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https://www.readbyqxmd.com/read/28550188/recommendations-for-splenectomy-in-hereditary-hemolytic-anemias
#1
Achille Iolascon, Immacolata Andolfo, Wilma Barcellini, Francesco Corcione, Loïc Garçon, Lucia De Franceschi, Claudio Pignata, Giovanna Graziadei, Dagmar Pospisilova, David C Rees, Mariane de Montalembert, Stefano Rivella, Antonella Gambale, Roberta Russo, Leticia Ribeiro, Jules Vives-Corrons, Patricia Aguilar-Martinez, Antonis Kattamis, Beatrice Gulbis, Maria Domenica Cappellini, Irene Roberts, Hannah Tamary
Hereditary hemolytic anemias are a group of disorders including red cell membrane defects, red blood cells enzyme disorders, congenital dyserythropoietic anemias, thalassemia syndromes and haemoglobinopathies. As damaged red blood cells passing through the spleen red pulp are efficiently removed by splenic macrophages, splenectomy is one possible therapeutic approach to the management of severely affected patients. However, except for hereditary spherocytosis for which the effectiveness of splenectomy has been well documented, the efficacy of splenectomy in other anemias within this group has yet to be determined and there are concerns regarding short- and long-term infectious and thrombotic complications...
May 26, 2017: Haematologica
https://www.readbyqxmd.com/read/28549669/the-iscreen-electronic-diabetes-dashboard-a-tool-to-improve-knowledge-and-implementation-of-clinical-practice-guidelines
#2
Stacy Zahanova, Alexandra Tsouka, Mark R Palmert, Farid H Mahmud
OBJECTIVES: Clinical practice guidelines (CPG) provide evidence-based recommendations for patient care but may not be optimally applied in clinical settings. As a pilot study, we evaluated the impact of a computerized, point-of-care decision support system (CDSS) on guideline knowledge and adherence in our diabetes clinic. METHODS: iSCREEN, a CDSS, integrated with a province-wide electronic health record, was designed based on the Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada...
May 23, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28549221/preventing-underfeeding-and-overfeeding-a-clinician-s-guide-to-the-acquisition-and-implementation-of-indirect-calorimetry
#3
Amy K Ladd, Heather E Skillman, Matthew A Haemer, Peter M Mourani
BACKGROUND: In critically ill patients, indirect calorimetry (IC) is the gold standard to determine energy needs, as the use of predictive equations can result in underfeeding or overfeeding. The aim of this quality improvement (QI) initiative was to describe the rationale for and implementation of a process to target energy provision according to IC measurements in a tertiary academic medical center pediatric intensive care unit (PICU). MATERIALS AND METHODS: To justify the purchase of an indirect calorimeter for clinical use, a needs assessment was conducted, followed by a training and implementation period...
May 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28547923/pediatric-heart-disease-simulation-curriculum-educating-the-pediatrician
#4
Tyler H Harris, Mark Adler, Sharon M Unti, Mary E McBride
BACKGROUND: Training guidelines state that pediatricians should be able to diagnose, manage, and triage patients with heart disease. Acutely ill cardiac patients present infrequently and with high acuity, yet residents receive less exposure to acute cardiac conditions than previous generations. Trainees must learn to manage these situations despite this gap. Simulation has been used successfully to train learners to provide acute care. We hypothesized that a simulation-based cardiac curriculum would improve residents' ability to manage cardiac patients...
May 26, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28547663/pediatric-predispositional-genetic-risk-communication-potential-utility-for-prevention-and-control-of-melanoma-risk-as-an-exemplar
#5
Yelena P Wu, Darren Mays, Wendy Kohlmann, Kenneth P Tercyak
Predispositional genetic testing among minor children is intensely debated due to the potential benefits and harms of providing this type of genetic information to children and their families. Existing guidelines on pediatric genetic testing state that predispositional testing could be appropriate for minors if preventive services exist that mitigate children's risk for or severity of the health condition in question. We use the example of hereditary melanoma to illustrate the rationale for and potential application of genetic risk communication for an adult-onset cancer to a pediatric population where childhood behaviors may reduce risk of disease later in life...
