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Pediatric and rct

Lissa C Baird, Paul Klimo, Ann Marie Flannery, David F Bauer, Alexandra Beier, Susan Durham, Alexander Y Lin, Catherine McClung-Smith, Laura Mitchell, Dimitrios Nikas, Mandeep S Tamber, Rachana Tyagi, Catherine Mazzola
BACKGROUND: Evidence-based guidelines are not currently available for the treatment of positional plagiocephaly and, in particular, for the use of physical therapy for treatment. OBJECTIVE: To answer the question: "does physical therapy provide effective treatment for positional plagiocephaly?" Treatment recommendations are created based on the available evidence. METHODS: The PubMed and the Cochrane Library were queried using MeSH headings and key words relevant to the objective of this systematic review...
November 2016: Neurosurgery
Zhantao Su, Rui Li, Zhongtao Gai
OBJECTIVE: This study aimed to evaluate the efficacy of intravenous (IV) and nebulized magnesium sulfate in acute asthma in children. METHODS: The PubMed, Cochrane Library, and EMBASE databases were searched. Randomized controlled trials and quasi-randomized controlled trials of IV and nebulized magnesium sulfate in pediatric acute asthma were included. The outcomes subject to meta-analysis were pulmonary function, hospitalization, and further treatment. If statistical heterogeneity was significant, random-effects models were used for meta-analysis, otherwise, fixed-effects models were applied...
October 4, 2016: Pediatric Emergency Care
Aris Oates, Kelly A Benedict, Karen Sun, Paul R Brakeman, Jessica Lim, Cynthia Kim
Evaluate laser acupuncture as an adjuvant therapy in pain management during percutaneous kidney biopsy procedure in children and adolescents. This prospective, double-blinded, randomized controlled trial enrolled patients aged 7-26 years admitted to a children's hospital for percutaneous kidney biopsy. Patients received laser acupuncture to treatment points (acupuncture group) or sham points (control group) prior to the procedure. Laser delivered a dose of 42 J/cm over 10 acupoints. Patients and parents rated the pain during and after the biopsy, and change in pain scores were calculated for each patient...
September 29, 2016: Pain
Giovanna Chidini, Daniele De Luca, Giorgio Conti, Paolo Pelosi, Stefano Nava, Edoardo Calderini
OBJECTIVE: Neurally adjusted ventilatory assist has been shown to improve patient-ventilator interaction in children with acute respiratory failure. Objective of this study was to compare the effect of noninvasive neurally adjusted ventilatory assist versus noninvasive flow-triggered pressure support on patient-ventilator interaction in children with acute respiratory failure, when delivered as a first-line respiratory support. DESIGN: Prospective randomized crossover physiologic study...
September 30, 2016: Pediatric Critical Care Medicine
Nicholas D Spence, Amanda S Newton, Rachel A Keaschuk, Kathryn A Ambler, Mary M Jetha, Nicholas L Holt, Rhonda J Rosychuk, John C Spence, Arya M Sharma, Geoff D C Ball
INTRODUCTION: Attrition in pediatric weight management is a substantial problem. This study examined factors associated with short- and long-term attrition from a lifestyle and behavioral intervention for parents of children with overweight or obesity. METHOD: Fifty-two families with children ages 6 to 12 years old and body mass index at or above the 85th percentile participated in a randomized controlled trial focused on parents, comparing parent-based cognitive behavioral therapy with parent-based psychoeducation for pediatric weight management...
October 12, 2016: Journal of Pediatric Health Care
Rebecca M Rentea, Shawn D St Peter, Charles L Snyder
Appendicitis is a common cause of abdominal pain in children. The diagnosis and treatment of the disease have undergone major changes in the past two decades, primarily as a result of the application of an evidence-based approach. Data from several randomized controlled trials, large database studies, and meta-analyses have fundamentally affected patient care. The best diagnostic approach is a standardized clinical pathway with a scoring system and selective imaging. Non-operative management of simple appendicitis is a reasonable option in selected cases, with the caveat that data in children remain limited...
October 14, 2016: Pediatric Surgery International
Anne Tsampalieros, Greg A Knoll, Amber O Molnar, Nicholas Fergusson, Dean A Fergusson
BACKGROUND: A number of corticosteroid minimization and avoidance protocols for post-solid organ transplant have been developed. The study objective was to examine the effect of corticosteroid withdrawal/avoidance on growth and safety parameters in pediatric solid organ transplant recipients. METHODS: A systematic review using Medline and Embase was performed. All randomized controlled trials (RCT) and observational studies comparing corticosteroid withdrawal/avoidance to controls receiving corticosteroids in pediatric transplant recipients which reported growth as change in height or final height were included...
