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Acceptable + reduction + pediatric

J M Ming, L C Lee, M E Chua, J Zhu, L H Braga, M A Koyle, A J Lorenzo
INTRODUCTION: While voiding cystourethrogram (VCUG) is a widely-accepted test, it is invasive and associated with radiation exposure. Most cases of primary vesicoureteral reflux (VUR) are low-grade and unlikely to be associated with acquired renal scarring. To select patients at greatest risk, in 2011 the American Academy of Pediatrics (AAP) published guidelines for evaluation of children ages 2 - 24 months with urinary tract infections (UTIs). Similarly, in 2010 the Society for Fetal Urology (SFU) published guidelines for patients with hydronephrosis...
January 3, 2019: Journal of Pediatric Urology
Homood Alharbi, Abdualrahman Alshehry
BACKGROUND: No study has examined the stress level and coping strategies among critical care nurses in Saudi Arabia. OBJECTIVES: Examine perceived stress and coping behaviors among nurses in intensive care units in Saudi Arabia, and the influence of mechanisms on stress. DESIGN: Descriptive cross-sectional. SETTING: Two tertiary training hospitals in Riyadh, Saudi Arabia. SUBJECTS AND METHODS: Nurses from cardiac, surgery and pediatric intensive care units responded to an online survey...
January 2019: Annals of Saudi Medicine
R F Wang, Y Lou, K Tang, G P Liu, M C Chen, G Lin
Objective: To investigate the early clinical outcomes of hip anterior short incision and open reduction and internal fixation for the treatment of children with Delbet Ⅱ femoral neck fracture. Methods: A retrospective analysis of 12 children with DelbetⅡ femoral neck fractures was performed with the anterior short incision approach at Department of Pediatric Orthopaedic, Children's Hospital, Nanjing Medical University from January 2014 to August 2016. There were 7 males and 5 females including 8 cases at left side and 4 cases at right side,aged (11...
February 1, 2019: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Pietro Zucchetta, Marco Branchini, Alessandra Zorz, Valentina Bodanza, Diego Cecchin, Marta Paiusco, Franco Bui
OBJECTIVE: The study performs a comprehensive analysis of image metrics to objectively support the reduction of injected activity in pediatric oncology 18 F-FDG PET/MR (18 F-fludeoxyglucose PET/MR) examinations. Contrast-to-Noise Ratio (CNR), Normalized Noise (NN), tumor burden, and standardized uptake value (SUV) parameters stability were investigated to robustly define the acceptable reduced activity level that preserves the clinical utility of images, considering different PET applications...
January 23, 2019: British Journal of Radiology
Justin Ryan, Jonathan Plasencia, Randy Richardson, Daniel Velez, John J Nigro, Stephen Pophal, David Frakes
BACKGROUND: 3D printing is an ideal manufacturing process for creating patient-matched models (anatomical models) for surgical and interventional planning. Cardiac anatomical models have been described in numerous case studies and journal publications. However, few studies attempt to describe wider impact of the novel planning augmentation tool. The work here presents the evolution of an institution's first 3 full years of 3D prints following consistent integration of the technology into clinical workflow (2012-2014) - a center which produced 79 models for surgical planning (within that time frame)...
November 8, 2018: 3D printing in medicine
Thomas G de Leeuw, Laura Mangiarini, Rebecca Lundin, Florentia Kaguelidou, Tjitske van der Zanden, Oscar Della Pasqua, Dick Tibboel, Adriana Ceci, Saskia N de Wildt
BACKGROUND: Gabapentin has shown efficacy in the treatment of chronic neuropathic or mixed pain in adults. Although pediatric pain specialists have extensive experience with gabapentin for the treatment of neuropathic pain, its use is off-label. Its efficacy and safety in this context have never been shown. The aim of this trial is to compare gabapentin with placebo as add-on to morphine for the treatment of severe chronic mixed or neuropathic pain in children. This trial is part of the European Union Seventh Framework Programme project Gabapentin in Paediatric Pain (GAPP) to develop a pediatric use marketing authorization for a new gabapentin suspension...
January 15, 2019: Trials
Leah K Crockett, George N Okoli, Christine J Neilson, Rasheda Rabbani, Ahmed M Abou-Setta, Terry P Klassen
Importance: Nonpublication of research results in considerable research waste and compromises medical evidence and the safety of interventions in child health. Objective: To replicate, compare, and contrast the findings of a study conducted 15 years ago to determine the impact of ethical, editorial, and legislative mandates to register and publish findings. Design, Setting, and Participants: In this cohort study, abstracts accepted to the Pediatric Academic Societies (PAS) meetings from May 2008 to May 2011 were screened in duplicate to identify phase 3 randomized clinical trials enrolling pediatric populations...
