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  1. Article ; Online: Design and Implementation of a Visual Analytics Electronic Antibiogram within an Electronic Health Record System at a Tertiary Pediatric Hospital.

    Simpao, Allan F / Ahumada, Luis M / Larru Martinez, Beatriz / Cardenas, Ana M / Metjian, Talene A / Sullivan, Kaede V / Gálvez, Jorge A / Desai, Bimal R / Rehman, Mohamed A / Gerber, Jeffrey S

    Applied clinical informatics

    2018  Volume 9, Issue 1, Page(s) 37–45

    Abstract: Background: Hospitals use antibiograms to guide optimal empiric antibiotic therapy, reduce inappropriate antibiotic usage, and identify areas requiring intervention by antimicrobial stewardship programs. Creating a hospital antibiogram is a time- ... ...

    Abstract Background: Hospitals use antibiograms to guide optimal empiric antibiotic therapy, reduce inappropriate antibiotic usage, and identify areas requiring intervention by antimicrobial stewardship programs. Creating a hospital antibiogram is a time-consuming manual process that is typically performed annually.
    Objective: We aimed to apply visual analytics software to electronic health record (EHR) data to build an automated, electronic antibiogram ("e-antibiogram") that adheres to national guidelines and contains filters for patient characteristics, thereby providing access to detailed, clinically relevant, and up-to-date antibiotic susceptibility data.
    Methods: We used visual analytics software to develop a secure, EHR-linked, condition- and patient-specific e-antibiogram that supplies susceptibility maps for organisms and antibiotics in a comprehensive report that is updated on a monthly basis. Antimicrobial susceptibility data were grouped into nine clinical scenarios according to the specimen source, hospital unit, and infection type. We implemented the e-antibiogram within the EHR system at Children's Hospital of Philadelphia, a tertiary pediatric hospital and analyzed e-antibiogram access sessions from March 2016 to March 2017.
    Results: The e-antibiogram was implemented in the EHR with over 6,000 inpatient, 4,500 outpatient, and 3,900 emergency department isolates. The e-antibiogram provides access to rolling 12-month pathogen and susceptibility data that is updated on a monthly basis. E-antibiogram access sessions increased from an average of 261 sessions per month during the first 3 months of the study to 345 sessions per month during the final 3 months.
    Conclusion: An e-antibiogram that was built and is updated using EHR data and adheres to national guidelines is a feasible replacement for an annual, static, manually compiled antibiogram. Future research will examine the impact of the e-antibiogram on antibiotic prescribing patterns.
    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Child ; Community-Acquired Infections/blood ; Community-Acquired Infections/drug therapy ; Electronic Health Records ; Health Plan Implementation ; Hospitals, Pediatric ; Humans ; Microbial Sensitivity Tests ; Tertiary Care Centers ; User-Computer Interface
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2018-01-17
    Publishing country Germany
    Document type Journal Article
    ISSN 1869-0327
    ISSN (online) 1869-0327
    DOI 10.1055/s-0037-1615787
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Novel strategies in the use of lopinavir/ritonavir for the treatment of HIV infection in children

    Beatriz Larru Martinez / F Andrew I Riordan

    HIV/AIDS : Research and Palliative Care, Vol 2010, Iss default, Pp 59-

    2010  Volume 67

    Abstract: Beatriz Larru Martinez1, F Andrew I Riordan21Laboratorio Inmuno-Biología Molecular ...

