Michelle Eckerle
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View article: An Online Survey of Practicing Emergency Medicine Clinicians' Pediatric Educational Needs
An Online Survey of Practicing Emergency Medicine Clinicians' Pediatric Educational Needs Open
Background Clinicians caring for children in emergency departments have variable pediatric training. This study aimed to identify practicing emergency clinicians' perceptions on pediatric topic prioritization, information seeking behaviors…
View article: Comprehensive assessment of pediatric acute and inpatient care at a tertiary referral hospital in Malawi: opportunities for quality improvement
Comprehensive assessment of pediatric acute and inpatient care at a tertiary referral hospital in Malawi: opportunities for quality improvement Open
Background Despite the reduction in global under-5 mortality over the last decade, childhood deaths remain high. To combat this, there has been a shift in focus from disease-specific interventions to use of healthcare data for resource all…
View article: Leukopenia, neutropenia, and procalcitonin levels in young febrile infants with invasive bacterial infections
Leukopenia, neutropenia, and procalcitonin levels in young febrile infants with invasive bacterial infections Open
Background and objective Serum procalcitonin ( PCT ) is a highly accurate biomarker for stratifying the risk of invasive bacterial infections ( IBIs ) in febrile infants ≤60 days old. However, PCT is unavailable in some settings. We explor…
View article: Virtual Interviews and the Pediatric Emergency Medicine Match Geography: A National Survey
Virtual Interviews and the Pediatric Emergency Medicine Match Geography: A National Survey Open
Introduction: Virtual interviews (VI) are now a permanent part of pediatric emergency medicine (PEM) recruitment, especially given the cost and equity advantages. Yet inability to visit programs in person can impact decision-making, leadin…
View article: Features Associated With Radiographic Pneumonia in Children with SARS-CoV-2
Features Associated With Radiographic Pneumonia in Children with SARS-CoV-2 Open
14% of children with SARS-CoV-2 infections had radiographic pneumonia. Hypoxemia, cough, higher temperature, and older age were associated with pneumonias. In children tested, SARS-CoV-2 test results were not associated with radiographic p…
View article: Impact of SARS-CoV-2 Infection on the Association Between Laboratory Tests and Severe Outcomes Among Hospitalized Children
Impact of SARS-CoV-2 Infection on the Association Between Laboratory Tests and Severe Outcomes Among Hospitalized Children Open
Background To assist clinicians with identifying children at risk of severe outcomes, we assessed the association between laboratory findings and severe outcomes among severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–infected c…
View article: Mortality by Admission Diagnosis in Children 1–60 Months of Age Admitted to a Tertiary Care Government Hospital in Malawi
Mortality by Admission Diagnosis in Children 1–60 Months of Age Admitted to a Tertiary Care Government Hospital in Malawi Open
Diagnosis-specific mortality is a measure of pediatric healthcare quality that has been incompletely studied in sub-Saharan African hospitals. Identifying the mortality rates of multiple conditions at the same hospital may allow leaders to…
View article: Effects of COVID-19 Pandemic on PEM Fellowship Training
Effects of COVID-19 Pandemic on PEM Fellowship Training Open
Background The COVID-19 pandemic led to training programs abruptly stopping in-person learning and redesigning curricula. Trainees had decreased patient contact time and use of telehealth visits became more prominent. Trainee well-being be…
View article: Antibiotic treatment failure in children aged 1 to 59 months with World Health Organization-defined severe pneumonia in Malawi: A CPAP IMPACT trial secondary analysis
Antibiotic treatment failure in children aged 1 to 59 months with World Health Organization-defined severe pneumonia in Malawi: A CPAP IMPACT trial secondary analysis Open
Background Pneumonia is a leading cause of mortality in children <5 years globally. Early identification of hospitalized children with pneumonia who may fail antibiotics could improve outcomes. We conducted a secondary analysis from the Ma…
View article: A Call to Action for Standardizing Letters of Recommendation
A Call to Action for Standardizing Letters of Recommendation Open
As more medical students are applying to residency and fellowship programs, the burden of reviewing applications and discriminating among individuals is increasing. In addition, studies highlight the need to intentionally target gender and…
View article: Post–COVID-19 Conditions Among Children 90 Days After SARS-CoV-2 Infection
Post–COVID-19 Conditions Among Children 90 Days After SARS-CoV-2 Infection Open
Importance Little is known about the risk factors for, and the risk of, developing post–COVID-19 conditions (PCCs) among children. Objectives To estimate the proportion of SARS-CoV-2–positive children with PCCs 90 days after a positive tes…
View article: Identifying modifiable risk factors for mortality in children aged 1–59 months admitted with WHO-defined severe pneumonia: a single-centre observational cohort study from rural Malawi
Identifying modifiable risk factors for mortality in children aged 1–59 months admitted with WHO-defined severe pneumonia: a single-centre observational cohort study from rural Malawi Open
Objective Although HIV infection, severe malnutrition and hypoxaemia are associated with high mortality in children with WHO-defined severe pneumonia in sub-Saharan Africa, many do not have these conditions and yet mortality remains elevat…
View article: Outcomes of SARS-CoV-2–Positive Youths Tested in Emergency Departments
