The Journal of pediatrics
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The Journal of pediatrics · Sep 2015
Trends in Ambulatory Care for Children with Concussion and Minor Head Injury from Eastern Massachusetts between 2007 and 2013.
To characterize trends in health care utilization and costs for children diagnosed with concussion or minor head injury within a large pediatric primary-care association. ⋯ Over the past 7 years, health care encounters for children diagnosed with concussion or minor head injury increased substantially in eastern Massachusetts. Care for these injuries increasingly shifted from the emergency department to primary-care and specialty providers.
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The Journal of pediatrics · Sep 2015
The Treatment of Juvenile Fibromyalgia with an Intensive Physical and Psychosocial Program.
To assess the short-term and 1-year outcomes of children with fibromyalgia treated with intensive physical and occupational therapy (PT/OT) and psychotherapy. ⋯ Children with fibromyalgia can be successfully treated without medications with a very intensive PT/OT and psychotherapy program. They have significantly improved pain and function by subject report and objective measures of function.
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The Journal of pediatrics · Sep 2015
Educational Module Improves Emergency Department Evaluation for Suspected Constipation.
To determine abdominal radiograph use and frequency of digital rectal examinations in children presenting to the emergency department (ED) with abdominal pain and suspected constipation and to determine the impact of an educational module on their use. ⋯ An educational module reviewing the established criteria for the diagnosis of constipation and presented to ED providers results in increased use of digital rectal examination and decreased use of abdominal radiograph in patients evaluated for abdominal pain and ultimately diagnosed with constipation. The change also was associated with reduction in cost and time and radiation exposure in the ED for these patients.
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The Journal of pediatrics · Sep 2015
Comparative StudySerum Cardiac Troponin I in the Evaluation of Nonaccidental Trauma.
To determine if troponin I is more often elevated in children with suspected nonaccidental trauma (NAT) compared with uninjured children of similar age, and describe associations between troponin I elevation and NAT injuries. ⋯ Troponin I is more often elevated in children with suspected NAT than uninjured children. Elevation of troponin I in children greater than 3 months of age with suspected NAT is concerning for trauma. Occult cardiac injury is more likely to occur in children with inflicted abdominal trauma, acute rib fractures, or ill appearance.