Pediatrics
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The goal was to establish the final supportive therapy determinants of hospital length of stay for bronchiolitis. ⋯ Oxygen supplementation is the prime determinant of the length of hospitalization for infants with bronchiolitis. Infants remaining in the hospital for oxygen supplementation once feeding difficulties had resolved did not experience deterioration to the extent of needing PICU support.
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The purpose of this study was to investigate the stability of fatigue in adolescents and to explore whether psychological, somatic, and lifestyle factors are involved in the onset and persistence of fatigue during adolescence. ⋯ The stability of severe fatigue among adolescents is substantial. The involvement in the onset and persistence of fatigue suggests that both preventive and therapeutic strategies with respect to fatigue treatment in adolescents should concentrate on emotional well-being. Moreover, adolescents at risk should be stimulated to spend more time on physical activities and to sleep longer.
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Randomized Controlled Trial
Analgesic properties of oral sucrose during routine immunizations at 2 and 4 months of age.
The purpose of this work was to evaluate the analgesic properties of oral sucrose during routine immunizations in infants at 2 and 4 months of age. ⋯ Oral sucrose is an effective, easy-to-administer, short-acting analgesic for use during routine immunizations.
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The objective of this study was to study the association between pepsin in tracheal aspirate samples and the development of bronchopulmonary dysplasia in preterm infants. ⋯ The concentration of pepsin was increased in the tracheal aspirate of preterm infants who developed bronchopulmonary dysplasia or died before 36 weeks' postmenstrual age. Recovery of pepsin in tracheal aspirate samples is secondary to gastric aspiration, not by hematogenous spread or local synthesis in the lungs. Chronic aspiration of gastric contents may contribute in the pathogenesis of bronchopulmonary dysplasia.
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The goal was to explore barriers to palliative care experienced by pediatric health care providers caring for seriously ill children. ⋯ Perceived barriers to pediatric end-of-life care differed from those impeding adult end-of-life care. The most-commonly perceived factors that interfered with optimal pediatric end-of-life care involved uncertainties in prognosis and discrepancies in treatment goals between staff members and family members, followed by barriers to communication. Improved staff education in communication skills and palliative care for children may help overcome some of these obstacles, but pediatric providers must realize that uncertainty may be unavoidable and inherent in the care of seriously ill children. An uncertain prognosis should be a signal to initiate, rather than to delay, palliative care.