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https://www.readbyqxmd.com/read/28509684/histone-complexed-dna-fragments-levels-are-associated-with-coagulopathy-endothelial-cell-damage-and-increased-mortality-after-severe-pediatric-trauma
#1
Robert T Russell, Sarah C Christiaans, Tate Nice, Morgan Banks, Vincent Mortellaro, Charity Morgan, Amy Duhachek-Stapelman, Steven J Lisco, Jeffrey D Kerby, Brant M Wagener, Mike K Chen, Jean-François Pittet
BACKGROUND: The release of damage-associated molecular pattern molecules (DAMPs) in the extracellular space secondary to injury has been shown to cause systemic activation of the coagulation system and endothelial cell damage. We hypothesized that pediatric trauma patients with increased levels of histone-complexed DNA fragments (hcDNA) would have evidence of coagulopathy and endothelial damage that would be associated with poor outcomes. METHODS: We conducted a prospective observational study of 149 pediatric trauma patients and 62 control patients at two level 1 pediatric trauma centers from 2013-2016...
May 15, 2017: Shock
https://www.readbyqxmd.com/read/28505989/pediatric-robotic-rehabilitation-current-knowledge-and-future-trends-in-treating-children-with-sensorimotor-impairments
#2
Konstantinos P Michmizos, Hermano Igo Krebs
BACKGROUND: Robot-aided sensorimotor therapy imposes highly repetitive tasks that can translate to substantial improvement when patients remain cognitively engaged into the clinical procedure, a goal that most children find hard to pursue. Knowing that the child's brain is much more plastic than an adult's, it is reasonable to expect that the clinical gains observed in the adult population during the last two decades would be followed up by even greater gains in children. Nonetheless, and despite the multitude of adult studies, in children we are just getting started: There is scarcity of pediatric robotic rehabilitation devices that are currently available and the number of clinical studies that employ them is also very limited...
May 11, 2017: NeuroRehabilitation
https://www.readbyqxmd.com/read/28490158/endoscopic-endonasal-approach-for-suprasellar-lesions-in-children-complications-and-prevention
#3
REVIEW
Yong Hwy Kim, Kyu-Chang Wang, Ji Hoon Phi, Seung-Ki Kim
The endoscopic endonasal approach (EEA) has been popularized in adults and has been applied to an expanding range of surgical modules and indications in this population. However, its clinical application in pediatric neurosurgery has been impeded by the differences in anatomical features and the relatively low incidence of diseases to which it is applicable. In this review article, we mainly discuss the surgical indications, feasibility, and complications of EEA for suprasellar lesions in children based on a review of the literature, focusing especially on the age-related anatomical features of the nasal cavity, various pathologic entities, and the impact of EEA on long-term craniofacial growth...
May 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28464558/prescribing-for-children-with-rheumatologic-disease-perceived-treatment-approaches-between-pediatric-and-adult-rheumatologists
#4
Heather Van Mater, Stephen J Balevic, Gary L Freed, Sarah J Clark
OBJECTIVE: To compare practice patterns and prescribing differences for juvenile idiopathic arthritis (JIA) between adult and pediatric rheumatologists, the perceived educational needs, and factors that enhance or impede co-management. METHODS: Two parallel, cross sectional surveys focusing on JIA were administered in 2009 to a random sample of 193 pediatric rheumatologists (PR) and 500 adult rheumatologists (AR) using the American College of Rheumatology membership file...
May 2, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28448390/comparison-of-postoperative-respiratory-monitoring-by-acoustic-and-transthoracic-impedance-technologies-in-pediatric-patients-at-risk-of-respiratory-depression
#5
Mario Patino, Megan Kalin, Allison Griffin, Abu Minhajuddin, Lili Ding, Timothy Williams, Stacey Ishman, Mohamed Mahmoud, C Dean Kurth, Peter Szmuk
BACKGROUND: In children, postoperative respiratory rate (RR) monitoring by transthoracic impedance (TI), capnography, and manual counting has limitations. The rainbow acoustic monitor (RAM) measures continuous RR noninvasively by a different methodology. Our primary aim was to compare the degree of agreement and accuracy of RR measurements as determined by RAM and TI to that of manual counting. Secondary aims include tolerance and analysis of alarm events. METHODS: Sixty-two children (2-16 years old) were admitted after tonsillectomy or receiving postoperative patient/parental-controlled analgesia...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28415959/the-practices-and-meanings-of-care-for-nurses-working-on-a-pediatric-bone-marrow-transplant-unit
#6
Caroline F Morrison, Edith J Morris
Bone marrow transplant (BMT) units are stressful work environments with high staff burnout, anxiety, and turnover. A qualitative study was undertaken to better understand care for nurses within the context of their clinical practice on a pediatric BMT unit. Understanding care practices for BMT nurses will allow us to design interventions and provide appropriate support for this subspecialty of nurses. Focus groups were held with 24 nurses as key participants, and 2 focus groups with general participants: unit management (N = 2) and caregivers of inpatients (N = 7)...
