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https://www.readbyqxmd.com/read/28818338/spinal-anesthesia-for-pediatric-urological-surgery-reducing-the-theoretic-neurotoxic-effects-of-general-anesthesia
#1
Emmett E Whitaker, Brianne Z Wiemann, Daniel G DaJusta, Seth A Alpert, Christina B Ching, Daryl J McLeod, Joseph D Tobias, Venkata R Jayanthi
BACKGROUND: Spinal anesthesia (SA) is an effective technique that has been used in children for years. With growing concern with regard to the risks of general anesthesia (GA), we developed a SA program to provide an alternative option. We present our initial experience with this program. OBJECTIVE: To implement a SA program at a large tertiary care pediatric center and assess the safety and efficacy of the technique as an alternative to GA for urologic surgery...
July 14, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28817401/challenges-in-the-anesthetic-management-of-ambulatory-patients-in-the-mri-suites
#2
Jasper Deen, Yzabel Vandevivere, Peter Van de Putte
PURPOSE OF REVIEW: MRI is becoming an indispensable diagnostic tool. The need for prolonged motion-free periods has substantially increased the need for deep sedation or anesthesia in a challenging environment. This review summarises recent literature with respect to pharmacological sedative strategies, nonpharmacological alternative approaches, airway management and safety issues in the ambulatory setting. RECENT FINDINGS: Most literature researches the pediatric patient population...
August 16, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28814256/current-issues-in-intravenous-fluid-use-in-hospitalized-children
#3
Jennifer Fuchs, Sarah T Adams, Julie Byerley
BACKGROUND: Fluid and electrolyte therapy is an important component in the care of the hospitalized child. Previous pediatric guidelines have followed the Holliday-Segar method of calculating and delivering maintenance IV fluids, using hypotonic fluids in maintenance therapy. However, research demonstrates that hypotonic fluids can lead to iatrogenic hyponatremia and that isotonic fluid is a safer alternative. OBJECTIVE: To provide the ideal approach to intravenous (IV) fluid use in the hospitalized child and determine the safety and effectiveness of isotonic maintenance fluid therapy...
August 16, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28813754/laparoscopic-pediatric-inguinal-hernia-repair-overview-of-true-herniotomy-technique-and-review-of-current-evidence
#4
Brendan P Feehan, David S Fromm
Inguinal hernia repair is one of the most commonly performed operations in the pediatric population. While the majority of pediatric surgeons routinely use laparoscopy in their practices, a relatively small number prefer a laparoscopic inguinal hernia repair over the traditional open repair. This article provides an overview of the three port laparoscopic technique for inguinal hernia repair, as well as a review of the current evidence with respect to visualization and identification of hernias, recurrence rates, operative times, complication rates, postoperative pain, and cosmesis...
May 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28811995/agreement-between-gamma-passing-rates-using-computed-tomography-in-radiotherapy-and-secondary-cancer-risk-prediction-from-more-advanced-dose-calculated-models
#5
Abdulhamid Chaikh, Jacques Balosso
BACKGROUND: During the past decades, in radiotherapy, the dose distributions were calculated using density correction methods with pencil beam as type 'a' algorithm. The objectives of this study are to assess and evaluate the impact of dose distribution shift on the predicted secondary cancer risk (SCR), using modern advanced dose calculation algorithms, point kernel, as type 'b', which consider change in lateral electrons transport. METHODS: Clinical examples of pediatric cranio-spinal irradiation patients were evaluated...
