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Blue Team MCH

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64 papers 100 to 500 followers
By Moahmmed Almazyad Pediatrics resident, interested in acute care
Xavier Monnet, Paul E Marik, Jean-Louis Teboul
In patients with acute circulatory failure, the decision to give fluids or not should not be taken lightly. The risk of overzealous fluid administration has been clearly established. Moreover, volume expansion does not always increase cardiac output as one expects. Thus, after the very initial phase and/or if fluid losses are not obvious, predicting fluid responsiveness should be the first step of fluid strategy. For this purpose, the central venous pressure as well as other "static" markers of preload has been used for decades, but they are not reliable...
December 2016: Annals of Intensive Care
Leigh-Anne Cioffredi, Ravi Jhaveri
IMPORTANCE: Management of febrile children is an intrinsic aspect of pediatric practice. Febrile children account for 15% of emergency department visits and outcomes range from the presence of serious bacterial infection to benign self-limited illness. OBSERVATIONS: Studies from 1979 to 2015 examining febrile infants and children were included in this review. Management of febrile infants younger than 90 days has evolved considerably in the last 30 years. Increased rates of Escherichia coli urinary tract infections, increasing resistance to ampicillin, and advances in viral diagnostics have had an effect on the approach to caring for these patients...
August 1, 2016: JAMA Pediatrics
Patricia M Guglietta, Christopher J Moran, Daniel P Ryan, Pallavi Sagar, Amelia E Huck
Presentation of Case. Dr. Patricia M. Guglietta: A 9.5-year-old girl with chronic constipation was seen in the gastroenterology clinic of this hospital because of recurrent episodes of abdominal pain with associated nonbilious vomiting. The patient had been generally well until she was 4 years of..
January 28, 2016: New England Journal of Medicine
Yung-Sen Chang, Michelle K Trivedi, Ayan Jha, Yen-Feng Lin, Liezeel Dimaano, Maria T García-Romero
IMPORTANCE: Atopic dermatitis (AD) is a highly prevalent condition that may be associated with an altered gastrointestinal microbiota that promotes an immune environment more susceptible to allergic disease. Synbiotics, a mixture of prebiotics and probiotics, have been used for the prevention and treatment of AD. OBJECTIVE: To investigate the efficacy of synbiotics for primary prevention and treatment of AD. DATA SOURCES: PubMed/MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and the CAB Abstracts Archive searchable database were searched from the inception of all databases to October 15, 2015, with no language restrictions...
March 2016: JAMA Pediatrics
L K Brown, R M Beattie, M P Tighe
Functional abdominal pain (FAP) is common in childhood, but is not often caused by disease. It is often the impact of the pain rather than the pain itself that results in referral to the clinician. In this review, we will summarise the currently available evidence and discuss the functional dimensions of the presentation, within the framework of commonly expressed parental questions. Using the Rome III criteria, we discuss how to classify the functional symptoms, investigate appropriately, provide reassurance regarding parental worries of chronic disease...
July 2016: Archives of Disease in Childhood
Catherine M Larson-Nath, Praveen S Goday
OBJECTIVES: We aimed to describe the clinical characteristics, diagnostic work-up, interventions, and outcomes of children referred to a pediatric gastroenterology clinic with the diagnosis of failure to thrive (FTT). METHODS: We prospectively enrolled 110 children seen for the first time in our pediatric gastroenterology clinic for FTT. Standard demographic information, history, and anthropometric data were collected at initial and follow-up visits. We also obtained data about diagnostic workup, therapeutic interventions, and growth outcomes...
June 2016: Journal of Pediatric Gastroenterology and Nutrition
Jose Rosa-Olivares, Amanda Porro, Marielys Rodriguez-Varela, Gloria Riefkohl, Iran Niroomand-Rad
.On the basis of research evidence, a recommended strategy for improving the care of middle ear infections is to identify the subset of patients least likely to benefit from antibiotic therapy. They include children ages 6 months to 23 months with unilateral disease without severe signs and symptoms (moderate or severe otalgia, otalgia lasting more than 48 hours,or temperature of 39°C [102.2°F]), and those older than 2 years ofage with unilateral or bilateral disease who have mild signs andsymptoms.(9) On the basis of research evidence, the initial treatment of otitis media with effusion is watchful observation...
November 2015: Pediatrics in Review
Steven H Abman, Georg Hansmann, Stephen L Archer, D Dunbar Ivy, Ian Adatia, Wendy K Chung, Brian D Hanna, Erika B Rosenzweig, J Usha Raj, David Cornfield, Kurt R Stenmark, Robin Steinhorn, Bernard Thébaud, Jeffrey R Fineman, Titus Kuehne, Jeffrey A Feinstein, Mark K Friedberg, Michael Earing, Robyn J Barst, Roberta L Keller, John P Kinsella, Mary Mullen, Robin Deterding, Thomas Kulik, George Mallory, Tilman Humpl, David L Wessel
Pulmonary hypertension is associated with diverse cardiac, pulmonary, and systemic diseases in neonates, infants, and older children and contributes to significant morbidity and mortality. However, current approaches to caring for pediatric patients with pulmonary hypertension have been limited by the lack of consensus guidelines from experts in the field. In a joint effort from the American Heart Association and American Thoracic Society, a panel of experienced clinicians and clinician-scientists was assembled to review the current literature and to make recommendations on the diagnosis, evaluation, and treatment of pediatric pulmonary hypertension...