    Abstract Beatriz Larru Martinez1, F Andrew I Riordan21Laboratorio Inmuno-Biología Molecular, Hospital General Universitario Gregorio Marañón, Madrid, Spain; 2Department of Infectious Diseases, Alder Hey Children’s NHS Foundation Trust, Liverpool, UKAbstract: Lopinavir/ritonavir (LPV/r) is considered by many as the first choice protease inhibitor (PI) for children. This co-formulation avoids the need for children to take ritonavir separately to “boost” the levels of lopinavir. LPV/r has high virologic potency, an excellent toxicity profile and a high barrier to the development of viral resistance. However, LPV/r has poor tolerability of the oral suspension (due to the poor taste of ritonavir), difficult dosing requirements and metabolic side effects, especially hyperlipidemia. The new tablet low-dose formulation (100/25 mg) may allow more convenient antiretroviral treatment in children. Novel strategies of LPV/r in childhood could maximize its advantages. For example, infants infected with HIV despite single dose Nevirapine after birth need effective combination antiretroviral treatment. This can be given using a higher dose of LPV/r with therapeutic drug monitoring. Other novel uses include once daily LPV/r regimens in older children and adolescents and lower doses of LPV/r in certain populations, which may decrease hyperlipidemia. Heavily pre-treated children might benefit from a double PI/r regimen which includes LPV/r. The high potency of LPV/r needs to be balanced with convenient regimens, to enhance adherence and decrease toxicity whenever possible. The aim of this review is to discuss the rationale behind these novel strategies of LPV/r use in pediatric antiretroviral treatment as well as their results and limitations.Keywords: human immunodeficiency virus, children, antiretroviral therapy, lopinavir, ritonavir
    Keywords Immunologic diseases. Allergy ; RC581-607 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Allergy and Immunology ; DOAJ:Medicine (General) ; DOAJ:Health Sciences ; Medicine (General) ; R5-920
    Subject code 360
    Language English
    Publishing date 2010-03-01T00:00:00Z
    Publisher Dove Medical Press
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Novel strategies in the use of lopinavir/ritonavir for the treatment of HIV infection in children.

    Martinez, Beatriz Larru / Riordan, F Andrew I

    HIV/AIDS (Auckland, N.Z.)

    2010  Volume 2, Page(s) 59–67

    Abstract: Lopinavir/ritonavir (LPV/r) is considered by many as the first choice protease inhibitor (PI) for children. This co-formulation avoids the need for children to take ritonavir separately to "boost" the levels of lopinavir. LPV/r has high virologic potency, ...

    Abstract Lopinavir/ritonavir (LPV/r) is considered by many as the first choice protease inhibitor (PI) for children. This co-formulation avoids the need for children to take ritonavir separately to "boost" the levels of lopinavir. LPV/r has high virologic potency, an excellent toxicity profile and a high barrier to the development of viral resistance. However, LPV/r has poor tolerability of the oral suspension (due to the poor taste of ritonavir), difficult dosing requirements and metabolic side effects, especially hyperlipidemia. The new tablet low-dose formulation (100/25 mg) may allow more convenient antiretroviral treatment in children. Novel strategies of LPV/r in childhood could maximize its advantages. For example, infants infected with HIV despite single dose Nevirapine after birth need effective combination antiretroviral treatment. This can be given using a higher dose of LPV/r with therapeutic drug monitoring. Other novel uses include once daily LPV/r regimens in older children and adolescents and lower doses of LPV/r in certain populations, which may decrease hyperlipidemia. Heavily pre-treated children might benefit from a double PI/r regimen which includes LPV/r. The high potency of LPV/r needs to be balanced with convenient regimens, to enhance adherence and decrease toxicity whenever possible. The aim of this review is to discuss the rationale behind these novel strategies of LPV/r use in pediatric antiretroviral treatment as well as their results and limitations.
    Language English
    Publishing date 2010-03-29
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2520734-9
    ISSN 1179-1373 ; 1179-1373
    ISSN (online) 1179-1373
    ISSN 1179-1373
    DOI 10.2147/hiv.s6616
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: A Pediatric Infectious Diseases Perspective of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and Novel Coronavirus Disease 2019 (COVID-19) in Children.

