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https://www.readbyqxmd.com/read/28820870/controversies-in-the-identification-and-management-of-acute-pulmonary-hypertension-in-preterm-neonates
#1
REVIEW
Regan E Giesinger, Kiran More, Jodie Odame, Amish Jain, Robert P Jankov, Patrick J McNamara
It is increasingly recognized that the abnormal physiologic consequences of pulmonary hypertension (PH) may contribute to poor cardiopulmonary health in premature babies. Conflicting literature has led to clinical uncertainty, pathological misinterpretation and variability in treatment approaches among practitioners. There are several disorders with overlapping and interrelated presentations and other disorders with a similar clinical phenotype but diverse pathophysiological contributors. In this review, we provide a diagnostic approach for acute HRF in the preterm neonate, outline the pathophysiological conditions that may present as acute PH and discuss the implications of high pulmonary vascular resistance (PVR) on the cardiovascular system...
August 18, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28818298/enhancing-the-pediatric-drug-development-framework-to-deliver-better-pediatric-therapies-tomorrow
#2
Christina Bucci-Rechtweg
Health care professionals involved in the clinical management of children have long appreciated the limited number of therapies suitably evaluated for their optimal use in the pediatric population. In the past century, advances in regulatory policy significantly evolved adult drug evaluation. The scarcity of available patient populations, practical complexities of drug development research, and minimal financial returns have hampered pharmaceutical investment in the study of therapies for children. More recently, pediatric policy and legislation in the United States and Europe have instituted a system of obligations and incentives to stimulate investment in pediatric drug development...
August 14, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28799158/-the-impact-of-immigrant-status-on-the-mode-of-hospital-referral-impression-of-disease-severity-and-length-of-stay-in-inpatient-general-pediatric-care
#3
Sebastian Ullrich, Yuriy Nesterko, Diana Briel, Andreas Hiemisch, Elmar Brähler, Heide Glaesmer
Background National as well as international research often shows differences in health and health behavior between children and youth with and without migration background. It is also noted that there are differences in the use of health services depending on the migration background. Patients and Methods Data from 266 pediatric patients, regarding their hospitalization, general impression of health status and length of stay in a hospital, were analyzed depending on the migration background. Information on migration background and treatment-related data were obtained from the parents of the patient or from the hospital information system (SAP)...
August 10, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28777680/the-headache-action-plan-project-for-youth-happy-school-nurses-as-facilitators-of-system-change-in-pediatric-migraine-care
#4
Mark Connelly, Jennifer Bickel, Tammie Wingert, Cindy Galemore
Migraine is a common health problem in youth that is ranked highest for disability among neurological conditions and is one of the leading reasons for school absences. Children with migraines frequently are seen by the school nurse for care, sometimes before ever being seen by another healthcare provider for evaluation and treatment. As such, school nurses have the unique opportunity to provide education and resources to children with migraines and their family. This article provides information on the Headache Action Plan Program for Youth (HAPPY), a project involving the provision of live and online migraine education and management resources to school nurses, children, families, and primary care providers in an effort to improve migraine recognition and care in the community...
August 1, 2017: NASN School Nurse
https://www.readbyqxmd.com/read/28774767/variation-in-the-evaluation-of-testicular-conditions-across-united-states-pediatric-emergency-departments
#5
Lois K Lee, Michael C Monuteaux, Joel D Hudgins, John J Porter, Susan C Lipsett, Florence Bourgeois, Bartley G Cilento, Mark I Neuman
OBJECTIVES: To explore the variation in diagnostic testing and management for males diagnosed with three testicular conditions (testicular torsion, appendix testis torsion, epididymitis/orchitis) using a large pediatric health care database. Diagnostic testing is frequently used in evaluation of the acute scrotum; however, there is likely variability in the use of these tests in the emergency department setting. METHODS: We conducted a cross-sectional study of males with the diagnoses of testicular torsion, appendix testis torsion, and epididymitis/orchitis...
