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Pain children emergency

Alice Louise Mears, May Bisharat, Feilim Murphy, Chandrasen K Sinha
PURPOSE: Following a previously published 1 year audit of readmissions, this is a reaudit of our readmission rate (ReAd) in paediatric surgery, asking: is ReAd reproducible, can it be an indicator of quality of care in paediatric surgery, and can it be improved? METHOD: Prospectively collected Hospital Episode statistics were used to identify readmissions over 1 year. Patients were subdivided into emergency vs elective regarding the first admission and outcomes compared including with our previously published ReAd data...
February 18, 2019: Pediatric Surgery International
Gangshan Liu, Ying Fan
BACKGROUND: Laparoscopic partial splenectomy (LPS) is a challenging procedure. The aim of this review was to evaluate its feasibility, safety, and potential benefits. METHODS: We conducted a comprehensive review for the years 1995-2018 to retrieve all relevant articles. RESULTS: A total of 44 studies with 252 patients undergoing LPS were reviewed. Six studies described combined operations. Ranges of operative time and estimated blood loss were 50-225 min and 0-1200 ml, respectively...
February 14, 2019: World Journal of Surgery
Joby Pulikkan, Agnisrota Mazumder, Tony Grace
Autism spectrum disorder (ASD) is a severe neurodevelopmental or neuropsychiatric disorder with elusive etiology and obscure pathophysiology. Cognitive inabilities, impaired communication, repetitive behavior pattern, and restricted social interaction and communication lead to a debilitating situation in autism. The pattern of co-occurrence of medical comorbidities is most intriguing in autism, compared to any other neurodevelopmental disorders. They have an elevated comorbidity burden among which most frequently are seizures, psychiatric illness, and gastrointestinal disorders...
2019: Advances in Experimental Medicine and Biology
Gunilla Pousette Lundgren, Tove Hasselblad, Anna Stigsdotter Johansson, Anna Johansson, Göran Dahllöf
Amelogenesis imperfecta (AI) is a hereditary developmental disorder affecting the enamel of teeth. Affected patients present with tooth hypersensitivity, rapid tooth wear, or fractures of enamel as well as alterations in color and shape, all of which compromise esthetic appearance and masticatory function. Chronic conditions in childhood severely impact the whole family, affecting normal family routines and/or increasing the family's financial burden. The aim of this study was to explore experiences and the impact on daily life of being a parent to a child with severe forms of amelogenesis imperfecta...
February 9, 2019: Dentistry journal
Jae Young Ji, Jin Soo Park, Ji Eun Kim, Dah Hyung Kim, Jin Hun Chung, Hea Rim Chun, Ho Soon Jung, Sie Hyeon Yoo
BACKGROUND: Sevoflurane is widely used to anesthetize children because of its rapid action with minimal irritation of the airways. However, there is a high risk of agitation after emergence from anesthesia. Strabismus surgery, in particular, can trigger agitation because patients have their eyes covered in the postoperative period. The aim of this study was to determine whether or not esmolol and lidocaine could decrease emergence agitation in children. METHODS: Eighty-four patients aged 3 to 9 years undergoing strabismus surgery were randomly assigned to a control group (saline only), a group that received intravenous lidocaine 1...
February 5, 2019: Chinese Medical Journal
Fatma Sarac, Selman Yeniocak, Sevgi Buyukbese Sarsu, Kamil Sahin, Esma Yucetas, Macit Koldas, Burak Katipoglu
AIM: The differential diagnosis of paediatric patients admitted to the emergency department presenting with acute abdominal pain may be difficult. This study aims to investigate the diagnostic value of ischaemia-modified albumin (IMA) in the differential diagnosis of acute abdominal pain in children and in distinguishing surgical from non-surgical cases. METHODS: The study was conducted with a total of 152 subjects who provided informed consent, including 112 patients admitted to the paediatric emergency department and paediatric surgical clinic and 40 healthy control subjects...
