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https://www.readbyqxmd.com/read/28441241/pelvic-inflammatory-disease-in-a-pediatric-emergency-department-epidemiology-and-treatment
#1
Michelle Solomon, Lisa Tuchman, Katie Hayes, Gia Badolato, Monika K Goyal
OBJECTIVES: Most adolescent cases of pelvic inflammatory disease (PID) are diagnosed in the emergency department (ED). An important step to prevent PID-related morbidity among this high-risk population is to quantify prevalence and microbial patterns and identify testing and treatment gaps. METHODS: We performed a retrospective, cross-sectional study of all visits by adolescents to an urban children's ED with an International Classification of Diseases, Ninth Revision, diagnosis of PID in 2012...
April 24, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28441240/emergency-department-management-of-bronchiolitis-in-the-united-states
#2
Constance Gong, Terri Byczkowski, Constance McAneney, Monika K Goyal, Todd A Florin
OBJECTIVE: The aim of this study was to examine differences between general and pediatric emergency departments (PEDs) in adherence to the American Academy of Pediatrics bronchiolitis management guidelines. METHODS: We conducted a nationally representative study of ED visits by infants younger than 24 months with bronchiolitis from 2002 to 2011 using the National Hospital Ambulatory Medical Care Survey. Diagnostic testing (complete blood counts, radiographs) and medication use (albuterol, corticosteroids, antibiotics and intravenous fluids) in general emergency departments (GEDs) were compared with those in PEDs before and after 2006 American Academy of Pediatrics guideline publication...
April 24, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28440913/piperacillin-tazobactam-versus-cefepime-incidence-of-acute-kidney-injury-in-combination-with-vancomycin-and-tobramycin-in-pediatric-cystic-fibrosis-patients
#3
Lisa K LeCleir, Rebecca S Pettit
BACKGROUND: Cystic fibrosis (CF) patients often receive prolonged courses of broad spectrum antibiotics, such as piperacillin-tazobactam or cefepime in combination with vancomycin and tobramycin. The objective of this study was to determine the difference in AKI for pediatric CF patients receiving piperacillin-tazobactam or cefepime in combination with vancomycin and tobramycin. METHODS: IRB approval from a single CF center was obtained for this retrospective cohort study...
April 25, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28439602/antibiogram-profile-of-septic-meningitis-among-children-in-duhok-iraq
#4
Abdulrahman T Saadi, Nadir A Garjees, Aveen H Rasool
  To determine the prevalence of bacteria in the cerebrospinal fluid (CSF), and the antibiogram profile in pediatric patients with suspected meningitis. Methods: This descriptive study was conducted between January 2014 and January 2016 in the Hevi Paediatric Teaching Hospital in Duhok, Iraq. The CSF samples were withdrawn from 432 pediatric patients suspected of meningitis. The samples were cultured, and antibiotic sensitivity tests were performed.  Results: There were 33 (7.6%) culture positive cases among 432 CSF samples...
May 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28436366/analysis-of-preoperative-antibiotic-prophylaxis-in-stented-distal-hypospadias-repair
#5
Jacob Smith, Ashay Patel, Ismael Zamilpa, Shasha Bai, Jeffrey Alliston, Stephen Canon
INTRODUCTION: Surgical site infection [SSI] is a risk for any surgical procedure, including hypospadias repair. Prophylactic antibiotic therapy for patients having surgery is often effective in preventing SSIs, but with increasing rates of antibiotic resistance, this practice has been questioned. The objectives of this study are 1) to assess the incidence of SSIs in patients following stented, distal hypospadias repair and 2) to observe for any potential difference in the incidence of SSIs for patients with and without preoperative antibiotic utilization in this setting...
