Current opinion in pediatrics
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Unintentional injuries are the leading cause of death for children and adolescents in the United States, and they create a significant burden of disability and financial cost. If motor vehicle-associated injuries are not considered, children are most commonly injured in their home and play environments. ⋯ In addition, recent epidemiologic studies describing risk factors for injury-related death are discussed. Injuries due to interpersonal violence and motor vehicles are covered elsewhere.
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Curr. Opin. Pediatr. · Aug 1999
ReviewAdolescent obesity, a need for greater awareness and improved treatment.
Obesity is arguably the most important medical problem in America today. About 25% of children are considered either overweight or obese, according to newly established national criteria. ⋯ Despite the enormous medical and economic implications of obesity, effective prevention and treatment strategies are lacking. This review summarizes the epidemiology, evaluation, and management of adolescent obesity, focusing on promising treatment strategies for the future.
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Ethylene glycol is a serious toxin that children frequently ingest. Diagnosis and treatment of this poisoning are challenging and frequently involve the use of novel therapies. In the past year, fomepizole (4-methylpyrazole) has been approved for use as an antidote in the treatment of ethylene glycol poisoning in adults, and the first article reporting the use of fomepizole in a pediatric ethylene glycol exposure was published. As a result, the therapy of ethylene glycol poisoning in children is likely to change from the traditional approach of ethanol administration coupled with hemodialysis to the administration of fomepizole with or without hemodialysis.
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Curr. Opin. Pediatr. · Jun 1999
ReviewAdvances in ventilatory support of the pediatric surgical patient.
Severe respiratory failure in newborn and pediatric patients is associated with significant morbidity and mortality. Basic science laboratory investigation has led to advances both in our understanding of ventilator-induced lung injury and in optimizing the supportive use of conventional ventilation strategies. ⋯ This review focuses on recent laboratory and clinical data detailing the techniques of permissive hypercapnia, high frequency oscillatory ventilation, inhaled nitric oxide, intratracheal pulmonary ventilation, and liquid ventilation. Some of these modalities are becoming commonplace, and others may have much to offer the clinician if their benefit is clearly demonstrated in future clinical trials.
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Pediatric interstitial lung disease comprises a diverse group of rare conditions characterized by an infiltrative process, abnormal gas exchange, and restrictive lung disease. Although the disorder is similar to its adult counterpart, its course is complicated by the continued need for lung growth and differentiation in infants and children. ⋯ Clinicians continue to define the various types of interstitial lung disease and to evaluate the roles of bronchoalveolar lavage, radiography, and biopsy in diagnosis. Together, investigators are working toward the development of specific, targeted therapy that will reduce the significant morbidity and mortality seen in pediatric interstitial lung disease.