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https://www.readbyqxmd.com/read/28230456/off-label-prescribing-for-children-with-migraines-in-u-s-ambulatory-care-settings
#1
L Leanne Lai, Leroy Koh, Jane Ai-Chen Ho, Alexander Ting, Augustine Obi
BACKGROUND: Migraines, Which Affect About 10% Of School-Age Children In The United States, Can Significantly Impair Quality Of Life. Despite Potential Disability, Many Children Do Not Receive Treatment Or Prophylaxis, Since Medications Specifically Approved For Children Are Significantly Less Than For Adults. There Is Also Controversy Surrounding The Apparent Widespread Practice Of Prescribing Off-Label Medications For Children With Migraines. However, Little Research Has Been Done To Identify Physician-Prescribing Patterns Of Migraine Medication For Children...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28225424/committee-opinion-no-689-delivery-of-a-newborn-with-meconium-stained-amniotic-fluid
#2
(no author information available yet)
In 2006, the American Academy of Pediatrics and the American Heart Association published the 2005 guidelines on neonatal resuscitation. Before the 2005 guidelines, management of a newborn with meconium-stained amniotic fluid included suctioning of the oropharynx and nasopharynx on the perineum after the delivery of the head but before the delivery of the shoulders. The 2005 guidelines did not support this practice because routine intrapartum suctioning does not prevent or alter the course of meconium aspiration syndrome in vigorous newborns...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28225419/committee-opinion-no-689-summary-delivery-of-a-newborn-with-meconium-stained-amniotic-fluid
#3
(no author information available yet)
In 2006, the American Academy of Pediatrics and the American Heart Association published the 2005 guidelines on neonatal resuscitation. Before the 2005 guidelines, management of a newborn with meconium-stained amniotic fluid included suctioning of the oropharynx and nasopharynx on the perineum after the delivery of the head but before the delivery of the shoulders. The 2005 guidelines did not support this practice because routine intrapartum suctioning does not prevent or alter the course of meconium aspiration syndrome in vigorous newborns...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28225377/inappropriate-shocks-and-power-delivery-using-adult-automatic-external-defibrillator-pads-in-a-pediatric-patient
#4
Shai Tejman-Yarden, Uriel Katz, Marina Rubinstein, Yehuda Attias, Reem Yahia, David Mishali, Michael Glikson
The use of automatic external defibrillators (AEDs) during pulseless resuscitations is considered safe and reliable, and was established as part of the guidelines in out-of-hospital events. Based on extensive studies, the use of the standard AED is now indicated in every age group with a preference of pediatric pad application for small children and babies. If unavailable, adult pads are recommended. We report a case of 2 inappropriate AED shocks that were delivered to a neonate during a pulseless resuscitation after application of adult pads...
February 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28224249/signal-enhancement-in-the-hplc-esi-ms-ms-analysis-of-spironolactone-and-its-metabolites-using-hfip-and-nh4f-as-eluent-additives
#5
Kalev Takkis, Rudolf Aro, Lenne-Triin Kõrgvee, Heili Varendi, Jana Lass, Koit Herodes, Karin Kipper
This paper describes an LC-MS/MS method to determine the concentration of spironolactone and its metabolites 7-alpha-methylthiospironolactone and canrenone in blood plasma samples. The resulting assay is simple (using protein precipitation for sample preparation) and sensitive (the lower limit of quantification is close to 0.5 ng/ml) while requiring only 50 μl of plasma, making it especially suitable for analyzing samples obtained from pediatric and neonatal patients where sample sizes are limited. The sensitivity is achieved by using ammonium fluoride as an eluent additive, which in our case amplifies the signal from our analytes in the plasma solution on average about 70 times...
February 21, 2017: Analytical and Bioanalytical Chemistry
https://www.readbyqxmd.com/read/28220574/selective-use-of-the-electrocardiogram-in-pediatric-preparticipation-athletic-examinations-among-pediatric-primary-care-providers
#6
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/28218628/childhood-obesity-screening-and-treatment-practices-of-pediatric-healthcare-providers
#7
Amanda Staiano, Arwen Marker, Michelle Liu, Ellery Hayden, Daniel Hsia, Stephanie Broyles
This study evaluated physicians' childhood obesity screening and treatment practices. A 26-question survey was delivered to pediatric providers in-person or via mail, e-mail, or fax throughout Louisiana. Fifty-seven providers completed the survey, the majority in primary care clinics. Five providers met at least four of seven clinical guidelines, but no provider met all of the guidelines. Whereas 88% of providers screened for obesity, 7% met guidelines for referring patients with obesity to weight management services...
January 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28217159/managing-tracheal-extubation-in-infants-with-stridor-and-congenital-neuraxial-anomalies
#8
Deepti Saigal, Pragati Ganjoo, Megha U Sharma, Daljit Singh
Stridor is a serious complication of congenital neuraxial anomalies, which though, can get completely resolved with early neurosurgical correction of the anomaly. However, stridor relief may or may not be achieved soon after surgery. Persistent postoperative stridor can potentially cause extubation failure that may be difficult to handle in small children. There are no extubation guidelines for difficult pediatric airways as yet, and fewer appropriate airway-assist devices for routine use. Management of an infant with occipital encephalocele, hydrocephalus and bilateral abductor vocal cord palsy, who developed post-extubation respiratory distress due to stridor is discussed, together with the relevant tracheal extubation issues in such cases...
