Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “PEDIATRICS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 469 records · Page 26Linked to original sources
PubMedDate not supplied

Clinical and professional role development among experienced pediatric nurses: the pediatric medical nursing certificate program.

ISSUES AND PURPOSE: The development of a multiunit-based certificate program to promote retention by increasing experienced pediatric nurses' knowledge, skills, and professional role development through a blend of didactic, clinical, and mentoring components. CONCLUSIONS: The certificate group demonstrated an increase in knowledge and skill, advanced leadership role acquisition, promotion, certification, and graduate school matriculation, and achieved a 95% retention rate within the organization. PRACTICE IMPLICATIONS: With support from management and multidisciplinary team members, a certificate program like this can be implemented in a variety of settings and specialties.

Certification↗
PubMed2004

A pediatric digital storytelling system for third year medical students: the virtual pediatric patients.

BACKGROUND: Computer-based patient simulations (CBPS) are common, effective, instructional methods for medical students, but have limitations. The goal of this project was to describe the development of a CBPS designed to overcome some of these limitations and to perform an online evaluation. METHODS: In 1996, patients and families experiencing a common pediatric problem were interviewed, photographed and a chart review completed. A digital storytelling template was developed: 1. patient's story, evaluation and clinical course, 2. problem-based approach to the evaluation, and 3. discussion of disease process. The media was digitized and placed onto the Internet. The digital stories and a 10-question online survey were pilot tested. Online survey responses were collected from 1999-2003. Overall use of the digital stories was measured by computer server logs and by the number of hyperlinks to the CBPS. RESULTS: Eight stories were created using this system. Over 4.5 years, 814,148 digital story pages were read by 362,351 users. Hyperlink citations from other websites to the CBPS were 108. Online survey respondents (N = 393) described the overall quality as excellent or very good (88.4%). The stores were clearly written (92%) at an appropriate level (91.4%). Respondents felt they could begin to evaluate a similar case presentation (95.4%), and would remember the case in the future (91%). CONCLUSIONS: A new type of CBPS, the digital storytelling system, has been developed and evaluated which and appears to be successful in overcoming some of the limitations of earlier CBPS by featuring patient's stories in their own words, by focusing on problems rather than diseases, and by having stories that are quick for students to work through.

Adult↗
PubMed2004

Randomized comparison of combination chemotherapy with etoposide, bleomycin, and either high-dose or standard-dose cisplatin in children and adolescents with high-risk malignant germ cell tumors: a pediatric intergroup study--Pediatric Oncology Group 9049 and Children's Cancer Group 8882.

PURPOSE: To determine in a randomized comparison whether combination chemotherapy with high-dose cisplatin (HDPEB) improves the event-free (EFS) and overall (OS) survival of children and adolescents with high-risk malignant germ cell tumors (MGCT) as compared with standard-dose cisplatin (PEB) and to compare the regimens' toxicity. PATIENTS AND METHODS: Between March 1990 and February 1996, 299 eligible patients with stage III and IV gonadal and extragonadal (all stages) MGCT were enrolled onto this Pediatric Oncology Group and Children's Cancer Group study. Chemotherapy included bleomycin 15 units/m(2) on day 1, etoposide 100 mg/m(2) on days 1 through 5, and either high-dose cisplatin 40 mg/m(2) on days 1 through 5 (HDPEB; n = 149) or standard-dose cisplatin 20 mg/m(2) on days 1 through 5 (PEB; n = 150). Patients were evaluated after four cycles of therapy, and those with residual disease underwent surgery. Those with malignant disease in resected specimen received two additional cycles of their assigned regimen. RESULTS: One hundred thirty-four eligible patients with advanced testicular (n = 60) or ovarian (n = 74) tumors and 165 with stage I to IV extragonadal tumors were enrolled. HDPEB treatment resulted in significantly improved 6-year EFS rate +/- SE (89.6% +/- 3.6% v 80.5% +/- 4.8% for PEB; P =.0284). There was no significant difference in OS (HDPEB 91.7% +/- 3.3% v PEB 86.0% +/- 4.1%). Tumor-related deaths were more common after PEB (14 deaths v two deaths). Toxic deaths were more common with HDPEB (six deaths v one death). Other treatment-related toxicities were more common with HDPEB. CONCLUSION: Combination chemotherapy with HDPEB significantly improves EFS for children with high-risk MGCT. The OS is similar in both regimens, and the significant toxicity associated with HDPEB limits its use.