May 18, 2018: JAMA network open
P Osateerakun, I Thara, N Limpaphayom
PURPOSE: Displaced pediatric supracondylar humerus fracture (SCHF) requires a reduction and instrumentation. The trend is to send the cases to a fellowship-trained pediatric orthopedist. This study reviewed the outcomes and complications of SCHF surgically managed by orthopedic surgeons with different backgrounds of subspecialty training. METHODS: The medical records of 87 children (87 elbows) with an average age of 5.9 ± 3.1 (range 1.3-14.1) years with SCHF Gartland 2 and 3 who underwent operative fixation were reviewed...
December 4, 2018: Musculoskeletal Surgery
Vladimir Milovanovic, Dejan Bisenic, Branko Mimic, Bilal Ali, Massimiliano Cantinotti, Ivan Soldatovic, Irena Vulicevic, Bruno Murzi, Slobodan Ilic
OBJECTIVE(S): Modified ultrafiltration has gained wide acceptance as a powerful tool against cardiopulmonary bypass morbidity in pediatric cardiac surgery. The aim of our study was to assess the importance of modified ultrafiltration within conditions of contemporary cardiopulmonary bypass characteristics. METHODS: Ninety⁻eight patients (overall cohort) weighing less than 12 kg undergoing surgical repair with cardiopulmonary bypass were prospectively enrolled in a randomized protocol to receive modified and conventional ultrafiltration (MUF group) or just conventional ultrafiltration (non-MUF group)...
December 1, 2018: Journal of Clinical Medicine
Jeremy Gauntlett-Gilbert, Batool Alamire, Geoffrey B Duggan
Objective: Acceptance of pain is a predictor of pain-related disability and treatment outcome in adolescents with pain. This variable has been previously measured using the Chronic Pain Acceptance Questionnaire for Adolescents (CPAQ-A, McCracken, Gauntlett-Gilbert, & Eccleston, European Journal of Pain, 14, 316-320, 2010). We set out to create a short, eight-item, form of this instrument that retained its factor structure and clinical utility. Methods: We used data collected from two independent samples of adolescents attending residential treatment for disabling chronic pain (N = 187 and N = 159)...
November 28, 2018: Journal of Pediatric Psychology
Deniz Akar, Cenk Köroğlu, Serkan Erkus, Ali Turgut, Önder Kalenderer
Introduction Distal radius fractures are the most frequent fractures seen in pediatric population and usually treated with closed reduction and casting. However, there is a risk of reduction loss and/or angulations in distal radial metaphyseal fractures. The purpose of this study is to evaluate the radiological and functional results of pediatric patients with distal radius metaphyseal fractures in which excessive displacement and/or angulations were accepted and to question upper acceptable limits in light of current literature...
September 5, 2018: Curēus
Alison J Dittmer, Domingo Molina, Cale A Jacobs, Janet Walker, Ryan D Muchow
INTRODUCTION: Following closed reduction and initial casting of pediatric forearm fractures, loss of reduction (LOR) occurs in ∼5% to 75% of fractures. Sugar-tong splinting has been shown to maintain acceptable reduction in pediatric distal radius fractures while potentially avoiding issues associated with circumferential casting. We hypothesized that the sugar-tong splint would be an acceptable method for initial immobilization to prevent LOR in distal, mid-shaft, and proximal pediatric forearm fractures...
November 20, 2018: Journal of Pediatric Orthopedics
M Lehner, F Hoffmann, B Kammer, M Heinrich, L Falkenthal, D Wendling-Keim, M Kurz
INTRODUCTION: In addition to infrastructural and conceptual planning, smooth interdisciplinary cooperation is crucial for trauma room care of severely injured children based on time-saving management and a clear set of priorities. The time to computed tomography (CT) is a well-accepted marker for the efficacy of trauma management. Up to now there are no guidelines in the literature for an adapted approach in pediatric trauma room care. METHODS: A step-by-step algorithm for pediatric trauma room care (Interdisciplinary Trauma Room Algorithm in Pediatric Surgery, iTRAPS ) was developed within the framework of an interdisciplinary team: pediatric surgeons, pediatric anaethesiologists, pediatric intensivists and pediatric radiologists...