    Shane, Andi L / Sato, Alice I / Kao, Carol / Adler-Shohet, Felice C / Vora, Surabhi B / Auletta, Jeffery J / Nachman, Sharon / Raabe, Vanessa N / Inagaki, Kengo / Akinboyo, Ibukunoluwa C / Woods, Charles / Alsulami, Abdulsalam O / Kainth, Mundeep K / Santos, Roberto Parulan / Espinosa, Claudia M / Burns, Julianne E / Cunningham, Coleen K / Dominguez, Samuel R / Martinez, Beatriz Larru /
    Zhu, Frank / Crews, Jonathan / Kitano, Taito / Saiman, Lisa / Kotloff, Karen

    Journal of the Pediatric Infectious Diseases Society

    2020  Volume 9, Issue 5, Page(s) 596–608

    Abstract: Understanding the role that children play in the clinical burden and propagation of severe acute respiratory syndrome coronavirus 2, responsible for coronavirus disease 2019 (COVID-19) infections, is emerging. While the severe manifestations and acute ... ...

    Abstract Understanding the role that children play in the clinical burden and propagation of severe acute respiratory syndrome coronavirus 2, responsible for coronavirus disease 2019 (COVID-19) infections, is emerging. While the severe manifestations and acute clinical burden of COVID-19 have largely spared children compared with adults, understanding the epidemiology, clinical presentation, diagnostics, management, and prevention opportunities and the social and behavioral impacts on child health is vital. Foremost is clarifying the contribution of asymptomatic and mild infections to transmission within the household and community and the clinical and epidemiologic significance of uncommon severe post-infectious complications. Here, we summarize the current knowledge, identify resources, and outline research opportunities. Pediatric infectious diseases clinicians have a unique opportunity to advocate for the inclusion of children in epidemiological, clinical, treatment, and prevention studies to optimize their care as well as to represent children in the development of guidance and policy during pandemic response.
    MeSH term(s) Asymptomatic Diseases ; Betacoronavirus ; COVID-19 ; COVID-19 Testing ; Child ; Child Health Services ; Clinical Laboratory Techniques ; Coronavirus Infections/diagnosis ; Coronavirus Infections/prevention & control ; Coronavirus Infections/therapy ; Coronavirus Infections/transmission ; Female ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases/epidemiology ; Infant, Newborn, Diseases/prevention & control ; Infectious Disease Transmission, Vertical ; Pandemics/prevention & control ; Pediatrics ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/therapy ; Pneumonia, Viral/transmission ; Practice Guidelines as Topic ; Pregnancy ; Pregnancy Complications, Infectious ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-08-24
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2668791-4
    ISSN 2048-7207 ; 2048-7193
    ISSN (online) 2048-7207
    ISSN 2048-7193
    DOI 10.1093/jpids/piaa099
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Design and Implementation of a Visual Analytics Electronic Antibiogram within an Electronic Health Record System at a Tertiary Pediatric Hospital

    Simpao, Allan F. / Ahumada, Luis M. / Larru Martinez, Beatriz / Cardenas, Ana M. / Metjian, Talene A. / Sullivan, Kaede V. / Gálvez, Jorge A. / Desai, Bimal R. / Rehman, Mohamed A. / Gerber, Jeffrey S.

    Applied Clinical Informatics

    2018  Volume 09, Issue 01, Page(s) 37–45

    Abstract: Background: Hospitals use antibiograms to guide optimal empiric antibiotic therapy, reduce inappropriate antibiotic usage, and identify areas requiring intervention by antimicrobial stewardship programs. Creating a hospital antibiogram is a time- ... ...

