Pediatrics
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Varicella is a nearly ubiquitous acquired childhood disease. Infectious complications of varicella can be life- or limb-threatening. ⋯ Airway complications of varicella are rare, rapidly evolving, and, unfortunately, difficult to visualize. We report a child who presented with a unique combination of varicella-induced airway complications-acute epiglottitis and subsequent necrotizing fasciitis of the head and neck. varicella, epiglottitis, necrotizing fasciitis, group A beta-hemolytic streptococcus, nasopharyngoscopy.
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The care of critically ill children has become more complex and demanding. This document establishes recommendations for developing regionalized integration of the care of these children into the emergency medical services system. These recommendations were developed by pediatricians with expertise in pediatric critical care, transport, and emergency medicine from the Committee on Pediatric Emergency Medicine, and the Pediatric Section of the Society of Critical Care Medicine Task Force on Regionalization of Pediatric Critical Care. The document was developed from existing guidelines from a number of professional organizations including the American Academy of Pediatrics and the Society of Critical Care Medicine, a thorough review of the literature, and expert consensus.
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Randomized Controlled Trial Clinical Trial
Intrapartum maternal fever and neonatal outcome.
Much of fever during term labor may not be infectious but rather a consequence of the use of epidural analgesia. Therefore, we investigated the association of elevated maternal intrapartum temperature with neonatal outcome when the infant does not develop an infection. ⋯ Intrapartum maternal fever, particularly if >101 degrees F, was associated with a number of apparently transient adverse effects in the newborn. Larger studies are needed to investigate the association of intrapartum fever with neonatal seizures and to determine whether any lasting injury to the fetus may occur.
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Comparative Study
Lung protective strategies of ventilation in the neonate: what are they?
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Randomized Controlled Trial Clinical Trial
Midazolam nasal spray reduces procedural anxiety in children.
Anxiety and pain even in minor procedures are still great problems in pediatrics, not least in pediatric oncology. Conscious sedation is indicated when other means to overcome a child's fear fail. The aim of this study was to investigate whether intranasal administration of midazolam given before insertion of a needle in a subcutaneously implanted central venous port could reduce anxiety, discomfort, pain, and procedure problems. ⋯ Nasal midazolam spray offers relief to children anxious about procedures, such as insertion of a needle in a subcutaneously implanted intravenous port, venous blood sampling, venous cannulation, etc. Its use, however, may be limited by nasal discomfort in some patients for whom rectal and oral routes might be alternatives.