Yanlin Yang, Jing Lv, Yajiao Li, Changping Gan, Peng Ji
BACKGROUND: Intracardiac thrombosis (ICT) is a rare complication after the cardiopulmonary surgery for interrupted aortic arch (IAA) or total anomalous pulmonary venous connection (TAPVC) without previous records. There are still no general guidelines regarding as the mechanism or management of postoperative ICT in neonates and younger infants. CASE PRESENTATION: We reported the conservative and surgical therapies in two neonates with intra-ventricular and intra-atrial thrombosis after the anatomical repair for IAA and TAPVC, respectively...
June 2, 2023: BMC Pediatrics
María Carolina Rivacoba, Rodolfo Villena, Juan Carlos Hormazabal, Dona Benadof, Ernesto Payá, Francisca Valdivieso, Andrea Canals, Cindy Arteta-Acosta, María Elena Santolaya
BACKGROUND: Hypervirulent clonal complex (cc) have been associated with higher incidence and case fatality rate of invasive meningococcal disease (IMD). The aim of this study was to describe the clinical manifestations of the hypervirulent cc of meningococcus in children. METHODS: Retrospective study in patients hospitalized by IMD microbiologically confirmed at three children's tertiary health care centers in Santiago, Chile, between 2010 and 2018. Demographic, clinical information and determination of the cc and factor H binding protein (fHbp) alleles were performed...
June 1, 2023: Pediatric Infectious Disease Journal
Michelle Munyikwa, Charles K Hammond, Leanne Langmaid, Leah Ratner
Extended life expectancies and shifting dynamics in chronic disease have changed the landscape of public health interventions worldwide, with an increasing emphasis on chronic care. As a result, transition from pediatric to adult care for medically complex adolescents and young adults is a growing area of intervention. Transition medicine is a nascent field whose current emphasis is on middle- and high-income countries, and thus far its methods and discourse have reflected those origins. Through several case-based examples, this paper aims to highlight the possibilities of an analytic approach grounded in structural competency for transforming transition medicine through a human rights-based framework, with an emphasis on imagining a more global framework for transition medicine...
June 2023: Health and Human Rights
Ivanna Natasha Maxson, Erik Su, Kyle A Brown, M Hossein Tcharmtchi, Sarah Ginsburg, Vidit Bhargava, Jesse Wenger, Gabriela I Centers, Kiyetta H Alade, Stephanie K Leung, Sharada H Gowda, Saul Flores, Alan Riley, Satid Thammasitboon
Point-of-care ultrasound (POCUS) is increasingly accepted in pediatric critical care medicine as a tool for guiding the evaluation and treatment of patients. POCUS is a complex skill that requires user competency to ensure accuracy, reliability, and patient safety. A robust competency-based medical education (CBME) program ensures user competency and mitigates patient safety concerns. A programmatic assessment model provides a longitudinal, holistic, and multimodal approach to teaching, assessing, and evaluating learners...
June 1, 2023: Pediatric Critical Care Medicine
Maryanne Bourque, Dawn Marie E Recigno, Katie Preedy
Purpose: Discharging infants from the NICU is complex, requiring the coordination of multiple aspects of care. Patient follow-up includes transferring medical care to primary care providers (PCP) who initially may have to rely on parents/caregivers for details about the child's history and current needs. Improving communication between the NICU and primary care offices within this pediatric health system was a goal of the organization, especially as value-based care was launched. Design: A pilot program was introduced in which families, PCP, and NICU providers for medically complex infants were offered the opportunity to participate in video conference calls...
June 1, 2023: Neonatal Network: NN
Noahlana Monzon, Emma M Kasahara, Aarthi Gunasekaran, Kathryn Y Burge, Hala Chaaban
Necrotizing enterocolitis (NEC) is the leading cause of morbidity and mortality in preterm infants. NEC is multifactorial and the result of a complex interaction of feeding, dysbiosis, and exaggerated inflammatory response. Feeding practices in the neonatal intensive care units (NICUs) can vary among institutions and have significant impact on the vulnerable gastointestinal tract of preterm infants. . These practices encompass factors such as the type of feeding and fortification, duration of feeding, and rate of advancement, among others...
May 23, 2023: Seminars in Pediatric Surgery
Maria Larsen Brattfjell, Thomas Jozefiak, Stian Lydersen, Lars Wichstrøm
OBJECTIVE: Psychosocial interventions for children's mental health problems typically differ in several characteristics, such as therapist training, content, motivation for treatment, and extent of comorbid conditions among patients, depending on whether the interventions take place in clinical research studies or in real-life settings. Accordingly, the effects found in research studies may not be generalizable to typical service provision. The authors sought to examine the potential associations between receiving usual care and later psychiatric symptoms, impairment, and potential improvements in social skills...
