The Journal of pediatrics
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The Journal of pediatrics · Feb 2011
Comparative StudyAgreement between proxy and adolescent assessment of disability, pain, and well-being in juvenile idiopathic arthritis.
Adolescents with juvenile idiopathic arthritis have demonstrated substantial disagreement with their proxy's assessment of their disability, pain, and well-being. Our objective was to describe the clinical and psychological factors associated with discordance. ⋯ Proxy and adolescent reports of pain and well-being are more likely to disagree in those with severe disease. Adolescents who report depressive symptoms are also more likely to disagree with their proxy. The reasons for these are multifactorial, and considerations of both reports are important when assessing outcomes in juvenile idiopathic arthritis.
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Neonatal asphyxia is associated with multi-organ hypoxia-ischemia and subsequent dysfunction. The cardiovascular system is frequently affected, causing signs of shock and complicating the neonatal circulatory transition. Hypothermia therapy can improve outcome from neonatal asphyxia without adversely affecting cardiovascular stability. Therapy directed at the cardiovascular system can improve short-term measures of systemic blood flow, but to date has not been demonstrated to improve long-term outcome.
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Acute kidney injury (AKI) is a common consequence of perinatal asphyxia, occurring in up to 56% of these infants. A major difficulty in diagnosing this condition is the lack of a consensus definition of neonatal AKI, largely because of a dearth of specific measurable variables and biochemical markers. This review will discuss the current evidence regarding the epidemiology, investigation, and treatment of AKI in the asphyxiated neonate. Particular emphasis will be given to the investigation of renal function in the neonate and to potential biomarkers that may aid the clinician in the diagnosis of renal injury in this population.
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The Journal of pediatrics · Feb 2011
Comparative StudyNeonatal morbidity in moderately preterm infants: a Swedish national population-based study.
To determine the gestational age (GA)-specific risks for neonatal morbidity and use of interventions in infants born at 30 to 34 completed gestational weeks. ⋯ Despite general advances in perinatal care, moderately preterm infants still have substantially increased risks for neonatal morbidity. Whereas the neonatal morbidity rate was similar to results of previous reports, management of respiratory problems differed markedly from other studies.
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The Journal of pediatrics · Feb 2011
Comparative StudyInsurance-associated disparities in hospitalization outcomes of Michigan children.
To investigate whether children in Michigan with private insurance have better hospitalization-related outcomes than those with public or no insurance. ⋯ There are disparities in health outcomes and charges between Michigan children and newborns with public/no insurance and those with private health insurance, presenting a significant opportunity to improve the efficiency and efficacy of care.