June 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28808577/transition-from-intravenous-to-enteral-ketamine-for-treatment-of-nonconvulsive-status-epilepticus
#6
Michael A Pizzi, Prasuna Kamireddi, William O Tatum, Jerry J Shih, Daniel A Jackson, William D Freeman
BACKGROUND: Nonconvulsive status epilepticus (NCSE) is a diagnosis that is often challenging and one that may progress to refractory NCSE. Ketamine is a noncompetitive N-methyl-d-aspartate antagonist that increasingly has been used to treat refractory status epilepticus. Current Neurocritical Care Society guidelines recommend intravenous (IV) ketamine infusion as an alternative treatment for refractory status epilepticus in adults. On the other hand, enteral ketamine use in NCSE has been reported in only 6 cases (1 adult and 5 pediatric) in the literature to date...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28807643/-use-of-subcutaneous-route-for-comfort-care%C3%A2-in-neonatal-palliative-population-systematic-review-and-survey-of-practices-in-france
#7
N Pouvreau, J Tandonnet, O Tandonnet, L Renesme
INTRODUCTION: Subcutaneous hydration (hypodermoclysis) and drug administration is a widely used method of analgesic therapy in adult palliative care medicine. Very little is known about its use in neonatal medicine. Evidence-based guidelines do not exist due to a lack of data. In this study, the advantages of subcutaneous analgesic therapy in terms of comfort in neonatal palliative care situations were investigated. METHODS: This report details the results of a systematic review associated with a survey in neonatal intensive care units (NICUs) and pediatric palliative care departments (PPCTs) in France...
August 11, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28806566/volumetric-adsorptive-microsampling-liquid-chromatography-tandem-mass-spectrometry-assay-for-the-simultaneous-quantification-of-four-antibiotics-in-human-blood-method-development-validation-and-comparison-with-dried-blood-spot
#8
Sebastiano Barco, Elio Castagnola, Andrea Moscatelli, James Rudge, Gino Tripodi, Giuliana Cangemi
In this paper we show the development and validation of a volumetric absorptive microsampling (VAMS™)-LC-MS/MS method for the simultaneous quantification of four antibiotics: piperacillin-tazobactam, meropenem, linezolid and ceftazidime in 10μL human blood. The novel VAMS-LC-MS/MS method has been compared with a dried blood spot (DBS)-based method in terms of impact of hematocrit (HCT) on accuracy, reproducibility, recovery and matrix effect. Antibiotics were extracted from VAMS and DBS by protein precipitation with methanol after a re-hydration step at 37°C for 10min...
August 2, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/28802643/update-on-urinary-stones-in-children-current-and-future-concepts-in-surgical-treatment-and-shockwave-lithotripsy
#9
REVIEW
Mesrur Selcuk Silay, Jonathan S Ellison, Thomas Tailly, Paolo Caione
CONTEXT: Miniaturized instrumentation used for endoscopic treatment of urinary stone disease in children has been readily adopted in clinical practice. However, there is a need to optimize and individualize the surgical approach according to the patient's age, body habitus, and stone characteristics. Promising novel equipment and techniques will continue to advance the surgical care of these children. OBJECTIVE: To review the literature regarding surgical and shockwave lithotripsy (SWL) treatment of urinary stone disease in children and provide an overview on future treatment innovations...
August 9, 2017: European Urology Focus
https://www.readbyqxmd.com/read/28801165/child-care-health-consultation-improves-infant-and-toddler-care
#10
Rosemary Johnston, Beth A DelConte, Libby Ungvary, Richard Fiene, Susan S Aronson
INTRODUCTION: Many families enroll their infants and toddlers in early education and child care programs. The Pennsylvania Chapter of the American Academy of Pediatrics recruited 32 child care centers that care for infants and toddlers to be linked with a child care health consultant (CCHC). METHOD: Project staff assigned the centers alternately to an immediate intervention or a 1-year delayed intervention (contrast) group. At entry into the project, and then 1 and 2 years later, an evaluator assessed center compliance with 13 standards for infants and toddler care selected from Caring for Our Children: National Health and Safety Performance Standards (3rd ed...
