Clinical Medicine Insights-Pediatrics最新文献

{"title":"Hydrocortisone Improves Oxygenation Index and Systolic Blood Pressure in Term Infants With Persistent Pulmonary Hypertension.","authors":"Mahdi Alsaleem,&nbsp;Aysha Malik,&nbsp;Satyan Lakshminrusimha,&nbsp;Vasantha Hs Kumar","doi":"10.1177/1179556519888918","DOIUrl":"https://doi.org/10.1177/1179556519888918","url":null,"abstract":"<p><p>Persistent pulmonary hypertension of the newborn (PPHN) is an essential cause for hypoxic respiratory failure with significant morbidity and mortality in term and near-term neonates. Hydrocortisone has been shown to decrease oxygen dependency and pulmonary hypertension in neonates with meconium aspiration syndrome and animal studies, respectively. We hypothesize that hydrocortisone will improve oxygenation in term and near-term infants with pulmonary hypertension. We performed a retrospective chart review of all infant with PPHN who received intravenous hydrocortisone therapy as a rescue for severe PPHN. Clinical response was objectively measured using, oxygenation index (OI), PaO₂/FiO₂ ratio, and inotrope score before, during, and after the hydrocortisone course. We found that hydrocortisone administration resulted in significant improvement of systolic blood pressure, OI, and PaO₂/FiO_2. In conclusion, hydrocortisone increased systolic blood pressure and improved oxygenation in term and near-term infants with persistent pulmonary hypertension. Prospective randomized trials are required to evaluate these findings further.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":"13 ","pages":"1179556519888918"},"PeriodicalIF":1.5,"publicationDate":"2019-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179556519888918","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Pediatric PICC Team Under an Existing Sedation Service: A 5-Year Experience","authors":"S. Rainey, Girish G Deshpande, Haley Boehm, Kim Camp, Annette Fehr, Kimberly Horack, Keith Hanson","doi":"10.1177/1179556519884040","DOIUrl":"https://doi.org/10.1177/1179556519884040","url":null,"abstract":"Objective: To examine our institutional experiences with ultrasound-guided peripherally inserted central catheter (US-PICC) placement by a dedicated US-PICC team under the umbrella of an existing pediatric sedation service. Methods: Retrospective review of quality data examining 968 US-PICC encounters over a 5-year period from 2012 to 2016. Data for each encounter included line indications, success rate, dwelling time, need for sedation, and incidence of complications including venous thrombosis, infection, and accidental removal. Results: US-PICC lines were successfully placed in 89% of patients with an average age of 5.4 years. Extended antibiotic treatment was the most common indication for US-PICC placement and the mean dwell time was 23 days. Long-term complications were noted in 6.1% of cases, with venous thrombosis and line infection complicating 1.7% and 0.9% of encounters, respectively. Conclusion: Results suggest that our endeavor of creating a dedicated US-PICC team under an existing pediatric sedation service is successful with regard to the number of lines placed, success rates, and incidence of complications. This approach may be beneficial to other institutions seeing to maximize resource utilization and streamline patient care.","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":"47 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78394077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating Postpartum Depression in the Adolescent Mother Using 3 Potential Qualitative Approaches","authors":"S. Ladores, J. Corcoran","doi":"10.1177/1179556519884042","DOIUrl":"https://doi.org/10.1177/1179556519884042","url":null,"abstract":"Adolescent mothers are twice as likely as their adult counterparts to have postpartum depression (PPD). Left undiagnosed and untreated, PPD can have significant consequences for the mothers, infants, families, communities, and society. Although the epidemiology has been well studied, there is a scarcity in the number of qualitative research studies being conducted to study this unique group of young women. Qualitative research is a perfect match to elicit the voices of adolescent mothers having PPD because the qualitative approach offers a way to gain insight, meaning, and understanding of a phenomenon that is still largely misunderstood and unaddressed. This article will discuss 3 major qualitative approaches (phenomenology, ethnography, and participatory action research) that may be employed to study PPD in the adolescent mother.","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":"39 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80351331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Qualitative Investigation of Swimming Experiences of Children With Autism Spectrum Disorders and Their Families.","authors":"Lisa Mische Lawson,&nbsp;Julie D'Adamo,&nbsp;Kayle Campbell,&nbsp;Bethany Hermreck,&nbsp;Sarah Holz,&nbsp;Jenna Moxley,&nbsp;Kayla Nance,&nbsp;Megan Nolla,&nbsp;Anna Travis","doi":"10.1177/1179556519872214","DOIUrl":"https://doi.org/10.1177/1179556519872214","url":null,"abstract":"<p><strong>Objective: </strong>To understand the swimming experience from the perspective of children with autism spectrum disorder (ASD) and their families.