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Paediatric Emergency

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https://www.readbyqxmd.com/read/28532628/milestones-barriers-and-beacons-shared-decision-making-in-canada-inches-ahead
#1
France Légaré, Dawn Stacey, Pierre-Gerlier Forest, Marie-France Coutu, Patrick Archambault, Laura Boland, Holly O Witteman, Annie LeBlanc, Krystina B Lewis, Anik M C Giguere
Canada's approach to shared decision making (SDM) remains as disparate as its healthcare system; a conglomerate of 14 public plans - ten provincial, three territorial and one federal. The healthcare research funding environment has been largely positive for SDM because there was funding for knowledge translation research which also encompassed SDM. The funding climate currently places new emphasis on patient involvement in research and on patient empowerment in healthcare. SDM fields have expanded from primary care to elder care, paediatrics, emergency and critical care medicine, cardiology, nutrition, occupational therapy and workplace rehabilitation...
May 19, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28530457/-patient-turnover-in-a-multidisciplinary-emergency-department
#2
Csaba Varga, Zsuzsanna Lelovics, Viktor Soós, Tibor Oláh
INTRODUCTION: More than twenty emergency departments were opened across Hungary in the past years. Data deficiency on patient flow, trends and lack of knowledge of indicators could raise numerous logistical and organisational problems. AIM: Collection, analysis and provision of data to facilitate successful operations of emergency medical care services. METHOD: During a three-year period investigated, at the multidisciplinary Emergency Department of "Moritz Kaposi" Teaching Hospital, data on patient flow (n = 106,203), epidemiology, triage and international classification of diseases were analysed...
May 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28530047/what-is-it-going-to-take-to-move-youth-related-hiv-programme-policies-into-practice-in-africa
#3
Daniella Mark, Lina Taing, Lucie Cluver, Chris Collins, Kate Iorpenda, Catarina Andrade, Luann Hatane
INTRODUCTION: HIV has been reported to be the leading cause of mortality amongst adolescents in Africa. This has brought attention to the changes in service provision and health management that many adolescents living with HIV experience when transferring from specialized paediatric- or adolescent-focused services to adult care. When transition is enacted poorly, adherence may be affected and the continuum of care disrupted. As the population of HIV-infected adolescents grows, effective and supported transition increases in significance as an operational imperative...
May 16, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28530041/hiv-healthcare-transition-outcomes-among-youth-in-north-america-and-europe-a-review
#4
Vicki Tepper, Stefanie Zaner, Patrick Ryscavage
INTRODUCTION: The transition from paediatric to adult care poses risks to the health of young adults living with HIV if unsuccessful, including interruptions in care and poor health outcomes. Evolving best practices in HIV healthcare transition should ideally be informed by real-world qualitative and quantitative clinical healthcare transition outcomes. There has been a recent proliferation of HIV healthcare transition outcome research, largely from Europe and North America. METHODS: A literature search was undertaken using the online databases PubMed, Web of Science, and Google Scholar...
May 16, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28530040/adolescents-with-hiv-and-transition-to-adult-care-in-the-caribbean-central-america-and-south-america-eastern-europe-and-asia-and-pacific-regions
#5
Heather Bailey, Maria Letícia Santos Cruz, Wipaporn Natalie Songtaweesin, Thanyawee Puthanakit
INTRODUCTION: The HIV epidemics in the Caribbean, Central America and South America (CCASA), Eastern Europe (EE) and Asia and Pacific (AP) regions are diverse epidemics affecting different key populations in predominantly middle-income countries. This narrative review describes the populations of HIV-positive youth approaching adolescence and adulthood in CCASA, EE and AP, what is known of their outcomes in paediatric and adult care to date, ongoing research efforts and future research priorities...
