Quality of Care in the Last Two Years of Life for Children With Complex Chronic Conditions.

Context: Limited data exists about care received by children with complex chronic conditions (CCCs) in the final years of their disease and end-of-life (EOL).

Objective: To examine hospital performance on EOL quality measures and to describe healthcare services during the last two years of life for children with CCCs who died in-hospital.

Methods: Retrospective automated electronic health record review of children with ≥1 CCC ICD-10 diagnosis code, who died inpatient between October 2020 and March 2023 at a single quaternary U.

Health-Related Quality of Life After Community-Acquired Septic Shock in Children With Preexisting Severe Developmental Disabilities.

Objectives: To serially evaluate health-related quality of life during the first year after community-acquired septic shock in children with preexisting severe developmental disabilities and explore factors associated with health-related quality of life changes in these children.

Design: Secondary analysis of the Life after Pediatric Sepsis Evaluation investigation.

Setting: Twelve academic PICU in the United States.

Biomarkers for Estimating Risk of Hospital Mortality and Long-Term Quality-of-Life Morbidity After Surviving Pediatric Septic Shock: A Secondary Analysis of the Life After Pediatric Sepsis Evaluation Investigation.

Objectives: The Life After Pediatric Sepsis Evaluation investigation recently reported that one-third of children who survive sepsis experience significant health-related quality-of-life impairment compared with baseline at 1 year after hospitalization. Pediatric Sepsis Biomarker Risk Model is a multibiomarker tool for estimating baseline risk of mortality among children with septic shock. We determined if the Pediatric Sepsis Biomarker Risk Model biomarkers have predictive capacity for estimating the risk of hospital mortality and long-term health-related quality-of-life morbidity among children with community-acquired septic shock.

Trajectories and Risk Factors for Altered Physical and Psychosocial Health-Related Quality of Life After Pediatric Community-Acquired Septic Shock.

Objectives: To evaluate the physical and psychosocial domains of health-related quality of life among children during the first year following community-acquired septic shock, and explore factors associated with poor physical and psychosocial health-related quality of life outcomes.

Design: Secondary analysis of the Life After Pediatric Sepsis Evaluation.

Setting: Twelve academic PICUs in the United States.

Longitudinal Trajectories of Caregiver Distress and Family Functioning After Community-Acquired Pediatric Septic Shock.

Objectives: To identify trajectories and correlates of caregiver distress and family functioning in families of children who survived community-acquired septic shock. We hypothesized that: 1) a substantial subset of families would demonstrate trajectories of persistent elevated caregiver distress and impaired family functioning 12 months after hospitalization and 2) sociodemographic and clinical risk factors would be associated with trajectories of persistent distress and family dysfunction.

Design: Prospective cohort.

Trajectory of Mortality and Health-Related Quality of Life Morbidity Following Community-Acquired Pediatric Septic Shock.

Objectives: In-hospital pediatric sepsis mortality has decreased substantially, but long-term mortality and morbidity among children initially surviving sepsis, is unknown. Accordingly, the Life After Pediatric Sepsis Evaluation investigation was conducted to describe the trajectory of mortality and health-related quality of life morbidity for children encountering community-acquired septic shock.

Design: Prospective, cohort-outcome study, conducted 2013-2017.

Critical Illness Factors Associated With Long-Term Mortality and Health-Related Quality of Life Morbidity Following Community-Acquired Pediatric Septic Shock.

Objectives: A companion article reports the trajectory of long-term mortality and significant health-related quality of life disability among children encountering septic shock. In this article, the investigators examine critical illness factors associated with these adverse outcomes.

Design: Prospective, cohort-outcome study, conducted 2013-2017.

Pediatric Respiratory Illness Measurement System (PRIMES) Scores and Outcomes.

Background And Objectives: The Pediatric Respiratory Illness Measurement System (PRIMES) generates condition-specific composite quality scores for asthma, bronchiolitis, croup, and pneumonia in hospital-based settings. We sought to determine if higher PRIMES composite scores are associated with improved health-related quality of life, decreased length of stay (LOS), and decreased reuse.

Methods: We conducted a prospective cohort study of 2334 children in 5 children's hospitals between July 2014 and June 2016.

Development and Testing of the ediatric espiratory llness asurement ystem (PRIMES) Quality Indicators.

Objectives: To develop and test quality indicators for assessing care in pediatric hospital settings for common respiratory illnesses.

Patients: A sample of 2796 children discharged from the emergency department or inpatient setting at 1 of the 3 participating hospitals with a primary diagnosis of asthma, bronchiolitis, croup, or community-acquired pneumonia (CAP) between January 1, 2010, and December 31, 2011.

Setting: Three tertiary care children's hospitals in the United States.

Quality Measures to Assess Care Transitions for Hospitalized Children.

Background: Transitions between sites of care are inherent to all hospitalizations, yet we lack pediatric-specific transitions-of-care quality measures. We describe the development and validation of new transitions-of-care quality measures obtained from medical record data.

Methods: After an evidence review, a multistakeholder panel prioritized quality measures by using the RAND/University of California, Los Angeles modified Delphi method.

A pilot study on the use of a perfluorohexyloctane/silicone oil solution as a heavier than water internal tamponade agent.

Aims: To report a prospective two centred non-comparative interventional pilot study of a solution of perfluorohexyloctane and silicone oil (Densiron-68) as a heavier than water internal tamponade.

Methods: 42 consecutive patients were recruited. The indications include proliferative vitreoretinopathy, retinal detachments arising from inferior retinal breaks, and inability to posture.

The role of matricellular proteins thrombospondin-1 and osteonectin during RPE cell migration in proliferative vitreoretinopathy.