Adolescent↗
PubMed2006

Decision making in pediatric oncology: who should take the lead? The decisional priority in pediatric oncology model.

Decision making in pediatric oncology can look different to the ethicist and the clinician. Popular ethical theories argue that clinicians should not make decisions for patients, but rather provide information so that patients can make their own decisions. However, this theory does not always reflect clinical reality. We present a new model of decision making that reconciles this apparent discrepancy. We first distinguish decisional priority from decisional authority. The person (parent, child, or clinician) who first identifies a preferred choice exercises decisional priority. In contrast, decisional authority is a nondelegable parental right and duty, in which a mature child may join. This distinction enables us to analyze decisional priority without diminishing parental authority. This model analyzes decisions according to two continuous underlying characteristics. One dominant characteristic is the likelihood of cure. Because cure, when possible, is the ultimate goal, the clinician is in a better position to assume decisional priority when a child probably can be cured. The second characteristic is whether there is more than one reasonable treatment option. The interaction of these two complex continual results in distinctive types of decisional situations. This model explains why clinicians sometimes justifiably assume decisional priority when there is one best medical choice. It also suggests that clinicians should particularly encourage parents (and children, when appropriate) to assume decisional priority when there are two or more clinically reasonable choices. In this circumstance, the family, with its deeper understanding of the child's nature and preferences, is better positioned to take the lead.

Child↗
PubMed2003

Phase 2 study of idarubicin in pediatric brain tumors: Pediatric Oncology Group study POG 9237.

Idarubicin (IDA), the 4-demethoxy analog of daunomycin, has had significant cytotoxicity in many malignancies. In previous reports, the alcohol metabolite of IDA, 4-demethoxydaunorubicinol (idarubicinol, or IDOL), had cytotoxic activity and the ability to penetrate the blood-brain barrier. For this reason, the Pediatric Oncology Group conducted a Phase 2 trial of IDA for children with recurrent or progressive brain tumors. Ninety-one eligible children were entered on this study, with ages ranging from 3 months to 19 years. Patients were stratified by tumor types into 6 categories: stratum 1, low-grade astrocytoma; stratum 2, malignant glioma (glioblastoma multiforme and anaplastic astrocytoma); stratum 3, medulloblastoma; stratum 4, brainstem glioma; stratum 5, ependymoma; and stratum 6, miscellaneous malignant tumors not included in the previous diagnoses. IDA(18 mg/m2) was infused over 4 h and followed by granulocyte colony-stimulating factor (G-CSF) beginning day 5 after infusion of IDA. G-CSF was continued until blood cell count recovery. Cycles were repeated at approximately 21-day intervals until patients developed progressive disease or had completed 6 cycles with stable or improved disease. Pharmacokinetic plasma and cerebrospinal fluid (CSF) samples were collected from a subset of these patients. Response was poor in all strata. Most patients developed progressive disease; however, in 21 patients with medulloblastoma there was 1 partial response, and 6 patients had stable disease (SD) that in 4 patients lasted more than 20 weeks. Grades 3/4 hematopoietic toxicities were the most common toxic events, and 14 infection-related events resulted in hospitalization of patients. Only 1 patient developed reduced cardiac function. The systemic clearance data for IDA and IDOL were nearly identical to those published on patients with leukemia, and the plasma elimination of the IDOL metabolite was substantially longer than that of the parent drug IDA. The peak CSF:plasma ratios of IDA and IDOL were very low. The overall response rates to IDA were disappointing despite periods of prolonged SD in nearly a fourth of the patients. We conclude from this data and from that in nonhuman primates that it is unlikely that IDA, daunomycin, or other related anthracyclines will be useful for treating primary CNS tumors.

Adolescent↗
PubMedDate not supplied

Meeting the continuing education needs of pediatric nurses: the Pediatric Nurse Exchange Program.

