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, Department of Pediatrics, Harvard Medical School, Boston, MA, USA Department of Pediatrics, University of California San Diego/Rady Children’s Hospital San Diego, San Diego, CA, USA Department of Paediatrics, Immunology and Medical Sciences, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA American College of Rheumatology, Atlanta, GA, USA (...) ACR Clinical Guidance for Pediatric Patients with Multisystem Inflammatory Syndrome in Children (MIS?C) Associated with SARS?CoV?2 and Hyperinflammation in COVID?19. Version 1 American College of Rheumatology Clinical Guidance for Pediatric Patients with Multisystem Inflammatory Syndrome in Children (MIS‐C) Associated with SARS‐CoV‐2 and Hyperinflammation in COVID‐19. Version 1 - Henderson - - Arthritis & Rheumatology - Wiley Online Library Working off-campus? Learn about our By continuing
Clinical Guidance Summary for Pediatric Patients with MIS-C Associated with SARS-CoV-2 and Hyperinflammation in COVID-19 1 Clinical Guidance for Pediatric Patients with Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with SARS-CoV-2 and Hyperinflammation in COVID-19 Developed by the ACR MIS-C and COVID-19 Related Hyperinflammation Task Force This draft summary was approved by the ACR Board of Directors on June 17, 2020. A full paper was published on July 23, 2020.* Purpose (...) definition of MIS-C because several already exist. Instead, the Task Force focused on consensus building to identify the most appropriate diagnostic and therapeutic steps that providers should consider at the present time. The Task Force also provided recommendations for children with hyperinflammation during COVID-19, the acute, infectious phase of SARS-CoV-2 infection. Given that our understanding of SARS-CoV-2-related syndromes in the pediatric population continues to evolve, this guidance document
, Children’s Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States Division of Pediatric Rheumatology, Nationwide Children’s Hospital, Ohio State University, Columbus, OH, USA Departments of Paediatrics and Medicine, University of Toronto, The Hospital for Sick Children, Toronto, Canada Division of Pediatric Infectious Diseases, NYU Grossman School of Medicine, Hassenfeld Children’s Hospital at NYU Langone, New York, United (...) , Columbus, OH, USA Departments of Paediatrics and Medicine, University of Toronto, The Hospital for Sick Children, Toronto, Canada Division of Pediatric Infectious Diseases, NYU Grossman School of Medicine, Hassenfeld Children’s Hospital at NYU Langone, New York, United States Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA American College of Rheumatology, Atlanta, GA, USA Rheumatic Diseases Division, UT Southwestern
COVID-19 Clinical Guidance Summary for Pediatric Patients with Rheumatic Disease 1 COVID-19 Clinical Guidance for Pediatric Patients with Rheumatic Disease Developed by the ACR COVID-19 Pediatric Rheumatology Clinical Guidance Task Force This draft summary was approved by the ACR Board of Directors on June 17, 2020. A full paper was published on July 23, 2020. + Purpose The purpose of this document is to provide clinical guidance to rheumatology providers who treat children with pediatric (...) infectious disease physicians, one adult rheumatologist and one pediatric nurse practitioner was convened on May 21, 2020. Clinical questions were drafted based on review of commonly encountered queries posed by patients, families, and rheumatology providers of children with PRD during the COVID-19 pandemic. An evidence report was generated based on a comprehensive review of the literature, and guidance statements were subsequently developed. Initial questions and subsequent statements were voted
of Medicine, University of Toronto, Toronto, Ontario, Canada. 3 Division of Cardiac Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada. 4 Division of Cardiovascular Surgery, The Labatt Family Heart Centre, Hospital for Sick Children, Toronto, Ontario, Canada. 5 Division of Cardiac Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada. 6 Division of Cardiology, Department of Pediatrics, The Labatt Family Heart Centre, The Hospital for Sick Children (...) , Toronto, Ontario, Canada. 7 Division of Cardiovascular Surgery, The Labatt Family Heart Centre, Hospital for Sick Children, Toronto, Ontario, Canada. Electronic address: email@example.com. PMID: 32727685 DOI: Item in Clipboard Duct stenting versus modified Blalock-Taussig shunt in neonates and infants with duct-dependent pulmonary blood flow: A systematic review and meta-analysis Ali Alsagheir et al. J Thorac Cardiovasc Surg . 2020 . Show details Display options Display options Format J Thorac
Comprehensive care of the ambulatory child with cerebral palsy (GMFCS I and II): A Canadian perspective In Canada, cerebral palsy (CP) is the most common physical disability, affecting approximately 2 to 3 per 1000 individuals. Paediatricians are sure to encounter and care for children with CP and their families. The role of the general paediatrician in caring for a child with CP is crucial, from diagnosis to providing a ‘medical home’; from ensuring care coordination to delivering (...) anticipatory guidance and preventive health and wellness care. The CP Health and Wellness Record that accompanies this practice point can assist both practitioners and children’s families by exploring key areas of health, function, participation, and wellness. This record may be used alongside other evidence-based health promotion guides, such as the Rourke Baby Record and the Greig Health Record, to prompt clinicians caring for ambulatory children with CP (Gross Motor Function Classification System
