The Journal of pediatrics
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The Journal of pediatrics · May 2008
Multicenter StudyVariation in inpatient resource utilization and management of apparent life-threatening events.
To report national variations in diagnostic approaches to apparent life-threatening events (ALTEs) and resource utilization. ⋯ There is considerable hospital-based variation in care for patients hospitalized for conditions potentially identifiable as ALTE, particularly in the evaluation and diagnosis of gastroesophageal reflux, which may contribute to adverse clinical and financial outcomes. An evidence-based national standard of care for ALTE is needed, as are multi-institutional initiatives to study different diagnostic and management strategies and their effect on patient outcomes.
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The Journal of pediatrics · Apr 2008
Comparative StudyDeep sedation for cardiac magnetic resonance imaging: a comparison with cardiac anesthesia.
To test the hypothesis that safety, efficacy, and image quality in pediatric patients who undergo deep sedation for cardiac magnetic resonance imaging (CMR) for congenital heart disease (CHD) is similar to general anesthesia (GA). ⋯ Sedation of appropriately screened pediatric patients with CHD undergoing CMR is safe and well tolerated and yields high-quality images similar to GA. GA should be considered for patients with CHD with hemodynamic or airway compromise, in whom sedation has failed, or who have special circumstances.
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The Journal of pediatrics · Apr 2008
The Pediatric Respiratory Assessment Measure: a valid clinical score for assessing acute asthma severity from toddlers to teenagers.
To determine the performance characteristics of the Preschool Respiratory Assessment Measure (PRAM) in preschool and school-aged children with acute asthma. ⋯ Good performance characteristics were observed in all age groups, making the PRAM an attractive score for assessing asthma severity and response to treatment.
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The Journal of pediatrics · Mar 2008
Randomized Controlled TrialA novel needle-free powder lidocaine delivery system for rapid local analgesia.
To determine the analgesic effect and tolerability of a novel needle-free powder lidocaine delivery system in children undergoing venipuncture. ⋯ The needle-free powder lidocaine delivery system was well tolerated and provided effective local analgesia when administered 2 to 3 minutes before venipuncture.
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The Journal of pediatrics · Mar 2008
Randomized Controlled TrialEffect of an integrated care pathway on acute asthma/wheeze in children attending hospital: cluster randomized trial.
To determine whether an integrated care pathway (ICP) could improve care delivered to patients coming to an emergency department only or to patients who were subsequently admitted. ⋯ An acute asthma/wheeze ICP improved education and prescribing errors, modestly reduced the length of stay when discharge criteria were adhered to, but did not influence recovery time. Further consideration of the effect on staff workload is required.