Pediatrics
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Outcomes of pediatric button battery ingestions have worsened substantially, predominantly related to the emergence of the 20-mm-diameter lithium cell as a common power source for household products. Button batteries lodged in the esophagus can cause severe tissue damage in just 2 hours, with delayed complications such as esophageal perforation, tracheoesophageal fistulas, exsanguination after fistulization into a major blood vessel, esophageal strictures, and vocal cord paralysis. Thirteen deaths have been reported. The objective of this study was to explore button battery ingestion scenarios to formulate prevention strategies. ⋯ Parents and child care providers should be taught to prevent battery ingestions. Because 61.8% of batteries that were ingested by children were obtained from products, manufacturers should redesign household products to secure the battery compartment, possibly requiring a tool to open it.
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Previous studies suggested that parents frequently do not adequately treat postoperative pain that is experienced at home. Reasons for these parental practices have not been extensively studied. Aims of this study were to examine parental postoperative pain assessment and management practices at home as well potential attitudinal barriers to such pain practices. ⋯ Parents detected pain in their children yet provided few doses of analgesics. Parents may benefit from interventions that provide them with information that addresses individual barriers regarding assessing and treating pain.
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Recent cases suggest that severe and fatal button battery ingestions are increasing and current treatment may be inadequate. The objective of this study was to identify battery ingestion outcome predictors and trends, define the urgency of intervention, and refine treatment guidelines. ⋯ Revised treatment guidelines promote expedited removal from the esophagus, increase vigilance for delayed complications, and identify patients who require urgent radiographs.
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The late effects of treatment with extracorporeal membrane oxygenation (ECMO) in nonneonatal pediatric patients remain unclear. The aims of our study were to better characterize the long-term survival and hospital readmission rates for pediatric patients after ECMO treatment. ⋯ Pediatric ECMO survivors suffered from significant long-term morbidities after initial hospital discharge. More than 60% of these children required subsequent readmissions, and late deaths were observed in 5%. Furthermore, hospitals with high case volumes were associated with improved long-term survival.
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To assess the peer relationships of adolescents with sickle cell disease (SCD) and demographically similar comparison peers who did not have a chronic illness 2 years after an initial evaluation. As a result of ongoing medical challenges associated with SCD and the psychological demands of adolescence, we hypothesized that children with SCD would be viewed by peers as more sensitive and isolated, they would have fewer friends, and they would be less well liked than comparison peers. ⋯ In general, the social functioning of children with SCD remained stable over time and was not suggestive of emergent social dysfunction. Findings are discussed within a developmental psychopathology framework, possible protective effect of SCD for youth from high-risk environments, and implications regarding pain management for these youth.