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Paediatric Emergency

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https://www.readbyqxmd.com/read/28346109/assessing-process-of-paediatric-care-in-a-resource-limited-setting-a-cross-sectional-audit-of-district-hospitals-in-rwanda
#1
Celestin Hategeka, Jeannie Shoveller, Lisine Tuyisenge, Larry D Lynd
BACKGROUND: Routine assessment of quality of care helps identify deficiencies which need to be improved. While gaps in the emergency care of children have been documented across sub-Saharan Africa, data from Rwanda are lacking. OBJECTIVE: To assess the care of sick infants and children admitted to Rwandan district hospitals and the extent to which it follows currently recommended clinical practice guidelines in Rwanda. METHODS: Data were gathered during a retrospective cross-sectional audit of eight district hospitals across Rwanda in 2012/2013...
March 27, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28341427/community-onset-carbapenem-resistant-klebsiella-pneumoniae-urinary-tract-infections-in-infancy-following-nicu-hospitalisation
#2
Eleni Vergadi, Maria Bitsori, Sofia Maraki, Emmanouil Galanakis
INTRODUCTION: Urinary tract infection (UTI) is a common bacterial infection in childhood with favourable outcome. However, the recent emergence of UTI caused by multidrug-resistant pathogens, such as carbapenem-resistant Enterobacteriaceae (CRE), has become a great concern worldwide. CRE are mainly responsible for nosocomial infections and community-onset CRE infections in healthy individuals are rare. OBJECTIVES: In this study, we report a series of infants without substantial genitourinary abnormalities that were admitted with community-onset urinary tract infections (UTIs) caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) and we discuss their aetiology...
March 11, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28341146/-construction-of-a-diagnostic-prediction-model-of-severe-bacterial-infection-in-febrile-infants-under-3-months-old
#3
Enrique Villalobos Pinto, Marciano Sánchez-Bayle
INTRODUCTION: Fever is a common cause of paediatric admissions in emergency departments. An aetiological diagnosis is difficult to obtain in those less than 3 months of age, as they tend to have a higher rate of serious bacterial infection (SBI). The aim of this study is to find a predictor index of SBI in children under 3 months old with fever of unknown origin. METHODS: A study was conducted on all children under 3 months of age with fever admitted to hospital, with additional tests being performed according to the clinical protocol...
March 21, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28337892/idiopathic-intracranial-hypertension-in-a-paediatric-population-a-retrospective-observational-study-on-epidemiology-symptoms-and-treatment
#4
M Barbagallo, G Vitaliti, F Greco, P Pavone, N Matin, G Panta, R Lubrano, R Falsaperla
Idiopathic intracranial hypertension (IIH) is a disorder of unknown origin, which is characterized by elevated intracranial pressure (ICP) without underlying etiological evidence of neurological disease. The purpose of the current study was to evaluate epidemiological features, clinical presentation, diagnostic findings and treatment of sixteen children (7 males and 9 females) with IIH. Medical records of the patients were obtained from the University Paediatric Hospital of Catania, Italy. Clinical features, investigations and treatment approaches were retrieved...
January 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28337672/fentanyl-formulations-in-the-management-of-pain-an-update
#5
REVIEW
Stephan A Schug, Sonya Ting
Fentanyl is a synthetic, highly selective opioid with many desirable physicochemical properties, including a high lipophilicity and predictable pharmacokinetics. These properties have an established record in the management of pain in a variety of settings, particularly acute pain and breakthrough cancer pain. Fentanyl was initially developed for parenteral use; however, this is invasive and impractical in the outpatient setting. Unfortunately, the high first-pass metabolism of fentanyl makes oral formulations unfeasible...
March 23, 2017: Drugs
https://www.readbyqxmd.com/read/28336372/doxorubicin-targets-multiple-players-a-new-view-of-an-old-problem
#6
REVIEW
Donato Cappetta, Francesca Rossi, Elena Piegari, Federico Quaini, Liberato Berrino, Konrad Urbanek, Antonella De Angelis
Anthracycline cardiotoxicity remains a serious problem in paediatric and adult cancer survivors, and the advancement of cardio-oncology is a necessary step for an effective care of the patients that experience adverse cardiovascular effects. In this review, we discuss the multiple instruments used by clinicians that constitute the current strategies for primary and secondary prevention aiming at contrasting the onset of early and late doxorubicin-induced cardiotoxic events. The importance of early detection of cardiotoxicity and the following pharmacological therapy has been acknowledged with the emphasis put on impaired diastolic function, an increasingly recognized precocious sign of doxorubicin cardiotoxicity with an emerging scientific and clinical interest...
March 20, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28334466/home-care-services-for-sick-children-healthcare-professionals-conceptions-of-challenges-and-facilitators
#7
Charlotte Castor, Inger Hallström, Helena Hansson, Kajsa Landgren
AIMS AND OBJECTIVES: To explore healthcare professionals' conceptions of caring for sick children in home care services. BACKGROUND: Families often prefer home care to hospital care and the number of home care services for children is increasing. Caring for children at home has been recognised as challenging for healthcare professionals in home care services used to providing care predominately for adults. DESIGN: An inductive qualitative design...