</p><p><strong>Methods: </strong>We interviewed 12 diverse families using a semi-structured interview with follow-up probing questions related to their swimming experiences. Interviews were transcribed verbatim and coded by researchers.</p><p><strong>Results: </strong>Themes included family water activities, safety, characteristics of ASD, instructional methods, swim skills, swimming preferences, barriers/challenges, and benefits of swimming. Findings indicate positive experiences and skill acquisition were prevalent when instructional methods matched a child's unique needs. Parents revealed they were more confident in safety as their children's swimming competence improved. Individualized instructional methods and unique characteristics of ASD may influence perceived safety.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":"13 ","pages":"1179556519872214"},"PeriodicalIF":1.5,"publicationDate":"2019-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179556519872214","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39914099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parental Antibiotic Use in Urban and Peri-Urban Health Care Centers in Lima: A Cross-Sectional Study of Knowledge, Attitudes, and Practices.","authors":"Jose L Paredes,&nbsp;Rafaella Navarro,&nbsp;Maribel Riveros,&nbsp;Veronica Picon,&nbsp;Francisco Conde,&nbsp;Mario Suito-Ferrand,&nbsp;Theresa J Ochoa","doi":"10.1177/1179556519869338","DOIUrl":"https://doi.org/10.1177/1179556519869338","url":null,"abstract":"<p><p>In pediatric patients, the antibiotic use is affected by parental beliefs and practices; especially in countries where it is possible to acquire them without prescription. This study aims to describe the knowledge, attitudes, and practices on antibiotic use among parents of children from urban and peri-urban health care centers in Lima. A cross-sectional study was performed at 1 urban and 2 peri-urban health care centers selected in Lima, Perú. Parents of children below the age of 3 years answered a knowledge-attitudes-practices-validated questionnaire about antibiotic use and were categorized as high, moderate, and low knowledge regarding antibiotics. We analyzed potential determinants for low knowledge and having medicated their children with unprescribed antibiotics using bivariate and multivariate analyses. A total of 224 parents were enrolled, and 8% were categorized as low knowledge. Half of the parents could not recognize that antibiotics cannot cure viral infections, 59.4% disagreed with \"antibiotics speed up recovery from a cold,\" and 53.2% stored antibiotics at home. Remarkably 23.5% of parents reported having medicated their children with antibiotics without prescription, which was associated with belonging to the peri-urban health care center, use of antibiotics by their children in the last 12 months, and having purchased antibiotics without physicians' prescription. An alarming overuse of antibiotics without prescription was described among children below the age of 3 years. Educational interventions, addressing parental attitudes and practices, and health policies should be developed to limit inappropriate antibiotic use especially in peri-urban communities.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":"13 ","pages":"1179556519869338"},"PeriodicalIF":1.5,"publicationDate":"2019-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179556519869338","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41215531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensory Integration and Functional Reaching in Children With Rett Syndrome/Rett-Related Disorders","authors":"Wendy Drobnyk, K. Rocco, S. Davidson, S. Bruce, Fang Zhang, S. Soumerai","doi":"10.1177/1179556519871952","DOIUrl":"https://doi.org/10.1177/1179556519871952","url":null,"abstract":"Background: The loss of functional hand skills is a primary characteristic of Rett syndrome. Stereotypies, dyspraxia, and other sensory processing issues severely limit the individual’s ability to reach toward and sustain grasp on objects. This loss of functional reach and grasp severely limits their ability to participate in self-help, play, and school-related activities. We proposed that Ayres Sensory Integration (ASI) treatment would improve sensory processing and motor planning, which would lay the sensory-motor groundwork for improving grasp of objects, an important first step in developing functional hand use. Objective: We examined effects of ASI treatment on rate of reaching and grasping for children with Rett syndrome/Rett-related disorders. Methods: We used an interrupted time series design to measure changes in outcome variables occurring after intervention initiation