May 25, 2017: Journal of Genetic Counseling
https://www.readbyqxmd.com/read/28544433/gynecological-challenges-in-the-diagnosis-and-care-of-patients-with-dsd-the-role-of-the-obstetrician-gynecologist-in-the-multidisciplinary-approach-to-the-patient
#6
Veronica Gomez-Lobo, Anne-Marie Amies Oelschlager
Disorders (differences) of sex development (DSD) are identified when there is atypical chromosomal, gonadal, or anatomic sex. Given the complexity of DSD conditions, the consensus guidelines recommend that affected individuals be evaluated and cared for by teams with expertise in DSD conditions. Obstetrician gynecologists are experts in genital and reproductive anatomy, hormonal function, fertility, sexuality, and obstetrics, allowing them to provide a unique and essential function within the DSD team. Furthermore, obstetrician gynecologists with expertise in Pediatric and Adolescent Gynecology may follow individuals from birth into adulthood and provide reproductive health care for all ages, allowing these patients to "grow up" with them...
May 25, 2017: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
https://www.readbyqxmd.com/read/28541857/a-multidisciplinary-child-protection-team-improves-the-care-of-nonaccidental-trauma-patients
#7
John M Draus
We initiated a multidisciplinary Child Protection Team (CPT) as a subgroup of our pediatric multidisciplinary trauma peer review committee. Meetings are held monthly. Nonaccidental trauma (NAT) patients from the preceding month are reviewed. The meeting has two parts. During the open part, detectives and child protective services (CPS) workers are invited to discuss specific cases. The closed part focuses on improvement of specific processes and future outcomes. Attendance is recorded and minutes are kept. We sought to review accomplishments of this group...
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28541262/joint-espghan-naspghan-guidelines-for-the-management-of-helicobacter-pylori-in-children-and-adolescents-update-2016
#8
Nicola L Jones, Sibylle Koletzko, Karen Goodman, Patrick Bontems, Samy Cadranel, Thomas Casswall, Steve Czinn, Benjamin D Gold, Jeannette Guarner, Yoram Elitsur, Matjaž Homan, Nicolas Kalach, Michal Kori, Armando Madrazo, Francis Megraud, Alexandra Papadopoulou, Marion Rowland
BACKGROUND: Because of the changing epidemiology of Helicobacter pylori infection and low efficacy of currently recommended therapies, an update of the European Society for Paediatric Gastroenterology Hepatology and Nutrition/North American Society for Pediatric Gastroenterology, Hepatology and Nutrition recommendations for the diagnosis and management of H pylori infection in children and adolescents is required. METHODS: A systematic review of the literature (time period: 2009-2014) was performed...
June 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28540695/pediatric-nasolacrimal-duct-obstruction-benefit-of-a-combined-therapeutic-approach
#9
Miloš Fischer, Iris-Susanne Horn, Mathias Otto, Mandy Pirlich, Andreas Dietz, Christian Mozet
BACKGROUND: Pediatric nasolacrimal duct obstruction (PNDO) requires therapeutic intervention after conservative procedures failed. As resilient treatment guidelines for the treatment are missing, the aim of this study was to evaluate the advantages of two different intervention techniques in children with PNDO. METHODS: Between January, 2006 and June, 2014, 233 children (0-208 months) were treated either with conventional probing by ophthalmologists only (Group I) or with endonasal endoscopic interdisciplinary approach (Group II)...
May 24, 2017: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/28540590/pediatric-psoriasis
#10
REVIEW
Maria Relvas, Tiago Torres
Psoriasis is a chronic inflammatory systemic disease associated with an important physical and physiological burden. It primarily affects the skin, but it is associated with several serious medical co-morbidities. One third of total psoriatic cases have their onset during the pediatric age, although some of them may not be diagnosed until the patient reaches adulthood. Additionally, in the pediatric age, there is an association with several medical co-morbidities; thus, an early recognition of the disease and a subsequent appropriate approach may delay or even prevent considerable co-morbidities...
