Outcomes of a respiratory therapist driven high flow nasal cannula management protocol for pediatric critical asthma patients.

Introduction: This study aimed to determine if a respiratory therapist (RT)-driven high flow nasal cannula (HFNC) protocol could decrease duration of HFNC use, pediatric intensive care unit (PICU) and hospital length of stay (LOS), and duration of continuous albuterol use in pediatric patients with critical asthma.

Methods: This was a quality improvement project performed at a quaternary academic PICU. Patients admitted to the PICU between 2 and 18 years of age with a diagnosis of asthma requiring continuous albuterol and HFNC were included.

Improving Outcomes for Bronchiolitis Patients After Implementing a High-Flow Nasal Cannula Holiday and Standardizing Discharge Criteria in a PICU.

Objectives: To decrease length of high-flow nasal cannula (HFNC), PICU, and hospital length of stay (LOS).

Design: Quality improvement project.

Setting: A quaternary academic PICU.

Engaging All Stakeholders to Create a Trusted, Data-Driven, Process Improvement Approach to Addressing Learner Mistreatment.

: Learner mistreatment has remained an ongoing challenge in academic medicine despite accreditation requirements mandating that every program has systems in place to prevent and respond to mistreatment. While efforts vary across institutions, much remains unanswered in the literature about best practices. Additionally, for the foreseeable future, challenges in the learning environment will likely continue and potentially worsen, given the confluence of multiple external stressors including the COVID-19 pandemic, faculty burnout and general political divisiveness in the nation.

Gravity and Electrostatic Separation for Recovering Metals from Obsolete Printed Circuit Board.

This study proposed an evaluation of enrichment processes of obsolete Printed Circuit Boards (PCBs), by means of gravity and electrostatic separation, aiming at the recovery of metals. PCBs are the most important component in electronic devices, having high concentrations of metals and offering a secondary source of raw materials. Its recycling promotes the reduction in the environmental impacts associated with its production, use, and disposal.

Diversifying Faculty Leadership in Academic Medicine: The Program to Launch Underrepresented in Medicine Success (PLUS).

PLUS (Program to Launch Underrepresented in Medicine Success) is a 2-year cohort program at Indiana University School of Medicine providing professional development, funding and skills to produce scholarship, and a community to mitigate social and/or professional isolation for underrepresented in medicine (URiM) faculty. In year 1, scholars participate in leadership and professional development seminars and regular meetings with their mentor(s). They are assigned a PLUS Advisory Council advisor with whom they meet 2 to 3 times annually.

To Improve Pain and Function, Platelet-Rich Plasma Injections May Be an Alternative to Surgery for Treating Lateral Epicondylitis: A Systematic Review.

Purpose: To determine whether platelet-rich plasma (PRP) injection for lateral epicondylitis offers patients comparable outcomes to lateral epicondylar surgery.

Methods: Embase, Cochrane Library, and MEDLINE databases were searched using the terms lateral epicondylitis, lateral elbow pain, tennis elbow, lateral epicondylalgia, and elbow tendinopathy individually and combined with the terms platelet-rich plasma injections and lateral epicondylar surgery. We compared pain relief, function between the 2 treatment options, and identified whether PRP injection reduced the incidence of lateral epicondylar surgery.

Extubation Readiness Practices and Barriers to Extubation in Pediatric Subjects.

Background: Invasive mechanical ventilation is a lifesaving intervention that is associated with short- and long-term morbidities. Extubation readiness protocols aim to decrease extubation failure rates and simultaneously shorten the duration of invasive ventilation. This study sought to analyze extubation readiness practices at one institution and identify barriers to extubation in pediatric patients who have passed an extubation readiness test (ERT).

Reducing Unnecessary Nitric Oxide Use: A Hospital-Wide, Respiratory Therapist-Driven Quality Improvement Project.

Background: We sought to evaluate the institutional use of inhaled nitric oxide (INO) and to create a pathway to reduce waste using the Institute for Healthcare Improvement's model for improvement. Our aim was to reduce the use of INO by 20% within 8 months.

Methods: This was a prospective, respiratory therapist-driven, quality improvement project.

Implementation of a High-Flow Nasal Cannula Management Protocol in the Pediatric ICU.

Background: High-flow nasal cannula (HFNC) therapy is a respiratory modality that has been adopted to support pediatric patients with bronchiolitis. There is no standardized protocol for initiation, escalation, or weaning of HFNC in the pediatric ICU. The aim of this respiratory therapist (RT)-driven quality improvement management protocol was to decrease duration of HFNC.

Neonatal meningitis: a multicenter study in Lima, Peru.

Objective: To determine the incidence and the clinical, bacteriological and cerebrospinal fluid characteristics of neonatal meningitis in Lima hospitals.

Materials And Methods: An observational, multicenter study was conducted in six hospitals in the city of Lima during 1 year of epidemiological surveillance.

Results: The cumulative hospital incidence was 1.

Progression of Respiratory Support Following Pediatric Extubation.

Objectives: High-flow nasal cannula and noninvasive positive pressure ventilation have become ubiquitous in contemporary PICUs. Practice patterns associated with the use of these modalities have not been well described. In this study, we aimed to describe the use of high-flow nasal cannula and noninvasive positive pressure ventilation in children after extubation and analyze the progression of usage in association with patient factors.

Relationship between iHOT12 and HOS scores in hip pain patients.

