Acceptability and Feasibility of Text Message Interface to Assess Parents' Real-time PICU Experiences.

Introduction: Parents of children in the pediatric intensive care unit (PICU) experience substantial stress; a parent's perception of their child's illness severity, more than objective measures, predicts psychological outcomes. No tools exist to assess parents' real-time experiences. This pilot study evaluated the feasibility and acceptability of a text-based tool to measure parental experience.

Short Telomere Syndrome presenting with pulmonary fibrosis, liver cirrhosis and hepatopulmonary syndrome: a case report.

Background: Idiopathic pulmonary fibrosis is thought to result from aberrant post-injury activation of epithelial cells leading to fibroblast proliferation and activation. A number of genetic aetiologies have been implicated in this disease process, including, among others, the short telomere syndromes. Short telomere syndromes follow an autosomal dominant pattern of inheritance resulting in shortened telomere length, which consequently leads to accelerated cell death.

Patient and physician factors associated with symptomatic undiagnosed asthma or COPD.

Background: It remains unclear why some symptomatic individuals with asthma or COPD remain undiagnosed. Here, we compare patient and physician characteristics between symptomatic individuals with obstructive lung disease (OLD) who are undiagnosed and individuals with physician-diagnosed OLD.

Methods: Using random-digit dialling and population-based case finding, we recruited 451 participants with symptomatic undiagnosed OLD and 205 symptomatic control participants with physician-diagnosed OLD.

Dexmedetomidine for sedation during hematopoietic stem cell harvest apheresis and leukapheresis in the PICU: Guideline development.

Background: Hematopoietic stem cell (HSC) harvest apheresis and leukapheresis are performed in the pediatric intensive care unit (PICU) for high-risk pediatric patients who require procedural sedation. Patients need central access either with their own central lines, ports or require apheresis catheter (CVL) placement. Previously, patients were either awake or emerging from sedation on PICU admission.

Meta-analytic Techniques to Assess the Association Between N-acetylcysteine and Acute Kidney Injury After Contrast Administration: A Systematic Review and Meta-analysis.

Importance: The most suitable analytic method to systematically analyze numerous trials with contradictory results is unclear. Multiple trials assessing the use of N-acetylcysteine (NAC) for prevention of contrast-induced acute kidney injury (CI-AKI) have had contradictory results with recent trials confirming a lack of benefit.

Objective: To systematically review the literature on NAC for the prevention of CI-AKI, and to explore the heterogeneity, publication bias, and small-study effect to determine the most suitable analytic method in a setting where the literature is contradictory.

Challenges of Immunotherapy in Stage IV Non-Small-Cell Lung Cancer.

Treatment for metastatic non-small-cell lung carcinoma has seen important advances in recent years with the introduction of targeted therapies and immunotherapy. Immune checkpoint inhibitors, which target the programmed death 1 receptor and programmed death ligand-1, alone or in combination with platinum-based chemotherapy, have become standard of care in the first-line setting for patients with advanced non-small-cell lung carcinoma without targetable driver mutations. However, several clinical questions have now since emerged.

Medications for sleep disturbance in children and adolescents with depression: a survey of Canadian child and adolescent psychiatrists.

Background: Primary care physicians and child and adolescent psychiatrists often treat sleep disturbances in children and adolescents with mood disorders using medications off-label, in the absence of clear evidence for efficacy, tolerability and short or long-term safety. This study is the first to report Canadian data about prescribing preferences and perceived effectiveness reported by child and adolescent psychiatrists regarding medications used to manage sleep disturbances in children and adolescents with depression.

Methods: Canadian child and adolescent psychiatrists were surveyed on their perception of effectiveness of a range of medications commonly prescribed for sleep disturbances, their ranked preferences for these medications, reasons for avoiding certain medications, and perceived side effects.

Would you do it again? A qualitative study of student and supervisor perceptions of an intercalated MBChB/PhD programme.

Background: Several studies have warned about the diminishing physician-scientist breed. Limited studies, however, have attempted to assess what factors (if any) enhanced or hindered the experience of trainee physician-scientists and their supervisors. Using Vroom's expectancy theory as a conceptual framework, we explored the highlights, motivations and barriers of an intercalated MBChB/PhD programme as experienced by students of the programme and their supervisors.

Publication rates of, and attitudes toward, summer research projects: 10-year experience from a single institution in New Zealand.

Research is increasingly being emphasized from an early stage in medical students' careers. Medical student involvement in research and authorship of peer-reviewed manuscripts have been shown to enhance their academic performance-both in the short term and long term. The aim of this study was to evaluate outcomes and motivations of the summer studentship research program at our institution, using Vroom's expectancy theory as a conceptual framework.

