25 results match your criteria: "Centre Mère-Enfant Soleil du Centre Hospitalier de l'Université Laval[Affiliation]"

Low-Value Clinical Practices in Pediatric Trauma Care.

JAMA Netw Open

October 2024

Department of Social and Preventive Medicine, School of Medicine, Laval University, Québec City, Québec, Canada.

Article Synopsis
  • The study highlights the significance of reducing low-value care in pediatric trauma, suggesting that it can enhance patient experiences and outcomes while minimizing unnecessary healthcare resource use.* -
  • A retrospective cohort study involving over 10,700 children admitted to trauma centers in a Canadian province was conducted to identify and assess low-value practices in pediatric trauma care.* -
  • The research found 19 low-value practices, with five showing moderate to high frequency and variation across hospitals, indicating a need for standardized care to improve pediatric trauma treatment.*
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Histone H3-mutant gliomas are deadly brain tumors characterized by a dysregulated epigenome and stalled differentiation. In contrast to the extensive datasets available on tumor cells, limited information exists on their tumor microenvironment (TME), particularly the immune infiltrate. Here, we characterize the immune TME of H3.

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Importance: Adult trauma centers (ATCs) have been shown to decrease injury mortality and morbidity in major trauma, but a synthesis of evidence for pediatric trauma centers (PTCs) is lacking.

Objective: To assess the effectiveness of PTCs compared with ATCs, combined trauma centers (CTCs), or nondesignated hospitals in reducing mortality and morbidity among children admitted to hospitals following trauma.

Data Sources: MEDLINE, Embase, and Web of Science through March 2023.

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Introduction: Given the lack of data to help caregivers in the follow-up of Hirschsprung disease (HD), this study aimed to compare the functional outcomes of isolated Hirschsprung disease (I-HD) to syndrome-associated Hirschsprung disease (SA-HD) at 1, 3, 5, and 10 years.

Methods: A retrospective chart review of patients diagnosed with HD between January 1990 and May 2021 at our pediatric center was performed to collect data on patient characteristics, investigations, and treatments. Ninety-five patients were identified, of whom 76 were included in the study.

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Background: Cancer predisposition syndromes (CPSs) are responsible for at least 10% of cancer diagnoses in children and adolescents, most of which are not clinically recognised prior to cancer diagnosis. A variety of clinical screening guidelines are used in healthcare settings to help clinicians detect patients who have a higher likelihood of having a CPS. The McGill Interactive Pediatric OncoGenetic Guidelines (MIPOGG) is an electronic health decision support tool that uses algorithms to help clinicians determine if a child/adolescent diagnosed with cancer should be referred to genetics for a CPS evaluation.

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Clinical practice guideline recommendations for pediatric solid organ injury care: A Systematic Review.

J Trauma Acute Care Surg

September 2023

From the Department of Surgery (N.Y.), University of Calgary, Calgary; Population Health and Optimal Health Practices Research Unit (P.-A.T., M.B., S.B., A.F.T., F.L., L.M.), Trauma-Emergency-Critical Care Medicine, Centre de Recherche du CHU de Québec, Université Laval (Hôpital de l'Enfant-Jésus); Department of Social and Preventative Medicine (L.M.), Université Laval, Quebec City, Quebec; Division of Emergency Medicine, Department of Paediatrics (G.F.), University of Toronto, Toronto; Faculty of Nursing (M.Bérubé), Université Laval, Quebec City, Quebec; Departments of Critical Care Medicine (H.T.S.), Medicine (H.T.S.), and Community Health Sciences (H.T.S.), O'Brien Institute for Public Health, University of Calgary, Calgary; Department of Paediatric Surgery (M.Beaudin), Sainte-Justine Hospital, Université de Montréal, Montreal, Quebec; Pediatrics, Emergency Medicine, and Community Health Sciences (A.S.), Cumming School of Medicine, University of Calgary, Calgary, Alberta; Division of Emergency Medicine (S.B.), Hospital for Sick Children, University of Toronto, Toronto, Ontario; Centre Mère-Enfant Soleil du CHU de Québec (M.W.), Transplant Quebec, Quebec City, Quebec; Division of Emergency Medicine, Department of Pediatrics (M.L.), CHU Sainte-Justine, Université de Montréal, Montreal; Department of Pediatrics (R.Z.), Children's Hospital of Eastern Ontario, Ottawa; Division of Pediatric Emergency Medicine (I.J.G.), McGill University Health Centre, Montreal Children's Hospital, Montréal; Département de Pédiatrie (E.B.), Faculté de Médecine, Centre Hospitalier Universitaire de Québec, and Department of Anesthesiology and Critical Care Medicine (A.F.T., F.L.), Division of Critical Care Medicine, Université Laval, Quebec City, Quebec, Canada; and School of Public Health and Preventive Medicine (B.G.), Monash University, Melbourne, Victoria, Australia.

