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Paediatric Emergency

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https://www.readbyqxmd.com/read/28924282/overcrowding-and-possible-solutions-for-a-busy-paediatric-emergency-department
#1
Muhammad Irfan Habib, Khalid Mehmood Khan
OBJECTIVE: To quantify the extent of emergency department overcrowding in a tertiary care hospital and to identify possible solutions. METHODS: This retrospective study was conducted at the National Institute of Child Health, Karachi, and comprised data of all patients presenting to the emergency department from November 2014 to January 2015. Data was collected through the health management information system which generates daily report of patients. Patients who stayed at the emergency department for 4 or more hours were included...
September 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28921622/national-survey-on-managing-minor-childhood-traumatic-head-injuries-in-the-netherlands-shows-low-guideline-adherence-and-large-inter-hospital-variations
#2
Nicky Niele, Lonneke Willemars, Marlies van Houten, Frans B Plötz
More than 12,000 children are seen in Dutch emergency departments with a mild traumatic head injury (MTHI) every year. In The Netherlands, the paediatric MTHI guidelines are primarily based on the Pediatric Emergency Care Applied Research Network study (1). The guidelines define several criteria, based on the patient's age, to help clinicians to decide whether they need to perform a computed tomography (CT) scan (2). This national study determined the adherence to the guidelines and the reasons why clinicians deviated from them...
September 16, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28920511/a-feasibility-study-of-working-memory-training-for-individuals-with-paediatric-onset-multiple-sclerosis
#3
Christine Till, Bravina Kuni, Elisea De Somma, E Ann Yeh, Brenda Banwell
OBJECTIVE: To investigate the feasibility and experiences of paediatric-onset multiple sclerosis (MS) patients completing a working memory training programme. METHODS: Nine paediatric-onset MS patients (mean age 19.3 ± 4.1 years) identified as having attention and/or working memory difficulties underwent a five-week (five days/week) internet-based working memory training programme (Cogmed™); weekly coaching was provided. Measures of adherence and tolerance were used to establish the feasibility of implementing computerised cognitive training...
September 18, 2017: Neuropsychological Rehabilitation
https://www.readbyqxmd.com/read/28913912/streptococcus-pneumoniae-colonization-of-the-nasopharynx-is-associated-with-increased-severity-during-respiratory-syncytial-virus-infection-in-young-children
#4
Jaelle C Brealey, Keith J Chappell, Sally Galbraith, Emmanuelle Fantino, Jane Gaydon, Sarah Tozer, Paul R Young, Patrick G Holt, Peter D Sly
BACKGROUND AND OBJECTIVE: Respiratory syncytial virus (RSV) is the most significant cause of acute respiratory infection (ARI) in early life. RSV and other respiratory viruses are known to stimulate substantial outgrowth of potentially pathogenic bacteria in the upper airways of young children. However, the clinical significance of interactions between viruses and bacteria is currently unclear. The present study aimed to clarify the effect of viral and bacterial co-detections on disease severity during paediatric ARI...
September 15, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28912964/is-the-south-african-triage-scale-valid-for-use-in-afghanistan-haiti-and-sierra-leone
#5
Mohammed Dalwai, Pola Valles, Michele Twomey, Yvonne Nzomukunda, Prince Jonjo, Manoj Sasikumar, Masood Nasim, Abdul Razaaq, Olivia Gayraud, Pierre Ronald Jecrois, Lee Wallis, Katie Tayler-Smith
OBJECTIVE: To assess the validity of the South African Triage Scale (SATS) in four Médecins Sans Frontières (MSF)-supported emergency departments (ED, two trauma-only sites, one mixed site (both medical and trauma cases) and one paediatric-only site) in Afghanistan, Haiti and Sierra Leone. METHODS: This was a retrospective cohort study conducted between June 2013 and June 2014. Validity was assessed by comparing patients' SATS ratings with their final ED outcome (ie, hospital admission, death or discharge)...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/28912165/holistic-care-of-complicated-tuberculosis-in-healthcare-settings-with-limited-resources
#6
Trevor Duke, Sharon Kasa Tom, Harry Poka, Henry Welch
In recent years, most of the focus on improving the quality of paediatric care in low-income countries has been on improving primary care using the Integrated Management of Childhood Illness, and improving triage and emergency treatment in hospitals aimed at reducing deaths in the first 24 hours. There has been little attention paid to improving the quality of care for children with chronic or complex diseases. Children with complicated forms of tuberculosis (TB), including central nervous system and chronic pulmonary TB, provide examples of acute and chronic multisystem paediatric illnesses that commonly present to district-level and second-level referral hospitals in low-income countries...
September 14, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28904637/the-emerging-trend-of-non-operative-treatment-in-paediatric-type-i-open-forearm-fractures
#7
REVIEW
H Zhang, M Fanelli, C Adams, J Graham, M Seeley
PURPOSE: Open fractures are considered an orthopaedic emergency and are generally an indication for operative debridement. Recent studies have questioned this approach for the management of Gustilo-Anderson Type I open fractures in the paediatric population. This meta-analysis studies the non-operative management of Type I open paediatric forearm fractures. METHODS: An Ovid MEDLINE and PubMed database literature search was performed for studies that involved a quantified number of Gustilo-Anderson Type I open forearm fractures in the paediatric population, which were treated without operative intervention...