Today's dynamic health care environment offers multiple challenges as hospitals attempt to design and implement successful nursing career plans and support the development of professional nurses along such plans. The Pediatric Nurse Exchange Program is designed as a means for personal and professional development to support professional nurses as they are challenged to provide quality nursing care to children and their families. A pilot project is designed to provide experiences for professional nurses in three children's hospitals in Ohio. Exchange experiences, of two to five days in length, provide opportunities for nurses to share expertise, exchange patient care strategies, and develop skills as consultants, change agents, educators, and communicators. Nurse participants in the program are awarded continuing education contact hours for the experience.

Clinical Competence↗
PubMed1992

[The practice of pediatric oncology in a general pediatric service in Black Africa. The experience of the hospital center of Libreville (Gabon)].

From 1984 through 1990, 41 children with malignant diseases were admitted to the department of general pediatrics of 6,700 patients. The department had 40 beds including ten for neonates. Patients often sought medical advice only late in the disease. In many cases, solutions can be found to the problems raised by the treatment of these patients in a tropical area with no specialized facilities. However, this treatment is a significant burden for both the physicians and the families and new, adapted solutions are needed.

Adolescent↗
PubMed1990

[Preventive and social pediatric activity at a university pediatric clinic. Retrospect--prospects].

Changes and results of prophylactic and socialpediatric activities at a childrens hospital are represented. The advantages of cooperation between prophylactic and curative spheres are emphasized, they are useful for research and education of students. Decrees are prepared for arrangement of such departments in every university childrens hospital corresponding to the future pediatric development.

Child↗
PubMed1990

Thyroid cancer in pediatric patients: the University Pediatric Hospital experience.

Seven patients with differentiated thyroid carcinoma were diagnosed and treated at the University Pediatric Hospital, San Juan, Puerto Rico during the years 1978 to 1983. Ages at the time of diagnosis were 6 to 17 years. Survival rate has been 100% at the time of this report. The clinical outcome is presented and the controversy regarding the appropriate surgical treatment for this type of thyroid carcinoma is reviewed. Two of 3 patients who underwent total thyroidectomy were free of disease with 131I one and 3 years after surgery. Hypothyroidism was eventually manifested in all patients and permanent hypoparathyroidism in 3, 2 of those who underwent total thyroidectomies. Follow up interval ranged from one to 10 years.

Adenocarcinoma↗
PubMed1977

Ethical issues in pediatric surgery: a national survey of pediatricians and pediatric surgeons.

The findings reported in this article are based on a nationwide survey of the attitudes and practices of pediatric surgeons and pediatricians with respect to some of the difficult ethical choices confronting them in medical practice. Four hundred fifty-seven physicians completed a questionnaire in the spring of 1975 in which they reacted to a wide range of issues that have been of increasing concern to the public, as well as to the medical profession. The survey attempts to identify some areas of physician consensus as well as some of the factors, personal and professional, influencing physicians' attitudes. The survey and its statistical analysis are intended to provide current sociological data and are not intended by the authors as an endorsement of any particular point of view or course of action.

Adult↗
PubMed1980

[Pediatric head injuries. Observations in pediatric surgery. 1,019 cases (author's transl)].

For 5 years, 1,019 children with head injury have been admitted in pediatric surgery. More often the patient is a boy one to five years old. 8.9 p. cent of the children had one or more other body injury. A skull fracture was found in 23 p. cent of the cases without influence on the evolutivity but a repeated clinical examination is necessary. For all head injuries an E.E.G. study is necessary. In 93.5 p. cent of the children the clinical findings allowed to said that head injury was "benign".

Adolescent↗
PubMed1995

How can pediatric care be provided in underserved areas? A view of rural pediatric care.

Building on the concept that the future is not what it used to be, this article will address the delivery of primary care pediatrics in rural America. I will discuss the demographic differences that exist today between urban and rural areas, the differences in practice style and lifestyle in different geographic arenas, and the unique hardships created by those differences. The strengths and opportunities that are available now and that will be in the future will be reviewed. I will discuss the application of those opportunities in an attempt to construct a framework for a successful transition into the "new future."

Allied Health Personnel↗