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Pediatric pain management

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https://www.readbyqxmd.com/read/28343240/childhood-angular-kyphosis-a-plea-for-involvement-of-the-pediatric-neurosurgeon
#1
E Cornips, S Koudijs, J Vles, L van Rhijn
INTRODUCTION: Childhood angular kyphosis is rare, as most children are affected by a mixed kyphotic and scoliotic deformity. Published series involving a mix of kyphosis and kyphoscoliosis, pediatric and adult, congenital and acquired cases are almost exclusively authored by orthopedic surgeons, suggesting that (pediatric) neurosurgeons are not involved. CASE SERIES: We present five cases that illustrate the spectrum of angular kyphosis, and these were treated by a multidisciplinary team including child neurologist, orthopedic surgeon, and pediatric neurosurgeon as complementary partners...
March 25, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28323671/codeine-and-opioid-metabolism-implications-and-alternatives-for-pediatric-pain-management
#2
Vidya Chidambaran, Senthilkumar Sadhasivam, Mohamed Mahmoud
PURPOSE OF REVIEW: Use of perioperative opioids for surgical pain management of children presents clinical challenges because of concerns of serious adverse effects including life-threatening respiratory depression. This is especially true for children with history of obstructive sleep apnea. This review will explore current knowledge of clinically relevant factors and genetic polymorphisms that affect opioid metabolism and postoperative outcomes in children. RECENT FINDINGS: Within the past several years, an increasing number of case reports have illustrated clinically important respiratory depression, anoxic brain injuries and even death among children receiving appropriate weight-based dosages of codeine and other opioids for analgesia at home setting particularly following tonsillectomy...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28299720/ketamine-infusion-as-a-counter-measure-for-opioid-tolerance-in-mechanically-ventilated-children-a-pilot-study
#3
Felix Neunhoeffer, Anja Hanser, Martin Esslinger, Vanja Icheva, Matthias Kumpf, Ines Gerbig, Michael Hofbeck, Jörg Michel
BACKGROUND: Drug rotation to prevent opioid tolerance is well recognized in chronic pain management. However, ketamine infusion as a counter measure for opioid tolerance is rarely described in mechanically ventilated children developing tolerance from prolonged opioid infusion. PATIENTS AND METHODS: We performed a retrospective study in a 14-bed medical-surgical-cardiac pediatric intensive care unit. Thirty-two mechanically ventilated children who had developed tolerance from prolonged intravenous infusion of opioids received a continuous intravenous infusion of ketamine as an opioid substitute for more than 2 days, scheduled in a drug rotation protocol...
March 15, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28293129/pain-experience-and-behavior-management-in-pediatric-dentistry-a-comparison-between-traditional-local-anesthesia-and-the-wand-computerized-delivery-system
#4
Annelyse Garret-Bernardin, Tiziana Cantile, Vincenzo D'Antò, Alexandros Galanakis, Gabriel Fauxpoint, Gianmaria Fabrizio Ferrazzano, Sara De Rosa, Giulia Vallogini, Umberto Romeo, Angela Galeotti
Aim. To evaluate the pain experience and behavior during dental injection, using the Wand computerized delivery system versus conventional local anesthesia in children and adolescents. Methods. An observational crossover split mouth study was performed on 67 patients (aged 7 to 15 years), requiring local anesthesia for dental treatments in both sides of the dental arch. Patients received both types of injections in two separate appointments, one with the use of a Computer Delivery System (the Wand STA system) and one with the traditional syringe...
2017: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/28291142/lower-extremity-avulsion-fractures-in-the-pediatric-and-adolescent-athlete
#5
Jonathan Schiller, Steven DeFroda, Travis Blood
Lower extremity avulsion fractures are uncommon in the pediatric population and can be misdiagnosed without proper imaging and/or clinical suspicion for these injuries. The most common locations of avulsion injuries are the ischial tuberosity, anterior superior iliac spine, and anterior inferior iliac spine. Less often, avulsion fractures occur in the tibial tubercle, calcaneus, and greater and lesser trochanters. When treated properly with rest and altered weight bearing, most of these injuries heal without complication...
