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pediatrics RCT

Maya Eiger-Moscovich, Oren Tomkins-Netzer, Radgonde Amer, Zohar Habot-Wilner, Ahmed Kasb, Ronit Friling, Michal Kramer
PURPOSE: To investigate the clinical course and visual outcome of macular edema (ME) in pediatric patients with chronic noninfectious uveitis. DESIGN: Retrospective case series. METHODS: The databases of the uveitis clinics of four tertiary medical centers in Israel and the UK were searched for all children treated for uveitic ME in 2005-2015. Data were collected from the medical records as follows: demographics, diagnosis, visual acuity, clinical and imaging findings, and treatment given specifically for ME...
February 14, 2019: American Journal of Ophthalmology
Catherine A Chapin, Simon P Horslen, James E Squires, Henry Lin, Niviann Blondet, Saeed Mohammad, Estella M Alonso
OBJECTIVE: To examine the characteristics and outcomes of a multicenter patient cohort with indeterminate pediatric acute liver failure (IND-PALF) and with aplastic anemia with acute hepatitis treated with corticosteroids. STUDY DESIGN: Retrospective study of patients age 1-17 years with IND-PALF and aplastic anemia with acute hepatitis who presented between 2009 and 2018 to 1 of 4 institutions and were treated with corticosteroids for presumed immune dysregulation...
February 12, 2019: Journal of Pediatrics
Pierangelo Torquato, Danilo Giusepponi, Anna Alisi, Roberta Galarini, Desirée Bartolini, Marta Piroddi, Laura Goracci, Alessandra Di Veroli, Gabriele Cruciani, Annalisa Crudele, Valerio Nobili, Francesco Galli
Two recent randomized controlled trials demonstrated improved radiographic, histological and hepatometabolic cues of non-alcoholic steatohepatitis (NASH) in pediatric patients treated with the ω-3 fatty acid docosahexaenoic acid (DHA) in combination with vitamin D (VD) or with choline (CHO) and vitamin E (VE), the DHA-VD and DHA-CHO-VE trials, respectively). In the present study we verified the nutritional compliance to these DHA-based multivitamin treatments; lipidomics biomarkers of the reported outcome on NASH indicators were also investigated...
February 14, 2019: Scientific Reports
Jun Young Choi, Woi Hyun Hong, Jin Soo Suh, Jae Hwi Han, Dong Joo Lee, Yong Jae Lee
BACKGROUND: We aimed to evaluate the structural effects of the long-term use of orthoses for pediatric flexible flat foot (PFFF) using an algorithmic approach and a structured critical framework to assess the methodological quality of reported studies. METHODS: A comprehensive literature search using five databases, namely MEDLINE, the Cochrane Library, Scopus, the Web of Science, and EMBASE, was performed for pertinent articles published before March 30, 2018. Studies with quantitative data on the effects of the long-term use of orthoses for PFFF were included...
February 1, 2019: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Hala S Abdel-Ghaffar, Hamdy A Youseff, Fatma A Abdelal, Mohamed A Osman, Jehan A Sayed, Mohamed Amir Fathy Riad, Marwa M Abdel-Rady
BACKGROUND: Effects of intraoperative recruitment maneuvers (RMs) on oxygenation and pulmonary compliance are lost during recovery if high inspired oxygen and airway suctioning are used. We investigated the effect of post-extubation noninvasive CPAP mask application on the alveolar arterial oxygen difference [(A-a) DO2 ] after pediatric laparoscopic surgery. METHODS: Sixty patients (1-6 years) were randomly allocated to three groups of 20 patients, to receive zero end-expiratory pressure (ZEEP group), RM with decremental PEEP titration only (RM group), or followed with post-extubation CPAP for 5 minutes (RM-CPAP group)...
February 14, 2019: Acta Anaesthesiologica Scandinavica
An Jacobs, Inge Derese, Sarah Vander Perre, Esther van Puffelen, Sören Verstraete, Lies Pauwels, Sascha Verbruggen, Pieter Wouters, Lies Langouche, Gonzalo Garcia Guerra, Koen Joosten, Ilse Vanhorebeek, Greet Van den Berghe
INTRODUCTION: Non-thyroidal illness (NTI), which occurs with fasting and in response to illness, is characterized by thyroid-hormone inactivation with low T3 and high rT3, followed by suppressed TSH. Withholding supplemental parenteral nutrition early in pediatric critical illness (late-PN), thus accepting low/no macronutrient intake up to day 8 in the pediatric intensive-care-unit (PICU), accelerated recovery as compared with initiating supplemental parenteral nutrition early (early-PN)...
February 14, 2019: Thyroid: Official Journal of the American Thyroid Association
Scott A Davis, Delesha Carpenter, Charles Lee, Nacire Garcia, Daniel S Reuland, Gail Tudor, Ceila E Loughlin, Betsy Sleath
BACKGROUND: Many adolescents do not obtain the maximum benefit from their asthma medications. Improving patient-provider communication may improve adolescents' asthma knowledge, adherence, and clinical outcomes. OBJECTIVE: To determine how a question prompt list and educational video intervention affect youth- and caregiver-reported medication adherence and self-reported medication problems. METHODS: Adolescents with persistent asthma (n = 359; 56...