July 12, 2016: Transplantation
Raphaële Nové-Josserand, Soazic Grard, Lila Auzou, Philippe Reix, Marlène Murris-Espin, François Brémont, Benyebka Mammar, Laurent Mely, Dominique Hubert, Isabelle Durieu, Pierre-Régis Burgel
Allergic bronchopulmonary aspergillosis (ABPA) affects up to 15% of patients with cystic fibrosis (CF). Corticosteroids are used as first-line therapy, but relapse and adverse effects commonly occur. Case reports have suggested the efficacy of the anti-IgE recombinant humanized monoclonal antibody omalizumab. A retrospective multicenter observational French study retrieved 32 CF patients (11 children and 21 adults) who have received omalizumab for more than 3 months in the context of ABPA. Clinical characteristics, concomitant medications (inhaled and oral corticosteroids, antifungal drugs), lung function, body mass index (BMI), and serum IgE were compared at the start and during the first year of omalizumab therapy...
October 7, 2016: Pediatric Pulmonology
Camilla R S Silva, Lívia B Andrade, Danielle A S X Maux, Andreza L Bezerra, Maria C M B Duarte
Objective: To evaluate the effectiveness of prophylactic, non-invasive ventilation (NIV) on respiratory function in seven- to 16-year-old children in the post-operative phase of cardiac surgery. Method: A randomized, controlled trial with 50 children who had undergone cardiac surgery with median sternotomy. After extubation, patients were randomly assigned to one of two groups: control group (n=26), which received instructions regarding posture, early ambulation, and cough stimulation, and CPAP group (continuous positive airway pressure; n=24), which received the same instructions as the control group and CPAP=10 cmH20 twice daily for 30 minutes from the 1st to the 5th post-operative day (POD)...
September 29, 2016: Brazilian Journal of Physical Therapy
Smeeta Sardesai, Manoj Biniwale, Fiona Wertheimer, Arlene Garingo, Rangasamy Ramanathan
Respiratory distress syndrome (RDS) due to surfactant deficiency is the most common cause of respiratory failure in preterm infants. Tremendous progress has been made since the original description that surfactant deficiency is the major cause of RDS. Surfactant therapy has been extensively studied in preterm infants and has been shown to significantly decrease air leaks and neonatal and infant mortality. Synthetic and animal-derived surfactants from bovine as well as porcine origin have been evaluated in randomized controlled trials...
October 5, 2016: Pediatric Research
Brian J Morris, Jeffrey D Klausner, John N Krieger, Bradley J Willcox, Pierre D Crouse, Neil Pollock
INTRODUCTION: The Canadian Pediatrics Society (CPS) recently released a position statement on early infant (newborn) male circumcision (EIMC). It concluded that since benefits do not exceed risks, circumcision should only be performed on boys in high-risk populations or circumstances. This contradicts recommendations by the American Academy of Pediatrics and the Centers for Disease Control and Prevention (CDC) whose policies each support more widespread implementation of EIMC. Here we review the CPS statement, particularly its risk-benefit analysis, to determine the basis for this disparity...
October 2016: Canadian Journal of Urology
Wineke Armbrust, G J F Joyce Bos, Nico M Wulffraat, Marco van Brussel, Jeannette Cappon, Pieter U Dijkstra, Jan H B Geertzen, G Elizabeth Legger, Marion A J van Rossum, Pieter J J Sauer, Otto T H M Lelieveld
Objective To determine the effects of Rheumates@work, an internet-based program supplemented with four group sessions, aimed at improving physical activity (PA), exercise capacity, health-related quality of life (HRQoL), and participation in children with juvenile idiopathic arthritis. Methods Patients were recruited from three pediatric rheumatology centers in the Netherlands for an observer blinded, randomized controlled, multicenter trial. PA level, time spend in rest, light, and moderate-to-vigorous physical activity (MVPA) were recorded in a diary and with an accelerometer, before intervention, after intervention, and at follow-up after 3 and 12 months (intervention group only)...
October 1, 2016: Arthritis Care & Research
Nooshin Razani, Michael A Kohn, Nancy M Wells, Doug Thompson, Hanna Hamilton Flores, George W Rutherford
BACKGROUND: Contact with nature improves human health; stress reduction is a mediating pathway. Stay Healthy in Nature Everyday (SHINE) is a stress reduction and health promotion intervention for low-income families at an urban Federally Qualified Health Center. We plan to evaluate two service-delivery models for SHINE and present here the intervention design and evaluation protocol. METHODS: Behavioral change theory and environmental education literature informed the intervention...