May 2017: Journal of Pediatric Oncology Nursing: Official Journal of the Association of Pediatric Oncology Nurses
https://www.readbyqxmd.com/read/28398650/white-paper-on-the-study-of-birth-defects
#7
Mustafa K Khokha, Laura E Mitchell, John B Wallingford
Birth defects are the leading cause of infant death in the United States and among the top causes of pediatric death and hospitalization. Despite the devastating impact of birth defects, we understand little of their etiology impeding progress towards treatment and prevention. Moreover, while surgical interventions have improved survival for many children to beyond their first year, our inability to accurately predict, diagnose and treat the common sequelae of birth defects leaves the economic, social and public health burden of birth defects unacceptably high...
January 30, 2017: Birth Defects Res
https://www.readbyqxmd.com/read/28297072/operational-failures-detected-by-frontline-acute-care-nurses
#8
Kathleen R Stevens, Eileen P Engh, Heather Tubbs-Cooley, Deborah Marks Conley, Tammy Cupit, Ellen D'Errico, Pam DiNapoli, Joleen Lynn Fischer, Ruth Freed, Anne Marie Kotzer, Carolyn L Lindgren, Marie Ann Marino, Lisa Mestas, Jessica Perdue, Rebekah Powers, Patricia Radovich, Karen Rice, Linda P Riley, Peri Rosenfeld, Linda Roussel, Nancy A Ryan-Wenger, Linda Searle-Leach, Nicole M Shonka, Vicki L Smith, Laura Sweatt, Mary Townsend-Gervis, Ellen Wathen, Janice S Withycombe
Frontline nurses encounter operational failures (OFs), or breakdowns in system processes, that hinder care, erode quality, and threaten patient safety. Previous research has relied on external observers to identify OFs; nurses have been passive participants in the identification of system failures that impede their ability to deliver safe and effective care. To better understand frontline nurses' direct experiences with OFs in hospitals, we conducted a multi-site study within a national research network to describe the rate and categories of OFs detected by nurses as they provided direct patient care...
March 15, 2017: Research in Nursing & Health
https://www.readbyqxmd.com/read/28290120/development-of-a-pediatric-physiologically-based-pharmacokinetic-model-of-clindamycin-using-opportunistic-pharmacokinetic-data
#9
Christoph P Hornik, Huali Wu, Andrea N Edginton, Kevin Watt, Michael Cohen-Wolkowiez, Daniel Gonzalez
Physiologically-based pharmacokinetic (PBPK) modeling is a powerful tool used to characterize maturational changes in drug disposition to inform dosing across childhood; however, its use is limited in pediatric drug development. Access to pediatric pharmacokinetic data is a barrier to widespread application of this model, which impedes its development and optimization. To support the development of a pediatric PBPK model, we sought to leverage opportunistically-collected plasma concentrations of the commonly used antibiotic clindamycin...
March 13, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28248832/pathophysiology-of-pediatric-multiple-organ-dysfunction-syndrome
#10
Joseph A Carcillo, Bradley Podd, Rajesh Aneja, Scott L Weiss, Mark W Hall, Timothy T Cornell, Thomas P Shanley, Lesley A Doughty, Trung C Nguyen
OBJECTIVE: To describe the pathophysiology associated with multiple organ dysfunction syndrome in children. DATA SOURCES: Literature review, research data, and expert opinion. STUDY SELECTION: Not applicable. DATA EXTRACTION: Moderated by an experienced expert from the field, pathophysiologic processes associated with multiple organ dysfunction syndrome in children were described, discussed, and debated with a focus on identifying knowledge gaps and research priorities...
