Current opinion in pediatrics
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Pneumonia is a common serious illness in children with acute episodes of fever and in children with more prolonged episodes of fever, termed fevers of unknown origin. Recent studies have demonstrated that the clinical evaluation, including observation, history, and the physical examination, is highly sensitive in identifying children with acute episodes of fever who have pneumonia. The sensitivity of the clinical evaluation for pneumonia has been demonstrated for febrile infants younger than 90 days of age as well as older children. In children with fever of unknown origin, the chest roentgenogram is considered part of the diagnostic evaluation, but further research may define specific indications for its use based on observation, history, and physical examination.
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There is an increasing focus on the recognition, assessment, and management of pain in children. Children undergo many painful procedures in different clinical environments and are frequently undertreated for their pain. The pediatrician should be familiar with general concepts about the perception of pain in children. ⋯ There has been an increase in the development of topical anesthetics as well as modifying injectable local anesthetic to decrease the pain of local infiltration. Nonpharmacologic methods of pain management are being tested, developed, and used alone or as adjuncts to pharmacologic therapy for children undergoing painful procedures. It is imperative that clinicians keep themselves informed about new advances pertaining to pain treatment and incorporate them into their practices.