April 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28433362/effect-of-preadmission-bowel-preparation-on-outcomes-of-elective-colorectal-procedures-in-young-children
#6
Guillermo J Ares, Irene Helenowski, Catherine J Hunter, Marybeth Madonna, Marleta Reynolds, Timothy Lautz
BACKGROUND: The utility of mechanical bowel preparation (MBP) to minimize infectious complications in elective colorectal surgery is contentious. Though data is scarce in children, adult studies suggest a benefit to MBP when administered with oral antibiotics (OAB). METHODS: After IRB approval, the Pediatric Health Information System (PHIS) was queried for young children undergoing elective colon surgery from 2011 to 2014. Patients were divided into: no bowel preparation (Group 1), MBP (Group 2), and MBP plus OAB (Group 3)...
March 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28426273/preclinical-development-of-bcg-hiva-2auxo-int-harboring-an-integrative-expression-vector-for-a-hiv-tb-pediatric-vaccine-enhancement-of-stability-and-specific-hiv-1-t-cell-immunity
#7
Aakash Mahant, Narcís Saubi, Yoshiki Eto, Núria Guitart, Josep M ª Gatell, Tomáš Hanke, Joan Joseph
One of the critical issues that should be addressed in the development of a BCG-based HIV vaccine is genetic plasmid stability. Therefore, to address this issue we have considered using integrative vectors and the auxotrophic mutant of BCG complemented with a plasmid carrying a wild-type complementing gene. In this study, we have constructed an integrative E. coli-mycobacterial shuttle plasmid, p2auxo.HIVA(int), expressing the HIV-1 clade A immunogen HIVA. This shuttle vector employs an antibiotic resistance-free mechanism for plasmid selection and maintenance...
April 20, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/28422948/beyond-the-uterine-environment-nonhuman-primate-model-to-investigate-maternal-fetal-and-neonatal-outcomes-following-chronic-intrauterine-infection
#8
Meredith A Kelleher, Zheng Liu, Xiaojie Wang, Christopher D Kroenke, Lisa A Houser, Brandy L Dozier, Lauren D Martin, Ken B Waites, Cindy McEvoy, Robert L Schelonka, Peta L Grigsby
BACKGROUND: Intrauterine infection is a significant cause of early preterm birth. We have developed a fetal-neonatal model in the rhesus macaque to determine the impact of chronic intrauterine infection with Ureaplasma parvum on early neonatal reflexes and brain development. METHODS: Time-mated, pregnant rhesus macaques were randomized to be inoculated with U. parvum (serovar 1; 10(5)cfu) or control media at ~120 dGA. Neonates were delivered by elective hysterotomy at 135-147 dGA (term=167d) stabilized and cared for in our nonhuman primate neonatal intensive care unit...
April 19, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28420262/impact-of-an-educational-intervention-to-improve-physician-adherence-to-bronchiolitis-clinical-practice-guidelines-a-pre-post-intervention-study
#9
Marquita C Genies, Julia M Kim, Kristina Pyclik, Suzanne Rossi, Natalie Spicyn, Janet R Serwint
Bronchiolitis is the leading cause of infant hospitalizations in the United States. Despite clinical practice guidelines discouraging the utilization of non-evidence-based therapies, there continues to be wide variation in care and resource utilization. A pre-post physician focused educational intervention was conducted with the aims to reduce the use of non-evidence-based medical therapies, including bronchodilators, among patients admitted for bronchiolitis. Among patients meeting inclusion criteria (pre: n = 45; post: n = 47), bronchodilator use decreased by 50% ( P < ...
April 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28419343/utilizing-a-modified-care-coordination-measurement-tool-to-capture-value-for-a-pediatric-outpatient-parenteral-and-prolonged-oral-antibiotic-therapy-program
#10
Louise E Vaz, Cindi L Farnstrom, Kimberly K Felder, Judith Guzman-Cottrill, Hannah Rosenberg, Richard C Antonelli
Background.: Outpatient parenteral or prolonged oral antibiotic therapy (OPAT) programs reduce inpatient healthcare costs by shifting care to outpatient settings. Care coordination (CC) is a necessary component to successfully transition patients. Our objective was to assess outcomes of provider time spent on nonreimbursable CC activities in a pediatric OPAT program. Methods.: We used a qualitative feasibility pilot design and modified the Care Coordination Measurement Tool...
