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Emergency pediatrics

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https://www.readbyqxmd.com/read/28107348/predicting-length-of-stay-among-patients-discharged-from-the-emergency-department-using-an-accelerated-failure-time-model
#1
Chung-Hsien Chaou, Hsiu-Hsi Chen, Shu-Hui Chang, Petrus Tang, Shin-Liang Pan, Amy Ming-Fang Yen, Te-Fa Chiu
BACKGROUND: Emergency department (ED) crowding continues to be an important health care issue in modern countries. Among the many crucial quality indicators for monitoring the throughput process, a patient's length of stay (LOS) is considered the most important one since it is both the cause and the result of ED crowding. The aim of this study is to identify and quantify the influence of different patient-related or diagnostic activities-related factors on the ED LOS of discharged patients...
2017: PloS One
https://www.readbyqxmd.com/read/28107287/case-volume-and-revisits-in-children-undergoing-gastrostomy-tube-placement
#2
Marjorie J Arca, Shawn J Rangel, Matt Hall, David H Rothstein, Martin L Blakely, Peter C Minneci, Samir S Shah, Kurt F Heiss, Charles L Snyder, Loren Berman, Marybeth Browne, Charles D Vinocur, Mehul V Raval, Adam B Goldin
OBJECTIVE: Emergency department (ED) visits and hospital readmissions are common following gastrostomy tube (GT) placement in children. We sought to characterize inter-hospital variation in revisit rates and explore the association between this outcome and hospital-specific GT case volume. STUDY DESIGN: We conducted a retrospective cohort study from 38 hospitals using the Pediatric Health Information System (PHIS) database. Patients <18 years who had a GT placed in 2010-2012 were assessed for a GT-related (mechanical or infectious) ED visit or inpatient readmission at 30 and 90 days following discharge from GT placement...
January 20, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28107262/suspected-cerebral-edema-in-diabetic-ketoacidosis-is-there-still-a-role-for-head-ct-in-treatment-decisions
#3
Carmen L Soto-Rivera, Lisa A Asaro, Michael S D Agus, Danielle D DeCourcey
OBJECTIVES: Neurologic deterioration associated with cerebral edema in diabetic ketoacidosis is typically sudden in onset, progresses rapidly, and requires emergent treatment. The utility of brain imaging by head CT in decisions to treat for cerebral edema has not been previously studied. The objective of this study was to describe the characteristics of pediatric patients with diabetic ketoacidosis who develop altered mental status and evaluate the role of head CT in this cohort. DESIGN: Retrospective analysis of clinical, biochemical, and radiologic data...
January 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28106673/outcomes-of-pediatric-fractures-managed-with-closed-reduction-by-orthopaedic-residents-in-the-emergency-department
#4
Vivek Natarajan, Ermias Abebe, James Dunlap, Patrick Bosch, Ozgur Dede, W Timothy Ward, James Roach
BACKGROUND: Closed reduction of pediatric fractures is commonly performed by orthopaedic residents using conscious sedation in the emergency department (ED). The purpose of this study was to determine the rate of satisfactory reductions as performed by residents, and to determine the outcomes of these procedures. METHODS: A retrospective review was performed of all fractures that underwent closed reduction under conscious sedation in the ED of a level 1 pediatric trauma center between January 1, 2010 and November 30, 2014...
January 18, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28105581/point-of-care-ultrasound-identification-of-pneumatosis-intestinalis-in-pediatric-abdominal-pain-a-case-report
#5
Vigil James, Aswin Warier, Khai Pin Lee, Gene Yong-Kwang Ong
We describe a case report of an infant with intussusception who presented to a pediatric emergency department with diarrhea and increased irritability. Pneumatosis intestinalis (intra-mural air) detected on point-of-care ultrasonography (but not apparent on plain abdominal radiographs) alerted the emergency physicians towards the severity of disease process.
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28103959/validation-of-a-case-definition-for-pediatric-brain-injury-using-administrative-data
#6
Jane McChesney-Corbeil, Karen Barlow, Hude Quan, Guanmin Chen, Samuel Wiebe, Nathalie Jette
BACKGROUND: Health administrative data are a common population-based data source for traumatic brain injury (TBI) surveillance and research; however, before using these data for surveillance, it is important to develop a validated case definition. The objective of this study was to identify the optimal International Classification of Disease , edition 10 (ICD-10), case definition to ascertain children with TBI in emergency room (ER) or hospital administrative data. We tested multiple case definitions...
January 20, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28103933/quantification-of-myocardial-deformation-in-children-by-cardiovascular-magnetic-resonance-feature-tracking-determination-of-reference-values-for-left-ventricular-strain-and-strain-rate
#7
Florian André, Daniëlle Robbers-Visser, Astrid Helling-Bakki, Angela Föll, Andreas Voss, Hugo A Katus, Willem A Helbing, Sebastian J Buss, Joachim G Eichhorn
BACKGROUND: The objective assessment of global and regional cardiac function in children has shown to be clinically relevant but is challenging to conduct. Cardiovascular magnetic resonance (CMR) has emerged as a valuable diagnostic modality especially in patients with cardiomyopathy or congenital heart disease. However, data on the normal cardiac deformation in children assessed by CMR is lacking at present. Thus, the aim of this study was to provide reference values for cardiac strain and strain rate in children and adolescents derived from CMR feature tracking (FT) measurements...
