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https://www.readbyqxmd.com/read/29351636/effectiveness-of-respiratory-syncytial-virus-immunoprophylaxis-on-bronchiolitis-hospitalizations-among-high-risk-infants
#1
Pingsheng Wu, Gabriel J Escobar, Tebeb Gebretsadik, Kecia N Carroll, Sherian X Li, Eileen M Walsh, Edward F Mitchel, Chantel Sloan, William D Dupont, Chang Yu, Jeffrey R Horner, Tina V Hartert
We sought to determine the real-world effectiveness of respiratory syncytial virus (RSV) immunoprophylaxis in a population-based cohort to inform policy. The study population included infants born 1996-2008 and enrolled in Kaiser Permanente Northern California. During the RSV season (November-March), RSV immunoprophylaxis administration and the following 30 days were defined as RSV immunoprophylaxis protected period(s), and all other days as unprotected period(s). Bronchiolitis hospitalizations were determined using the International Classification of Diseases Ninth Revision codes during RSV season...
January 17, 2018: American Journal of Epidemiology
https://www.readbyqxmd.com/read/29350758/obesity-and-pediatric-drug-development
#2
Janelle D Vaughns, Laurie S Conklin, Ying Long, Panli Zheng, Fahim Faruque, Dionna J Green, John N van den Anker, Gilbert J Burckart
There is a lack of dosing guidelines for use in obese children. Moreover, the impact of obesity on drug safety and clinical outcomes is poorly defined. The paucity of information needed for the safe and effective use of drugs in obese patients remains a problem, even after drug approval. To assess the current incorporation of obesity as a covariate in pediatric drug development, the pediatric medical and clinical pharmacology reviews under the Food and Drug Administration (FDA) Amendments Act of 2007 and the FDA Safety and Innovation Act (FDASIA) of 2012 were reviewed for obesity studies...
January 19, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29346512/validation-of-the-pids-idsa-severity-criteria-in-children-with-community-acquired-pneumonia
#3
Todd A Florin, Cole Brokamp, Rachel Mantyla, Bradley DePaoli, Richard Ruddy, Samir S Shah, Lilliam Ambroggio
Background: The Pediatric Infectious Diseases Society (PIDS)/Infectious Diseases Society of America (IDSA) guideline for community-acquired pneumonia (CAP) recommends intensive care unit (ICU) admission or continuous monitoring for children meeting severity criteria. Our objective was to validate these criteria. Methods: This was a retrospective cohort study of children age 3 months-18 years diagnosed with CAP in a pediatric Emergency Department (ED) from 9/2014-8/2015...
January 13, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29346233/video-recordings-to-analyze-preventable-management-errors-in-pediatric-resuscitation-bay
#4
Julia Borns, Jörg Ersch, Milana Dobrovoljac, Georg Staubli, Barbara Brotschi
OBJECTIVE: In treating patients of different ages and diseases in the pediatric resuscitation bay, management errors are common. This study aimed to analyze the adherence to advanced trauma life support and pediatric advanced life support guidelines and identify management errors in the pediatric resuscitation bay by using video recordings. METHODS: Video recording of all patients admitted to the pediatric resuscitation bay at University Children's Hospital Zurich during a 13-month period was performed...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29346221/a-validation-argument-for-a-simulation-based-training-course-centered-on-assessment-recognition-and-early-management-of-pediatric-sepsis
#5
Gary L Geis, Derek S Wheeler, Amy Bunger, Laura G Militello, Regina G Taylor, Jerome P Bauer, Terri L Byczkowski, Benjamin T Kerrey, Mary D Patterson
INTRODUCTION: Early recognition of sepsis remains one of the greatest challenges in medicine. Novice clinicians are often responsible for the recognition of sepsis and the initiation of urgent management. The aim of this study was to create a validity argument for the use of a simulation-based training course centered on assessment, recognition, and early management of sepsis in a laboratory-based setting. METHODS: Five unique simulation scenarios were developed integrating critical sepsis cues identified through qualitative interviewing...
