Current opinion in pediatrics
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Curr. Opin. Pediatr. · Oct 2012
Review Meta AnalysisScreening for critical congenital heart disease: advancing detection in the newborn.
Screening for critical congenital heart disease (CCHD) using pulse oximetry was added to the recommended uniform screening panel through an endorsement by the Health and Human Services Secretary in September 2011. As organizations on both the macrolevels and microlevels consider implementation, research efforts and professional endorsements have been completed, providing important guidance moving forward. ⋯ CCHD screening is easily implemented in community hospitals, and is cost effective, and some states may be better prepared for implementation than previously hypothesized.
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Clostridium difficile is an intestinal infection associated with antibiotic use, commonly seen in patients with chronic medical issues. The purpose of this review is to discuss the association of C. difficile-associated diarrhea with use of proton pump inhibitors. ⋯ An association exists between C. difficile infection and proton pump inhibitor use. Treatment options exist for C. difficile-associated diarrhea, although judicious use of proton pump inhibitors and antibiotics, emphasis on hand washing, and appropriate use of patient isolation should be implemented as well.
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Teen pregnancy has been subject of public concern for many years. In the United States, despite nearly 2 decades of declining teen pregnancy and birth rates, the problem persists, with significant disparities present across racial groups and in state-specific rates. This review examines recent trends, pregnancy prevention initiatives and family planning policies that address the special needs of vulnerable youth. ⋯ There is strong consensus that effective teen pregnancy prevention strategies should be multifaceted, focusing on delay of sexual activity especially in younger teens while promoting consistent and correct use of effective methods of contraception for those youth who are or plan to be sexually active. There is a need for further research to identify effective interventions for vulnerable populations.
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To review recent research on the management of acute procedural pain in pediatric patients. ⋯ Pediatric patients experience pain from procedures related to their care. Pediatricians should educate themselves regarding the accurate assessment of pain, and the pharmacologic and nonpharmacologic methods of managing acute pain.
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We review recommendations from recent publications on the management of fever with antipyretics, the classification and diagnosis of fevers of unknown origin (FUO), and the evaluation of fever in infants under 90 days of age. ⋯ Pediatricians should spend more time educating parents about fever and antipyretic use. Not all persistent fever is FUO, and testing should be targeted to the child's clinical condition. Existing low-risk criteria should be used to identify febrile infants who can be managed without extensive work-up and antibiotics. Adherence to evidence-based recommendations will lessen the morbidity and mortality associated with febrile illnesses in children.