Current opinion in pediatrics
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Curr. Opin. Pediatr. · Jun 2008
ReviewPediatric traumatic brain injury: an update of research to understand and improve outcomes.
Traumatic brain injury is the leading cause of death in the pediatric population. The purpose of this review is to highlight recent contributions in evaluation, management, and predictors of outcome in pediatric traumatic brain injury. ⋯ Traumatic brain injury is the leading cause of mortality and is a major public health issue in the pediatric population. There have been many recent contributions in the diagnosis, treatment, and long-term morbidity of traumatic brain injury. Ongoing work is needed to improve outcomes of traumatic brain injury equitably for all patients.
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Curr. Opin. Pediatr. · Jun 2008
ReviewPulmonary arterial hypertension in children: a medical update.
With rapid advances in the understanding and treatment of pulmonary arterial hypertension, navigating the pediatric literature becomes challenging. A comprehensive review of the most recent literature over the past year on available and emerging novel therapies as well as an approach to target pediatric populations will provide insight into the current management of pediatric pulmonary hypertension patients. ⋯ The data in children are often limited to case reports as many of those described here. Thus, the reader needs to be cautious about the interpretation of such small uncontrolled studies. While many of these data support the rationale for using novel agents for children with pulmonary arterial hypertension, further controlled and well designed studies are necessary to assess the true impact of these agents on various subgroups of children with pulmonary arterial hypertension.
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Sickle cell disease is one of the most prevalent genetic diseases, affecting 1 in 600 African-Americans. The lung is one of the major organs affected in sickle cell disease and the pulmonary complications of sickle cell disease result in significant morbidity and mortality in children. ⋯ The pulmonary complications of sickle cell disease include airway hyperreactivity, acute chest syndrome, chronic sickle lung disease, pulmonary hypertension, and sleep disordered breathing. Further understanding of the interrelationships between these disorders will lead to improved therapies.
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Curr. Opin. Pediatr. · Jun 2008
ReviewALARA: is there a cause for alarm? Reducing radiation risks from computed tomography scanning in children.
Radiation exposure from computed tomography is associated with a small but significant increase in risk for fatal cancer over a child's lifetime. This review aims to heighten awareness and spearhead efforts to reduce unnecessary computed tomography scans in children. ⋯ Advocacy by pediatric healthcare providers to promote intelligent dose reduction based on the principles of ALARA and the judicious use of computed tomography scanning is essential to foster the safest possible care of children.
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Curr. Opin. Pediatr. · Jun 2008
ReviewEmergency department treatment of primary headaches in children and adolescents.
Headaches in children and adolescents are common presenting complaints in emergency departments. There is wide variation among acute treatments. We sought to review options for acute emergency department management and the recent evidence supporting their use. ⋯ Further research is needed on therapies targeted toward children and adolescents with headache subtypes other than migraine, including those without a previous diagnosis. While little evidence exists, most authors agree with an initial trial of ibuprofen followed by sumatriptan nasal spray for children over 12 years of age for those with persistent symptoms. Antiemetics remain an option for those with nausea and/or vomiting as a prominent feature of their illness. Other treatments such as ketorolac are still being investigated in children.