January 17, 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29346023/fertility-preservation-in-pediatric-oncology-patients-new-perspectives
#6
Chiara Gertosio, Mariasole Magistrali, Paola Musso, Cristina Meazza, Mauro Bozzola
Over the past 30 years, advances in antineoplastic treatment led to a significant increase in the survival of patients with childhood cancer. In Europe and the United States, 82% of children, adolescents, and young adults survive 5 years from the cancer diagnosis and the majority achieves long-term survival into adulthood. The impact of cancer therapy on fertility is related to the age of the patient and to the duration, dose/intensity, and type of treatment. Exposure to chemotherapy or to radiation to gonads or pituitary brings long-term complications of cancer-directed therapies that include effects on reproductive capacity...
January 18, 2018: Journal of Adolescent and Young Adult Oncology
https://www.readbyqxmd.com/read/29345595/hospital-management-of-severe-hypertriglyceridemia-in-children
#7
Ambika Ashraf, Badhma Valaiyapathi
Severe hypertriglyceridemia (HTG), i.e., triglyceride levels exceeding 1000 mg/dL, is one of the established causes of acute pancreatitis and severe abdominal pain. There are no established pediatric guidelines for treatment of children and adolescents with severe HTG. Management often includes hospital admission, fasting followed by fat free diet until the triglyceride (TG) levels are below 1000 mg/dL. Insulin infusion lowers TG levels in patients, especially in those with diabetes. Plasmapheresis is a limited option due to its restricted availability and scarcity of studies on its efficacy and safety in children...
January 16, 2018: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29343557/dicer1-and-associated-conditions-%C3%A2-identification-of-at-risk-individuals-and-recommended-surveillance-strategies
#8
Kris Ann P Schultz, Gretchen M Williams, Junne Kamihara, Douglas R Stewart, Anne K Harris, Andrew J Bauer, Joyce Turner, Rachana Shah, Katherine Schneider, Kami Wolfe Schneider, Ann Garrity Carr, Laura A Harney, Shari Baldinger, A Lindsay Frazier, Daniel Orbach, Dominik T Schneider, David Malkin, Louis P Dehner, Yoav H Messinger, Ashley Hill
Pathogenic germline DICER1 variants cause a hereditary cancer predisposition syndrome with a variety of manifestations. In addition to conferring increased cancer risks for pleuropulmonary blastoma (PPB) and ovarian sex cord-stromal tumors, particularly Sertoli-Leydig cell tumor, individuals with pathogenic germline DICER1 variants may also develop lung cysts, cystic nephroma, renal sarcoma and Wilms tumor, nodular hyperplasia of the thyroid, nasal chondromesenchymal hamartoma, ciliary body medulloepithelioma, genitourinary embryonal rhabdomyosarcoma and brain tumors including pineoblastoma and pituitary blastoma...
January 17, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/29342478/design-and-implementation-of-a-visual-analytics-electronic-antibiogram-within-an-electronic-health-record-system-at-a-tertiary-pediatric-hospital
#9
Allan F Simpao, Luis M Ahumada, Beatriz Larru Martinez, Ana M Cardenas, Talene A Metjian, Kaede V Sullivan, Jorge A Gálvez, Bimal R Desai, Mohamed A Rehman, Jeffrey S Gerber
BACKGROUND:  Hospitals use antibiograms to guide optimal empiric antibiotic therapy, reduce inappropriate antibiotic usage, and identify areas requiring intervention by antimicrobial stewardship programs. Creating a hospital antibiogram is a time-consuming manual process that is typically performed annually. OBJECTIVE:  We aimed to apply visual analytics software to electronic health record (EHR) data to build an automated, electronic antibiogram ("e-antibiogram") that adheres to national guidelines and contains filters for patient characteristics, thereby providing access to detailed, clinically relevant, and up-to-date antibiotic susceptibility data...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29341967/new-modalities-for-the-administration-of-inhaled-nitric-oxide-in-intensive-care-units-after-cardiac-surgery-or-for-neonatal-indications-a-prospective-observational-study
#10
Philippe Gaudard, Claudio Barbanti, Bertrand Rozec, Philippe Mauriat, Mimoun M'rini, Gilles Cambonie, Jean Michel Liet, Claude Girard, Pierre Louis Leger, Ziad Assaf, Pierre Damas, Gauthier Loron, Laurent Lecourt, Julien Amour, Philippe Pouard
BACKGROUND: Nitric oxide (NO) has a well-known efficacy in pulmonary hypertension (PH), with wide use for 20 years in many countries. The objective of this study was to describe the current use of NO in real life and the gap with the guidelines. METHODS: This is a multicenter, prospective, observational study on inhaled NO administered through an integrated delivery and monitoring device and indicated for PH according to the market authorizations. The characteristics of NO therapy and ventilation modes were observed...
