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https://www.readbyqxmd.com/read/28816891/computed-tomography-use-plateaus-among-children-with-emergency-visits-for-abdominal-pain
#1
Jahan Fahimi, Aaron E Kornblith, Hemal Kanzaria, Andrew Herring, Ralph C Wang
OBJECTIVES: Abdominal pain is a common pediatric complaint to emergency departments (EDs), and clinicians often rely on imaging for diagnosis. Studies have demonstrated an increase in computed tomography (CT) in this population. Following emphasis on radiation reduction by researchers and organizations, this study evaluates recent national trends in CT use among pediatric patients presenting to EDs with abdominal pain. METHODS: This is a cross-sectional analysis of ED patients 18 years or younger with chief complaint of abdominal pain in the National Hospital Ambulatory Medical Care Survey from 2008 to 2011...
August 14, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28816795/voriconazole-antifungal-prophylaxis-in-children-with-malignancies-a-nationwide-study
#2
Zoi Dorothea Pana, Maria Kourti, Katerina Vikelouda, Antonia Vlahou, Nikolaos Katzilakis, Maria Papageorgiou, Dimitrios Doganis, Loizos Petrikkos, Anna Paisiou, Dimitrios Koliouskas, Antonios Kattamis, Eftichia Stiakaki, Maria Chatzistilianou, Helen Vasilatou-Kosmidis, Sophia Polychronopoulou, Stelios Grafakos, Emmanuel Roilides
BACKGROUND: Antifungal prophylaxis (AFP) is recommended in at-risk hematology-oncology patients. We evaluated the safety of AFP with voriconazole (VRC) in pediatric hematology/oncology patients. MATERIALS AND METHODS: A retrospective study of VRC AFP in children with malignancies hospitalized in all 7 Greek pediatric hematology/oncology centers during 2008 to 2012 was conducted. Patients' demographics, outcome, and adverse event (AE) data were recorded. RESULTS: Four hundred twenty-nine VRC AFP courses in 249 patients (median age 6 y, 55% boys) were studied...
August 14, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28816756/characterizing-the-posttransfer-period-among-patients-with-pediatric-onset-ibd-the-impact-of-academic-versus-community-adult-care-on-emergent-health-resource-utilization
#3
Natasha Bollegala, Eric I Benchimol, Anne M Griffiths, Adrienne Kovacs, Allan H Steinhart, Xinbei Zhao, Geoffrey C Nguyen
BACKGROUND: Patients diagnosed with inflammatory bowel disease (IBD) during childhood require transfer to an adult gastroenterologist, in Ontario usually just before their 18th birthday. Pediatric onset IBD is a complex phenotype with demonstrated noncompliance risk that may require targeted measures to optimize health care outcomes in the adult care setting. PURPOSE: The purpose of this study was to determine the impact of posttransfer health care setting (academic versus community gastroenterologist) on emergent health resource utilization...
September 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28816746/characterizing-the-posttransfer-period-among-patients-with-pediatric-onset-ibd-the-impact-of-academic-versus-community-adult-care-on-emergent-health-resource-utilization
#4
Natasha Bollegala, Eric I Benchimol, Anne M Griffiths, Adrienne Kovacs, Allan H Steinhart, Xinbei Zhao, Geoffrey C Nguyen
BACKGROUND: Patients diagnosed with inflammatory bowel disease (IBD) during childhood require transfer to an adult gastroenterologist, in Ontario usually just before their 18th birthday. Pediatric onset IBD is a complex phenotype with demonstrated noncompliance risk that may require targeted measures to optimize health care outcomes in the adult care setting. PURPOSE: The purpose of this study was to determine the impact of posttransfer health care setting (academic versus community gastroenterologist) on emergent health resource utilization...
August 14, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28816278/-analysis-of-development-safety-and-efficacy-of-percutaneous-nephrolithotomy-for-management-of-upper-urinary-tract-calculi-in-pediatric-patients
#5
L P Yu, T Xu
OBJECTIVE: To evaluate the development, safety and efficacy of percutaneous nephrolithotomy(PNL) for management of upper urinary tract calculi in pediatric patients. METHODS: In the study, 77 pediatric patients undergoing 87 PNLs through mini or standard tract for upper urinary tract calculi between January 2005 and December 2016 in Peking University People's hospital were reviewed, including 69 renal calculi, 6 upper ureteral calculi, 12 renal and upper ureteral calculi, 35 single calculi, 43 multiple calculi and 9 staghorn calculi...
August 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28815799/characterization-of-opioid-use-in-sickle-cell-disease
#6
Jin Han, Jifang Zhou, Santosh L Saraf, Victor R Gordeuk, Gregory S Calip
PURPOSE: Opioid analgesics are commonly used to treat vaso-occlusive pain episodes in sickle cell disease (SCD), but comprehensive evidence characterizing opioid use in this patient population is limited. Our objective was to characterize opioid use patterns among SCD patients using a large nationwide database. METHODS: A large, US medical claims database was utilized to identify a cohort of 3882 SCD patients, and characteristics of opioid use were analyzed. Clinical variables including age, gender, medication use, health care utilization, and medical history were evaluated for correlations with opioid use...