February 5, 2019: Journal of Paediatrics and Child Health
A Siu Uribe, J I Garrido Pérez, F Vázquez Rueda, M R Ibarra Rodrígue, F J Murcia Pascual, S D Ramnarine Sánchez, R M Paredes Esteban
AIM: To present our experience in pediatric patients with testicular torsion (TT) treated by manual detorsion (MD). PATIENTS AND METHODS: Retrospective analysis of patients treated by MD in a 10-year period in a single center. Description of symptoms, detorsion technique, follow-up and complications. RESULTS: 76 patients diagnosed with TT were studied in a 10-year period. 16 patients were treated by MD. Mean age was 12 years (Range: 10-13 years) and time from onset of pain was 5...
January 21, 2019: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Catarina Faria, Henedina Antunes, Teresa Pontes, Ana Antunes, Sofia Martins, Susana Carvalho
Background Venous thromboembolism (VTE) - which includes deep venous thrombosis (DVT) and pulmonary embolism (PE) - has been increasingly recognized in the pediatric population. The estimated incidence is 0.07-0.14 cases per 10,000 children. Most cases are associated with two or more risk factors. Medium and long-term complications include recurrence and post-thrombotic syndrome (PTS). Objective To characterize the adolescent population with the diagnosis of DVT of lower limbs in a tertiary hospital, regarding its clinical presentation, associated risk factors, treatment and outcome...
February 1, 2019: International Journal of Adolescent Medicine and Health
Angélica Marie Garcia, Imran Asad, Mark O Tessaro, Adam Sivitz, Katharine Osborn, Ashkon Shaahinfar, Stephanie K Leung, Erin Rowe, Antonio Riera
Point-of-care ultrasound can be used to screen for malrotation with and without volvulus in the newborn with bilious vomiting, as well as children with unexplained intermittent abdominal pain. We discuss cases where infants and children presenting to pediatric emergency departments with bilious vomiting and/or intermittent abdominal pain were initially screened for small bowel pathology with point-of-care ultrasound. Bedside findings suggestive of midgut volvulus were confirmed with radiology-performed ultrasound or upper gastrointestinal fluoroscopy...
January 29, 2019: Pediatric Emergency Care
Cristina Parra, Nuria Carreras, Alba Vergés, Victoria Trenchs, Carles Luaces
OBJECTIVES: To study the experience reported by pediatric patients when visiting a pediatric emergency department (PED). METHODS: This was a prospective descriptive study, carried out in November 2014. A 12-question survey was developed, based on the Picker Patient Experience Questionnaire. The aim was to assess patient experience of children between 8 and 18 years old, attended in the PED of a high-complexity pediatric hospital. Questions were about the waiting time and setting, medical staff explanations and actions, treatment, and discharge...
January 29, 2019: Pediatric Emergency Care
Lindsay Marie Day, Rong Huang, Pamela Joy Okada
OBJECTIVES: The primary objective of this study was to evaluate the management of pain after traumatic injury in the pediatric emergency department (ED) as measured by time to analgesic administration and pain resolution, stratified by triage acuity level. METHODS: This is a retrospective descriptive study evaluating the management of children who presented with pain after injury to an urban level 1 trauma center. Consecutive enrollment of 1000 patients identified by ICD-9 codes that included all injuries or external causes for injury (700-999 and all E codes) and who had pain identified by triage pain assessment was performed...
January 29, 2019: Pediatric Emergency Care
Scott Hartman, Elizabeth Brown, Elizabeth Loomis, Holly Ann Russell
Acute gastroenteritis is defined as a diarrheal disease of rapid onset, with or without nausea, vomiting, fever, or abdominal pain. In the United States, acute gastroenteritis accounts for 1.5 million office visits, 200,000 hospitalizations, and 300 deaths in children each year. Evaluation of a child with acute gastroenteritis should include a recent history of fluid intake and output. Significant dehydration is unlikely if parents report no decrease in oral intake or urine output and no vomiting. The physical examination is the best way to evaluate hydration status...
February 1, 2019: American Family Physician
James S Lin, Julie Balch Samora
Acute compartment syndrome (ACS) is an emergency with potentially devastating consequences. Delayed recognition may be especially concerning for the pediatric population, as children present with a wide variety of etiologies, symptoms, and levels of communication. We sought to determine the average time from injury to diagnosis, most common presentations, the degree to which providers obtained pressure measurements, and outcomes of ACS in the pediatric population. We performed a systematic review of multiple databases to include English-language clinical studies reporting ACS of the extremity in pediatric patients...
