The Association Between Early Initiation of Systemic Corticosteroids and the Hospital Length of Stay in Patients With Multisystem Inflammatory Syndrome in Children.

Objective: Patients with multisystem inflammatory syndrome in children (MIS-C) often require hospital admission. Treatment of MIS-C has included intravenous immunoglobulin, systemic corticosteroids, and/or immunomodulators. There is no standardized approach to when steroids should be initiated during treatment.

Diphenhydramine and Migraine Treatment Failure in Pediatric Patients Receiving Prochlorperazine.

Objectives: The objectives are to determine whether diphenhydramine coadministered with prochlorperazine versus prochlorperazine only is associated with a difference in the risk of migraine treatment failure, as measured by the need for additional therapy, hospitalization rates, and 72-hour return rates, and to compare extrapyramidal adverse effects between groups.

Methods: Retrospective cohort of patients aged 7 to 18 years treated in the emergency department for migraines using prochlorperazine with or without diphenhydramine between 2013 and 2019. Patients were included if they had International Classification of Diseases, Ninth or Tenth Revision, codes for migraine or unspecified headache and were treated with prochlorperazine as part of their initial migraine therapy.

Factors influencing physical therapy utilization after shoulder surgery: a retrospective review.

Background: Postoperative physical therapy (PT) is a cornerstone to achieve optimal patient outcomes. Access to postoperative PT can be limited by insurance type, coverage, and cost. With copayments (CP) for PT as high as $75 per visit, PT can be costprohibitive for patients.

Assembling a global database of child pneumonia studies to inform WHO pneumonia management algorithm: Methodology and applications.

Background: The existing World Health Organization (WHO) pneumonia case management guidelines rely on clinical symptoms and signs for identifying, classifying, and treating pneumonia in children up to 5 years old. We aimed to collate an individual patient-level data set from large, high-quality pre-existing studies on pneumonia in children to identify a set of signs and symptoms with greater validity in the diagnosis, prognosis, and possible treatment of childhood pneumonia for the improvement of current pneumonia case management guidelines.

Methods: Using data from a published systematic review and expert knowledge, we identified studies meeting our eligibility criteria and invited investigators to share individual-level patient data.

Derivation and validation of a novel risk assessment tool to identify children aged 2-59 months at risk of hospitalised pneumonia-related mortality in 20 countries.

Introduction: Existing risk assessment tools to identify children at risk of hospitalised pneumonia-related mortality have shown suboptimal discriminatory value during external validation. Our objective was to derive and validate a novel risk assessment tool to identify children aged 2-59 months at risk of hospitalised pneumonia-related mortality across various settings.

Methods: We used primary, baseline, patient-level data from 11 studies, including children evaluated for pneumonia in 20 low-income and middle-income countries.

Identification of α1,2-fucosylated signaling and adhesion molecules in head and neck squamous cell carcinoma.

Head and neck cancer is the seventh most common cancer in the world, and most cases manifest as head and neck squamous cell carcinoma. Despite the prominent role of fucosylated carbohydrate antigens in tumor cell adhesion and metastasis, little is known about the functional role of fucose-modified glycoproteins in head and neck cancer pathobiology. Inactivating polymorphisms of the fut2 gene, encoding for the α1,2-fucosyltransferase FUT2, are associated with an increased incidence of head and neck cancer among tobacco users.

Comparison of the Demographics and Visit Characteristics of Patients Who Left the Pediatric Emergency Department Without Being Seen With Those Who Were Evaluated in the Emergency Department.

Background: We compared those patients who left without being seen (LWBS) with those who stay for evaluation and determined which subsets were more likely to depart prematurely in the largest pediatric population studied to date.

Methods: We retrospectively extracted data from the electronic medical records of all pediatric patients who visited the emergency department between January 1, 2013, and December 31, 2015. The demographics and visit characteristics were compared between patients who LWBS and those seen by a provider.

Ondansetron Prescription Is Associated With Reduced Return Visits to the Pediatric Emergency Department for Children With Gastroenteritis.

Study Objective: We determine whether an ondansetron prescription for pediatric patients with vomiting or gastroenteritis is associated with decreased return visits to the emergency department (ED), and whether alternate diagnoses are more frequent on return visits in patients prescribed ondansetron.

Methods: This is a retrospective cohort study of patients 6 months to 18 years of age, presenting to a pediatric ED or its affiliated urgent care centers between 2012 and 2017 with an International Classification of Diseases, Ninth Revision or International Statistical Classification of Diseases and Related Health Problems, 10th Revision diagnosis of gastroenteritis, gastritis, vomiting, or vomiting with diarrhea. Multivariate logistic regression analysis was used to measure the association between an ondansetron prescription and the odds of 72-hour return visits.

Strategies discussed at the XIIth international conference on Kangaroo mother care for implementation on a countrywide scale.

Aim: Building strategies for the country-level dissemination of Kangaroo mother care (KMC) to reduce the mortality rate in preterm and low birth weight babies and improve quality of life. KMC is an evidence-based healthcare method for these infants. However, KMC implementation at the global level remains low.

Performance of Emergency Medical Service Providers in Pediatric and Adult Simulation of Unstable Supraventricular Tachycardia.

Objective: The aim of the study was to compare emergency medical service resuscitation of pediatric and adult high-fidelity manikins in unstable supraventricular tachycardia. The primary objective was time to cardioversion. The secondary objective was to assess if the cardioversion was synchronized at the correct dosage for the manikin's weight.

Racial disparities in cancer-related survival in patients with squamous cell carcinoma of the esophagus in the US between 1973 and 2013.