Background: Observed variations in the management of pediatric solid organ injuries (SOIs) may be due to difficulty in finding and integrating recommendations from multiple clinical practice guidelines (CPGs) with heterogeneous methodological approaches. We aimed to systematically review CPG recommendations for pediatric SOIs.

Methods: We conducted a systematic review of CPGs including at least one recommendation targeting pediatric SOI populations, using Medical Analysis and Retrieval System Online, Excerpta Medica dataBASE, Web of Science, and websites of clinical organizations.

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Purpose: Infant and young childhood medulloblastoma (iMB) is usually treated without craniospinal irradiation (CSI) to avoid neurocognitive late effects. Unfortunately, many children relapse. The purpose of this study was to assess salvage strategies and prognostic features of patients with iMB who relapse after CSI-sparing therapy.

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Article Synopsis
  • Prompt diagnosis of cancer predisposition syndromes (CPS) in children is crucial for effective management and genetic counseling, but many institutions lack the necessary resources for accurate diagnoses.
  • The McGill Interactive Pediatric OncoGenetic Guidelines (MIPOGG) tool was evaluated for its accuracy in predicting CPS in pediatric oncology patients, involving 1,071 participants across multiple centers.
  • Results showed that MIPOGG successfully identified 99.5% of patients with confirmed CPS, outperforming standard clinical practices in early detection.
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Health care professionals (HCPs) play a critical role in helping to address weight-related issues with pediatric patients, yet often feel ill-equipped to discuss/manage this complex and sensitive health issue. Using the five As ("Ask, Assess, Advise, Agree, and Assist") of Pediatric Obesity Management, we created a series of educational videos and evaluated the content, quality (acceptability, engagement), and impact of these videos on HCPs' self-efficacy, knowledge, and change in practice when addressing weight-related issues with pediatric patients and their families using questionnaires. HCPs ( = 65) participated in a baseline assessment and 4-6 month follow-up ( = 54).

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Resumption of Cardiac Activity after Withdrawal of Life-Sustaining Measures.

N Engl J Med

January 2021

From the Children's Hospital of Eastern Ontario (S.D.), Children's Hospital of Eastern Ontario Research Institute (S.D., L.H., A. van Beinum, M.H., H.T.), Faculty of Medicine (S.D.) and Centre for Health Law, Policy, and Ethics (J.A.C.), University of Ottawa, Canadian Blood Services (L.H., S.D.S.), Carleton University (A. van Beinum), the Dynamical Analysis Lab (N.B.S., C.H., A.S.), Clinical Epidemiology Program (N.B.S., C.H., A.S.), and Clinical Epidemiology Program Methods Centre (T.R.), Ottawa Hospital Research Institute, the Departments of Critical Care and General Surgery (G.P.) and Surgery (A.S.) and Division of Thoracic Surgery (A.S.), Ottawa Hospital, and Interventional Cardiology Program, University of Ottawa Heart Institute (D. So), Ottawa, the Department of Critical Care, Trauma and Neurosurgery Program, St. Michael's Hospital (A. Baker), Li Ka Shing Knowledge Institute, Unity Health-St. Michael's Hospital (J.O.F., D. Scales), University of Toronto (J.O.F.), Mount Sinai Hospital (S.M., L.M.) and Interdepartmental Division of Critical Care Medicine (S.M., L.M., D. Scales), University of Toronto, Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (D. Scales), and the Canadian Donation and Transplantation Research Program (H.T.), Toronto, the Departments of Critical Care and Anesthesia, Dalhousie University, Halifax, NS (S.B.), the Departments of Medicine and Critical Care Medicine, Queen's University, Kingston, ON (J.G.B., D.M.M.), the Department of Medicine (Critical Care), Research Centre of the University of Montreal Hospital (M.C.), the Department of Critical Care, Division of Pulmonary Medicine, McGill University (J.S.), McGill University Health Centre and Research Institute (J.S., S.D.S.), Transplant Québec (M.W.), and the Division of Critical Care, Montreal Children's Hospital (S.D.S.), Montreal, the Department of Anesthesiology, Université de Sherbrooke and Centre de Recherche du Centre Hospitalier Universitaire (CHU) de Sherbrooke, Sherbrooke, QC (F. D'Aragon), the Departments of Critical Care Medicine, Community Health Sciences, and Medicine, Cumming School of Medicine (C.J.D.), and the Departments of Critical Care Medicine and Clinical Neurosciences (A.H.K.), University of Calgary, and Calgary Zone, Alberta Health Services (C.J.D.), Calgary, the Department of Clinical Neurological Sciences, London Health Sciences Centre (T.G.), Schulich School of Medicine and Dentistry (T.G.), the Department of Psychology, King's University College (L.N.), and the Department of Medicine and the Brain and Mind Institute (M. Slessarev), Western University, London, ON, the Division of Critical Care, Departments of Medicine and Anesthesia, University of British Columbia, Vancouver (G.I.), the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (D.J.K.), the Department of Medicine, McMaster University, and Hamilton Health Sciences Centre, Hamilton, ON (M.M.), and the Division of Pediatric Intensive Care, CHU de Québec, Centre Mère-Enfant Soleil, and the Department of Pediatrics, Faculté de Médecine, Université Laval, Quebec City, QC (M.W.) - all in Canada; Safar Center for Resuscitation Research, Critical Care Medicine Department, University of Pittsburgh School of Medicine, Pittsburgh (C.D.); Charles University, Third Faculty of Medicine and FNKV University Hospital (F. Duska, M. Schmidt, P.W.), and the Department of Palliative Medicine, First Faculty of Medicine, Charles University and General University Hospital (K.R.), Prague, Czech Republic; NHS Blood and Transplant, Bristol (D.G., D.H.), and Adult Critical Care, Nottingham University Hospitals NHS Trust, Nottingham (D.G., D.H.) - both in the United Kingdom; and the Department of Intensive Care Medicine, Maastricht University Medical Center, and the School of Health Professions Education, Maastricht University (W.N.K.A.M.), and the Heart and Vascular Center, Maastricht University Medical Center (J.T.W.), Maastricht, the Netherlands.