October 25, 2018: Der Anaesthesist
Santiago Vallasciani, Badawiya Abdo, Zainab Rauf, Abeeda Anjum, Sanaa Ghulman, Hanan Alghammas, Waleed AlTaweel
BACKGROUND: Almost one-fifth of the population of Saudi Arabia lives in rural areas and may still lack access to specialty healthcare. Because of the growing demand for telehealth services, we initiated the virtual clinic (VC) concept for new referrals to the pediatric urology clinic (PUC), the primary tertiary care unit in Riyadh. METHODS: We conducted a retrospective analysis of costs and timing involved with the VC practice for a 1-year period. The cost analysis is based on savings realized by patients as a result of the VC evaluation...
October 25, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Craig S Derkay, Andrew E Bluher
PURPOSE OF REVIEW: Recurrent respiratory papillomatosis (RRP) is the most common as well as the costliest benign airway neoplasm in the United States [Ivancic et al. (2018). Laryngoscope Investig Otolaryngol 3:22; Derkay (1995). Arch Otolaryngol Head Neck Surg 121:1386]. In addition, it is potentially deadly, with risk of airway obstruction as well as a 3-7% risk of malignant conversion [Schraff et al. (2004). Arch Otolaryngol Head Neck Surg 130:1039]. This review highlights exciting advancements over the past 1-2 years in scientific understanding of the pathophysiology, epidemiology, natural history, prevention, and treatment of this difficult disease...
December 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Deepak Khandelwal, Namita Kalra, Rishi Tyagi, Amit Khatri, Komal Gupta
INTRODUCTION: Visiting a dentist can easily evoke strong fear reactions and acute anxiety in children. It is one of the most basic reasons for avoidance and neglect of dental care. It may obstruct delivery of dental care, as the child may be unwilling to accept the treatment being provided by the dentist. AIM: To evaluate and compare reduction in anxiety level in patients undergoing dental treatment at first dental visit. TECHNIQUE: The study was conducted on 400 patients coming to the Department of Pedodontics and Preventive Dentistry, Guru Teg Bahadur Hospital, University College of Medical Sciences, New Delhi, for their first dental visit...
September 1, 2018: Journal of Contemporary Dental Practice
Rajesh Arora, Puneet Mishra, Aditya Nath Aggarwal, Rahul Anshuman, Ravi Sreenivasan
Background: Pediatric forearm fractures are still considered an enigma in view of their propensity to redisplace in cast. The redisplacement may be a potential cause for malalignment. We prospectively analyzed the role of risk factors and above casting indices in predicting significant redisplacement of pediatric forearm fractures treated by closed reduction and cast. Materials and Methods: 113 patients of age range 2-13 years with displaced forearm fractures, treated by closed reduction and cast were included in this prospective study...
September 2018: Indian Journal of Orthopaedics
M Catherine Sargent
Use of a single-leg spica cast for femoral fractures in ambulatory children 1 to 5 years of age facilitates care and mobilization of the patient. It may allow a shorter duration of cast treatment than is possible with a traditional one and one-half-leg spica cast, particularly in patients 1 to 3 years of age. The single-leg spica is indicated for children who are small enough to be lifted safely in the cast and who have an isolated, closed, low-energy femoral shaft fracture. The procedure consists of the following steps:Step 1: Obtain adequate sedation...
September 28, 2017: JBJS Essential Surgical Techniques
John K Lin, Benjamin J Lerman, James I Barnes, Brian C Boursiquot, Yuan Jin Tan, Alex Q L Robinson, Kara L Davis, Douglas K Owens, Jeremy D Goldhaber-Fiebert
Purpose The anti-CD19 chimeric antigen receptor T-cell therapy tisagenlecleucel was recently approved to treat relapsed or refractory pediatric acute lymphoblastic leukemia. With a one-time infusion cost of $475,000, tisagenlecleucel is currently the most expensive oncologic therapy. We aimed to determine whether tisagenlecleucel is cost effective compared with currently available treatments. Methods Markov modeling was used to evaluate tisagenlecleucel in pediatric relapsed or refractory acute lymphoblastic leukemia from a US health payer perspective over a lifetime horizon...
September 13, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
K B Fieten, R Schappin, W T Zijlstra, L Rijssenbeek-Nouwens, Y Meijer, S G M A Pasmans
BACKGROUND: A 6 week personalized integrative multidisciplinary treatment program (PIM) was developed for children with difficult to treat AD who appeared unresponsive to treatment according to current guidelines. OBJECTIVE: The aim of the present study was to identify clinical and psychosocial characteristics that predict long-term treatment success after PIM. METHODS: Treatment was considered successful when there was a 75% reduction on the Self-Administered Eczema Area and Severity Index and/or little impact of AD on daily life, measured with the Children's Dermatology Life Quality Index (score <= 6), six months after the end of PIM...
September 10, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
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