March 23, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28333866/prevention-of-gastrointestinal-side-effects-in-paediatric-oncology-what-are-the-guidelines
#8
Karis K F Cheng
PURPOSE OF REVIEW: Gastrointestinal side-effects, particularly with regard to alimentary tract mucositis and chemotherapy-induced nausea and vomiting (CINV), continue to be frequent and debilitating symptomatic conditions among children and adolescents receiving cytotoxic cancer therapy. Further avenues of progress for mucositis and CINV prevention in paediatric oncology setting are warranted. RECENT FINDINGS: The current article reviews the major guidelines and literature published in 2016 pertaining to the prevention of mucositis and CINV...
March 22, 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28332331/computed-tomography-for-head-injuries-in-children-change-in-australian-usage-rates-over-time
#9
Ed Oakley, Rachel May, Tobias Hoeppner, Kam Sinn, Jeremy Furyk, Simon Craig, Pamela Rosengarten, Amit Kochar, David Krieser, Sarah Dalton, Stuart Dalziel, Jocelyn Neutze, Tim Cain, Kim Jachno, Franz E Babl
OBJECTIVE: Paediatric head injury is a common presentation to the ED. North American studies demonstrate increasing use of computed tomography (CT) brain scan (CTB) to investigate head injury. No such data exists for Australian EDs. The aim of this study was to describe CTB use in head injury over time in eight Australian EDs. METHODS: Retrospective ED electronic database and medical imaging database audit was undertaken for the years 2001-2010 by International Classification of Diseases (ICD) 9 or 10 code for head injury in children <16 years...
April 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28329893/graves-ophthalmopathy-in-a-paediatric-population
#10
Y Sadeghi, A Obéric, G Theintz, M Hamédani
Background Graves' disease is an autoimmune disorder leading to hyperthyroidism. It is often associated with ophthalmic manifestations. Graves' disease is reported to be rare in the paediatric population. Patients and Methods We performed a retrospective analysis on all patients diagnosed with ophthalmopathy related to Graves' disease at a paediatric age (less than 18 years old) in our institution between 2004 and 2015. Results Eight patients were identified: 6 females and 2 males. The median age at diagnosis was 11...
March 22, 2017: Klinische Monatsblätter Für Augenheilkunde
https://www.readbyqxmd.com/read/28326162/trauma-informed-care-for-children-in-the-ambulance-international-survey-among-pre-hospital-providers
#11
Eva Alisic, Mark P Tyler, Melita J Giummarra, Rahim Kassam-Adams, Juul Gouweloos, Markus A Landolt, Nancy Kassam-Adams
Background: Pre-hospital providers, such as paramedics and emergency medical technicians, are in a position to provide key emotional support to injured children and their families. Objective: Our goal was to examine (a) pre-hospital providers' knowledge of traumatic stress in children, attitudes towards psychosocial aspects of care, and confidence in providing psychosocial care, (b) variations in knowledge, attitudes, and confidence according to demographic and professional characteristics, and (c) training preferences of pre-hospital providers regarding psychosocial care to support paediatric patients and their families...
2017: European Journal of Psychotraumatology
https://www.readbyqxmd.com/read/28325381/-early-treatment-and-nursing-role-in-the-case-of-a-haemorrhagic-stroke
#12
Séverine Héraud-Carré, Bruno Le Roy, Gladys Prével
Paediatric stroke constitute a medical and/or surgical emergency. The speed and timeliness of the treatment have a significant impact on the prognosis. The nursing role, from carrying out continuous observation to specific procedures, is essential in the assessment, the care pathway and the short-, medium- and long-term outcome for the child.
March 2017: Soins. Pédiatrie, Puériculture
https://www.readbyqxmd.com/read/28318729/acute-cerebellitis-in-paediatric-patients-our-experience
#13
J P García-Iñiguez, F J López-Pisón, P Madurga Revilla, I Montejo Gañán, M Domínguez Cajal, L Monge Galindo, S B Sánchez Marco, M C García Jiménez
INTRODUCTION: Acute cerebellitis is a rare inflammatory disease with a highly variable clinical course that ranges from benign self-limiting symptoms to a fulminant presentation associated with a high risk of death due to compression of the posterior fossa, acute hydrocephalus, and intracranial hypertension. METHODS: We reviewed clinical, laboratory, and radiological findings from children diagnosed with acute cerebellitis between May 2007 and November 2016. We analysed treatments and clinical and radiological progression...
March 15, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28315728/can-ambulance-telephone-triage-using-nhs-pathways-accurately-identify-paediatric-cardiac-arrest
#14
Charles D Deakin, Simon England, Debbie Diffey, Ian Maconochie
BACKGROUND: Most out-of-hospital paediatric cardiac arrests (CA) are not identified until a call is made to the emergency medical services. Accurate identification increases overall survival by enabling immediate ambulance dispatch and delivery of bystander CPR. European ambulance services use a variety of didactic telephone scripts to interrogate the caller and rapidly identify paediatric CA. The performance of these scripts has not been reported. This study aims to evaluate the diagnostic accuracy of the NHS Pathways as a telephone triage tool to identify patients less than 16 years age in cardiac arrest...
