The Journal of pediatrics
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The Journal of pediatrics · Aug 2014
Randomized Controlled Trial Multicenter StudyTotal body polyethylene wraps for preventing hypothermia in preterm infants: a randomized trial.
To evaluate whether a polyethylene total body wrapping (covering both the body and head) is more effective than conventional treatment (covering up to the shoulders) in reducing perinatal thermal losses in very preterm infants. ⋯ Total body wrapping is comparable with covering the body up to the shoulders in preventing postnatal thermal losses in very preterm infants.
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The Journal of pediatrics · Aug 2014
Multicenter StudyHypothermia therapy for neonatal hypoxic ischemic encephalopathy in the state of California.
To characterize the implementation of hypothermia for neonatal hypoxic ischemic encephalopathy (HIE) in a population-based cohort. ⋯ Our findings highlight an opportunity to explore practice-site variation and to develop quality improvement interventions to assure consistent evidence-based care of term infants with HIE and appropriate application of hypothermia therapy for eligible newborns.
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The Journal of pediatrics · Aug 2014
Randomized Controlled Trial Multicenter StudyRespiratory outcomes of the surfactant positive pressure and oximetry randomized trial (SUPPORT).
To explore the early childhood pulmonary outcomes of infants who participated in the National Institute of Child Health and Human Development's Surfactant Positive Airway Pressure and Pulse Oximetry Randomized Trial (SUPPORT), using a factorial design that randomized extremely preterm infants to lower vs higher oxygen saturation targets and delivery room continuous positive airway pressure (CPAP) vs intubation/surfactant. ⋯ Treatment with early CPAP rather than intubation/surfactant is associated with less respiratory morbidity by 18-22 months CA. Longitudinal assessment of pulmonary morbidity is necessary to fully evaluate the potential benefits of respiratory interventions for neonates.
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The Journal of pediatrics · Jun 2014
Multicenter Study Comparative StudyEffect of Hispanic ethnicity and language barriers on appendiceal perforation rates and imaging in children.
To determine the association between Hispanic ethnicity and limited English proficiency (LEP) and the rates of appendiceal perforation and advanced radiologic imaging (computed tomography and ultrasound) in children with abdominal pain. ⋯ Hispanic ethnicity with LEP is an important risk factor for appendiceal perforation in pediatric patients brought to the emergency department with possible appendicitis. Among patients with moderate clinical severity, Hispanic ethnicity with LEP appears to be associated with lower imaging rates. This effect of English proficiency and Hispanic ethnicity warrants further investigation to understand and overcome barriers, which may lead to increased appendiceal perforation rates and differential diagnostic evaluation.
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The Journal of pediatrics · Jun 2014
Multicenter Study Comparative StudyDevelopmental outcomes of very preterm infants with tracheostomies.
To evaluate the neurodevelopmental outcomes of very preterm (<30 weeks) infants who underwent tracheostomy. ⋯ Tracheostomy in preterm infants is associated with adverse developmental outcomes and cannot mitigate the significant risk associated with many complications of prematurity. These data may inform counseling about tracheostomy in this vulnerable population.