March 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28224647/electrical-impedance-myography-eim-in-individuals-with-col6-and-lama2-congenital-muscular-dystrophy-a-cross-sectional-and-two-year-analysis
#11
Carmel Nichols, Minal S Jain, Katherine G Meilleur, Tianxia Wu, James Collins, Melissa R Waite, Jahannaz Dastgir, Anam Salman, Sandra Donkervoort, Tina Duong, Katherine Keller, Meganne E Leach, Donovan J Lott, Michelle N McGuire, Leslie Nelson, Anne Rutkowski, Carole Vuillerot, Carsten G Bönnemann, Tanya J Lehky
INTRODUCTION: Electrical impedance myography (EIM) is a non-invasive electrophysiological technique that characterizes muscle properties through bioimpedance. We compared EIM measurements to function, strength, and disease severity in a population with congenital muscular dystrophy (CMD). METHODS: Forty-one patients with CMD, either collagen 6 related disorders (COL6-RD) (n = 21) or laminin alpha 2-related disorders (LAMA2-RD) (n = 20) and 21 healthy pediatric controls underwent 2 yearly EIM exams...
February 22, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/28224606/single-subject-research-designs-in-pediatric-rehabilitation-a-valuable-step-towards-knowledge-translation
#12
REVIEW
Lynne Romeiser-Logan, Rebecca Slaughter, Robbin Hickman
Knowledge translation may be particularly challenging in pediatric rehabilitation, where study findings are often ambiguous owing to low statistical power or inconsistent responses to intervention. Disconnection between research protocols and clinical practicality, as well as variability of responsiveness in heterogeneous pediatric populations, may further impede integration of research findings into everyday practice. Use of single-subject research designs (SSRDs) may bridge the gap between research and practice, with robust design options that better identify and preserve patterns of responsiveness to specific interventions and offer protocols that are more readily implemented in practice settings than can be done in traditional randomized controlled trials...
February 22, 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/28221733/regional-lung-ventilation-pattern-in-preschool-children-with-bronchopulmonary-dysplasia-is-modified-by-bronchodilator-response
#13
Wojciech Durlak, Małgorzata Klimek, Przemko Kwinta
BACKGROUND: Bronchopulmonary dysplasia (BPD) remains a significant long-term complication of prematurity. A standardized method of pulmonary function testing is still not available in preschool children with BPD. We investigated the feasibility of Electrical Impedance Segmentography (EIS) monitoring in this group and the impact of bronchodilator response (BDR) to salbutamol on the pattern of lung ventilation. METHODS: We conducted a follow-up study of 4-year-old premature children who had been treated in the tertiary NICU...
March 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28209414/barriers-and-facilitators-to-the-implementation-of-evidence-based-practice-by-pediatric-surgeons
#14
Katrina J Sullivan, Carolyn Wayne, Andrea M Patey, Ahmed Nasr
BACKGROUND/PURPOSE: Evidence-based practice (EBP) has been identified as a foundation of mainstream medical practice, yet pediatric surgery has been slow in the acceptance and implementation of EBP. METHODS: Semi-structured interviews of 14 pediatric surgeons were conducted to determine barriers and facilitators to EBP. Resulting data were analyzed using a systematic 3-step approached of coding, generation of specific beliefs, and identification of domains relevant to practice change...
February 8, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28185711/impact-of-gastroesophageal-reflux-and-delayed-gastric-emptying-on-pediatric-lung-transplant-outcomes
#15
Fei Jamie Dy, Dawn Freiberger, Enju Liu, Debra Boyer, Gary Visner, Rachel Rosen
BACKGROUND: Gastroesophageal reflux disease is thought to predispose to adverse lung allograft outcomes. However, little is known about the burden of gastroesophageal reflux (GER) and gastroparesis in pediatric patients. In this study we describe the burden of reflux and gastroparesis in children undergoing lung transplant, and evaluates their impact on allograft survival and rejection incidence. METHODS: This study is a retrospective analysis of pediatric lung transplant recipients who had combined pH and multichannel intraluminal impedance testing (pH-MII) and gastric-emptying scans (GES)...
