Combined evaluation of regional coronary artery calcium and myocardial perfusion by 82Rb PET/CT in predicting lesion-related outcome

European Journal of Nuclear Medicine and Molecular Imaging - Cardiac imaging with positron emission tomography/computed tomography (PET/CT) allows measurement of coronary artery calcium (CAC),...     

Rapid Identification of Pathogens from Pediatric Blood Cultures by Use of the FilmArray Blood Culture Identification Panel

The performance of the FilmArray blood culture identification (BCID) panel has been studied in adult patients. We describe here an evaluation of this assay for the rapid identification of pathogens in Bactec Peds Plus/F and Bactec standard anaerobic/F bottles that contained blood samples from pediatric patients at a tertiary care children''s hospital.     

Assessment of Inhalation Technique in Children in General Practice: Increased Risk of Incorrect Performance with New Device

In a general practice based population 76% of 530 children inhaling asthma medication inhaled correctly. However, important differences among inhalers were found. Children with a pressurized metered-dose inhaler without a spacer device performed worst, with only 22% inhaling without essential errors. At a second evaluation of the inhaler technique, one year after the first assessment, performances with a new device were more often incorrect versus the unchanged devices (21.1% and 10.8%, respectively; p = 0.01). Providing children with a new device should be carefully controlled over time especially because these children are error prone.     

An implementation model for managing cloud-based longitudinal care plans for children with medical complexity

ObjectiveWe aimed to iteratively refine an implementation model for managing cloud-based longitudinal care plans (LCPs) for children with medical complexity (CMC).Materials and MethodsWe conducted iterative 1-on-1 design sessions with CMC caregivers (ie, parents/legal guardians) and providers between August 2017 and March 2019. During audio-recorded sessions, we asked participants to walk through role-specific scenarios of how they would create, review, and edit an LCP using a cloud-based prototype, which we concurrently developed. Between sessions, we reviewed audio recordings to identify strategies that would mitigate barriers that participants reported relating to 4 processes for managing LCPs: (1) taking ownership, (2) sharing, (3) reviewing, and (4) editing. Analysis informed iterative implementation model revisions.ResultsWe conducted 30 design sessions, with 10 caregivers and 20 providers. Participants emphasized that cloud-based LCPs required a team of owners: the caregiver(s), a caregiver-designated clinician, and a care coordinator. Permission settings would need to include universal accessibility for emergency providers, team-level permission options, and some editing restrictions for caregivers. Notifications to review and edit the LCP should be sent to team members before and after clinic visits and after hospital encounters. Mitigating double documentation barriers would require alignment of data fields between the LCP and electronic health record to maximize interoperability.DiscussionThese findings provide a model for how we may leverage emerging Health Insurance Portability and Accountability Act–compliant cloud computing technologies to support families and providers in comanaging health information for CMC.ConclusionsUtilizing these management strategies when implementing cloud-based LCPs has the potential to improve team-based care across settings.     

Determination of active substances in antiallergic and antiphlogistic multicomponent preparations by high performance liquid chromatography (HPLC)

The aim of the present study was the elaboration of an HPLC method enabling the identification and determination of the content of selected compounds occurring in multicomponent preparations applied in allergic and non-allergic diseases of upper respiratory tracts. These compounds include: buzepide methyl iodide, clocinizine dihydrochloride, phenylpropanolamine hydrochloride, pseudoephedrine sulfate and dexbrompheniramine maleate. The elaborated HPLC method shows that a good separation of the mentioned compounds is feasible. The regression analysis has demonstrated linearity of the method in concentration range suitable for the intended experiments. The determination of the compounds in pharmaceutical preparations and the statistical evaluation of the results indicate that both the selectivity and precision of the method are good.     

Discarding ideology: the nature/nurture endgame

TOPIC: The concepts and research that underpin our understanding of how the brain is the organ of the mind. PURPOSE: To describe the dynamic nature of nervous system functioning and development; to discuss how the nervous system changes anatomically throughout the lifespan; to examine the vital role and interaction of genetics and environment; and to discuss the relationship among the brain, neurotransmission, genes, and psychiatric illness. SOURCES: Published literature. CONCLUSIONS: The latest research from the neurosciences lays to rest any suggestion that psychiatric illnesses are psychologically induced.     

School refusal in children and adolescents

School refusal is a problem that is stressful for children, families, and school personnel. Failing to attend school has significant short- and long-term effects on children's social, emotional, and educational development. School refusal often is associated with comorbid psychiatric disorders such as anxiety and depression. It is important to identify problems early and provide appropriate interventions to prevent further difficulties. Assessment and management of school refusal require a collaborative approach that includes the family physician, school staff, parents, and a mental health professional. Because children often present with physical symptoms, evaluation by a physician is important to rule out any underlying medical problems. Treatments include educational-support therapy, cognitive behavior therapy, parent-teacher interventions, and pharmacotherapy. Family physicians may provide psychoeducational support for the child and parents, monitor medications, and help with referral to more intensive psychotherapy.