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https://www.readbyqxmd.com/read/28220574/selective-use-of-the-electrocardiogram-in-pediatric-preparticipation-athletic-examinations-among-pediatric-primary-care-providers
#1
Bradley C Clark, Joshua M Hayman, Charles I Berul, Kristin M Burns, Jonathan R Kaltman
OBJECTIVES: Recent literature examining insurance administrative data suggests that a selective approach, with concurrent history and physical exam (H&P), for obtaining an electrocardiogram (ECG) as a part of a preparticipation examination (PPE) for pediatric athletes is commonly used in the primary care setting demonstrating a high rate of disease detection. We sought to understand practice patterns of providers with regard to usage of ECG as a part of PPE. METHODS: Utilizing an online survey, we queried primary care providers regarding their practice patterns, rationale, and concerns regarding use of ECGs as a part of the PPE...
February 21, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28213995/thoracoscopic-division-of-vascular-rings
#2
Kevin M Riggle, Samuel E Rice-Townsend, John Ht Waldhausen
BACKGROUND/PURPOSE: Vascular rings are traditionally treated via an open thoracotomy. In recent years the use of thoracoscopy has increased. Herein we report our experience with thoracoscopic division of vascular rings in pediatric patients. METHODS: We reviewed all patients who underwent thoracoscopic or open division of a vascular ring at our institution between 2007 and 2015. We analyzed patient demographics, presenting symptoms, diagnostic imaging modality, ring anatomy, operative details, complications, and symptom resolution...
February 2, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28212655/elderly-onset-hereditary-pulmonary-alveolar-proteinosis-and-its-cytokine-profile
#3
Masayuki Ito, Kazuyuki Nakagome, Hiromitsu Ohta, Keiichi Akasaka, Yoshitaka Uchida, Atsushi Hashimoto, Ayako Shiono, Toshinori Takada, Makoto Nagata, Jun Tohyama, Koichi Hagiwara, Minoru Kanazawa, Koh Nakata, Ryushi Tazawa
BACKGROUND: Pulmonary alveolar proteinosis (PAP) is a rare lung disease characterized by surfactant accumulation, and is caused by disruption of granulocyte/macrophage colony-stimulating factor (GM-CSF) signaling. Abnormalities in CSF2 receptor alpha (CSF2RA) were reported to cause pediatric hereditary PAP. We report here the first case of CSF2RA-mutated, elderly-onset hereditary (h) PAP. CASE PRESENTATION: The patient developed dyspnea on exertion, and was diagnosed with PAP at the age of 77 years, based on findings from chest computed tomography scan and bronchoalveolar lavage...
February 17, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28212059/pediatric-chest-ct-diagnostic-reference-ranges-development-and-application
#4
Keith J Strauss, Marilyn J Goske, Alexander J Towbin, Debapriya Sengupta, Michael J Callahan, Kassa Darge, Daniel J Podberesky, Donald P Frush, Charles Maxfield, Sjirk J Westra, Jeffrey S Prince, Huimin Wu, Mythreyi Bhargavan-Chatfield
Purpose To determine diagnostic reference ranges on the basis of the size of a pediatric patient's chest and to develop a method to estimate computed tomographic (CT) scanner-specific mean size-specific dose estimates (SSDEs) as a function of patient size and the radiation output of each CT scanner at a site. Materials and Methods The institutional review boards of each center approved this retrospective, HIPAA-compliant, multicenter study; informed consent was waived. CT dose indexes (SSDE, volume CT dose index, and dose length product) of 518 pediatric patients (mean age, 9...
February 17, 2017: Radiology
https://www.readbyqxmd.com/read/28205035/serial-improvement-of-quality-metrics-in-pediatric-thoracoscopic-lobectomy-for-congenital-lung-malformation-an-analysis-of-learning-curve
#5
Samina Park, Eung Re Kim, Yoohwa Hwang, Hyun Joo Lee, In Kyu Park, Young Tae Kim, Chang Hyun Kang
Video-assisted thoracic surgery (VATS) pulmonary resection in children is a technically demanding procedure that requires a relatively long learning period. This study aimed to evaluate the serial improvement of quality metrics according to case volume experience in pediatric VATS pulmonary resection of congenital lung malformation (CLM). Methods VATS anatomical resection in CLM was attempted in 200 consecutive patients. The learning curve for the operative time was modeled by cumulative sum analysis. Quality metrics were used to measure technical achievement and efficiency outcomes...