and cessation. We analyzed daily video observations during baseline, intervention, and post-intervention periods, over a span of 7 months. Results: During baseline, rate of grasping declined moderately. There was a 15% increase in grasping from the end of baseline to end of the post-intervention period. There was no significant change in rate of reaching. Conclusions: This study provides preliminary data showing very small improvements in hand grasp of children with Rett syndrome following ASI treatment; larger studies in diverse settings are needed to establish the effectiveness of this approach. This study shows that an interrupted time series research design provides a valid template for evaluating interventions for children with rare disorders.","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":"50 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88235216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-Grade Surface Osteosarcoma of the Temporal Bone in Paediatric Patients: A Case Report and Literature Review.","authors":"Noémie Villemure-Poliquin,&nbsp;Mathieu Trudel,&nbsp;Sebastien Labonté,&nbsp;Valérie Blouin,&nbsp;Gaétan Fradet","doi":"10.1177/1179556519855381","DOIUrl":"https://doi.org/10.1177/1179556519855381","url":null,"abstract":"<p><strong>Purpose of the study: </strong>Primary osteosarcoma of the temporal bone is an exceedingly rare pathology in the paediatric population. As of now, only 3 cases have been reported in the English literature. We describe the additional case of a 16-year-old girl with an osteosarcoma of the mastoid bone. This study aims to report a rare paediatric case of low-grade surface osteosarcoma of the temporal bone.</p><p><strong>Materials and methods used: </strong>A literature review was performed to better understand paediatric osteosarcomas of the head and neck region, to optimize their investigation, to describe their histopathological and radiological characteristics, and to establish the optimal modalities of medical and surgical treatments. The research of previous published data was done using PubMed and Embase library with the keywords mentioned below.</p><p><strong>Results: </strong>The patient presented with a rapidly progressive left retroauricular lesion over a 3-week period. Radiological studies demonstrated aggressive and invasive features. An open biopsy followed and confirmed the diagnosis of a low-grade surface osteosarcoma. In accordance with the multidisciplinary team, we decided to perform a complete surgical resection with wide surgical margins. We did not administer any adjuvant therapies. A control computed tomography (CT) scan obtained 26 months postoperatively still showed no signs of recurrence.</p><p><strong>Conclusion: </strong>Osteosarcomas are aggressive malignant neoplasms found in the head and neck region in only 6% to 10% of cases. They represent approximately 1% of head and neck cancers, and these are generally high-grade lesions. Temporal bone involvement is rare, particularly for low-grade lesions in paediatric patients. In addition to reporting the fourth paediatric case of primary temporal bone osteosarcoma, this study describes its specific clinical, histopathological, and radiological findings, to improve the management and the prognostic of patients affected with this particular clinical entity.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":"13 ","pages":"1179556519855381"},"PeriodicalIF":1.5,"publicationDate":"2019-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179556519855381","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37387650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time to Recovery of Feeding After Alveolar Bone Graft Is Associated With Postoperative Nausea and Vomiting Within 2 Hours in Children.","authors":"Kaoru Yamashita,&nbsp;Toshiro Kibe,&nbsp;Sachi Ohno,&nbsp;Minako Uchino,&nbsp;Yurina Higa,&nbsp;Ayako Niiro,&nbsp;Norifumi Nakamura,&nbsp;Mitsutaka Sugimura","doi":"10.1177/1179556519855387","DOIUrl":"https://doi.org/10.1177/1179556519855387","url":null,"abstract":"<p><strong>Objective: </strong>To examine the relationship between the method of anesthesia for alveolar bone graft surgery and postoperative nausea and vomiting (PONV) based on the difference in surgical timing and to assess factors related to the postoperative quality of life.</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Setting: </strong>Hospital.</p><p><strong>Participants: </strong>Patients with cleft lip and palate who underwent alveolar bone graft surgery under general anesthesia. The subjects were divided into two groups based on surgical timing: secondary bone graft (SBG) and late secondary bone graft (LSBG) groups.</p><p><strong>Main outcome measures: </strong>Relationship between time to recovery of feeding and the types of anesthesia, PONV, and postoperative pain period.