Outcomes of SARS-CoV-2–Positive Youths Tested in Emergency Departments Open
In this study, approximately 3% of SARS-CoV-2-positive youths tested in EDs experienced severe outcomes within 2 weeks of their ED visit. Among children discharged home from the ED, the risk was much lower. Risk factors such as age, underl…
View article: Cardiovascular Dysfunction Criteria in Critically Ill Children: The PODIUM Consensus Conference
Cardiovascular Dysfunction Criteria in Critically Ill Children: The PODIUM Consensus Conference Open
CONTEXT Cardiovascular dysfunction is associated with poor outcomes in critically ill children. OBJECTIVE We aim to derive an evidence-informed, consensus-based definition of cardiovascular dysfunction in critically ill children. DATA SOUR…
View article: PRagMatic Pediatric Trial of Balanced vs nOrmaL Saline FlUid in Sepsis: study protocol for the PRoMPT BOLUS randomized interventional trial
PRagMatic Pediatric Trial of Balanced vs nOrmaL Saline FlUid in Sepsis: study protocol for the PRoMPT BOLUS randomized interventional trial Open
Background/aims Despite evidence that preferential use of balanced/buffered fluids may improve outcomes compared with chloride-rich 0.9% saline, saline remains the most commonly used fluid for children with septic shock. We aim to determin…
View article: Relationship between distance of referring facilities and haemoglobin change in children in Malawi
Relationship between distance of referring facilities and haemoglobin change in children in Malawi Open
Using distance as a proxy for time, this suggests that referring facilities are transferring children sufficiently quickly to avert significant reductions in Hb. Despite this, there is a need to identify the factors that influence the deci…
View article: Blood transfusion and mortality in children with severe anaemia in a malaria-endemic region
Blood transfusion and mortality in children with severe anaemia in a malaria-endemic region Open
This study suggests that transfusion of children with profound anaemia and malaria may confer increased in-hospital survival. An understanding of the factors associated with mortality from SA will allow for interventions to prioritise the …
View article: Predicting severe pneumonia in the emergency department: a global study of the Pediatric Emergency Research Networks (PERN)—study protocol
Predicting severe pneumonia in the emergency department: a global study of the Pediatric Emergency Research Networks (PERN)—study protocol Open
Introduction Pneumonia is a frequent and costly cause of emergency department (ED) visits and hospitalisations in children. There are no evidence-based, validated tools to assist physicians in management and disposition decisions for child…
View article: Lessons learned from the development and implementation of an electronic paediatric emergency and acute care database in Lilongwe, Malawi
Lessons learned from the development and implementation of an electronic paediatric emergency and acute care database in Lilongwe, Malawi Open
As the field of global child health increasingly focuses on inpatient and emergency care, there is broad recognition of the need for comprehensive, accurate data to guide decision-making at both patient and system levels. Limited financial…
View article: Focus group discussions on low-flow oxygen and bubble CPAP treatments among mothers of young children in Malawi: a CPAP IMPACT substudy
Focus group discussions on low-flow oxygen and bubble CPAP treatments among mothers of young children in Malawi: a CPAP IMPACT substudy Open
Objective To determine the acceptability of bubble continuous positive airway pressure (bCPAP) and low-flow oxygen among mothers of children who had received either therapy. Setting A district hospital in Salima, Malawi. Participants We co…
View article: Antibiotic Use and Outcomes in Children in the Emergency Department With Suspected Pneumonia
Antibiotic Use and Outcomes in Children in the Emergency Department With Suspected Pneumonia Open
BACKGROUND AND OBJECTIVES: Antibiotic therapy is often prescribed for suspected community-acquired pneumonia (CAP) in children despite a lack of knowledge of causative pathogen. Our objective in this study was to investigate the associatio…
View article: Implementation of Targeted Point of Care HIV Testing in a Pediatric Emergency Department
Implementation of Targeted Point of Care HIV Testing in a Pediatric Emergency Department Open
Introduction: HIV infection rates are increasing among adolescents. Despite guidelines recommending annual HIV screening among sexually active adolescents, 3.6% of adolescents tested for other sexually transmitted infections (STI) in a ped…
View article: A pediatric death audit in a large referral hospital in Malawi
A pediatric death audit in a large referral hospital in Malawi Open
Background Death audits have been used to describe pediatric mortality in under-resourced settings, where record keeping is often a challenge. This information provides the cornerstone for the foundation of quality improvement initiatives.…
View article: Building Sustainable Partnerships to Strengthen Pediatric Capacity at a Government Hospital in Malawi
Building Sustainable Partnerships to Strengthen Pediatric Capacity at a Government Hospital in Malawi Open
The development of a novel partnership between relevant stakeholders in Malawi and US-based partners with expertise in PEM should help to further decrease pediatric mortality through the coordinated provision of acute care expertise and tr…
View article: Metabolomics as a Driver in Advancing Precision Medicine in Sepsis
Metabolomics as a Driver in Advancing Precision Medicine in Sepsis Open
The objective of this review is to explain the science of metabolomics—a science of systems biology that measures and studies endogenous small molecules (metabolites) that are present in a single biological sample—and its application to th…