February 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28202294/point-of-care-lung-ultrasound-in-children-with-community-acquired-pneumonia
#6
Hayri Levent Yilmaz, Ahmet Kağan Özkaya, Sinem Sarı Gökay, Özlem Tolu Kendir, Hande Şenol
OBJECTIVES: To present lung ultrasound findings in children assessed with suspected pneumonia in the emergency department and to show the benefit of lung ultrasound in diagnosing pneumonia in comparison with chest X-rays. METHODS: This observational prospective study was performed in the pediatric emergency department of a single center. Point of care lung ultrasound was performed on each child by an independent sonographer blinded to the patient's clinical and chest X-ray findings...
February 1, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28198527/coexistence-of-bicuspid-aortic-valve-aberrant-right-subclavian-artery-and-common-origin-of-carotid-arteries
#7
Paweł Tyczyński, Ilona Michałowska, Aneta Fronczak, Rafał Wolny, Hubert Łazarczyk, Zbigniew Chmielak, Adam Witkowski
BACKGROUND: Prevalence of bicuspid aortic valve (BAV) and right aberrant subclavian artery (ASA) separately is relatively common in general population, and much higher in some disorders. Surprisingly, coexistence of both valve and vessel anomalies has only been reported in single cases. METHODS: From 2008 to 2016, in a single, high-volume tertiary cardiac center, patients who underwent chest computed tomography or magnetic resonance imaging for various reasons, were retrospectively screened for the presence of right ASA...
February 15, 2017: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/28187061/bronchopulmonary-disease-caused-by-flagellated-protozoa-infection-in-15-chinese-children
#8
Jinrong Liu, Shaogang Li, Huimin Li, Yimu Fan, Haiming Yang, Hui Xu, Yuelin Shen, Shunying Zhao
BACKGROUND: Bronchopulmonary disease caused by flagellated protozoa infection (BPFP) is thought to be rare in children but may be an emerging or underestimated disease, especially in developing countries. METHODS: In this study, we retrospectively reviewed records of 15 patients who presented with a cough, wheezing, or bronchopulmonary disease of unknown causes at admission and were finally diagnosed with BPFP from January 2014 to January 2015 were enrolled. Protozoa were observed in bronchoalveolar lavage fluid by light microscopy...
December 13, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28186860/traumatic-rib-injury-patterns-imaging-pitfalls-complications-and-treatment
#9
Brett S Talbot, Christopher P Gange, Apeksha Chaturvedi, Nina Klionsky, Susan K Hobbs, Abhishek Chaturvedi
The ribs are frequently affected by blunt or penetrating injury to the thorax. In the emergency department setting, it is vital for the interpreting radiologist to not only identify the presence of rib injuries but also alert the clinician about organ-specific injury, specific traumatic patterns, and acute rib trauma complications that require emergent attention. Rib injuries can be separated into specific morphologic fracture patterns that include stress, buckle, nondisplaced, displaced, segmental, and pathologic fractures...
February 10, 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28186477/bilateral-sagittal-split-mandibular-osteotomies-for-enhanced-exposure-of-the-anterior-cervical-spine-in-children-technical-note
#10
Michael Karsy, Neal Moores, Faizi Siddiqi, Douglas L Brockmeyer, Robert J Bollo
The bilateral sagittal split mandibular osteotomy (BSSMO), a common maxillofacial technique for expanding the oropharynx during treatment of micrognathia, is a rarely employed but useful adjunct to improve surgical access to the ventral cervical spine in children. Specifically, it provides enhanced exposure of the craniocervical junction in the context of midface hypoplasia, and of the subaxial cervical spine in children with severe kyphosis. The authors describe their technique for BSSMO and evaluate long-term outcomes in patients...
