Pediatrics
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Comparative Study
Comparison of critically ill and injured children transferred from referring hospitals versus in-house admissions.
The purpose of this work was to compare the outcomes, severity of illness, and resource use of patients transferred to PICUs from outside hospitals to patients admitted from within the same hospital. ⋯ On average, children admitted to a cohort of US PICUs from referring hospitals were more ill and required more intensive care resources than patients admitted to the same PICUs from within the institution. Hospital-level differences in PICU efficiency and severity of illness were highly variable. These data highlight the need for standardized PICU admission criteria to maximize hospital efficiency and suggest opportunities for earlier intervention and consultation by hospitals with PICU-level services to improve quality of care for critically ill children.
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The objective of this study was to describe the epidemiology of gymnastics-related injuries among children in the United States. ⋯ Gymnastics has one of the highest injury rates of all girls' sports. Establishment of a national database for gymnastics-related injuries, including exposure data for direct calculation of injury rates, would permit better identification and monitoring of risk factors for gymnastics-related injuries and aid in the development, implementation, and evaluation of injury prevention strategies based on epidemiologic evidence.
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Although nasal continuous positive airway pressure is widely used in neonatal units, its use in neonatal transport is not yet established. Previous reports have been limited to small numbers of primary road transports and larger numbers of return transports while its use in air transportation has not been reported. The aim of this study was to assess the safety and effectiveness of transporting neonates and infants by road or air while treated with nasal continuous positive airway pressure. ⋯ Nasal continuous positive airway pressure is effective and has an acceptable safety margin for the road-based transportation of infants with acute respiratory distress. Air transport is feasible but larger studies are required to assess safety.
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Various inflammatory cytokines and chemokines are thought to be associated with the pathophysiology of meconium aspiration syndrome. To clarify any such association, we compared various serum cytokine and chemokine profiles in patients with and without meconium aspiration syndrome. ⋯ Most types of proinflammatory cytokines and chemokines in sera of neonates with meconium aspiration syndrome were higher than those without meconium aspiration syndrome, giving support to the suggestion that elevated levels are associated with the pathogenesis of meconium aspiration syndrome.
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The purposes of this study were to develop a pediatric-focused tool for adverse drug event detection and describe the incidence and characteristics of adverse drug events in children's hospitals identified by this tool. ⋯ Adverse drug event rates in hospitalized children are substantially higher than previously described. Most adverse drug events resulted in temporary harm, and 22% were classified as preventable. Only 3.7% were identified by using traditional voluntary reporting methods. Our pediatric-focused trigger tool is effective at identifying adverse drug events in inpatient pediatric populations.