"Helping the Helpers"-Making Access to Buprenorphine the New Standard of Care for Physicians in State Monitoring Programs.

This commentary argues that the Federation of State Medical Board's (FSMB) recommendations concerning the use of buprenorphine for physicians in their state-affiliated monitoring programs falls short of effectively permitting an evidence-based treatment for opioid use disorder. Although the FSMB acknowledges the benefits of medications for opioid use disorder and recommends that physicians who elect to start on buprenorphine receive treatment safely and privately, the FSMB is opposed to health care professionals practicing while on buprenorphine. Their rationale is based on the notion that physicians are exceptional in their ability to remain in recovery without medications for opioid use disorder and the unsupported assumption that buprenorphine causes significant cognitive impairment.

The Crooked Nose: A Practical Guide to Successful Management.

Learning Objectives: After studying this article, the participant should be able to: (1) Preoperatively evaluate the patient with a crooked nose. (2) Develop a comprehensive preoperative plan specific to the patient. (3) Effectively "deconstruct" and rebuild the crooked nose to address both aesthetic and functional concerns.

Point-of-Care Ultrasound Diagnosis of Perforated Appendicitis in the Pediatric Emergency Department: A Case Series.

Point-of-care ultrasound (POCUS) is being used for clinical decision making with increasing frequency across a broad range of indications in pediatric emergency medicine (PEM). We present a series of 4 patients in whom POCUS was used to facilitate a diagnosis of perforated appendicitis.

Focused Cardiac Ultrasound in Pediatric Pulmonary Hypertension.

We present 2 cases of pediatric pulmonary hypertension presenting with respiratory distress. Focused cardiac ultrasound revealed findings consistent with right ventricular dilatation and elevated right ventricular pressure. These findings, in conjunction with the clinical presentation, allowed for early identification and rapid evaluation of a pathologic process that can often go unidentified.

Anterior Segment Optical Coherence Tomography of Previously Operated Extraocular Muscles.

Background And Purpose: To assess the possibility of determining the insertion distance from the limbus of previously operated extraocular rectus muscles (EOM) with the Heidelberg Spectralis anterior segment optical coherence tomography (AS-OCT).

Patient And Method: Subjects with a history of previous strabismus surgery underwent AS-OCT of the EOM before planned additional strabismus surgery. The EOM insertion distances from the limbus were measured pre-operatively on the AS-OCT and compared to the caliper distance measured during the strabismus surgery.

Evidence-Based Medicine Curriculum Improves Pediatric Emergency Fellows' Scores on In-Training Examinations.

Objectives: The aim of this study was to determine if implementation of our evidence-based medicine (EBM) curriculum had an effect on pediatric emergency medicine fellows' scores on the relevant section of the in-training examination (ITE).

Methods: We obtained deidentified subscores for 22 fellows over 6 academic years for the Core Knowledge in Scholarly Activities (SA) and, as a balance measure, Emergencies Treated Medically sections. We divided the subscores into the following 3 instruction periods: "baseline" for academic years before our current EBM curriculum, "transition" for academic years with use of a research method curriculum with some overlapping EBM content, and "EBM" for academic years with our current EBM curriculum.

Elevated admission international normalized ratio strongly predicts mortality in victims of abusive head trauma.

Background: Victims of abusive head trauma have poor outcomes compared with other injured children. There is often a delay in diagnosis because these young patients are unable to communicate with health care providers. These critically injured patients would benefit from early identification and therapy.

Evidence-based medicine: Unilateral cleft lip and nose repair.

Learning Objectives: After reading this article, the participant should be able to: 1. Describe the anatomical malformations found in unilateral cleft lip deformity. 2.

Defining success in infant penetrating keratoplasty for developmental corneal opacities.

Background And Purpose: Neonatal corneal opacities (NCO) are one of the common causes of visual impairment in infants. We present the two infants with penetrating keratoplasty (PKP) for unilateral NCO with different visual and graft outcomes, and illustrate the importance of timing of surgery, importance of visual rehabilitation, and the lack of necessity of a clear graft to achieve reasonable visual function in infants with NCO.

Patients And Methods: Two infants with unilateral NCO (Peters anomaly) underwent PKP at age of 5.

Child neurology: tick paralysis: a diagnosis not to miss.

A 4-year-old girl presented to our tertiary care hospital with a complaint of lower extremity weakness and unsteady gait for 2 days. She was able to pull herself to stand, but could not stand unsupported. She had no sensory symptoms or pain.

215 mandible fractures in 120 children: demographics, treatment, outcomes, and early growth data.

Background: Optimal management of pediatric mandible fractures demands that the practitioner balance reduction and fixation with preservation of growth potential and function. The ideal synthesis of these goals has not yet been defined. The authors catalogue their experience with pediatric mandible fractures at a major pediatric teaching hospital with reference to demographics, injury type, treatment, and outcomes to inform future management of these injuries.

Pediatric orbital fractures: classification, management, and early follow-up.

Background: Scarce literature exists addressing the presentation, classification, and management of pediatric orbital fractures. The aim of this study is to review the authors' experience with the presentation, management, and early follow-up of pediatric orbital fractures.

Methods: A retrospective review of pediatric orbital fractures presenting to the Children's Hospital of Pittsburgh between 2003 and 2007 was performed.