April 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28288914/a-double-masked-randomized-trial-of-postoperative-local-anesthetic-for-pain-control-in-pediatric-strabismus-surgery
#6
Laura B Enyedi, David K Wallace, Guy de L Dear
PURPOSE: To determine to what extent local anesthetic reduces postoperative pain after pediatric strabismus surgery. METHODS: In this double-masked, randomized clinical trial of 50 children 13-91 months of age undergoing strabismus surgery, subjects were randomly assigned to one of three treatments given at the conclusion of surgery: topical lidocaine gel and sub-Tenon's (balanced salt solution) placebo (n = 16), topical placebo (hypromellose) and sub-Tenon's bupivacaine 0...
March 10, 2017: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/28286527/interactive-palliative-and-end-of-life-care-modules-for-pediatric-residents
#7
Mindy K Ross, Ami Doshi, London Carrasca, Patricia Pian, JoAnne Auger, Amira Baker, James A Proudfoot, Mark S Pian
Background. There is a need for increased palliative care training during pediatric residency. Objective. In this pilot study, we created a comprehensive experiential model to teach palliative care skills to pediatric residents. Our Comfort Care Modules (CCMs) address pediatric palliative care (PPC) topics of breaking bad news, dyspnea, anxiety, pain management, and the dying child. We also evaluated a scoring system and gathered qualitative data. Methods. The CCMs are part of the University of California San Diego pediatric residency's second-year curriculum...
2017: International Journal of Pediatrics
https://www.readbyqxmd.com/read/28276824/clinical-profile-and-treatment-outcome-of-chronic-pancreatitis-in-children-a-long-term-follow-up-study-of-156-cases
#8
Ujjal Poddar, Surender Kumar Yachha, Vibhor Borkar, Anshu Srivastava, Vivek A Saraswat
AIM: There is a paucity of literature in pediatric chronic pancreatitis (CP) and most information is derived from adult literature. We, therefore, analyzed our experience of CP to look for clinical profile and long-term outcome. METHODS: From January 2003 to December 2015, 156 consecutive children (≤18 years) diagnosed as CP were included. Their clinical profile, management, and follow-up data were retrieved. Genetic markers (PRSS1, SPINK1, and CFTR) were studied in 40 idiopathic cases...
March 1, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28274251/knowledge-and-factors-associated-with-pain-management-for-hospitalized-children-among-nurses-working-in-public-hospitals-in-mekelle-city-north-ethiopia-cross-sectional-study
#9
Remla Miftah, Weyzer Tilahun, Atsde Fantahun, Seid Adulkadir, Kahsu Gebrekirstos
BACKGROUND: American Nurses Association reflects, the role of the nurse in pain management encompasses the entire nursing process, assessment of pain, plans pharmacological and non-pharmacological pain management strategies, implements the plan, and evaluates the response of the patient to the interventions. Pediatric pain management has been left largely unaddressed due to factors like limited resources, inadequate training, as well as cultural diversity and language barriers which made sick and injured children not to receive basic pain care...
March 9, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28267679/the-effect-of-silver-coated-dressing-on-pain-management-and-hospitalization-duration-in-pediatric-partial-thickness-burns-a-retrospective-matched-cohort-study
#10
Itay Wiser, Ophir Schein, Julietta D Rubin, Roni Averbuch Sagie, Iris Reshef, Adi Lotan, Avshalom Shalom
OBJECTIVE: Daily burn wound dressing protocols elicit pain and anxiety, especially in pediatric burn patients. Novel dressing technologies reduce pain by obviating the need for frequent dressing changes. The objective of this study was to assess the effect of silver-coated dressings (SCDs) on pain management and outcomes in pediatric burn patients. MATERIALS AND METHODS: A retrospective, matched cohort study compared a SCD to standard dressing protocols in admitted pediatric burn patients...
