A5042740804- Cardiac Arrest and Resuscitation
- Emergency and Acute Care Studies
- Diabetes and associated disorders
- Trauma and Emergency Care Studies
- Diabetes Management and Research
- Trauma Management and Diagnosis
- Injury Epidemiology and Prevention
- Diet and metabolism studies
- Disaster Response and Management
- Airway Management and Intubation Techniques
- Respiratory Support and Mechanisms
- Simulation-Based Education in Healthcare
- Traumatic Brain Injury and Neurovascular Disturbances
- Family and Patient Care in Intensive Care Units
- Pancreatic function and diabetes
- Gun Ownership and Violence Research
- Ultrasound in Clinical Applications
- Sepsis Diagnosis and Treatment
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Electronic Health Records Systems
- Restraint-Related Deaths
- Healthcare Systems and Technology
- Diet, Metabolism, and Disease
- Pediatric Urology and Nephrology Studies
Children's Hospital of Philadelphia
2015-2024
University of Pennsylvania
2013-2024
Sage (United Kingdom)
2013-2019
Pediatrics and Genetics
2018
Saudi Aramco Medical Services Organization
2017
Philadelphia University
2011-2016
National Institutes of Health
2003
National Institute of Neurological Disorders and Stroke
2003
Essex County Council
1937
Diabetic ketoacidosis in children may cause brain injuries ranging from mild to severe. Whether intravenous fluids contribute these has been debated for decades.
Objectives More childhood deaths are attributed to trauma than all other causes combined. Our objectives were provide the first national description of proportion injured children treated at pediatric centers (TCs), and clarity presumed benefit TC verification by comparing injury mortality across hospital types. Methods We performed a population-based cohort study using 2006 Healthcare Cost Utilization Project Kids Inpatient Database combined with inventories. included discharges (≤16 y)...
OBJECTIVE This study assessed whether a single diabetic ketoacidosis (DKA) episode is associated with cognitive declines in children newly diagnosed type 1 diabetes and the same true who had previously been after accounting for variations glycemic control other relevant factors. RESEARCH DESIGN AND METHODS We prospectively enrolled 758 children, 6–18 years old, presented DKA randomized multisite clinical trial evaluating intravenous fluid protocols treatment. was moderate/severe 430 mild 328...
<h3>Importance</h3> Acute kidney injury (AKI) occurs commonly during diabetic ketoacidosis (DKA) in children, but the underlying mechanisms and associations are unclear. <h3>Objective</h3> To investigate risk factors for AKI its association with neurocognitive outcomes pediatric DKA. <h3>Design, Setting, Participants</h3> This cohort study was a secondary analysis of data from Pediatric Emergency Care Applied Research Network Fluid Therapies Under Investigation DKA Study, prospective,...
Abstract Introduction Young children with type 1 diabetes (T1D) may be at particularly high risk of cognitive decline following diabetic ketoacidosis (DKA). However, studies functioning in T1D typically examine school‐age children. The goal this study was to whether a single experience DKA is associated lower young We found that recently diagnosed 3‐ 5‐year‐olds who experienced one episode, regardless its severity, exhibited IQ scores than those no exposure. Methods prospectively enrolled 46...
A pediatric capacity crisis developed across the country in Fall and Winter of 2022 due to a combination factors, including surge respiratory viruses, staffing shortages, historical closures inpatient units. The COVID-19 pandemic associated critically ill adult patients demonstrated that health care systems workers can quickly implement creative collaborative system-wide solutions deliver best possible during crisis. Similar are needed respond future surges volume maintain high standard such...
Concussion is a common injury in the adolescent and young adult populations. While branched chain amino acid (BCAA) supplementation has shown improvements neurocognitive sleep function pre-clinical animal models of mild to moderate traumatic brain (TBI), date, no studies have been performed evaluating efficacy BCAAs concussed adolescents adults. The goal this pilot trial was determine efficacy, tolerability, safety varied doses oral group study conducted as pilot, double-blind, randomized...