To determine if scores of the International Hip Outcome Tool-12 (iHOT12) and the Hip Outcome Score (HOS) correlate with one another in hip pain patients. Patients reporting to an orthopedic clinic for their scheduled appointment for hip pain were given a paper survey consisting of the iHOT12 and the HOS. Demographic information [age, weight, height and body mass index (BMI)] was obtained by chart review.

Implementing a Respiratory Therapist-Driven Continuous Albuterol Weaning Protocol in the Pediatric ICU.

Background: Status asthmaticus is one of the most frequent admission diagnoses in the pediatric ICU (PICU). Collaboration between respiratory therapists (RTs) and physicians may help efficiently deliver care to a patient in status asthmaticus. The Pediatric Asthma Severity Score (PASS) is a measure of severity of a patient's asthma exacerbation at a point in time.

Combined predictors of neurodevelopment in very low birth weight preterm infants.

Objective: To evaluate the combined prognostic value of neurological examination, head circumference and cranial ultrasound for neurodevelopmental delay (NDD) in very low birth weight (VLBW, <1500 g) preterm infants.

Methods: Prospective follow-up study. Preterm infants with VLWB were assessed for NDD using the Mullen Scales of Early Learning test at 24 months of corrected age.

Modification and Assessment of the Bedside Pediatric Early Warning Score in the Pediatric Allogeneic Hematopoietic Cell Transplant Population.

Objectives: To determine the validity of the Bedside Pediatric Early Warning Score system in the hematopoietic cell transplant population, and to determine if the addition of weight gain further strengthens the association with need for PICU admission.

Design: Retrospective cohort study of pediatric allogeneic hematopoietic cell transplant patients from 2009 to 2016. Daily Pediatric Early Warning Score and weights were collected during hospitalization.

Comparison between chloral hydrate and propofol-ketamine as sedation regimens for pediatric auditory brainstem response testing.

Introduction: The use of diagnostic auditory brainstem response testing under sedation is currently the "gold standard" in infants and young children who are not developmentally capable of completing the test.

Objective: The aim of the study is to compare a propofol-ketamine regimen to an oral chloral hydrate regimen for sedating children undergoing auditory brainstem response testing.

Methods: Patients between 4 months and 6 years who required sedation for auditory brainstem response testing were included in this retrospective study.

An Interprofessional Quality Improvement Initiative to Standardize Pediatric Extubation Readiness Assessment.

Objectives: Establishing protocols to wean mechanical ventilation and assess readiness for extubation, with the goal of minimizing morbidity associated with extubation failure and prolonged mechanical ventilation, have become increasingly important in contemporary PICUs. The aim of this quality improvement initiative is to establish a respiratory therapist-led daily spontaneous breathing trial protocol to standardize extubation readiness assessment and documentation in our PICU.

Design: A quality improvement project.

[Linee guida flebo-linfologiche SIF-SICVE 2016 della Società Italiana di Flebologia e della Società Italiana di Chirurgia Vascolare ed Endovascolare].

Phlebology is not a specialty for its own in Italy. Phlebological patients are treated by vascular and general surgeons, dermatologists, phlebologists, angiologists, internists and even general practitioners. Even tough guidelines present a series of recommendations based on evidence-based medicine, guidelines may also be a tool to unify the diagnostic and therapeutic approach in a vast medical field like phlebology.

[Use of lumbar puncture in the evaluation of late-onset sepsis in low birth weight neonates].

The objective of this study was to analyze the use of lumbar punctures (LP) in the evaluation of late-onset neonatal sepsis. It is recommended to perform an LP as part of the evaluation of late-onset sepsis. We used a cohort of 414 newborns with a birth weight <2000g in three hospitals in Lima.

An Official American Thoracic Society Clinical Practice Guideline: Pediatric Chronic Home Invasive Ventilation.

Background: Children with chronic invasive ventilator dependence living at home are a diverse group of children with special health care needs. Medical oversight, equipment management, and community resources vary widely. There are no clinical practice guidelines available to health care professionals for the safe hospital discharge and home management of these complex children.

Development of a reliable dual-gene amplification RT-PCR assay for the detection of Turkey Meningoencephalitis virus in Turkey brain tissues.

The Turkey Meningoencephalitis virus (TMEV) causes neuroparalytic signs, paresis, in-coordination, morbidity and mortality in turkeys. In parallel to the increased worldwide scientific interest in veterinary avian flaviviruses, including the Bagaza, Tembusu and Tembusu-related BYD virus, TMEV-caused disease also reemergence in commercial turkeys during late summer of 2010. While initially TMEV was detected by NS5-gene RT-PCR, subsequently, the env-gene RT-PCR was employed.

Disaccharidase activity in infants and comparison based on symptoms and histological changes.

Objectives: There is uncertainty regarding disaccharidase activity (DA) in infants. In this study, values for DA in infants were established and compared with symptoms and intestinal mucosal histological appearance.

Patients And Methods: Disaccharidase activity and histological appearance of endoscopically obtained intestinal mucosal biopsy specimens from 131 infants (75 males; mean age 180 days; range 20-364 days) obtained during an 8-year period were reviewed.

A 12-month clinical evaluation of composite resins in class III restorations.

Purpose: This paired-tooth randomized controlled prospective clinical study compared the clinical performance of three composite resins in Class III cavities after 12 months.

Materials And Methods: Three materials were evaluated: a microfilled composite resin (Durafill VS), a hybrid composite resin (Filtek Z250), and a nanofilled composite resin (Filtek Supreme). Thirty-eight patients having at least three Class III restorations were enrolled in this study.