May 24, 2017: American Journal of Clinical Dermatology
https://www.readbyqxmd.com/read/28538532/identification-and-management-of-obese-patients-in-a-pediatric-orthopaedic-clinic
#11
Natalia Davila, Joy Vess, Emily E Johnson
BACKGROUND: Childhood obesity is a complex healthcare problem that affects all aspects of a child's health. The American Academy of Pediatrics and the Expert Committee recommends that all children be evaluated for current medical conditions including the risk for obesity by identifying elevated body mass index (BMI), physical activity habits, and diet. Childhood obesity is defined as a BMI of 95th percentile or greater on standardized age-based growth charts. Abdominal and visceral fat mass has a negative effect on bone formation during childhood and adolescence...
May 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28538388/myxedema-coma-a-case-report-of-pediatric-emergency-care
#12
Yueniu Zhu, Wenjuan Qiu, Mengyan Deng, Xiaodong Zhu
RAIONALE: Myxedema coma (MC) is extremely rare but lethal in pediatric patients with hypothyroidism leading to altered mental status and hypothermia. But there is no clinical guideline for such cases. PATIENT CONCERNS: A 6-year-old Chinese girl presented with coma and hypothermia preceded by pneumonia. Her lab results were: free thyroxin (T4) 4.18 pmol/L and thyroid-stimulating hormone (TSH) > 150 μIU/mL with extremely elevated anti-thyroid peroxidase (TPO-Ab) and anti-thyroglobulin...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28538329/perioperative-care-for-pediatric-patients-with-penetrating-brain-injury-a-review
#13
Marco Mikhael, Elizabeth Frost, Maria Cristancho
Traumatic brain injury (TBI) continues to be the leading cause of death and acquired disability in young children and adolescents, due to blunt or penetrating trauma, the latter being less common but more lethal. Penetrating brain injury (PBI) has not been studied extensively, mainly reported as case reports or case series, due to the assumption that both types of brain injury have common pathophysiology and consequently common management. However, recommendations and guidelines for the management of PBI differ from those of blunt TBI in regards to neuroimaging, intracranial pressure (ICP) monitoring, and surgical management including those pertaining to vascular injury...
May 19, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28537762/creation-of-an-integrated-knowledge-translation-process-to-improve-pediatric-emergency-care-in-canada
#14
Robin M Featherstone, Carly Leggett, Lisa Knisley, Mona Jabbour, Terry P Klassen, Shannon D Scott, Greg Van De Mosselaer, Lisa Hartling
TREKK (Translating Emergency Knowledge for Kids) was established to address knowledge needs to support care of children in general emergency departments. To achieve this goal, we developed an integrated knowledge translation (KT) process based on identified priorities to create the TREKK Evidence Repository, containing "knowledge pyramids" and Bottom Line Recommendations (summary documents) on the diagnosis and treatment of emergency pediatric conditions. The objective of this article is to describe our methods for developing and disseminating the TREKK Evidence Repository to improve pediatric emergency care in Canada...
May 24, 2017: Health Communication
https://www.readbyqxmd.com/read/28535583/molecular-testing-of-brain-tumor
#15
REVIEW
Sung-Hye Park, Jaekyung Won, Seong-Ik Kim, Yujin Lee, Chul-Kee Park, Seung-Ki Kim, Seung-Hong Choi
The World Health Organization (WHO) classification of central nervous system (CNS) tumors was revised in 2016 with a basis on the integrated diagnosis of molecular genetics. We herein provide the guidelines for using molecular genetic tests in routine pathological practice for an accurate diagnosis and appropriate management. While astrocytomas and IDH-mutant (secondary) glioblastomas are characterized by the mutational status of IDH, TP53 , and ATRX , oligodendrogliomas have a 1p/19q codeletion and mutations in IDH, CIC , FUBP1 , and the promoter region of telomerase reverse transcriptase ( TERTp )...