February 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28165669/non-invasive-ct-screening-for-pulmonary-arteriovenous-malformations-in-children-with-confirmed-hereditary-hemorrhagic-telangiectasia-results-from-two-pediatric-centers
#11
Nurcan Soysal, Mélanie Eyries, Suzanne Verlhac, Virginie Escabasse, Natascha Remus, Aline Tamalet, Jean-Yves Rioux, Stéphanie Franchi-Abella, Manuela Vasile, Sarah Robert, Céline Delestrain, Isabelle Hau, Hubert Ducou-Le Pointe, Florent Soubrier, Marie-France Carette, Ralph Epaud
BACKGROUND: Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant genetic disorder that is caused by mutations in mainly two genes, that is ENG, encoding endoglin (HHT1), or ACVRL1, encoding activin receptor-like kinase 1 (ALK-1/HHT2). HHT is characterized by recurrent epistaxis, mucocutaneous telangiectasia, and vascular visceral dysplasia responsible for visceral arteriovenous malformations (AVM). AIM: to report the experience of two university hospitals (Trousseau, Paris, and CHIC, Creteil) with screening children for HHT and pulmonary AVM (PAVM) using high resolution computed tomography (HRCT)...
February 6, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28165347/google-glass-for-residents-dealing-with-pediatric-cardiopulmonary-arrest-a-randomized-controlled-simulation-based-study
#12
David Drummond, Cécile Arnaud, Romain Guedj, Alexandre Duguet, Nathalie de Suremain, Arnaud Petit
OBJECTIVES: To determine whether real-time video communication between the first responder and a remote intensivist via Google Glass improves the management of a simulated in-hospital pediatric cardiopulmonary arrest before the arrival of the ICU team. DESIGN: Randomized controlled study. SETTING: Children's hospital at a tertiary care academic medical center. SUBJECTS: Forty-two first-year pediatric residents. INTERVENTIONS: Pediatric residents were evaluated during two consecutive simulated pediatric cardiopulmonary arrests with a high-fidelity manikin...
February 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28157836/continuous-capnography-monitoring-during-resuscitation-in-a-transitional-large-mammalian-model-of-asphyxial-cardiac-arrest
#13
Praveen Chandrasekharan, Payam Vali, Munmun Rawat, Bobby Mathew, Sylvia F Gugino, Carmon Koenigschnekt, Justin Helman, Jayasree Nair, Sara Berkelhamer, Satyan Lakshminrusimha
BACKGROUND: In neonates requiring chest compression (CC) during resuscitation, neonatal resuscitation program (NRP) recommends against relying on a single feedback device such as end-tidal carbon dioxide (ETCO2) or SpO2 to determine return of spontaneous circulation (ROSC) until more evidence becomes available. METHODS: We evaluated the role of monitoring ETCO2 during resuscitation in a lamb model of cardiac arrest induced by umbilical cord occlusion (n=21). Lambs were resuscitated as per NRP guidelines...
February 3, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28157808/improved-clinical-performance-and-teamwork-of-pediatric-interprofessional-resuscitation-teams-with-a-simulation-based-educational-intervention
#14
Elaine Gilfoyle, Deanna A Koot, John C Annear, Farhan Bhanji, Adam Cheng, Jonathan P Duff, Vincent J Grant, Cecilia E St George-Hyslop, Nicole J Delaloye, Afrothite Kotsakis, Carolyn D McCoy, Christa E Ramsay, Matthew J Weiss, Ronald D Gottesman
OBJECTIVES: To measure the effect of a 1-day team training course for pediatric interprofessional resuscitation team members on adherence to Pediatric Advanced Life Support guidelines, team efficiency, and teamwork in a simulated clinical environment. DESIGN: Multicenter prospective interventional study. SETTING: Four tertiary-care children's hospitals in Canada from June 2011 to January 2015. SUBJECTS: Interprofessional pediatric resuscitation teams including resident physicians, ICU nurse practitioners, registered nurses, and registered respiratory therapists (n = 300; 51 teams)...