July 26, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28771646/assessing-disaster-preparedness-among-select-children-s-summer-camps-in-the-united-states-and-canada
#6
Megan Chang, Alan Sielaff, Stuart Bradin, Kevin Walker, Michael Ambrose, Andrew Hashikawa
OBJECTIVE: Children's summer camps are at risk for multiple pediatric casualties during a disaster. The degree to which summer camps have instituted disaster preparedness is unknown. We assessed disaster preparedness among selected camps nationally for a range of disasters. METHODS: We partnered with a national, web-based electronic health records system to send camp leadership of 315 camp organizations a 14-question online survey of disaster preparedness. One response from each camp was selected in the following order of importance: owner, director, physician, nurse, medical technician, office staff, and other...
August 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28765382/health-care-expenditures-and-utilization-for-children-with-noncomplex-chronic-disease
#7
Erik R Hoefgen, Annie L Andrews, Troy Richardson, Matthew Hall, John M Neff, Michelle L Macy, Jessica L Bettenhausen, Samir S Shah, Katherine A Auger
BACKGROUND: Pediatric health care expenditures and use vary by level of complexity and chronic illness. We sought to determine expenditures and use for children with noncomplex chronic diseases (NC-CDs). METHODS: We performed a retrospective, cross-sectional analysis of Medicaid enrollees (ages 0-18 years) from January 1, 2012, through December 31, 2013, using administrative claims (the Truven MarketScan Medicaid Database). Patients were categorized by chronicity of illness by using 3M Health Information System's Clinical Risk Groups (CRGs) as follows: without chronic diseases (WO-CDs) (CRG 1-2), NC-CDs (CRG 3-5), and complex chronic diseases (C-CDs) (CRG 6-9)...
August 1, 2017: Pediatrics
https://www.readbyqxmd.com/read/28755589/children-s-environmental-health-based-on-birth-cohort-studies-of-asia
#8
Meng-Shan Tsai, Mei-Huei Chen, Ching-Chun Lin, Sharon Ng, Chia-Jung Hsieh, Chen-Yu Liu, Wu-Shiun Hsieh, Pau-Chung Chen
Numerous studies have explored the associations between environmental pollutants and pediatric health. Recent studies have investigated the issue in Asia, but no systematic review has been published to date. This study aims to elucidate the issue by summarizing relevant epidemiologic evidence for cohorts in Asia, using information from the Birth Cohort Consortium of Asia (BiCCA). Environmental pollutants include mercury, environmental tobacco smoke (ETS), polychlorinated biphenyls (PCB), perfluoroalkyl substances (PFAS) and phthalates...
July 26, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28752820/variation-in-preoperative-testing-and-antireflux-surgery-in-infants
#9
Heather L Short, Nikolay P Braykov, James E Bost, Mehul V Raval
BACKGROUND: Despite the availability of objective tests, gastroesophageal reflux disease (GERD) diagnosis and management in infants remains controversial and highly variable. Our purpose was to characterize national variation in diagnostic testing and surgical utilization for infants with GERD. METHODS: Using the Pediatric Health Information System, we identified infants <1 year old diagnosed with GERD between January 2011 and March 2015. Outcomes included progression to antireflux surgery (ARS) and use of relevant diagnostic testing...
July 28, 2017: Pediatrics
https://www.readbyqxmd.com/read/28745210/variability-in-threshold-for-medication-error-reporting-between-physicians-nurses-pharmacists-and-families
#10
Patricia Keefer, Kelley Kidwell, Candace Lengyel, Kavita Warrier, Deborah Wagner
BACKGROUND: Voluntary medication error reporting is an imperfect resource used to improve the quality of medication administration. It requires judgment by front-line staff to determine how to report enough to identify opportunities to improve patient safety but not jeopardize that safety by creating a culture of "report fatigue." OBJECTIVE: This study aims to provide information on interpretability of medication error and the variability between subgroups of caregivers in the hospital setting...