October 2016: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/28216959/prescription-patterns-and-appropriateness-of-antibiotics-in-the-management-of-cough-cold-and-diarrhea-in-a-rural-tertiary-care-teaching-hospital
#9
Akram Ahmad, Muhammad Umair Khan, Sadiqa Malik, Guru Prasad Mohanta, S Parimalakrishnan, Isha Patel, Sameer Dhingra
BACKGROUND: Acute gastroenteritis and respiratory illnesses are the major causes of morbidity and mortality in children under 5 years of age. The objective of this study was to evaluate the prescription pattern of antibiotic utilization during the treatment of cough/cold and/or diarrhea in pediatric patients. METHODS: A descriptive, cross-sectional study was conducted for 6 months in pediatric units of a tertiary care hospital in South India. Children under 5 years of age presenting with illness related to diarrhea and/or cough/cold were included in this study...
October 2016: Journal of Pharmacy & Bioallied Sciences
https://www.readbyqxmd.com/read/28216033/safety-of-transcranial-magnetic-stimulation-in-children-a-systematic-review-of-the-literature
#10
REVIEW
Corey H Allen, Benzi M Kluger, Isabelle Buard
BACKGROUND: Data and best practice recommendations for transcranial magnetic stimulation (TMS) use in adults are largely available. Although there are fewer data in pediatric populations and no published guidelines, its practice in children continues to grow. METHODS: We performed a literature search through PubMed to review all TMS studies from 1985 to 2016 involving children and documented any adverse events. Crude risks were calculated per session. RESULTS: Following data screening we identified 42 single-pulse and/or paired-pulse TMS studies involving 639 healthy children, 482 children with central nervous system disorders, and 84 children with epilepsy...
January 4, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28214152/clinical-and-genetic-diagnosis-of-familial-hypertrophic-cardiomyopathy-results-in-pediatric-cardiology
#11
Bárbara Cardoso, Inês Gomes, Petra Loureiro, Conceição Trigo, Fátima Ferreira Pinto
INTRODUCTION: Hypertrophic cardiomyopathy (HCM) is most often of autosomal dominant inheritance with incomplete penetrance and variable expression. The main purpose of family screening is to identify relatives with unrecognized HCM and to monitor those at risk for disease, in order to minimize complications and to assess risk of sudden cardiac death. The ESC and ACCF/AHA guidelines on the diagnosis and management of HCM recommend the screening of child relatives from the age of 10-12 years...
February 14, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28212059/pediatric-chest-ct-diagnostic-reference-ranges-development-and-application
#12
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/28210840/dietary-sources-of-energy-and-nutrient-intake-among-children-and-adolescents-with-chronic-kidney-disease
#13
Wen Chen, Kirstie Ducharme-Smith, Laura Davis, Wun Fung Hui, Bradley A Warady, Susan L Furth, Alison G Abraham, Aisha Betoko
BACKGROUND: Our purpose was to identify the main food contributors to energy and nutrient intake in children with chronic kidney disease (CKD). METHODS: In this cross-sectional study of dietary intake assessed using Food Frequency Questionnaires (FFQ) in the Chronic Kidney Disease in Children (CKiD) cohort study, we estimated energy and nutrient intake and identified the primary contributing foods within this population. RESULTS: Completed FFQs were available for 658 children...
February 16, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28210801/patient-radiation-doses-and-reference-levels-in-pediatric-interventional-radiology
#14
Bouchra Habib Geryes, Adeline Bak, Julie Lachaux, Augustin Ozanne, Nathalie Boddaert, Francis Brunelle, Olivier Naggara, Guillaume Saliou
OBJECTIVES: To describe, in a multicentric paediatric population, reference levels (RLs) for three interventional radiological procedures. METHODS: From January 2012 to March 2015, children scheduled for an interventional radiological procedure in two French tertiary centres were retrospectively included and divided into four groups according to age: children younger than 2 years (A1), aged 2-7 years (A5), 8-12 years (A10) and 13-18 years (A15). Three procedures were identified: cerebral digital subtraction angiography (DSA), brain arteriovenous malformation (bAVM) embolization, and head and neck superficial vascular malformation (SVM) percutaneous sclerotherapy...
February 16, 2017: European Radiology
https://www.readbyqxmd.com/read/28209292/cholesterol-screening-and-treatment-practices-and-preferences-a-survey-of-united-states-pediatricians
#15
Sarah D de Ferranti, Angie Mae Rodday, Susan K Parsons, William L Cull, Karen G O'Connor, Stephen R Daniels, Laurel K Leslie
OBJECTIVES: To determine pediatricians' practices, attitudes, and barriers regarding screening for and treatment of pediatric dyslipidemias in 9- to 11-year-olds and 17- to 21-year-olds. STUDY DESIGN: American Academy of Pediatrics (AAP) 2013-2014 Periodic Survey of a national, randomly selected sample of 1627 practicing AAP physicians. Pediatricians' responses were described and modeled. RESULTS: Of 614 (38%) respondents who met eligibility criteria, less than half (46%) were moderately/very knowledgeable about the 2008 AAP cholesterol statement; fewer were well-informed about 2011 National Heart, Lung, and Blood Institute Guidelines or 2007 US Preventive Service Task Force review (both 26%)...