February 13, 2019: Annals of Pharmacotherapy
Dilek Konuk Sener, Meryem Aydin, Sengul Cangur, Evren Guven
PURPOSE: This study was performed to determine the effect of oral care using chlorhexidine, vitamin E and honey on oral mucositis (OM) management in children treated in a pediatric intensive care unit (PICU). DESIGN AND METHODS: The study was a randomized controlled trial with a parallel design. The study sample was composed of 150 children who were treated in the PICU of a university hospital in Turkey. Children enrolled in the study were randomly divided into six groups based on the oral care solutions used (n = 25 in each group)...
February 8, 2019: Journal of Pediatric Nursing
Gabriella Bottari, Matteo Di Nardo, James Gleeson, Francesca Minoia, Andrea Moscatelli, Corrado Cecchetti, Enrico E Verrina
BACKGROUND: Data on clinical applications of blood purification techniques in children are scarce. The aim of this review is to offer a clinical overview, as complete as possible, on blood purification in children with hyper-inflammatory syndromes (HS). METHODS: A review of the literature using the PubMed, EMBASE, Web of Science, and Scopus databases, on the most recent data about blood purification in children was conducted until June 2018. Except for three randomized controlled trials (RCTs) on Plasma-exchange (PE), no RCTs, but only observational studies or case reports were found regarding other blood purification techniques in children...
February 7, 2019: Minerva Anestesiologica
Ioannis Bellos, Dimitrios C Iliopoulos, Despina N Perrea
BACKGROUND: Acute kidney injury constitutes a major complication of cardiac surgery in pediatric patients. The present meta-analysis aims to accumulate current literature and assess the efficacy of pharmacological interventions in preventing postoperative renal dysfunction after congenital heart surgery. METHODS: Literature search was conducted using Medline (1966-2018), Scopus (2004-2018), Cochrane Central Register of Controlled Trials CENTRAL (1999-2018), Clinicaltrials...
February 8, 2019: Clinical and Experimental Nephrology
David G Bundy, Hardeep Singh, Ruth Ek Stein, Tammy M Brady, Christoph U Lehmann, Moonseong Heo, Heather C O'Donnell, Elizabeth Rice-Conboy, Michael L Rinke
BACKGROUND: Diagnostic errors contribute to the large burden of healthcare-associated harm experienced by children. Primary care settings involve high diagnostic uncertainty and limited time and information, creating ideal conditions for diagnostic errors. We report on the design and conduct of Project RedDE, a stepped-wedge, cluster-randomized controlled trial of a virtual quality improvement collaborative aimed at reducing diagnostic errors in pediatric primary care. METHODS: Project RedDE cluster-randomized pediatric primary care practices into one of three groups...
February 5, 2019: Clinical Trials: Journal of the Society for Clinical Trials
Dilek Küçük Alemdar, Yeşim Yaman Aktaş
PURPOSE: This study aimed to investigate the effects of the Buzzy, Jet lidokaine, bubble-blowing and inhalation aromatherapy with lavender essence on pain, stress and fear in children undergoing phlebotomy. DESIGNS AND METHODS: This study was a prospective, randomized controlled trial. The sample was comprised of children aged 5 to 10 years requiring blood tests. Children were assigned to five subgroups through randomization performed using a computer program: the Buzzy group (n = 39), Jet lidokaine group (n = 39), bubble-blowing group (n = 39), inhalation aromatherapy with lavender essence group (n = 39) and control group (n = 39)...
January 30, 2019: Journal of Pediatric Nursing
Mandy Niemitz, Miriam Schrader, Julia Carlens, Meike Hengst, Claudia Eismann, Lutz Goldbeck, Matthias Griese, Nicolaus Schwerk
OBJECTIVE: Patient education in children with rare chronic diseases like children's interstitial lung disease (chILD) remains a challenge. AIMS: To develop and evaluate a component-based educational program for individual counselling and to improve patients' and caregivers' self-efficacy and treatment satisfaction. Furthermore, to create chILD-specific educational material and assess physicians' satisfaction with the intervention as well as patients' health-related quality of life (HrQoL)...
January 23, 2019: Patient Education and Counseling
Merrick S Fallah, Mateen R Shaikh, Binod Neupane, Daniel Rusiecki, Teresa A Bennett, Joseph Beyene
OBJECTIVE: Irritability is common in pediatric autism spectrum disorder (ASD) patients. This can have major implications in child development, receptivity to behavioral therapy, as well as child and caregiver well-being. A systematic review and network meta-analysis were conducted to assess the efficacy and safety of atypical antipsychotics in treating irritability in these patients. METHODS: Studies were identified from Medline, Embase, and PsycINFO from inception to March 2018...
