Suzanne Berman
No abstract text is available yet for this article.
November 8, 2019: Pediatrics
James C Bohnhoff, Jill M Taormina, Lorraine Ferrante, David Wolfson, Kristin N Ray
OBJECTIVES: Incomplete subspecialty referrals, whether unscheduled or unattended, represent unmet patient needs and an opportunity to improve patient safety and experiences. Our objectives were to describe the rates of appointment scheduling and visit attendance after pediatric subspecialty referral and to examine patient and systems factors associated with scheduled referrals and attended appointments. METHODS: We conducted a retrospective review of referrals within a network of 52 primary and urgent care sites from November 2016 to October 2017...
November 8, 2019: Pediatrics
Christiana J Bernal, Ida Aka, Robert J Carroll, Joseph R Coco, John J Lima, Sari A Acra, Dan M Roden, Sara L Van Driest
OBJECTIVES: Proton pump inhibitors (PPIs) are often used in pediatrics to treat common gastrointestinal disorders, and there are growing concerns for infectious adverse events. Because CYP2C19 inactivates PPIs, genetic variants that increase CYP2C19 function may decrease PPI exposure and infections. We tested the hypothesis that CYP2C19 metabolizer phenotypes are associated with infection event rates in children exposed to PPIs. METHODS: This retrospective biorepository cohort study included individuals aged 0 to 36 months at the time of PPI exposure...
November 7, 2019: Pediatrics
Brian A Hummel, Michael Rieder
No abstract text is available yet for this article.
November 7, 2019: Pediatrics
Michimasa Fujiogi, Tadahiro Goto, Hideo Yasunaga, Jun Fujishiro, Jonathan M Mansbach, Carlos A Camargo, Kohei Hasegawa
OBJECTIVES: To investigate the temporal trend in the national incidence of bronchiolitis hospitalizations, their characteristics, inpatient resource use, and hospital cost from 2000 through 2016. METHODS: We performed a serial, cross-sectional analysis of nationally representative samples (the 2000, 2003, 2006, 2009, 2012, and 2016 Kids' Inpatient Databases) of children (age <2 years) hospitalized for bronchiolitis. We identified all children hospitalized with bronchiolitis by using International Classification of Diseases, Ninth Revision, Clinical Modification 466...
November 7, 2019: Pediatrics
Alex R Kemper, Coleen A Boyle, Jeffrey P Brosco, Scott D Grosse
No abstract text is available yet for this article.
November 6, 2019: Pediatrics
Stephen B Freedman, Sajid B Soofi, Andrew R Willan, Sarah Williamson-Urquhart, Emaduddin Siddiqui, Jianling Xie, Fady Dawoud, Zulfiqar A Bhutta
BACKGROUND: Ondansetron is an effective antiemetic employed to prevent vomiting in children with gastroenteritis in high-income countries; data from low- and middle-income countries are sparse. METHODS: We conducted a randomized, double-blind, placebo-controlled superiority trial in 2 pediatric emergency departments in Pakistan. Dehydrated children aged 6 to 60 months with ≥1 diarrheal (ie, loose or liquid) stool and ≥1 vomiting episode within the preceding 4 hours were eligible to participate...
November 6, 2019: Pediatrics
Andrea K Garber, Jing Cheng, Erin C Accurso, Sally H Adams, Sara M Buckelew, Cynthia J Kapphahn, Anna Kreiter, Daniel Le Grange, Vanessa I Machen, Anna-Barbara Moscicki, Kristina Saffran, Allyson F Sy, Leslie Wilson, Neville H Golden
BACKGROUND: Lower weight has historically been equated with more severe illness in anorexia nervosa (AN). Reliance on admission weight to guide clinical concern is challenged by the rise in patients with atypical anorexia nervosa (AAN) requiring hospitalization at normal weight. METHODS: We examined weight history and illness severity in 12- to 24-year-olds with AN ( n = 66) and AAN ( n = 50) in a randomized clinical trial, the Study of Refeeding to Optimize Inpatient Gains (www...
November 6, 2019: Pediatrics
Adam L Turner, Murrey Olmsted, Amanda C Smith, Victoria Dounoucos, Andrew Bradford, Linda Althouse, Laurel K Leslie
BACKGROUND AND OBJECTIVES: This article is the second of a 2-part series examining results regarding self-reported learning and practice change from the American Board of Pediatrics 2017 pilot of an alternative to the proctored, continuing certification examination, termed the Maintenance of Certification Assessment for Pediatrics (MOCA-Peds). Because of its design, MOCA-Peds has several learning advantages compared with the proctored examination. METHODS: Quantitative and qualitative analyses with 5081 eligible pediatricians who registered to participate in the 2017 pilot; 81...
November 5, 2019: Pediatrics
Jennifer E deSante-Bertkau, Catherine D Shubkin, William A Nelson, Erica K Salter, John D Lantos
We present the case of a 2-year-old boy with epidermolysis bullosa and supraglottic stenosis whose parents refuse an elective tracheostomy because of the significant care the tracheostomy would require. The patient's family lives in a rural area with few health care resources and his parents are already handling hours of daily skin care for his epidermolysis bullosa. In an attempt to convince the parents to pursue the intervention, the medical team recommends that the family move to an area with additional resources to assist in the child's care...
