over the next 20 years...
October 17, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28980897/comparison-of-patients-with-familial-mediterranean-fever-accompanied-with-sacroiliitis-and-patients-with-juvenile-spondyloarthropathy
#11
Hafize Emine Sönmez, Ezgi Deniz Batu, Selcan Demir, Yelda Bilginer, Seza Özen
OBJECTIVES: Familial Mediterranean fever (FMF) is the most common autoinflammatory disease manifesting with self-limited recurrent febrile attacks and polyserositis. Acute recurrent monoarthritis is the most common form of musculoskeletal involvement in FMF; however, up to 5% of FMF patients may develop chronic joint diseases including sacroiliitis. It is difficult to distinguish whether sacroiliitis is a musculoskeletal finding of FMF or whether this is the coexistence of two diseases, FMF and SpA...
September 26, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28930627/fitness-body-composition-and-vascular-health-in-adolescent-and-young-adult-survivors-of-paediatric-brain-cancer-and-cranial-radiotherapy
#12
Treya M Long, Shoshana R Rath, Tessa D Maroni, Karen E Wallman, Helen C Atkinson, Nicholas G Gottardo, Catherine H Cole, Catherine S Choong, Louise H Naylor
Background Survivors of paediatric brain cancer and/or cranial radiotherapy (CRT) are at an increased risk of developing serious comorbidities. Established risk factors for chronic disease include central obesity, endothelial abnormalities and diminished fitness. Objectives Here we characterised anthropometry, body composition, bone mineral density (BMD), heart rate (HR), blood pressure (BP), endothelial function, muscular strength and endurance and aerobic fitness in adolescent and young adult (AYA) survivors...
September 20, 2017: International Journal of Adolescent Medicine and Health
https://www.readbyqxmd.com/read/28853599/pyomyositis-of-the-pectineus-muscle-in-an-adolescent-male
#13
J Hiddema, S Hassan, N Mangat, N Siddiqui
The 'irritable hip' continues to pose a challenge for clinicians. Even with predictive clinical algorithms, decision making can be difficult. Emergency treatment is required if septic arthritis is suspected. Other differential diagnoses such as transient synovitis, pyomyositis of the pelvic girdle muscles and osteomyelitis must be considered in order to help guide appropriate investigations and allow early treatment. We report the case of a 13-year-old boy presenting to our institution with an acutely painful left hip but still able to weight bear...
September 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28835150/aggressive-development-of-an-aneurysmal-bone-cyst-of-the-proximal-femur-in-a-paediatric-patient-a-case-report
#14
Alexandru Ulici, Alin Gabriel Sterian, Iulia Tevanov, Madalina Carp, Andrei Dusca, Dan Cosma
We report development of an aneurysmal bone cyst (ABC) that was located in the proximal region of the femur in an 11-year-old girl. Over a period of 30 weeks, the ABC showed fulminant local progression, with destruction of the bone, which led to an abrupt loss of function of the left hip. The standard tumour treatment protocol was followed. We performed embolisation of the tumour followed by a biopsy, which confirmed the diagnosis of ABC. The outcome was negative with total destruction of the proximal third of the femur, despite repeating the embolisation...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28828067/patient-factors-associated-with-delayed-diagnosis-of-developmental-dysplasia-of-the-hip
#15
A W Lindberg, V Bompadre, E K Satchell, A C R Larson, K K White
PURPOSE: Early detection and intervention for developmental dysplasia of the hip (DDH) is important for normal hip development. Previous studies have shown disparities in access to paediatric specialty care among different racial and socioeconomic backgrounds. This study aims to identify whether these factors are related to timely referral for infants with DDH. METHODS: A retrospective cohort study of patients seen and treated for DDH between July 2006 and June 2011 at a single institution were reviewed...
June 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28728961/avascular-necrosis-of-the-femoral-head-in-patients-treated-for-leukaemia-assessment-of-the-need-for-a-diagnostic-protocol
#16
J Alguacil Pinel, P Vila Vives, M Salom Taverner
OBJECTIVE: To evaluate the incidence of avascular necrosis of the hip in leukaemia patients treated in our hospital with high doses of corticosteroids in order to evaluate the necessity for an early detection protocol. MATERIAL AND METHODS: Observational-descriptive and retrospective study from 2005 to 2016 of 253 patients diagnosed with paediatric leukaemia. Patients with musculoskeletal pathology were identified and patients with avascular necrosis were analysed...
July 17, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28716002/epidemiological-and-clinical-profile-of-paediatric-malaria-a-cross-sectional-study-performed-on-febrile-children-in-five-epidemiological-strata-of-malaria-in-cameroon
#17
Tebit Emmanuel Kwenti, Tayong Dizzle Bita Kwenti, Andreas Latz, Longdoh Anna Njunda, Theresa Nkuo-Akenji
BACKGROUND: In the wake of a decline in global malaria, it is imperative to describe the epidemiology of malaria in a country to inform control policies. The purpose of this study was to describe the epidemiological and clinical profile of paediatric malaria in five epidemiological strata of malaria in Cameroon including: the Sudano-sahelian (SS) strata, the High inland plateau (HIP) strata, the South Cameroonian Equatorial forest (SCEF) strata, the High western plateau (HWP) strata, and the Coastal (C) strata...
July 17, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28659058/diagnosis-and-treatment-of-developmental-dysplasia-of-the-hip-a-current-practice-of-paediatric-orthopaedic-surgeons
#18
Rakan S Al-Essa, Fares H Aljahdali, Rakan M Alkhilaiwi, Winnie Philip, Ayman H Jawadi, Khalid I Khoshhal
BACKGROUND: Developmental dysplasia of the hip (DDH) is one of the prevalent musculoskeletal conditions in young adults and is a leading cause of hip osteoarthrosis in this age group. The optimum age for surgical intervention when needed is not well established in the literature and the lack of management guidelines and standard practice of DDH leads to different practices worldwide. This study aims to investigate the current practice of paediatric orthopaedic surgeons in diagnosing and treating DDH worldwide and identify points of agreement and disagreement...
May 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28537411/-treatment-of-pelvic-avulsion-fractures-in-children-and-adolescents
#19
A Stančák, J Kautzner, T Trč, V Havlas
INTRODUCTION: Paediatric avulsion fractures of the pelvis and hip joint are rare injuries most commonly associated with a rapid muscle contraction of the respected apophysis, which is the weakest component of the growing skeleton. The chosen therapy option can be either conservative or surgical. METHODS: We present a cohort of 69 patients treated for an apophyseal avulsion fracture of the anterior superior / inferior iliac spine, the lesser and greater trochanters iliac crest and the ischial tubercle...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28536211/pathological-fracture-of-the-femoral-neck-following-septic-coxitis-and-chronic-osteomyelitis-a-potential-complication-of-lemierre-s-syndrome
#20
Dominik Maximilian Vogt, Ludger Tüshaus, Martin Kaiser, Martin Russlies
We portray the case of a 16-year-old girl who was initially admitted to the paediatric emergency department with non-specific symptoms of a severe cold and was first treated symptomatically on an ambulatory basis. Within 6 days she developed the full clinical picture of Lemierre's syndrome with the extraordinary manifestation of involvement of her right hip. Despite an interdisciplinary coordinated treatment as well as surgical therapy, a full-blown sepsis evolved within a short time period and resulted in almost 2 months of intensive care...
May 22, 2017: BMJ Case Reports
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