April 17, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28419275/clinical-care-guideline-for-improving-pediatric-acute-musculoskeletal-infection-outcomes
#11
Murray D Spruiell, Justin Benjamin Searns, Travis C Heare, Jesse L Roberts, Erin Wylie, Laura Pyle, Nathan Donaldson, Jaime R Stewart, Heather Heizer, Jennifer Reese, Halden F Scott, Kelly Pearce, Colin J Anderson, Mark Erickson, Sarah K Parker
Background.: Acute pediatric musculoskeletal infections are common, leading to significant use of resources and antimicrobial exposure. In order to decrease variability and improve the quality of care, Children's Hospital Colorado implemented a clinical care guideline (CCG) for these infections. The purpose of this study is to evaluate clinical and resource outcomes PRE and POST this CCG. Methods.: Retrospective chart review evaluated patients admitted to a large pediatric quaternary referral center (CHCO) diagnosed with acute osteomyelitis, septic arthritis, pyomyositis, and/or musculoskeletal abscess prior to and after guideline implementation...
April 17, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28407828/-clinical-features-of-invasive-candidiasis-and-risk-factors-for-candida-bloodstream-infection-in-children-a-multicenter-study-in-urumqi-china
#12
Ai Bi Bai Ai Er Ken, Zhi-Hua Ma, Dai-Qin Xiong, Pei-Ru Xu
OBJECTIVE: To investigate the clinical features of invasive candidiasis in children and the risk factors for Candida bloodstream infection. METHODS: A retrospective study was performed on 134 children with invasive candidiasis and hospitalized in 5 tertiary hospitals in Urumqi, China, between January 2010 and December 2015. The Candida species distribution was investigated. The clinical data were compared between the patients with and without Candida bloodstream infection...
April 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28407067/evaluation-of-a-second-sign-process-for-antimicrobial-prior-authorization
#13
Aimee M Dassner, Jennifer E Girotto
Background.: A second-sign prospective restriction of select broad-spectrum antimicrobials was fully implemented in January 2015 as a pediatric antimicrobial stewardship program (ASP) initiative to help ensure the most appropriate empiric use of ceftaroline, cefepime, fidaxomicin, linezolid, and vancomycin (intravenous). The objective of this evaluation is to assess the effectiveness of a forced second-sign process in the electronic medical record as a pediatric ASP strategy. We anticipated that the second-sign process for antibiotics would increase the appropriateness of empiric antibiotic use, as defined by preapproved criteria, clinical pathways, national guidelines, and pediatric-specific infectious diseases reference texts, while not causing significant delay in the initial administration of antibiotic therapy...
April 12, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28405061/emergency-department-discharge-prescription-errors-in-an-academic-medical-center
#14
Kelly A Murray, April Belanger, Lauren T Devine, Aaron Lane, Michelle E Condren
This study described discharge prescription medication errors written for emergency department patients. This study used content analysis in a cross-sectional design to systematically categorize prescription errors found in a report of 1000 discharge prescriptions submitted in the electronic medical record in February 2015. Two pharmacy team members reviewed the discharge prescription list for errors. Open-ended data were coded by an additional rater for agreement on coding categories. Coding was based upon majority rule...
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28399047/assessing-quality-and-safety-in-pediatric-supracondylar-humerus-fracture-care
#15
Christopher A Iobst, Matthew Stillwagon, Deidre Ryan, Eric Shirley, Steven L Frick
BACKGROUND: Recently, there has been an emphasis on improving quality, safety, and value in the delivery of health care in the United States. The American Board of Orthopedic Surgery (ABOS) has developed a performance improvement questionnaire (PIQ) for orthopaedic surgeons managing pediatric supracondylar humerus fracture (PSCHF). Using the supracondylar PIQ as a guide, this study evaluates the process of measuring the outcomes and variations in care to PSCHF patients among pediatric orthopaedic surgeons...