August 16, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28815624/morbidity-and-mortality-in-children-undergoing-bronchoscopy-for-foreign-body-removal
#7
Christopher A Roberts, Michele M Carr
OBJECTIVES/HYPOTHESIS: Analyze morbidity and mortality among children undergoing bronchoscopy for foreign body removal. STUDY DESIGN: Multicenter retrospective review using the American College of Surgeons Pediatric National Surgical Quality Improvement Program from 2014 and 2015. METHODS: Patients were identified using Current Procedural Terminology code 31635. Demographics, time to surgery, operative times, hospitalization time, and complications were collected...
August 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28815363/the-use-of-natural-language-processing-on-pediatric-diagnostic-radiology-reports-in-the-electronic-health-record-to-identify-deep-venous-thrombosis-in-children
#8
Jorge A Gálvez, Janine M Pappas, Luis Ahumada, John N Martin, Allan F Simpao, Mohamed A Rehman, Char Witmer
Venous thromboembolism (VTE) is a potentially life-threatening condition that includes both deep vein thrombosis (DVT) and pulmonary embolism. We sought to improve detection and reporting of children with a new diagnosis of VTE by applying natural language processing (NLP) tools to radiologists' reports. We validated an NLP tool, Reveal NLP (Health Fidelity Inc, San Mateo, CA) and inference rules engine's performance in identifying reports with deep venous thrombosis using a curated set of ultrasound reports...
August 16, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28815143/analyzing-electronic-medical-records-to-predict-risk-of-dit-death-intubation-or-transfer-to-icu-in-pediatric-respiratory-failure-or-related-conditions
#9
Teeradache Viangteeravat, Oguz Akbilgic, Robert Lowell Davis
Large volumes of data are generated in hospital settings, including clinical and physiological data generated during the course of patient care. Our goal, as proof of concept, was to identify early clinical factors or traits useful for predicting the outcome, of death, intubation, or transfer to ICU, for children with pediatric respiratory failure. We implemented both supervised and unsupervised methods to extend our understanding on statistical relationships in clinical and physiological data. As a supervised learning method, we use binary logistic regression to predict the risk of developing DIT outcome...
2017: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/28814627/prematurity-and-sudden-unexpected-infant-deaths-in-the-united-states
#10
Barbara M Ostfeld, Ofira Schwartz-Soicher, Nancy E Reichman, Julien O Teitler, Thomas Hegyi
BACKGROUND AND OBJECTIVES: Prematurity, a strong risk factor for sudden unexpected infant death (SUID), was addressed in recommendations by the American Academy of Pediatrics in 2011 for safe sleep education in NICUs. We documented associations between gestational age (GA) and SUID subsequent to these guidelines. METHODS: Using the 2012-2013 US linked infant birth and death certificate period files, we documented rates per live births of sudden infant death syndrome, ill-defined and unspecified causes, accidental suffocation and strangulation in bed, and overall SUID by GA in postneonatal, out-of-hospital, and autopsied cases; compared survivors and cases; and estimated logistic regression models of associations between GA and SUID...
June 5, 2017: Pediatrics
https://www.readbyqxmd.com/read/28814624/outcomes-of-nonoperative-management-of-uncomplicated-appendicitis
#11
Richard G Bachur, Susan C Lipsett, Michael C Monuteaux
BACKGROUND AND OBJECTIVES: Nonoperative management (NOM) of uncomplicated pediatric appendicitis has promise but remains poorly studied. NOM may lead to an increase in resource utilization. Our objective was to investigate the trends in NOM for uncomplicated appendicitis and study the relevant clinical outcomes including subsequent appendectomy, complications, and resource utilization. METHODS: Retrospective analysis of administrative data from 45 US pediatric hospitals...
June 2, 2017: Pediatrics
https://www.readbyqxmd.com/read/28814553/mallory-la-osorio-sn-prato-bs-et-al-impact-pilot-study-group-project-impact-pilot-report-feasibility-of-implementing-a-hospital-to-home-transition-bundle-pediatrics-2017-139-3-e20154626
#12
https://www.readbyqxmd.com/read/28814443/antibiotic-use-by-pediatric-residents-identifying-opportunities-and-strategies-for-antimicrobial-stewardship
#13
Prateek J Shukla, Maria Behnam-Terneus, Beatriz Cunill-De Sautu, Geovanny F Perez
OBJECTIVES: To determine the antibiotic prescribing practices of pediatric residents and assess how they acquire knowledge leading to prescribing behaviors. METHODS: We performed a cross-sectional electronic survey of all pediatric residents at the Children's National Medical Center and Nicklaus Children's Hospital, assessing antibiotic prescribing patterns for common pediatric infections, use of antibiograms, and factors influencing antibiotic choice. RESULTS: Eighty-five surveys (45%) were returned complete and included in the analysis...