February 1, 2019: Journal of Child and Adolescent Psychopharmacology
Ericka L Fink, Sue R Beers, Amy J Houtrow, Rudolph Richichi, Cheryl Burns, Lesley Doughty, Roberto Ortiz-Aguayo, Catherine A Madurski, Cynthia Valenta, Maddie Chrisman, Lynn Golightly, Michelle Kiger, Cheryl Patrick, Amery Treble-Barna, Dorothy Pollon, Craig M Smith, Patrick Kochanek
OBJECTIVES: Few feasibility, safety, and efficacy data exist regarding ICU-based rehabilitative services for children. We hypothesized that early protocolized assessment and therapy would be feasible and safe versus usual care in pediatric neurocritical care patients. DESIGN: Randomized controlled trial. SETTING: Three tertiary care PICUs in the United States. PATIENTS: Fifty-eight children between the ages of 3-17 years with new traumatic or nontraumatic brain insult and expected ICU admission greater than 48 hours...
January 30, 2019: Pediatric Critical Care Medicine
Andrea Kresz, Benjamin Mayer, Maria Zernickel, Carsten Posovszky
Background and study aims  Use of carbon dioxide (CO 2 ) instead of room air (RA) during colonoscopy in adults revealed significantly less flatulence and abdominal pain in several studies. The objectives of this study were to investigate the effects of CO 2 usage on post-interventional pain, abdominal discomfort, abdominal girth, pCO 2 levels, and narcotic requirement in deeply sedated pediatric patients. Patients and methods  A total of 97 children and adolescents aged 4 years to 17 years undergoing colonoscopy were randomized to RA or CO 2 in a prospective, randomized, controlled trial...
February 2019: Endoscopy International Open
Nancy Samir Elbarbary, Eman Abdel Rahman Ismail, Mamdouh Ahmed Zaki, Yasser Wagih Darwish, Marwa Zaki Ibrahim, Manal El-Hamamsy
BACKGROUND: Homocysteine levels are elevated in patients with type 1 diabetes mellitus (T1DM) and could induce renal injury. B vitamins have an important role in preventing microvascular complications of diabetes. AIM: We performed a randomized-controlled trial of oral supplementation with vitamin B complex as an adjuvant therapy for nephropathy in pediatric T1DM patients and assessed its relation to homocysteine and cystatin C as a marker of nephropathy. METHODS: This trial included 80 T1DM patients with microalbuminuria, despite oral angiotensin-converting enzyme inhibitors, aged 12-18 years with at least 5 years disease duration and HbA1c ≤8...
January 17, 2019: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Jeremias Antinew, Bruno Pitrosky, Lloyd Knapp, Mary Almas, Verne Pitman, Jing Liu, Dana Craiu, Margaret Modequillo, Douglas Nordli, Viktor Farkas, Mark Kristof Farkas
Efficacy and safety of pregabalin as adjunctive treatment for children (aged 4-16 years) with partial-onset seizures, hereafter termed focal onset seizures for this study, was evaluated. This double-blind, randomized, placebo-controlled, international study had 3 phases: 8-week baseline, 12-week double-blind treatment (2-week dose escalation; 10-week fixed dose), and 1-week taper. Selection criteria included experiencing focal onset seizures and receiving a stable regimen of 1 to 3 antiepileptic drugs. Study treatments were pregabalin 2...
January 27, 2019: Journal of Child Neurology
Ya-Lei Sun, Hai-Tao Zheng, Jia-Lei Tao, Ming-Chen Jiang, Chan-Chan Hu, Xin-Min Li, Bin Yuan
OBJECTIVE: Chinese herbal medicine has been gradually used to treat pediatric adenoid hypertrophy. This meta-analysis were conducted to evaluate the clinical efficacy and safety of Chinese herbal medicine in the treatment of pediatric adenoid hypertrophy. METHODS: Randomized controlled trials involving Chinese herbal medicine in the treatment of pediatric adenoid hypertrophy were identified from Cochrane Central Register of Controlled Trials, PubMed, EMBASE, Chinese National Knowledge Infrastructure, Chinese Biomedical Database, Wanfang Database and VIP Information Database...
January 19, 2019: International Journal of Pediatric Otorhinolaryngology
Sureyya Hikmet Kozcu, Erhan Demirhan, İbrahim Çukurova
INTRODUCTION: Adenoidectomy is one of the most frequently performed surgical procedures with different techniques and technologies. Although curettage adenoidectomy (CA) has been practiced conventionally for many years, endoscopic microdebrider adenoidectomy (EMA) has emerged as an innovative surgical method. Comparing physiological effects, efficacy and safety of the endoscopic microdebrider adenoidectomy (EMA) and curettage adenoidectomy (CA) in pediatric population is aimed with this prospective, single-blind, randomized, controlled trial...
January 16, 2019: International Journal of Pediatric Otorhinolaryngology
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