Pediatrics
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The National Childhood Vaccine Injury Act of 1986 established the National Vaccine Injury Compensation Program to compensate people thought to be injured by certain vaccines. The act's goals are to ensure an adequate supply of vaccines, to stabilize vaccine costs, and to establish and maintain an accessible and efficient setting for providing compensation to people found to have been injured by certain childhood vaccines. In addition, the legislation called for the reporting of adverse events after vaccination, the creation of vaccine-information materials that detail vaccine benefits and risks, and Institute of Medicine studies of possible vaccine-related injuries and encouraged research and development of new and safer vaccines. Over its 22-year history, the National Vaccine Injury Compensation Program has been a key component in stabilizing the US vaccine market through liability protection to both vaccine companies and health care providers and by providing a forum for people, no matter what age, to seek compensation.
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Comparative Study
Association of neck circumference with perioperative adverse respiratory events in children.
The purpose of this investigation was to examine the association of neck circumference (NC) with perioperative respiratory adverse events in children undergoing elective noncardiac surgery, a relationship that has not been previously characterized. ⋯ NC was positively correlated with other indices of obesity in children, and large NC (indicative of central obesity) was associated with some adverse respiratory events in these children undergoing noncardiac surgery. NC could be a useful clinical screening tool for the occurrence of perioperative adverse respiratory events in children.
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Guidelines for prevention of group B streptococcal (GBS) infection have successfully reduced early onset (EO) GBS disease. Study results suggest that Escherichia coli is an important EO pathogen. ⋯ In the era of intrapartum chemoprophylaxis to reduce GBS, rates of EO infection have declined but reflect a continued burden of disease. GBS remains the most frequent pathogen in term infants, and E coli the most significant pathogen in preterm infants. Missed opportunities for GBS prevention continue. Prevention of E coli sepsis, especially among preterm infants, remains a challenge.
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To determine if pediatric procedural sedation-provider medical specialty affects major complication rates when sedation-providers are part of an organized sedation service. ⋯ In our sedation services consortium, pediatric procedural sedation performed outside the operating room is unlikely to yield serious adverse outcomes. Within this framework, no differences were evident in either the adjusted or unadjusted rates of major complications among different pediatric specialists.
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Development of safe and effective vaccines is one the greatest medical triumphs. However, despite high immunization rates in the United States, 85% of health care providers (HCPs) will have a parent refuse a vaccine for his or her child each year. HCPs have the greatest influence on a parent's decision to vaccinate his or her child. ⋯ HCPs should establish an open, nonconfrontational dialogue with vaccine-hesitant parents at an early stage and provide unambiguous, easily comprehensible answers about known vaccine adverse events and provide accurate information about vaccination. Personal stories and visual images of patients and parents affected by vaccine-preventable diseases and reports of disease outbreaks serve as useful reminders of the need to maintain high immunization rates. Ongoing dialogue including provider recommendations may successfully reassure vaccine-hesitant parents that immunization is the best and safest option for their child.