November 5, 2019: Pediatrics
Laurel K Leslie, Adam L Turner, Amanda C Smith, Victoria Dounoucos, Murrey G Olmsted, Linda Althouse
BACKGROUND AND OBJECTIVES: The American Board of Pediatrics (ABP) certifies that general and subspecialty pediatricians meet standards of excellence established by their peers, immediately after training and over the course of their careers (ie, Maintenance of Certification [MOC]). In 2015-2016, the ABP developed the Maintenance of Certification Assessment for Pediatrics (MOCA-Peds) as an alternative assessment to the current proctored, closed-book general pediatrics (GP) MOC examination...
November 5, 2019: Pediatrics
Joshua T B Williams, John Rice, Matt Cox-Martin, Elizabeth A Bayliss, Sean T O'Leary
BACKGROUND: Forty-five states permit religious exemptions to school immunization laws; 15 allow personal belief exemptions. Updated religious exemption estimates are lacking, and it is unclear if personal belief exemption availability impacts religious exemption rates. We aimed to (1) update religious exemption trends in kindergartners, (2) compare states' proportions of kindergartners with religious exemptions by personal belief exemption availability, and (3) describe whether the proportion of kindergartners with religious exemptions changed in Vermont after it eliminated personal belief exemptions in 2016...
November 4, 2019: Pediatrics
David Axelson
No abstract text is available yet for this article.
November 4, 2019: Pediatrics
Ryan K McBain, Aaron Kofner, Bradley D Stein, Jonathan H Cantor, William B Vogt, Hao Yu
BACKGROUND: Historically, there has been a shortage of child psychiatrists in the United States, undermining access to care. This study updated trends in the growth and distribution of child psychiatrists over the past decade. METHODS: Data from the Area Health Resource Files were used to compare the number of child psychiatrists per 100 000 children ages 0 to 19 between 2007 and 2016 by state and county. We also examined sociodemographic characteristics associated with the density of child psychiatrists at the county level over this period using negative binomial multivariable models...
November 4, 2019: Pediatrics
Dmitry Dukhovny, Madge E Buus-Frank, Erika M Edwards, Timmy Ho, Kate A Morrow, Arjun Srinivasan, Daniel A Pollock, John A F Zupancic, DeWayne M Pursley, Donald Goldmann, Karen M Puopolo, Roger F Soll, Jeffrey D Horbar
OBJECTIVES: To determine if NICU teams participating in a multicenter quality improvement (QI) collaborative achieve increased compliance with the Centers for Disease Control and Prevention (CDC) core elements for antibiotic stewardship and demonstrate reductions in antibiotic use (AU) among newborns. METHODS: From January 2016 to December 2017, multidisciplinary teams from 146 NICUs participated in Choosing Antibiotics Wisely, an Internet-based national QI collaborative conducted by the Vermont Oxford Network consisting of interactive Web sessions, a series of 4 point-prevalence audits, and expert coaching designed to help teams test and implement the CDC core elements of antibiotic stewardship...
November 1, 2019: Pediatrics
Laura C Hart, Marie Crawford, Peter Crawford, Garey Noritz
No abstract text is available yet for this article.
November 1, 2019: Pediatrics
Erica Andrist, Carley L Riley, Cole Brokamp, Stuart Taylor, Andrew F Beck
BACKGROUND: Disparities in health service use have been described across a range of sociodemographic factors. Patterns of PICU use have not been thoroughly assessed. METHODS: This was a population-level, retrospective analysis of admissions to the Cincinnati Children's Hospital Medical Center PICU between 2011 and 2016. Residential addresses of patients were geocoded and spatially joined to census tracts. Pediatric patients were eligible for inclusion if they resided within Hamilton County, Ohio...
November 1, 2019: Pediatrics
Jason Adam Wasserman, Mark Christopher Navin, Christian John Vercler
No abstract text is available yet for this article.
October 30, 2019: Pediatrics
Wei-Sheng Lin, Meng-Fai Kuo, Steven Shinn-Forng Peng, Pi-Chuan Fan
Schilder disease, also termed diffuse myelinoclastic sclerosis, is characterized by a large demyelinating lesion involving 1 or both sides of the centrum semiovale of the cerebral hemispheres. It often presents with tumorlike features and poses a diagnostic challenge. Schilder disease can be monophasic or relapsing, and disease-modifying therapy for the latter scenario is largely empirical. Here, we report a 14-year-old girl with relapsing Schilder disease within 1 year after disease onset. She has been followed-up for nearly 10 years and remains in sustained remission ever since interferon-β therapy was prescribed after the second attack...
October 29, 2019: Pediatrics
Nicholas M Potisek, Barrett Fromme, Michael S Ryan
No abstract text is available yet for this article.
October 29, 2019: Pediatrics
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