    Abstract Background: Hospitals use antibiograms to guide optimal empiric antibiotic therapy, reduce inappropriate antibiotic usage, and identify areas requiring intervention by antimicrobial stewardship programs. Creating a hospital antibiogram is a time-consuming manual process that is typically performed annually.
    Objective: We aimed to apply visual analytics software to electronic health record (EHR) data to build an automated, electronic antibiogram (“e-antibiogram”) that adheres to national guidelines and contains filters for patient characteristics, thereby providing access to detailed, clinically relevant, and up-to-date antibiotic susceptibility data.
    Methods: We used visual analytics software to develop a secure, EHR-linked, condition- and patient-specific e-antibiogram that supplies susceptibility maps for organisms and antibiotics in a comprehensive report that is updated on a monthly basis. Antimicrobial susceptibility data were grouped into nine clinical scenarios according to the specimen source, hospital unit, and infection type. We implemented the e-antibiogram within the EHR system at Children's Hospital of Philadelphia, a tertiary pediatric hospital and analyzed e-antibiogram access sessions from March 2016 to March 2017.
    Results: The e-antibiogram was implemented in the EHR with over 6,000 inpatient, 4,500 outpatient, and 3,900 emergency department isolates. The e-antibiogram provides access to rolling 12-month pathogen and susceptibility data that is updated on a monthly basis. E-antibiogram access sessions increased from an average of 261 sessions per month during the first 3 months of the study to 345 sessions per month during the final 3 months.
    Conclusion: An e-antibiogram that was built and is updated using EHR data and adheres to national guidelines is a feasible replacement for an annual, static, manually compiled antibiogram. Future research will examine the impact of the e-antibiogram on antibiotic prescribing patterns.
    Keywords antibiogram ; electronic health records ; clinical decision support systems ; analytics ; data visualization ; pediatrics ; quality improvement
    Language English
    Publishing date 2018-01-01
    Publisher Schattauer GmbH
    Publishing place Stuttgart ; New York
    Document type Article
    ISSN 1869-0327
    ISSN (online) 1869-0327
    DOI 10.1055/s-0037-1615787
    Database Thieme publisher's database

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  6. Article: A Pediatric Infectious Disease Perspective of SARS-CoV-2 and COVID-19 in Children

    Shane, Andi L / Sato, Alice I / Kao, Carol / Adler-Shohet, Felice C / Vora, Surabhi B / Ery, Jeff / Auletta, J / Nachman, Sharon / Raabe, Vanessa N / Inagaki, Kengo / Akinboyo, Ibukunoluwa C / Woods, Charles / Alsulami, Abdulsalam O / Kainth, Mundeep K / Santos, Roberto Parulan / Espinosa, Claudia M / Burns, Julianne E / Cunningham, Coleen K / Dominguez, Samuel R /
    Larru Martinez, Beatriz / Zhu, Frank / Crews, Jonathan / Kitano, Taito / Saiman, Lisa / Kotloff, Karen

    Journal of the Pediatric Infectious Diseases Society

    Abstract: Understanding the role that children play in the clinical burden and propagation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) responsible for novel coronavirus (COVID-19) infections is emerging. While the severe manifestations and ... ...

    Abstract Understanding the role that children play in the clinical burden and propagation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) responsible for novel coronavirus (COVID-19) infections is emerging. While the severe manifestations and acute clinical burden of COVID-19 has largely spared children compared to adults, understanding the epidemiology, clinical presentation, diagnostics, management, and prevention opportunities as well as the social and behavioral impacts on child health is vital. Foremost is clarifying the contribution of asymptomatic and mild infections to transmission within the household and community and the clinical and epidemiologic significance of uncommon severe post-infectious complications. Herein we summarize the current knowledge, identify useful resources, and outline research opportunities. Pediatric infectious disease clinicians have a unique opportunity to advocate for the inclusion of children in epidemiological, clinical, treatment and prevention studies to optimize their care, as well as to represent children in the development of guidance and policy during pandemic response.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #729173
    Database COVID19

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  7. Article: A Pediatric Infectious Diseases Perspective of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and Novel Coronavirus Disease 2019 (COVID-19) in Children

    Shane, Andi L / Sato, Alice I / Kao, Carol / Adler-Shohet, Felice C / Vora, Surabhi B / Auletta, Jeffery J / Nachman, Sharon / Raabe, Vanessa N / Inagaki, Kengo / Akinboyo, Ibukunoluwa C / Woods, Charles / Alsulami, Abdulsalam O / Kainth, Mundeep K / Santos, Roberto Parulan / Espinosa, Claudia M / Burns, Julianne E / Cunningham, Coleen K / Dominguez, Samuel R / Martinez, Beatriz Larru /
    Zhu, Frank / Crews, Jonathan / Kitano, Taito / Saiman, Lisa / Kotloff, Karen

    J Pediatric Infect Dis Soc

    Abstract: Understanding the role that children play in the clinical burden and propagation of severe acute respiratory syndrome coronavirus 2, responsible for coronavirus disease 2019 (COVID-19) infections, is emerging. While the severe manifestations and acute ... ...