Background: The minimum duration of pulselessness required before organ donation after circulatory determination of death has not been well studied.

Methods: We conducted a prospective observational study of the incidence and timing of resumption of cardiac electrical and pulsatile activity in adults who died after planned withdrawal of life-sustaining measures in 20 intensive care units in three countries. Patients were intended to be monitored for 30 minutes after determination of death.

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Background: Parents may struggle to initiate healthy weight-related conversations with their children. Educational videos may be an effective tool for improving parents' knowledge and self-efficacy on this topic. The aim of this pilot study was to develop an educational video to assist parents in weight-related conversations with their child, and to assess changes in parents' self-efficacy on this topic.

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Novel Recessive TNNT1 Congenital Core-Rod Myopathy in French Canadians.

Ann Neurol

April 2020

Department of Child Neurology, Centre Hospitalier de l'Université Laval et Centre Mère-Enfant Soleil, Université Laval, Quebec City, Quebec, Canada.

Objective: Recessive null variants of the slow skeletal muscle troponin T1 (TNNT1) gene are a rare cause of nemaline myopathy that is fatal in infancy due to respiratory insufficiency. Muscle biopsy shows rods and fiber type disproportion. We report on 4 French Canadians with a novel form of recessive congenital TNNT1 core-rod myopathy.

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Childhood brain tumors have suspected prenatal origins. To identify vulnerable developmental states, we generated a single-cell transcriptome atlas of >65,000 cells from embryonal pons and forebrain, two major tumor locations. We derived signatures for 191 distinct cell populations and defined the regional cellular diversity and differentiation dynamics.

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The use of transition readiness questionnaires is strongly recommended in adolescents with chronic conditions. The aim of our study was to validate "Good2Go," the first French-language transition readiness questionnaire. We analyzed the data from 2 multicentric studies (Canada and France) involving adolescents with chronic conditions (type 1 diabetes, inflammatory bowel disease, cystic fibrosis, epilepsy, juvenile idiopathic arthritis).

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Purpose: Children with unresectable brainstem-infiltrated ganglioglioma have poor progression-free survival when treated with conventional chemotherapy and radiation regimens. The BRAF mutation occurs in a large number of gangliogliomas, making them amenable for targeted therapy using mutation-specific kinase inhibitors. However, limited data exists on the effectiveness and best treatment duration of these inhibitors in this tumor setting.

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Importance: Guidelines for declaration of brain death in children were revised in 2011 by the Society of Critical Care Medicine, American Academy of Pediatrics, and Child Neurology Society. Despite widespread medical, legal, and ethical acceptance, ongoing controversies exist with regard to the concept of brain death and the procedures for its determination.

Objectives: To determine the epidemiology and clinical characteristics of pediatric patients declared brain dead in the United States.

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The purpose of this study was to identify which averaging methods most accurately measures peak cardiorespiratory fitness (CRF) parameters [peak O uptake (VO), peak Opulse and peak respiratory exchange ratio (RER)] in a sample of healthy children and adolescents. In this cross-sectional multicenter study, we recruited 278 healthy children aged 12-17 years. We compared the mean peak value of three CRF parameters using the recommended averaging methods (30-second block average) with alternative averaging methods such as moving averages or shorter smoothing periods.