May 16, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28513890/risk-of-hospitalisation-after-early-revisit-in-the-emergency-department
#6
Giorgio Cozzi, Sergio Ghirardo, Ilaria Fiorese, Ilaria Proietti, Lorenzo Monasta, Marta Minute, Egidio Barbi, Lorenzo Calligaris
AIM: Early-revisits are frequent in the paediatric emergency department (ED) setting, but few data are available about early-revisited patients. The aim of this study was to investigate the hospitalisation rate of a population of early-revisited patients and to detect if an early-revisited patient was at risk of a more severe disease. METHODS: Between June 2014 and January 2015, we conducted a retrospective cohort study, considering all patients presented to the ED of a tertiary level children's hospital in Italy...
May 17, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28511800/epidemiologic-pattern-of-paediatric-supracondylar-fractures-of-humerus-in%C3%A2-a%C3%A2-teaching-hospital-of-rural-india-a-prospective-study-of-263-cases
#7
Rashid Anjum, Vivek Sharma, Ramesh Jindal, Tarun Pratap Singh, Narender Rathee
PURPOSE: This prospective study aimed to investigate the epidemiologic parameters of supracondylar humeral fractures in children admitted to a teaching institution of a developing country primarily catering to rural population, to find any preventable cause of such injuries. METHODS: All suspected cases of supracondylar humeral fracture reporting to emergency or outpatients department were analysed for various epidemiologic parameters including age, sex, laterality, time of presentation, associated injuries, neurovascular complications and classification over a period of four years...
April 19, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28511472/short-term-unscheduled-revisits-to-paediatric-emergency-department-a-six-year-data
#8
Onder Kilicaslan, Feruza Turan Sönmez, Harun Gunes, Ramazan Cahit Temizkan, Kenan Kocabay, Ayhan Saritas
INTRODUCTION: Reviewing the reasons for return visits within 24 hours is a very important method of determining possible problems of emergency health care. Several causes stay behind unscheduled emergency return visits. Therefore, identifying these factors is crucial to set strategies in order to decrease the number of unnecessary visits. AIM: To define the characteristics of the patients returning to the Paediatric Emergency Department (PED) within 24 hours via determining rate, number and demographic data of patients...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28489673/systematic-review-nutrition-and-physical-activity-in-the-management-of-paediatric-non-alcoholic-fatty-liver-disease
#9
Philippa S Gibson, Sarah Lang, Anil Dhawan, Emer Fitzpatrick, Michelle L Blumfield, Helen Truby, Kathryn H Hart, J Bernadette Moore
OBJECTIVES: To evaluate efficacy of nutrition and physical activity interventions in the clinical management of paediatric non-alcoholic fatty liver disease (NAFLD). The prevalence of paediatric NAFLD continues to rise alongside childhood obesity. Weight loss through lifestyle modification is currently first-line treatment, although supplementation of specific dietary components may be beneficial. METHODS: Medline, CINAHL, EMBASE, Scopus and Cochrane Libraries were systematically searched to identify randomised controlled trials (RCTs) assessing nutritional and physical activity interventions...
May 9, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28486889/coming-full-circle-thirty-years-of-paediatric-fluid-resuscitation
#10
N J Glassford, B Gelbart, R Bellomo
Fluid bolus therapy (FBT) is a cornerstone of the management of the septic child, but clinical research in this field is challenging to perform, and hard to interpret. The evidence base for independent benefit from liberal FBT in the developed world is limited, and the Fluid Expansion as Supportive Therapy (FEAST) trial has led to conservative changes in the World Health Organization-recommended approach to FBT in resource-poor settings. Trials in the intensive care unit (ICU) and emergency department settings post-FEAST have continued to explore liberal FBT strategies as the norm, despite a strong signal associating fluid accumulation with pulmonary pathology in the paediatric population...