February 27, 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28267665/laparoscopic-partial-splenectomy-for-congenital-splenic-cyst-in-a-pediatric-patient-case-report-and-review-of-literature
#11
Ulises Garza-Serna, Christian Ovalle-Chao, David Martinez, Eduardo Flores-Villalba, Jose A Diaz-Elizondo, Ulises de Jesus Garza-Luna
Non-parasitic splenic cysts (NPSC) are a rare condition that makes difficult to know their true incidence and represent 10% of all benign splenic cysts, they can be either congenital with the presence of epithelial lining that originate from invagination of the capsular mesothelial lining or post-traumatic with absence of epithelial lining. We present our management of a splenic congenital cyst in a pediatric patient. A 10-year-old female patient presented to the clinic complaining with a 3-week abdominal pain at the left upper quadrant...
February 20, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28265317/inguinoscrotal-pathology
#12
REVIEW
Luis Guerra, Michael Leonard
Infants, children, and adolescents with inguinoscrotal pathology comprise a significant proportion of emergency department and outpatient visits. Visits to the emergency department primarily comprise individuals presenting with scrotal pain due to testicular torsion or torsion of the testicular appendages. At such time, immediate urological consultation is sought. Outpatient visits comprise those individuals with undescended testes, hydroceles, and varicoceles. Rare, but important problems, such as pediatric testicular tumours, may also present in the office setting...
January 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28261698/pediatric-cholecystectomy-for-symptomatic-gallstones-unrelated-to-hematologic-disorder
#13
Sang Gyun Suh, Yoo-Shin Choi, Kwi-Won Park, Seung Eun Lee
BACKGROUNDS/AIMS: Gallstones are being increasingly diagnosed in pediatric patients. The purpose of this study was to determine characteristics of pediatric patients who underwent cholecystectomy because of symptomatic gallstone disease unrelated to hemolytic disorder. METHODS: We reviewed cases of pediatric patients (under 18 years old) who underwent cholecystectomy between May 2005 and December 2015. RESULTS: A total 20 pediatric patients (under 18 years old) underwent cholecystectomy during the study period...
November 2016: Ann Hepatobiliary Pancreat Surg
https://www.readbyqxmd.com/read/28260348/current-views-of-pediatric-intensive-care-unit-picu
#14
Conghai Fan, Boxiang Qi, Chao Chen
International best practice endorses the use of standardized approaches in the management of pediatric patients in the Pediatric Intensive Care Unit (PICU). There is increasing awareness of the risk of prolonged duration of mechanical ventilation as a consequence of morphine use leading to ventilator associated pneumonia (VAP), extended PICU and hospital length of stay and increased morbidity and mortality. Accordingly a fundamental outcome measure of this study was to determine whether raising awareness of these issues and the introduction of analgesia and sedation guidelines led to a reduction in the amount of analgesics and sedatives administered to PICU patients, while not exposing them to pain and distress...
March 3, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28259265/benign-natural-history-of-spondylolysis-in-adolescence-with-midterm-follow-up
#15
Ted Sousa, David L Skaggs, Priscella Chan, Kent T Yamaguchi, Jerald Borgella, Christopher Lee, Jeffrey Sawyer, Alice Moisan, John M Flynn, Melissa Gunderson, M Timothy Hresko, Pierre D'Hemecourt, Lindsay M Andras
STUDY DESIGN: Retrospective chart review. OBJECTIVES: To use the Micheli Functional Scale to assess adolescent patients with spondylolysis treated conservatively at midterm follow-up. SUMMARY OF BACKGROUND: Spondylolysis is a common source of back pain for adolescents and is generally managed with bracing and physical therapy. There is little data regarding the results of conservative management of spondylolysis over time. METHODS: Four major academic pediatric institutions performed a retrospective chart review of patients from 5 to 21 years of age with the initial diagnosis of spondylolysis...
