Pediatrics
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Because of questions about the basis for the use of naloxone in resuscitation of the newborn, we wished to evaluate the use of naloxone at our institution and an affiliated hospital. ⋯ The use of naloxone in practice may not conform to the American Academy of Pediatrics' guidelines for use in resuscitation of the newborn. The use of naloxone in resuscitation of the newborn should be reevaluated.
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Clinical Trial Controlled Clinical Trial
Impact of appointment reminders on vaccination coverage at an urban clinic.
To test if appointment reminders blinded to immunization status improve kept-appointment and vaccination coverage rates. Design. Controlled trial. ⋯ Appointment reminders blind to immunization status are a practical and cost-effective strategy to increase kept-appointment rates for all children, and, through this mechanism, reach and vaccinate children who are not up-to-date.appointment reminder, vaccination coverage.
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Environmental tobacco smoke (ETS) exposure is a well-known health hazard for children. Poor urban children may be at increased risk of exposure from nonparental sources of tobacco smoke. The unique problems of ETS exposure in urban children have previously not been well-defined. ⋯ Nonparental sources of ETS exposure are reported to be common in urban children. Children may be exposed to tobacco smoke even in homes where smoking is banned. Many caregivers would like help from pediatricians in reducing children's exposure to tobacco smoke.
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Premature infants experience brain injury, ie, germinal matrix-intraventricular hemorrhage (GMH-IVH) and periventricular leukomalacia (PVL), in considerable part because of disturbances in cerebral blood flow (CBF). Because such infants are susceptible to major fluctuations in mean arterial blood pressure (MAP), impaired cerebrovascular autoregulation would increase the likelihood for the changes in CBF that could result in GMH-IVH and PVL. The objectives of this study were to determine whether a state of impaired cerebrovascular autoregulation could be identified reliably and conveniently at the bedside, the frequency of any such impairment, and the relation of the impairment to the subsequent occurrence of severe GMH-IVH and PVL. ⋯ We conclude that NIRS can be used in a noninvasive manner at the bedside to identify premature infants with impaired cerebrovascular autoregulation, that this impairment is relatively common in such infants, and that the presence of this impairment is associated with a high likelihood of occurrence of severe GMH-IVH/PVL.