Pediatrics
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Usefulness of Pyuria to Diagnose UTI in Children
Of 4,188 children aged 1 to 36 months screened for urinary tract infection (UTI) in emergency departments, 407 (9.7%) had a culture-positive UTI. Pyuria (by various means of assessment) was not present in 20% of febrile children with a UTI, raising questions about the validity of using pyuria as a necessary component or as a tool for the diagnosis of UTI in young children.
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Pink Eye: Do Antibiotics Matter?
Acute infectious conjunctivitis, commonly referred to as pink eye, is common in children and is caused by bacteria more often than by viruses. Nonetheless, neither the clinical course of uncomplicated cases nor the spread of infection to peers is significantly altered by treatment with topical antibiotics or by exclusion of infected children from daycare and school settings.
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Pediatric Pneumonia, Diagnostic Uncertainty, and Communication
Community-acquired pneumonia is a common cause of hospitalization among children in resourced countries and is the leading cause of childhood death in lower-income countries. However, the diagnosis of pneumonia is fraught with uncertainty, and management practices vary widely. Clinician behaviors and attributes that engender trust in the face of diagnostic uncertainty have been documented.
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Viruses, Newborns, and Liver Failure
Neonatal liver failure due to herpesvirus infection is rare but can be severe. Herpes simplex virus 1 (HSV-1) is a more likely cause than HSV-2. Only about two-thirds of affected patients survive, despite recommended treatment with parenteral acyclovir.
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Emergencies in the First Week of Life
The first week of life is a critical period for newborns, marked by rapid physiological transitions and a heightened vulnerability to various medical emergencies. This article provides an in-depth exploration of several significant neonatal emergencies that can arise during this time.
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Nonaccidental Trauma
Nonaccidental trauma is a significant problem in emergency medicine and serves as the frontline of defense and protection for children. All providers must have a high degree of suspicion for the sometimes subtle presentation of an abused child. Early diagnosis and timely intervention are the only ways to allow these vulnerable children a chance at a normal, healthy life.
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Preparing for Pediatric Asthma Exacerbations in the ED
Asthma is a common disease in pediatrics, with exacerbations occurring frequently. Every clinician who cares for children must be familiar with recognition and timely management to optimize each child's outcome.
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Family/Clinician Conflicts Are Top Reason for Pediatric Ethics Consults
Conflicts between family members and clinicians are the most common issue addressed during ethics consults, according to a group of researchers. This article discusses implications for clinicians and ethics consultants.
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Diagnosing, Differentiating, and Managing Status Epilepticus
Pediatric seizures are a common acute care visit. Recognizing seizures, including the more subtle presentations, is critical for instituting appropriate, timely treatment to improve patient care. An awareness of a stepwise approach to seizure management will assist providers and optimize outcomes.
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First-Choice Antibiotic for Acute Bacterial Sinusitis in Children
Review of a large database reveals that, for children treated for acute sinusitis, amoxicillin and amoxicillin-clavulanate yield similar rates of treatment failure. However, medication side effects are more common when amoxicillin-clavulanate is used.