Antibacterial efficacy of Azadirachta indica, Mimusops elengi and 2% CHX on multispecies dentinal biofilm.

Aims: To check the antimicrobial activity of Azadirachta indica (Neem), Mimusops elengi (Bakul), and Chlorhexidine gluconate (CHX) on multispecies biofilm of common endodontic pathogens such as Streptococcus mutans, Enterococcus faecalis, Staphylococcus aureus and Candida albicans.

Settings And Design: In vitro dentin disinfection model used to check the antimicrobial efficacy of herbal extracts.

Materials And Methods: The in vitro dentin disinfection model was used to check the antimicrobial activity of the methanolic extracts of the medicinal plants along with Chlorhexidine gluconate.

Corticosteroid Use in a Prospective, Community-Based Cohort of Newly Diagnosed Inflammatory Bowel Disease Patients.

Background: Systemic corticosteroids (CS) are a mainstay of treatment for patients with newly diagnosed inflammatory bowel disease (IBD). Previous population-based studies report CS exposure rates range from 39 to 75 % within the first year of diagnosis with surgical resection rates as high as 13-18 % in the same time frame. These reports represent an older cohort of patients enrolled over prolonged periods of time and do not necessarily reflect current treatment approaches.

Characteristics of Children With Cancer Discharged or Admitted From the Emergency Department.

Background: Emergency department (ED) utilization by children with cancer is poorly understood. Among children with cancer, we explored reasons for ED visits and factors associated with admission within U.S.

Bilateral pigmented villonodular synovitis of the knee.

Pigmented villonodular synovitis is a disorder resulting in a villous, nodular, or villonodular proliferation of the synovium, with pigmentation related to the presence of hemosiderin. These lesions are almost exclusively benign with rare reports of malignancy. Pigmented villonodular synovitis can occur in a variety of joints and at any age but most often occurs within the knee in the young adult.

The Family Perspective on Hospital to Home Transitions: A Qualitative Study.

Background And Objective: Transitions from the hospital to home can be difficult for patients and families. Family-informed characterization of this vulnerable period may facilitate the identification of interventions to improve transitions home. Our objective was to develop a comprehensive understanding of hospital-to-home transitions from the family perspective.

Single Center Outcomes of Status Epilepticus at a Paediatric Intensive Care Unit.

Background: Status epilepticus (SE) is a frequent admission diagnosis to paediatric intensive care units (PICUs) and is associated with variable outcomes. We have audited our experience of patients presenting in SE at a Canadian PICU to determine unfavorable outcome variables.

Methods: Charts of patients <18 years of age presenting in SE to a tertiary care PICU over a 10-year period were audited.

Treatment Failures and Excess Mortality Among HIV-Exposed, Uninfected Children With Pneumonia.

Background: Human immunodeficiency virus (HIV)-exposed, uninfected (HIV-EU) children are at increased risk of infectious illnesses and mortality compared with children of HIV-negative mothers (HIV-unexposed). However, treatment outcomes for lower respiratory tract infections among HIV-EU children remain poorly defined.

Methods: We conducted a hospital-based, prospective cohort study of N = 238 children aged 1-23 months with pneumonia, defined by the World Health Organization.

Chest Radiographic Findings and Outcomes of Pneumonia Among Children in Botswana.

Background: Chest radiography is increasingly used to diagnose pneumonia in low-income and middle-income countries. Few studies examined whether chest radiographic findings predict outcomes of children with clinically suspected pneumonia in these settings.

Methods: This is a hospital-based, prospective cohort study of children 1-23 months of age meeting clinical criteria for pneumonia in Botswana.

Socioeconomic Status and Hospitalization Costs for Children with Brain and Spinal Cord Injury.

Objective: To determine if household income is associated with hospitalization costs for severe traumatic brain injury (TBI) and spinal cord injury (SCI).

Study Design: Retrospective cohort study of inpatient, nonrehabilitation hospitalizations at 43 freestanding children's hospitals for patients <19 years old with unintentional severe TBI and SCI from 2009-2012. Standardized cost of care for hospitalizations was modeled using mixed-effects methods, adjusting for age, sex, race/ethnicity, primary payer, presence of chronic medical condition, mechanism of injury, injury severity, distance from residence to hospital, and trauma center level.

Emergency Department Use of Computed Tomography for Children with Ventricular Shunts.

