Pediatrics
-
Comparative Study
Professionalism expectations seen through the eyes of resident physicians and patient families.
Resident physicians and patient families have not traditionally been involved in setting expectations for professional behavior by physicians. ⋯ There was important overlap in the attributes of professionalism generated and prioritized by resident physicians and patient families, although only residents identified ways that health care providers should interact with each other. This novel approach to identifying professionalism attributes provides opportunities for curriculum improvement.
-
Multicenter Study
Early-childhood neurodevelopmental outcomes are not improving for infants born at <25 weeks' gestational age.
We compared neurodevelopmental outcomes at 18 to 22 months' corrected age of infants born with extremely low birth weight at an estimated gestational age of <25 weeks during 2 periods: 1999-2001 (epoch 1) and 2002-2004 (epoch 2). ⋯ Early-childhood outcomes for infants born at <25 weeks' estimated gestational age were unchanged between the 2 periods.
-
To determine the cost-effectiveness of treatment with caffeine compared with placebo for apnea of prematurity in infants with birth weights less than 1250 g, from birth through 18 to 21 months' corrected age. ⋯ In comparison with placebo, caffeine therapy for apnea of prematurity in infants weighing less than 1250 g is economically appealing for infants up to 18 to 21 months' corrected age.
-
Case Reports
Occult pulmonary hemorrhage as a rare presentation of propylthiouracil-induced vasculitis.
Propylthiouracil, a drug commonly used to treat hyperthyroidism, is known to cause antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis as a rare complication. The wide clinical spectrum of propylthiouracil-induced vasculitis ranges from mild forms with rash and/or arthralgia to severe forms with renal or pulmonary involvement, which can be critical and life-threatening if left unrecognized and untreated. Given its rarity and exceedingly variable clinical presentations, diagnosis may be challenging, and delayed diagnosis is not uncommon without a high index of suspicion, as illustrated by this report of a 17-year-old girl with Graves' disease who developed occult pulmonary hemorrhage as an overlooked rare presentation of ANCA-associated vasculitis after administration of propylthiouracil. ⋯ Serologic test results were positive for perinuclear ANCA, cytoplasmic ANCA, myeloperoxidase-ANCA, proteinase 3-ANCA, and cryoglobulins but negative for antinuclear antibody, anti-double-stranded DNA, rheumatoid factor, and anti-hepatitis C virus antibody. The symptoms resolved after discontinuation of propylthiouracil and a few months of corticosteroids and azathioprine. This report highlights the necessity for physicians to keep alert for the protean manifestations of propylthiouracil-induced vasculitis.
-
Physical activity is thought to decline during childhood, but the extent of the decline is unknown. We made objective measures of 2-year changes in physical activity and sedentary behavior in English children who participated in the Gateshead Millennium Study to explore the nature, timing, and extent of changes in physical activity and sedentary behavior before adolescence. ⋯ We report here new evidence of low and declining levels of physical activity and MVPA and increasing sedentary behavior before adolescence.