Anales de pediatría : publicación oficial de la Asociación Española de Pediatría (A.E.P.)
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Comparative Study
[Chest radiograph in bronchiolitis: is it always necessary?].
The routine use of chest radiograph in infants with bronchiolitis increases health costs and can often unnecessarily expose the patient to radiation. ⋯ Most infants presenting with bronchiolitis had a normal chest radiograph. Temperature >or = 38 degrees and O2 saturation < 94 % were significantly associated with infiltrate/atelectasis. In most infants with bronchiolitis, the absence of fever and hypoxia are good predictors of normal chest radiographs.
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To describe patient demand and management in a hospital pediatric emergency setting. ⋯ The number of patients attended in our pediatric emergency unit gradually increased between 1995 and 2002, mostly due to young children with fever or respiratory distress. In nearly half of the patients, a thorough anamnesis and physical examination were sufficient for evaluation. Because many of the processes were of recent onset, continuous observation, whether at home or in hospital, was useful to adequately monitor these children.
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The Internet has revolutionized access to biomedical information among health professionals and the general public. There is demand for pediatric societies to develop quality contents directed at both pediatricians and parents. ⋯ The presence of pediatric societies on the Internet is acceptable, without noteworthy differences between Spanish organizations and member organizations of the Latin American Pediatric Association. In general, interaction with parents is of poor quality.
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The most common causes of persistent cough are upper respiratory tract disease (postnasal drip syndrome, infections) and asthma. In the last year, six patients (four boys and two girls), aged 7-12 years old, with a diagnosis of hard-to-manage asthma and/or persistent cough were referred to our department. All the patients had undergone treatment with multiple drugs for long periods without favorable clinical response. ⋯ Intelligence quotient was in the lower normal range and generalized anxiety order was identified, thus establishing a diagnosis of psychogenic cough. Treatment consisted of relaxation techniques and psychopedagogic support with favorable outcome. To avoid diagnostic errors and inappropriate treatment, psychogenic cough should be included in the differential diagnosis of persistent cough and hard-to-manage asthma.
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Measuring the quality of care in emergency departments requires tools to quantify the most important aspects in the care process. The quality indicator is the quantitative measure used in quality assurance. ⋯ The quality indicators are useful in measuring concrete and specific aspects of clinical care and in providing information on quality. The indicators provide valid, reliable and objective information. The indicator is an early warning sign to identify areas requiring improvement and allows appropriate measures to be taken to correct the detected deficiencies. The use of indicators allows comparisons with uniform criteria to be made.