May 2017: Journal of Pathology and Translational Medicine
https://www.readbyqxmd.com/read/28535139/otitis-media-with-effusion-our-national-practice
#16
Rachel E Roditi, Richard M Rosenfeld, Jennifer J Shin
Otitis media with effusion (OME) is the focus of an updated multidisciplinary clinical practice guideline published by the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) and the American Academy of Pediatrics (AAP). Based on data from clinical trials, the guideline recommends against using antihistamines, antibiotics, oral steroids, and intranasal steroids for OME. To understand practice patterns related to these guidelines, we assessed nationally representative data. Despite controlling for age, sex, race/ethnicity, and other potential confounders individualized for each medication class, an increased risk of antihistamine (odds ratio [OR], 3...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28533057/late-effects-screening-guidelines-after-hematopoietic-cell-transplantation-hct-for-inherited-bone-marrow-failure-syndromes-ibmfs-consensus-statement-from-the-second-pediatric-blood-and-marrow-transplant-consortium-international-conference-on-late-effects-after
#17
REVIEW
Andrew C Dietz, Sharon A Savage, Adrianna Vlachos, Parinda A Mehta, Dorine Bresters, Jakub Tolar, Carmem Bonfim, Jean Hugues Dalle, Josu de la Fuente, Roderick Skinner, Farid Boulad, Christine N Duncan, K Scott Baker, Michael A Pulsipher, Jeffrey M Lipton, John E Wagner, Blanche P Alter
Patients with inherited bone marrow failure syndromes (IBMFS) such as Fanconi anemia (FA), dyskeratosis congenita (DC), and Diamond Blackfan anemia (DBA) can have hematologic manifestations cured through hematopoietic cell transplantation (HCT). Subsequent late effects seen in these patients arise from a combination of the underlying disease, the pre-HCT therapy, and the HCT process. During the international consensus conference sponsored by the Pediatric Blood and Marrow Transplant Consortium entitled "Late Effects Screening and Recommendations Following Allogeneic Hematopoietic Cell Transplant for Immune Deficiency and Nonmalignant Hematologic Disease" held in Minneapolis, Minnesota in May of 2016, a half-day session was focused specifically on the unmet needs for these patients with IBMFS...
May 19, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28531776/the-nutritional-value-of-food-service-meals-ordered-by-hospitalized-children
#18
Jeannie S Huang, Stanford Chun, Christopher Cheung, Linda Poon, Laura Terrones
BACKGROUND AND AIMS: US hospitals routinely provide food to hospitalized children. The nutritional content of provided foods has not been evaluated. We performed our study to examine meal orders of hospitalized youth and determine whether the nutritional contents of ordered meals meet dietary guidelines. METHODS: We performed a cross-sectional evaluation among hospitalized youth ≥1 y receiving all nutritional intake by mouth and not on a clear liquid diet. Meal orders from hospitalized youth were analyzed for nutritional content...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28530325/-diversity-in-product-selection-and-thresholds-for-platelets-transfusion-in-neonates-and-premature-infants
#19
Shraga Aviner, Ornit Cohen, Faid El-Ubra, Vered Yahalom, Haim Bibi, Shmuel Zangen
INTRODUCTION: Many premature and full-term newborns receive prophylactic platelet transfusions to prevent bleeding, particularly the most prevalent one, i.e, intracranial hemorrhages. However, the platelet count threshold above which bleeding is prevented and the efficacy of platelet transfusion in thrombocytopenic neonates, have yet to be established. Therefore, inter-Neonatal Intensive Care Units (NICU) variations in treatment indications and practices are expected. Considerable inter-NICU variations will emphasize the need for guidelines on platelet transfusions to neonates and premature infants...
August 2016: Harefuah
https://www.readbyqxmd.com/read/28528936/efficacy-of-non-carbapenem-antibiotics-for-pediatric-patients-with-first-febrile-urinary-tract-infection-due-to-extended-spectrum-beta-lactamase-producing-escherichia-coli
#20
Yoshifusa Abe, Işil Inan-Erdogan, Kunihiko Fukuchi, Hitomi Wakabayashi, Yasuha Ogawa, Satoshi Hibino, Shunsuke Sakurai, Kazuhiko Matsuhashi, Yoshitaka Watanabe, Kaori Hashimoto, Kazuhisa Ugajin, Kazuo Itabashi
Although carbapenem is the recommended for urinary tract infection (UTI) caused by extended-spectrum beta-lactamase (ESBL)-producing organisms, non-carbapenems have been reported to be effective for adult patients with UTI caused by ESBL-producing organisms. The purpose of this study was to evaluate the efficacy of non-carbapenems for pediatric patients with UTI due to ESBL-producing Escherichia coli (E. coli) based on the microbiologic and clinical outcomes. Fifteen children, who were treated for first febrile UTI caused by ESBL-producing E...
May 18, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
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