May 31, 2023: Psychiatric Services: a Journal of the American Psychiatric Association
Laura Libreros-Peña, Jaime A Quintero, Arnold Gelves, Juliana Alarcón, Sergio Morales, María Fernanda Escobar, Andres M Valencia, Sara Guzmán, Julio Diez-Sepulveda
INTRODUCTION: As a result of the new coronavirus pandemic, a highly complex academic hospital in Latin America implemented a telemedicine service for the care of obstetric, pediatric, and adult patients. In 2020, regional emergency services collapsed due to the increase in demand for care, generating the need to open expansion services and seek strategies to provide timely care to consulting patients. OBJECTIVE: We retrospectively describe the clinical experience of patients who consulted the emergency department via telemedicine across a videoconference tool using digital platforms...
May 30, 2023: BMC Health Services Research
Shay Reinke, Zairha Snider
Children with recurrent fevers in a short period of time need to be worked up to identify the underlying cause. Fevers in children and infants can be from many different sources. Vesicoureteral reflux (VUR) is an anatomical and physiological anomaly in children that can lead to retrograde urine flow from the bladder back into the distal ureters. This retrograde flow can cause distention, scarring, and recurrent infections including urinary tract infections (UTIs) and pyelonephritis. Identification of multiple UTIs in a short period of time should raise suspicion for a more complex pathology such as VUR and requires a more thorough workup...
April 2023: Curēus
Mark S Brittan, Catia Chavez, Christy Blakely, Brooke Dorsey Holliman, Jeannie Zuk
OBJECTIVES: We evaluated Colorado's paid family caregiver certified nursing assistant (CNA) program by assessing stakeholders' perceptions of the model's strengths and potential areas for improvement. METHODS: A professional bilingual research assistant conducted key informant interviews of English- and Spanish-speaking certified nursing assistant (CNA) family caregivers (FCs), primary care providers, and pediatric home health administrators of children with medical complexity in the family caregiver CNA program...
May 30, 2023: Pediatrics
Erin M Garvey, Megan Fuller, Jason Frischer, Casey M Calkins, Rebecca M Rentea, Matthew Ralls, Richard Wood, Michael D Rollins, Jeffrey Avansino, Ron W Reeder, Megan M Durham
BACKGROUND/RATIONALE: Anorectal malformations (ARM) are associated with congenital anomalies of the spine, but the impact of a minor spinal cord dysraphism (mSCD) on fecal continence in the setting of ARM remains unclear. MATERIALS/METHODS: A retrospective review was performed utilizing data from the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) registry. The patient cohort was reviewed for ARM type, mSCD screening/incidence/neurosurgical intervention and age-based BMP utilization...
April 29, 2023: Journal of Pediatric Surgery
John J Connolly, Eta S Berner, Maureen Smith, Samuel Levy, Shannon Terek, Margaret Harr, Dean Karavite, Sabrina Suckiel, Ingrid A Holm, Kevin Dufendach, Catrina Nelson, Atlas Khan, Rex L Chisholm, Aimee Allworth, Wei-Qi Wei, Sarah T Bland, Ellen Wright Clayton, Emily R Soper, Jodell E Linder, Nita A Limdi, Alexandra Miller, Scott Nigbur, Hana Bangash, Marwan Hamed, Alborz Sherafati, Anna C F Lewis, Emma Perez, Lori A Orlando, Tejinder K Rakhra-Burris, Mustafa Al-Dulaimi, Selma Cifric, Courtney Lynam Scherr, Julia Wynn, Hakon Hakonarson, Maya Sabatello
Polygenic risk scores (PRS) have potential to improve healthcare by identifying individuals at elevated risk for common complex conditions. Use of PRS in clinical practice, however, requires careful assessment of the needs and capabilities of patients, providers, and healthcare systems. The electronic Medical Records and Genomics (eMERGE) Network is conducting a collaborative study which will return PRS to 25,000 pediatric and adult participants. All participants will receive a risk report, potentially classifying them as high risk (∼2-10% per condition) for one or more of 10 conditions based on PRS...
May 26, 2023: Genetics in Medicine: Official Journal of the American College of Medical Genetics
Blythe Pollack, Ryan P Barbaro, Stephen M Gorga, Erin F Carlton, Michael Gaies, Joseph G Kohne
AIM: Extracorporeal membrane oxygenation (ECMO) provides temporary support in severe cardiac or respiratory failure and can be deployed in children who suffer cardiac arrest. However, it is unknown if a hospital's ECMO capability is associated with better outcomes in cardiac arrest. We evaluated the association between pediatric cardiac arrest survival and the availability of pediatric extracorporeal membrane oxygenation (ECMO) at the treating hospital. METHODS: We identified cardiac arrest hospitalizations, including in- and out-of-hospital, in children (0-18 years old) using data from the Health Care Utilization Project (HCUP) National Inpatient Sample (NIS) between 2016-2018...