August 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28901726/antimicrobial-stewardship-in-paediatric-oncology-impact-on-optimising-gentamicin-use-in-febrile-neutropenia
#8
Stefanie Hennig, Christine E Staatz, Daniel Natanek, Sabina Bialkowski, Carolina Consuelo Llanos Paez, Rachael Lawson, Julia Clark
OBJECTIVES: To evaluate the impact of an antimicrobial stewardship (AMS) intervention, involving introduction of new guidelines on the treatment of febrile neutropenia (FN), on improving the use of gentamicin in paediatric oncology patients. DESIGN AND INTERVENTION: Updated guidelines for gentamicin usage in paediatrics with FN were implemented at a tertiary children's teaching hospital, in Brisbane, Australia. Data on gentamicin usage before and after the guideline change were collected retrospectively from children with cancer admitted to hospital with FN between January 2012 and December 2013...
September 13, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28899311/australian-national-enterovirus-reference-laboratory-annual-report-2014
#9
Jason Roberts, Linda Hobday, Aishah Ibrahim, Thomas Aitken, Bruce Thorley
Following the World Health Organization (WHO) recommendation, Australia conducts surveillance for cases of acute flaccid paralysis (AFP) in children less than 15 years of age as the main method to monitor its polio-free status. Cases of AFP in children are notified to the Australian Paediatric Surveillance Unit or the Paediatric Active Enhanced Disease Surveillance System and faecal specimens are referred for virological investigation to the National Enterovirus Reference Laboratory. In 2014, no cases of poliomyelitis were reported from clinical surveillance and Australia reported 1...
June 30, 2017: Communicable Diseases Intelligence Quarterly Report
https://www.readbyqxmd.com/read/28898506/physical-activity-may-decrease-the-likelihood-of-children-developing-constipation
#10
Sandra Seidenfaden, Orri Thor Ormarsson, Sigrun H Lund, Einar S Bjornsson
AIM: Childhood constipation is common. We evaluated children diagnosed with constipation, who were referred to an Icelandic paediatric emergency department, and determined the effect of lifestyle factors on its aetiology. METHODS: The parents of children who were diagnosed with constipation and participated in a phase IIB clinical trial on laxative suppositories answered an online questionnaire about their children's lifestyle and constipation in March-April 2013...
September 12, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28886882/insights-into-defective-serological-memory-after-acute-lymphoblastic-leukaemia-treatment-the-role-of-the-plasma-cell-survival-niche-memory-b-cells-and-gut-microbiota-in-vaccine-responses
#11
REVIEW
Shanie Saghafian-Hedengren, Ismael Söderström, Eva Sverremark-Ekström, Anna Nilsson
Acute lymphoblastic leukaemia (ALL) is the most common type of cancer in children, accounting for approximately 25% of childhood cancer cases. As a result of effective treatments over the past decades, paediatric ALL mortality has been greatly reduced. Chemotherapy, however, has a range of harmful side effects including the loss of protective antibodies against vaccine-preventable diseases. Since ALL survivors have an increased risk of health problems including organ insufficiencies, acquired vaccine-preventable infections subsequent to clinical remission could become life threatening to these individuals...
August 26, 2017: Blood Reviews
https://www.readbyqxmd.com/read/28886038/diagnoses-infections-and-injuries-in-northern-syrian-children-during-the-civil-war-a-cross-sectional-study
#12
Gerlant van Berlaer, Abdallah Mohamed Elsafti, Mohammad Al Safadi, Saad Souhil Saeed, Ronald Buyl, Michel Debacker, Atef Redwan, Ives Hubloue
BACKGROUND: The civil war in Syria including the deliberate targeting of healthcare services resulted in a complex humanitarian emergency, seriously affecting children's health. The objectives of this study are to document diagnoses and disease categories in Northern Syrian children after four years of conflict, and to document infectious diseases and injuries in this vulnerable population. METHODS: In a prospective cross-sectional observational sample study conducted in May 2015, healthcare workers registered demographics, comorbidities, and diagnoses (categorised according to the International Classification of Diseases version 10) in children visited at home and in internally displaced persons camps in four Syrian governorates...
2017: PloS One
https://www.readbyqxmd.com/read/28881007/delayed-antibiotic-prescriptions-for-respiratory-infections
#13
REVIEW
Geoffrey Kp Spurling, Chris B Del Mar, Liz Dooley, Ruth Foxlee, Rebecca Farley
BACKGROUND: Concerns exist regarding antibiotic prescribing for respiratory tract infections (RTIs) owing to adverse reactions, cost, and antibacterial resistance. One proposed strategy to reduce antibiotic prescribing is to provide prescriptions, but to advise delay in antibiotic use with the expectation that symptoms will resolve first. This is an update of a Cochrane Review originally published in 2007, and updated in 2010 and 2013. OBJECTIVES: To evaluate the effects on clinical outcomes, antibiotic use, antibiotic resistance, and patient satisfaction of advising a delayed prescription of antibiotics in respiratory tract infections...
