Clinical Pediatrics最新文献

A total of 101 patients with a clinical picture of persisting Lyme disease seen at the University of Connecticut Health Center and Boston Medical Center were recruited for the study to determine whether persistent infection is the likely cause. Brain SPECT imaging and responses to antibiotic treatments were recorded. Patients had more than 5 symptoms lasting more than 6 months. A history of tick bite and/or rash was present in 40%. Western blots were more sensitive than enzyme immunoassays screening tests. Brain SPECT scans were abnormal in 65% of patients. Treatment with specific antibiotics over time resolved the illness in most children. A clinical diagnosis can be made based on the combination of certain persisting symptoms, and serologic and nuclear medicine studies support the clinical diagnosis. Treatment with specific antibiotics over a number of months is helpful as a diagnostic test and lead to resolution of symptoms in most patients.

To optimize the deployment of Generative Artificial Intelligence in health care, it's essential for health care professionals (HCPs) to understand these technologies' capabilities and constraints. This study explores HCPs' initial impressions and experiences using ChatGPT, a Generative Pre-trained Transformer, in Pediatric Critical Care Units (PICUs). By conducting focus groups with a diverse set of HCPs, we aimed to assess their awareness, utilization, perceived benefits, and concerns about incorporating ChatGPT into their PICUs. The discussions highlighted three main themes: familiarity and usability of ChatGPT, its role in clinical and organizational tasks, and ethical concerns. While participants appreciated ChatGPT's user-friendliness and potential to expedite tasks and provide rapid information, they expressed concerns regarding data reliability, recency, and ethical implications. Despite these reservations, there is cautious optimism about integrating these tools in PICU, underscoring the need for vigilance and ongoing evaluation of novel health care-related implications as these technologies evolve.

Educational interventions to prepare pediatric residents to care for grieving people are rare. This study aimed to identify gaps in grief training and assess any changes in grief-related experience, attitudes, and skills during residency training. Pediatric residents completed a survey conducted from March to April 2022 that assessed their experience, attitudes, skills, and knowledge of organizational support related to caring for grieving patients and families. The survey achieved a 49% response rate. Residents reported increasing clinical experience with grief over time (r = 0.45, P = .001), yet formal training about grief was inadequate and did not improve with time (r = 0.14, P = .34). Despite improvements in competence with delivering difficult news with years in residency (r = 0.31, P = .03), only 35.7% felt competent by PGY3/4. Only 19.5% of residents overall believe adequate grief support exists within their training program. Pediatric residents care for grieving people throughout residency. Opportunities for residents to receive formal grief training are inadequate.

HealthySteps is an evidence-based, prevention program for families of children ages 0 to 3 integrated into pediatric primary care. Our objective was to synthesize feedback on local implementation of an enhanced HealthySteps+ program from various stakeholder viewpoints to improve implementation. Qualitative data were gathered from HealthySteps+ team members (n = 14), current clinic staff (n = 15), and a focus group of parents serving on the program's advisory committee (n = 7). Responses indicate that the core features of the HealthySteps+ program are consultations about typical and atypical child development, facilitated connections to resources, and parent mental health support. Key challenges to implementing the program include retention of skilled staff to sustain trusting relationships with parents and other providers. Based on these findings, the HealthySteps+ implementation team has increased communication with clinic staff at daily huddles, developed orientation materials for new pediatricians, and offered families additional peer support opportunities.

We reviewed electronic health record documentation of outpatient and emergency department (ED) visits with a positive pregnancy test from January 1, 2014, to June 1, 2021, within a tertiary-care pediatric system for documentation of pregnancy options counseling. We excluded encounters where patients were admitted or referred/transferred to another ED, or nurse-only visits. Of 88 eligible encounters, 51/88 (58%) occurred in the ED and 37/88 (42%) in outpatient clinic. Options counseling was documented in 20 encounters (23%), including 6/51 (12%) of ED visits and 14/37 (38%) of clinic visits. By logistic regression adjusting for age, race, insurance type, and prior positive pregnancy test, options counseling documentation was significantly more likely for outpatient clinic visits than the ED (aOR = 4.80, 95% CI = 1.52-15.18, P = .008). Rates of documentation of options counseling in pediatric settings are low and are lower for ED than outpatient visits, suggesting low rates of options counseling in pediatric practice.

This study assesses the diaper choices, diapering practices, and irritant diaper dermatitis (IDD) prevention strategies in Turkey and compares them to the practices worldwide. A Computer-Assisted Web Interview was conducted with 306 mothers, nursing their infants between 0 and 3 years. The average daily diaper usage was 6.3, with a higher utilization during daytime. Concerningly, 44.4% of infants exhibited skin issues. In total, 63.7% of parents observed the occurrence of IDD during the first month, with 39.9% indicating its continued presence afterwards. The IDD predominantly affected the buttocks and genitalia. Many parents sought medical advice for IDD. Regarding interventions, 56.9% of parents believed that anti-rash products were effective. The primary reason for brand preference was the presence of an elastic waistband. Parents were willing to adopt a novel anti-rash diaper. The research underscored the widespread occurrence of IDD, emphasizing the susceptibility of young infants. Diapering practices and preventive measures varied across various countries.

The aim was to investigate the effect of adding virtual reality (VR) training to an individualized exercise therapy program in children with hemiparetic cerebral palsy (CP). Thirty-one children with hemiparetic CP were randomly allocated into 2 groups as experimental (n = 16) and control (n = 15). Experimental group received additional VR twice a week for 12 weeks. Gross motor function (Gross Motor Function Measure-66), balance (one leg standing), and functional mobility (timed up and go test) were evaluated. All parameters were improved in the experimental group (P < .05). In the control group, all parameters other than timed up and go test, and eyes closed one leg standing improved (P < .05). When the changes in the groups were compared, greater improvements were detected in the experimental group (P < .05). Adding VR training to the individualized exercise therapy program may have potential additional benefits for improving gross motor function, balance, and functional mobility in children with hemiparetic CP.