August 16, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28814371/dental-management-considerations-in-a-pediatric-patient-with-moyamoya-disease
#14
Htet Bo, David Avenetti, Evelina Kratunova
Moyamoya disease is a rare progressive cerebral arteriopathy associated with risk of ischemic and hemorrhagic brain complications. The dental care of affected individuals should be performed in a pain- and stress-free manner to decrease the chance of occurrence of episodes of hypocapnia, hypercapnia, hypotension, hypovolemia, and hypothermia. Dental treatment may be provided in an outpatient dental setting or in a hospital setting, but both venues require interdisciplinary collaboration to ensure safe delivery of patient care...
May 15, 2017: Journal of Dentistry for Children
https://www.readbyqxmd.com/read/28814365/pediatric-admissions-after-dental-care-under-general-anesthesia-a-retrospective-study-at-a-tertiary-care-center
#15
Anna L Lucy, Roopa P Gandhi, Lilyana Gross, Bryan McNair
PURPOSE: The purpose of this study was to identify factors associated with planned and unplanned pediatric hospital admissions following dental treatment under general anesthesia (DGA) in a tertiary care center. METHODS: Dental and medical records of 100 subjects one to 20 years of age, with a known history of admission after DGA, were reviewed retrospectively for patient-, procedure-, and anesthesia-related factors as well as adverse events following DGA. RESULTS: During the review period (December 3, 2011 to June 30, 2015), 10,371 subjects underwent DGA, of which 100 subjects (less than one percent) required admission...
May 15, 2017: Journal of Dentistry for Children
https://www.readbyqxmd.com/read/28814263/acute-pain-management-in-hospitalized-children
#16
Ria Dancel, Edmund Allen Liles, Darren Fiore
BACKGROUND: Acute pain in hospitalized pediatric patients is prevalent. Recent shifts in the paradigm of pediatric acute pain management focus less on reliance on opioids, due to their adverse side effects and risk of dependence, and more on multimodal pain management. OBJECTIVE: We sought to review the most recent studies on acute pain management in hospitalized pediatric patients. METHODS: We searched the Cochrane Database and PubMed for articles published in the past five years regarding the treatment of acute pain in pediatric patients focusing on large randomized or quasi-randomized control trials, cohort trials, and meta-analyses...
August 16, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28814261/recent-studies-on-the-care-of-first-febrile-urinary-tract-infection-in-infants-and-children-for-the-pediatric-hospitalist
#17
Ashley G Sutton, Nicole Chandler, Kenneth B Roberts
BACKGROUND: Urinary tract infection (UTI) is a common cause of bacterial infection in young children, and accounts for a significant number of pediatric hospitalizations. OBJECTIVE: To review recent publications focusing on the care of children hospitalized with their first febrile UTI Methods: A PubMed search was performed including publications from 2011-2016 on first febrile UTI in childhood. Abstracts were reviewed for being relevant to the care of hospitalized children and their follow-up...
August 16, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28814257/discharge-interventions-and-modifiable-risk-factors-for-preventing-hospital-readmissions-in-children-with-medical-complexity
#18
John Stephens, Kelly S Kimple, Michael J Steiner, Jay G Berry
BACKGROUND: Concerns about the costs and quality of hospital care have led to increased interest in hospital readmissions in children. Children with medical complexity account for high proportions of inpatient utilization and have a higher risk of hospital readmission. OBJECTIVE: To identify studies of discharge interventions to prevent hospital readmissions in children with medical complexity. METHODS: We conducted a search to identify studies of discharge interventions...
August 16, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28814256/current-issues-in-intravenous-fluid-use-in-hospitalized-children
#19
Jennifer Fuchs, Sarah T Adams, Julie Byerley
BACKGROUND: Fluid and electrolyte therapy is an important component in the care of the hospitalized child. Previous pediatric guidelines have followed the Holliday-Segar method of calculating and delivering maintenance IV fluids, using hypotonic fluids in maintenance therapy. However, research demonstrates that hypotonic fluids can lead to iatrogenic hyponatremia and that isotonic fluid is a safer alternative. OBJECTIVE: To provide the ideal approach to intravenous (IV) fluid use in the hospitalized child and determine the safety and effectiveness of isotonic maintenance fluid therapy...
August 16, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28813765/bronchiolitis-in-infants-and-children
#20
Alexandra Schaller, Carl S Galloway
Bronchiolitis is among the most common illnesses in infants and children, and is the most common cause for hospitalization in infants in the U.S. This illness can be caused by many viruses, most commonly respiratory syncytial virus. It is diagnosed clinically by history and physical exam findings, with a narrow role for ancillary testing. Management is supportive, with medications demonstrating limited utility in multiple studies. Preventive measures include hand hygiene, breastfeeding, avoiding tobacco smoke exposure, and isolation precautions for hospitalized patients...
June 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
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