Understanding mothers' perception of child's illness: Adapting the CONNECT Instrument for pediatrics.

Aims And Objectives: To adapt the CONNECT Instrument for use in the paediatric population, to assess validity of this instrument after its adaptation and to assess concordance between mothers' perception of their child's illness and providers' understanding of mothers' perceptions.

Background: The CONNECT Instrument (Patient Education and Counseling, 73, 2008, 232-239) was validated in an adult outpatient population to characterise both patients' perspectives and physicians' understanding of their patients' perspectives for several dimensions of the illness experience. However, this did not include the paediatric population or advanced practice providers.

Comparison of prostaglandin and mechanical cervical ripening in the setting of small for gestational age neonates.

The objective of this study is to determine whether cervical ripening with misoprostol (MP) is associated with higher rates of cesarean delivery (CD) compared with dinoprostone (DP) or Pitocin/Foley balloon (PFB) in infants found to be small for gestational age (SGA). Single center institution based cohort study of all inductions between 2008 and 2012 where birth weight was found to be as SGA (< 10th percentile). Maternal demographic, obstetric, and labor characteristics were compared between SGA births where cervical ripening with MP, DP, or PFB was used as the primary agent.

Accuracy of Sonographically Estimated Fetal Weight Near Delivery in Pregnancies Complicated With Diabetes Mellitus.

Objectives: The purpose of this study was to evaluate the accuracy of sonographic estimations of fetal weight (FW) and signed percent error between pregnant patients with and without diabetes mellitus (DM).

Methods: We conducted a retrospective cohort study of all singleton nonanomalous live births who delivered after 34 weeks and received a sonographic estimation of FW within 2 weeks of delivery at the University of Cincinnati Medical Center between 2008 and 2011. Our primary outcome compared the ΔFW and signed percent error between DM and non-DM pregnancies.

Prostaglandin versus mechanical dilation and the effect of maternal obesity on failure to achieve active labor: a cohort study.

Purpose: Assess the impact of obesity on successful cervical ripening with mechanical versus prostaglandin ripening.

Materials And Methods: We compared obese to non-obese women in an analysis stratified by induction method, prostaglandin versus mechanical. Misoprostol dosing was the same for obese and non-obese women.

Pleural effusion in a child with a ventriculoperitoneal shunt and congenital heart disease.

We present the unique case of an 8 month old infant who required extracorporeal membrane oxygenation (ECMO) after neonatal repair of tetralogy of Fallot. While on ECMO, he developed grade 3 intraventricular hemorrhage resulting in hydrocephalus requiring ventriculoperitoneal (VP) shunt placement at 5 months of life. He presented to cardiology clinic with a 2-month history of poor weight gain, tachypnea, and grunting and was found to have a large right sided pleural effusion.

Association of Fetal Abdominal-Head Circumference Size Difference With Shoulder Dystocia: A Multicenter Study.

Objective This study aims to determine if shoulder dystocia is associated with a difference in the fetal abdominal (AC) to head circumference (HC) of 50 mm or more noted on antenatal ultrasound. Study Design A multicenter matched case-control study was performed comparing women who had shoulder dystocia to controls who did not. Women with vaginal births of live born nonanomalous singletons ≥ 36 weeks of gestation with an antenatal ultrasound within 4 weeks of delivery were included.

Association between marijuana use and adverse obstetrical and neonatal outcomes.

Objective: To evaluate associations between marijuana exposure and adverse outcomes excluding women with polysubstance abuse and stratifying for concurrent maternal tobacco use.

Study Design: We performed a retrospective cohort study evaluating various obstetrical and neonatal outcomes including: preterm delivery, pre-eclampsia, gestational diabetes, cesarean delivery, fetal growth restriction, a composite which included stillbirth or neonatal intensive care unit admission, and perinatal mortality. We stratified study groups according to the maternal tobacco use and performed a logistic regression analysis.

Increasing maternal body mass index and the accuracy of sonographic estimation of fetal weight near delivery.

Objectives: To evaluate whether an increasing body mass index (BMI) influences the accuracy of sonographic estimation of fetal weight.

Methods: We performed a retrospective cohort study of singleton deliveries over a 2-year period in a single institution. Patients were included if they had a fetal weight estimation within 2 weeks of delivery.

Changes in lung activity of superoxide dismutase and copper concentration during lung tumorigenesis by hydralazine in Swiss mice.

Hydralazine (1-hydrazinophthalazine) was administered in drinking water as a 0.0312% solution to randomly bred Swiss mice for life beginning at 5 weeks of age. The treatments gave rise to statistically significant incidences of lung tumors: 55% in females and 43% in males.