Neonatal hyperbilirubinemia is a common cause of delayed discharge and readmissions in our institution. As previously published, the irradiance our phototherapy (PT) units provided was below the irradiance recommended by the AAP for intensive phototherapy (>30 µW/cm2/nm). We measured irradiance delivered by our PT units (Drager 4000) using a standardized footprint grid. By varying number of blue and white fluorescent PT lights, height of PT unit above the neonate and type of bed used (open bassinet versus isolette), we determined the optimal PT arrangement needed to deliver intensive PT (30 µW/cm2/nm). We then developed a standardized, multidisciplinary protocol specifying light arrangement and distance required needed to achieve the desired irradiance level. We were able to show improved irradiance following above changes. Onsite measurement of irradiance provided by local phototherapy units and development of a multidisciplinary, standardized protocol are necessary to assure delivery of recommended levels PT for neonates with hyperbilirubinemia.Rising rates of mumps in Georgia have been reported. We hypothesize that the incidence of parotitis and mumps presenting to Children's Healthcare of Atlanta (CHOA) has increased over the past decade among immunized children. Retrospective chart reviews were conducted using ICD9/10-codes for parotitis and mumps from January 2007 to December 2017. Data on demographics, vaccination status, labs, management and disposition were collected. 1017 parotitis cases were diagnosed; an upward trend in incidence occurred over time. Mumps testing was done in 47 (4.6%) parotitis cases; 9 mumps cases were identified, with 6 diagnosed in 2017. Seven patients (78%) were fully vaccinated. Median age for mumps was 13 years. Few symptoms differentiate mumps from non-mumps-parotitis. The incidence of parotitis and mumps in children has increased since 2007 in the Atlanta area, reflecting a nationwide trend. Mumps is likely underreported as rates of testing are low, and should be considered in children with parotitis regardless of vaccination history.We describe trends in cell phone-related injuries in patients 21 years of age and under presenting to United States Emergency Departments. We calculated age-adjusted rates of cell phone-related injury per 100 000 individuals using data from the National Electronic Injury Surveillance System (NEISS) database and United States Census Bureau. From 2002 to 2015, an estimated 38 063 patients 21 years old and younger sustained a cell phone-related injury. The overall rate of injuries for all ages increased from 17.1 injuries per 100 000 in 2002 to 138 injuries per 100 000 in 2015, an increase of over 700%. The incidence of cell phone-related injuries increased across all age groups, with children 2 years of age and under experiencing the highest single incidence rate of 159 injuries per 100 000 in 2014. These findings highlight an important and relatively under-reported pediatric safety issue. Anticipatory guidance and injury prevention plans should be updated accordingly.China approved a human papillomavirus (HPV) vaccine in 2018. Recommendations from health care providers can positively impact vaccine receipt. This study characterized vaccine providers' attitudes toward the HPV vaccine and contrasted attitudes by the providers' demographic characteristics. In total, 120 vaccine providers in Shanghai, China, completed a questionnaire. Associations between essential characteristics of the HPV vaccine and providers' urbanicity and working length were explored using the Kruskal-Wallis test. Doctors with ≤5 years' work experience were more likely to think it important to emphasize that HPV is a sexually transmitted disease compared to doctors with longer work experiences (P = .0231). More suburban than urban providers thought that China should include the HPV vaccine into the publicly funded Expanded Program on Immunization (P = .0315). Differences in attitudes toward HPV could lead to variation in how providers talk to parents and adolescents about the HPV vaccine, with disparities in vaccine uptake as a result.Due to lack of robust data on childhood cystic fibrosis (CF) in Bangladesh we sought to evaluate their clinico-epidemiology. A cross-sectional observation was conducted adopting CF-foundation consensus-panel-diagnostic criteria in 3 tertiary-care-hospitals in Bangladesh from 2000 to 2017. Clinically suspected 95 CF-cases were subjected to sweat-chloride testing using locally-developed a fast, cheap and effective indigenously body-wrapped sweating technique measured by US-Easy Lyte-automated microprocessor-controlled analyzer marking ≥60 mmol/L as positive. Mean-age of CF-cases at disease-onset was 16.9 ± 26.6 months that significantly differed with age-at-diagnosis (P  less then  .02). Pulmonary syndromes included chronic wet cough in 100%, respiratory distress in 90.5%, digital-clubbing in 78%, mucopurulent-sputum in 74%-cases, and crepitation in 82%. Radio-imaging revealed bronchiectasis in 60%, hyperinflation/peribronchial-thickening in 22% and, pan-sinusitis in 89%-cases. While 37% had history-of malabsorption, high-fecal-fat revealed in 53%-cases. Malnutrition prevailed as severe-underweight in 87%-cases and all CF-cases (100%) had high sweat-chloride (mean = 118 ± 53.34 mmol/L). Thus, children with pulmonary features coupled with severe malnutrition and associated radio-imaging bronchiectasis should be screened for CF with a fast, cheap and effective sweat test in resource poor settings.Objective Our aim is to (1) ascertain the proportion of pediatric patients at a tertiary hospital in Western Massachusetts over a 10-year period with hospital-acquired venous thromboembolism (VTE) of particular characteristics and (2) determine whether ACCP or Cincinnati Children's guidelines would have recommended VTE prophylaxis in these patients. Setting Urban teaching hospital in the United States.  https://www.selleckchem.com/products/a2ti-2.html  Participants Data from 98 477 pediatric hospital admissions (roughly 10 000 admission per year) from 2008 to 2017 were reviewed. There were a total of 177 VTE cases identified. Outcome measures Hospital-acquired venous thromboembolism (including deep venous thrombosis and pulmonary embolism). Result 177 charts were extracted that carried the diagnosis of VTE based on ICD-9 and ICD-10 codes over a 10-year-period. Among these patients, 34 (19%) met the inclusion criteria for HA-VTE; 5 (16%) would qualify for prophylaxis according to ACCP and 7 (21%) according to Cincinnati Children's guideline. The most common age group to have a VTE was infants under 1 year of age (41%), and the most common characteristic was the presence of a central line (82%).