Articles: pediatrics.
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This study aimed to conduct a comprehensive bibliometric analysis of the literature on Brief Resolved Unexplained Event (BRUE) and its predecessor, Apparent Life-Threatening Event (ALTE), from 1988 to 2024, in order to identify research trends, collaborative networks, and areas of focus in this field. ⋯ This bibliometric analysis provides valuable insights into the evolution and current state of BRUE/ALTE research. The findings highlight the field's progression toward more precise, evidence-based approaches. The identified research trends and gaps, particularly the limited studies from developing countries, offer direction for future research. These results can inform clinical practice, guide research priorities, and support the development of standardized guidelines for BRUE/ALTE management.
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Abusive head trauma (AHT) is a leading cause of death in young children. Analyses of patient characteristics presenting to Emergency Medical Services (EMS) are often limited to structured data fields. Artificial Intelligence (AI) and Large Language Models (LLM) may identify rare presentations like AHT through factors not found in structured data. Our goal was to apply AI and LLM to EMS narrative documentation of young children to detect AHT. ⋯ AI and LLMs have high sensitivity and specificity to detect AHT-CAN in EMS free-text narratives. Words associated with physical signs of trauma are strongly associated with AHT-CAN. LLMs augmented with a list of n-grams may help EMS identify signs of trauma that aid in the detection of AHT in young children.
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Competence in neonatal care is especially important for military pediatricians because military pediatricians can be asked to serve in remote duty locations with limited resources. We sought to understand how this competence is defined, developed, and assessed by military pediatric training programs. ⋯ Competence in the neonatal setting is particularly important for military pediatricians. Essential skills undergo differential assessment and current assessment methods differ from ideal assessment methods. Future work should focus on how these facets can support a unified curriculum in newborn medicine.
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Current literature supports a multidisciplinary approach to penicillin allergy delabeling. Our study aims to review the success rate of penicillin challenges performed at Walter Reed National Military Medical Center Allergy Clinic and assess the reaction rate associated with a direct oral challenge in low-risk patients. ⋯ Given the low rate of adverse events in this study, expansion of penicillin delabeling in the primary care setting should be considered in patients deemed to be at low risk. It is important for allergists to empower and educate their peers and push forward a movement to create a multidisciplinary approach to penicillin delabeling.
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J Pain Symptom Manage · Jan 2025
Symptom Documentation in Unstructured Palliative Care Notes of Children and Adolescents with Cancer.
Children and adolescents with cancer experiencing complex symptoms can benefit from subspeciality palliative care. However, standardized methods of symptom documentation by pediatric palliative care teams are lacking. Understanding current approaches to symptom documentation will inform next steps to optimize symptom support. ⋯ Palliative care clinicians routinely documented the co-occurrence of multiple complex symptoms experienced by children and adolescents with cancer. Unstructured progress notes captured evidence of symptom impact on daily life. Clinicians may benefit from a systematic approach to document symptoms in the clinical record which supports symptom identification and communication across clinical teams.