ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Lacerations account for a significant number of emergency department and urgent care clinic visits for pediatric patients. Children represent a unique challenge in repairing lacerations because of their developmental and behavioral characteristics, making rapidity, ease of performance, and minimal pain particularly desirable. This review focuses on three concepts in laceration repair where there have been significant advances in the past several years in terms of new techniques and drugs. New pharmacologic modalities such as the fentanyl oralet for sedation of children are discussed as well as important nonpharmacological techniques such as parental presence. Topical administration of anesthetics such as tetracaine, adrenaline, and cocaine and lidocaine, epinephrine, and tetracaine offers the advantage of replacing lidocaine infiltration and provides an effective, safe, and painless alternative for local anesthesia. Finally, the introduction of cyanoacrylate tissues adhesives such as Histoacryl Blue (Trihawk International, Montreal, Canada) and Dermabond (Ethicon, Somerville, NJ) appear to be an ideal technique for laceration closure in children because they are easy and rapid to apply, are relatively painless, eliminate the need for suture removal, and provide an acceptable cosmetic result.

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Hepatitis C virus (HCV) affects approximately 1 % of the world's people. In the past there has been a lack of interest in HCV in the pediatric population; however, new data are accumulating at an exponential pace about the epidemiology, clinical spectrum, HCV genotypes, and molecular variants and evolution of HCV infection in infants and children. Thousands of children with chronic hepatitis C are enrolled in multicenter and multinational clinical protocols and therapeutic trials. This paper highlights recent advances in diagnosis, epidemiology, natural history, and therapy for hepatitis C in children and the implications of these advances for pediatric and primary care practice.

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The Emergency Medical Treatment and Active Labor Act (EMTALA) was passed to prevent hospitals from refusing to care for an indigent patient in an emergency situation or transferring the patient before the emergency medical condition was stabilized. The act applies to all patients, whether or not they have insurance or belong to a managed care organization. At times, managed care organizations conflict with emergency departments on the treatment of children who present for care when life-threatening emergencies are not apparent. These conflicts frequently involve EMTALA with regards to medical screening examinations and transfer of patients from the emergency department to other facilities.

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Pediatric addiction to nicotine from cigarette smoking is a major public health problem, extracting a tremendous societal toll in terms of human suffering, a loss of future productivity, and the consumption of scarce health care resources. Teenagers smoke 1.1 billion packs of cigarettes yearly and will account for more than $200 billion in future health care costs. Recent behavioral studies confirm nicotine's ability to induce in adolescents both the tolerance and abstinence phenomena typical of other addicting substances. A range of adverse health effects, first detectable in adolescent cigarette smokers, extend into adulthood. Through the effects of environmental smoke or smoking during pregnancy, adolescent smokers affect not only their own health, but that of friends, family members, and even their own fetuses and children. Additional research into effective prevention and smoking cessation programs is urgently needed to forestall the ravaging of yet another generation by this preventable and deadly habit.

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The incidence of human rabies in the United States has fallen dramatically over the past 4 decades. This is directly related to the universal immunization of domestic cats and dogs. Recently, a number of cases of human rabies have been associated with the appearance of a previously rare strain of the virus in the silver-haired bat. There have been other recent changes in the epizoology of rabies with the expansion of raccoon rabies from a small pocket around northern Virginia to most of the northeastern United States. Postexposure prophylaxis using rabies immune globulin and rabies vaccine is effective in preventing rabies following a bite by a rabid animal when given according to current recommendations. There has been considerable debate, however, surrounding the cost of prophylaxis and the possibility of reducing the recommended number of doses of rabies immune globulin.

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Although most children receive their primary care in private physicians' offices, surprisingly little of the child health knowledge base has been generated from office settings. Research in practice settings is increasing, however, especially through networks of office-based pediatricians who are now collaborating with academic researchers to produce high-quality research on primary pediatric care. This paper provides a current overview of practice-based research in pediatrics, highlights contributions by regional and national pediatric research networks, and suggests directions for practice-based research in the future.

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

This review highlights recent information on the topics of atopic diseases and upper respiratory infections. Recent findings on the costs and therapies of atopic dermatitis are discussed. New insights into egg allergy, peanut allergy, food-induced exercise anaphylaxis, and the management of food allergy are presented. Topics highlighted in the section on asthma include airway remodeling and anti-inflammatory therapy, leukotriene synthesis inhibitors and receptor antagonists, steroid resistance and alternative therapy, and new delivery systems. Recent publications in the areas of allergic rhinoconjunctivitis and upper respiratory infections are also reviewed.

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The aim of this review is to describe recent developments in the field of pancreatic disorders in children. First, recent developments in the genetic research of hereditary pancreatitis are discussed. Subsequently, several issues of acute pancreatitis are presented. These include a description of the potential hazardous morbidity and mortality of this disorder in children. In addition, various novel etiologies that have been described lately in the medical literature are illustrated. Next, this paper discusses two examples of pancreatic disorders associated with systemic manifestations,ie, ganglioneuromatosis and diabetes mellitus. Finally, a few rare genetic syndromes with pancreatic involvement are touched upon, an association that is not very well recognized. Cystic fibrosis is not covered.

ISSN:1040-8703    

出版商:OVID    

年代:1997

数据来源: OVID