August 8, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28800051/alternative-tests-versus-measurement-of-fasting-plasma-glucose-and-oral-glucose-tolerance-test-for-diagnosis-of-pediatric-type-2-pre-diabetes-a-systematic-review-protocol
#11
Dagmar Tučková, Miloslav Klugar, Tomasz Lasota, Jakub Lasák, Jared M Campbell, Zachary Munn
The gold standard for the diagnosis of pre-diabetes is the measurement of fasting plasma glucose and the oral glucose tolerance test. The objective of this systematic review is to identify all alternative tests currently in use for the diagnosis of type 2 pre-diabetes mellitus in children and establish their accuracy relative to this gold standard.
August 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28792258/utilization-of-intravenous-catheters-by-prehospital-providers-during-pediatric-transports
#12
Timothy VanderKooy, Kelsey Spaur, Lina Brou, Sean Caffrey, Kathleen M Adelgais
INTRODUCTION: Prehospital intravenous (IV) access in children may be difficult and time-consuming. Emergency Medical Service (EMS) protocols often dictate IV placement; however, some IV catheters may not be needed. The scene and transport time associated with attempting IV access in children is unknown. The objective of this study is to examine differences in scene and transport times associated with prehospital IV catheter attempt and utilization patterns of these catheters during pediatric prehospital encounters...
August 9, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28781150/2016-guidelines-for-the-use-of-antifungal-agents-in-patients-with-invasive-fungal-diseases-in-taiwan
#13
REVIEW
Hsiang-Chi Kung, Po-Yen Huang, Wei-Ting Chen, Bor-Sheng Ko, Yee-Chun Chen, Shan-Chwen Chang, Yin-Ching Chuang
The Infectious Diseases Society of Taiwan, Medical Foundation in Memory of Dr. Deh-Lin Cheng, Foundation of Professor Wei-Chuan Hsieh for Infectious Diseases Research and Education, and CY Lee's Research Foundation for Pediatric Infectious Diseases and Vaccines have updated the guidelines for the use of antifungal agents in adult patients with invasive fungal diseases in Taiwan. This guideline replaces the 2009 version. Recommendations are provided for Candida, Cryptococcus, Aspergillus and Mucormycetes. The focus is based on up-to-date evidence on indications for treatment or prophylaxis of the most common clinical problems...
July 25, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28777412/atypical-use-of-picc-in-infants-and-small-children-a-unicentric-experience
#14
Filippo Bernasconi, Clelia Zanaboni, Andrea Dato, Andrea Dolcino, Michela Bevilacqua, Luigi Montagnini, Nicola Disma
INTRODUCTION: The peripherally inserted central catheters (PICCs) are vascular access devices (VAD) that are increasingly being used in the pediatric population. If a small vein caliber prevents positioning the catheter in the arm, the following step is to position the same catheter in the supraclavicular area, which can be defined as an off-label use or "atypical" approach, first described by Pittiruti. MATERIALS AND METHODS: We retrospectively reviewed PICC positioning with puncture-site in the supra-clavicular area ("atypical" PICC insertion) and then tunneled on the chest...
July 29, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28776543/transcatheter-closure-of-congenital-coronary-artery-fistulas-with-a-giant-coronary-artery-aneurysm-in-children-experiences-from-a-single-center
#15
Yi-Fan Li, Zhi-Wei Zhang, Shu-Shui Wang, Zhao-Feng Xie, Xu Zhang, Yu-Fen Li
BACKGROUND: Transcatheter closure of congenital coronary artery fistulas (CCAFs) is an alternative therapy to surgery; however, data regarding transcatheter closure for CCAF with a giant coronary artery aneurysm (CAA) in pediatric patients are still limited due to the rarity of the disease. We aimed to evaluate the efficacy and safety of transcatheter closure for CCAF with a giant CAA in a pediatric population at a single center. METHODS: Medical records of pediatric patients (<18 years old) who underwent transcatheter closure of CCAF with a giant CAA between April 2007 and September 2016 at Guangdong Cardiovascular Institute (Guangdong, China) were reviewed...