July 24, 2017: Current Drug Safety
https://www.readbyqxmd.com/read/28734656/patterns-of-emergency-department-care-for-newly-diagnosed-immune-thrombocytopenia-in-united-states-children-s-hospitals
#11
LaQuita Jones, Terah Koch, Joseph Stanek, Sarah H O'Brien
We used the Pediatric Health Information Systems database to ascertain treatment patterns of immune thrombocytopenia across the US. Despite the recently published guidelines by the American Society of Hematology, most patients are still being hospitalized for immune thrombocytopenia, even in the absence of documented bleeding symptoms.
July 19, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28729240/empiric-antibiotic-use-and-susceptibility-in-infants-with-bacterial-infections-a-multicenter-retrospective-cohort-study
#12
Elana A Feldman, Russell J McCulloh, Angela L Myers, Paul L Aronson, Mark I Neuman, Miranda C Bradford, Elizabeth R Alpern, Frances Balamuth, Mercedes M Blackstone, Whitney L Browning, Katie Hayes, Rosalynne Korman, Rianna C Leazer, Lise E Nigrovic, Richard Marble, Emily Roben, Derek J Williams, Joel S Tieder
OBJECTIVES: To assess hospital differences in empirical antibiotic use, bacterial epidemiology, and antimicrobial susceptibility for common antibiotic regimens among young infants with urinary tract infection (UTI), bacteremia, or bacterial meningitis. METHODS: We reviewed medical records from infants <90 days old presenting to 8 US children's hospitals with UTI, bacteremia, or meningitis. We used the Pediatric Health Information System database to identify cases and empirical antibiotic use and medical record review to determine infection, pathogen, and antimicrobial susceptibility patterns...
July 20, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28728827/the-use-of-perioperative-ketorolac-in-the-surgical-treatment-of-pediatric-spontaneous-pneumothorax
#13
R Michael Dorman, George Ventro, Sarah B Cairo, Kaveh Vali, David H Rothstein
BACKGROUND: We sought to determine the effect of ketorolac on pediatric primary spontaneous pneumothorax recurrence after operation. METHODS: The Pediatric Health Information System database was queried for patients ages 10-16years discharged in the years 2004-2014 with pneumothorax or pleural bleb and a related operative procedure. Deaths and secondary pneumothorax were excluded. Variables included demographics, chronic disease, intensive care unit admission, mechanical ventilation, and lung resection or plication...
June 23, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28727288/complications-preceding-early-deaths-in-black-and-white-children-with-acute-myeloid-leukemia
#14
Lena E Winestone, Kelly D Getz, Tamara P Miller, Yimei Li, Yuan-Shung Huang, Alix E Seif, Brian T Fisher, Richard Aplenc
Black patients have a twofold increased risk of induction mortality compared to White patients with acute myeloid leukemia (AML). We reviewed diagnosis and billing data from Pediatric Health Information System for 28 AML Induction I deaths to investigate conditions preceding death in White and Black patients. Half of deaths occurred within 10 days of initial diagnostic admission. Respiratory, cardiac, renal, and infectious complications were common prior to both White and Black deaths. Deaths in White patients were more commonly preceded by intracranial hemorrhage compared to deaths in Black patients...
July 20, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28723610/pediatric-reference-intervals-for-29-ortho-vitros-5600-immunoassays-using-the-caliper-cohort-of-healthy-children-and-adolescents
#15
Victoria Higgins, Angela W S Fung, Man Khun Chan, Joseph Macri, Khosrow Adeli
BACKGROUND: Accurate reference intervals (RIs) based on a healthy pediatric population are essential for pediatric test result interpretation. The CALIPER project has recruited a large healthy cohort and completed a series of a priori studies to address gaps in pediatric RIs. As immunoassays from different manufacturers for endocrine and special chemistry markers are not standardized and show marked intermethod differences, direct RI studies are needed for each major analytical platform...