September 29, 2016: Contemporary Clinical Trials
Jeremy D Deer, Amod Sawardekar, Santhanam Suresh
PURPOSE OF REVIEW: The objective of this review is to provide an overview of recent developments in pediatric regional anesthesia and elucidate outcomes as it relates to patient safety and overall satisfaction. RECENT FINDINGS: Since the inception of the Pediatric Regional Anesthesia Network database, the acquisition of data has enabled the pediatric anesthesiologist to extrapolate results and translate them into useful outcomes. Despite the growing trend to provide regional anesthesia in the pediatric population, there continues to be a paucity of available research studies to evaluate outcomes of various regional nerve blocks...
September 28, 2016: Current Opinion in Anaesthesiology
Jiyalal Harnot, Sanjay Verma, Sunit Singhi, Naveen Sankhyan, Naresh Sachdeva, Bhavneet Bharti
OBJECTIVE: To compare the efficacy and safety of 300,000 and 600,000 IU vitamin-D single-oral dose for the treatment of vitamin-D deficiency (VDD) in young children (3 mo - 3 y). METHODS: This double-blind randomized control trial (Clinical Trail Registration-CTRI/2012/05/002621) was conducted in the Pediatric out-patient department (OPD) at a tertiary-care referral hospital. Children (3 mo - 3 y) with clinical/radiological features suggestive of VDD were screened; those found to be having 25(OH)D below 15 ng/ml and meeting inclusion and exclusion criteria's were enrolled after taking informed consent...
September 29, 2016: Indian Journal of Pediatrics
P Garzon, L Lemelle, S Auvin
Childhood absence epilepsy (CAE) is a common pediatric epilepsy syndrome accounting for 10% of all pediatric epilepsies. The aim of this review is to provide an updated overview of this epilepsy syndrome to pediatricians. Most of the patients can be initially managed in private practice or in general pediatric settings. Absence seizures are the only seizure type observed at the time of diagnosis in these patients. An electroencephalogram recording and a clinical evaluation lead to the diagnosis. The underlying mechanisms are not yet fully understood...
September 24, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Julie Chartrand, Jocelyne Tourigny, Johnna Maccormick
AIMS: To examine the effect of a pre-operative DVD on parents' knowledge, participation and anxiety and on children's distress, pain, analgesic requirements and length of recovery after same-day surgery. BACKGROUND: Very few parents are adequately prepared to participate in their child's care at the time of a same-day surgery. An educational DVD was developed to educate parents on how to actively support their child in the recovery room. DESIGN: Single-blind, post-test randomized controlled trial...
September 28, 2016: Journal of Advanced Nursing
D A Leiman, B P Riff, S Morgan, D C Metz, G W Falk, B French, C A Umscheid, J D Lewis
In patients with gastroesophageal reflux disease (GERD) and erosive esophagitis, treatment with proton pump inhibitors (PPIs) is highly effective. However, in some patients, especially those with non-erosive reflux disease or atypical GERD symptoms, acid suppressive therapy with PPIs is not as successful. Alginates are medications that work through an alternative mechanism by displacing the post-prandial gastric acid pocket. We performed a systematic review and meta-analysis to examine the benefit of alginate-containing compounds in the treatment of patients with symptoms of GERD...
September 26, 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Jorrit W van As, Henk van den Berg, Elvira C van Dalen
BACKGROUND: Platinum-based therapy, including cisplatin, carboplatin, oxaliplatin or a combination of these, is used to treat a variety of paediatric malignancies. One of the most important adverse effects is the occurrence of hearing loss or ototoxicity. In an effort to prevent this ototoxicity, different otoprotective medical interventions have been studied. This review is the second update of a previously published Cochrane review. OBJECTIVES: To assess the efficacy of medical interventions to prevent hearing loss and to determine possible effects of these interventions on anti-tumour efficacy, toxicities other than hearing loss and quality of life in children with cancer treated with platinum-based therapy...
September 27, 2016: Cochrane Database of Systematic Reviews
Zafira Bhaloo, Denise Adams, Yali Liu, Namrata Hansraj, Lisa Hartling, Caroline B Terwee, Sunita Vohra
OBJECTIVE: Conduct a systematic review of pediatric randomized controlled trials published in high impact journals to assess the reporting of primary outcomes and the psychometric properties of their measures. STUDY DESIGN AND SETTING: Systematic review with screening and simultaneous data extraction conducted by two independent reviewers. Electronic searches of six general medicine and four pediatric journals were conducted in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) databases...
September 22, 2016: Journal of Clinical Epidemiology
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