May 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28483276/effectiveness-of-finger-marker-for-maintaining-the-correct-compression-point-during-paediatric-resuscitation-a-simulation-study
#11
Jae Yun Jung, Young Ho Kwak, Hyuksool Kwon, Yoo Jin Choi, Do Kyun Kim, Hee Chan Kim, Jung Chan Lee, Ji Heum Park, Hyungsoo Lim
OBJECTIVE: High-quality cardiopulmonary resuscitation is a significant factor for increasing the survival rate of paediatric patients. This study is to investigate the effectiveness of finger-marker stickers for maintaining the correct compression point during simulated infant cardiopulmonary resuscitation (CPR). METHODS: This crossover simulation study was conducted with 40 emergency physicians and paramedics at emergency departments of 2 tertiary hospitals. We used a remodeled infant CPR manikin developed to measure CPR quality indicators...
April 11, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28477327/circulating-rotavirus-genotypes-in-the-irish-paediatric-population-prior-to-the-introduction-of-the-vaccination-programme
#12
Z Yandle, S Coughlan, R J Drew, N O'Flaherty, J O'Gorman, C De Gascun
BACKGROUND: Rotavirus is the leading cause of viral gastroenteritis in children, and it is anticipated that the introduction of the Rotarix™ vaccine (GlaxoSmithKline Biologicals S.A., Rixensart, Belgium) into the Irish immunisation schedule will result in a significant reduction of rotavirus-associated disease. In the pre- and post-vaccination eras, it is important to determine circulating strains of rotavirus to assess vaccine effectiveness, to monitor vaccine failures, and to detect potential emerging strains...
May 5, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28472973/arterial-stiffness-by-oscillometric-device-and-telomere-lenght-in-juvenile-idiopathic-artrhitis-with-no-cardiovascular-risk-factors-a-cross-sectional-study
#13
Maria Mercedes Picarelli, Luiz Cláudio Danzmann, Lucas Kich Grun, Nevton Teixeira Rosa Júnior, Patrícia Lavandovsky, Fátima Theresinha Costa Rodrigues Guma, Renato T Stein, Florência Barbé-Tuana, Marcus Herbert Jones
BACKGROUND: Advances in juvenile idiopathic arthritis (JIA) treatment is promoting free disease survival. Cardiovascular disease (CVD) may emerge as an important cause of morbidity and mortality. Pulse wave velocity (PWV), a surrogate marker of arterial stiffness, and telomere length (TL) are considered as potential predictors of CVD and its outcomes. The study aim was to assess PWV, TL in a JIA population and to test its correlation. In a cross sectional study, 24 JIA patients, 21 controls for TL and 20 controls for PWV were included...
May 4, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28472332/the-spectrum-of-rem-sleep-related-episodes-in-children-with-type-1-narcolepsy
#14
Elena Antelmi, Fabio Pizza, Stefano Vandi, Giulia Neccia, Raffaele Ferri, Oliviero Bruni, Marco Filardi, Gaetano Cantalupo, Rocco Liguori, Giuseppe Plazzi
Type 1 narcolepsy is a central hypersomnia due to the loss of hypocretin-producing neurons and characterized by cataplexy, excessive daytime sleepiness, sleep paralysis, hypnagogic hallucinations and disturbed nocturnal sleep. In children, close to the disease onset, type 1 narcolepsy has peculiar clinical features with severe cataplexy and a complex admixture of movement disorders occurring while awake. Motor dyscontrol during sleep has never been systematically investigated. Suspecting that abnormal motor control might affect also sleep, we systematically analysed motor events recorded by means of video polysomnography in 40 children with type 1 narcolepsy (20 females; mean age 11...
May 1, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28470071/nurses-knowledge-attitudes-and-practices-regarding-evidence-based-practice-in-the-prevention-of-mother-to-child-transmission-of-hiv-programme-in-malawi
#15
Chisomo Mulenga, Joanne R Naidoo
BACKGROUND: HIV continues to be a global public health concern with Malawi being among the worst affected countries. The prevalence of HIV among pregnant women is also very high, thereby raising concerns of mother-to-child transmission of the virus. Prevention of mother-to-child transmission (PMTCT) of HIV is therefore a priority in the efforts to curb the HIV pandemic. Keeping in mind that the area of HIV management is rapidly evolving, underpinning nursing care with evidence-based practice is essential and has been reported to reduce mother-to-child transmission...
