Pediatric emergency care
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Acute appendicitis in children is the most common condition requiring urgent evaluation and surgery in the emergency department. At times, despite the appendix being seen on ultrasound (US), there can be discrepancy as to whether a patient has clinical appendicitis. Secondary findings suggestive of appendicitis can be helpful in identifying and evaluating these children. ⋯ When the appendix is seen on US but diagnosis of appendicitis is questioned, the absence of inflammatory changes, WBC count of less than 10,000/μL, and appendix diameter of 7 mm or less should decrease suspicion for appendicitis.
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Pediatric emergency care · Dec 2021
Integration of Physical Examination, Old and New Biomarkers, and Ultrasonography by Using Neural Networks for Pediatric Appendicitis.
The objective of this study was to evaluate physical examinations, imaging, and laboratory analyses individually and combined using innovative statistical analysis methods for the accurate diagnosis of pediatric appendicitis. ⋯ Although none of the biomarkers were sufficient for an accurate diagnosis of appendicitis individually, a combination of physical examination and laboratory and US was a good diagnostic tool for pediatric appendicitis.
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Pediatric emergency care · Dec 2021
Case ReportsFacial Nerve Hematoma After Penetrating Middle Ear Trauma: A Cause of Delayed Facial Palsy.
Penetrating middle ear injury may cause hearing loss, vertigo, or facial nerve injury, although facial nerve paralysis followed by head trauma is a rare condition. In this study, we report a case of a 3-year-old patient with delayed facial palsy on the left side that developed 4 days after an accidental tympanic membrane perforation caused by a cotton-tipped swab. ⋯ Pre- and postcontrast T1-weighted magnetic resonance imaging demonstrated high signal intensity along the tympanic portion of the fallopian canal, which suggested that hemorrhage within the facial canal may be a cause of delayed facial palsy. It can be assumed that traumatic injury at the dehiscent facial nerve in the tympanic portion caused hematoma within the fallopian canal, resulting in delayed facial nerve palsy.
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Pediatric emergency care · Dec 2021
Multicenter StudyDeep Neck Abscesses in Children: An Italian Retrospective Study.
Retropharyngeal and parapharyngeal abscesses (RPAs, PPAs) usually affect young children. Surgical drainage and/or antibiotic therapy are treatment of choice, but no specific guidelines exist. In order to reduce the risk of severe complications, appropriate diagnosis and therapy are necessary. The aims of the study were to review diagnosis and management of children with RPAs/PPAs and to compare surgical versus medical approach. ⋯ Deep neck abscesses mostly affect patients in early childhood, with a combination of nonspecific signs and symptoms, and it still emerges as a heterogeneous approach in diagnosis and management of these infections. Thus, common shared protocols represent an essential tool in order to standardize care and improve patients' outcomes.
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Pediatric emergency care · Dec 2021
Multicenter Study Observational StudyThe Burden of Burnout Syndrome in Pediatric Intensive Care Unit and Pediatric Emergency Department: A Multicenter Evaluation.
The objective of this study was to detect variables associated with burnout syndrome (BS) in pediatric intensive care units (PICUs) and pediatric emergency medicine departments (PEDs) in high-volume centers from different parts of Turkey. ⋯ By creating early intervention programs to prevent BS, shortages of health care professionals can be avoided and the costs of health care expenditures related to infections can be decreased.