35 results match your criteria: "Alpert Medical School of Brown University and Hasbro Children's Hospital[Affiliation]"

Factors associated with Helicobacter pylori antimicrobial resistance in a US pediatric cohort.

J Pediatr Gastroenterol Nutr

November 2024

Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts, USA.

Article Synopsis
  • A study was conducted to explore the epidemiological factors associated with antimicrobial resistance in US children infected with Helicobacter pylori from 2015 to 2022.
  • Out of 273 patients, 43.2% showed resistance to at least one antimicrobial, with clarithromycin being the most common.
  • Findings indicated that resistance varied by race and socioeconomic status, with Asian children having a higher resistance rate compared to white children, and lower household income linked to greater metronidazole resistance.
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Objectives: Helicobacter pylori rates of eradication to common first-line regimens continue to decline globally. Prescription of the appropriate medication dosage is an important consideration, particularly in the pediatric population due to medication weight-based dosing. Limited data is available on the impact of guideline-recommended weight-based dosing on the successful eradication of H.

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Purpose: Despite educational mandates to assess resident teaching competence, limited instruments with validity evidence exist for this purpose. Existing instruments do not allow faculty to assess resident-led teaching in a large group format or whether teaching was interactive. This study gathers validity evidence on the use of the Resident-led Large Group Teaching Assessment Instrument (Relate), an instrument used by faculty to assess resident teaching competency.

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Article Synopsis
  • The study aimed to investigate whether starting valganciclovir treatment after one month of age could enhance hearing in children with congenital cytomegalovirus-associated hearing loss.
  • Researchers conducted a randomized, double-blind trial involving 54 participants aged 1 month to 3 years, comparing the effects of 6 weeks of valganciclovir versus a placebo on hearing outcomes and viral load.
  • Results showed no significant improvement in hearing for the treatment group compared to the placebo, despite a notable reduction in viral load, indicating that starting treatment later does not effectively improve hearing in affected children.
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Article Synopsis
  • - This study examined concussion severity and outcomes in children involved in various activities (e.g., non-sport trauma, organized sports, and recreational activities) by measuring glial and neuronal biomarkers GFAP and UCH-L1.
  • - A total of 131 participants with concussions were enrolled, revealing significant differences in GFAP and UCH-L1 levels across groups, suggesting variations in concussion severity based on the type of activity.
  • - CT scans showed intracranial lesions in a small percentage of cases, and elevated UCH-L1 levels were linked to poorer outcomes, indicating that while concussion severity and outcomes appeared similar across groups, biomarker levels provide insights into the extent of injury.
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Objective: The objective was to develop a disability-based metric for quantifying disability rates as a result of motor vehicle crash (MVC) spine injuries and compare functional outcomes between pediatric and adult subgroups.

Methods: Disability rate was quantified using Functional Independence Measure (FIM) scores within the National Trauma Data Bank-Research Data System for the top 95% most frequent Abbreviated Injury Scale (AIS) 3 spine injuries (14 unique injuries). Pediatric (7-18 years), young adult (19-45 years), middle-aged adult (46-65 years), and older adult (66+ years) MVC occupants with FIM scores available and at least one of the 14 spine injuries were included.

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Supporting youth mental health during the COVID-19 pandemic.

Acad Emerg Med

December 2021

Departments of Emergency Medicine and Pediatrics, Division of Pediatric Emergency Medicine, Alpert Medical School of Brown University and Hasbro Children's Hospital, Providence, Rhode Island, USA.

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Objectives: Concussion is a commonly encountered diagnosis for pediatric emergency medicine (PEM) providers, yet little is known regarding referral patterns to specialists. Our goal was to assess PEM providers' referral patterns and current usage of standardized evaluation tools.

Methods: This study was conducted as cross-sectional survey of PEM providers recruited from the American Academy of Pediatrics Section on Emergency Medicine Listserv.

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Article Synopsis
  • Concussion is a common mild traumatic brain injury seen in pediatric patients in emergency departments, requiring providers to stay informed about its management.
  • Understanding the mechanisms behind concussion symptoms and recovery is continuously evolving, leading to updated recommendations for treatment.
  • The article will cover essential aspects such as definition, frequency, causes, diagnosis, and management of pediatric concussion within the emergency department context.
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Thyrotoxicosis in a Postpartum Adolescent: A Simulation Case for Emergency Medicine Providers.

MedEdPORTAL

September 2020

Assistant Professor, Departments of Emergency Medicine and Pediatrics, Division of Pediatric Emergency Medicine, Warren Alpert Medical School of Brown University and Rhode Island Hospital/Hasbro Children's Hospital; Director of Pediatric Simulation, Lifespan Medical Simulation Center.

Introduction: Thyroid storm is a rare but life-threatening disease process that may be difficult to recognize and mimics other disease processes. It is critical for the emergency medicine clinician to be able to recognize thyroid storm in patients in order to effectively stabilize and treat them.

Methods: In this standardized patient case, learners were faced with a 17-year-old postpartum woman presenting to the emergency department with respiratory distress and altered mental status secondary to thyroid storm.

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Background: Clinicians cannot reliably predict complications of acute hematogenous osteomyelitis (AHO).

Methods: Consecutive cases of AHO from 2 pediatric centers in the United States were analyzed retrospectively to develop clinical tools from data obtained within 96 hours of hospitalization to predict acute and chronic complications of AHO. Two novel composite prediction scores derived from multivariable logistic regression modeling were compared with a previously published severity of illness (SOI) score, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) using area under the receiver operating characteristic curve analyses.