April 12, 2017: Curationis
https://www.readbyqxmd.com/read/28469906/improving-access-for-urgent-patients-in-paediatric-neurology
#16
Khalid Mohamed, Basema Al Houri, Khalid Ibrahim, Abdulhafeez M Khair
Referral and flow management is an important part of outpatient care; some patients require to be seen earlier than the next available appointment because of the nature of their presentation. We did not have a clear pathway for urgent patients being referred to our pediatric neurology service. When we reviewed this process in our Quality Improvement meeting we identified wide variation in the length of time such patients wait to be seen in clinic ranging from 2 to 11 weeks. Only 25% of patients identified as requiring urgent clinic appointments were seen in clinic within 2 weeks of triage...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28462830/a-systematic-review-of-the-impact-of-nurse-initiated-medications-in-the-emergency-department
#17
REVIEW
C J Cabilan, Mary Boyde
BACKGROUND: Nurse-initiated medications are one of the most important strategies used to facilitate timely care for people who present to Emergency Departments (EDs). The purpose of this paper was to systematically review the evidence of nurse-initiated medications to guide future practice and research. METHODS: A systematic review of the literature was conducted to locate published studies and Grey literature. All studies were assessed independently by two independent reviewers for relevance using titles and abstracts, eligibility dictated by the inclusion criteria, and methodological quality...
April 24, 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28444335/incidence-of-iga-vasculitis-in-children-estimated-by-four-source-capture-recapture-analysis-a-population-based-study
#18
Maryam Piram, Carla Maldini, Sandra Biscardi, Nathalie De Suremain, Christine Orzechowski, Emilie Georget, Delphine Regnard, Isabelle Koné-Paut, Alfred Mahr
Objectives.: The aim was to describe the epidemiological characteristics of childhood IgA vasculitis (IgAV) defined by the EULAR/PRINTO/Paediatric Rheumatology European Society criteria in a population-based sample from France and ascertain its incidence over 3 years by a four-source capture-recapture analysis. Methods.: Cases were prospectively collected in Val de Marne county, a suburb of Paris, with 263 874 residents <15 years old. Children with incident IgAV living in this area from 2012 to 2014 were identified by four sources of case notification (emergency departments, paediatrics departments, private-practice paediatricians and general practitioners)...
April 24, 2017: Rheumatology
https://www.readbyqxmd.com/read/28433980/a-paediatric-case-of-bilateral-mandibular-condyle-fracture-presenting-with-bloody-otorrhoea-following-trauma
#19
Yat Chun Chan, Kwan Leong Au-Yeung
A 7-year-old boy presented to the emergency department with bilateral bloody otorrhoea after falling from his scooter. Skull base fracture was suspected. CT showed no evidence of skull base fracture but bilateral mandibular condyle and external acoustic canals fractures. We report this case to illustrate a rare possibility of bilateral external acoustic canal fracture associated with condylar fracture in trauma patients presented with bloody otorrhoea.
April 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28425829/effects-of-dexmedetomidine-versus-midazolam-for-premedication-in-paediatric-anaesthesia-with-sevoflurane-a-meta-analysis
#20
Ji-Feng Feng, Xiao-Xia Wang, Yan-Yan Lu, Deng-Ge Pang, Wei Peng, Jian-Lan Mo
Background Dexmedetomidine (DEX), an α2-adrenergic receptor agonist, produces ideal sedation and early postoperative recovery for premedication in paediatric surgery, reducing preoperative anxiety and facilitating smooth induction of anaesthesia. We performed a meta-analysis to compare the effects of DEX and midazolam (MDZ) in paediatric anaesthesia with sevoflurane. Methods PubMed, Ovid, Web of Science, and Public Health Management Corporation were searched through December 2016 for randomized controlled trials (RCTs) that compared DEX and MDZ in children undergoing sevoflurane anaesthesia...
January 1, 2017: Journal of International Medical Research
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