January 16, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29341962/withdrawal-of-life-sustaining-therapy
#11
Barbara G Jericho
PURPOSE OF REVIEW: The aim of this review is to examine literature relating to the withdrawal of life-sustaining therapy (WLST). RECENT FINDINGS: Discussions regarding end-of-life issues in adults and children are not occurring comprehensively. Discussions relating to the WLST in the pediatric population varies by institution and may vary by race, age, health insurance, diagnosis, and severity of illness. Completing advance directives prior to placement of life-sustaining treatments is not consistent practice...
January 15, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29340851/comparison-of-antibiotic-dosing-recommendations-for-neonatal-sepsis-from-established-reference-sources
#12
T B Y Liem, E M A Slob, J U M Termote, T F W Wolfs, A C G Egberts, C M A Rademaker
Background Incorrect dosing is the most frequent prescribing error in neonatology, with antibiotics being the most frequently prescribed medicines. Computer physician order entry and clinical decision support systems can create consistency contributing to a reduction of medication errors. Although evidence-based dosing recommendations should be included in such systems, the evidence is not always available and subsequently, dosing recommendations mentioned in guidelines and textbooks are often based on expert opinion...
January 16, 2018: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29338495/clinical-challenges-in-de-novo-pediatric-acute-myeloid-leukemia
#13
Kim Klein, Valérie de Haas, Gertjan J L Kaspers
Although the prognosis of pediatric acute myeloid leukemia (pAML) has improved, with current survival rates up to 75%, relapse rates remain high. Areas covered: The low number of patients, the heterogeneous genomic landscape of AML, novel diagnostic techniques, divergent available treatment protocols, and dose-limiting toxicity of conventional agents all contribute to the complexity of AML treatment. This review gives an overview of the current clinical challenges with respect to diagnostics, treatment, and supportive care in pAML...
January 17, 2018: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/29337001/antidepressant-treatment-duration-in-pediatric-depressive-and-anxiety-disorders-how-long-is-long-enough
#14
Elizabeth E Hathaway, John T Walkup, Jeffrey R Strawn
Anxiety and depressive disorders are common in the pediatric primary care setting, and respond to both psychotherapeutic and psychopharmacologic treatment. However, there are limited data regarding the optimal treatment duration. This article systematically reviews guidelines and clinical trial data related to antidepressant treatment duration in pediatric patients with depressive and anxiety disorders. The extant literature suggests 9-12 months of antidepressant treatment for youth with major depressive disorder...
January 11, 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/29336853/updated-guidelines-on-infection-prevention-in-pediatric-ambulatory-settings
#15
Deborah L McBride
The American Academy of Pediatrics (AAP) recently released updated guidelines on infection control and prevention in pediatric outpatient settings. Key recommendations include mandatory influenza vaccination for all healthcare workers offered free to all staff, expanded guidance on infection control practices for children with cystic fibrosis, guidance on additional prevention procedures during community outbreaks of infectious diseases and recommendations on improving communication between healthcare facilities when referring potentially contagious patients...
January 11, 2018: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29336799/access-to-high-pediatric-readiness-emergency-care-in-the-united-states
#16
Kristin N Ray, Lenora M Olson, Elizabeth A Edgerton, Michael Ely, Marianne Gausche-Hill, Patricia Schmuhl, David J Wallace, Jeremy M Kahn
OBJECTIVE: To determine the geographic accessibility of emergency departments (EDs) with high pediatric readiness by assessing the percentage of US children living within a 30-minute drive time of an ED with high pediatric readiness, as defined by collaboratively developed published guidelines. STUDY DESIGN: In this cross-sectional analysis, we examined geographic access to an ED with high pediatric readiness among US children. Pediatric readiness was assessed using the weighted pediatric readiness score (WPRS) of US hospitals based on the 2013 National Pediatric Readiness Project (NPRP) survey...