January 25, 2019: Journal of Pediatric Orthopedics. Part B
P Luu, B Mestdagh, C Barré-Drouard, P Richart, C Courtecuisse-Vamour, T Rakza, C Garabedian, D Subtil
BACKGROUND: Considering its benefits, immediate skin-to-skin should be applied irrespective of the way of delivery. While it is increasingly applied in case of vaginal delivery, it remains difficult to implement in case of caesarean section. OBJECTIVE: To estimate the degree of implementation of skin-to-skin in case of caesarean section. METHODS: Survey in immediate postpartum with a continuous series of patients having given birth by caesarean - whether scheduled or not - in a level 3 hospital systematically realizing skin-to-skin in case of vaginal delivery...
January 24, 2019: Gynecologie, Obstetrique, Fertilite & Senologie
Katie A Schappacher, Wenrui Xie, Jun-Ming Zhang, Mark L Baccei
Our recent work has shown that the early-life administration of vincristine (VNC), commonly used to treat pediatric cancers, evokes mechanical pain hypersensitivity in rats that emerges during adolescence and persists into adulthood. However, the underlying mechanisms remain unclear, as nothing is known about how neonatal VNC treatment influences peripheral and central nociceptive processing at the cellular level. Here, we used in vitro intracellular microelectrode and whole-cell patch-clamp recordings to evaluate the consequences of early-life VNC administration on the intrinsic membrane properties of adolescent dorsal root ganglion and spinal superficial dorsal horn neurons...
November 19, 2018: Pain
Jia Bainga Kangbai, Christian Heumann, Michael Hoelscher, Foday Sahr, Guenter Froeschl
BACKGROUND: The West Africa Ebola Virus Disease (EVD) outbreak in 2014-2016 was declared by the World Health Organization (WHO) a public health emergency of international concern. Most of the previous studies done in Sierra Leone relating to the clinical and epidemiological features of EVD during the 2014-2016 West African outbreak focused on adult EVD patients. There have been conflicting reports about the effects of EVD on children during previous outbreaks. METHODS: This is an observational retrospective analysis of medical data of all laboratory confirmed paediatric EVD patients below 15 years of age who were admitted at the 34 Military Hospital Ebola Treatment Center (ETC) in Wilberforce, Sierra Leone between June 2014 to April 2015...
January 24, 2019: BMC Infectious Diseases
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
Alice Brambilla, Mattia Pasti, Niccolò Parri
OBJECTIVE: Otitis media, facial pain in trigeminal region, and ipsilateral abducens nerve palsy clinically define Gradenigo syndrome, a rare but serious complication of suppurative middle ear infection. Radiological investigation is required to confirm petrous apex involvement and to exclude further consequences as sinus thrombosis, meningitis, and intracranial abscess. METHODS/RESULTS: We report the case of an 8-year-old child referred to our emergency department for recurrent headache and sudden strabismus...
January 21, 2019: Pediatric Emergency Care
Alberto Di Mascio, Benedetta Bossini, Egidio Barbi, Franca Benini, Giorgio Cozzi
Procedural sedation and analgesia with ketamine are part of daily practice for children undergoing painful procedures in the paediatric emergency department (ED) of North America. A massive number of studies demonstrate ketamine's safety and efficacy in the hands of trained ED paediatricians, with few severe adverse events (SAEs) recorded. Since there are no data on ketamine's usage in Italian paediatric EDs, we created a survey to examine procedural sedation with ketamine in the EDs of the Italian PIPER (Pain in Paediatric Emergency Room) group, which includes 36 paediatric EDs providing 1...
January 22, 2019: European Journal of Pediatrics
Anja Hetland Smeland, Tone Rustøen, Torgun Naess, Lill Nybro, Stefan Lundberg, Hanne Reinertsen, Trond H Diseth, Alison Twycross
AIMS AND OBJECTIVES: To explore children's postsurgical experiences with pain and pain management in the recovery unit. BACKGROUND: Children's pain is underestimated and undertreated. Untreated pain can cause unnecessary suffering, increased complication risks, and may lead to chronic pain. Research exploring children's experiences with postoperative pain and pain management is limited. DESIGN: A qualitative, exploratory study. The study complied with the Consolidated Criteria for Reporting Qualitative Research (COREQ)...
January 22, 2019: Journal of Clinical Nursing
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