March 15, 2017: Resuscitation
https://www.readbyqxmd.com/read/28306345/a-retrospective-study-on-non-drug-related-poisoning-in-the-community-among-children-from-south-india
#15
Debasis Das Adhikari, Saibal Das, Blessed Winston A, Kaysina Vazhudhi, Aniket Kumar, Margaret Shanthi Fx, Indira Agarwal
OBJECTIVES: This retrospective study was performed to determine the incidence, demographic distribution, types and outcomes across various non-drug related poisonings among children attending a tertiary care center in south India. METHODS: All children from 0-16 years who presented to the Paediatric Emergency Department, Christian Medical College, Vellore with non-drug related poisoning from October 2004 to September 2013 were included. RESULTS: Out of the total 997 cases of poisoning, 629 (63...
March 24, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28303815/prevalence-and-characterization-of-rotaviruses-in-children-hospitalized-for-diarrheal-disease-in-a-tertiary-care-hospital-pune
#16
Sae Satish Pol, Ashwini Kacharu Dedwal, Sujata Sudhir Ranshing, Shobha Dattatray Chitambar, Sushma Narayan Pednekar, Renu Satish Bharadwaj
BACKGROUND: Diarrhoea remains the second most common cause of death among children below 5 years globally. Among various enteric pathogens, rotavirus appears to be the most important aetiological agent of acute gastroenteritis in infants and young children. Increased understanding of epidemiology of rotavirus infections is needed to improve the vaccine efficacy. AIM: This study aims to determine prevalence rotavirus infection and prevalent circulating strains of rotavirus in and around Pune...
January 2017: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28297089/cone-beam-computed-tomographic-imaging-in-orthodontics
#17
W C Scarfe, B Azevedo, S Toghyani, A G Farman
Over the last 15 years, cone beam computed tomographic (CBCT) imaging has emerged as an important supplemental radiographic technique for orthodontic diagnosis and treatment planning, especially in situations which require an understanding of the complex anatomic relationships and surrounding structures of the maxillofacial skeleton. CBCT imaging provides unique features and advantages to enhance orthodontic practice over conventional extraoral radiographic imaging. While it is the responsibility of each practitioner to make a decision, in tandem with the patient/family, consensus-derived, evidence-based clinical guidelines are available to assist the clinician in the decision-making process...
March 2017: Australian Dental Journal
https://www.readbyqxmd.com/read/28292594/the-management-of-boys-under-3-months-of-age-with-an-inguinal-hernia-and-ipsilateral-palpable-undescended-testis
#18
Naomi J Wright, Joseph R Davidson, Christina Major, Natalie Durkin, Yew-Wei Tan, Matthew Jobson, Niyi Ade-Ajayi, Nigel J Hall, Nordeen Bouhadiba
AIMS: The optimal management for boys under 3 months of age with an indirect inguinal hernia (IIH) and ipsilateral palpable undescended testis (IPUDT) is unknown. We aimed to: 1) determine the current practice for managing these boys across the UK, and 2) compare outcomes of different treatment strategies. METHODOLOGY: We undertook two studies. Firstly, we completed a National Survey of all surgeons on the British Association of Paediatric Surgeons email list in 2014...
March 6, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28289051/paediatric-early-warning-systems-for-detecting-and-responding-to-clinical-deterioration-in-children-a-systematic-review
#19
Veronica Lambert, Anne Matthews, Rachel MacDonell, John Fitzsimons
OBJECTIVE: To systematically review the available evidence on paediatric early warning systems (PEWS) for use in acute paediatric healthcare settings for the detection of, and timely response to, clinical deterioration in children. METHOD: The electronic databases PubMed, MEDLINE, CINAHL, EMBASE and Cochrane were searched systematically from inception up to August 2016. Eligible studies had to refer to PEWS, inclusive of rapid response systems and teams. Outcomes had to be specific to the identification of and/or response to clinical deterioration in children (including neonates) in paediatric hospital settings (including emergency departments)...
March 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28288531/occupational-therapists-and-physiotherapists-perceptions-of-implementing-occupational-performance-coaching
#20
Fiona Graham, Pauline Boland, Jenny Ziviani, Sylvia Rodger
PURPOSE: Occupational Performance Coaching (OPC) has been proposed as an intervention for working with caregivers towards achievement of goals for themselves and their children. Preliminary studies indicate the effectiveness of OPC; however, translation into practice requires an understanding of therapists' perceptions of applying OPC in their service delivery settings. This study explored physio- and occupational-therapists' experiences of using OPC and their perceptions of the contextual factors which influence its implementation...
March 13, 2017: Disability and Rehabilitation
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