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Malnutrition contributes to nearly half of all preventable deaths in children under the age of five. While the burden of disease is heaviest in Sub-Saharan Africa, South, and Southeast Asia, malnutrition in Latin America remains high, especially within indigenous communities. This study evaluates the prevalence of malnutrition and its relationship with access to healthcare resources within 172 indigenous Wayuú communities in La Guajira, Colombia.

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The objective was to develop a disability-based metric for motor vehicle crash (MVC) upper and lower extremity injuries and compare functional outcomes between children and adults. Disability risk (DR) was quantified using Functional Independence Measure (FIM) scores within the National Trauma Data Bank-Research Data System for the top 95% most frequently occurring Abbreviated Injury Scale (AIS) 3 extremity injuries (22 unique injuries). Pediatric (7-18 years), young adult (19-45 years), middle-aged (46-65 years), and older adult (66+ years) MVC occupants with an FIM score and at least one of the 22 extremity injuries were included.

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Aggrecan is an integral component of the extracellular matrix in cartilaginous tissues, including the growth plate. Heterozygous defects in the aggrecan gene have been identified as a cause of autosomal dominant short stature, bone age acceleration, and premature growth cessation. The mechanisms accounting for this phenotype remain unknown.

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Objectives: This study aimed to provide an assessment of medical malpractice claims involving pediatric patients cared for in emergency department and urgent care settings.

Methods: We performed a retrospective review of all closed malpractice claims involving children (0-17 years old) originating from emergency department or urgent care centers from the Physician Insurers Association of America's Data Sharing Project database for a 15-year period (2001-2015). Reported data collected include medical specialty involved, medical diagnoses, chief medical factors, severity of resulting injury, claim disposition, average indemnity, and average defense costs.

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Use of the vestibular and oculomotor examination for concussion in a pediatric emergency department.

Am J Emerg Med

July 2019

Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, PA, United States of America; Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, United States of America; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America.

Background: Concussion guidelines recommend a vestibular and oculomotor (VOM) examination be performed for all patients with concern for concussion, however the feasibility of performing testing is unknown. We aimed to measure rates of exam performance after implementation of training and support tools in a pediatric emergency department.

Methods: We conducted a retrospective study of patients age 6 to 18 years old presenting over a 12-month period.

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Background: Current consensus guidelines do not recommend routine follow-up imaging for blunt splenic injury (BSI) in children. However, repeat imaging is recommended based on persistent symptoms. Wide variation of practice continues to exist among surgeons.

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Suboptimal compliance with child restraint system (CRS) recommendations can increase risk for injury or death in a motor vehicle crash. The purpose of this study was to examine scenarios associated with incomplete CRS use and non-use in children ages 4⁻10 years. We used a cross-sectional online survey with a convenience sample of parent/caregivers from the United States, age ≥18 years, with a child age 4⁻10 years in their home, who could read and spoke English, and drove child ≥6 times in previous three months.

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Objectives: To examine characteristics associated with cell phone use while driving by parents and caregivers of children ages 4-10 years.

Study Design: National cross-sectional online survey with a convenience sample (March 2017-April 2017).

Inclusion Criteria: Parent/caregiver of a child age 4-10 years in their home, age ≥18 years, read and spoke English, and drove child ≥6 times in previous 3 months.

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Objective: Injury is the leading cause of death and acquired disability in children. Primary care providers routinely provide age-appropriate injury prevention (IP) counselling during healthcare visits. The objective was to review evaluations of the effectiveness of office-based paediatric IP counselling research.

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Objective: To determine the proportion of non-concussed, neurologically normal children with failures on a vestibular and oculomotor examination for concussion performed in an acute setting.

Design: This was a cross-sectional study of subjects 6-18 years old presenting to a paediatric emergency department with non-neurologic chief complaints. The examination was administered by a paediatric emergency medicine physician, and includes assessments of dysmetria, nystagmus, smooth pursuits, saccades, gaze stability, near-point of convergence, and gait/balance testing.

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Cervical Spine Imaging and Injuries in Young Children With Non-Motor Vehicle Crash-Associated Traumatic Brain Injury.

Pediatr Emerg Care

January 2021

Department of Pediatrics, Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center, Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh.

Objectives: The aim of this study was to evaluate cervical magnetic resonance imaging (MRI) and computed tomography (CT) practices and cervical spine injuries among young children with non-motor vehicle crash (MVC)-associated traumatic brain injury (TBI).

Methods: We performed a retrospective study of a stratified, systematic random sample of 328 children younger than 2 years with non-MVC-associated TBI at 4 urban children's hospitals from 2008 to 2012. We defined TBI etiology as accidental, indeterminate, or abuse.

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Objective: Characterization of the severity of injury should account for both mortality and disability. The objective of this study was to develop a disability metric for thoracic injuries in motor vehicle crashes (MVCs) and compare the functional outcomes between the pediatric and adult populations.

Methods: Disability risk (DR) was quantified using Functional Independence Measure (FIM) scores within the National Trauma Data Bank for the most frequently occurring Abbreviated Injury Scale (AIS) 2-5 thoracic injuries.

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Hutchinson-Gilford progeria syndrome (HGPS) is a rare genetic condition associated with mutations in the gene. This disease recapitulates some aspects of normal aging, such as hair loss, thin skin, joint stiffness, and atherosclerosis. The latter leads to heart attack or stroke that causes death at an average age of 14.

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