A5000433934- Respiratory viral infections research
- Emergency and Acute Care Studies
- Pneumonia and Respiratory Infections
- Healthcare Policy and Management
- Respiratory Support and Mechanisms
- Transplantation: Methods and Outcomes
- Child and Adolescent Health
- Neonatal Respiratory Health Research
- HIV/AIDS Research and Interventions
- Adolescent and Pediatric Healthcare
- Healthcare cost, quality, practices
- Viral gastroenteritis research and epidemiology
- Innovations in Medical Education
- Adolescent Sexual and Reproductive Health
- Healthcare Systems and Technology
- Pediatric Hepatobiliary Diseases and Treatments
- Patient Satisfaction in Healthcare
- Streptococcal Infections and Treatments
- Food Security and Health in Diverse Populations
- Urinary Tract Infections Management
- Ethics and Legal Issues in Pediatric Healthcare
- Hospital Admissions and Outcomes
- Primary Care and Health Outcomes
- Viral Infections and Immunology Research
- Clinical Reasoning and Diagnostic Skills
Thomas Jefferson University
2024
Hasbro Children's Hospital
2013-2022
Brown University
2012-2022
Providence College
2012-2021
Massachusetts General Hospital
2019
Tufts Medical Center
2018
Tufts University
2018
Tufts Children's Hospital
2018
Lifespan
2017
Rhode Island Hospital
2009-2017
Evidenced-based guidelines for management of infants and children with community-acquired pneumonia (CAP) were prepared by an expert panel comprising clinicians investigators representing community pediatrics, public health, the pediatric specialties critical care, emergency medicine, hospital infectious diseases, pulmonology, surgery. These are intended use primary care subspecialty providers responsible otherwise healthy CAP in both outpatient inpatient settings. Site-of-care management,...
This guideline is a revision of the clinical practice guideline, “Diagnosis and Management Bronchiolitis,” published by American Academy Pediatrics in 2006. The applies to children from 1 through 23 months age. Other exclusions are noted. Each key action statement indicates level evidence, benefit-harm relationship, recommendation. Key statements as follows:
This Policy Statement was reaffirmed February 2019. Palivizumab licensed in June 1998 by the Food and Drug Administration for reduction of serious lower respiratory tract infection caused syncytial virus (RSV) children at increased risk severe disease. Since that time, American Academy Pediatrics has updated its guidance use palivizumab 4 times as additional data became available to provide a better understanding infants young greatest hospitalization attributable RSV infection. The...
Guidance from the American Academy of Pediatrics (AAP) for use palivizumab prophylaxis against respiratory syncytial virus (RSV) was first published in a policy statement 1998. initially based on result single randomized, placebo-controlled clinical trial conducted 1996-1997 describing an overall reduction RSV hospitalization rate 10.6% among placebo recipients to 4.8% children who received prophylaxis. The results second with hemodynamically significant heart disease were 2003 and revealed...
Abstract Evidenced-based guidelines for management of infants and children with community-acquired pneumonia (CAP) were prepared by an expert panel comprising clinicians investigators representing community pediatrics, public health, the pediatric specialties critical care, emergency medicine, hospital infectious diseases, pulmonology, surgery. These are intended use primary care subspecialty providers responsible otherwise healthy CAP in both outpatient inpatient settings. Site-of-care...
Clinical practice guidelines for managing infants and children hospitalized bronchiolitis recommend only obtaining intermittent or "spot check" pulse oximetry readings those who show clinical improvement. The effect of such monitoring is currently unknown.To determine the vs continuous on hospital length stay among nonhypoxemic young bronchiolitis.Randomized, parallel-group, superiority trial otherwise healthy 2 years age younger during period from 2009 to 2014 at 1 4 children's hospitals in...
Background Acute bronchiolitis is a common illness accounting for $500 million annually in hospitalizations. Despite the frequency of bronchiolitis, its diagnosis and management variable. To address this variability, American Academy Pediatrics (AAP) published an evidence-based practice guideline 2006. Objective Assess changes physician behavior before after publication 2006 AAP guideline. Methods A retrospective chart review was performed at two academic medical centers children <24 months...