December 5, 2016: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/28103732/evaluation-of-antivenom-therapy-for-vipera-palaestinae-bites-in-children-experience-of-two-large-tertiary-care-pediatric-hospitals
#8
Dikla Pivko-Levy, Itamar Munchnak, Ayelet Rimon, Uri Balla, Dennis Scolnik, Christopher Hoyte, Yair Voliovitch, Miguel Glatstein
BACKGROUND: Antivenom has been successfully used to treat systemic and progressive, local manifestations of envenomation inflicted by Vipera (V.) palaestinae, the most common venomous snake in Israel. The objective of this study was to evaluate the fixed dose V. palaestinae monovalent (equine) immunoglobulin G antivenom used in two pediatric emergency departments. In particular, we wanted to assess the need for repeated antivenom administration and the rate of adverse antivenom effects in children...
January 20, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28103718/peer-review-improves-psychometric-characteristics-of-multiple-choice-questions
#9
Hani Abozaid, Yoon Soo Park, Ara Tekian
PURPOSE: For new and emerging medical schools, developing a system to peer-review and evaluate the assessment processes through faculty development programs can be a challenge. This study evaluates the impact of peer-review practices on item analysis, reliability, and the standard error of measurement of multiple-choice questions for summative final examinations. METHODS: This study used a retrospective cohort design of two consecutive academic years in 2012 and in 2013...
January 20, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28103632/global-health-and-emergency-care-defining-clinical-research-priorities
#10
Bhakti Hansoti, Adam R Aluisio, Meagan A Barry, Kevin Davey, Brian A Lentz, Payal Modi, Jennifer A Newberry, Melissa H Patel, Tricia A Smith, Alexandra M Vinograd, Adam C Levine
OBJECTIVES: Despite recent strides in the development of Global Emergency Medicine (EM), the field continues to lag in applying a scientific approach to identifying critical knowledge gaps and advancing evidence-based solutions to clinical and public health problems seen in emergency departments worldwide. Here, progress on the Global EM research agenda created at the 2013 Academic Emergency Medicine Global Health and Emergency Care Consensus Conference is evaluated and critical areas for future development in emergency care research internationally are identified...
January 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28102534/evacuation-performance-evaluation-tool
#11
Sharon Farra, Elaine T Miller, Matthew Gneuhs, Nathan Timm, Gengxin Li, Ashley Simon, Whittney Brady
OBJECTIVE: Hospitals conduct evacuation exercises to improve performance during emergency events. An essential aspect in this process is the creation of reliable and valid evaluation tools. The objective of this article is to describe the development and implications of a disaster evacuation performance tool that measures one portion of the very complex process of evacuation. DESIGN: Through the application of the Delphi technique and DeVellis's framework, disaster and neonatal experts provided input in developing this performance evaluation tool...
April 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28101450/hyponatremic-hypertensive-syndrome-a-retrospective-cohort-study
#12
Devdeep Mukherjee, Rajiv Sinha, Md Shakil Akhtar, Agni Sekhar Saha
AIM: To ascertain the frequency of hyponatremic hypertensive syndrome (HHS) in a cohort of children with hypertensive emergency in a tertiary pediatric hospital. METHODS: A retrospective review was undertaken among children with hypertensive emergency admitted in our tertiary children hospital between June 2014 and December 2015 with an aim to identify any children with HHS. Three children with HHS were identified during this period. RESULTS: The 3 patients with HHS presented with hypertensive emergency...
January 6, 2017: World Journal of Nephrology
https://www.readbyqxmd.com/read/28100274/using-medical-specialty-and-selection-criteria-clusters-to-study-specialty-selection-by-israeli-medical-students
#13
Yoram G Weiss, Rachel Yaffa Zisk-Rony, Howard Tandeter, Uriel Elchalal, Alex Avidan, Josh E Schroeder, Charles Weissman
BACKGROUND: During their final year of medical school, Israeli students must consider which specialty to choose for residency. Based on the vocational counseling literature we presumed that choices are made by selecting from a cluster of related specialties while considering professional and socio-economic issues. METHODS: Questionnaires distributed to final-year medical students at two Israeli medical schools ascertained inclinations toward various medical specialties and the importance of various selection criteria...