September 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28876149/acute-post-concussive-symptoms-in-young-children
#14
Coco Bernard, Audrey McKinlay, David Krieser, Renee Testa, And Jennie Ponsford
OBJECTIVES: Despite peaks of mild traumatic brain injury (mTBI) incidence in young children, few studies have examined the nature of post-concussive symptoms (PCSs) in children under the age of eight, whilst controlling for pre-injury symptoms and effects of trauma. The current study aimed to identify which PCSs differentiate children with mTBI from trauma controls early post-injury, and whether these differed among preschool and school-aged children. METHODS: The sample comprised 101 children aged 2-12 presenting to an emergency department, with concussion or other minor bodily injury (control)...
September 6, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28868733/national-study-of-parental-confidence-in-general-practitioners
#15
Gary L Freed, Neil Spike, Jonathan O'Hara, Harriet Hiscock, Anthea L Rhodes
AIM: To assess a national sample of Australian parental confidence in general practitioner (GP) care for illness and injury for their children. METHODS: Cross-sectional, internet-based survey of a national, representative sample of parents of children birth - 17 years in Australia was used. Purposeful recruitment was used to achieve a national, representative sample of 2100 Australian parents, reflective of demographic and geographic distribution based on census data...
September 3, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28867793/diet-gut-microbiome-and-epigenetics-emerging-links-with-inflammatory-bowel-diseases-and-prospects-for-management-and-prevention
#16
REVIEW
Krasimira Aleksandrova, Beatriz Romero-Mosquera, Vicent Hernandez
Inflammatory bowel diseases (IBD) represent a growing public health concern due to increasing incidence worldwide. The current notion on the pathogenesis of IBD is that genetically susceptible individuals develop intolerance to dysregulated gut microflora (dysbiosis) and chronic inflammation develops as a result of environmental triggers. Among the environmental factors associated with IBD, diet plays an important role in modulating the gut microbiome, influencing epigenetic changes, and, therefore, could be applied as a therapeutic tool to improve the disease course...
August 30, 2017: Nutrients
https://www.readbyqxmd.com/read/28867331/reference-ranges-for-serum-s100b-neuroprotein-specific-to-infants-under-four-months-of-age
#17
Jeanne Simon-Pimmel, Fleur Lorton, Damien Masson, Damien Bouvier, Matthieu Hanf, Christèle Gras-Le Guen
BACKGROUND: Minor head traumatisms are a common reason for consultation in paediatric emergency departments. The diagnosis of traumatic brain injuries involves performing a cranial computed tomography (CCT), associated with a risk of cancer due to the radiation. The serum S100B is an effective biomarker used to reduce reliance on CCT. While reference ranges have been determined, the limited number of cases regarding infants less than 4months of age has not allowed this biomarker to be used with this age group...
September 1, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28856440/the-impact-of-the-introduction-of-pecarn-head-ct-rules-on-the-utilisation-of-head-ct-scans-in-a-private-tertiary-hospital-in-sub-saharan-africa
#18
Isaac O Kobe, Mahmoud M Qureshi, Saidi Hassan, David L Oluoch-Olunya
BACKGROUND: The decision to order head CT scans to rule out clinically significant traumatic brain injury in mild head injury in children is made on the basis of clinical decision rules of which the Paediatric Emergency Care Applied Research Network (PECARN) CT head rules have been found to be most sensitive. PURPOSES: The purpose of this study is to determine the proportion of head CT scans done for children with mild head injury and to determine disposition of patients from casualty after the introduction of PECARN head CT rules compared to the period before...
August 30, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28855237/predict-prioritisation-study-establishing-the-research-priorities-of-paediatric-emergency-medicine-physicians-in-australia-and-new-zealand
#19
Heather Carol Deane, Catherine L Wilson, Franz E Babl, Stuart R Dalziel, John Alexander Cheek, Simon S Craig, Ed Oakley, Meredith Borland, Nicholas G Cheng, Michael Zhang, Elizabeth Cotterell, Tibor Schuster, David Krieser
BACKGROUND: The Paediatric Research in Emergency Departments International Collaborative (PREDICT) performs multicentre research in Australia and New Zealand. Research priorities are difficult to determine, often relying on individual interests or prior work. OBJECTIVE: To identify the research priorities of paediatric emergency medicine (PEM) specialists working in Australia and New Zealand. METHODS: Online surveys were administered in a two-stage, modified Delphi study...
August 30, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28853599/pyomyositis-of-the-pectineus-muscle-in-an-adolescent-male
#20
J Hiddema, S Hassan, N Mangat, N Siddiqui
The 'irritable hip' continues to pose a challenge for clinicians. Even with predictive clinical algorithms, decision making can be difficult. Emergency treatment is required if septic arthritis is suspected. Other differential diagnoses such as transient synovitis, pyomyositis of the pelvic girdle muscles and osteomyelitis must be considered in order to help guide appropriate investigations and allow early treatment. We report the case of a 13-year-old boy presenting to our institution with an acutely painful left hip but still able to weight bear...
September 2017: Annals of the Royal College of Surgeons of England
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