The Journal of pediatrics
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The Journal of pediatrics · Sep 2013
Multicenter StudyImpact of gender on sepsis mortality and severity of illness for prepubertal and postpubertal children.
To investigate differences in sepsis mortality between prepubertal and postpubertal males and females. ⋯ Sepsis mortality is similar in prepubertal males and females. However, postpubertal males have a higher sepsis mortality than postpubertal females, likely related to their greater severity of illness on PICU admission. These outcome differences in postpubertal children may reflect a hormonal influence on the response to infection or differences in underlying comorbidities, source of infection, or behavior.
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The Journal of pediatrics · Sep 2013
Trends in Clostridium difficile infection and risk factors for hospital acquisition of Clostridium difficile among children with cancer.
To study the trend of Clostridium difficile infection (CDI) and risk factors for hospital acquired CDI (HA-CDI) among children with cancer. ⋯ Despite an apparent decrease in CDI incidence from 2006-2010, HA-CDI remains prevalent and morbid among children with cancer. Recent exposure to chemotherapy, proton pump inhibitor, and certain antibiotics were independent risk factors for HA-CDI.
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To delineate the long-term outcomes and mechanisms of pediatric sinus bradycardia. ⋯ The long-term outcomes of the children and adolescents with sinus bradycardia identified using school electrocardiographic survey are favorable. Parasympathetic hyperactivity, instead of HCN4 gene mutation, is responsible for the occurrence of sinus bradycardia.
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The Journal of pediatrics · Sep 2013
Anaphylaxis knowledge and practice preferences of pediatric emergency medicine physicians: a national survey.
To assess the knowledge and practice preferences of anaphylaxis in pediatric emergency medicine (PEM) physicians by practice setting, and to identify factors associated with intramuscular (IM) epinephrine administration and admission of patients with anaphylaxis. ⋯ Even though the majority of PEM physicians correctly report using epinephrine in pediatric anaphylaxis, not all use the preferred administration route, and many discharge patients home after an abbreviated period.
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The Journal of pediatrics · Sep 2013
Low morbidity and mortality in children with diabetic ketoacidosis treated with isotonic fluids.
To assess current rates of complications of diabetic ketoacidosis (DKA), particularly cerebral edema, in a large tertiary-care pediatric hospital with a consistent management protocol. ⋯ Compared with data in recent consensus statements, the Dallas protocol is associated with extremely low rates of death and disability (0.08% vs 0.3%) from DKA.