Pediatrics
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Randomized Controlled Trial Multicenter Study Comparative Study
Elevated temperature after hypoxic-ischemic encephalopathy: risk factor for adverse outcomes.
The goal was to determine whether the risk of death or moderate/severe disability in term infants with hypoxic-ischemic encephalopathy increases with relatively high esophageal or skin temperature occurring between 6 and 78 hours after birth. ⋯ Relatively high temperatures during usual care after hypoxia-ischemia were associated with increased risk of adverse outcomes. The results may reflect underlying brain injury and/or adverse effects of temperature on outcomes.
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Randomized Controlled Trial Multicenter Study Comparative Study
Early treatment of acute pyelonephritis in children fails to reduce renal scarring: data from the Italian Renal Infection Study Trials.
The American Academy of Pediatrics recommendation for febrile infants and young children suspected of having a urinary tract infection is early antibiotic treatment, given parenterally if necessary. In support of this recommendation, data suggesting that delay in treatment of acute pyelonephritis increases the risk of kidney damage are cited. Because the risk was not well defined, we investigated renal scarring associated with delayed versus early treatment of acute pyelonephritis in children. ⋯ Early treatment of acute pyelonephritis in infants and young children had no significant effect on the incidence of subsequent renal scarring. Furthermore, there was no significant difference in the rate of scarring after acute pyelonephritis when infants and young children were compared with older children.
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Multicenter Study Comparative Study
Diagnosing hypersensitivity reactions to cephalosporins in children.
The goals were to evaluate the usefulness of skin tests, patch tests, serum specific IgE assays, and challenges in diagnosing hypersensitivity reactions to cephalosporins and to clarify the pathogenic mechanism of such reactions. ⋯ Extremely few nonimmediate manifestations associated with cephalosporin therapy are actually hypersensitivity reactions, whereas most immediate reactions to cephalosporins are IgE-mediated. Cephalosporin skin testing is a useful tool for evaluating such reactions.
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Multicenter Study Comparative Study
Incidence of fractures attributable to abuse in young hospitalized children: results from analysis of a United States database.
The goal was to assess the proportion of children with fractures attributable to abuse and the incidence of fractures caused by abuse among children <36 months of age who were hospitalized in the United States. ⋯ The Kids' Inpatient Database can be used to provide reasonable estimates of the incidence of hospitalization with fractures attributable to child abuse. For children <12 months of age, the incidence was 36.1 cases per 100000, a rate similar to that of inflicted traumatic brain injury (25-32 cases per 100000).
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Infancy is a critical period for brain development. Few studies have examined the extent to which infant weight gain is associated with later neurodevelopmental outcomes in healthy populations. ⋯ Slower infant weight gain was not associated with poorer neurodevelopmental outcomes in healthy, term-born 3-year-old children. These results should aid in determining optimal growth patterns in infants to balance risks and benefits of health outcomes through the life course.