Pediatrics
-
Case Reports
Successive multisite peripheral nerve catheters for treatment of complex regional pain syndrome type I.
Complex regional pain syndrome (CRPS) type I is a painful and disabling syndrome that is accompanied by physical changes in the affected extremity. It generally occurs after trauma, manifesting as pain that is out of proportion to the inciting event. Treatment of the disorder is difficult, with many patients being refractory to multiple pharmacologic regimens. ⋯ A continuous infusion of 0.1% ropivacaine was infused via the catheters for ~60 hours. The patient was subsequently able to participate in physical therapy as well as activities of daily living with improved eating, sleeping, and mood. Although many therapeutic modalities have been tried in CRPS type I, given the debilitating nature of the disorder and the variable response to therapy, new and alternative therapeutic interventions, such as continuous peripheral nerve catheters, are needed.
-
Review Case Reports
An agenda for children for the 113th Congress: recommendations from the pediatric academic societies.
The 113th Congress of the United States begins in January 2013. With each new Congress, there are many changes, not only in the faces of the newly elected, but also in the membership of committees and the staff serving the members. ⋯ In the past, when these conflicts were resolved, children were rarely at the top of the list. Given the numerous pressing national issues, both domestic and foreign, the same trend will likely occur.
-
Randomized Controlled Trial
A randomized trial of stylets for intubating newborn infants.
Endotracheal intubation of newborn infants is a common and potentially lifesaving procedure but a skill that trainees find difficult. Despite widespread use, no data are available on whether the use of a stylet (introducer) improves success rates. We aimed to determine whether pediatric trainees were more successful at neonatal orotracheal intubation when a stylet was used. ⋯ Using an endotracheal stylet did not significantly improve the success rate of pediatric trainees at neonatal orotracheal intubation.
-
Accurate, timely diagnosis of pediatric appendicitis minimizes unnecessary operations and treatment delays. Preoperative abdominal-pelvic computed tomography (CT) scan is sensitive and specific for appendicitis; however, concerns regarding radiation exposure in children obligate scrutiny of CT use. Here, we characterize recent preoperative imaging use and accuracy among pediatric appendectomy subjects. ⋯ Widespread preoperative imaging did not eliminate unnecessary pediatric appendectomies. Controlling for factors potentially associated with referral bias, a CT scan was more likely to be performed in children initially evaluated at community hospitals compared with the children's hospital. Broadly-applicable strategies to systematically maximize diagnostic accuracy for childhood appendicitis, while minimizing ionizing radiation exposure, are urgently needed.
-
Randomized Controlled Trial
Association of nutrient-dense snack combinations with calories and vegetable intake.
With other factors such as general diet and insufficient exercise, eating non-nutrient dense snack foods such as potato chips contributes to childhood obesity. We examined whether children consumed fewer calories when offered high-nutrient dense snacks consisting of cheese and vegetables than children who were offered non-nutrient dense snacks (ie, potato chips). ⋯ The combination snack of vegetables and cheese can be an effective means for children to reduce caloric intake while snacking. The effect was more pronounced among children who were overweight or obese and children from low-involvement families.