</p><p><strong>Results: </strong>The mean patient age was 9.97 ± 1.33 years in the SBG group and 15.39 ± 0.31 years in the LSBG group. In the SBG group, patients who were administered fentanyl or remifentanil had significantly higher incidence of PONV than those who were not administered these drugs. In the SBG group, the time to recovery of feeding was significantly longer in patients experiencing PONV within 2 hours or that lasted for 24 hours than in those without PONV. In the LSBG group, there was no significant difference regarding any of the above factors.</p><p><strong>Conclusions: </strong>Our results suggest that the occurrence of PONV within 2 hours or lasting for 24 hours postoperatively in school-age children prolonged the time to recovery of feeding. This indicates that the time to recovery of feeding can be predicted based on the occurrence of PONV within the first 2 hours.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":"13 ","pages":"1179556519855387"},"PeriodicalIF":1.5,"publicationDate":"2019-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179556519855387","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37358311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Reported and Actual Involvement of Community Pharmacy Professionals in the Management of Childhood Diarrhea: A Cross-Sectional and Simulated Patient Study at two Towns of Eastern Ethiopia.","authors":"Getnet Mengistu,&nbsp;Kassahun Gietnet,&nbsp;Firehiwot Amare,&nbsp;Mekonnen Sisay,&nbsp;Bisrat Hagos,&nbsp;Desye Misganaw","doi":"10.1177/1179556519855380","DOIUrl":"https://doi.org/10.1177/1179556519855380","url":null,"abstract":"<p><strong>Background: </strong>Role of community pharmacy professionals is observed in the prevention and treatment of diarrhea and the associated problem of dehydration in children. The aim of this study was to assess self-reported knowledge and actual practices of community pharmacy professionals toward the management of diarrhea in Harar town and Dire Dawa city administration.</p><p><strong>Methodology: </strong>Community-based cross-sectional study was conducted on community pharmacy professionals practicing in community drug outlets of the two towns. Structured questionnaires and simulated patient were used to collect data.</p><p><strong>Results: </strong>A total of 105 community pharmacy professionals from 105 community pharmacies were invited, out of which 69.5% were men. Age was the most frequently taken history in both studies and none of the participants take history about weight of the child, medication history, and nutrition condition in the simulated study. Even though more than 90% of the participants reported to recommend oral rehydration salt (ORS) plus zinc, above 85% of them dispense antimicrobial agents for the simulated patient. Dose (96%), frequency (98%), how to prepare ORS (98%), and duration (98%) were the most frequently given information in the questionnaire survey. However, the simulated study revealed that information about common side effects and major interactions were not given to the patient.</p><p><strong>Conclusion: </strong>The study identified that there is a great difference between self-reported knowledge and actual practices on the management of childhood diarrhea in community pharmacies.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":"13 ","pages":"1179556519855380"},"PeriodicalIF":1.5,"publicationDate":"2019-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179556519855380","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37352142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Some Scars Do Not Run Deep: The Qualitative and Quantitative Nature of Neonatal Seldinger Pigtail Chest Drain Scars.","authors":"Leo Bh Gundle,&nbsp;Aimee Dowek,&nbsp;Priya Heer,&nbsp;Steven Jones,&nbsp;David Bartle","doi":"10.1177/1179556519855384","DOIUrl":"https://doi.org/10.1177/1179556519855384","url":null,"abstract":"<p><p>Pneumothorax is a complication of respiratory distress syndrome, of which many preterm babies suffer. If significant, these pneumothoraces can be treated by the insertion of a chest drain. There are a number of different types of chest drain, and techniques of insertion. This study aims to establish both the quantitative nature, and emotional significance of neonatal pigtail chest drain scarring, as inserted via the Seldinger technique. Parents were interviewed by telephone and asked to send photographs of their child's scar to be graded. Researchers found that, on the whole, the scar size and severity was not significant, and that those interviewed generally agreed that while the scar served as a reminder of a traumatic time, its size was unimportant. These results may inform future practice on a basis of chest drain comparison; results imply that chest drains with the greatest efficacy should be used.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":"13 ","pages":"1179556519855384"},"PeriodicalIF":1.5,"publicationDate":"2019-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179556519855384","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37344609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}