Arch Pediat Adol Med
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Arch Pediat Adol Med · Apr 2002
Clinical Trial Controlled Clinical TrialDemonstrated use of metered-dose inhalers and peak flow meters by children and adolescents with acute asthma exacerbations.
To determine the ability of children and adolescents with acute asthma exacerbations to adhere to national guidelines for proper metered-dose inhaler (MDI) and peak flow meter (PFM) technique and to define characteristics associated with improper use. ⋯ Among children with acute asthma, we found high rates of improper MDI use and PFM underuse. A greater emphasis must be placed on teaching methods to optimize drug delivery and to instruct patients about the importance of self-monitoring of disease severity.
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Arch Pediat Adol Med · Apr 2002
Measuring quality of life in children with attention-deficit/hyperactivity disorder and their families: development and evaluation of a new tool.
To psychometrically evaluate a new parent-completed questionnaire that measures the effect of attention-deficit/hyperactivity disorder (ADHD) on the everyday well-being of children and their families. ⋯ The ADHD Impact Module meets stringent psychometric standards. Further validation is required, but current evidence suggests it is a promising new questionnaire.
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Arch Pediat Adol Med · Apr 2002
Case ReportsProspective identification and treatment of children with pediatric autoimmune neuropsychiatric disorder associated with group A streptococcal infection (PANDAS).
The current diagnostic criteria for pediatric autoimmune neuropsychiatric disorder associated with group A streptococcal infection (PANDAS) are pediatric onset, neuropsychiatric disorder (obsessive-compulsive disorder [OCD]) and/or tic disorder; abrupt onset and/or episodic course of symptoms; association with group A beta-hemolytic streptococcal (GABHS) infection; and association with neurological abnormalities (motoric hyperactivity or adventitious movements, including choreiform movements or tics). ⋯ To our knowledge, this is the first prospective study to confirm that PANDAS is associated with acute GABHS tonsillopharyngitis and responds to appropriate antibiotic therapy at the sentinel episode.
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Arch Pediat Adol Med · Apr 2002
Children and adolescents with acute alcohol intoxication/self-poisoning presenting to the emergency department.
To describe the presentations, characteristics, and follow-up care of children and adolescents aged 10 to 18 years who present to emergency departments (EDs) with acute alcohol intoxication/self-poisoning. ⋯ When children or adolescents present to an ED with acute alcohol intoxication/self-poisoning, their risk factors for psychosocial dysfunction appear to be inadequately assessed, documented, and followed up. Clear guidelines for assessment and referral pathways must be established in EDs.
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Arch Pediat Adol Med · Apr 2002
Effect of managed care on children's relationships with their primary care physicians: differences by race.
Racial and ethnic disparities in the quality of the patient-provider relationship have been documented previously, but only among adults. Few studies have examined this aspect of primary care quality for children, and none has examined the role of managed care in mediating disparities. ⋯ Our data suggest that racial and ethnic minority children experience poorer patient-provider relationships compared with white children, even controlling for socioeconomic status and health system factors. Minority children are particularly sensitive to managed care policies that restrict patient freedom in choosing where to seek care. Implementing less restrictive policies may enhance the development of the patient-provider relationship.