January 12, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29336603/comparison-of-unlicensed-and-off-label-use-of-antipsychotics-prescribed-to-child-and-adolescent-psychiatric-outpatients-for-treatment-of-mental-and-behavioral-disorders-with-different-guidelines-the-china-food-and-drug-administration-versus-the-fda
#17
Xiuqing Zhu, Jinqing Hu, Bin Sun, Shuhua Deng, Yuguan Wen, Weijia Chen, Chang Qiu, Dewei Shang, Ming Zhang
OBJECTIVES: This study aims to compare the prevalence of unlicensed and off-label use of antipsychotics among child and adolescent psychiatric outpatients with guidelines proposed by the China Food and Drug Administration (CFDA) and the U.S. Food and Drug Administration (FDA), and to identify factors associated with inconsistencies between the two regulations. METHODS: A retrospective analysis of 29,326 drug prescriptions for child and adolescent outpatients from the Affiliated Brain Hospital of Guangzhou Medical University was conducted...
January 16, 2018: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/29335899/the-ultrasonographic-whirlpool-sign-in-testicular-torsion-valuable-tool-or-waste-of-valuable-time-a-systematic-review-and-meta-analysis
#18
Jared McDowall, Ahmed Adam, Louis Gerber, Callistus O A Enyuma, Sunday J Aigbodion, Sean Buchanan, Abdullah E Laher
PURPOSE: A positive whirlpool sign (WS) is defined as the presence of a spiral-like pattern when the spermatic cord is assessed during ultrasonography (US), using standard, high-resolution ultrasonography (HRUS) and/or color Doppler sonography (CDS), in the presence of testicular torsion. The objective of this review was to assess the validity and accuracy of this sign by performing a comprehensive systematic literature review and meta-analysis. METHODS: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, a comprehensive literature search was performed (August, 2017), using the following databases: BMJ Best Practice, Cochrane Library, Embase, PubMed, Scopus, and Web of Science...
January 15, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29334996/italian-guidelines-on-the-assessment-and-management-of-pediatric-head-injury-in-the-emergency-department
#19
REVIEW
Liviana Da Dalt, Niccolo' Parri, Angela Amigoni, Agostino Nocerino, Francesca Selmin, Renzo Manara, Paola Perretta, Maria Paola Vardeu, Silvia Bressan
OBJECTIVE: We aim to formulate evidence-based recommendations to assist physicians decision-making in the assessment and management of children younger than 16 years presenting to the emergency department (ED) following a blunt head trauma with no suspicion of non-accidental injury. METHODS: These guidelines were commissioned by the Italian Society of Pediatric Emergency Medicine and include a systematic review and analysis of the literature published since 2005...
January 15, 2018: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29334532/cost-effectiveness-and-improved-parent-and-provider-satisfaction-with-outpatient-management-of-pediatric-oncology-patients-with-low-risk-fever-and-neutropenia
#20
Abhishek Bavle, Amanda Grimes, Sibo Zhao, Daniel Zinn, Andrea Jackson, Binita Patel, Timothy Porea, Ankhi Dutta, Heidi Russell, Andras Heczey
On the basis of significant evidence for safety, the international pediatric fever and neutropenia committee recommends the identification and management of patients with "low-risk fever and neutropenia" (LRFN), outpatient with oral antibiotics, instead of traditional inpatient management. The aim of our study was to compare the cost-per-patient with these 2 strategies, and to evaluate parent and provider satisfaction with the outpatient management of LRFN. Between March 2016 and February 2017, 17 LRFN patients (median absolute neutrophil count, 90/μL) were managed at a single institution, per new guidelines...
January 12, 2018: Journal of Pediatric Hematology/oncology
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