suppression. Two changes from previous guidelines are the concern for fluid overload, implying the need for clinical re-assessment after administration of each fluid bolus, and the removal of dopamine as the initial vasoactive agent for use in hypotensive paediatric patients, with recommendations for the use of epinephrine or norepinephrine as dictated by the clinical context. This practice point focuses primarily on sepsis management in older infants, children, and youth. Keywords: Guidelines (...) Diagnosis and management of sepsis in the paediatric patient Sepsis is a systemic inflammatory response to suspected or proven infection. Given its importance in terms of morbidity and mortality, a number of initiatives by several professional societies in recent years have led to the development of guidelines for the recognition and timely management of sepsis. The principal elements of the most recent guidelines are summarized in this practice point. These elements include
. doi: 10.1001/jamapediatrics.2020.2282. Online ahead of print. Efficacy of Ketogenic Diet, Modified Atkins Diet, and Low Glycemic Index Therapy Diet Among Children With Drug-Resistant Epilepsy: A Randomized Clinical Trial , , , , , , , , , , Affiliations Expand Affiliations 1 Center of Excellence & Advanced Research on Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India. 2 Department of Pediatrics, All (...) Among Children With Drug-Resistant Epilepsy: A Randomized Clinical Trial Vishal Sondhi et al. JAMA Pediatr . 2020 . Show details Display options Display options Format JAMA Pediatr Actions . 2020 Aug 3;e202282. doi: 10.1001/jamapediatrics.2020.2282. Online ahead of print. Authors , , , , , , , , , , Affiliations 1 Center of Excellence & Advanced Research on Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi
Ondansetron Prescription Is Associated With Reduced Return Visits to the Pediatric Emergency Department for Children With Gastroenteritis Journal Club Eastern Virginia Medical School Therapy Article Presenter: Drexel Proctor Date: 8/31/20 Citation: Benary D et al, Ondansetron Prescription Is Associated With Reduced Return Visits to the Pediatric Emergency Department for Children With Gastroenteritis, Annals of Emergency Medicine, Ann Emerg Med. 2020 May 26:S0196-0644(20)30262-6. 2020, I. WHAT (...) IS BEING STUDIED? 1. Study Objective Primary objective: to evaluate whether a prescription for ondansetron on discharge from the pediatric ED or urgent care center in patients with vomiting or gastroenteritis was associated with a difference in return rates in 72 hours. Secondary objectives: to evaluate the association between ondansetron prescription and return rates in patients specifically receiving a diagnosis of gastroenteritis, and to assess whether there was an association between an ondansetron
A Clinical Prediction Rule to Identify Febrile Infants 60 Days and Younger at Low Risk for Serious Bacterial Infections CRITICAL REVIEW FORM FOR A CLINICAL PREDICTION RULE Resident: Shane Leighton Date: 8/31/2020 Citation: Kupperman et al. A Clinical Prediction Rule to Identify Febrile Infants 60 Days and Younger at Low Risk for Serious Bacterial Infections Pediatr 2019 Apr 1;173(4):342-351. Study Objective: To derive and validate a prediction rule to identify febrile infants less than 60 days (...) clinical sense in a narrow patient population.. Unlike the "step by step" clinical prediction rule which involves a more subjective component (the pediatric assessment triangle), this clinical decision rule only includes objective predictors such as pro-calcitonin, ANC and UA in a non-toxic appearing child. 3. Did validation include prospective studies on several different populations from that used to derive it (II) or was it restricted to a single population (III)? No. It was restricted to a single
Nifurtimox (Lampit) - To treat Chagas disease in certain pediatric patients younger than age 18 Drug Approval Package: LAMPIT U.S. Department of Health and Human Services Search FDA Submit search Drug Approval Package: LAMPIT Company: Bayer HealthCare Pharmaceuticals, Inc. Application Number: 213464 Approval Date: 08/6/2020 Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634 for assistance. FDA Approval Letter and Labeling (PDF) (PDF) FDA Application
Ketamine Use for Tracheal Intubation in Critically Ill Children Is Associated With a Lower Occurrence of Adverse Hemodynamic Events Journal Club Eastern Virginia Medical School Therapy Article Presenter: Allison Wood Date: 8/31/20 Citation: Conway, J., et al, Ketamine Use for Tracheal Intubation in Critically Ill Children Is Associated With a Lower Occurrence of Adverse Hemodynamic Events. Critical Care Medicine, 47, p.498. I. WHAT IS BEING STUDIED? 1. Study Objective To study “whether (...) the administration of ketamine for tracheal intubation in critically ill children with or without shock was associated with fewer adverse hemodynamic events compared with other induction agents.” “We also investigated if there was a dose dependence for any association between ketamine use and adverse hemodynamic events.” 2. Study Design Retrospective analysis of prospectively collected observational data from the NEAR4KIDS and PALISI databases that included 40 PICU’s in US & Canada 3. Inclusion Criteria All
Clinical Benefits, Harms, and Cost-Effectiveness of Breast Cancer Screening for Survivors of Childhood Cancer Treated With Chest Radiation : A Comparative Modeling Study. Surveillance with annual mammography and breast magnetic resonance imaging (MRI) is recommended for female survivors of childhood cancer treated with chest radiation, yet benefits, harms, and costs are uncertain.To compare the benefits, harms, and cost-effectiveness of breast cancer screening strategies in childhood cancer (...) mammography to MRI increased in both models, although the conclusions about preferred starting age remained unchanged.Elevated breast cancer risk was based on survivors diagnosed with childhood cancer between 1970 and 1986.Early initiation (at ages 25 to 30 years) of annual breast cancer screening with MRI, with or without mammography, might reduce breast cancer mortality by half or more in survivors of childhood cancer.American Cancer Society and National Institutes of Health.