Background: Esophageal cancer makes up approximately 1% of all diagnosed cancers in the US. There is a persistent disparity in incidence and cancer-related mortality rates among different races for esophageal squamous cell carcinoma (SCC). Most previous studies investigated racial disparities between black and white patients, occasionally examining disparities for Hispanic patients.

Use of a Metronome in Cardiopulmonary Resuscitation: A Simulation Study.

Objective: Determine whether the use of a metronome improves chest compression rate and depth during cardiopulmonary resuscitation (CPR) on a pediatric manikin.

Methods: A prospective, simulation-based, crossover, randomized controlled trial was conducted. Participants included pediatric residents, fellows, nurses, and medical students who were randomly assigned to perform chest compressions on a pediatric manikin with and without an audible metronome.

Pediatric psychiatric emergency department visits during a full moon.

Objective: This study aimed to verify the hypothesis that the lunar cycle influences the number of pediatric psychiatric emergency department (ED) visits.

Methods: Pediatric psychiatric ED visits between 2009 and 2011 were obtained retrospectively. Patients aged between 4 and 21 years presenting to Miami Children's Hospital ED with a primary psychiatric complaint were included in the study.

Cervical Spine Motion During Airway Management Using Two Manual In-line Immobilization Techniques: A Human Simulator Model Study.

Objective: The aim of this study is to evaluate cervical spine motion using 2 manual inline immobilization techniques with the use of a human simulator model.

Methods: Medical students, pediatric and family practice residents, and pediatric emergency medicine fellows were recruited to maintain cervical manual in line immobilization above the head of the bed and across the chest of a human simulator while orotracheal intubation was performed. Participants were then instructed on appropriate holding techniques after the initial session took place.

Impact of an academic-community partnership in medical education on community health: evaluation of a novel student-based home visitation program.

Objectives: Current US healthcare delivery systems do not adequately address healthcare demands. Physicians are integral but rarely emphasize prevention as a primary tool to change health outcomes. Home visitation is an effective method for changing health outcomes in some populations.

Accuracy of laceration length estimation in a pediatric emergency department and its impact on billing practices.

Objectives: This study aimed to determine the accuracy of laceration length estimation in a pediatric emergency department among health care providers of varying levels of training and its impact on billing practices.

Methods: This study involves a prospective case series. Children younger than 21 years with lacerations evaluated and repaired in the pediatric emergency department between January 1 and April 30, 2012, were eligible for enrollment.

Metallic stents for tracheobronchial pathology treatment.

Purpose: To present the 7-year experience of the treatment of benign and malignant tracheobronchial stenoses using metallic stents.

Patients And Methods: One hundred twenty-three stents were inserted in 86 patients (74 benign and 12 malignant stenoses). Ninety-seven stents were placed in the trachea and 26 in the bronchi.

Prophylactic probiotics to prevent death and nosocomial infection in preterm infants.

Background And Objective: It has been suggested that probiotics may decrease infant mortality and nosocomial infections because of their ability to suppress colonization and translocation of bacterial pathogens in the gastrointestinal tract. We designed a large double-blinded placebo-controlled trial using Lactobacillus reuteri to test this hypothesis in preterm infants.

Methods: Eligible infants were randomly assigned during the first 48 hours of life to either daily probiotic administration or placebo.

Regional variation on rates of bronchopulmonary dysplasia and associated risk factors.

Background. An abnormally high incidence (44%) of bronchopulmonary dysplasia with variations in rates among cities was observed in Colombia among premature infants. Objective.

Very early surfactant without mandatory ventilation in premature infants treated with early continuous positive airway pressure: a randomized, controlled trial.

Background: Chronic lung disease is one of the most frequent and serious complications of premature birth. Because mechanical ventilation is a major risk factor for chronic lung disease, the early application of nasal continuous positive airway pressure has been used as a strategy for avoiding mechanical ventilation in premature infants. Surfactant therapy improves the short-term respiratory status of premature infants, but its use is traditionally limited to infants being mechanically ventilated.

The impact of acute lymphoblastic leukemia treatment on central nervous system results in Bogota, Colombia.

To improve the outcome of children with acute lymphoblastic leukemia (ALL) treated at the National Cancer Institute, Bogota, Colombia, a protocol based on the BFM-90 (Berlin, Frankfurt, Munster study) and the LSA2L2 regimens was implemented in the year 1993. The patients were classified as being standard risk (SR) or high risk (HR) according to clinical criteria, to which cytogenetic information and day-8 prednisone response were also added. A 123-patient cohort entered the study, 18 of them being considered SR and 105 HR.

Funding agencies in low- and middle-income countries: support for knowledge translation.

Objective: The aim was to describe how selected health research funding agencies active in low- and middle-income countries promote the translation of their funded research into policy and practice.

Methods: We conducted inductive analysis of semi-structured interviews with key informants from a purposive sample of 23 national and international funding agencies that fund health research in Brazil, Colombia, India, the Philippines, South Africa and Thailand. We also surveyed web sites.

Evaluation of circulating intestinally committed memory B cells in children vaccinated with attenuated human rotavirus vaccine.

In a double blind trial, 319 fully immunized children received two doses of either placebo or 10(6.7) focus-forming units of the attenuated RIX4414 human rotavirus (RV) vaccine ("all-in-one" formulation). Plasma RV-specific IgA (RV IgA), stool RV IgA, and circulating total and RV memory B cells (CD19+ IgD+/- CD27+) with an intestinal homing phenotype (alpha4beta7+ CCR9+/-) were measured, after the first and second doses, as potential correlates of protection.

Open letter to the leader of academic medicine.

As their campaign comes to a close, ICRAM presents a challenge to academic medicine's invisible leaders