January 18, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28099351/effectiveness-of-a-radiation-reduction-campaign-targeting-children-with-gastrointestinal-symptoms-in-a-pediatric-emergency-department
#14
Hyuksool Kwon, Jae Yun Jung
Children feature more active cellular division and a smaller body area, which leads to a greater radiation dosage accumulation. We tried to reduce radiation hazards by reducing unnecessary radiological studies in a pediatric emergency department (PED) through the radiation reduction campaign.Our campaign involved a reduction from 2 (erect and supine) to 1 ordered abdominal plain radiograph (erect). This quasi-experimental, uncontrolled before-and-after study aimed to evaluate the campaign effect. We compared simple radiograph orders, length of stay (LOS) in PED, and return visit (RV) to PED between the before period (June 1, 2011-May 30, 2014) and the after period (June 1, 2014-May 30, 2015)...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28099296/a-reexamination-of-the-accuracy-of-the-broselow-tape-as-an-instrument-for-weight-estimation
#15
Muhammad Waseem, Justin Chen, Mark Leber, Ashley E Giambrone, Linda M Gerber
BACKGROUND: Accurate weight estimation is important for calculating appropriate medication dosages, determining rates of fluid replacement, and selecting correct equipment sizes in critically ill children requiring resuscitation. The actual measurement of the weight of a critically ill or injured child is often not possible. The Broselow Pediatric Emergency Tape (BT) is an important tool for predicting a child's weight based on his/her height. Although BT has previously been validated, given the increasing prevalence of obesity in today's society, it behooves clinicians relying on this resuscitation aid to revisit the issue...
January 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28099295/comparison-of-resource-utilization-and-length-of-hospitalization-between-overweight-and-healthy-weight-pediatric-trauma-patients-presenting-to-a-pediatric-emergency-department-with-moderate-to-severe-injury-a-prospective-study
#16
Theresa Romano, Ioannis Koutroulis, Evan Weiner, Anthony Little, Sabina Singh
OBJECTIVES: Our study aimed to compare overweight and healthy-weight pediatric trauma patient outcomes, specifically with respect to hospital length of stay and resource utilization. We hypothesized that overweight pediatric trauma patients would have increased hospital length of stay and radiographic study use compared with their healthy-weight counterparts. METHODS: This was a prospective, observational, cohort study of pediatric trauma patients aged 2 to 19 years presenting to an urban pediatric emergency department over a period of 1 year...
January 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28099293/validating-a-clinical-prediction-rule-for-ventricular-shunt-malfunction
#17
Tehnaz P Boyle, Amir A Kimia, Lise E Nigrovic
OBJECTIVE: This study aims to validate a published ventricular shunt clinical prediction rule for the identification of children at low risk for ventricular shunt malfunction based on the absence of 3 high-risk clinical predictors (irritability, nausea or vomiting, and headache). METHODS: We identified children aged 21 years and younger with a ventricular shunt who presented between 2010 and 2013 to a single pediatric emergency department (ED) for evaluation of potential shunt malfunction...
January 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28096977/high-rates-of-multidrug-resistance-among-uropathogenic-escherichia-coli-in-children-and-analyses-of-esbl-producers-from-nepal
#18
Narayan Prasad Parajuli, Pooja Maharjan, Hridaya Parajuli, Govardhan Joshi, Deliya Paudel, Sujan Sayami, Puspa Raj Khanal
BACKGROUND: Emergence of Extended-spectrum beta-lactamase producing Escherichia coli causing urinary tract infections (UTI) among pediatric patients is an increasing problem worldwide. However, very little is known about pediatric urinary tract infections and antimicrobial resistance trend from Nepal. This study was conducted to assess the current antibiotic resistance rate and ESBL production among uropathogenic Escherichia coli in pediatric patients of a tertiary care teaching hospital of Nepal...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28096130/early-life-nutrition-and-neurodevelopment-use-of-the-piglet-as-a-translational-model
#19
REVIEW
Austin T Mudd, Ryan N Dilger
Optimal nutrition early in life is critical to ensure proper structural and functional development of infant organ systems. Although pediatric nutrition historically has emphasized research on the relation between nutrition, growth rates, and gastrointestinal maturation, efforts increasingly have focused on how nutrition influences neurodevelopment. The provision of human milk is considered the gold standard in pediatric nutrition; thus, there is interest in understanding how functional nutrients and bioactive components in milk may modulate developmental processes...
January 2017: Advances in Nutrition
https://www.readbyqxmd.com/read/28095378/advanced-neuroimaging-techniques-in-pediatric-hydrocephalus
#20
Smruti K Patel, Weihong Yuan, Francesco T Mangano
From the early days of pneumoencephalography and ventriculography to the emerging technology of magnetic resonance diffusion tensor imaging (DTI) of the present day, neuroimaging has always been a critical tool in the diagnosis and treatment of pediatric hydrocephalus. There is accumulating evidence from both human and animal research suggesting that one of the major pathophysiological mechanisms underlying poor outcomes in these children is damage to vulnerable white matter (WM) structures in the brain as a result of ventricular enlargement and increased intracranial pressure...
January 18, 2017: Pediatric Neurosurgery
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