Objectives: To quantify rates and variation in emergency department (ED) cranial computed tomography (CT) utilization in children with ventricular shunts, estimate radiation exposure, and evaluate the association between CT utilization and shunt revision.

Study Design: Retrospective longitudinal cohort study of ED visits from 2003-2013 in children 0-18 years old with initial shunt placement in 2003. Data were examined from 31 hospitals in the Pediatric Health Information System.

Association between Hospital Volume and Within-Hospital Intensive Care Unit Transfer for Sickle Cell Disease in Children's Hospitals.

Objective: To assess the relationship between hospital volume and intensive care unit (ICU) transfer among hospitalized children with sickle cell disease (SCD).

Study Design: We conducted a retrospective cohort study of 83,477 SCD-related hospitalizations at children's hospitals (2009-2012) using the Pediatric Health Information System database. Hospital-level all-cause and SCD-specific volumes were dichotomized (low vs high).

Identifying Pediatric Severe Sepsis and Septic Shock: Accuracy of Diagnosis Codes.

Objectives: To evaluate accuracy of 2 established administrative methods of identifying children with sepsis using a medical record review reference standard.

Study Design: Multicenter retrospective study at 6 US children's hospitals. Subjects were children >60 days to <19 years of age and identified in 4 groups based on International Classification of Diseases, Ninth Revision, Clinical Modification codes: (1) severe sepsis/septic shock (sepsis codes); (2) infection plus organ dysfunction (combination codes); (3) subjects without codes for infection, organ dysfunction, or severe sepsis; and (4) infection but not severe sepsis or organ dysfunction.

Strategies to engage stakeholders in research to improve acute care delivery.

Many families involved in research are well versed in the care system due to chronic conditions. Engagement of families of children with serious acute illnesses is infrequent, and no studies have documented the feasibility or acceptability of different methods of family engagement. We describe a model used in the Hospital-to-Home Outcomes study, which utilized a novel approach of short-term focused engagement of families and other stakeholders to incorporate the unique viewpoints of families whose care experience is primarily focused around the period surrounding their child's hospitalization for acute illness.

Adjunct Systemic Corticosteroid Therapy in Children With Community-Acquired Pneumonia in the Outpatient Setting.

Background: The role of adjunct systemic corticosteroid therapy in children with community-acquired pneumonia (CAP) is not known. The objective was to determine the association between adjunct systemic corticosteroid therapy and treatment failure in children who received antibiotics for treatment of CAP in the outpatient setting.

Methods: The study included a retrospective cohort study of children, aged 1-18 years, with a diagnosis of CAP who were managed at an outpatient practice affiliated with Geisinger Health System from January 1, 2008 to January 31, 2010.

Beta-lactam versus beta- lactam/macrolide therapy in pediatric outpatient pneumonia.

Objective: The objective was to evaluate the comparative effectiveness of beta-lactam monotherapy and beta- lactam/macrolide combination therapy in the outpatient management of children with community-acquired pneumonia (CAP).

Methods: This retrospective cohort study included children, ages 1-18 years, with CAP diagnosed between January 1, 2008 and January 31, 2010 during outpatient management in the Geisinger Health System. The primary exposure was receipt of beta-lactam monotherapy or beta-lactam/macrolide combination therapy.

Structure and Function of Observation Units in Children's Hospitals: A Mixed-Methods Study.

Objective: Observation unit (OU) use has been promoted recently to decrease resource utilization and costs for select patients, but little is known about the operations of pediatric OUs. This study aimed to characterize the infrastructure and function of OUs within freestanding children's hospitals and to compare characteristics between hospitals with and without OUs.

Methods: All 43 freestanding children's hospitals that submit data to the Pediatric Health Information System were contacted in 2013 to identify OUs that admitted unscheduled patients from their emergency department (ED) in 2011.

Microsurgical Reconstruction of Large Oncologic Chest Wall Defects for Locally Advanced Breast Cancer or Osteoradionecrosis: A Retrospective Review of 26 Cases over a 5-Year Period.

Background: Locally advanced breast cancer (LABC) and chest wall osteoradionecrosis (ORN) often require extensive and composite tissue resection, including muscles, ribs, pleura, and lung parenchyma. As such, these cases necessitate complex reconstructive procedures for skeletal chest wall reconstruction and soft tissue resurfacing of extensive defects. Traditional local and regional flaps are often inadequate, and many such cases are prospectively labeled "unresectable.