Publications by authors named "Melissa L Hutchinson"

Article Synopsis
  • Inpatient child neurology programs are vital for pediatric care, and researchers aimed to assess the structure and challenges of these programs in North America.
  • A survey was conducted among child neurologists from various academic programs, with a response rate of 71%, primarily from program directors and senior staff.
  • The findings revealed issues such as high workload, out-of-hours documentation, and frequent phone calls related to patient care, which contribute to faculty burnout and indicate a need for better support and resources in these programs.
View Article and Find Full Text PDF
Article Synopsis
  • During the first 6 weeks of COVID-19 Shelter-in-Place orders, there was a 54% reduction in hospital encounters for children with neurologic conditions compared to the same period in the previous 3 years.
  • The patients seen during this period were younger, with significant drops in cases of migraines (72%) and acute neurologic issues such as status epilepticus and traumatic brain injury (56% reductions across the board).
  • Those who were hospitalized required more intensive care and diagnostic testing, indicating a need for continued neurologic hospital services amid concerns about delayed care for serious conditions.
View Article and Find Full Text PDF

Aim: To describe factors affecting eligibility for, and rates of utilization of, hyperacute therapy in children with acute ischemic stroke (AIS) following establishment of our institutional acute stroke treatment pathway in 2005.

Methods: A retrospective analysis of a prospectively enrolled, single-center cohort was performed including children age 2 - <18 years with acute AIS from 2005 through 2017. Descriptive statistics were used to summarize clinical characteristics, presentation data, and Pediatric NIH Stroke Scale (PedNIHSS) scores that were abstracted from medical records.

View Article and Find Full Text PDF

Antibody-mediated encephalitis is a treatable cause of encephalitis that manifests over days to weeks as changes in behavior and cognition, seizures, movement disorders, and autonomic dysfunction. Patients with autoimmune encephalitis develop a variety of symptoms. As such, they require a multidisciplinary approach to care.

View Article and Find Full Text PDF

Pressure injury treatments are tailored to the characteristics of the wound. Wound depth, exudate, presence of infection, and patient goals of care will guide appropriate dressing and treatment selection. The interprofessional team, patient, and family should collaborate to create a plan of care for wound healing.

View Article and Find Full Text PDF

Intensive care units (ICUs) are an appropriate focus of antibiotic stewardship program efforts because a large proportion of any hospital's use of parenteral antibiotics, especially broad-spectrum, occurs in the ICU. Given the importance of antibiotic stewardship for critically ill patients and the importance of critical care practitioners as the front line for antibiotic stewardship, a workshop was convened to specifically address barriers to antibiotic stewardship in the ICU and discuss tactics to overcome these. The working definition of antibiotic stewardship is "the right drug at the right time and the right dose for the right bug for the right duration.

View Article and Find Full Text PDF

Hemorrhagic transformation can complicate both arterial ischemic stroke and cerebral sinus venous thrombosis. Risk factors for hemorrhagic transformation after adult arterial ischemic stroke include larger infarct volume, cardioembolic stroke, and anticoagulation in the acute period. Large hemorrhagic transformation in adults is associated with poor outcome.

View Article and Find Full Text PDF

OBJECTIVES: Contingency management (CM), long known to be efficacious in the treatment of substance-dependent men and women, has also been found to be efficacious for substance-dependent pregnant women. However, the specific CM reinforcement parameters in the special population of opioid-dependent pregnant women have been less fully and systematically studied. The Drug Abuse Incentive Systems (DAISY) study, a randomized controlled trial (RCT) of opioid-dependent pregnant patients, found that escalating reinforcement was not superior to a fixed reinforcement CM schedule after a 13-week intervention.

View Article and Find Full Text PDF