Current opinion in pediatrics
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Curr. Opin. Pediatr. · Jun 2008
ReviewALARA: is there a cause for alarm? Reducing radiation risks from computed tomography scanning in children.
Radiation exposure from computed tomography is associated with a small but significant increase in risk for fatal cancer over a child's lifetime. This review aims to heighten awareness and spearhead efforts to reduce unnecessary computed tomography scans in children. ⋯ Advocacy by pediatric healthcare providers to promote intelligent dose reduction based on the principles of ALARA and the judicious use of computed tomography scanning is essential to foster the safest possible care of children.
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Curr. Opin. Pediatr. · Jun 2008
ReviewEmergency department treatment of primary headaches in children and adolescents.
Headaches in children and adolescents are common presenting complaints in emergency departments. There is wide variation among acute treatments. We sought to review options for acute emergency department management and the recent evidence supporting their use. ⋯ Further research is needed on therapies targeted toward children and adolescents with headache subtypes other than migraine, including those without a previous diagnosis. While little evidence exists, most authors agree with an initial trial of ibuprofen followed by sumatriptan nasal spray for children over 12 years of age for those with persistent symptoms. Antiemetics remain an option for those with nausea and/or vomiting as a prominent feature of their illness. Other treatments such as ketorolac are still being investigated in children.
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Sickle cell disease is one of the most prevalent genetic diseases, affecting 1 in 600 African-Americans. The lung is one of the major organs affected in sickle cell disease and the pulmonary complications of sickle cell disease result in significant morbidity and mortality in children. ⋯ The pulmonary complications of sickle cell disease include airway hyperreactivity, acute chest syndrome, chronic sickle lung disease, pulmonary hypertension, and sleep disordered breathing. Further understanding of the interrelationships between these disorders will lead to improved therapies.