April 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28397171/pediatric-antibiotic-stewardship-successful-interventions-to-reduce-broad-spectrum-antibiotic-use-on-general-pediatric-wards
#16
Katharina Kreitmeyr, Ulrich von Both, Alenka Pecar, Johannes P Borde, Rafael Mikolajczyk, Johannes Huebner
PURPOSE: Antibiotic stewardship programs (ASP) optimize antibiotic usage and combat antibiotic resistance of bacteria. The objective of this study was to assess the impact of specific ASP interventions on antibiotic consumption in general pediatric wards. METHODS: We conducted a prospective study to compare a pre-intervention (Sept.-Dec. 2014) and post-intervention (Sept.-Dec. 2015) period. An ASP bundle was established including (1) infectious diseases (ID) ward rounds (prospective-audit-with-feedback), (2) ID consultation service, (3) internal guidelines on empiric antibiotic therapy...
April 10, 2017: Infection
https://www.readbyqxmd.com/read/28396027/risk-factors-for-community-associated-clostridium-difficile-infection-in-children
#17
Daniel J Adams, Matthew D Eberly, Michael Rajnik, Cade M Nylund
OBJECTIVE: To characterize the medication and other exposures associated with pediatric community-associated Clostridium difficile infections (CA-CDIs). STUDY DESIGN: We performed a case-control study using billing records from the US military health system database. CA-CDI cases included children 1-18 years of age with an outpatient International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic code for Clostridium difficile infection (CDI) from 2001 to 2013...
April 7, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28393062/the-likelihood-of-preventing-respiratory-exacerbations-in-children-and-adolescents-with-either-chronic-suppurative-lung-disease-or-bronchiectasis
#18
REVIEW
Kerry-Ann F O'Grady, Keith Grimwood
Chronic suppurative lung disease (CSLD) and bronchiectasis in children and adolescents are important causes of respiratory morbidity and reduced quality of life (QoL), also leading to subsequent premature death during adulthood. Acute respiratory exacerbations in pediatric CSLD and bronchiectasis are important markers of disease control clinically, given that they impact upon QoL and increase health-care-associated costs and can adversely affect future lung functioning. Preventing exacerbations in this population is, therefore, likely to have significant individual, familial, societal, and health-sector benefits...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28377653/clinical-and-radiological-evaluation-of-turmeric-powder-as-a-pulpotomy-medicament-in-primary-teeth-an-in-vivo-study
#19
Rajiv N Purohit, Manohar Bhatt, Kanchan Purohit, Jitendra Acharya, Rajesh Kumar, Rakesh Garg
Many plants with biological and antimicrobiological properties have been studied since there has been a relevant increase in the incidence of antibiotic overuse and misuse. In dentistry, phytomedicines have been used as anti-inflammatory, antibiotic, analgesic, and sedative agents. Turmeric is used extensively in foods for its flavor and color, as well as having a long tradition of use in the Chinese and Ayurvedic systems of medicine, particularly as an anti-inflammatory and for the treatment of flatulence, jaundice, menstrual difficulties, hematuria, hemorrhage, and colic...
January 2017: International Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/28376809/molecular-characterization-of-penicillin-non-susceptible-streptococcus-pneumoniae-isolated-before-and-after-pneumococcal-conjugate-vaccine-implementation-in-casablanca-morocco
#20
Idrissa Diawara, Abouddihaj Barguigua, Khalid Katfy, Kaotar Nayme, Houria Belabbes, Mohammed Timinouni, Khalid Zerouali, Naima Elmdaghri
BACKGROUND: Streptococcus pneumoniae is a major cause of morbidity and mortality worldwide, especially among children and the elderly. The ability to effectively treat pneumococcal infection has been compromised due to the acquisition of antibiotic resistance, particularly to β-lactam drugs. This study aimed to describe the prevalence and molecular evolution of penicillin non-susceptible S. pneumoniae (PNSP) isolated from invasive diseases before and after pneumococcal conjugate vaccine implementation in Casablanca, Morocco...
April 4, 2017: Annals of Clinical Microbiology and Antimicrobials
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