February 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28146440/sudden-collapse-of-a-preschool-aged-child-on-the-playground
#15
RoseAnn L Scheller, Laurie H Johnson, Michelle C Caruso, Angela Lorts
PURPOSE: Primary cardiac events are rare in children. There is little information in the literature regarding the most appropriate emergency department (ED) management of this type of pediatric patient, especially with regard to medication use. SUMMARY: This case highlights the pediatric ED evaluation and treatment of sudden collapse in a child with an ultimate diagnosis of hypertrophic cardiomyopathy. Cardiac disorders represent 2% to 6% of cases of pediatric syncope presenting to EDs, particularly if there are previous prodromal symptoms and/or a history of exertion...
February 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28141852/imaging-of-pediatric-great-vessel-stents-computed-tomography-or-magnetic-resonance-imaging
#16
A M den Harder, D Suchá, R W van Hamersvelt, R P J Budde, P A de Jong, A M R Schilham, C Bos, J M P J Breur, T Leiner
BACKGROUND: Complications might occur after great vessel stent implantation in children. Therefore follow-up using imaging is warranted. PURPOSE: To determine the optimal imaging modality for the assessment of stents used to treat great vessel obstructions in children. MATERIAL AND METHODS: Five different large vessel stents were evaluated in an in-vitro setting. All stents were expanded to the maximal vendor recommended diameter (20mm; n = 4 or 10mm; n = 1), placed in an anthropomorphic chest phantom and imaged with a 256-slice CT-scanner...
2017: PloS One
https://www.readbyqxmd.com/read/28141730/-footprints-in-the-bathroom-the-role-of-spirituality-in-patient-diagnosis
#17
Veronica Meneses, Douglas Vanderbilt, Linda Barnes, Marilyn Augustyn
Lucy is a 12-year-old Latina whose mother brought her to the pediatric clinic for help with her anxiety symptoms, "hearing voices," and episodes of "spacing out." Lucy did not cry at birth secondary to vocal cord paralysis and still has the tracheostomy performed at a few days of life. In addition to her neonatal intensive care unit stay, she has been hospitalized for pneumonia. Her mother says she is "sickly" and has a weak immune system due to her asthma symptoms. Lucy also experiences somatic complaints related to gastroesophageal reflux and constipation...
February 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28141725/acute-agitation-and-self-injury-in-a-5-year-old-with-autism
#18
Jason Schweitzer, Christine James, Willough Jenkins, Michael I Reiff, Martin T Stein
A 5-year-old nonverbal child with autism spectrum disorder (ASD) was admitted to inpatient pediatrics with new onset agitation and self-injurious behavior. His parents described him as a pleasant child without previous episodes of self-injury. Four days before admission, the parents noted new irritability followed by 2 days of self-injury to the face without clear precipitant. His hitting intensified with closed fist to face, and he required parental physical restraint to prevent further injury. Car rides and ibuprofen provided only temporary relief...
February 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28141606/an-unusual-case-of-chest-pain-in-an-adolescent-male-important-cues-to-differential-diagnosis
#19
Kathleen S Jordan, Sarah E Mannle
Chest pain is a common presenting symptom in the pediatric population, and in contrast to adults, the etiology is rarely cardiac or life-threatening. The majority of chest pain complaints in children and adolescents are benign and can be managed with reassurance and follow-up. The emergency care provider must obtain a comprehensive history and physical examination, as the differential diagnosis of pediatric chest pain is extensive and serious underlying organic pathology may be present. This article describes the case of an adolescent male with an unusual case of chest pain with a serious underlying medical condition...
January 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/28134745/the-risk-of-m-tuberculosis-transmission-from-pediatric-index-cases-to-school-pupils
#20
Paola Piccini, Elisabetta Venturini, Leila Bianchi, Simonetta Baretti, Paolo Filidei, Luana Paliaga, Franca Mazzoli, Elena Chiappini, Maurizio de Martino, Luisa Galli
This study is the largest report on M. tuberculosis transmission rate (TR) from children with pulmonary tuberculosis to school pupils. Higher TR (around 21.6%) was observed in contacts of smear-positive children. TR from pediatric smear-negative index cases was around 0. If our data are confirmed, school contacts of a smear-negative index case could be screened only by clinical evaluation and TST, avoiding routine use of chest radiographs in children less than 5 years of age as well.
January 26, 2017: Pediatric Infectious Disease Journal
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