Xpert MTB/RIF and Xpert MTB/RIF Ultra assays for active tuberculosis and rifampicin resistance in children. Every year, at least one million children become ill with tuberculosis and around 200,000 children die. Xpert MTB/RIF and Xpert Ultra are World Health Organization (WHO)-recommended rapid molecular tests that simultaneously detect tuberculosis and rifampicin resistance in adults and children with signs and symptoms of tuberculosis, at lower health system levels. To inform updated WHO (...) guidelines on molecular assays, we performed a systematic review on the diagnostic accuracy of these tests in children presumed to have active tuberculosis.Primary objectives • To determine the diagnostic accuracy of Xpert MTB/RIF and Xpert Ultra for (a) pulmonary tuberculosis in children presumed to have tuberculosis; (b) tuberculous meningitis in children presumed to have tuberculosis; (c) lymph node tuberculosis in children presumed to have tuberculosis; and (d) rifampicin resistance in children
Clinical characteristics of children and young people admitted to hospital with covid-19 in United Kingdom: prospective multicentre observational cohort study. To characterise the clinical features of children and young people admitted to hospital with laboratory confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the UK and explore factors associated with admission to critical care, mortality, and development of multisystem inflammatory syndrome in children (...) and adolescents temporarily related to coronavirus disease 2019 (covid-19) (MIS-C).Prospective observational cohort study with rapid data gathering and near real time analysis.260 hospitals in England, Wales, and Scotland between 17 January and 3 July 2020, with a minimum follow-up time of two weeks (to 17 July 2020).651 children and young people aged less than 19 years admitted to 138 hospitals and enrolled into the International Severe Acute Respiratory and emergency Infections Consortium (ISARIC) WHO
A Randomized Trial of Closed-Loop Control in Children with Type 1 Diabetes. A closed-loop system of insulin delivery (also called an artificial pancreas) may improve glycemic outcomes in children with type 1 diabetes.In a 16-week, multicenter, randomized, open-label, parallel-group trial, we assigned, in a 3:1 ratio, children 6 to 13 years of age who had type 1 diabetes to receive treatment with the use of either a closed-loop system of insulin delivery (closed-loop group) or a sensor-augmented (...) insulin pump (control group). The primary outcome was the percentage of time that the glucose level was in the target range of 70 to 180 mg per deciliter, as measured by continuous glucose monitoring.A total of 101 children underwent randomization (78 to the closed-loop group and 23 to the control group); the glycated hemoglobin levels at baseline ranged from 5.7 to 10.1%. The mean (±SD) percentage of time that the glucose level was in the target range of 70 to 180 mg per deciliter increased from 53
Fat supplementation of human milk for promoting growth in preterm infants. As preterm infants do not experience the nutrient accretion and rapid growth phase of the third trimester of pregnancy, they are vulnerable to postnatal nutritional deficits, including of fat. Consequently, they require higher fat intakes compared to their full term counterparts to achieve adequate growth and development. Human milk fat provides the major energy needs of the preterm infant and also contributes to several (...) metabolic and physiological functions. Although human milk has many benefits for this population, its fat content is highly variable and may be inadequate for their optimum growth and development. This is a 2020 update of a Cochrane Review last published in 2000.To determine whether supplementation of human milk with fat compared with unsupplemented human milk fed to preterm infants improves growth, body composition, cardio-metabolic, and neurodevelopmental outcomes without significant adverse
Effect of Vitamin D3 Supplementation on Severe Asthma Exacerbations in Children With Asthma and Low Vitamin D Levels: The VDKA Randomized Clinical Trial. Severe asthma exacerbations cause significant morbidity and costs. Whether vitamin D3 supplementation reduces severe childhood asthma exacerbations is unclear.To determine whether vitamin D3 supplementation improves the time to a severe exacerbation in children with asthma and low vitamin D levels.The Vitamin D to Prevent Severe Asthma (...) Exacerbations (VDKA) Study was a randomized, double-blind, placebo-controlled clinical trial of vitamin D3 supplementation to improve the time to severe exacerbations in high-risk children with asthma aged 6 to 16 years taking low-dose inhaled corticosteroids and with serum 25-hydroxyvitamin D levels less than 30 ng/mL. Participants were recruited from 7 US centers. Enrollment started in February 2016, with a goal of 400 participants; the trial was terminated early (March 2019) due to futility, and follow