Pediatric clinics of North America
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Pediatr. Clin. North Am. · Aug 2005
ReviewPediatric central nervous system infections and inflammatory white matter disease.
This article reviews the immunology of the central nervous system and the clinical presentation, diagnosis, and treatment of children with viral or parainfectious encephalitis. The emphasis is on the early recognition of treatable causes of viral encephalitis (herpes simplex virus), and the diagnosis and treatment of acute disseminated encephalomyelitis are described in detail. Laboratory and imaging findings in the two conditions also are described.
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Pediatric hospitalists should make pain assessment and treatment a high priority and a central part of their daily practice. Efforts at improving pain treatment in pediatric hospitals should be multidisciplinary and should involve combined use of pharmacologic and nonpharmacologic approaches. Although available information can permit effective treatment of pain for most children in hospitals, there is a need for more research on pediatric analgesic pharmacology, various nonpharmacologic treatments, and different models of delivery of care.
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Microbiologic causes of meningitis include bacteria, viruses, fungi, and parasites. Before routine use of pneumococcal conjugate vaccine, bacterial meningitis affected almost 6000 people every year in the United States, and about half of all cases occurred in children 18 years old or younger. ⋯ Appropriate use of antibiotics, along with adjunctive therapies, such dexamethasone, has proved helpful in the prevention of neurologic sequelae in children with bacterial meningitis. Better understanding of pathophysiologic mechanisms likely would result in more effective therapies in the future.
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Pediatr. Clin. North Am. · Jun 2005
ReviewReducing the impact of viral respiratory infections in children.
This article reviews the epidemiology and clinical aspects of the major viral causes of upper and lower respiratory tract disease in children. Particular emphasis is placed on prevention and control of viral disease through the use of vaccines and antiviral agents. Evolution of new viral pathogens, such as avian influenza virus and the SARS-CoV, are discussed.
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Pediatr. Clin. North Am. · Apr 2005
ReviewPediatric pain syndromes and management of pain in children and adolescents with rheumatic disease.
This article introduces important issues related to pain in children with musculoskeletal pain syndromes and rheumatic disease, using juvenile primary fibromyalgia syndrome (JPFS) and juvenile idiopathic arthritis (JIA) as models. A brief summary of the prevalence of pain in healthy children is followed by a summary of existing pain-assessment techniques. The remainder of the article describes the pain experience of children with JPFS and JIA and discusses issues related to pain management.