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Introduction: Dickkopf-1 (DKK1) is a soluble protein and antagonist of the Wnt/β-catenin signaling pathway. DKK1 is found elevated in serum from patients affected with various types of cancers and in some instances, it is considered a diagnostic and prognostic biomarker. Elevated serum levels of DKK1 have also been detected in animal models of chronic inflammatory diseases.

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Evaluation of height-dependent and height-independent methods of estimating baseline serum creatinine in critically ill children.

Pediatr Nephrol

October 2017

Department of Pediatrics, Division of Nephrology, Montreal Children's Hospital, McGill University Health Centre, 1001 Blvd Decarie, Room BRC.6168, Montreal, QC, H4A 3J1, Canada.

Article Synopsis
  • Baseline serum creatinine (bSCr) is crucial for diagnosing acute kidney injury (AKI) in children, but measurements are often missing, especially when height is unavailable for estimating bSCr using equations.
  • A study of 538 children in the ICU found that both height-based and height-independent methods underestimated bSCr, but had good agreement in defining AKI compared to measured values.
  • The findings suggest that both estimation methods are similar and that they can aid in AKI research and clinical care, particularly when height data is not accessible.
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Attitudes of pediatric intensive care unit physicians towards the use of cognitive aids: a qualitative study.

BMC Med Inform Decis Mak

May 2016

Department of Family and Emergency Medicine, Université Laval, Faculty of Medicine, Pavillon Ferdinand-Vandry, 1050, avenue de la Médecine Local 2207A, Québec, G1V 0A6, Canada.

Background: Cognitive aids are increasingly recommended in clinical practice, yet little is known about the attitudes of physicians towards these tools.

Methods: We employed a qualitative, descriptive design to explore physician attitudes towards cognitive aids in pediatric intensive care units (PICUs). Semi-structured interviews elicited the opinions of a convenience sample of practicing PICU physicians towards the use of cognitive aids.

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Pediatric Donation After Circulatory Determination of Death: A Scoping Review.

Pediatr Crit Care Med

March 2016

1Division of Pediatric Critical Care, Departement of Pediatrics, Centre Mère-Enfant Soleil du Centre Hospitalier Universitaire de Québec, Québec, QC, Canada. 2Research Center of the CHU de Québec, Reproduction, Mother and Youth Health Axis, Québec, QC, Canada. 3Department of Pediatrics, Faculty of Medicine, Université Laval, Québec, QC, Canada. 4Canadian pDCDD Guideline Development Committee, Canadian Blood Services, Ottawa, ON, Canada. 5DePPaRT Study, Pediatric Critical Care, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada. 6Deceased Donation, Organs and Tissue, Canadian Blood Services, Ottawa, ON, Canada. 7Division of Critical Care, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre and Research Institute, Montreal, QC, Canada. 8Department of Pediatrics, McGill University, Montreal, QC, Canada. 9Deceased Donation, Organs and Tissues, Canadian Blood Services, Ottawa, ON, Canada.

Objective: Although pediatric donation after circulatory determination of death is increasing in frequency, there are no national or international donation after circulatory determination of death guidelines specific to pediatrics. This scoping review was performed to map the pediatric donation after circulatory determination of death literature, identify pediatric donation after circulatory determination of death knowledge gaps, and inform the development of national or regional pediatric donation after circulatory determination of death guidelines.

Data Sources: Terms related to pediatric donation after circulatory determination of death were searched in Embase and MEDLINE, as well as the non-MEDLINE sources in PubMed from 1980 to May 2014.

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Cirque du Monde as a health intervention: perceptions of medical students and social circus experts.

Can Fam Physician

November 2014

Emergency physician at Centre de santé et de services sociaux Alphonse-Desjardins, Assistant Professor in the Department of Family Medicine and Emergency Medicine at Laval University, and Université Laval-Centre hospitalier affilié universitaire Hôtel-Dieu de Lévis Research Chair in Emergency Medicine.

Objective: To present Cirque du Soleil's social circus program, Cirque du Monde, to explore its potential as a primary health care tool for family physicians.

Data Sources: A review of the literature in PubMed, the Cochrane Library, PsycINFO, LaPresse, Eureka, Google Scholar, and Érudit using the key words circus, social circus, Cirque du Monde, and Cirque du Soleil; a Montreal-based initiative, Espace Transition, modeled on Cirque du Monde; and personal communication with Cirque du Soleil's Social Circus Training Advisor.

Study Selection: The first 50 articles or websites identified for each key word in each of the databases were examined on the basis of their titles and abstracts in the case of articles, and on the basis of their titles and page content in the case of websites.

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