August 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28771805/cutaneous-small-vessel-vasculitis-in-two-children-with-inflammatory-bowel-disease-case-series-and-review-of-the-literature
#16
Tina Ho, Lauren A V Orenstein, Markus D Boos, Kevin P White, Nicole Fett
Cutaneous small-vessel vasculitis (CSVV) is an infrequent manifestation of pediatric inflammatory bowel disease (IBD). We report two cases of CSVV associated with ulcerative colitis, review the literature, and discuss the diagnostic evaluation of children who present with CSVV and abdominal pain. After excluding more common causes of CSVV and abdominal pain in children, including immunoglobulin A vasculitis (previously Henoch-Schönlein purpura), infectious colitis, and drug-induced vasculitis, alternative diagnoses such as CSVV secondary to IBD or systemic vasculitis with gastrointestinal involvement must be considered...
August 2, 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/28771734/modified-surgical-approach-to-hypoglossal-nerve-stimulator-implantation-in-the-pediatric-population
#17
Sarah N Bowe, Gillian R Diercks, Christopher J Hartnick
Upper airway stimulation with the hypoglossal nerve stimulator is a promising treatment modality for severe obstructive sleep apnea in carefully selected patients with Down syndrome. The pediatric population presents a greater variety in body habitus, including thorax size. A modified surgical approach, utilizing a medially placed, single chest incision, instead of two separate chest incisions, provides an alternative that is particularly useful for pediatric patients with small stature. As this technology is evaluated for Food and Drug Administration clearance in the pediatric population, it is important to consider modifications in surgical technique, partnering prior surgical experience with the technical support of company representatives...
August 3, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28770583/can-you-see-me-now-video-supplementation-for-pediatric-teledermatology-cases
#18
Dana F Feigenbaum, Christy K Boscardin, Ilona J Frieden, Erin F D Mathes
BACKGROUND/OBJECTIVES: Digital video is widely available and is used sporadically in clinical settings to evaluate patients, but whether it helps improve clinical management has not been determined. The aim of this study was to assess whether recorded video in addition to still images can improve residents' diagnostic and management accuracy and confidence with pediatric teledermatology cases. METHODS: Dermatology residents from three programs were assigned alternately to an online survey with 15 pediatric teledermatology cases presented with still images only (still) or still images plus recorded video (mixed)...
August 2, 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/28763427/safety-of-outpatient-parenteral-antimicrobial-therapy-in-children
#19
Priyanka Fernandes, Carly Milliren, Helen M Mahoney-West, Laura Schwartz, Catherine S Lachenauer, Mari M Nakamura
BACKGROUND AND OBJECTIVE: Outpatient parenteral antimicrobial therapy (OPAT) provides numerous benefits but may pose unique risks in children. We aimed to determine rates of OPAT antimicrobial- and intravenous-access-related complications and their associations with specific antimicrobials and type of intravenous access in pediatric patients. METHODS: Observational cohort study of patients receiving OPAT from 8/2008 to 5/2015 cared for by the Infectious Diseases service at a tertiary children's hospital...
July 31, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28761989/comparing-the-dimensional-structure-and-diagnostic-algorithms-between-dsm-5-and-icd-11-ptsd-in-children-and-adolescents
#20
Cedric Sachser, Lucy Berliner, Tonje Holt, Tine Jensen, Nathaniel Jungbluth, Elizabeth Risch, Rita Rosner, Lutz Goldbeck
In contrast to the DSM-5, which expanded the posttraumatic stress disorder (PTSD) symptom profile to 20 symptoms, a workgroup of the upcoming ICD-11 suggested a reduced symptom profile with six symptoms for PTSD. Therefore, the objective of the study was to investigate the dimensional structure of DSM-5 and ICD-11 PTSD in a clinical sample of trauma-exposed children and adolescents and to compare the diagnostic rates of PTSD between diagnostic systems. The study sample consisted of 475 self-reports and 424 caregiver-reports on the child and adolescent trauma screen (CATS), which were collected at pediatric mental health clinics in the US, Norway and Germany...
July 31, 2017: European Child & Adolescent Psychiatry
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