March 2017: Spine Deformity
https://www.readbyqxmd.com/read/28258881/ultrasound-for-diagnosis-of-appendicitis-in-a-community-hospital-emergency-department-has-a-high-rate-of-nondiagnostic-studies
#16
Scott M Alter, Brian Walsh, Patrick J Lenehan, Richard D Shih
BACKGROUND: Radiation concerns are changing the way emergency physicians evaluate patients. This is especially prevalent in pediatrics, and exemplified by abdominal pain management. Large academic center-based studies suggest appendix ultrasound (U/S) is sensitive and specific for appendicitis, with low nondiagnostic rates. OBJECTIVES: We sought to determine the diagnostic rate of appendix U/S and incidence of follow-up computed tomography (CT) imaging for pediatric patients at a community hospital...
February 28, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28258263/evaluation-of-the-role-of-music-as-a-nonpharmacological-technique-in-management-of-child-patients
#17
Neha Gupta, Himanshu Gupta, Prahlad Gupta, Nidhi Gupta
INTRODUCTION: Behavior management and reducing anxiety and pain are very important for success of treatment. Hence, apart from pharmacological management, such as conscious sedation, nonpharmacological interventions like music play a significant role. This study aims to evaluate the effects of music in reducing anxiety, pain, and behavior management. MATERIALS AND METHODS: This study was conducted at the Department of Pedodontics in 2015. It consisted of 60 patients, age ranging from 3 to 7 years, who required dental treatment with local anesthesia...
March 1, 2017: Journal of Contemporary Dental Practice
https://www.readbyqxmd.com/read/28251525/updates-in-pediatric-regional-anesthesia-and-its-role-in-the-treatment-of-acute-pain-in-the-ambulatory-setting
#18
REVIEW
Alecia L S Stein, Dorothea Baumgard, Isis Del Rio, Jacqueline L Tutiven
PURPOSE OF REVIEW: The purpose of this review is to summarize the latest advances in pediatric regional anesthesia with special emphasis on its role in the ambulatory surgical setting. RECENT FINDINGS: Undertreated pain in children following ambulatory surgery is not a rare occurrence and it is associated with increased morbidity and significant psychosocial harm. Use of regional anesthesia as part of the anesthetic approach in the ambulatory setting is safe when performed on children under general anesthesia and inclusion of certain adjuncts improves block outcomes...
February 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28251295/management-of-pin-tract-infection-in-pediatric-supracondylar-humerus-fractures-a-comparative-study-of-three-methods
#19
Di Lu, Te Wang, Hua Chen, Liao-Jun Sun
The objective of this study was to prospectively compare the incidence of pin tract infection in pediatric supracondylar humerus fractures managed with pin care daily or every other day or weekly. We hypothesized that there were some differences between these three methods. From June 2012 to May 2015, 135 children with supracondylar humerus fractures were randomized to postoperative pin care by cleaning pin tracts daily (group A, 45 cases) or cleaning every 2 days (group B, 45 cases) or cleaning weekly (group C, 45 cases)...
March 1, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28247325/medical-expulsive-therapy-worthwhile-or-wishful-thinking
#20
REVIEW
Tad Kroczak, Kenneth T Pace, Jason Y Lee
PURPOSE OF REVIEW: We set out to provide an overview of the most recent evidence for medical expulsive therapy (MET). Conflicting level 1 evidence for and against the use of MET has been published. RECENT FINDINGS: The largest double-blind randomized control trial (1110 patients) comparing placebo, tamsulosin, and nifedipine found no benefit for MET in preventing the need for secondary intervention. A recent meta-analysis of 55 randomized trials using alpha-blockers suggests that no benefit is seen with smaller ureteric calculi, but patients with larger ureteric calculi experience shorter times to stone passage, fewer episodes of pain, require less surgical intervention, and fewer hospital admissions...
April 2017: Current Urology Reports
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