The goal of this study was to assess the association introduction a ward's high-flow nasal cannula (HFNC) guideline with clinical outcomes infants bronchiolitis.We conducted retrospective, pre-post intervention an interrupted time series analysis admitted bronchiolitis between 2010 and 2014 at urban, tertiary care children's hospital. Patients in 24 months before after initiation for HFNC use on general wards were compared. primary outcome length hospital stay. Secondary PICU transfer rate...
Abstract Objective Variation in bronchiolitis management by race and ethnicity within emergency departments (EDs) has been described single‐center prospective studies, but large‐scale assessments across EDs inpatient settings are lacking. Our objective is to describe the association between 37 U.S. freestanding children's hospitals from 2015 2018. Methods Using Pediatric Health Information System, we analyzed ED visits November 2018 of children with 3 24 months old. Rates use for specific...
Purpose Clinical performance evaluations are major components of medical school clerkship grades. But they sufficiently objective? This study aimed to determine whether student and evaluator gender is associated with assessment overall clinical performance. Method was a retrospective analysis 4,272 core by 829 evaluators 155 third-year students, within the Alpert Medical School grading database for 2013–2014 academic year. Overall performance, assessed on three-point scale (meets...
To assess the association of introduction a high-flow nasal cannula (HFNC) protocol with clinical outcomes and hospital charges infants bronchiolitis initially admitted to PICU.We conducted retrospective, nonrandomized, preintervention-postintervention study PICU for HFNC. We compared patients in 24 months before after initiation HFNC use on general wards. The primary outcome assessed was length stay (LOS), secondary included total charges, intubation, 30-day readmission. bivariate analysis...
Less than one-half of sexually active adolescents have received counseling regarding contraception and transmitted disease (STD) from their health care provider. We hypothesized that hospitalized would be interested in receiving reproductive education and/or STD testing. In addition, we assessed the opinion female on initiation during hospitalization.A convenience sample 13- to 18-year-old male adolescent patients at a tertiary pediatric hospital were approached for inclusion. Consenting...
To improve child health at a community level, pediatricians require knowledge and skills that have not been traditionally included in residency training. Recent policy statements from the American Academy of Pediatrics requirements Accreditation Council for Graduate Medical Education Residency Review committees emphasizing importance pediatrics training provided additional incentive pediatric programs to actively explore methods teaching principles promoting practice resident trainees. With...
Background Blood cultures are often recommended for the evaluation of community-acquired pneumonia (CAP). However, institutions vary in their use blood cultures, and have unclear utility CAP management hospitalized children. Objective To identify clinical factors associated with obtaining children CAP, to estimate association between culture obtainment hospital length stay (LOS). Methods We performed a multicenter retrospective cohort study admitted diagnosis any four pediatric hospitals...
OBJECTIVES: To determine the frequency of sexual history taking and associated characteristics hospitalized adolescents in pediatric hospitalist service. METHODS: A retrospective chart review 14 to 18 years old who were admitted service at an urban, academic children’s hospital Northeast from 2013 2015 was conducted. Repeat admissions, admissions specialty services, charts that noted impairment because psychosis, cognitive delay, or illness severity excluded. For met criteria, admission...
Objective: The goal of this study was to evaluate provider practice patterns for evaluation serious bacterial infection (SBI) in patients hospitalized with bronchiolitis and assess the association SBI testing length stay antibiotic use. Design: This a retrospective chart review &lt;24 months age discharge diagnosis from 2 separate sites during 2004 2008. Patient characteristics, laboratory testing, use, clinical outcomes were assessed relation testing. Results: A total 1233 charts met...
Mercury intoxication is an uncommon cause of hypertension in children and can mimic several other diseases, such as pheochromocytoma vasculitis. present a diagnostic challenge because levels catecholamines may be elevated, suggesting that the etiology catecholamine-secreting tumor. Once acrodynia identified primary symptom, 24-hour urine mercury level confirm diagnosis. Inclusion differential diagnosis early on help avoid unnecessary invasive tests therapeutic interventions. We discuss case...