January 6, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28157839/establishment-of-a-method-for-evaluating-endothelial-cell-injury-by-tnf-%C3%AE-in-vitro-for-clarifying-the-pathophysiology-of-virus-associated-acute-encephalopathy
#16
Kyohei Miyazaki, Koichi Hashimoto, Masatoki Sato, Masahiro Watanabe, Naoki Tomikawa, Shuto Kanno, Yukihiko Kawasaki, Nobuo Momoi, Mitsuaki Hosoya
BACKGROUND: Virus-associated acute encephalopathy (VAE) is a severe central nervous system complication caused by common viral infections in children. The pathophysiology of VAE is thought to be endothelial injury. This study was designed to establish an in vitro VAE model for evaluating endothelial injury caused by the proinflammatory cytokine TNF-α. METHODS: Transwell-grown human umbilical vein endothelial cells (HUVECs) monolayers were incubated with serially diluted TNF-α...
February 3, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28146046/brazilian-specialists-perspectives-on-the-patient-referral-process
#17
Carmen Juliani, Maura MacPhee, Wilza Spiri
Since 1988, healthcare has been considered a citizen's right in Brazil. The Sistema Único de Saúde (SUS), has undergone development and expansion to ensure universal health coverage for the Brazilian public, the world's fifth largest population. The coordination of effective communications between primary care physicians, specialists and patients is a significant challenge, particularly the referral process. Our study objective was to understand the facilitators and barriers associated with referral process communications between primary care physicians and regional university hospital specialists in the State of Sao Paulo...
January 29, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/28134656/photographs-of-daily-activities-youth-english-validating-a-targeted-assessment-of-worry-and-anticipated-pain
#18
Laura E Simons, Melissa Pielech, Shannon McAvoy, Caitlin Conroy, Melinda Hogan, Jeanine A Verbunt, Marielle E Goossens
PHODA is an electronic measure that individualizes and guides treatment for individuals with chronic pain. Implicit in its design is recognition that pain-related fear is a driving force that impedes treatment progress. With this tool, patients visually rate their expectations about the harmful consequences of specific movements. This study aimed to (1) develop and validate PHODA-Youth English (PHODA-YE) and (2) evaluate the potential impact of PHODA-YE assessment on treatment outcomes. Participants were 195 youth, age 8 to 20 years, who presented to an outpatient pain clinic for evaluation (n = 99), or enrolled at the Pediatric Pain Rehabilitation Center (PPRC) intensive program (PPRC; n = 96)...
May 2017: Pain
https://www.readbyqxmd.com/read/28097839/nutritional-assessment-of-a-population-with-a-history-of-childhood-craniopharyngioma-seen-at-hospital-prof-dr-juan-p-garrahan
#19
Carolina Caminiti, Carola Saure, Ilanit Bomer, Mercedes Brea, Javier González Ramos
INTRODUCTION: Craniopharyngiomas are histologically benign malformations located between the pituitary and hypothalamus that may affect key hormone secretion for endocrine regulation and satiety modulation. Although this is a relatively benign disease, the combination of severe hypothalamic obesity and associated comorbidities results in a reduced quality of life. OBJECTIVE: To assess the nutritional status of patients after craniopharyngioma surgery. POPULATION AND METHODS: Patients younger than 21 years old at the time of the study who required craniopharyngioma surgery at Hospital de Pediatr...
February 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28086770/social-pediatrics-weaving-horizontal-and-vertical-threads-through-pediatric-residency
#20
REVIEW
Meta van den Heuvel, Maria Athina Tina Martimianakis, Rebecca Levy, Adelle Atkinson, Elizabeth Ford-Jones, Michelle Shouldice
BACKGROUND: Social pediatrics teaches pediatric residents how to understand disease within their patients' social, environmental and political contexts. It's an essential component of pediatric residency training; however there is very little literature that addresses how such a broad-ranging topic can be taught effectively. The aim of this study was to determine and characterize social pediatric education in our pediatric residency training in order to identify strengths and gaps. METHODS: A social pediatrics curriculum map was developed, attending to 3 different dimensions: (1) the intended curriculum as prescribed by the Objectives of Training for Pediatrics of the Royal College of Physicians and Surgeons of Canada (RCPSC), (2) the formal curriculum defined by rotation-specific learning objectives, and (3) the informal/hidden curriculum as reflected in resident and teacher experiences and perceptions...
January 13, 2017: BMC Medical Education
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