May 26, 2023: Resuscitation
Erin Brandon, Pamela Green, Lori Palozzi, Dilshad Kassam-Lallani, Andrea Lauzon, Vera Nenadovic, Ritu Puthen, Louise Rudden, Marilyn Ballantyne
The nurse practitioner role is strongly suited to meet the needs of children with complex developmental conditions in pediatric rehabilitation settings as they have a unique combination of clinical expertise. To meet the increasing demands in a large Canadian pediatric rehabilitation hospital, the NP role was implemented in several clinical program settings to improve access to care. This paper describes the contributions of NPs to nine specialized inpatient and outpatient programs in NP-led, collaborative NP and physician or interagency care team models of practice...
May 27, 2023: Journal of Pediatric Health Care
Marie L Neumann, Jessica Y Allen, Amy Ladner, Swapna Kakani, Meaghann S Weaver, David F Mercer
BACKGROUND: Children with short bowel syndrome (SBS) have complex care needs, most of which are met in the home by family caregivers who may experience a range of stressors unique to this experience. Prior research suggests that parents of children with SBS have poorer health-related quality of life than peers parenting children without health needs, but the mechanisms shaping parent outcomes are understudied. METHODS: A pilot survey was developed using a community-driven research design to measure the impact of disease-specific items on parent-perceived well-being...
May 28, 2023: Nutrition in Clinical Practice
Gunjan Tiyyagura, Nicole Clayton, Paula Schaeffer, Marcie Gawel, John M Leventhal, Kristen Hammel, Karen Jubanyik, Destanee Crawley, Ashley Frechette, Daniel M Lindberg, Tami Sullivan, Andrea Asnes
OBJECTIVES: To identify barriers and facilitators of evaluating children exposed to caregiver intimate partner violence (IPV) and develop a strategy to optimize the evaluation. STUDY DESIGN: Using the EPIS (Exploration, Preparation, Implementation, and Sustainment) framework, we conducted qualitative interviews of 49 care providers, including emergency department clinicians (n=18), child abuse pediatricians(n=15), child protective services staff (n=12), and caregivers who experienced IPV (n=4), and reviewed meeting minutes of a family violence community advisory board (CAB)...
May 25, 2023: Journal of Pediatrics
Chiara Caporilli, Giuliana Giannì, Federica Grassi, Susanna Esposito
Short-bowel syndrome (SBS) in pediatric age is defined as a malabsorptive state, resulting from congenital malformations, significant small intestine surgical resection or disease-associated loss of absorption. SBS is the leading cause of intestinal failure in children and the underlying cause in 50% of patients on home parental nutrition. It is a life-altering and life-threatening disease due to the inability of the residual intestinal function to maintain nutritional homeostasis of protein, fluid, electrolyte or micronutrient without parenteral or enteral supplementation...
May 17, 2023: Nutrients
Maya Dahan, Leahora Rotteau, Shelley Higazi, Ophelia Kwayke, Giselle Lai, Wendy Moulsdale, Lisa Sampson, Jennifer Stannard, Paige Terrien Church, Karel O'Brien
Enabling individualized decision-making for patients requires an understanding of the family context (FC) by healthcare providers. The FC is everything that makes the family unique, from their names, preferred pronouns, family structure, cultural or religious beliefs, and family values. While there is an array of approaches for individual clinicians to incorporate the FC into practice, there is a paucity of literature guiding the process of collecting and integrating the FC into clinical care by multidisciplinary interprofessional teams...
May 17, 2023: Children
Sharon Goldfeld, Amanda Tapley, Elodie O'Connor, Neil Spike, Simon Morgan, Gary L Freed, Andrew Davey, Elizabeth Holliday, Jean Ball, Parker Magin
AIM: Functional bowel (constipation and faecal incontinence) and bladder (urinary incontinence and enuresis) problems in children are often treated by paediatricians yet should mostly be managed by general practitioners (GPs). To understand whether the necessary skills and knowledge are being built in general practice, this study aimed to establish the prevalence and associated skills of Australian general practice registrars managing children with functional bowel and bladder problems...
May 26, 2023: Journal of Paediatrics and Child Health
Niloofar Falahinia, Samaneh Razeghi, Ahmad Reza Shamshiri, Manijeh Firoozi, Simin Zahra Mohebbi
BACKGROUND: Some studies suggest a higher effectiveness of motivational interviewing compared to common oral health instruction in healthy individuals. As regards to higher prevalence of dental diseases like early childhood caries, oral mucositis, and gingivitis are reported for leukemic children, the present study aims to compare the effectiveness of educating mothers through MI with the common instruction (CI) for the oral health of children with leukemia under six years old...
May 24, 2023: BMC Pediatrics
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