Monroe Carell Jr. Children's Hospital at Vanderbilt

About: Monroe Carell Jr. Children's Hospital at Vanderbilt is a based out in . It is known for research contribution in the topics: Population & Medicine. The organization has 1046 authors who have published 1262 publications receiving 28063 citations. The organization is also known as: Vanderbilt Children's Hospital.

Caregiver stress in children with craniosynostosis: a systematic literature review

Abstract: We present an overview of the literature on caregiver stress in children with craniosynostosis and report common trends in the literature Craniosynostosis occurs approximately 1 in 2500 births As this is a diagnosis most common in infants and often requires surgical treatment, this is a significant and stressful ordeal for caregivers Caregiver stress impacts various outcomes for the child, and little is understood and known about caregiver stress in the pediatric craniosynostosis population A literature search for all articles pertaining to craniosynostosis and parental/caregiver stress was conducted using PubMed, Embase, PsychINFO, and CINAHL databases Seven articles on caregiver stress in craniofacial abnormalities patients and three articles on caregiver stress in pediatric craniosynostosis patients specifically were identified Three articles on parental satisfaction after craniosynostosis repair were also identified and included in the review Few published studies exist in the literature on caregiver stress in children with craniosynostosis and no clear trends were identified It is evident that caregiver stress significantly affects the psychosocial outcomes of children with craniosynostosis However, there are an equal number of studies reporting significant differences in caregiver stress in children with craniosynostosis as those reporting no significant differences There is evidence that caregiver stress affects psychosocial outcomes of children with craniosynostosis, but no clear trends of either increased or decreased levels of stress were identified in caregivers of children with craniosynostosis Additional research is needed to identify risk factors related to caregiver stress

Variation in Diagnostic Testing and Hospitalization Rates in Children With Acute Gastroenteritis

Abstract: Acute gastroenteritis (AGE) remains a major cause of childhood morbidity and mortality in the United States. The routine use of vaccines targeting rotavirus, the most common cause of pediatric AGE, has decreased all-cause AGE emergency department (ED) visits and hospitalizations.1 However, the burden of pediatric AGE remains substantial. With annual hospitalization rates of 3 to 5 per 1000 US children $350 million in costs annually.3 Care for uncomplicated AGE is largely supportive, and guidelines from the American Academy of Pediatrics and other international organizations emphasize conservative management and discourage routine diagnostic testing for AGE, with or without dehydration.4–6 Yet there continues to be wide variation in AGE management among individual providers and hospitals in the United States and abroad.7,8 Studies in children with acute respiratory illness show similar variation in care that is associated with important outcome differences, with higher resource utilization linked to higher rates of hospitalization and longer hospital length of stay (LOS), irrespective of the severity of illness.9,10 Whether similar associations exist between resource utilization and outcomes in children with AGE is largely unexplored. With the use of data from 34 US children’s hospitals, we sought …

Entrainment to distinguish orthodromic reciprocating tachycardia from atrioventricular nodal reentry tachycardia in children.

Abstract: Background: Studies in adults suggest that after entrainment from the right ventricle, a post-pacing interval (PPI) minus tachycardia cycle length (TCL), when corrected for atrioventricular node delay (cPPI-TCL), is useful to distinguish atrioventricular nodal reentry tachycardia (AVNRT) from orthodromic reciprocating tachycardia (ORT), but this has not been evaluated in children. Methods: In 100 children undergoing catheter ablation, entrainment of ORT or AVNRT was performed from the right ventricular apex. The atrial-His (AH) interval was measured on the return cycle (post-AH) and during tachycardia just prior to pacing (pre-AH). The cPPI-TCL was calculated as (PPI-TCL) − (post-AH − pre-AH). In the first 50 children, the best cutoff was identified and then validated in the next 50 children. Results: In the first 50 children, cPPI-TCL was longer in AVNRT compared with ORT (122 ± 19 ms vs 63 ± 23 ms, P 95 ms was 95% specific for AVNRT. There was even greater separation of cPPI-TCL values comparing AVNRT with ORT utilizing a septal accessory pathway. Conclusions: The cPPI-TCL is a useful technique to distinguish AVNRT from ORT in children. Our data suggest that in children a cPPI-TCL 95 ms is rarely observed in ORT. This technique is particularly useful to distinguish AVNRT from ORT utilizing a septal accessory pathway. (PACE 2010; 469–474)

Vaccines in pediatric transplant recipients-Past, present, and future.

Abstract: Infections significantly impact outcomes for solid organ and hematopoietic stem cell transplantation in children Vaccine-preventable diseases contribute to morbidity and mortality in both early and late posttransplant time periods Several infectious diseases and transplantation societies have published recommendations and guidelines that address immunization in adult and pediatric transplant recipients In many cases, pediatric-specific studies are limited in size or quality, leading to recommendations being based on adult data or mixed adult-pediatric studies We therefore review the current state of evidence for selected immunizations in pediatric transplant recipients and highlight areas for future investigation Specific attention is given to studies that enrolled only children