Clinical pediatrics
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To determine the frequency, causes, and clinical significance of hyponatremia in hospitalized children, we reviewed the clinical and laboratory data of all hyponatremic children in Texas Children's Hospital over a 12-month period. One hundred sixty-one patients from among 11,702 hospital admissions were found to have hyponatremia, defined as serum sodium value of less than 130 mEq/L, an overall frequency of 1.38%. Sixty-nine patients (43%) had hyponatremia on admission, and 92 patients (57%) had hospital-acquired hyponatremia. ⋯ Six patients (3.7%) had neurologic impairment on discharge, and 19 patients (12%) ultimately died long after their hyponatremia was corrected. Each patient who had neurologic sequelae and each patient who died had underlying medical conditions which could explain their morbidity and/or mortality. The prognosis appears to be more clearly related to the underlying medical disorder rather than to the hyponatremic state or its correction.
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Idiopathic constipation and encopresis of childhood are thought to occur when children volitionally withhold stool. Withholding may be prompted by social pressures or by episodes of painful defecation. Repetitive withholding may result in colonic dilatation and colorectal dysfunction. ⋯ A retrospective review of patients treated without enemas revealed 45 patients whose course could be followed for six months. Ninety-eight percent of these had successful initial cleanouts without enemas; 94% had continued success at six months. These results, comparable with other treatment programs, demonstrate that therapy without enemas is a reasonable alternative in the treatment of childhood constipation and encopresis.
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Clinical pediatrics · Apr 1991
Comparative Study Clinical Trial Controlled Clinical TrialComparison of a tympanic thermometer to rectal and oral thermometers in a pediatric emergency department.
We performed a clinical trial of a new tympanic thermometer to test its accuracy in a pediatric emergency department. Tympanic temperature was compared to oral or rectal glass and electronic temperature, depending on the developmental age of the child. ⋯ Our results suggest good correlation of tympanic with oral and rectal glass thermometry except in infants less than three months of age. Sensitivity and specificity, respectively, were 80% and 93% for detecting fever of 38 degrees C and 80% and 95% for detecting fever of 38.5 degrees C.
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Clinical pediatrics · Apr 1991
Comparative StudyComparison of pulmonary artery, rectal, and tympanic membrane temperatures in adult intensive care unit patients.
Tympanic thermometry using infrared thermography technology offers a noninvasive, rapid temperature measurement tool which may be useful for selected intensive care unit (ICU) patients. Multiple comparisons of pulmonary artery catheter (PAC), rectal (R), and tympanic membrane (TM) temperatures were performed in nine adult ICU patients using PAC temperatures as the gold standard. ⋯ Differences between either R (+0.4 degrees C) or TM (-0.1 degrees C) and PAC temperatures were consistent over selected ranges between 35 degrees C and 40 degrees C. The performance of TM and R was similar in the ability to predict PAC temperatures.