Diabetic kidney disease is among the most important causes of end-stage worldwide. Risk factors for diabetic remain incompletely defined. Recent studies document a high frequency acute injury (AKI) during ketoacidosis (DKA) in children, raising question whether these AKI episodes might contribute to future risk disease.To determine occurring DKA children are associated with increased development microalbuminuria.This retrospective review medical records included type 1 diabetes or more urine...
The tyrosine phosphorylation sites of the Disabled 1 (Dab1) docking protein are essential for transmission Reelin signal, which regulates neuronal placement. Here we identify Nckβ as a phosphorylation-dependent, Dab1-interacting protein. SH2 domain but not Nckα binds Dab1 phosphorylated on Reelin-regulated site, Y220, or Y232. is coexpressed with in developing brain and cultured neurons, where stimulation leads to redistribution from cell soma into processes. We found that...
OBJECTIVES The pediatric emergency department (ED)–based Pediatric Septic Shock Collaborative (PSSC) aimed to improve mortality and key care processes among children with presumed septic shock. METHODS This was a multicenter learning improvement collaborative of 19 EDs from November 2013 May 2016 shared screening patient identification recommendations, bundles care, educational materials. Process metrics included minutes initial vital sign assessment first third fluid bolus antibiotic...
Abstract The demands on emergency services have grown relentlessly, and the Institute of Medicine (IOM) has asserted need for “regionalized, coordinated, accountable care systems throughout country.” There are large gaps in evidence base needed to fix problem how is organized delivered, science urgently define measure success emerging network care. In 2010, Academic Emergency convened a consensus conference entitled “Beyond Regionalization: Integrated Networks Care.” This article product...
Fluid replacement to correct dehydration, acidosis, and electrolyte abnormalities is the cornerstone of treatment for diabetic ketoacidosis (DKA), but little known about optimal fluid infusion rates content. The objective this study was evaluate whether different protocols affect rate normalization biochemical derangements during DKA treatment. current analysis involved moderate or severe episodes (n = 714) in children age <18 years enrolled Therapies Under Investigation (FLUID) Trial....
BACKGROUND Unintentional injuries are one of the leading causes death in United States. Many these preventable, and unintentional firearm injuries, particular, may be responsive to prevention efforts. We investigated relationship between urbanicity among adults. METHODS This study was a retrospective analysis national certificate data. adult deaths States from 1999 2006 were identified using Multiple Cause Death Data files National Center for Health Statistics. Decedents assigned county...
Trauma system planners use patient home address as a proxy for injury location, although this has not been validated. We sought to determine the precision of by evaluating relationship between location death and residence.This national descriptive analysis used Multiple Cause Death data files from 1999 2006 proportion subjects in which county residence (RC) matched all US deaths. Subgroup analyses were completed age intentionality using two sample tests proportions. χ(2) evaluate differences...
Objectives The aims of this study were to (1) assess the reasons for pediatric interfacility transfers as identified by transferring providers and review emergency medical care delivered at receiving facilities (2) investigate department (ED) among subpopulation patients discharged from facility. Methods We performed a multicenter, cross-sectional survey ED younger than 18 years 1 4 US tertiary hospitals with subsequent record Referring completed surveys detailing transfer. Results Eight...
The aim of this study was to determine the reasons for pediatric emergency department (ED) transfers and professional characteristics transferring providers.We performed a multicenter, cross-sectional survey ED medical providers patients younger than 18 years 1 4 tertiary care children's hospitals. Referring completed surveys detailing primary transfer their training.The data were collected 25 months, during which 641 890 surveys, with an overall response rate 25%. Most seen by physicians...
We examine nursing documentation on a newly implemented electronic flowsheet in medical resuscitations to identify the temporal patterns of and how recorded information supported time-critical teamwork. To determine when was documented, we compared timestamps from 58 logs those verbal communications derived video review. also drew observations 95 understand behaviors nurse documenters. found that only 8% reports were documented near real-time (one minute within report), while 42% not...