July 19, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28717779/impact-of-middle-east-respiratory-syndrome-outbreak-on-the-use-of-emergency-medical-resources-in-febrile-patients
#16
Hyunho Jeong, Sikyoung Jeong, Juseok Oh, Seon Hee Woo, Byung Hak So, Jeong Hee Wee, Ji Hoon Kim, Ji Yong Im, Seung Pill Choi, Kyoungnam Park, Byul Nim Hee Cho, Sungyoup Hong
OBJECTIVE: Outbreaks of transmissible respiratory infection are suspected to have significant effects on the health of pediatric and geriatric patients. The objective was to assess the impact of the Middle East respiratory syndrome (MERS) outbreak on the use of emergency resources. METHODS: An ecologic analysis of emergency department (ED) records between September and December 2015, was performed. Data was obtained from the National Emergency Department Information System database for Korea...
June 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28713146/-being-persistent-without-being-pushy-student-reflections-on-vaccine-hesitancy
#17
Amy E Caruso Brown, Manika Suryadevara, Thomas R Welch, Ann S Botash
Our goal as pediatric educators is to graduate physicians who have witnessed effective approaches and have grasped the nuances of communication strategies between vaccine-hesitant families and health care providers. We identified vaccine hesitancy as a recurring topic in 19 of 304 medical student reflective narratives addressing an issue in professionalism or systems-based practice. We conducted content analysis on the narratives in order to gain a better understanding of student perceptions of visits in which they observed a provider discussing vaccine hesitancy with a parent...
2017: Narrative Inquiry in Bioethics
https://www.readbyqxmd.com/read/28699942/hospital-level-factors-associated-with-pediatric-emergency-department-return-visits
#18
Zachary Pittsenbarger, Cary Thurm, Mark Neuman, Sandra Spencer, Harold Simon, Craig Gosdin, Samir Shah, Richard McClead, Anne Stack, Elizabeth Alpern
BACKGROUND: Return visits (RVs) and RVs with admission (RVAs) are commonly used emergency department quality measures. Visit- and patient-level factors, including several social determinants of health, have been associated with RV rates, but hospital-specific factors have not been studied. OBJECTIVE: To identify what hospital-level factors correspond with high RV and RVA rates. SETTING: Multicenter mixed-methods study of hospital characteristics associated with RV and RVA rates...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28696061/outcomes-and-healthcare-utilization-in-children-and-young-adults-with-aplastic-anemia-a-multiinstitutional-analysis
#19
Ashish Gupta, Pingfu Fu, Hasan Hashem, Anant Vatsayan, Steven Shein, Jignesh Dalal
BACKGROUND: Aplastic anemia is a bone marrow failure syndrome with high mortality affecting children and young adults. Although current treatment guidelines recommend hematopoietic stem cell transplant (HCT) for patients with matched sibling donors, outcomes with alternate donor options have been improving. PROCEDURE: We analyzed a validated multiinstitutional pediatric cohort using one of the largest pediatric and young adult database, the Pediatric Health Information System, for patients diagnosed with aplastic anemia (AA) from 2006 to 2015...
July 11, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28691936/national-variation-in-the-use-of-tracheostomy-in-patients-with-congenital-heart-disease
#20
Joyce T Johnson, Bradley S Marino, Darren Klugman, Pirouz Shamszad
OBJECTIVES: The postsurgical care of children with congenital heart disease may be complicated by the need for cardiorespiratory support, including tracheostomy. The variation of the use of tracheostomy across multiple pediatric cardiac surgical centers has not been defined. We describe multicenter variation in the use of tracheostomy in children undergoing congenital heart surgery. DESIGN: We retrospectively analyzed a multicenter cohort. SETTING: Pediatric Health Information Systems database retrospective cohort...
July 6, 2017: Pediatric Critical Care Medicine
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