The Journal of pediatrics
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The Journal of pediatrics · Mar 2015
Randomized Controlled Trial Multicenter Study Observational StudySevere obesity and comorbid condition impact on the weight-related quality of life of the adolescent patient.
To assess links between comorbid health status, severe excess weight, and weight-related quality of life (WRQOL) in adolescents with severe obesity and undergoing weight-loss surgery (WLS) to inform clinical care. ⋯ WRQOL impairment is substantial for adolescents with severe obesity undergoing WLS, with predictors varying by sex. These patient-data highlight targets for education, support, and adjunctive care referrals before WLS. Furthermore, they provide a comprehensive empirical base for understanding heterogeneity in adolescent WRQOL outcomes after WLS, as weight and comorbidity profiles change over time.
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The Journal of pediatrics · Mar 2015
Multicenter StudyPediatric exposure to opioid and sedation medications during terminal hospitalizations in the United States, 2007-2011.
To describe the use of opioids and sedatives to pediatric patients dying in the hospital in the 2 weeks preceding death. ⋯ Although most pediatric patients terminally hospitalized are exposed to opioid and sedation medication, some patients do not receive such medications before death. Given that patient and hospital characteristics were associated with opioid/sedative exposure, these findings suggest areas of potential quality improvement and further research.
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The Journal of pediatrics · Feb 2015
Randomized Controlled Trial Multicenter StudyMulticenter randomized controlled trial of inhaled nitric oxide for pediatric acute respiratory distress syndrome.
To test the hypothesis that inhaled nitric oxide (iNO) would lead to improved oxygenation and a decrease in duration of mechanical ventilation in pediatric patients with acute respiratory distress syndrome. ⋯ The use of iNO was associated with a significantly reduced duration of mechanical ventilation and significantly greater rate of extracorporeal membrane oxygenation-free survival.
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The Journal of pediatrics · Dec 2014
Multicenter StudyAccuracy of the abdominal examination for identifying children with blunt intra-abdominal injuries.
To determine the accuracy of complaints of abdominal pain and findings of abdominal tenderness for identifying children with intra-abdominal injury (IAI) stratified by Glasgow Coma Scale (GCS) score. ⋯ The sensitivity of abdominal findings for IAI decreases as GCS score decreases. Although abdominal computed tomography is not mandatory, the risk of IAI is sufficiently high that diagnostic evaluation is warranted in children with isolated abdominal pain or tenderness.
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The Journal of pediatrics · Dec 2014
Multicenter Study Observational StudyEmergency department practice variation in computed tomography use for children with minor blunt head trauma.
To describe factors associated with computed tomography (CT) use for children with minor blunt head trauma that are evaluated in emergency departments. ⋯ Substantial variation exists in the use of CT for children with minor blunt head trauma not explained by patient severity or rates of positive CT scans or clinically important traumatic brain injuries.