The Journal of pediatrics
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The Journal of pediatrics · Oct 1993
Comparative StudyNo resuscitation and withdrawal of therapy in a neonatal and a pediatric intensive care unit in Canada.
To compare and contrast the modes of death in a neonatal (NICU) and a pediatric (PICU) intensive care unit. ⋯ This study confirms that both withdrawal of therapy and no-CPR orders are part of current clinical practice in both the NICU and PICU settings. The ethical foundations and implications of these practices need further elaboration.
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The Journal of pediatrics · Oct 1993
Persistent hyperinsulinemic hypoglycemia of infancy: long-term octreotide treatment without pancreatectomy.
Eight patients with persistent hyperinsulinemic hypoglycemia of infancy who were treated with octreotide without pancreatectomy are described. All had severe, early-onset disease that would have required partial pancreatectomy had octreotide not been available. Along with octreotide, frequent feedings and raw cornstarch at night were required by all. ⋯ The remaining three patients (aged 5 to 9 months) are still being treated with octreotide. We conclude that, with the use of octreotide, pancreatectomy can be avoided in some patients. Particularly in light of our findings of a high incidence of diabetes years after partial pancreatectomy, and clinical improvement after months to years of octreotide treatment, we believe that aggressive medical therapy, when effective, is preferable to partial pancreatectomy.
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The Journal of pediatrics · Sep 1993
Pediatric critical care and hospital costs under reimbursement by diagnosis-related group: effect of clinical and demographic characteristics.
To determine the relationship of demographic and clinical variables to cost, to revenue based on diagnosis-related groups, and to profit in patients in a pediatric intensive care unit (PICU). ⋯ Under a DRG-based reimbursement system, the operation of an active PICU with a broad referral base may not be desirable from a financial perspective. Similar studies at other institutions could help establish a data base with which the DRG system can be refined.