The Journal of pediatrics
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The Journal of pediatrics · Jan 2013
Yield of skeletal surveys in children ≤ 18 months of age presenting with isolated skull fractures.
To measure the yield of a skeletal survey in children ≤ 18 months old presenting with isolated skull fractures without significant intracranial injury. ⋯ The skeletal survey in patients with isolated skull fractures revealed additional fractures in 6% of patients. Thus, a skeletal survey may yield clinically and forensically relevant data in such patients. However, it may be possible to restrict the window for obtaining a skeletal survey to younger infants, particularly those who are premobile.
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The Journal of pediatrics · Jan 2013
Comparative StudyThe utility of serum hepcidin as a biomarker for late-onset neonatal sepsis.
To assess the utility of hepcidin, a potent regulator of host defense and inflammation, in the diagnosis of late-onset sepsis in very low birth weight infants. ⋯ Serum hepcidin concentration may be a useful adjunct test, in addition to blood culture and other markers of infection, in the evaluation of late-onset sepsis in very low birth weight infants.
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The Journal of pediatrics · Jan 2013
Randomized Controlled Trial Comparative StudyProspective randomized crossover evaluation of three anesthetic regimens for painful procedures in children with cancer.
To identify the most effective sedation regimen for bone marrow aspiration and lumbar puncture procedures with a prospective trial of 3 combinations of sedation/analgesia. ⋯ The addition of fentanyl 1 mcg/kg to propofol for brief painful procedures reduces movement, propofol dose, and recovery time.
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The Journal of pediatrics · Jan 2013
Risk factors for and outcomes of acute kidney injury in neonates undergoing complex cardiac surgery.
To characterize the epidemiology of and identify risk factors for neonatal cardiac surgery-associated acute kidney injury (CS-AKI) and determine its impact on clinical outcomes. ⋯ Neonatal CS-AKI is common and independently predicts important clinical outcomes, including mortality. Many risk factors are similar to those in older children, but some are unique to neonates. The observation that lower baseline SCr predicts CS-AKI merits further study. The AKIN definition, based on preoperative SCr value, is a reasonable method for defining CS-AKI in neonates. Many previous studies of CS-AKI have excluded neonates; we suggest that future intervention studies on approaches to reducing CS-AKI incidence and improving outcomes should include neonates.
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The Journal of pediatrics · Dec 2012
Multicenter Study Comparative StudyComparative effectiveness of empiric β-lactam monotherapy and β-lactam-macrolide combination therapy in children hospitalized with community-acquired pneumonia.
To determine the comparative effectiveness of β-lactam monotherapy and β-lactam and macrolide combination therapy on clinical outcomes in the treatment of children hospitalized with community-acquired pneumonia (CAP). ⋯ School-aged patients hospitalized with CAP who received β-lactam plus macrolide combination therapy have a shorter length of stay and similar rates of readmission compared with school-aged patients who receive β-lactam monotherapy.