Pediatrics
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Terrorism leads to adolescent depression, but little is known about protective factors. We investigated 90 adolescents (in grades 7-9) residing in Dimona, Israel, before and after their exposure to a suicide bombing. ⋯ In adolescence, social support from friends might protect against the depressogenic effect of terrorism-related perceived stress.
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We describe videolaryngoscopy equipment and technique for endotracheal intubation and airway evaluation in the delivery room (DR) and NICU for endotracheal intubation and airway evaluation. We report our first experience of 47 patients. ⋯ This new technique and technology show promise to improve airway management, evaluation, and teaching. Future research to validate improved intubation success in difficult airways and in teaching situations is warranted.
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Comparative Study
Impact of ethics and economics on end-of-life decisions in an Indian neonatal unit.
The aim of this article was to describe how providers in an Indian NICU reach life-or-death treatment decisions. ⋯ In a tertiary-level academic Indian NICU, multiple factors external to predicted clinical survival of a preterm newborn influence treatment decisions. Providers adjust their decisions about withdrawing or withholding treatment on the basis of pragmatic considerations. Numerous issues related to resource scarcity are relevant, and providers prioritize outcomes that affect stakeholders other than the newborn. These findings may have implications for initiatives that seek to improve global neonatal health.
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The purpose of this statement is to address the state of evidence on the routine use of pulse oximetry in newborns to detect critical congenital heart disease (CCHD). ⋯ Currently, CCHD is not detected in some newborns until after their hospital discharge, which results in significant morbidity and occasional mortality. Furthermore, routine pulse oximetry performed on asymptomatic newborns after 24 hours of life, but before hospital discharge, may detect CCHD. Routine pulse oximetry performed after 24 hours in hospitals that have on-site pediatric cardiovascular services incurs very low cost and risk of harm. Future studies in larger populations and across a broad range of newborn delivery systems are needed to determine whether this practice should become standard of care in the routine assessment of the neonate.
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Randomized Controlled Trial
Sleep-disordered breathing and behaviors of inner-city children with asthma.
To explore the relationship between sleep-disordered breathing (SDB) and behavioral problems among inner-city children with asthma. ⋯ We found that poor sleep was independently associated with behavior problems in a large proportion of urban children with asthma. Systematic screening for SDB in this high-risk population might help to identify children who would benefit from additional intervention.