November 24, 2015: Circulation
Alan J Garber, Martin J Abrahamson, Joshua I Barzilay, Lawrence Blonde, Zachary T Bloomgarden, Michael A Bush, Samuel Dagogo-Jack, Ralph A DeFronzo, Daniel Einhorn, Vivian A Fonseca, Jeffrey R Garber, W Timothy Garvey, George Grunberger, Yehuda Handelsman, Robert R Henry, Irl B Hirsch, Paul S Jellinger, Janet B McGill, Jeffrey I Mechanick, Paul D Rosenblit, Guillermo E Umpierrez
No abstract text is available yet for this article.
January 2016: Endocrine Practice
H Cody Meissner
No abstract text is available yet for this article.
January 7, 2016: New England Journal of Medicine
Michael L Moritz, Juan C Ayus
No abstract text is available yet for this article.
October 2015: New England Journal of Medicine
Allan R de Caen, Marc D Berg, Leon Chameides, Cheryl K Gooden, Robert W Hickey, Halden F Scott, Robert M Sutton, Janice A Tijssen, Alexis Topjian, Élise W van der Jagt, Stephen M Schexnayder, Ricardo A Samson
No abstract text is available yet for this article.
November 2015: Pediatrics
Neil F Goodman, Rhoda H Cobin, Walter Futterweit, Jennifer S Glueck, Richard S Legro, Enrico Carmina
Polycystic Ovary Syndrome (PCOS) is recognized as the most common endocrine disorder of reproductive-aged women around the world. This document, produced by the collaboration of the American Association of Clinical Endocrinologists (AACE) and the Androgen Excess and PCOS Society (AES) aims to highlight the most important clinical issues confronting physicians and their patients with PCOS. It is a summary of current best practices in 2015. PCOS has been defined using various criteria, including menstrual irregularity, hyperandrogenism, and polycystic ovary morphology (PCOM)...
November 2015: Endocrine Practice
Myra H Wyckoff, Khalid Aziz, Marilyn B Escobedo, Vishal S Kapadia, John Kattwinkel, Jeffrey M Perlman, Wendy M Simon, Gary M Weiner, Jeanette G Zaichkin
No abstract text is available yet for this article.
November 2015: Pediatrics
Adam J Shapiro, Maimoona A Zariwala, Thomas Ferkol, Stephanie D Davis, Scott D Sagel, Sharon D Dell, Margaret Rosenfeld, Kenneth N Olivier, Carlos Milla, Sam J Daniel, Adam J Kimple, Michele Manion, Michael R Knowles, Margaret W Leigh
Primary ciliary dyskinesia (PCD) is a genetically heterogeneous, rare lung disease resulting in chronic oto-sino-pulmonary disease in both children and adults. Many physicians incorrectly diagnose PCD or eliminate PCD from their differential diagnosis due to inexperience with diagnostic testing methods. Thus far, all therapies used for PCD are unproven through large clinical trials. This review article outlines consensus recommendations from PCD physicians in North America who have been engaged in a PCD centered research consortium for the last 10 years...
February 2016: Pediatric Pulmonology
Lawrence F Eichenfield, Mark Boguniewicz, Eric L Simpson, John J Russell, Julie K Block, Steven R Feldman, Adele R Clark, Susan Tofte, Jeffrey D Dunn, Amy S Paller
Atopic dermatitis affects a substantial number of children, many of whom seek initial treatment from their pediatrician or other primary care provider. Approximately two-thirds of these patients have mild disease and can be adequately managed at the primary care level. However, recent treatment guidelines are written primarily for use by specialists and lack certain elements that would make them more useful to primary care providers. This article evaluates these recent treatment guidelines in terms of evaluation criteria, treatment recommendations, usability, accessibility, and applicability to nonspecialists and integrates them with clinical evidence to present a streamlined severity-based treatment model for the management of a majority of atopic dermatitis cases...
September 2015: Pediatrics
Tomer Avni, Adi Lador, Shaul Lev, Leonard Leibovici, Mical Paul, Alon Grossman
OBJECTIVE: International guidelines recommend dopamine or norepinephrine as first-line vasopressor agents in septic shock. Phenylephrine, epinephrine, vasopressin and terlipressin are considered second-line agents. Our objective was to assess the evidence for the efficiency and safety of all vasopressors in septic shock. METHODS: Systematic review and meta-analysis. We searched electronic database of MEDLINE, CENTRAL, LILACS and conference proceedings up to June 2014...
2015: PloS One
Alex J Sinclair, Aaron Sturrock, Brendan Davies, Manjit Matharu
Headache is one of the most common conditions presenting to the neurology clinic, yet a significant proportion of these patients are unsatisfied by their clinic experience. Headache can be extremely disabling; effective treatment is not only essential for patients but is rewarding for the physician. In this first of two parts review of headache, we provide an overview of headache management, emerging therapeutic strategies and an accessible interpretation of clinical guidelines to assist the busy neurologist...
December 2015: Practical Neurology
Karen S Powers
No abstract text is available yet for this article.
July 2015: Pediatrics in Review
Amish Jain, Prakesh S Shah
Patent ductus arteriosus (PDA) poses a diagnostic and therapeutic dilemma for clinicians. Diagnosis of persistent PDA and determination of its clinical and hemodynamic significance are challenging. Although the condition has been associated with substantial neonatal morbidities such as intraventricular hemorrhage, bronchopulmonary dysplasia, and necrotizing enterocolitis, most therapeutic approaches have failed to show improvement in these outcomes. As such, clinicians have tended toward conservative management strategies; however, the benefits and risks of such an approach are unclear...
September 2015: JAMA Pediatrics
2015-07-20 15:02:38
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