Purpose: To investigate the hypothesis that the Matricellular proteins thrombospondin 1 (TSP1), tenascin (TN) and Secreted Protein Acidic and Rich in Cysteine (SPARC) modulate the migration of RPE cells in the epiretinal membranes of proliferative vitreoretinopathy.

Methods: Ten PVR epiretinal membranes were studied by immunohistochemical methods in which aggregates of RPE cells were identified by their expression of a broad range of cytokeratins. RPE subsets containing migratory RPE cells were detected by immunoreactivity for the monoclonal antibody RGE53 (which detects an epitope on cytokeratin-18 on motile RPE cells).

Effects of the matricellular protein SPARC on human retinal pigment epithelial cell behavior.

Purpose: To determine the effects of the matricellular protein SPARC (Secreted Protein, Acidic and Rich in Cysteine) on human retinal pigment epithelial (HRPE) cell behavior in vitro.

Methods: Proliferation and migration assays were performed on HRPE cells exposed to various concentrations of SPARC. Additionally, HRPE cells were seeded on top of collagen matrices (a 2D model of the retinal scarring disorder known as proliferative vitreoretinopathy or PVR) and were exposed to SPARC over a 7 day period.

Trypan blue staining of internal limiting membrane and epiretinal membrane during vitrectomy: visual results and histopathological findings.

Aims: To report on the use of trypan blue (TB) 0.06% for staining the internal limiting membrane (ILM) and epiretinal membrane (ERM) during vitrectomy and report on their histology.

Method: 14 consecutive patients with idiopathic macular hole or macular pucker (seven patients each) were prospectively recruited for ILM or ERM peel respectively.

Rhegmatogenous retinal detachment after transscleral local resection of choroidal melanoma.

Objective: To report on the incidence and outcome of rhegmatogenous retinal detachment after transscleral local resection of choroidal melanoma.

Design: Prospective, noncomparative, interventional case series.

Participants: One hundred fifty-six patients with choroidal melanoma treated by transscleral local resection between January 1993 and June 2000.

Vitreous penetration of levofloxacin in the uninflamed phakic human eye.

Aims: To assess the vitreous penetration of oral levofloxacin (a new fluoroquinolone antibiotic with improved Gram positive activity) in uninflamed phakic eyes.

Methods: 15 patients for macula hole surgery were recruited to the study. 10 received a single 500 mg dose of levofloxacin by mouth preoperatively.

Endonasal laser dacryocystorhinostomy and external dacryocystorhinostomy outcome profile in a general ophthalmic service unit: a comparative retrospective study.

Purpose: To evaluate the outcome profile of endonasal laser dacryocystorhinostomy (ENL-DCR) in comparison with external dacryocystorhinostomy (ENL-DCR) carried out as part of general ophthalmic service within the same center.

Methods: Patients who have undergone external or endonasal laser DCR in the authors institute with a minimum follow-up of 9 months and at least 3 months after removal of the tubes were invited to participate in this research. We used a questionnaire and a systematic clinical examination for detecting lacrimal passage patency and function.

The role of nurse practitioners in a primary care eye clinic.

This paper reports on a study conducted to audit the practice of nurse practitioners in a primary care eye clinic at St Paul's Eye Unit at the Royal Liverpool University Hospital, UK. The clinic deals with ophthalmic accidents and emergencies and routine referral patients from general practitioners. This was a prospective study of the case notes of 250 consecutive patients who attended the clinic without prior appointment.

Synthesis of osteonectin by human retinal pigment epithelial cells is modulated by cell density.

Purpose: To determine whether human retinal pigment epithelial (HRPE) cells are able to synthesize the antiadhesive protein osteonectin, also known as secreted protein, acidic and rich in cysteine (SPARC). Additionally, because locally produced SPARC may modulate cellular behavior during tissue repair, to ascertain whether HRPE SPARC production and HRPE proliferation, migration, and/or differentiation are associated, in a simple HRPE wound-healing model.

Methods: Immunohistochemical and Western blot analyses of SPARC protein expression by low- and high-density cultured HRPE cells were undertaken.

Trends in vitreoretinal surgery at a tertiary referral centre: 1987 to 1996.

Aim: To identify trends in vitreoretinal surgery at a tertiary referral centre from 1987 to 1996.

Methods: A retrospective study of patients who had undergone vitreoretinal surgery at St Paul's Eye Unit over two 6 month periods in 1987 and 1996. Preoperative ocular status, surgery details, and outcome were collected.

Visual function and patient satisfaction after macular hole surgery.

Purpose: Over recent years success in macular hole surgery has increased in terms of anatomical closure. However, debate still continues on the benefit to the patient in terms of visual outcome. We designed a prospective study to investigate the outcome of full thickness macular hole (FTMH) surgery in terms of anatomical closure, visual outcome, incidence of complications and patient satisfaction.

Local anaesthesia for vitreoretinal surgery: a case-control study of 200 cases.

Purpose: In the United Kingdom the majority of vitreoretinal (VR) surgery is performed under general anaesthesia (GA). The aim of this study was to demonstrate the scope of local anaesthesia (LA) for VR surgery, to measure the acceptance of LA to patients and surgeons and to compare the surgical outcomes, complication rates and duration of the surgical procedures under LA and GA.

Methods: A case-control study was undertaken to compare 100 cases performed under LA with 100 matched cases performed under GA.

Intravitreal penetration of teicoplanin.

Teicoplanin is a glycopeptide antibiotic, similar to vancomycin, but safer and better tolerated. The purpose of this study was to evaluate the penetration of teicoplanin into the vitreous when administered topically and intravenously. Twenty-five patients undergoing routine vitrectomy were recruited.