Author: Jenny Fernandez

Quick Note: Odds of hospital readmission increase for children as they become adults

Busy garage as hospital readmission rates increase

As accountable care organizations continue to evolve, primary care pediatricians may increasingly share financial risks with hospitals on quality of care measures, including hospital readmissions.

In an article published in The BMJ, Boston Children’s Hospital readmission experts Jay Berry, MD, MPH, and Emily Bucholz, MD, MPH, PhD, show that the odds of hospital readmission increase substantially for children as they become adolescents and enter adulthood. In fact, their odds of readmission are just as high or higher than elderly, Medicare beneficiaries.

Berry and Bucholz discuss the reasons for those findings and how better systems of care are needed for children — especially those with chronic conditions — as they transition to adulthood.

Read the paper published in The BMJ.

Paper Trail: Challenges for developmental-behavioral workforce, pediatric dentistry trends, implications of herpes zoster and more

Clinical research from Boston Children's

Boston Children’s Hospital is at the forefront of clinical research. Stay connected with Paper Trail — a monthly feature highlighting recently published outcomes data and new approaches to the diagnosis, treatment and prevention of pediatric illnesses.

Implications of herpes zoster in vaccinated children

Researchers including dermatologist Jennifer Huang, MD, describe seven children without a history of primary varicella who presented with herpes zoster that correlated with the original VZV vaccination site and resolved without complications. These cases, published on Feb. 6 in Pediatric Dermatology, highlight the close correlation between the vaccination site and cutaneous eruption.

Trends in pediatric dental care use

Co-authored by Dentist-in-Chief Man Wai Ng and published in the April 2018 issue of Dental Clinics of North America, this article explores trends in three areas of pediatric dental services: access among Medicaid-enrolled children, treatment of oral health conditions, and use of emergency departments for dental needs among U.S. children.

Parents’ perceptions of their child’s health status 

The aim of this study by Nurse Scientists Kristine Maria Ruggiero and Judith A. Vessey, Associate Chief Nurse Patricia Hickey and colleagues, was to examine parents’ perceptions of the health-related quality of life (HRQOL) in their school-age child with congenital heart disease (CHD). The results of this study, published in the Journal for Specialists in Pediatric Nursing, are useful in providing practical recommendations in caring for children with CHDs while informing relevant policies.

Challenges for developmental-behavioral peds

In this Pediatrics paper published Feb. 16, Carolyn Bridgemohan, MD and colleagues surveyed a sample of the developmental-behavioral pediatric workforce and found it struggles to meet current service demands. Clinician burnout was reported with increased patient complexity and female subspecialists spent more time in billable and nonbillable components of clinical care.

For more clinically-actionable insights, bookmark Boston Children’s Notes blog for primary care providers.

Paper Trail: Uterine bleeding in transmasculine and nonbinary teens, opioids for severe abdominal pain, status epilepticus and more

Latest clinical research from Boston Children's

Boston Children’s Hospital is at the forefront of clinical research. Stay connected with Paper Trail — a monthly feature highlighting recently published outcomes data and new approaches to the diagnosis, treatment and prevention of pediatric illnesses.

Status epilepticus: Should we treat it like stroke?

Status epilepticus, a state of prolonged seizures, is one of the most common pediatric neurologic emergencies, affecting 10-20% of pediatric epilepsy patients. A new study published in JAMA Neurology underscores the point that rapid treatment improves outcomes and may save lives. “Status epilepticus should be considered a time-sensitive emergency, such as a stroke or other cardiovascular events,” says Tobias Loddenkemper, MD, senior author and director of clinical epilepsy research at Boston Children’s.

Pain management in pediatric acute pancreatitis: Opioid vs. non-opioid

Nearly all patients with acute pancreatitis (AP) experience some degree of severe abdominal pain, yet strategies for pain management in AP have been poorly studied, particularly in the field of pediatrics. Gastroenterology researcher Amit Grover, MD examines the initial provision of analgesia to children who presented to a pediatric emergency department with AP. Learn more in this Journal of Pediatric Gastroenterology and Nutrition paper.

Persistent uterine bleeding in transmasculine and nonbinary teens

The treatment of persistent uterine bleeding can be difficult in a subset of patients who identify as transmasculine or nonbinary. In this recent Transgender Health article, endocrinology researchers Stephanie Roberts, MD and Jeremi Carswell, MD review the physiology of the normal menstrual cycle and the hormonal influences on the endometrium, and explore options for the treatment of persistent bleeding for people both already on testosterone and for those who are either not ready for or who do not desire testosterone.

A practical approach to severe asthma in children

Severe asthma accounts for only a small proportion of the children with asthma, but a disproportionately high amount of resource utilization and morbidity. In a new Annals of the American Thoracic Society paper, senior author and pulmonology researcher Jonathan Gaffin, MD describes the importance of an evidence-based, multidisciplinary approach to treating severe asthma.

For more clinically-actionable insights, bookmark Boston Children’s Notes blog for primary care providers.

Multidisciplinary care to treat severe asthma

Multidisciplinary care for severe asthma

The Severe Asthma Program at Boston Children’s Hospital provides care to children and young adults with severe persistent asthma who have difficulty with disease management or chronic systemic steroid use. “We’ve developed a one-stop shop for the highest risk, highest cost, highest morbidity population of pediatric asthma,” says pulmonologist Jonathan Gaffin, MD, MMSc, who conceived of the program after witnessing hundreds of patients crossing between Boston Children’s Division of Pulmonary Respiratory Diseases and Division of Allergy and Immunology…Read More