February 13, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28207918/disruptive-mood-dysregulation-disorder-and-its-effect-on-bipolar-disorder
#16
Shama Faheem, Victoria Petti, George Mellos
BACKGROUND: In the last few decades, a noticeable increase in the diagnosis of bipolar disorder (BD) in youth has raised concerns, particularly because of a consequent increase in the use of psychotropic medications with adverse side effects. After observing the development of those youth into adulthood, clinicians and researchers have questioned the notion of expanding the diagnostic boundaries of BD to encapsulate these youth. METHODS: Our research is aimed at gleaning further information on disruptive mood dysregulation disorder (DMDD) and to observe whether its introduction has affected the rates of BD in children and adolescents...
February 1, 2017: Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists
https://www.readbyqxmd.com/read/28206896/survey-of-current-clinical-and-curriculum-practices-of-postgraduate-pediatric-dentistry-programs-in-nonintravenous-conscious-sedation-in-the-united-states
#17
Aline Morin, Romer Ocanto, Lesbia Drukteinis, Patrick C Hardigan
PURPOSE: The purposes of this study were to: (1) describe the sedation protocols of postgraduate pediatric dentistry programs (PPDPs) in the U.S.; (2) evaluate how consistent they were with current American Academy of Pediatric Dentistry sedation guidelines and Commission on Dental Accreditation (CODA) sedation curriculum requirements; (3) identify barriers to and tools for implementing these guidelines; and (4) determine the independent association between PPDPs' adherence to guidelines and the program setting...
October 15, 2016: Pediatric Dentistry
https://www.readbyqxmd.com/read/28206888/evidence-based-clinical-practice-guideline-for-the-use-of-pit-and-fissure-sealants
#18
(no author information available yet)
BACKGROUND: This article presents evidence-based clinical recommendations for the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars in children and adolescents. A guideline panel convened by the American Dental Association (ADA) Council on Scientific Affairs and the American Academy of Pediatric Dentistry conducted a systematic review and formulated recommendations to address clinical questions in relation to the efficacy, retention, and potential side effects of sealants to prevent dental caries; their efficacy compared with fluoride varnishes; and a head-to-head comparison of the different types of sealant material used to prevent caries on pits-and-fissures of occlusal surfaces...
October 15, 2016: Pediatric Dentistry
https://www.readbyqxmd.com/read/28206886/guideline-for-monitoring-and-management-of-pediatric-patients-before-during-and-after-sedation-for-diagnostic-and-therapeutic-procedures-update-2016
#19
(no author information available yet)
The safe sedation of children for procedures requires a systematic approach that includes the following: no administration of sedating medication without the safety net of medical/dental supervision, careful presedation evaluation for underlying medical or surgical conditions that would place the child at increased risk from sedating medications, appropriate fasting for elective procedures and a balance between the depth of sedation and risk for those who are unable to fast because of the urgent nature of the procedure, a focused airway examination for large (kissing) tonsils or anatomic airway abnormalities that might increase thepotential for airway obstruction, a clear understanding of the medication's pharmacokinetic and pharmacodynamic effects and drug interactions, appropriate training and skills in airway management to allow rescue of the patient, age- and size-appropriate equipment for airway management and venous access, appropriate medications and reversal agents, sufficient numbers of staff to both carry out the procedure and monitor the patient, appropriate physiologic monitoring during and after the procedure, a properly equipped and staffed recovery area, recovery to the presedation level of consciousness before discharge from medical/dental supervision, and appropriate discharge instructions...
October 15, 2016: Pediatric Dentistry
https://www.readbyqxmd.com/read/28203042/relationship-between-dose-of-antithyroid-drugs-and-adverse-events-in-pediatric-patients-with-graves-disease
#20
Kie Yasuda, Yoko Miyoshi, Makiko Tachibana, Noriyuki Namba, Kazunori Miki, Yukiko Nakata, Toru Takano, Keiichi Ozono
Graves' disease (GD) accounts for a large proportion of pediatric hyperthyroidism, and the first-line treatment is antithyroid drug (ATD) therapy. Methimazole (MMI) is effective in most patients but is associated with significant adverse events (AEs). We reviewed the medical records of GD patients (n = 56) with onset age of <15 yr and investigated the relationship between MMI dose and AEs. The study population comprised 11 male and 45 female patients and the median age at diagnosis was 11 yr. All patients were initially treated with ATDs...
January 2017: Clinical Pediatric Endocrinology: Case Reports and Clinical Investigations: Official Journal of the Japanese Society for Pediatric Endocrinology
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