The Journal of pediatrics
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The Journal of pediatrics · Aug 2011
Comparative StudyInfants with single ventricle physiology in the emergency department: are physicians prepared?
To assess emergency department (ED) utilization and physician preparedness for infants with single ventricle (SV) physiology between stage 1 and stage 2 surgical palliation. ⋯ Between stages I and II, infants with SV physiology utilized the ED frequently, often with high disease acuity. Most ED physicians surveyed appeared underprepared for these infants. These findings underscore the need for educational efforts aimed at increasing ED preparedness.
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The Journal of pediatrics · Aug 2011
Multicenter Study Comparative StudyWhom are we comforting? An analysis of comfort medications delivered to dying neonates.
To clarify the use of end-of-life comfort medications or neuromuscular blockers (NMBs) in culturally different neonatal intensive care units (NICUs). ⋯ Comfort medications were administered to almost all dying infants in each NICU. Some, but not all, centers were comfortable increasing these medications around or after extubation. In three centers, NMBs were at times present at the time of death. However, only in Holland were NMBs initiated after extubation.
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The Journal of pediatrics · Aug 2011
Comparative StudyPatent foramen ovale in children with migraine headaches.
To determine the prevalence of patent foramen ovale (PFO) in children with migraine. ⋯ Children with migraine with aura have a significantly higher prevalence of PFO compared with those without aura or the general population. These data suggest that PFO may contribute to the pathogenesis of migraine with aura in children and have implications for clinical decision making.
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The Journal of pediatrics · Aug 2011
Comparative StudyDelayed onset of sleep-wake cycling with favorable outcome in hypothermic-treated neonates with encephalopathy.
To determine whether hypothermia modulates acquisition of sleep-wake cycling in term neonates with moderate to severe hypoxic-ischemic encephalopathy (HIE) and the relationship to outcome. ⋯ Although onset of sleep-wake cycling is markedly delayed in term neonates with moderate to severe HIE treated with hypothermia, approximately 65% with acquisition of cycling have a normal outcome. Sleep-wake cycling is an important additional tool for assessing recovery in term infants with moderate to severe HIE treated with hypothermia.
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The Journal of pediatrics · Jul 2011
Review Meta AnalysisTonsillectomy in children with periodic fever with aphthous stomatitis, pharyngitis, and adenitis syndrome.
To seek evidence supporting a role for tonsillectomy or adenotonsillectomy in the management of affected children with periodic fever with aphthous stomatitis, pharnygitis, and adenitis (PFAPA) syndrome. ⋯ Surgery appears to be a possible option for management of PFAPA syndrome. Available evidence is limited, however, and the precise role of surgery remains to be clarified. We suggest considering this option when symptoms markedly interfere with the child's quality of life and medical treatment has failed.