Clinical pediatrics
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Clinical pediatrics · Mar 2011
The changing clinical presentation of hypertrophic pyloric stenosis: the experience of a large, tertiary care pediatric hospital.
The authors reviewed the clinical and laboratory data from cases of hypertrophic pyloric stenosis (HPS) diagnosed at their institution from 2006 to 2008. They assessed and compared presentation of patients with HPS over time at their institution. A total of 118 patients were included in this study. ⋯ In patients from this institution, hypochloremia was present in 23% and alkalosis in 14.4%, which are less frequent than the incidence of these abnormalities in older studies. There was a change in the additional "classical" symptoms, represented by the lower percentage of infants in whom an "olive" was palpated and the lower numbers of patients with severe electrolyte imbalances. The reason for this change appears to be the frequent use of ultrasound.
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Clinical pediatrics · Mar 2011
Risk factors for morbidity and mortality in pediatric home mechanical ventilation.
Home mechanical ventilation (HMV) is increasingly used in children with chronic respiratory insufficiency, but data on incidence and type of adverse events are limited. ⋯ Pediatric HMV including all age and diagnostic groups shows a low incidence of emergencies.
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This study quantified the types of extremity fractures most commonly missed on plain radiographs by pediatric emergency medicine specialists after an initial emergency department (ED) encounter. From February 2006 to June 2009, extremity radiographs obtained in a pediatric ED in which a radiologist categorized the ED attendings' read of normal as incorrect were tabulated. The authors also counted the total number of each type of radiograph completed when radiologists were unavailable. ⋯ It was found that a total of 220 fractures were missed during ED encounters in the study period. The most frequently missed fractures were of the hand phalanges (26.4%) followed by metatarsus (9.5%), distal radius (7.7%), tibia (7.3%), and phalanges of the foot (5.5%). Emergency physicians should be aware that the most commonly missed fractures were phalanges of the hand and metatarsal fractures.
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Clinical pediatrics · Mar 2011
Alcohol intoxication among Dutch adolescents: acute medical complications in the years 2000-2010.
To investigate acute medical complications of alcohol intoxication among adolescents presenting to Reinier de Graaf Hospital, a major nonacademic hospital in Delft, the Netherlands. ⋯ Acute medical complications because of alcohol intoxication appeared to be mild, and most remarkably none of the patients experienced hypoglycemia.