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Providence, RI, United States

Dennehy P.H.,Hasbro Childrens Hospital
Infectious Disease Clinics of North America

Rotavirus infection is the most common cause of severe diarrhea disease in infants and young children worldwide. Vaccination is the only control measure likely to have a significant impact on the incidence of severe disease. Rotavirus vaccines have reduced the burden of disease in the United States and Europe and vaccine programs are being introduced in Asia and Africa where it is hoped that vaccine will have significant impact on severe infection. Long-term monitoring and strain surveillance are needed to assess the effects of rotavirus immunization programs and to determine whether changes in strain ecology will affect rotavirus vaccine effectiveness. © 2015 Elsevier Inc.. Source

Owens J.A.,Hasbro Childrens Hospital | Jones C.,Durham University
Journal of Developmental and Behavioral Pediatrics

OBJECTIVE:: The purpose of this study was to examine the associations among parental knowledge and beliefs about healthy sleep, sleep practices, and insufficient sleep in a pediatric primary care clinic sample. METHODS:: A convenience sample of caregivers of patients between 3 months and 12 years attending a hospital-based pediatric primary care clinic in an academic center completed a brief survey on (1) child sleep habits, (2) basic sleep knowledge, and (3) beliefs and attitudes regarding sleep as a health behavior. RESULTS:: Of the 184 analyzable surveys (response rate 72%; mean age of index child 4.0 ± 3.2 years), 42% of children did not have a consistent bedtime, 43% had a bedtime later than 9 pm, 76% had a television in the bedroom, 69% frequently fell asleep with an adult present, and 18% had daily caffeine intake. Although 76% of parents underestimated their child's sleep needs compared to recommended amounts, just 8% reported that their child was not getting adequate sleep. More than half of parents believed that inadequate sleep increases the risk of being underweight and endorsed snoring as a sign of healthy sleep. An increased level of sleep knowledge was associated with a number of positive sleep practices and inversely correlated with sleep duration. CONCLUSION:: The results of this study document the need for increased targeted caregiver education regarding healthy sleep practices, the importance of adequate sleep, the impact of insufficient sleep on health, and recognition of potential signs of sleep problems in young children, especially in high-risk populations. Copyright © 2011 Lippincott Williams & Wilkins. Source

Dennehy P.H.,Hasbro Childrens Hospital | Dennehy P.H.,Brown University
Current Infectious Disease Reports

Rotavirus infection is the most common cause of severe diarrhea disease in infants and young children worldwide and continues to have a major global impact on childhood morbidity and mortality. No antiviral therapy is available. Treatment of rotavirus gastroenteritis is limited to rehydration therapy. Recently, therapies, such as probiotics, have been developed as adjuncts to rehydration therapy. Two effective rotavirus vaccines are available and recommended for routine immunization of all infants. These vaccines have been introduced in both developed and developing countries. As rotavirus vaccines are implemented, studies that assess health impact, indirect benefits, and strain changes after the introduction of rotavirus vaccine have been reported. In the United States, rotavirus vaccination has led to dramatic drops in severe rotavirus-related hospitalizations and has reduced emergency room visits. Herd immunity has also been noted after routine rotavirus immunization. There have been no significant strain shifts or escape mutants noted since the introduction of rotavirus vaccines. © 2013 Springer Science+Business Media New York. Source

Diamond D.A.,Childrens Hospital | Gargollo P.C.,Childrens Medical Center Dallas | Caldamone A.A.,Hasbro Childrens Hospital
Fertility and Sterility

The authors review the current approach to management of the adolescent varicocele which has evolved over the past two decades. Principles of observational, surgical and adjunctive management are discussed relative to significant clinical findings. A selective approach to surgical intervention is advocated with the goal of preserving fertility potential. Copyright © 2011 American Society for Reproductive Medicine. Source

Chapman L.L.,Hasbro Childrens Hospital | Pacheco A.L.,Rhode Island Hospital | Draleau C.P.,Hasbro Childrens Hospital | Becker B.M.,Hasbro Childrens Hospital
Academic Emergency Medicine

Objectives: Peripheral intravenous catheter (PIV) placement is a common, painful, and frequently difficult procedure in children. The VeinViewer is a device that delineates subcutaneous veins using near-infrared light and video technology. To the best of our knowledge, the benefit of this device for PIV placement in children in the emergency department (ED) has not been studied. Methods: The authors enrolled a prospective, randomized sample of children aged 0 to 17 years who required a nonemergent PIV in a tertiary care pediatric ED. Participants were randomized to standard PIV cannulation (SC) or PIV cannulation with the VeinViewer (VV). The primary outcome measure was time to PIV placement. Secondary outcome measures included number of PIV attempts and pain scores as reported by the child, parent or guardian, and nurse using a 100-mm visual analog scale (VAS). Results: A total of 323 patients completed the study: 174 boys and 149 girls. Age, sex, and body mass index (BMI) were not different between groups. There were no differences in time to PIV placement, number of PIV attempts, or pain scores for the overall study group. However, a planned subgroup analysis of children age 0 to 2 years (n = 107) did yield significant results for the geometric mean time to place the PIV (121 seconds [VV] vs. 167 seconds [SC], p = 0.047) and for nurses' perception of pain (median VAS 34 [VV] vs. 46 [SC], p = 0.01). Conclusions: While no results were significant for the overall study group, subgroup analysis of children age 0 to 2 years suggests that the VeinViewer may decrease the time to PIV placement. © 2011 by the Society for Academic Emergency Medicine. Source

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