    Abstract Understanding the role that children play in the clinical burden and propagation of severe acute respiratory syndrome coronavirus 2, responsible for coronavirus disease 2019 (COVID-19) infections, is emerging. While the severe manifestations and acute clinical burden of COVID-19 have largely spared children compared with adults, understanding the epidemiology, clinical presentation, diagnostics, management, and prevention opportunities and the social and behavioral impacts on child health is vital. Foremost is clarifying the contribution of asymptomatic and mild infections to transmission within the household and community and the clinical and epidemiologic significance of uncommon severe post-infectious complications. Here, we summarize the current knowledge, identify resources, and outline research opportunities. Pediatric infectious diseases clinicians have a unique opportunity to advocate for the inclusion of children in epidemiological, clinical, treatment, and prevention studies to optimize their care as well as to represent children in the development of guidance and policy during pandemic response.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #919282
    Database COVID19

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  8. Article ; Online: A Pediatric Infectious Diseases Perspective of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and Novel Coronavirus Disease 2019 (COVID-19) in Children

    Shane, Andi L / Sato, Alice I / Kao, Carol / Adler-Shohet, Felice C / Vora, Surabhi B / Auletta, Jeffery J / Nachman, Sharon / Raabe, Vanessa N / Inagaki, Kengo / Akinboyo, Ibukunoluwa C / Woods, Charles / Alsulami, Abdulsalam O / Kainth, Mundeep K / Santos, Roberto Parulan / Espinosa, Claudia M / Burns, Julianne E / Cunningham, Coleen K / Dominguez, Samuel R / Martinez, Beatriz Larru /
    Zhu, Frank / Crews, Jonathan / Kitano, Taito / Saiman, Lisa / Kotloff, Karen

    Journal of the Pediatric Infectious Diseases Society

    2020  Volume 9, Issue 5, Page(s) 596–608

    Abstract: Abstract Understanding the role that children play in the clinical burden and propagation of severe acute respiratory syndrome coronavirus 2, responsible for coronavirus disease 2019 (COVID-19) infections, is emerging. While the severe manifestations and ...

    Abstract Abstract Understanding the role that children play in the clinical burden and propagation of severe acute respiratory syndrome coronavirus 2, responsible for coronavirus disease 2019 (COVID-19) infections, is emerging. While the severe manifestations and acute clinical burden of COVID-19 have largely spared children compared with adults, understanding the epidemiology, clinical presentation, diagnostics, management, and prevention opportunities and the social and behavioral impacts on child health is vital. Foremost is clarifying the contribution of asymptomatic and mild infections to transmission within the household and community and the clinical and epidemiologic significance of uncommon severe post-infectious complications. Here, we summarize the current knowledge, identify resources, and outline research opportunities. Pediatric infectious diseases clinicians have a unique opportunity to advocate for the inclusion of children in epidemiological, clinical, treatment, and prevention studies to optimize their care as well as to represent children in the development of guidance and policy during pandemic response.
    Keywords Pediatrics, Perinatology, and Child Health ; Infectious Diseases ; General Medicine ; covid19
    Language English
    Publisher Oxford University Press (OUP)
    Publishing country uk
    Document type Article ; Online
    ZDB-ID 2668791-4
    ISSN 2048-7207 ; 2048-7193
    ISSN (online) 2048-7207
    ISSN 2048-7193
    DOI 10.1093/jpids/piaa099
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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